| 1 | The Insurance Committee recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to a health insurance plan study group; |
| 7 | creating a health insurance plan study group; specifying |
| 8 | membership; providing for staff support for the study |
| 9 | group; requiring the study group to investigate certain |
| 10 | issues relating to high deductible health insurance plans; |
| 11 | requiring the group to meet and submit recommendations to |
| 12 | the Governor and Legislature; providing an effective date. |
| 13 |
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| 14 | Be It Enacted by the Legislature of the State of Florida: |
| 15 |
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| 16 | Section 1. (1)(a) A 13-member health insurance plan study |
| 17 | group is created, to be composed of: |
| 18 | 1. Three representatives of employers offering high |
| 19 | deductible health plans to their employees, one of whom shall be |
| 20 | appointed by the Florida Chamber of Commerce, one by the |
| 21 | National Federation of Independent Business, and one by |
| 22 | Associated Industries of Florida. Of these representatives, one |
| 23 | shall be a small employer as defined in s. 627.6699, Florida |
| 24 | Statutes. |
| 25 | 2. Three representatives of commercial health plans, to be |
| 26 | appointed by the America's Health Insurance Plans. |
| 27 | 3. Three representatives of hospitals, one of whom shall |
| 28 | be a representative of a statutory teaching hospital, to be |
| 29 | appointed by the Florida Hospital Association. |
| 30 | 4. Two physician representatives, one appointed by the |
| 31 | Florida Medical Association and one appointed by the Florida |
| 32 | Osteopathic Medical Association. |
| 33 | 5. The Secretary of the Agency for Health Care |
| 34 | Administration, who shall serve as co-chair. |
| 35 | 6. The Director of the Office of Insurance Regulation, who |
| 36 | shall serve as co-chair. |
| 37 | (b) Staff support for the study group shall be provided |
| 38 | jointly by the Agency for Health Care Administration and the |
| 39 | Office of Insurance Regulation. |
| 40 | (2) The study group shall study the following issues |
| 41 | related to high deductible health insurance plans, including, |
| 42 | but not limited to, health savings accounts and health |
| 43 | reimbursement arrangements: |
| 44 | (a) The impact of high deductibles on access to health |
| 45 | care services and pharmaceutical benefits. |
| 46 | (b) The impact of high deductibles on use of health care |
| 47 | services and overuse of health care services. |
| 48 | (c) The impact on hospitals' inability to collect |
| 49 | deductibles and copayments. |
| 50 | (d) The ability of hospitals and insureds to determine, |
| 51 | prior to service delivery, the level of deductible and copayment |
| 52 | required of the insured. |
| 53 | (e) The methods to assist hospitals and insureds to |
| 54 | determine prior to service delivery status of the insured in |
| 55 | meeting annual deductible requirements and any subsequent |
| 56 | copayments. |
| 57 | (f) The methods to assist hospitals in the collection of |
| 58 | deductibles and copayments, including electronic payments. |
| 59 | (g) Alternative approaches to the collection of |
| 60 | deductibles and copayments when either the amounts of patient |
| 61 | financial responsibility are unknown in advance or there are no |
| 62 | funds electronically available from the patient to pay for the |
| 63 | deductible and any associated copayment. |
| 64 | (3) The study group shall also study the following issues |
| 65 | in addition to those specified in subsection (2): |
| 66 | (a) The assignment of benefits attestations and contract |
| 67 | provisions which nullify the attestations of insureds. |
| 68 | (b) The standardization of insured or subscriber |
| 69 | identification cards. |
| 70 | (c) The standardization of claim edits or insuring that |
| 71 | claim edits comply with nationally recognized editing |
| 72 | guidelines. |
| 73 | (d) The provision of comparative cost information to |
| 74 | insureds and subscribers. |
| 75 | (4) The study group shall meet by August 1, 2005, and |
| 76 | shall submit recommendations to the Governor, the President of |
| 77 | the Senate, and the Speaker of the House of Representatives by |
| 78 | January 1, 2006. |
| 79 | Section 2. This act shall take effect July 1, 2005. |