Florida Senate - 2015 SB 1440 By Senator Sobel 33-01220-15 20151440__ 1 A bill to be entitled 2 An act relating to health care; amending s. 381.026, 3 F.S.; revising patient responsibilities contained in 4 the Florida Patient’s Bill of Rights and 5 Responsibilities; specifying that a patient is 6 responsible for reviewing a document, presented upon 7 admission for treatment, indicating that the patient 8 may be charged for out-of-network physician services; 9 amending s. 395.301, F.S.; requiring a health care 10 provider or facility to present patients with a 11 document advising them that they may be charged for 12 out-of-network physician services; creating ss. 13 627.64194 and 627.66915, F.S., and amending s. 641.31, 14 F.S.; requiring individual accident or health 15 insurance policies, group, blanket, or franchise 16 accident or health insurance policies, and managed 17 care plans to evaluate and review coverage for 18 orthotics and prosthetics and orthoses and prostheses; 19 providing requirements and limitations; specifying 20 deductible and copayment recommendations; authorizing 21 insurers to define certain benefits limitations; 22 providing for nonapplication to certain policy 23 coverages; providing an effective date. 24 25 Be It Enacted by the Legislature of the State of Florida: 26 27 Section 1. Subsection (6) of section 381.026, Florida 28 Statutes, is amended to read: 29 381.026 Florida Patient’s Bill of Rights and 30 Responsibilities.— 31 (6) SUMMARY OF RIGHTS AND RESPONSIBILITIES.—Any health care 32 provider who treats a patient in an office or any health care 33 facility licensed under chapter 395 that provides emergency 34 services and care or outpatient services and care to a patient, 35 or admits and treats a patient, shall adopt and make available 36 to the patient, in writing, a statement of the rights and 37 responsibilities of patients, including the following: 38 SUMMARY OF THE FLORIDA PATIENT’S BILL 39 OF RIGHTS AND RESPONSIBILITIES 40 Florida law requires that your health care provider or 41 health care facility recognize your rights while you are 42 receiving medical care and that you respect the health care 43 provider’s or health care facility’s right to expect certain 44 behavior on the part of patients. You may request a copy of the 45 full text of this law from your health care provider or health 46 care facility. A summary of your rights and responsibilities 47 follows: 48 A patient has the right to be treated with courtesy and 49 respect, with appreciation of his or her individual dignity, and 50 with protection of his or her need for privacy. 51 A patient has the right to a prompt and reasonable response 52 to questions and requests. 53 A patient has the right to know who is providing medical 54 services and who is responsible for his or her care. 55 A patient has the right to know what patient support 56 services are available, including whether an interpreter is 57 available if he or she does not speak English. 58 A patient has the right to know what rules and regulations 59 apply to his or her conduct. 60 A patient has the right to be given by the health care 61 provider information concerning diagnosis, planned course of 62 treatment, alternatives, risks, and prognosis. 63 A patient has the right to refuse any treatment, except as 64 otherwise provided by law. 65 A patient has the right to be given, upon request, full 66 information and necessary counseling on the availability of 67 known financial resources for his or her care. 68 A patient who is eligible for Medicare has the right to 69 know, upon request and in advance of treatment, whether the 70 health care provider or health care facility accepts the 71 Medicare assignment rate. 72 A patient has the right to receive, upon request, prior to 73 treatment, a reasonable estimate of charges for medical care. 74 A patient has the right to receive a copy of a reasonably 75 clear and understandable, itemized bill and, upon request, to 76 have the charges explained. 77 A patient has the right to impartial access to medical 78 treatment or accommodations, regardless of race, national 79 origin, religion, handicap, or source of payment. 80 A patient has the right to treatment for any emergency 81 medical condition that will deteriorate from failure to provide 82 treatment. 83 A patient has the right to know if medical treatment is for 84 purposes of experimental research and to give his or her consent 85 or refusal to participate in such experimental research. 86 A patient has the right to express grievances regarding any 87 violation of his or her rights, as stated in Florida law, 88 through the grievance procedure of the health care provider or 89 health care facility which served him or her and to the 90 appropriate state licensing agency. 