Florida Senate - 2010                                     SB 214
       
       
       
       By Senator Ring
       
       
       
       
       32-00050B-10                                           2010214__
    1                        A bill to be entitled                      
    2         An act relating to autism; creating s. 381.986, F.S.;
    3         requiring that a physician refer a minor to an
    4         appropriate specialist for screening for autism
    5         spectrum disorder under certain circumstances;
    6         defining the term “appropriate specialist”; amending
    7         ss. 627.6686 and 641.31098, F.S.; defining the term
    8         “direct patient access”; requiring certain insurers
    9         and health maintenance organizations to provide direct
   10         patient access to an appropriate specialist for a
   11         minimum number of visits per year for the screening,
   12         evaluation, or diagnosis of autism spectrum disorder;
   13         providing an effective date.
   14  
   15  Be It Enacted by the Legislature of the State of Florida:
   16  
   17         Section 1. Section 381.986, Florida Statutes, is created to
   18  read:
   19         381.986 Screening for autism spectrum disorder.—
   20         (1) If the parent or legal guardian of a minor who is an
   21  eligible individual, as defined in s. 627.6686 or s. 641.31098,
   22  believes that the minor exhibits symptoms of autism spectrum
   23  disorder, the parent or legal guardian may report his or her
   24  observation to a physician licensed in this state. The physician
   25  shall immediately refer the minor to an appropriate specialist
   26  for the screening for, evaluation of, or diagnosis of autism
   27  spectrum disorder. This section does not apply to a physician
   28  providing care under s. 395.1041.
   29         (2) As used in this section, the term “appropriate
   30  specialist” means a qualified professional who is experienced in
   31  the evaluation of autism spectrum disorder, who has training in
   32  validated diagnostic tools, and includes, but is not limited to,
   33  a person who is licensed in this state as:
   34         (a) A psychologist;
   35         (b) A psychiatrist;
   36         (c) A neurologist;
   37         (d) A developmental or behavioral pediatrician who
   38  specializes in child neurology; or
   39         (e) A professional whose licensure is deemed appropriate by
   40  the Children’s Medical Services Early Steps Program within the
   41  Department of Health.
   42         Section 2. Present paragraphs (c), (d), and (e) of
   43  subsection (2) of section 627.6686, Florida Statutes, are
   44  redesignated as paragraphs (d), (e), and (f), respectively, a
   45  new paragraph (c) is added to that subsection, and paragraph (a)
   46  of subsection (3) of that section is amended, to read:
   47         627.6686 Coverage for individuals with autism spectrum
   48  disorder required; exception.—
   49         (2) As used in this section, the term:
   50         (c) “Direct patient access” means the ability of an insured
   51  to obtain services from an in-network provider without a
   52  referral or other authorization before receiving services.
   53         (3) A health insurance plan issued or renewed on or after
   54  April 1, 2009, shall provide coverage to an eligible individual
   55  for:
   56         (a) Direct patient access to an appropriate specialist, as
   57  defined in s. 381.986, for a minimum of three visits per policy
   58  year for the screening for, evaluation of, or diagnosis Well
   59  baby and well-child screening for diagnosing the presence of
   60  autism spectrum disorder.
   61         Section 3. Present paragraphs (c) and (d) of subsection (2)
   62  of section 641.31098, Florida Statutes, are redesignated as
   63  paragraphs (d) and (e), respectively, a new paragraph (c) is
   64  added to that subsection, and paragraph (a) of subsection (3) of
   65  that section is amended, to read:
   66         641.31098 Coverage for individuals with developmental
   67  disabilities.—
   68         (2) As used in this section, the term:
   69         (c) “Direct patient access” means the ability of a
   70  subscriber to obtain services from an in-network provider
   71  without a referral or other authorization before receiving
   72  services.
   73         (3) A health maintenance contract issued or renewed on or
   74  after April 1, 2009, shall provide coverage to an eligible
   75  individual for:
   76         (a) Direct patient access to an appropriate specialist, as
   77  defined in s. 381.986, for a minimum of three visits per policy
   78  year for the screening for, evaluation of, or diagnosis Well
   79  baby and well-child screening for diagnosing the presence of
   80  autism spectrum disorder.
   81         Section 4. This act shall take effect July 1, 2010.