Florida Senate - 2020                      CS for CS for SB 1556
       
       
        
       By the Committees on Appropriations; and Banking and Insurance;
       and Senator Bean
       
       
       
       
       576-04306-20                                          20201556c2
    1                        A bill to be entitled                      
    2         An act relating to nondiscrimination in organ
    3         transplants; creating s. 765.523, F.S.; defining
    4         terms; prohibiting certain entities from making
    5         certain determinations or engaging in certain actions
    6         related to organ transplants solely on the basis of an
    7         individual’s disability; specifying an instance where
    8         certain entities may consider an individual’s
    9         disability, with an exception; requiring certain
   10         entities to make reasonable modifications in their
   11         policies, practices, and procedures under certain
   12         circumstances, with an exception; providing criteria
   13         for such modifications; requiring certain entities to
   14         take certain necessary steps to ensure an individual
   15         with a disability is not denied services, with
   16         exceptions; providing a cause of action for injunctive
   17         and other relief; providing construction; creating ss.
   18         627.64197, 627.65736, and 641.31075, F.S.; prohibiting
   19         certain individual and group health insurers and
   20         health maintenance organizations, respectively, from
   21         denying coverage for organ transplants solely on the
   22         basis of an individual’s disability under certain
   23         circumstances; providing construction; defining the
   24         terms “disability” and “organ transplant”; amending s.
   25         627.6699, F.S.; requiring certain health benefit plans
   26         covering small employers to comply with certain
   27         provisions; providing an effective date.
   28          
   29  Be It Enacted by the Legislature of the State of Florida:
   30  
   31         Section 1. Section 765.523, Florida Statutes, is created to
   32  read:
   33         765.523Discrimination in access to anatomical gifts and
   34  organ transplants prohibited.—
   35         (1)As used in this section, the term:
   36         (a)“Auxiliary aids and services” means:
   37         1.Qualified interpreters or other effective methods of
   38  making aurally delivered materials available to individuals with
   39  hearing impairments.
   40         2.Qualified readers, recorded texts, texts in an
   41  accessible electronic format, or other effective methods of
   42  making visually delivered materials available to individuals
   43  with visual impairments.
   44         3.Supported decisionmaking services, including any of the
   45  following:
   46         a.The use of a support person to assist an individual in
   47  making medical decisions, communicating information to the
   48  individual, or ascertaining his or her wishes.
   49         b.The provision of information to a person designated by
   50  the individual, consistent with federal and state laws governing
   51  the disclosure of health information.
   52         c.Measures used to ensure that the individual’s guardian
   53  or legal representative, if any, is included in decisions
   54  involving the individual’s health care and that medical
   55  decisions are in accordance with the individual’s own expressed
   56  interests.
   57         d.Any other aid or service that is used to provide
   58  information in a format that is readily understandable and
   59  accessible to individuals with cognitive, neurological,
   60  developmental, or intellectual disabilities.
   61         (b)“Covered entity” means any of the following:
   62         1.A licensed health care practitioner as defined in s.
   63  456.001.
   64         2.A health care facility as defined in s. 408.07.
   65         3.Any other entity responsible for potential recipients of
   66  an anatomical gift or organ transplant.
   67         (c)“Disability” has the same meaning as “developmental
   68  disability” and “intellectual disability” as those terms are
   69  defined in s. 393.063.
   70         (d)“Organ transplant” means the transplantation or
   71  transfusion of a part of a human body into the body of another
   72  individual for the purpose of treating or curing a medical
   73  condition.
   74         (e)“Qualified individual” means an individual who has a
   75  disability and meets the clinical eligibility requirements for
   76  the receipt of an anatomical gift or an organ transplant,
   77  regardless of:
   78         1.The support networks available to the individual;
   79         2.The provision of auxiliary aids and services; or
   80         3.Reasonable modifications to the policies, practices, or
   81  procedures of a covered entity pursuant to subsection (4).
   82         (2)A covered entity may not do any of the following solely
   83  on the basis of an individual’s disability:
   84         (a)Consider a qualified individual ineligible to receive
   85  an anatomical gift or organ transplant.
   86         (b)Deny medical or other services related to an organ
   87  transplant, including evaluation, surgery, counseling, and
   88  posttransplant treatment and services.
   89         (c)Refuse to refer the individual to an organ procurement
   90  organization or a related specialist for the purpose of
   91  evaluation or receipt of an organ transplant.
   92         (d)Refuse to place a qualified individual on an organ
   93  transplant waiting list.
