Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. CS for CS for SB 308
       
       
       
       
       
       
                                Barcode 117968                          
       
                              LEGISLATIVE ACTION                        
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       The Policy and Steering Committee on Ways and Means
       (Haridopolos) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 85 - 230
    4  and insert:
    5         (c) “Developmental disability” means a disorder or syndrome
    6  attributable to cerebral palsy or Down syndrome, which manifests
    7  before the age of 18 years old and constitutes a substantial
    8  handicap that can reasonably be expected to continue
    9  indefinitely. As used in this section:
   10         1. “Cerebral palsy” has the same meaning as in s. 393.063.
   11         2. “Down syndrome” means a disorder caused by the presence
   12  of an extra chromosome 21.
   13         (d)(c) “Eligible individual” means an individual under 18
   14  years of age or an individual 18 years of age or older who is in
   15  high school and who has been diagnosed as having a developmental
   16  disability at 8 years of age or younger.
   17         (e)(d) “Health insurance plan” means a group health
   18  insurance policy or group health benefit plan offered by an
   19  insurer which includes the state group insurance program
   20  provided under s. 110.123. The term does not include a any
   21  health insurance plan offered in the individual market, a any
   22  health insurance plan that is individually underwritten, or a
   23  any health insurance plan provided to a small employer.
   24         (f)(e) “Insurer” means an insurer providing health
   25  insurance coverage, which is licensed to engage in the business
   26  of insurance in this state and is subject to insurance
   27  regulation.
   28         (3) A health insurance plan issued or renewed on or after
   29  April 1, 2009, shall provide coverage to an eligible individual
   30  for:
   31         (a) Well-baby and well-child screening for diagnosing the
   32  presence of autism spectrum disorder or other developmental
   33  disability.
   34         (b) Treatment of autism spectrum disorder or other
   35  developmental disability through speech therapy, occupational
   36  therapy, physical therapy, and applied behavior analysis.
   37  Applied behavior analysis services shall be provided by an
   38  individual certified pursuant to s. 393.17 or an individual
   39  licensed under chapter 490 or chapter 491.
   40         (11) Notwithstanding any provision of this section, an
   41  insurer shall provide direct patient access for screening,
   42  evaluation of, or diagnosis for autism spectrum disorder or
   43  other developmental disability to an appropriate specialist, as
   44  defined in s. 381.986. As used in this subsection, the term
   45  “direct patient access” means the ability of a subscriber or
   46  insured to obtain services from an in-network provider without a
   47  referral or other authorization before receiving services.
   48  Pursuant to this subsection, the insurer’s policy must provide a
   49  minimum of three visits per policy year for the screening,
   50  evaluation, or diagnosis for autism spectrum disorder or other
   51  developmental disability.
   52         Section 3. Subsections (2) and (3) of section 641.31098,
   53  Florida Statutes, are amended, and subsection (10) is added to
   54  that section, to read:
   55         641.31098 Coverage for individuals with developmental
   56  disabilities.—
   57         (2) As used in this section, the term:
   58         (a) “Applied behavior analysis” means the design,
   59  implementation, and evaluation of environmental modifications,
   60  using behavioral stimuli and consequences, to produce socially
   61  significant improvement in human behavior, including, but not
   62  limited to, the use of direct observation, measurement, and
   63  functional analysis of the relations between environment and
   64  behavior.
   65         (b) “Autism spectrum disorder” means any of the following
   66  disorders as defined in the most recent edition of the
   67  Diagnostic and Statistical Manual of Mental Disorders of the
   68  American Psychiatric Association:
   69         1. Autistic disorder.
   70         2. Asperger’s syndrome.
   71         3. Pervasive developmental disorder not otherwise
   72  specified.
   73         (c) “Developmental disability” means a disorder or syndrome
   74  attributable to cerebral palsy or Down syndrome, which manifests
   75  before the age of 18 years old and constitutes a substantial
   76  handicap that can reasonably be expected to continue
   77  indefinitely. As used in this section:
   78         1. “Cerebral palsy” has the same meaning as in s. 393.063.
   79         2. “Down syndrome” means a disorder caused by the presence
   80  of an extra chromosome 21.
   81  
   82  ================= T I T L E  A M E N D M E N T ================
   83         And the title is amended as follows:
   84         Delete line 11
   85  and insert:
   86         disability” to include cerebral palsy and Down
   87         syndrome; providing health insurance coverage for