House Bill 2061

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    Florida House of Representatives - 2000                HB 2061

        By the Committee on Insurance and Representatives Bainter,
    Cosgrove, Waters, Patterson, Rayson, Melvin, Wiles, Dockery,
    Tullis, Lawson, Lee, Goode, Sublette, Casey, Crady, Bronson,
    Trovillion, Kelly, Argenziano and Futch



  1                      A bill to be entitled

  2         An act relating to mandated health benefits;

  3         creating s. 11.90, F.S.; creating the Advisory

  4         Commission on Mandated Health Benefits;

  5         specifying the purpose and membership of the

  6         commission; prescribing duties and

  7         responsibilities of the commission; amending s.

  8         624.215, F.S.; revising legislative intent;

  9         providing a definition; revising reporting

10         requirements; providing for criteria for

11         assessing social and financial impacts;

12         providing for automatic repeal of mandated

13         health benefits; providing an exception;

14         providing an appropriation; providing an

15         effective date.

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

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19         Section 1.  Section 11.90, Florida Statutes, is created

20  to read:

21         11.90  Advisory Commission on Mandated Health

22  Benefits.--

23         (1)  The Advisory Commission on Mandated Health

24  Benefits is created for the purpose of reviewing legislation

25  proposing mandated health benefits and managing the cumulative

26  impact of mandated health benefits.  The commission shall be

27  comprised of six members appointed as follows: three members

28  of the Senate appointed by the President of the Senate, one of

29  whom must be a member of the minority party; and three members

30  of the House of Representatives appointed by the Speaker of

31  the House of Representatives, one of whom must be a member of

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  1  the minority party.  The chair and vice chair of the

  2  commission shall be appointed from the commission membership

  3  by the President of the Senate and the Speaker of the House of

  4  Representatives for 1-year terms with the appointments

  5  alternating between the President of the Senate and the

  6  Speaker of the House of Representatives.

  7         (2)  The commission shall:

  8         (a)  Compile an official inventory of all mandated

  9  health benefits as defined in s. 624.215(2).

10         (b)  Monitor the cumulative cost impact of mandated

11  health benefits as a percentage of premiums on an ongoing

12  basis, beginning with the establishment of a baseline cost

13  impact for mandated health benefits in effect as of October 1,

14  2000.  The commission shall contract for actuarial or other

15  professional services through the Office of Economic and

16  Demographic Research for the completion of the baseline cost

17  impact analysis and in identifying the primary beneficial

18  social and health consequences.

19         (c)  Assess the impact of legislation proposing

20  mandated health benefits, in accordance with s. 624.215, if

21  proponents submit an impact assessment meeting the

22  requirements of that section and rules adopted by the

23  commission. The commission may contract with actuaries and

24  other professionals through the Office of Economic and

25  Demographic Research to conduct the impact assessments and may

26  establish ad hoc panels of experts to assist in the assessment

27  process.

28         (d)  Certify that legislation proposing mandated health

29  benefits has satisfied requirements specified in s. 624.215,

30  and in rules adopted by the commission.

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  1         (e)  Adopt rules governing commission operations and

  2  procedures for reviewing legislation proposing mandated health

  3  benefits, including the format and timing of information to be

  4  submitted to the commission.  These rules must be submitted to

  5  the President of the Senate and the Speaker of the House of

  6  Representatives for approval.

  7         (f)  As warranted, after receipt and consideration of

  8  the baseline cost impact assessment conducted pursuant to

  9  paragraph (b), recommend legislation to manage the impacts of

10  mandated health benefits, including legislation to repeal or

11  amend particular mandated health benefits, convert some or all

12  mandated health benefits to mandatory offers of coverage,

13  adjust the mix of mandated health benefits to comply with any

14  limits imposed on the percentage of total premium that

15  mandated health benefits may represent, or create additional

16  mandated health benefits.

17         (g)  As warranted, recommend and develop legislation

18  necessary to resolve any statutory ambiguities or

19  inconsistencies creating interpretative differences over the

20  application of particular mandated health benefits to

21  insurance policies or health maintenance organization

22  contracts.

23         (h)  Recommend a limit on the percentage of total

24  premium costs that mandated health benefits in the aggregate

25  may represent based on the baseline cost impact assessment

26  conducted pursuant to paragraph (b).

27         (3)  The Office of Economic and Demographic Research

28  shall develop and maintain a system and program of data

29  collection to enable the commission to assess the cumulative

30  impact of mandated health benefits on an ongoing basis and the

31  impact of legislation proposing mandated health benefits.

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  1         (4)  The commission shall not be considered an agency

  2  or part of an agency for purposes of chapter 120.

  3         Section 2.  Section 624.215, Florida Statutes, is

  4  amended to read:

  5         624.215  Proposals for legislation which mandates

  6  health benefit coverage; review by Legislature.--

  7         (1)  LEGISLATIVE INTENT.--The Legislature finds that

  8  there has been a dramatic increase in the is an increasing

  9  number of proposals which mandate that certain health benefits

10  be provided by insurers and health maintenance organizations

11  as components of individual and group policies.  The

12  Legislature further finds that many of these mandated health

13  benefits provide beneficial social and health consequences

14  which may be in the public interest.  However, the Legislature

15  also finds recognizes that most mandated health benefits

16  contribute to the increasing cost of health insurance

17  premiums.  Therefore, it is the intent of the Legislature to

18  conduct a systematic review of current and proposed mandated

19  health benefits or mandatorily offered health coverages and to

20  establish a process guidelines for conducting such a review.

21  This review will assist the Legislature in determining whether

22  or not a particular mandated health benefit mandating a

23  particular coverage is in the public interest.

