Senate Bill sb0016

    Florida Senate - 2007                                    SB 16

    By Senator Bullard





    39-8-07

  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 of mandating health insurers

19  and health maintenance organizations to provide coverage for

20  cranial-skull-molding orthotics and other therapies used in

21  the treatment of deformational or positional plagiocephaly.

22  The agency and office shall evaluate whether or not gaps in

23  coverage currently exist in the small and large group

24  insurance markets for medically necessary care and treatment

25  of plagiocephaly. The agency shall provide information

26  concerning the types of benefits, including the cost of such

27  benefits, provided to Medicaid recipients for the treatment of

28  plagiocephaly, and the demographic characteristics of such

29  Medicaid recipients. The Department of Health shall coordinate

30  with the agency to provide such information concerning

31  

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






    Florida Senate - 2007                                    SB 16
    39-8-07




 1  coverage and costs provided to children having plagiocephaly

 2  who are enrolled in the Children's 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 medical necessity, efficacy, and

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

 9  and recommendations related to mandating insurance coverage

10  for the treatment of plagiocephaly to the President of the

11  Senate and the Speaker of the House of Representatives no

12  later than January 1, 2008.

13         Section 2.  For the 2007-2008 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, 2007.

20  

21            *****************************************

22                          SENATE SUMMARY

23    Requires that the Agency for Health Care Administration,
      in consultation with the Office of Insurance Regulation,
24    conduct a study concerning the medical necessity, costs,
      and efficacy of mandating coverage for certain treatments
25    and therapies for deformational or positional
      plagiocephaly. Requires that the agency report its
26    findings and recommendations to the Legislature. Provides
      an appropriation.
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CODING: Words stricken are deletions; words underlined are additions.