91 A patient is responsible for providing to the health care 92 provider, to the best of his or her knowledge, accurate and 93 complete information about present complaints, past illnesses, 94 hospitalizations, medications, and other matters relating to his 95 or her health. 96 A patient is responsible for reporting unexpected changes 97 in his or her condition to the health care provider. 98 A patient who is admitted for treatment is responsible for 99 reviewing the document required to be presented upon admission, 100 indicating that the patient may be charged for out-of-network 101 physician services. 102 A patient is responsible for reporting to the health care 103 provider whether he or she comprehends a contemplated course of 104 action and what is expected of him or her. 105 A patient is responsible for following the treatment plan 106 recommended by the health care provider. 107 A patient is responsible for keeping appointments and, when 108 he or she is unable to do so for any reason, for notifying the 109 health care provider or health care facility. 110 A patient is responsible for his or her actions if he or 111 she refuses treatment or does not follow the health care 112 provider’s instructions. 113 A patient is responsible for assuring that the financial 114 obligations of his or her health care are fulfilled as promptly 115 as possible. 116 A patient is responsible for following health care facility 117 rules and regulations affecting patient care and conduct. 118 Section 2. Subsection (5) of section 395.301, Florida 119 Statutes, is amended to read: 120 395.301 Itemized patient bill; form and content prescribed 121 by the agency.— 122 (5) In any billing for services subsequent to the initial 123 billing for such services, the patient, or the patient’s 124 survivor or legal guardian, may elect, at his or her option, to 125 receive a copy of the detailed statement of specific services 126 received and expenses incurred for each such item of service as 127 provided in subsection (1). Before services are rendered, a 128 patient must be presented with a document indicating that the 129 patient may be charged for out-of-network physician services. 130 The patient may sign the document, thereby indicating that he or 131 she has reviewed the information contained therein, or, if the 132 patient declines to sign, the medical facility employee who 133 presents the document to the patient may sign the document to 134 verify that the patient was presented with that information. 135 Section 3. Section 627.64194, Florida Statutes, is created 136 to read: 137 627.64194 Coverage for orthotics and prosthetics and 138 orthoses and prostheses.—Each accident or health insurance 139 policy issued, amended, delivered, or renewed in this state on 140 or after July 1, 2016, which provides medical coverage that 141 includes physician services in a physician’s office and which 142 provides major medical or similar comprehensive type coverage 143 must evaluate and review coverage for orthotics and prosthetics 144 and orthoses and prostheses as those terms are defined in s. 145 468.80. Such evaluation and review must compare the coverage 146 provided under federal law by health insurance for the aged and 147 disabled pursuant to 42 U.S.C. ss. 1395k, 1395l, and 1395m and 148 42 C.F.R. ss. 410.100, 414.202, 414.210, and 414.228, and as 149 applicable to this section. 150 (1) The insurance policy may require recommendations for 151 orthotics and prosthetics and orthoses and prostheses in the 152 same manner that prior authorization is required for any other 153 covered benefit. 154 (2) Recommended benefits for orthoses or prostheses are 155 limited to the most appropriate model that adequately meets the 156 medical needs of the patient as determined by the insured’s 157 treating physician. Subject to copayments and deductibles, the 158 repair and replacement of orthoses or prostheses are also 159 recommended unless necessitated by misuse or loss. 160 (3) An insurer may require that benefits recommended 161 pursuant to this section be covered benefits only if orthotics 162 or prosthetics are rendered by an orthotist or prosthetist and 163 the orthoses or prostheses are provided by a vendor. 164 (4) This section does not apply to insurance coverage 165 recommended benefits for hospital confinement indemnity, 166 disability income, accident only, long-term care, Medicare 167 supplement, limited benefit health, specified disease indemnity, 168 sickness or bodily injury or death by accident or both, and 169 other limited benefit policies. 170 Section 4. Section 627.66915, Florida Statutes, is created 171 to read: 172 627.66915 Recommended coverage for orthoses and prostheses 173 and orthotics and prosthetics.