Senate Bill sb0168

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    Florida Senate - 2001                                   SB 168

    By Senators Wasserman Schultz and Geller





    29-116-01

  1                      A bill to be entitled

  2         An act relating to health insurance; creating

  3         the "Equity in Prescription Insurance and

  4         Contraceptive Coverage Act"; providing

  5         legislative findings and intent; providing

  6         requirements with respect to plans provided by

  7         religious health plan sponsors; creating ss.

  8         627.64061, 627.65741, F.S., and amending

  9         641.31, F.S.; requiring certain health

10         insurance policies and health maintenance

11         contracts to provide coverage for prescription

12         oral contraceptives; amending s. 627.6515,

13         F.S.; applying certain requirements for group

14         coverage to out-of-state groups; amending s.

15         627.6699, F.S.; applying certain requirements

16         for group coverage relating to prescription

17         oral contraceptives to small employer carriers

18         issuing health benefit plans; providing an

19         effective date.

20

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

22

23         Section 1.  This act may be cited as the "Equity in

24  Prescription Insurance and Contraceptive Coverage Act."

25         Section 2.  Legislative findings and intent.--

26         (1)  The Legislature finds that:

27         (a)  Each year, more than half of all pregnancies in

28  this state are unintended.

29         (b)  Contraceptive services are part of basic health

30  care, allowing families to both adequately space desired

31  pregnancies and avoid unintended pregnancy.

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  1         (c)  Contraceptives are highly cost effective, yielding

  2  from $4 to $14 dollars in savings for every dollar expended.

  3         (d)  By reducing rates of unintended pregnancy,

  4  contraceptives help reduce the need for abortions.

  5         (e)  Unintended pregnancies lead to higher rates of

  6  infant mortality, low birth weight, and maternal morbidity and

  7  threaten the economic viability of families.

  8         (f)  Most women in this state of childbearing age rely

  9  on private employment-related insurance to cover their medical

10  expenses.

11         (g)  Most private insurers cover prescription drugs,

12  but many exclude coverage for prescription contraceptives.

13         (h)  The lack of contraceptive coverage in health

14  insurance policies places many effective forms of

15  contraceptives beyond the financial reach of many women,

16  leading to unintended pregnancies.

17         (2)  Therefore, the Legislature determines that

18  enactment of this bill constitutes an important state

19  interest.

20         Section 3.  Option for plans and policyholders of plans

21  provided by religious health plan sponsors.

22         (1)  GENERAL RULE.--Notwithstanding any other provision

23  of section 627.64061 or section 627.65741, Florida Statutes, a

24  religious health plan sponsor may provide a health plan that

25  does not provide benefits for prescription oral contraceptives

26  that are contrary to the religious tenets of the religion or

27  religious corporation, association, or society referred to in

28  subsection (3). Further, the requirements of section 627.64061

29  or section 627.65741, Florida Statutes, do not apply to an

30  individual health care service plan contract or a group health

31  care service plan contract purchased by an employer that is a

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    Florida Senate - 2001                                   SB 168
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  1  religious health plan sponsor, including, but not limited to,

  2  any church, religious school, religious association, or other

  3  religious organization that is not organized for private

  4  profit, if the provision of prescription oral contraceptives

  5  under such sections is inconsistent with the religious beliefs

  6  of the organization. 

  7         (2)  EXCEPTION.--This section does not authorize the

  8  exclusion of coverage under a health plan of prescription oral

  9  contraceptives necessary to preserve the life or health of the

10  patient.

11         (3)  DEFINITION.--As used in this section, the term

12  "religious health plan sponsor" means a health plan sponsor

13  that meets the definition of "church plan" under s. 3(33) of

14  the Employee Retirement Income Security Act of 1974.

15         (4)  This act does not require coverage for chemically

16  induced abortions.

17         Section 4.  Section 627.64061, Florida Statutes, is

18  created to read:

19         627.64061  Coverage for prescription contraceptives.--A

20  health insurance policy that provides coverage for outpatient

21  prescription drugs must cover prescription oral contraceptives

22  approved by the federal Food and Drug Administration and

23  prescribed by a practitioner authorized by state licensure to

24  prescribe such medication.  Coverage must be provided to the

25  same extent and subject to the same contract terms, including

26  copayments and deductibles, as any other prescription drug.

27         Section 5.  Paragraph (c) of subsection (2) of section

28  627.6515, Florida Statutes, is amended to read:

29         627.6515  Out-of-state groups.--

30

31

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  1         (2)  This part does not apply to a group health

  2  insurance policy issued or delivered outside this state under

  3  which a resident of this state is provided coverage if:

  4         (c)  The policy provides the benefits specified in ss.

  5  627.419, 627.6574, 627.65741, 627.6575, 627.6579, 627.6612,

  6  627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691,

  7  and 627.66911.

  8         Section 6.  Section 627.65741, Florida Statutes, is

  9  created to read:

10         627.65741  Coverage for prescription contraceptives.--A

11  group, franchise, accident, or health insurance policy that

12  provides coverage for outpatient prescription drugs must cover

13  prescription oral contraceptives approved by the federal Food

14  and Drug Administration and prescribed by a practitioner

15  authorized by state licensure to prescribe such medication.

16  Coverage must be provided to the same extent and subject to

17  the same contract terms, including copayments and deductibles,

18  as any other prescription drug.

