HB 161

1	A bill to be entitled
2	An act relating to congenital craniofacial anomalies;
3	requiring the Agency for Health Care Administration, in
4	consultation with the Office of Insurance Regulation, to
5	conduct a study concerning the medical necessity, costs,
6	and efficacy of mandating coverage for certain treatments
7	and therapies; providing an appropriation; requiring a
8	report to the Legislature; providing an effective date.
9
10	Be It Enacted by the Legislature of the State of Florida:
11
12	Section 1.  (1)  The Agency for Health Care Administration,
13	in consultation with the Office of Insurance Regulation, shall
14	conduct a study evaluating the medical necessity, efficacy, and
15	costs associated with mandating health insurers and health
16	maintenance organizations to provide coverage for cranial skull
17	molding orthotics and other therapies used in the treatment of
18	deformational or positional plagiocephaly. The agency and office
19	shall evaluate whether gaps in coverage currently exist in the
20	small and large group insurance markets for medically necessary
21	care and treatment of plagiocephaly. The agency shall provide
22	information concerning the types of benefits, including the cost
23	of such benefits, provided to Medicaid recipients for the
24	treatment of plagiocephaly, and the demographic characteristics
25	of such Medicaid recipients. The Department of Health shall
26	coordinate with the agency to provide such information
27	concerning coverage and costs provided to children having
28	plagiocephaly who are enrolled in the Children's Medical
29	Services Program.
30	(2)  The agency, in consultation with the office, may
31	contract with an actuary who is a member of the American Academy
32	of Actuaries and any other person or persons who have an
33	extensive background in health insurance for the purpose of
34	assisting the agency in evaluating the medically necessity,
35	efficacy, and costs of such coverage. The agency shall report
36	its findings and recommendations related to mandating insurance
37	coverage for the treatment of plagiocephaly to the President of
38	the Senate and the Speaker of the House of Representatives no
39	later than January 1, 2008.
40	Section 2.  For the 2007-2008 fiscal year, the sum of
41	$25,000 is appropriated in nonrecurring funds from the Insurance
42	Regulatory Trust Fund to the Office of Insurance Regulation for
43	the purpose of funding the study conducted by the Agency for
44	Health Care Administration as provided in this act.
45	Section 3.  This act shall take effect July 1, 2007.

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