Senate Bill 2152
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Florida Senate - 2000 SB 2152
By Senator Latvala
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1 A bill to be entitled
2 An act relating to health insurance; amending
3 s. 216.136, F.S.; creating the Mandated Health
4 Insurance Benefits and Providers Estimating
5 Conference; providing for membership and duties
6 of the conference; providing duties of
7 legislative committees that have jurisdiction
8 over health insurance matters; amending s.
9 624.215, F.S.; providing that certain
10 legislative proposals must be submitted to and
11 assessed by the conference, rather than the
12 Agency for Health Care Administration; amending
13 guidelines for assessing the impact of a
14 proposal to legislatively mandate certain
15 health coverage; providing prerequisites to
16 legislative consideration of such proposals;
17 providing an effective date.
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19 Be It Enacted by the Legislature of the State of Florida:
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21 Section 1. Subsection (12) is added to section
22 216.136, Florida Statutes, to read:
23 216.136 Consensus estimating conferences; duties and
24 principals.--
25 (12) MANDATED HEALTH INSURANCE BENEFITS AND PROVIDERS
26 ESTIMATING CONFERENCE.--
27 (a) Duties.--The Mandated Health Insurance Benefits
28 and Providers Estimating Conference shall:
29 1. Develop and maintain, with the Department of
30 Insurance, a system and program of data collection to assess
31 the impact of mandated benefits and providers, including costs
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1 to employers and insurers, impact of treatment, cost savings
2 in the health care system, number of providers, and other
3 appropriate data.
4 2. Prescribe the format, content, and timing of
5 information that is to be submitted to the conference and used
6 by the conference in its assessment of proposed and existing
7 mandated benefits and providers. Such format, content, and
8 timing requirements are binding upon all parties submitting
9 information for the conference to use in its assessment of
10 proposed and existing mandated benefits and providers.
11 3. Provide assessments of proposed and existing
12 mandated benefits and providers and other studies of mandated
13 benefits and provider issues as requested by the Legislature
14 or the Governor. When a legislative measure containing a
15 mandated health insurance benefit or provider is proposed, the
16 standing committee of the Legislature which has jurisdiction
17 over the proposal shall request that the conference prepare
18 and forward to the Governor and the Legislature a study that
19 provides, for each measure, a cost-benefit analysis that
20 assesses the social and financial impact and the medical
21 efficacy according to prevailing medical standards of the
22 proposed mandate. The conference has 12 months after the
23 committee makes its request in which to complete and submit
24 the conference's report. The standing committee may not
25 consider such a proposed legislative measure until 12 months
26 after it has requested the report and has received the
27 conference's report on the measure.
28 4. The standing committees of the Legislature which
29 have jurisdiction over health insurance matters shall request
30 that the conference assess the social and financial impact and
31 the medical efficacy of existing mandated benefits and
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1 providers. The committees shall submit to the conference by
2 January 1, 2001, a schedule of evaluations that sets forth the
3 respective dates by which the conference must have completed
4 its evaluations of particular existing mandates.
5 (b) Principals.--The Executive Office of the Governor,
6 the Insurance Commissioner, the Director of the Division of
7 Economic and Demographic Research of the Joint Legislative
8 Management Committee, and professional staff of the Senate and
9 the House of Representatives who have health insurance
10 expertise, or their designees, are the principals of the
11 Mandated Health Insurance Benefits and Providers Estimating
12 Conference. The responsibility of presiding over sessions of
13 the conference shall be rotated among the principals.
14 Section 2. Section 624.215, Florida Statutes, is
15 amended to read:
16 624.215 Proposals for legislation which mandates
17 health benefit coverage; review by Legislature.--
18 (1) LEGISLATIVE INTENT.--The Legislature finds that
19 there is an increasing number of proposals which mandate that
20 certain health benefits be provided by insurers and health
21 maintenance organizations as components of individual and
22 group policies. The Legislature further finds that many of
23 these benefits provide beneficial social and health
24 consequences which may be in the public interest. However,
25 the Legislature also recognizes that most mandated benefits
26 contribute to the increasing cost of health insurance
27 premiums. Therefore, it is the intent of the Legislature to
28 conduct a systematic review of current and proposed mandated
29 or mandatorily offered health coverages and to establish
30 guidelines for such a review. This review will assist the
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1 Legislature in determining whether mandating a particular
2 coverage is in the public interest.