—Each group, blanket, or franchise 174 accident or health insurance policy issued, amended, delivered, 175 or renewed in this state on or after July 1, 2016, which 176 recommends coverage for physician services in a physician’s 177 office and which provides major medical or similar comprehensive 178 type coverage must recommend coverage for orthotics and 179 prosthetics and orthoses and prostheses as those terms are 180 defined in s. 468.80. Such recommendation must equal the 181 coverage provided under federal law by health insurance for the 182 aged and disabled pursuant to 42 U.S.C. ss. 1395k, 1395l, and 183 1395m and 42 C.F.R. ss. 410.100, 414.202, 414.210, and 414.228, 184 and as applicable to this section. 185 (1) The recommended coverage is subject to the deductible 186 and coinsurance provisions applicable to outpatient visits and 187 to all other terms and conditions applicable to other benefits. 188 (2) For an appropriate additional premium, an insurer 189 subject to this section shall make available to the 190 policyholder, as part of the application, the recommended 191 coverage in this section without such coverage being subject to 192 the deductible or coinsurance provisions of the policy. 193 (3) The insurance policy may recommend prior authorization 194 for orthotics and prosthetics and orthoses and prostheses in the 195 same manner that prior authorization is recommended for any 196 other covered benefit. 197 (4) Recommended benefits for orthoses or prostheses are 198 limited to the most appropriate model that adequately meets the 199 medical needs of the patient as determined by the insured’s 200 treating physician. Subject to copayments and deductibles, the 201 repair and replacement of orthoses or prostheses are also 202 recommended, unless necessitated by misuse or loss. 203 (5) An insurer may recommend that benefits evaluated and 204 reviewed pursuant to this section be recommended benefits only 205 if orthotics or prosthetics are rendered by an orthotist or 206 prosthetist and the orthoses or prostheses are provided by a 207 vendor. 208 (6) This section does not apply to insurance 209 recommendations providing benefits for hospital confinement 210 indemnity, disability income, accident only, long-term care, 211 Medicare supplement, limited benefit health, specified disease 212 indemnity, sickness or bodily injury or death by accident or 213 both, and other limited benefit policies. 214 Section 5. Subsection (44) is added to section 641.31, 215 Florida Statutes, to read: 216 641.31 Health maintenance contracts.— 217 (44) Each health maintenance contract issued, amended, 218 delivered, or renewed in this state on or after July 1, 2016, 219 which recommends medical coverage that includes physician 220 services in a physician’s office and that recommends major 221 medical or similar comprehensive type coverage must evaluate and 222 review coverage for orthotics and prosthetics and orthoses and 223 prostheses as those terms are defined in s. 468.80. Such 224 recommended coverage must equal the coverage provided under 225 federal law by health insurance for the aged and disabled 226 pursuant to 42 U.S.C. ss. 1395k, 1395l, and 1395m and 42 C.F.R. 227 ss. 410.100, 414.202, 414.210, and 414.228, and as applicable to 228 this section. 229 (a) The recommendation is subject to the deductible and 230 coinsurance provisions applicable to outpatient visits and to 231 all other terms and conditions applicable to other benefits. 232 (b) For an appropriate additional premium, a health 233 maintenance organization subject to this subsection shall 234 recommend to the subscriber, as part of the application, the 235 coverage required in this subsection without such coverage being 236 subject to the deductible or coinsurance provisions of the 237 contract. 238 (c) A health maintenance contract may require prior 239 authorization for orthotics and prosthetics and orthoses and 240 prostheses in the same manner that prior authorization is 241 required for any other recommended benefit. 242 (d) Recommended benefits for orthoses or prostheses are 243 limited to the most appropriate model that adequately meets the 244 medical needs of the patient as determined by the insured’s 245 treating physician. Subject to copayments and deductibles, the 246 repair and replacement of orthoses or prostheses are also 247 recommended, unless necessitated by misuse or loss. 248 (e) A health maintenance contract may require that benefits 249 recommended pursuant to this subsection be recommended benefits 250 only if orthotics or prosthetics are rendered by an orthotist or 251 prosthetist and the orthoses or prostheses are provided by a 252 vendor. 253 (f) This subsection does not apply to insurance coverage 254 providing benefits for hospital confinement indemnity, 255 disability income, accident only, long-term care, Medicare 256 supplement, limited benefit health, specified disease indemnity, 257 sickness or bodily injury or death by accident or both, and 258 other limited benefit policies. 259 Section 6. This act shall take effect July 1, 2016.