Senate Bill 2156

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    Florida Senate - 2000                                  SB 2156

    By Senator Holzendorf





    2-1355-00

  1                      A bill to be entitled

  2         An act relating to health insurance; amending

  3         s. 624.215, Florida Statutes; defining the term

  4         "mandated health benefit"; providing an

  5         effective date.

  6

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

  8

  9         Section 1.  Section 624.215, Florida Statutes, is

10  amended to read:

11         624.215  Proposals for legislation which mandates

12  health benefit coverage; review by Legislature.--

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

14  there is an increasing number of proposals which mandate that

15  certain health benefits be provided by insurers and health

16  maintenance organizations as components of individual and

17  group policies.  The Legislature further finds that many of

18  these benefits provide beneficial social and health

19  consequences which may be in the public interest.  However,

20  the Legislature also recognizes that most mandated benefits

21  contribute to the increasing cost of health insurance

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

23  conduct a systematic review of current and proposed mandated

24  or mandatorily offered health coverages and to establish

25  guidelines for such a review.  This review will assist the

26  Legislature in determining whether mandating a particular

27  coverage is in the public interest.

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

29  "mandated health benefit" is a statutory requirement imposed

30  upon health benefit plans offered by health insurers or health

31  maintenance organizations to provide their insureds,

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    Florida Senate - 2000                                  SB 2156
    2-1355-00




  1  policyholders, or subscribers with coverage for specific

  2  health care services, treatments, drugs, or supplies; coverage

  3  for particular health conditions; coverage for certain

  4  providers of health care services; or coverage for certain

  5  persons because of their relation to the covered individual.

  6         (3)(2)  MANDATED HEALTH COVERAGE; REPORT TO AGENCY FOR

  7  HEALTH CARE ADMINISTRATION AND LEGISLATIVE COMMITTEES;

  8  GUIDELINES FOR ASSESSING IMPACT.--Every person or organization

  9  seeking consideration of a legislative proposal which would

10  mandate a health coverage or the offering of a health coverage

11  by an insurance carrier, health care service contractor, or

12  health maintenance organization as a component of individual

13  or group policies, shall submit to the Agency for Health Care

14  Administration and the legislative committees having

15  jurisdiction a report which assesses the social and financial

16  impacts of the proposed coverage. Guidelines for assessing the

17  impact of a proposed mandated or mandatorily offered health

18  coverage, to the extent that information is available, shall

19  include:

20         (a)  To what extent is the treatment or service

21  generally used by a significant portion of the population.

22         (b)  To what extent is the insurance coverage generally

23  available.

24         (c)  If the insurance coverage is not generally

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

26  persons avoiding necessary health care treatment.

27         (d)  If the coverage is not generally available, to

28  what extent does the lack of coverage result in unreasonable

29  financial hardship.

30         (e)  The level of public demand for the treatment or

31  service.

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    Florida Senate - 2000                                  SB 2156
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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)  To what extent will the coverage increase or

  7  decrease the cost of the treatment or service.

  8         (i)  To what extent will the coverage increase the

  9  appropriate uses of the treatment or service.

10         (j)  To what extent will the mandated treatment or

11  service be a substitute for a more expensive treatment or

12  service.

13         (k)  To what extent will the coverage increase or

14  decrease the administrative expenses of insurance companies

15  and the premium and administrative expenses of policyholders.

16         (l)  The impact of this coverage on the total cost of

17  health care.

18         Section 2.  This act shall take effect July 1, 2000.

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21                          SENATE SUMMARY

22    Defines the term "mandated health benefit" for purposes
      of assessing the effects of legislative proposals
23    mandating benefits.

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