Senate Bill sb2678e1

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    CS for CS for SB 2678                          First Engrossed



  1                      A bill to be entitled

  2         An act relating to health care practice

  3         parameters; repealing s. 408.02, F.S., relating

  4         to practice parameters; amending s. 440.13,

  5         F.S.; providing for practice parameters and

  6         protocols; amending ss. 440.134, 627.6418,

  7         627.6613, F.S., relating to worker's

  8         compensation managed care plans and health

  9         insurance policy coverage for mammograms;

10         removing references and legislative intent, to

11         conform; providing legislative intent that the

12         statutory requirements conform to certain

13         parameters relating to mammograms; amending s.

14         409.904, F.S.; postponing the effective date of

15         changes to standards for eligibility for

16         certain optional medical assistance, including

17         coverage under the medically needy program;

18         providing appropriations; providing for

19         retroactive application; providing effective

20         dates.

21  

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

23  

24         Section 1.  Section 408.02, Florida Statutes, is

25  repealed.

26         Section 2.  Subsection (15) of section 440.13, Florida

27  Statutes, is amended to read:

28         440.13  Medical services and supplies; penalty for

29  violations; limitations.--

30         (15)  PRACTICE PARAMETERS.--The practice parameters and

31  protocols mandated under this chapter shall be the Workers'


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    CS for CS for SB 2678                          First Engrossed



 1  Compensation Utilization Management Standards adopted by the

 2  American Accreditation Health Care Commission in effect on

 3  January 1, 2003.

 4         (a)  The Agency for Health Care Administration, in

 5  conjunction with the department and appropriate health

 6  professional associations and health-related organizations

 7  shall develop and may adopt by rule scientifically sound

 8  practice parameters for medical procedures relevant to

 9  workers' compensation claimants. Practice parameters developed

10  under this section must focus on identifying effective

11  remedial treatments and promoting the appropriate utilization

12  of health care resources. Priority must be given to those

13  procedures that involve the greatest utilization of resources

14  either because they are the most costly or because they are

15  the most frequently performed. Practice parameters for

16  treatment of the 10 top procedures associated with workers'

17  compensation injuries including the remedial treatment of

18  lower-back injuries must be developed by December 31, 1994.

19         (b)  The guidelines may be initially based on

20  guidelines prepared by nationally recognized health care

21  institutions and professional organizations but should be

22  tailored to meet the workers' compensation goal of returning

23  employees to full employment as quickly as medically possible,

24  taking into consideration outcomes data collected from managed

25  care providers and any other inpatient and outpatient

26  facilities serving workers' compensation claimants.

27         (c)  Procedures must be instituted which provide for

28  the periodic review and revision of practice parameters based

29  on the latest outcomes data, research findings, technological

30  advancements, and clinical experiences, at least once every 3

31  years.


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    CS for CS for SB 2678                          First Engrossed



 1         (d)  Practice parameters developed under this section

 2  must be used by carriers and the agency in evaluating the

 3  appropriateness and overutilization of medical services

 4  provided to injured employees.

 5         Section 3.  Subsection (11) of section 440.134, Florida

 6  Statutes, is amended to read:

 7         440.134  Workers' compensation managed care

 8  arrangement.--

 9         (11)  A description of the use of workers' compensation

10  practice parameters and protocols for treatment for health

11  care services when adopted by the agency.

12         Section 4.  Subsection (1) of section 627.6418, Florida

13  Statutes, is amended to read:

14         627.6418  Coverage for mammograms.--

15         (1)  An accident or health insurance policy issued,

16  amended, delivered, or renewed in this state must provide

17  coverage for at least the following:

18         (a)  A baseline mammogram for any woman who is 35 years

19  of age or older, but younger than 40 years of age.

20         (b)  A mammogram every 2 years for any woman who is 40

21  years of age or older, but younger than 50 years of age, or

22  more frequently based on the patient's physician's

23  recommendation.

24         (c)  A mammogram every year for any woman who is 50

25  years of age or older.

26         (d)  One or more mammograms a year, based upon a

27  physician's recommendation, for any woman who is at risk for

28  breast cancer because of a personal or family history of

29  breast cancer, because of having a history of biopsy-proven

30  benign breast disease, because of having a mother, sister, or

31  


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    CS for CS for SB 2678                          First Engrossed



 1  daughter who has or has had breast cancer, or because a woman

 2  has not given birth before the age of 30.

