Senate Bill 1324

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    Florida Senate - 1998                                  SB 1324

    By Senator Rossin





    35-1029-98

  1                      A bill to be entitled

  2         An act relating to insurance, creating the

  3         "Equity in Prescription Insurance and

  4         Contraceptive Coverage Act"; providing

  5         definitions; requiring health insurance plans

  6         that provide benefits for prescription drugs

  7         and devices and benefits for outpatient

  8         services to provide coverage for persons

  9         needing contraceptive drugs or devices or

10         outpatient contraceptive services; prohibiting

11         extraordinary surcharges; prohibiting health

12         insurance plans from other specified

13         discriminatory practices; providing for

14         enforcement by the Department of Insurance;

15         authorizing the department to adopt rules;

16         providing an effective date.

17

18         WHEREAS, the United States Department of Health and

19  Human Services and the Institute of Medicine Committee on

20  Unintended Pregnancy urge that the rate of unintended

21  pregnancy in the United States be reduced by 50 percent by the

22  year 2000, and

23         WHEREAS, fifty-seven percent of all pregnancies in this

24  country are unintended, which results in approximately 3

25  million unintended pregnancies each year in the United States,

26  and

27         WHEREAS, there are approximately 1.5 million abortions

28  annually in the United States, and

29         WHEREAS, many women in this state are at risk of

30  unintended pregnancy, and unintended pregnancies carry

31  appreciable risks, including higher rates of infant mortality,

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    Florida Senate - 1998                                  SB 1324
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  1  low-birth weight, and maternal morbidity and can threaten the

  2  economic stability of families, and

  3         WHEREAS, contraceptives are a cost-effective way of

  4  preventing unintended pregnancies, because every $1 of public

  5  funds spent on contraception saves $3 that otherwise would be

  6  spent on pregnancy-related and newborn medical care alone, and

  7         WHEREAS, two-thirds of women of childbearing age rely

  8  on some form of private-employment-related insurance to defray

  9  their medical expenses, and

10         WHEREAS, women of reproductive age spend 68 percent

11  more than men on out-of-pocket health care costs, with

12  contraceptives and reproductive health care services

13  accounting for much of the difference, and

14         WHEREAS, forty-nine percent of all typical large group

15  insurance plans do not routinely cover any contraceptive

16  method, and

17         WHEREAS, ninety-seven percent of large group insurance

18  plans routinely cover prescription drugs, yet only 33 percent

19  routinely cover oral contraceptives, the most commonly used

20  reversible prescription contraceptive in the United States,

21  and

22         WHEREAS, ninety-two percent of large group insurance

23  plans routinely cover medical devices, yet only 15 percent

24  cover diaphragms, and

25         WHEREAS, the Institute of Medicine Committee on

26  Unintended Pregnancy recommends that more health insurance

27  policies provide coverage for contraceptive services and

28  supplies in order to reduce the rate of unintended

29  pregnancies, NOW, THEREFORE,

30

31  Be It Enacted by the Legislature of the State of Florida:

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    Florida Senate - 1998                                  SB 1324
    35-1029-98




  1         Section 1.  Short title.--This act may be cited as the

  2  "Equity in Prescription Insurance and Contraceptive Coverage

  3  Act."

  4         Section 2.  Definitions.--As used in this act the term:

  5         (1)  "Covered person" means the policyholder,

  6  subscriber, certificateholder, enrollee, or other individual

  7  who is participating in or receiving coverage under the health

  8  insurance plan.

  9         (2)  "Health insurance plan" means any individual or

10  group plan, policy, certificate, subscriber contract, contract

11  of insurance provided by a managed-care plan,

12  preferred-provider agreement, or health maintenance

13  organization subscriber contract that is delivered, issued,

14  renewed, modified, amended, or extended by a health insurer in

15  this state and that pays for or purchases health care services

16  for covered persons.

17         (3)  "Health insurer" means a disability insurer,

18  health care insurer, health maintenance organization, accident

19  and sickness insurer, fraternal benefit society, nonprofit

20  hospital service corporation, health service corporation,

21  health care service plan, preferred provider organization or

22  arrangement, or multiple employer welfare arrangement.