3 (2) MANDATED HEALTH COVERAGE; REPORT TO THE MANDATED
4 HEALTH INSURANCE BENEFITS AND PROVIDERS ESTIMATING CONFERENCE
5 AGENCY FOR HEALTH CARE ADMINISTRATION AND LEGISLATIVE
6 COMMITTEES; GUIDELINES FOR ASSESSING IMPACT.--Every person or
7 organization seeking consideration of a legislative proposal
8 which would mandate a health coverage or the offering of a
9 health coverage by an insurance carrier, health care service
10 contractor, or health maintenance organization as a component
11 of individual or group policies, shall submit to the Mandated
12 Health Insurance Benefits and Providers Estimating Conference
13 Agency for Health Care Administration and the legislative
14 committees having jurisdiction a report which assesses the
15 social and financial impacts of the proposed coverage.
16 Guidelines for assessing the impact of a proposed mandated or
17 mandatorily offered health coverage must, to the extent that
18 information is available, shall include:
19 (a) To what extent is the treatment or service
20 generally used by a significant portion of the population.
21 (b) To what extent is the insurance coverage generally
22 available.
23 (c) If the insurance coverage is not generally
24 available, to what extent does the lack of coverage result in
25 persons avoiding necessary health care treatment.
26 (d) If the coverage is not generally available, to
27 what extent does the lack of coverage result in unreasonable
28 financial hardship.
29 (e) The level of public demand for the treatment or
30 service.
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1 (f) The level of public demand for insurance coverage
2 of the treatment or service.
3 (g) The level of interest of collective bargaining
4 agents in negotiating for the inclusion of this coverage in
5 group contracts.
6 (h) A report, prepared by a certified actuary, of the
7 extent to which To what extent will the coverage will increase
8 or decrease the cost of the treatment or service.
9 (i) A report, prepared by a certified actuary, of the
10 extent to which To what extent will the coverage will increase
11 the appropriate uses of the treatment or service.
12 (j) A report, prepared by a certified actuary, of the
13 extent to which To what extent will the mandated treatment or
14 service will be a substitute for a more expensive treatment or
15 service.
16 (k) A report, prepared by a certified actuary, of the
17 extent to which To what extent will the coverage will increase
18 or decrease the administrative expenses of insurance companies
19 and the premium and administrative expenses of policyholders.
20 (l) A report, prepared by a certified actuary, as to
21 the impact of this coverage on the total cost of health care.
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23 The standing committee of the Legislature which has
24 jurisdiction over the legislative proposal must request and
25 receive a report from the Mandated Health Insurance Benefits
26 and Providers Estimating Conference before the committee
27 considers the proposal. The committee may not consider a
28 legislative proposal that would mandate a health coverage or
29 the offering of a health coverage by an insurance carrier,
30 health care service contractor, or health maintenance
31 organization until after the committee's request to the
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Florida Senate - 2000 SB 2152
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1 Mandated Health Insurance Benefits and Providers Estimating
2 Conference has been answered. As used in this section, the
3 term "health coverage mandate" includes mandating the use of a
4 type of provider.
5 Section 3. This act shall take effect July 1, 2000.
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8 SENATE SUMMARY
9 Creates the Mandated Health Insurance Benefits and
Providers Estimating Conference. Provides for conference
10 membership and duties. Provides duties of legislative
committees that have jurisdiction over health insurance
11 matters. Provides that certain proposals for legislative
enactment of health care mandates must be submitted to
12 and assessed by the conference, rather than the Agency
for Health Care Administration. Amends guidelines for
13 assessing the impact of such proposals. Provides that the
conference must have submitted its report on any such
14 proposal before a legislative committee may consider the
proposal.
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