   94         (e)Place a qualified individual at a lower priority
   95  position on an organ transplant waiting list than the position
   96  at which the qualified individual would have been placed if not
   97  for the disability.
   98         (3)(a)A covered entity may take an individual’s disability
   99  into account if, following an individualized evaluation of him
  100  or her, a physician finds the individual’s disability to be
  101  medically significant to the provision of the anatomical gift or
  102  organ transplant, but only to the extent that the covered entity
  103  is making treatment or coverage recommendations or decisions for
  104  the individual.
  105         (b)If an individual has the necessary support system to
  106  assist him or her in complying with posttransplant medical
  107  requirements, a covered entity may not consider the individual’s
  108  inability to independently comply with the posttransplant
  109  medical requirements to be medically significant for the
  110  purposes of paragraph (a).
  111         (4)A covered entity shall make reasonable modifications to
  112  policies, practices, or procedures when the modifications are
  113  necessary to allow an individual with a disability access to
  114  services, including transplant-related counseling, information,
  115  coverage, or treatment, unless the covered entity can
  116  demonstrate that making the modifications would fundamentally
  117  alter the nature of the services. Such modifications shall
  118  include, but not be limited to, communication with the persons
  119  responsible for supporting the individual with his or her
  120  postsurgical and posttransplant care, including medication. Such
  121  modifications shall also consider the support networks available
  122  to the individual, including, but not limited to, family,
  123  friends, and home and community-based services coverage when
  124  determining whether the individual is able to comply with
  125  posttransplant medical requirements.
  126         (5)A covered entity shall take such steps as may be
  127  necessary to ensure that an individual with a disability is not
  128  denied services, including transplant-related counseling,
  129  information, coverage, or treatment, due to the absence of
  130  auxiliary aids and services, unless the covered entity can
  131  demonstrate that taking the steps would fundamentally alter the
  132  nature of the services being offered or would result in an undue
  133  burden on the covered entity.
  134         (6)If a covered entity violates this section, the
  135  qualified individual who is affected by the violation may bring
  136  an action in the appropriate circuit court for injunctive or
  137  other equitable relief.
  138         (7)This section may not be construed to require a covered
  139  entity to make a referral or recommendation for or perform a
  140  medically inappropriate organ transplant.
  141         Section 2. Section 627.64197, Florida Statutes, is created
  142  to read:
  143         627.64197Coverage for organ transplants.—A health
  144  insurance policy that provides major medical coverage and
  145  coverage for organ transplants and that is delivered, issued, or
  146  renewed on or after July 1, 2020, in this state by an insurer
  147  may not deny coverage for an organ transplant solely on the
  148  basis of an insured’s disability. This section may not be
  149  construed to require such insurer to provide coverage for an
  150  organ transplant that is not medically necessary. For purposes
  151  of this section, the terms “disability” and “organ transplant”
  152  have the same meaning as in s. 765.523.
  153         Section 3. Section 627.65736, Florida Statutes, is created
  154  to read:
  155         627.65736Coverage for organ transplants.—A group health
  156  insurance policy that provides major medical coverage and
  157  coverage for organ transplants and that is delivered, issued, or
  158  renewed on or after July 1, 2020, in this state by an insurer
  159  may not deny coverage for an organ transplant solely on the
  160  basis of an insured’s disability. This section may not be
  161  construed to require such insurer to provide coverage for an
  162  organ transplant that is not medically necessary. For purposes
  163  of this section, the terms “disability” and “organ transplant”
  164  have the same meaning as in s. 765.523.
  165         Section 4. Paragraph (g) is added to subsection (5) of
  166  section 627.6699, Florida Statutes, to read:
  167         627.6699 Employee Health Care Access Act.—
  168         (5) AVAILABILITY OF COVERAGE.—
  169         (g) A health benefit plan covering small employers which is
  170  delivered, issued, or renewed on or after July 1, 2020, must
  171  comply with s. 627.65736.
  172         Section 5. Section 641.31075, Florida Statutes, is created
  173  to read:
  174         641.31075Coverage for organ transplants.—A health
  175  maintenance contract that provides major medical coverage and
  176  coverage for organ transplants and that is delivered, issued, or
  177  renewed on or after July 1, 2020, in this state by a health
  178  maintenance organization may not deny coverage for an organ
  179  transplant solely on the basis of a subscriber’s disability.
  180  This section may not be construed to require such health
  181  maintenance organization to provide coverage for an organ
  182  transplant that is not medically necessary. For purposes of this
  183  section, the terms “disability” and “organ transplant” have the
  184  same meaning as in s. 765.523.
  185         Section 6. This act shall take effect July 1, 2020.