 3  

 4  It is the intent of the Legislature that, the requirements of

 5  this section conform to the practice parameters relating to

 6  mammograms as recognized by the United States Agency for

 7  Healthcare Research and Quality when practice parameters for

 8  the delivery of mammography services are developed pursuant to

 9  s. 408.02(7), the Legislature review the requirements of this

10  section and conform to the practice parameters.

11         Section 5.  Subsection (1) of section 627.6613, Florida

12  Statutes, is amended to read:

13         627.6613  Coverage for mammograms.--

14         (1)  A group, blanket, or franchise accident or health

15  insurance policy issued, amended, delivered, or renewed in

16  this state must provide coverage for at least the following:

17         (a)  A baseline mammogram for any woman who is 35 years

18  of age or older, but younger than 40 years of age.

19         (b)  A mammogram every 2 years for any woman who is 40

20  years of age or older, but younger than 50 years of age, or

21  more frequently based on the patient's physician's

22  recommendation.

23         (c)  A mammogram every year for any woman who is 50

24  years of age or older.

25         (d)  One or more mammograms a year, based upon a

26  physician's recommendation, for any woman who is at risk for

27  breast cancer because of a personal or family history of

28  breast cancer, because of having a history of biopsy-proven

29  benign breast disease, because of having a mother, sister, or

30  daughter who has or has had breast cancer, or because a woman

31  has not given birth before the age of 30.


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    CS for CS for SB 2678                          First Engrossed



 1  

 2  It is the intent of the Legislature that the requirements of

 3  this section conform to the practice parameters relating to

 4  mammograms as recognized by the United States Agency for

 5  Healthcare Research and Quality, when practice parameters for

 6  the delivery of mammography services are developed pursuant to

 7  s. 408.02(7), the Legislature review the requirements of this

 8  section and conform to the practice parameters.

 9         Section 6.  Effective May 1, 2003, subsection (2) of

10  section 409.904, Florida Statutes, is amended to read:

11         409.904  Optional payments for eligible persons.--The

12  agency may make payments for medical assistance and related

13  services on behalf of the following persons who are determined

14  to be eligible subject to the income, assets, and categorical

15  eligibility tests set forth in federal and state law.  Payment

16  on behalf of these Medicaid eligible persons is subject to the

17  availability of moneys and any limitations established by the

18  General Appropriations Act or chapter 216.

19         (2)  A caretaker relative or parent, a pregnant woman,

20  a child under age 19 who would otherwise qualify for Florida

21  Kidcare Medicaid, a child up to age 21 who would otherwise

22  qualify under s. 409.903(1), a person age 65 or over, or a

23  blind or disabled person, who would otherwise be eligible for

24  Florida Medicaid, except that the income or assets of such

25  family or person exceed established limitations. For a family

26  or person in one of these coverage groups, medical expenses

27  are deductible from income in accordance with federal

28  requirements in order to make a determination of eligibility.

29  Expenses used to meet spend-down liability are not

30  reimbursable by Medicaid. Effective July May 1, 2003, when

31  determining the eligibility of a pregnant woman, a child, or


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    CS for CS for SB 2678                          First Engrossed



 1  an aged, blind, or disabled individual, $270 shall be deducted

 2  from the countable income of the filing unit. When determining

 3  the eligibility of the parent or caretaker relative as defined

 4  by Title XIX of the Social Security Act, the additional income

 5  disregard of $270 does not apply. A family or person eligible

 6  under the coverage known as the "medically needy," is eligible

 7  to receive the same services as other Medicaid recipients,

 8  with the exception of services in skilled nursing facilities

 9  and intermediate care facilities for the developmentally

10  disabled.

11         Section 7.  The non-recurring sums of $8,265,777 from

12  the General Revenue Fund, $2,505,224 from the Grants and

13  Donations Trust Fund, and $11,727,287 from the Medical Care

14  Trust Fund are appropriated to the Agency for Health Care

15  Administration to implement section 6 of this act during the

16  2002-2003 fiscal year. This section takes effect May 1, 2003.

17         Section 8.  Except as otherwise expressly provided,

18  this act shall take July 1, 2003, but if it becomes a law

19  after May 1, 2003, sections 6 and 7 of this act shall operate

20  retroactively to that date.

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