Senate Bill 2008

CODING: Words stricken are deletions; words underlined are additions.



    Florida Senate - 2000                                  SB 2008

    By Senator King





    8-1420-00

  1                      A bill to be entitled

  2         An act relating to insurance; amending ss.

  3         627.4239, 641.31, F.S.; prohibiting insurers

  4         and health maintenance organizations from

  5         excluding coverage for any drug prescribed for

  6         the treatment of chronic, disabling, or

  7         life-threatening illness because it is not

  8         federally approved; providing an effective

  9         date.

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

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13         Section 1.  Section 627.4239, Florida Statutes, is

14  amended to read:

15         627.4239  Coverage for use of drugs in treatment of

16  cancer or chronic, disabling, or life-threatening illnesses.--

17         (1)  DEFINITIONS.--As used in this section, the term:

18         (a)  "Medical literature" means scientific studies

19  published in a United States peer-reviewed national

20  professional journal.

21         (b)  "Standard reference compendium" means:

22         1.  The United States Pharmacopeia Drug Information;

23         2.  The American Medical Association Drug Evaluations;

24  or

25         3.  The American Hospital Formulary Service Drug

26  Information.

27         (2)  COVERAGE FOR TREATMENT OF CANCER OR CHRONIC,

28  DISABLING, OR LIFE-THREATENING ILLNESSES.--

29         (a)  An insurer may not exclude coverage in any

30  individual or group insurance policy issued, amended,

31  delivered, or renewed in this state which covers the treatment

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    Florida Senate - 2000                                  SB 2008
    8-1420-00




  1  of cancer or other chronic, disabling, or life-threatening

  2  illnesses for any drug prescribed for the treatment of such

  3  illness cancer on the ground that the drug is not approved by

  4  the United States Food and Drug Administration for a

  5  particular indication, if that drug is recognized for

  6  treatment of that indication in a standard reference

  7  compendium or recommended in the medical literature.

  8         (b)  Coverage for a drug required by this section also

  9  includes the medically necessary services associated with the

10  administration of the drug.

11         (3)  APPLICABILITY AND SCOPE.--This section may not be

12  construed to:

13         (a)  Alter any other law with regard to provisions

14  limiting coverage for drugs that are not approved by the

15  United States Food and Drug Administration.

16         (b)  Require coverage for any drug if the United States

17  Food and Drug Administration has determined that the use of

18  the drug is contraindicated.

19         (c)  Require coverage for a drug that is not otherwise

20  approved for any indication by the United States Food and Drug

21  Administration.

22         (d)  Affect the determination as to whether particular

23  levels, dosages, or usage of a medication associated with bone

24  marrow transplant procedures are covered under an individual

25  or group health insurance policy or health maintenance

26  organization contract.

27         (e)  Apply to specified disease or supplemental

28  policies.

29         (4)  Nothing in this section is intended, expressly or

30  by implication, to create, impair, alter, limit, modify,

31  enlarge, abrogate, prohibit, or withdraw any authority to

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    Florida Senate - 2000                                  SB 2008
    8-1420-00




  1  provide reimbursement for drugs used in the treatment of any

  2  other disease or condition.

  3         Section 2.  Subsection (39) is added to section 641.31,

  4  Florida Statutes, to read:

  5         641.31  Health maintenance contracts.--

  6         (39)  A health maintenance organization that covers

  7  drugs for the treatment of a chronic, disabling, or

  8  life-threatening illness must comply with s. 627.4239.

  9         Section 3.  This act shall take effect July 1, 2000.

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12                          SENATE SUMMARY

13    Prohibits insurers and health maintenance organizations
      from excluding coverage for any drug prescribed for the
14    treatment of chronic, disabling, or life-threatening
      illness because it is not approved by the United States
15    Food and Drug Administration.

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