Senate Bill 2152

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    Florida Senate - 2000                                  SB 2152

    By Senator Latvala





    19-819A-00

  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.

18

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

20

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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    Florida Senate - 2000                                  SB 2152
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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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    Florida Senate - 2000                                  SB 2152
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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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    Florida Senate - 2000                                  SB 2152
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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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    Florida Senate - 2000                                  SB 2152
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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
    19-819A-00




  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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