Florida Senate - 2008 CS for SB 1010

By the Committee on Banking and Insurance; and Senators Hill and Bullard

597-06354-08 20081010c1

1

A bill to be entitled

2

An act relating to health insurance; creating the "Senator

3

Les Miller Act"; creating ss. 627.64091 and 627.6614,

4

F.S., and amending s. 641.31, F.S.; requiring that health

5

insurance policies, group health insurance policies, and

6

health maintenance contracts provide coverage for an

7

annual screening for prostate cancer for men of a

8

specified age or older; providing requirements for the

9

screening; providing that coverage for prostate cancer

10

screening does not limit diagnostic benefits otherwise

11

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

12

providing for the benefit requirement to apply to a group

13

health insurance policy issued or delivered outside the

14

state; providing a finding that the act fulfills an

15

important state interest; providing for application of the

16

act; providing an effective date.

17

18

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

19

20

     Section 1. This act may be cited as the "Senator Les Miller

21

Act."

22

     Section 2.  Section 627.64091, Florida Statutes, is created

23

to read:

24

     627.64091 Coverage for prostate cancer screening.--

25

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

26

40 years of age or older must provide coverage for annual

27

screening for prostate cancer for such man in accordance with the

28

guidelines for the early detection of prostate cancer set forth

29

in the National Comprehensive Cancer Network guidelines.

30

     (2) The coverage for prostate cancer screening shall

31

consist, at a minimum, of the following tests:

32

     (a) Prostate-specific antigen blood test; and

33

     (b) Digital rectal examination.

34

     (3) If a licensed medical practitioner recommends that an

35

insured undergo a prostate-specific antigen blood test, coverage

36

may not be denied because that person previously had a digital

37

rectal exam and the exam results were negative.

38

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

39

diagnostic benefits otherwise allowable under the policy.

40

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

41

627.6515, Florida Statutes, is amended to read:

42

     627.6515  Out-of-state groups.--

43

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

44

does not apply to a group health insurance policy issued or

45

delivered outside this state under which a resident of this state

46

is provided coverage if:

47

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

48

627.419, 627.6574, 627.6575, 627.6579, 627.6612, 627.66121,

49

627.66122, 627.6613, 627.6614, 627.667, 627.6675, 627.6691, and

50

627.66911.

51

     Section 4.  Section 627.6614, Florida Statutes, is created

52

to read:

53

     627.6614 Coverage for prostate cancer screening.--

54

     (1) A group health insurance policy that provides coverage

55

to a man 40 years of age or older must provide coverage for

56

annual screening for prostate cancer for such man in accordance

57

with the guidelines for the early detection of prostate cancer

58

set forth in the National Comprehensive Cancer Network

59

guidelines.

60

     (2) The coverage for prostate cancer screening shall

61

consist, at a minimum, of the following tests:

62

     (a) Prostate-specific antigen blood test; and

63

     (b) Digital rectal examination.

64

     (3) If a licensed medical practitioner recommends that an

65

insured undergo a prostate-specific antigen blood test, coverage

66

may not be denied because that person previously had a digital

67

rectal exam and the exam results were negative.

68

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

69

diagnostic benefits otherwise allowable under the policy.

70

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

71

Florida Statutes, to read:

72

     641.31  Health maintenance contracts.--

73

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

74

provides coverage to a man 40 years of age or older must provide

75

coverage for annual screening for prostate cancer for such man in

76

accordance with the guidelines for the early detection of

77

prostate cancer set forth in the National Comprehensive Cancer

78

Network guidelines.

79

     (b) The coverage for prostate cancer screening shall

80

consist, at a minimum, of the following tests:

81

     1. Prostate-specific antigen blood test; and

82

     2. Digital rectal examination.

83

     (c) If a licensed medical practitioner recommends that a

84

subscriber undergo a prostate-specific antigen blood test,

85

coverage may not be denied because that person previously had a

86

digital rectal exam and the exam results were negative.

87

     (d) The benefits required by this section do not limit

88

diagnostic benefits otherwise allowable under the contract.

89

     Section 6. The Legislature finds that the provisions of

90

this act fulfill an important state interest.

91

     Section 7.  This act shall take effect January 1, 2009, and

92

applies to policies and contracts issued or renewed on or after

93

that date.

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