Senate Bill sb0110c1

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    Florida Senate - 2007                            CS for SB 110

    By the Committee on Banking and Insurance; and Senators Hill,
    Justice, Argenziano, Peaden, Bullard, Wise, Dawson, Siplin,
    Bennett, Posey, Storms, Joyner, Lynn, Margolis, Jones and
    Lawson


    597-2115-07

  1                      A bill to be entitled

  2         An act relating to health insurance; creating

  3         the "Senator Les Miller Act"; creating ss.

  4         627.64091 and 627.6418, F.S., and amending s.

  5         641.31, F.S.; requiring that health insurance

  6         policies, group health insurance policies, and

  7         health maintenance contracts provide coverage

  8         for an annual screening for prostate cancer for

  9         men of a specified age or older; providing

10         requirements for the screening; providing that

11         coverage for prostate cancer screening does not

12         limit diagnostic benefits otherwise allowed

13         under the policy; amending s. 627.6515, F.S.;

14         providing for the benefit requirement to apply

15         to a group health insurance policy issued or

16         delivered outside the state; providing a

17         finding that the act fulfills an important

18         state interest; providing for application of

19         the act; providing an 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 "Senator Les

24  Miller Act."

25         Section 2.  Section 627.64091, Florida Statutes, is

26  created to read:

27         627.64091  Coverage for prostate cancer screening.--

28         (1)  A health insurance policy providing coverage to a

29  man age 40 or older must provide coverage for annual screening

30  for prostate cancer for such a man in accordance with the

31  

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    Florida Senate - 2007                            CS for SB 110
    597-2115-07




 1  prostate cancer early detection guidelines of the National

 2  Comprehensive Cancer Network.

 3         (2)  The coverage for prostate cancer screening shall

 4  consist, at a minimum, of the following tests:

 5         (a)  Prostate-specific antigen blood test; and

 6         (b)  Digital rectal examination.

 7         (3)  If a licensed medical practitioner recommends that

 8  an insured undergo a prostate-specific antigen blood test,

 9  coverage may not be denied because that person previously had

10  a digital rectal exam and the exam results were negative.

11         (4)  The benefits required by this section do not limit

12  diagnostic benefits otherwise allowable under the policy.

13         Section 3.  Paragraph (c) of subsection (2) of section

14  627.6515, Florida Statutes, is amended to read:

15         627.6515  Out-of-state groups.--

16         (2)  Except as otherwise provided in this part, this

17  part does not apply to a group health insurance policy issued

18  or delivered outside this state under which a resident of this

19  state is provided coverage if:

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

21  627.419, 627.6418, 627.6574, 627.6575, 627.6579, 627.6612,

22  627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691,

23  and 627.66911.

24         Section 4.  Section 627.6418, Florida Statutes, is

25  created to read:

26         627.6418  Coverage for prostate cancer screening.--

27         (1)  A group health insurance policy which provides

28  coverage to a man age 40 or older must provide coverage for

29  annual screening for prostate cancer for such a man in

30  accordance with the prostate cancer early detection guidelines

31  of the National Comprehensive Cancer Network.

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    Florida Senate - 2007                            CS for SB 110
    597-2115-07




 1         (2)  The coverage for prostate cancer screening shall

 2  consist, at a minimum, of the following tests:

 3         (a)  Prostate-specific antigen blood test; and

 4         (b)  Digital rectal examination.

 5         (3)  If a licensed medical practitioner recommends that

 6  an insured undergo a prostate-specific antigen blood test,

 7  coverage may not be denied because that person previously had

 8  a digital rectal exam and the exam results were negative.

 9         (4)  The benefits required by this section do not limit

10  diagnostic benefits otherwise allowable under the policy.

11         Section 5.  Subsection (41) is added to section 641.31,

12  Florida Statutes, to read:

13         641.31  Health maintenance contracts.--

14         (41)(a)  A health maintenance organization contract

15  which provides coverage to a man age 40 or older must provide

16  coverage for annual screening for prostate cancer for such a

17  man in accordance with the prostate cancer early detection

18  guidelines of the National Comprehensive Cancer Network.

19         (b)  The coverage for prostate cancer screening shall

20  consist, at a minimum, of the following tests:

21         1.  Prostate-specific antigen blood test; and

22         2.  Digital rectal examination.

23         (c)  If a licensed medical practitioner recommends that

24  a subscriber undergo a prostate-specific antigen blood test,

25  coverage may not be denied because that person previously had

26  a digital rectal exam and the exam results were negative.

27         (d)  The benefits required by this subsection do not

28  limit diagnostic benefits otherwise allowable under the

29  contract.

30         Section 6.  The Legislature finds that the provisions

31  of this act fulfill an important state interest.

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    Florida Senate - 2007                            CS for SB 110
    597-2115-07




 1         Section 7.  This act shall take effect January 1, 2008,

 2  and shall apply to policies or contracts issued or renewed on

 3  or after that date.

 4  

 5          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 6                         Senate Bill 110

 7                                 

 8  The Committee Substitute provides the following changes:

 9  1.   Limits the application of the insurance health benefit
         mandate to individual and group insurance policies and
10       HMO contracts.

11  2.   Clarifies that the coverage required in this bill must be
         provided and not merely offered.
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    3.   Eliminates the provision that such coverage is not
13       subject to any deductible in the policy or contract.

14  4.   Names the act the "Senator Les Miller Act."

15  5.   Specifies that the bill fulfills an important state
         interest.
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