23         (4)  "Outpatient contraceptive services" includes

24  consultations, examinations, procedures, and medical services

25  provided on an outpatient basis and related to the use of

26  contraceptive methods to prevent pregnancy.

27         Section 3.  Parity for contraceptives.--

28         (1)  Health insurance plans that provide benefits for

29  prescription drugs or devices may not exclude or restrict

30  benefits to covered persons for prescription contraceptive

31

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    Florida Senate - 1998                                  SB 1324
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  1  drugs or devices approved by the Federal Food and Drug

  2  Administration.

  3         (2)  Health insurance plans that provide benefits for

  4  outpatient services provided by a health care professional may

  5  not exclude or restrict outpatient contraceptive services for

  6  covered persons.

  7         Section 4.  Extraordinary surcharges prohibited.--A

  8  health insurance plan may not:

  9         (1)  Impose a deductible, coinsurance, or other

10  cost-sharing or a waiting period in relation to benefits for

11  prescription contraceptive drugs or devices under a health

12  insurance plan unless such a deductible, coninsurance, or

13  other cost-sharing or waiting period is no greater than that

14  for other prescription drugs or devices covered under the

15  health insurance plan.

16         (2)  Impose a deductible, coinsurance, or other

17  cost-sharing or a waiting period in relation to benefits for

18  outpatient contraceptive services under a health insurance

19  plan unless such a deductible, coinsurance, or other

20  cost-sharing or waiting period is no greater than that for

21  other outpatient services covered under the health insurance

22  plan.

23         Section 5.  Other prohibitions.--A health insurance

24  plan may not:

25         (1)  Deny to any individual or covered person

26  eligibility or continued eligibility to enroll in or to renew

27  coverage under the terms of the plan because of the

28  individual's or covered person's use or potential use of items

29  or services that are covered under this act.

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    Florida Senate - 1998                                  SB 1324
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  1         (2)  Provide monetary payments or rebates to a covered

  2  person to encourage such covered person to accept less than

  3  the minimum protections available under this act.

  4         (3)  Penalize or otherwise reduce or limit the

  5  reimbursement of a health care professional because the

  6  professional prescribed contraceptive drugs or devices or

  7  provided contraceptive services under this act.

  8         (4)  Provide incentives to a health care professional

  9  to induce the professional to withhold from a covered person

10  contraceptives drugs, devices, or contraceptive services.

11         Section 6.  Enforcement.--The Department of Insurance

12  shall accept and review written complaints regarding

13  compliance with this act.  If the department determines that a

14  health insurance plan is not in compliance with this act, the

15  department must:

16         (1)  Recommend a correction plan that must be followed

17  by the health insurer.

18         (2)  Institute corrective action that must be followed

19  by the health insurer.

20         (3)  Suspend or revoke the health insurer's certificate

21  of authority or deny the health insurer's application for a

22  certificate of authority.

23         (4)  Use any of the department's enforcement powers to

24  obtain the health insurer's compliance with this act.

25         Section 7.  Rules.--The Department of Insurance may

26  adopt rules to enforce this act.

27         Section 8.  Applicability.--This act does not apply to

28  a health insurance plan in force on July 1, 1998, but does

29  apply to any health insurance plan that is delivered, issued,

30  renewed, modified, amended, or extended on or after that date.

31         Section 9.  This act shall take effect July 1, 1998.

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    Florida Senate - 1998                                  SB 1324
    35-1029-98




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  2                          SENATE SUMMARY

  3    Creates the "Equity in Prescription Insurance and
      Contraceptive Coverage Act." Provides definitions.
  4    Requires health insurance plans that provide benefits for
      prescription drugs and devices and benefits for
  5    outpatient services to provide coverage for persons
      needing contraceptive drugs or devices or outpatient
  6    contraceptive services. Prohibits extraordinary
      surcharges. Prohibits health insurance plans from other
  7    specified discriminatory practices. Provides for
      enforcement by the Department of Insurance. Authorizes
  8    the department to adopt rules.

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