Florida Senate - 2022 PROPOSED COMMITTEE SUBSTITUTE
Bill No. SB 292
Ì304450tÎ304450
576-02110-22
Proposed Committee Substitute by the Committee on Appropriations
(Appropriations Subcommittee on Health and Human Services)
1 A bill to be entitled
2 An act relating to newborn screenings; amending s.
3 383.145, F.S.; revising and defining terms; requiring
4 hospitals and other state-licensed birthing facilities
5 to test for congenital cytomegalovirus in newborns
6 within a specified timeframe under certain
7 circumstances; revising the timeframe in which health
8 care providers attending home births must make certain
9 referrals; requiring certain health care providers
10 practicing in the primary care setting to screen
11 certain newborns in their care for hearing loss within
12 a specified timeframe; requiring such providers to
13 test such newborns for congenital cytomegalovirus
14 within a specified timeframe under certain
15 circumstances; revising the timeframe within which
16 hospitals must complete newborn hearing screenings
17 that were not completed before discharge due to
18 temporary staffing or scheduling limitations;
19 providing that certain test results must be reported
20 to the Department of Health within a specified
21 timeframe; deleting a requirement that the parents of
22 certain newborns be instructed on and provided
23 specified information; revising a provision related to
24 Medicaid coverage of newborn hearing screenings and
25 follow-up reevaluations to delete obsolete language;
26 deleting a requirement that certain uninsured persons
27 be provided a list of specified providers; providing
28 an effective date.
29
30 Be It Enacted by the Legislature of the State of Florida:
31
32 Section 1. Section 383.145, Florida Statutes, is amended to
33 read:
34 383.145 Newborn and infant hearing screening.—
35 (1) LEGISLATIVE INTENT.—It is the intent of the Legislature
36 this section is to provide a statewide comprehensive and
37 coordinated interdisciplinary program of early hearing loss
38 impairment screening, identification, and follow-up followup
39 care for newborns. The goal is to screen all newborns for
40 hearing loss impairment in order to alleviate the adverse
41 effects of hearing loss on speech and language development,
42 academic performance, and cognitive development. It is further
43 the intent of the Legislature that the provisions of this
44 section act only be implemented to the extent that funds are
45 specifically included in the General Appropriations Act for
46 carrying out the purposes of this section.
47 (2) DEFINITIONS.—As used in this section, the term:
48 (a) “Audiologist” means a person licensed under part I of
49 chapter 468 to practice audiology “Agency” means the Agency for
50 Health Care Administration.
51 (b) “Department” means the Department of Health.
52 (c) “Hearing loss impairment” means a hearing loss of 30 dB
53 HL or greater in the frequency region important for speech
54 recognition and comprehension in one or both ears, approximately
55 500 through 4,000 hertz.
56 (d) “Hospital” means a facility as defined in s.
57 395.002(13) and licensed under chapter 395 and part II of
58 chapter 408.
59 (e) “Infant” means an age range from 30 days through 12
60 months.
61 (f)(e) “Licensed health care provider” means a physician or
62 physician assistant licensed under pursuant to chapter 458; an
63 osteopathic physician or physician assistant licensed under or
64 chapter 459; an advanced practice registered nurse, a registered
65 nurse, or a licensed practical nurse licensed under part I of
66 pursuant to chapter 464; a midwife licensed under chapter 467;,
67 or a speech-language pathologist or an audiologist licensed
68 under part I of pursuant to chapter 468, rendering services
69 within the scope of his or her license.
70 (g)(f) “Management” means the habilitation of the hearing
71 impaired child with hearing loss.
72 (h)(g) “Newborn” means an age range from birth through 29
73 days.
74 (i) “Physician” means a person licensed under chapter 458
75 to practice medicine or chapter 459 to practice osteopathic
76 medicine.
77 (j)(h) “Screening” means a test or battery of tests
78 administered to determine the need for an in-depth hearing
79 diagnostic evaluation.
80 (3) REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE
81 COVERAGE; REFERRAL FOR ONGOING SERVICES.—
82 (a) Each licensed hospital or other state-licensed birthing
83 facility that provides maternity and newborn care services shall
84 ensure provide that all newborns are, before prior to discharge,
85 screened for the detection of hearing loss, to prevent the
86 consequences of unidentified disorders. If a newborn fails the
87 screening for the detection of hearing loss, the hospital or
88 other state-licensed birthing facility must administer a test
89 approved by the United States Food and Drug Administration or
90 another diagnostically equivalent test on the newborn to screen
91 for congenital cytomegalovirus before the newborn becomes 21
92 days of age or before discharge, whichever occurs earlier.
93 (b) Each licensed birth center that provides maternity and
94 newborn care services shall ensure provide that all newborns
95 are, before prior to discharge, referred to an a licensed
96 audiologist, a physician licensed under chapter 458 or chapter
97 459, or a hospital, or another other newborn hearing screening
98 provider, for screening for the detection of hearing loss, to
99 prevent the consequences of unidentified disorders. The referral
100 for appointment shall be made within 30 days after discharge.
101 Written documentation of the referral must be placed in the
102 newborn’s medical chart.
103 (c) If the parent or legal guardian of the newborn objects
104 to the screening, the screening must not be completed. In such
105 case, the physician, midwife, or other person who is attending
106 the newborn shall maintain a record that the screening has not
107 been performed and attach a written objection that must be
108 signed by the parent or guardian.
