Senate Bill sb0016c1

    Florida Senate - 2007                             CS for SB 16

    By the Committee on Health and Human Services Appropriations;
    and Senator Bullard




    603-2485-07

  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; requiring that the

  9         agency report its findings and recommendations

10         to the Legislature; providing an appropriation;

11         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                             CS for SB 16
    603-2485-07




 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 purpose of conducting the study

14  provided in section 1 of this act:

15         (1)  For the 2007-2008 fiscal year, $25,000 in

16  nonrecurring funds from the Insurance Regulatory Trust Fund in

17  the Office of Insurance Regulation is appropriated for

18  transfer to the Administrative Trust Fund in the Agency for

19  Health Care Administration.

20         (2)  For the 2007-2008 fiscal year, $25,000 in

21  nonrecurring funds from the Administrative Trust Fund is

22  appropriated to the Agency for Health Care Administration.

23         Section 3.  This act shall take effect on July 1, 2007.

24  

25          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
26                          Senate Bill 16

27                                 

28  Changes the appropriation from general revenue to trust fund.

29  

30  

31  

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