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The Committee on Banking and Insurance (Peaden) recommended the

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following amendment:

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     Senate Amendment (with title amendment)

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     Delete everything after the enacting clause

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and insert:

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     Section 1.  Section 627.42395, Florida Statutes, is amended

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to read:

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     627.42395  Coverage for certain prescription and

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nonprescription enteral or amino acid formulas.--

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     (1) Notwithstanding any other provision of law, any health

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insurance policy delivered or issued for delivery, to any person

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in this state or any group, blanket, or franchise health

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insurance policy delivered or issued for delivery in this state

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shall make available to the policyholder as part of the

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application, for an appropriate additional premium, coverage for:

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     (a) Prescription and nonprescription enteral formulas for

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home use which are physician prescribed as medically necessary

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for the treatment of inherited diseases of amino acid, organic

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acid, carbohydrate, or fat metabolism as well as malabsorption

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originating from congenital defects present at birth or acquired

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during the neonatal period. Such coverage for inherited diseases

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of amino acids and organic acids shall include food products

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modified to be low protein, in an amount not to exceed $2,500

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annually for any insured individual, through the age of 24.

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     (b) Amino-acid-based elemental formulas, regardless of the

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method of intake, for the medically necessary treatment of

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medically diagnosed conditions of severe multiple food protein

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allergies, gastroesophageal reflux, eosinophilic disorders, and

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short bowel syndrome when ordered by a licensed physician.

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Treatments using amino-acid-based elemental formulas must be

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medically necessary and appropriate treatment that is consistent

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with the person's symptoms, diagnosis, and condition, and may not

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be furnished primarily for the convenience of the person or

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provider. Conditions for which these formulas are used in

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experimental or investigational services do not meet the

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criterion of medical necessity.

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     (2) This section applies to any person or family

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notwithstanding the existence of any preexisting condition.

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     Section 2.  Subsection (41) is added to section 641.31,

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Florida Statutes, to read:

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     641.31  Health maintenance contracts.--

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     (41) A health maintenance contract must make available

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coverage of amino-acid-based elemental formulas, regardless of

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the method of intake, for the medically necessary treatment of

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medically diagnosed conditions such as severe multiple food

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protein allergies, gastroesophageal reflux, eosinophilic

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disorders, and short bowel syndrome when ordered by a licensed

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physician. Treatments using amino-acid-based elemental formulas

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must be medically necessary and appropriate treatment that is

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consistent with the person's symptoms, diagnosis, and condition,

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and may not be furnished primarily for the convenience of the

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person or provider. Conditions for which these formulas are used

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in experimental or investigational services do not meet the

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criterion of medical necessity.

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     Section 3.  This act shall take effect October 1, 2008.

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================ T I T L E  A M E N D M E N T ================

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And the title is amended as follows:

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     Delete everything before the enacting clause

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and insert:

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A bill to be entitled

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An act relating to optional coverage of health-related

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disorders; amending ss. 627.42395 and 641.31, F.S.;

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requiring health insurance policies and health maintenance

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contracts in this state to provide additional premium

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coverage for amino-acid-based elemental formulas for the

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treatment of certain medical conditions; providing an

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effective date.

3/24/2008  11:09:00 AM     2-05467-08