Florida Senate - 2024                                     SB 132
       
       
        
       By Senator Berman
       
       
       
       
       
       26-00006-24                                            2024132__
    1                        A bill to be entitled                      
    2         An act relating to coverage for diagnostic and
    3         supplemental breast examinations; amending s. 110.123,
    4         F.S.; prohibiting the state group insurance program
    5         from imposing any enrollee cost-sharing liability with
    6         respect to coverage for diagnostic breast examinations
    7         and supplemental breast examinations; defining the
    8         terms “diagnostic breast examination” and
    9         “supplemental breast examination”; creating ss.
   10         627.64181, 627.66131, and 641.31093, F.S.; defining
   11         terms; prohibiting the imposition of cost-sharing
   12         requirements for diagnostic and supplemental breast
   13         examinations by individual accident and health
   14         insurance policies; group, blanket, and franchise
   15         accident or health insurance policies; and health
   16         maintenance contracts, respectively, which provide
   17         such coverage; authorizing the Financial Services
   18         Commission to adopt rules; providing an effective
   19         date.
   20          
   21  Be It Enacted by the Legislature of the State of Florida:
   22  
   23         Section 1. Subsection (15) is added to section 110.123,
   24  Florida Statutes, to read:
   25         110.123 State group insurance program.—
   26         (15) COVERAGE FOR DIAGNOSTIC AND SUPPLEMENTAL BREAST
   27  EXAMINATIONS.—The state group insurance program may not impose
   28  any enrollee cost-sharing liability with respect to coverage for
   29  diagnostic breast examinations and supplemental breast
   30  examinations. As used in this subsection, the terms “diagnostic
   31  breast examination” and “supplemental breast examination” have
   32  the same meanings as in s. 627.64181(1).
   33         Section 2. Section 627.64181, Florida Statutes, is created
   34  to read:
   35         627.64181 Coverage for diagnostic and supplemental breast
   36  examinations; cost-sharing requirements prohibited.—
   37         (1)As used in this section, the term:
   38         (a)“Cost-sharing requirement” means an insured’s
   39  deductible, coinsurance, copayment, or other out-of-pocket
   40  expense.
   41         (b)“Diagnostic breast examination” means a medically
   42  necessary and appropriate examination of the breast, including
   43  an examination using diagnostic mammography, breast magnetic
   44  resonance imaging, or breast ultrasound, which is used to
   45  evaluate an abnormality:
   46         1.Seen or suspected from a screening examination for
   47  breast cancer; or
   48         2.Detected by another means of examination.
   49         (c)“Supplemental breast examination” means a medically
   50  necessary and appropriate examination of the breast, including
   51  an examination using breast magnetic resonance imaging or breast
   52  ultrasound, which is:
   53         1.Used to screen for breast cancer when there is no
   54  abnormality seen or suspected; and
   55         2.Based on personal or family medical history or
   56  additional factors that may increase the individual’s risk of
   57  breast cancer.
   58         (2)An accident or health insurance policy issued, amended,
   59  delivered, or renewed on or after January 1, 2025, which
   60  provides coverage for diagnostic breast examinations and
   61  supplemental breast examinations shall not impose any cost
   62  sharing requirement with respect to such coverage.
   63         (3)The commission may adopt rules to administer this
   64  section.
   65         Section 3. Section 627.66131, Florida Statutes, is created
   66  to read:
   67         627.66131 Coverage for diagnostic and supplemental breast
   68  examinations; cost-sharing requirements prohibited.—
   69         (1)As used in this section, the terms “cost-sharing
   70  requirement,” “diagnostic breast examination,” and “supplemental
   71  breast examination” have the same meanings as in s.
   72  627.64181(1).
   73         (2)A group, blanket, or franchise accident or health
   74  insurance policy issued, amended, delivered, or renewed on or
   75  after January 1, 2025, which provides coverage for diagnostic
   76  breast examinations and supplemental breast examinations shall
   77  not impose any cost-sharing requirement with respect to such
   78  coverage.
   79         (3)The commission may adopt rules to administer this
   80  section.
   81         Section 4. Section 641.31093, Florida Statutes, is created
   82  to read:
   83         641.31093 Coverage for diagnostic and supplemental breast
   84  examinations; cost-sharing requirements prohibited.—
   85         (1)As used in this section, the term:
   86         (a)“Cost-sharing requirement” means a subscriber’s
   87  deductible, coinsurance, copayment, or other out-of-pocket
   88  expense.
   89         (b)“Diagnostic breast examination” has the same meaning as
   90  in s. 627.64181(1).
   91         (c)“Supplemental breast examination” has the same meaning
   92  as in s. 627.64181(1).
   93         (2)A health maintenance contract issued, amended,
   94  delivered, or renewed on or after January 1, 2025, which
   95  provides coverage for diagnostic breast examinations and
   96  supplemental breast examinations shall not impose any cost
   97  sharing requirement with respect to such coverage.
   98         (3)The commission may adopt rules to administer this
   99  section.
  100         Section 5. This act shall take effect July 1, 2024.