19         Section 7.  Paragraph (b) of subsection (12) of section

20  627.6699, Florida Statutes, is amended to read:

21         627.6699  Employee Health Care Access Act.--

22         (12)  STANDARD, BASIC, AND LIMITED HEALTH BENEFIT

23  PLANS.--

24         (b)1.  Each small employer carrier issuing new health

25  benefit plans shall offer to any small employer, upon request,

26  a standard health benefit plan and a basic health benefit plan

27  that meets the criteria set forth in this section.

28         2.  For purposes of this subsection, the terms

29  "standard health benefit plan" and "basic health benefit plan"

30  mean policies or contracts that a small employer carrier

31  offers to eligible small employers that contain:

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    Florida Senate - 2001                                   SB 168
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  1         a.  An exclusion for services that are not medically

  2  necessary or that are not covered preventive health services;

  3  and

  4         b.  A procedure for preauthorization by the small

  5  employer carrier, or its designees.

  6         3.  A small employer carrier may include the following

  7  managed care provisions in the policy or contract to control

  8  costs:

  9         a.  A preferred provider arrangement or exclusive

10  provider organization or any combination thereof, in which a

11  small employer carrier enters into a written agreement with

12  the provider to provide services at specified levels of

13  reimbursement or to provide reimbursement to specified

14  providers. Any such written agreement between a provider and a

15  small employer carrier must contain a provision under which

16  the parties agree that the insured individual or covered

17  member has no obligation to make payment for any medical

18  service rendered by the provider which is determined not to be

19  medically necessary.  A carrier may use preferred provider

20  arrangements or exclusive provider arrangements to the same

21  extent as allowed in group products that are not issued to

22  small employers.

23         b.  A procedure for utilization review by the small

24  employer carrier or its designees.

25

26  This subparagraph does not prohibit a small employer carrier

27  from including in its policy or contract additional managed

28  care and cost containment provisions, subject to the approval

29  of the department, which have potential for controlling costs

30  in a manner that does not result in inequitable treatment of

31  insureds or subscribers.  The carrier may use such provisions

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  1  to the same extent as authorized for group products that are

  2  not issued to small employers.

  3         4.  The standard health benefit plan shall include:

  4         a.  Coverage for inpatient hospitalization;

  5         b.  Coverage for outpatient services;

  6         c.  Coverage for newborn children pursuant to s.

  7  627.6575;

  8         d.  Coverage for child care supervision services

  9  pursuant to s. 627.6579;

10         e.  Coverage for adopted children upon placement in the

11  residence pursuant to s. 627.6578;

12         f.  Coverage for mammograms pursuant to s. 627.6613;

13         g.  Coverage for handicapped children pursuant to s.

14  627.6615;

15         h.  Emergency or urgent care out of the geographic

16  service area; and

17         i.  Coverage for services provided by a hospice

18  licensed under s. 400.602 in cases where such coverage would

19  be the most appropriate and the most cost-effective method for

20  treating a covered illness.

21         5.  The standard health benefit plan and the basic

22  health benefit plan may include a schedule of benefit

23  limitations for specified services and procedures.  If the

24  committee develops such a schedule of benefits limitation for

25  the standard health benefit plan or the basic health benefit

26  plan, a small employer carrier offering the plan must offer

27  the employer an option for increasing the benefit schedule

28  amounts by 4 percent annually.

29         6.  The basic health benefit plan shall include all of

30  the benefits specified in subparagraph 4.; however, the basic

31  health benefit plan shall place additional restrictions on the

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  1  benefits and utilization and may also impose additional cost

  2  containment measures.

  3         7.  Sections 627.419(2), (3), and (4), 627.6574,

  4  627.65741, 627.6612, 627.66121, 627.66122, 627.6616, 627.6618,

  5  627.668, and 627.66911 apply to the standard health benefit

  6  plan and to the basic health benefit plan. However,

  7  notwithstanding said provisions, the plans may specify limits

  8  on the number of authorized treatments, if such limits are

  9  reasonable and do not discriminate against any type of

10  provider.

11         8.  Each small employer carrier that provides for

12  inpatient and outpatient services by allopathic hospitals may

13  provide as an option of the insured similar inpatient and

14  outpatient services by hospitals accredited by the American

15  Osteopathic Association when such services are available and

16  the osteopathic hospital agrees to provide the service.

17         Section 8.  Subsection (40) is added to section 641.31,

18  Florida Statutes, to read:

19         641.31  Health maintenance contracts.--

20         (40)  A health maintenance contract that provides

21  coverage for outpatient prescription drugs must cover

22  prescription oral contraceptives approved by the federal Food

23  and Drug Administration and prescribed by a practitioner

24  authorized by state licensure to prescribe such medication

25  when such practitioner is under the organization's direct

26  employ or under contract or other arrangement with the

27  organization to provide health care services to subscribers.

28  Coverage must be provided to the same extent and subject to

29  the same contract terms, including copayments, as any other

30  prescription medication.

31         Section 9.  This act shall take effect October 1, 2001.

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    Florida Senate - 2001                                   SB 168
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  2                          SENATE SUMMARY

  3    Creates the Equity in Prescription Insurance and
      Contraceptive Coverage Act. Provides legislative findings
  4    and intent. Provides that a health maintenance contract,
      a health insurance policy, and any group, franchise,
  5    accident, or health insurance policy that provides
      coverage for outpatient prescription drugs must cover
  6    prescription oral contraceptives. Authorizes a religious
      health plan sponsor to provide a health plan that does
  7    not provide benefits for prescription oral contraceptives
      contrary to its beliefs.
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