109 (d) For home births, the health care provider in attendance
110 is responsible for coordination and referral to an a licensed
111 audiologist, a physician, a hospital, or another other newborn
112 hearing screening provider. The referral for appointment must
113 shall be made within 7 30 days after the birth. In cases in
114 which the home birth is not attended by a primary health care
115 provider, a referral to a licensed audiologist, physician
116 licensed pursuant to chapter 458 or chapter 459, hospital, or
117 other newborn hearing screening provider must be made by the
118 health care provider within the first 3 months after the child’s
119 birth.
120 (e) Each licensed health care provider practicing in the
121 primary care setting must ensure that a newborn in his or her
122 care whose birth was not attended by a health care provider is
123 screened for hearing loss within 21 days after the birth. If a
124 newborn fails the screening for the detection of hearing loss,
125 the licensed health care provider must administer a test
126 approved by the United States Food and Drug Administration or
127 another diagnostically equivalent test on the newborn to screen
128 for congenital cytomegalovirus before the newborn becomes 21
129 days of age.
130 (f) All newborn and infant hearing screenings must shall be
131 conducted by an a licensed audiologist, a physician licensed
132 under chapter 458 or chapter 459, or an appropriately supervised
133 individual who has completed documented training specifically
134 for newborn hearing screening. Every licensed hospital that
135 provides maternity or newborn care services shall obtain the
136 services of an a licensed audiologist, a physician licensed
137 pursuant to chapter 458 or chapter 459, or another other newborn
138 hearing screening provider, through employment or contract or
139 written memorandum of understanding, for the purposes of
140 appropriate staff training, screening program supervision,
141 monitoring the scoring and interpretation of test results,
142 rendering of appropriate recommendations, and coordination of
143 appropriate follow-up followup services. Appropriate
144 documentation of the screening completion, results,
145 interpretation, and recommendations must be placed in the
146 medical record within 24 hours after completion of the screening
147 procedure.
148 (g)(f) The screening of a newborn’s hearing must should be
149 completed before the newborn is discharged from the hospital.
150 However, if the screening is not completed before discharge due
151 to scheduling or temporary staffing limitations, the screening
152 must be completed within 21 30 days after the birth discharge.
153 Screenings completed after discharge or performed because of
154 initial screening failure must be completed by an audiologist
155 licensed in the state, a physician licensed under chapter 458 or
156 chapter 459, or a hospital, or another other newborn hearing
157 screening provider.
158 (h)(g) Each hospital shall formally designate a lead
159 physician responsible for programmatic oversight for newborn
160 hearing screening. Each birth center shall designate a licensed
161 health care provider to provide such programmatic oversight and
162 to ensure that the appropriate referrals are being completed.
163 (i)(h) When ordered by the treating physician, screening of
164 a newborn’s hearing must include auditory brainstem responses,
165 or evoked otoacoustic otacoustic emissions, or appropriate
166 technology as approved by the United States Food and Drug
167 Administration.
168 (j)(i) The results of any test conducted pursuant to this
169 section, including, but not limited to, newborn hearing loss
170 screening, congenital cytomegalovirus testing, and any related
171 diagnostic testing, must be reported to the department within 7
172 days after receipt of such results Newborn hearing screening
173 must be conducted on all newborns in hospitals in this state on
174 birth admission. When a newborn is delivered in a facility other
175 than a hospital, the parents must be instructed on the
176 importance of having the hearing screening performed and must be
177 given information to assist them in having the screening
178 performed within 3 months after the child’s birth.
179 (k)(j) The initial procedure for screening the hearing of
180 the newborn or infant and any medically necessary follow-up
181 followup reevaluations leading to diagnosis shall be a covered
182 benefit for, reimbursable under Medicaid as an expense
183 compensated supplemental to the per diem rate for Medicaid
184 patients enrolled in MediPass or Medicaid patients covered by a
185 fee for service program. For Medicaid patients enrolled in HMOs,
186 providers shall be reimbursed directly by the Medicaid Program
187 Office at the Medicaid rate. This service may not be considered
188 a covered service for the purposes of establishing the payment
189 rate for Medicaid HMOs. All health insurance policies and health
190 maintenance organizations as provided under ss. 627.6416,
191 627.6579, and 641.31(30), except for supplemental policies that
192 only provide coverage for specific diseases, hospital indemnity,
193 or Medicare supplement, or to the supplemental polices, shall
194 compensate providers for the covered benefit at the contracted
195 rate. Nonhospital-based providers are shall be eligible to bill
196 Medicaid for the professional and technical component of each
197 procedure code.
198 (l)(k) A child who is diagnosed as having a permanent
199 hearing loss must impairment shall be referred to the primary
200 care physician for medical management, treatment, and follow-up
201 followup services. Furthermore, in accordance with Part C of the
202 Individuals with Disabilities Education Act, Pub. L. No. 108
203 446, Infants and Toddlers with Disabilities, any child from
204 birth to 36 months of age who is diagnosed as having a hearing
205 loss impairment that requires ongoing special hearing services
206 must be referred to the Children’s Medical Services Early
207 Intervention Program serving the geographical area in which the
208 child resides.
209 (l) Any person who is not covered through insurance and
210 cannot afford the costs for testing shall be given a list of
211 newborn hearing screening providers who provide the necessary
212 testing free of charge.
213 Section 2. This act shall take effect January 1, 2023.