Senate Bill sb0482c1

    Florida Senate - 2006                            CS for SB 482

    By the Committee on Banking and Insurance; and Senator Bullard





    597-2362-06

  1                      A bill to be entitled

  2         An act relating to congenital craniofacial

  3         anomalies; requiring that the Agency for Health

  4         Care Administration, in consultation with the

  5         Office of Insurance Regulation, conduct a study

  6         concerning the medical necessity, costs, and

  7         efficacy of mandating coverage for certain

  8         treatments and therapies; providing an

  9         appropriation; requiring that the agency report

10         its findings and recommendations to the

11         Legislature; providing an effective date.

12  

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

14  

15         Section 1.  (1)  The Agency for Health Care

16  Administration, in consultation with the Office of Insurance

17  Regulation, shall conduct a study evaluating the medical

18  necessity, efficacy, and costs associated with mandating

19  health insurers and health maintenance organizations to

20  provide coverage for cranial skull molding orthotics and other

21  therapies used in the treatment of deformational or positional

22  plagiocephaly. The agency and office shall evaluate whether or

23  not gaps in coverage currently exist in the small and large

24  group insurance markets for medically necessary care and

25  treatment of plagiocephaly. The agency shall provide

26  information concerning the types of benefits, including the

27  cost of such benefits, provided to Medicaid recipients for the

28  treatment of plagiocephaly, and the demographic

29  characteristics of such Medicaid recipients. The Department of

30  Health shall coordinate with the agency to provide such

31  information concerning coverage and costs provided to children

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2006                            CS for SB 482
    597-2362-06




 1  having plagiocephaly who are enrolled in the Children's

 2  Medical Services Program.

 3         (2)  The agency, in consultation with the office, may

 4  contract with an actuary who is a member of the American

 5  Academy of Actuaries and other persons who have an extensive

 6  background in health insurance for the purpose of assisting

 7  the agency in evaluating the medically necessity, efficacy,

 8  and costs of such coverage. The agency shall report its

 9  findings and recommendations related to mandating insurance

10  coverage for the treatment of plagiocephaly to the President

11  of the Senate and the Speaker of the House of Representatives

12  no later than January 1, 2007.

13         Section 2.  For the 2006-2007 fiscal year, the sum of

14  $25,000 is appropriated in nonrecurring funds from the

15  Insurance Regulatory Trust Fund to the Office of Insurance

16  Regulation for the purpose of funding the study conducted by

17  the Agency for Health Care Administration as provided in this

18  act.

19         Section 3.  This act shall take effect on July 1, 2006.

20  

21          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
22                         Senate Bill 482

23                                 

24  1.   Requires the Agency for Health Care Administration, in
         consultation with the Office of Insurance Regulation, to
25       conduct a study evaluating the medical necessity,
         efficacy, and costs associated with mandating health
26       insurance coverage for cranial skull molding orthotics
         and other therapies used in the treatment of certain
27       craniofacial anomalies.

28  

29  

30  

31  

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CODING: Words stricken are deletions; words underlined are additions.