HB 465

1
A bill to be entitled
2An act relating to congenital craniofacial anomalies;
3requiring that the Agency for Health Care Administration,
4in consultation with the Office of Insurance Regulation,
5conduct a study concerning the medical necessity, costs,
6and efficacy of mandating coverage for certain treatments
7and therapies; requiring that the agency report its
8findings and recommendations to the Legislature; providing
9an appropriation; providing an effective date.
10
11Be It Enacted by the Legislature of the State of Florida:
12
13     Section 1.  (1)  The Agency for Health Care Administration,
14in consultation with the Office of Insurance Regulation, shall
15conduct a study evaluating the medical necessity, efficacy, and
16costs of requiring health insurers and health maintenance
17organizations to provide coverage for cranial-skull-molding
18orthotics and other therapies used in the treatment of
19deformational or positional plagiocephaly. The agency and office
20shall evaluate whether gaps in coverage currently exist in the
21small and large group insurance markets for medically necessary
22care and treatment of plagiocephaly. The agency shall provide
23information concerning the types of benefits, including the cost
24of such benefits, provided to Medicaid recipients for the
25treatment of plagiocephaly, and the demographic characteristics
26of such Medicaid recipients. The Department of Health shall
27coordinate with the agency to provide such information
28concerning coverage and the costs of providing such coverage to
29children having plagiocephaly who are enrolled in the Children's
30Medical Services Program.
31     (2)  The agency, in consultation with the office, may
32contract with an actuary who is a member of the American Academy
33of Actuaries and other persons who have an extensive background
34in health insurance for the purpose of assisting the agency in
35evaluating the medical necessity, efficacy, and costs of such
36coverage. The agency shall report its findings and
37recommendations related to mandating insurance coverage for the
38treatment of plagiocephaly to the President of the Senate and
39the Speaker of the House of Representatives no later than
40January 1, 2009.
41     Section 2.  For the 2008-2009 fiscal year, the sum of
42$25,000 is appropriated in nonrecurring funds from the Insurance
43Regulatory Trust Fund to the Office of Insurance Regulation for
44the purpose of funding the study conducted by the Agency for
45Health Care Administration as provided in this act.
46     Section 3.  This act shall take effect July 1, 2008.


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