24         (2)  DEFINITION.--For purposes of this section,

25  "mandated health benefits" are requirements imposed upon

26  health benefit plans offered by health insurers or health

27  maintenance organizations to provide their insureds,

28  policyholders, or subscribers with coverage for specific

29  health care services, treatments, drugs, or supplies;

30  particular health conditions; certain providers of health care

31  services; or certain persons because of their relation to the

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  1  covered individual. "Mandated health benefits" includes

  2  requirements to offer or make available optional coverages.

  3         (3)(2)  MANDATED HEALTH BENEFITS COVERAGE; REPORT TO

  4  ADVISORY COMMISSION ON MANDATED HEALTH BENEFITS AGENCY FOR

  5  HEALTH CARE ADMINISTRATION AND LEGISLATIVE COMMITTEES;

  6  CRITERIA GUIDELINES FOR ASSESSING IMPACT.--Every person or

  7  organization seeking consideration of legislation containing a

  8  mandated health benefit must submit to the Advisory Commission

  9  on Mandated Health Benefits, at the time the proposal is filed

10  in either house, an impact assessment of the proposal

11  conducted by certified actuaries and other appropriate

12  professionals using the criteria set forth in this subsection.

13  If the proponents submit an impact assessment meeting the

14  requirements of this section and rules adopted by the

15  commission, the commission shall prepare its own impact

16  assessment and, upon completion, submit its assessment to the

17  presiding officers of both houses.  In preparing its own

18  assessment, the commission shall consider the assessment

19  submitted by proponents of the proposed mandated health

20  benefit and similar assessments conducted by other entities,

21  including state agencies, insurers, and health maintenance

22  organizations.  The criteria used by proponents and the

23  commission in assessing the social and financial impacts of

24  proposed mandated health benefits a legislative proposal which

25  would mandate a health coverage or the offering of a health

26  coverage by an insurance carrier, health care service

27  contractor, or health maintenance organization as a component

28  of individual or group policies, shall submit to the Agency

29  for Health Care Administration and the legislative committees

30  having jurisdiction a report which assesses the social and

31  financial impacts of the proposed coverage. Guidelines for

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  1  assessing the impact of a proposed mandated or mandatorily

  2  offered health coverage, to the extent that information is

  3  available, shall include:

  4         (a)  For the social impact:

  5         1.(a)  To what extent is the treatment or service

  6  generally used by a significant portion of the population.

  7         2.(b)  To what extent is the insurance coverage

  8  generally available.

  9         3.(c)  If the insurance coverage is not generally

10  available, to what extent does the lack of coverage result in

11  persons avoiding necessary health care treatment.

12         4.(d)  If the coverage is not generally available, to

13  what extent does the lack of coverage result in unreasonable

14  financial hardship.

15         5.(e)  The level of public demand for the treatment or

16  service.

17         6.(f)  The level of public demand for insurance

18  coverage of the treatment or service.

19         7.(g)  The level of interest of collective bargaining

20  agents in negotiating for the inclusion of this coverage in

21  group contracts.

22         8.  To what extent can the expressed need be met

23  through other alternatives.

24         (b)  For the financial impact:

25         1.(h)  To what extent will the coverage increase or

26  decrease the cost of the treatment or service.

27         2.(i)  To what extent will the coverage increase the

28  appropriate uses of the treatment or service.

29         3.(j)  To what extent will the mandated treatment or

30  service be a substitute for a more expensive treatment or

31  service.

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  1         4.(k)  To what extent will the coverage increase or

  2  decrease the administrative expenses of insurance companies

  3  and the premium and administrative expenses of policyholders

  4  or subscribers.

  5         5.  To what extent will the coverage increase or

  6  decrease the premium costs of policyholders or subscribers.

  7         6.(l)  The impact of this coverage on the total cost of

  8  health care.

  9         7.  The cumulative impact of all mandated health

10  benefits on the ability and willingness of employers to

11  purchase health benefit plans for their employees, or maintain

12  or improve the terms of coverage for their employees.

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14  A bill proposing a mandated health benefit shall not be

15  considered by any committee in the Senate or the House of

16  Representatives unless and until the commission has submitted

17  its impact assessment to the presiding officers of the Senate

18  and the House of Representatives, except as otherwise provided

19  in joint rules adopted by the Senate and the House of

20  Representatives or in rules applicable to either the Senate or

21  the House of Representatives.

22         (4)  AUTOMATIC REPEAL OF MANDATED HEALTH BENEFITS.--

23         (a)  Any mandated health benefit enacted on or after

24  July 1, 2000, shall stand repealed 5 years after the date

25  enacted, unless otherwise reenacted by the Legislature.

26         (b)  The repeal of a mandated health benefit under

27  paragraph (a) shall not apply to an insurance policy or health

28  maintenance organization contract in existence on the

29  effective date of the repeal but shall apply to any renewal or

30  extension of such policy or contract, or issuance of any new

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  1  policy or contract, on or after the effective date of the

  2  repealer.

  3         Section 3.  There is hereby appropriated from the

  4  Insurance Commissioner's Regulatory Trust Fund an amount

  5  sufficient to implement this act.

  6         Section 4.  This act shall take effect upon becoming a

  7  law.

  8

  9            *****************************************

10                          HOUSE SUMMARY

11
      Creates the Advisory Commission on Mandated Health
12    Benefits to review legislation proposing mandated health
      benefits and manage the impacts of such benefits. Defines
13    mandated health benefits, requires any person or
      organization seeking consideration of legislation
14    proposing a mandated health benefit to submit an impact
      assessment to the commission, and specifies criteria to
15    assess the social and financial impacts of such proposed
      mandated health benefits. See bill for details.
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