| 1 | A bill to be entitled |
| 2 | An act relating to health insurance; providing a short |
| 3 | title; creating ss. 627.64091 and 627.64185, F.S., and |
| 4 | amending s. 641.31, F.S.; requiring health insurance |
| 5 | policies, group health insurance policies, and health |
| 6 | maintenance contracts to provide coverage for an annual |
| 7 | screening for prostate cancer for men of a specified age |
| 8 | or older; providing requirements for the screening; |
| 9 | providing that coverage for prostate cancer screening does |
| 10 | not limit diagnostic benefits otherwise allowed under the |
| 11 | policy or contract; amending s. 627.6515, F.S.; revising a |
| 12 | nonapplication provision relating to group, blanket, and |
| 13 | franchise policy requirements for out-of-state group |
| 14 | policies containing certain provisions; providing a |
| 15 | finding that the act fulfills an important state interest; |
| 16 | providing application; providing an effective date. |
| 17 |
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| 18 | Be It Enacted by the Legislature of the State of Florida: |
| 19 |
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| 20 | Section 1. This act may be cited as the "Senator Les |
| 21 | Miller 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 | age 40 or older must provide coverage for annual screening for |
| 27 | prostate cancer for such a man in accordance with the prostate |
| 28 | cancer early detection guidelines of the National Comprehensive |
| 29 | Cancer Network. |
| 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. |
| 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. Section 627.64185, Florida Statutes, is created |
| 41 | to read: |
| 42 | 627.64185 Coverage for prostate cancer screening.-- |
| 43 | (1) A group health insurance policy which provides |
| 44 | coverage to a man age 40 or older must provide coverage for |
| 45 | annual screening for prostate cancer for such a man in |
| 46 | accordance with the prostate cancer early detection guidelines |
| 47 | of the National Comprehensive Cancer Network. |
| 48 | (2) The coverage for prostate cancer screening shall |
| 49 | consist, at a minimum, of the following tests: |
| 50 | (a) Prostate-specific antigen blood test. |
| 51 | (b) Digital rectal examination. |
| 52 | (3) If a licensed medical practitioner recommends that an |
| 53 | insured undergo a prostate-specific antigen blood test, coverage |
| 54 | may not be denied because that person previously had a digital |
| 55 | rectal exam and the exam results were negative. |
| 56 | (4) The benefits required by this section do not limit |
| 57 | diagnostic benefits otherwise allowable under the policy. |
| 58 | Section 4. Paragraph (c) of subsection (2) of section |
| 59 | 627.6515, Florida Statutes, is amended to read: |
| 60 | 627.6515 Out-of-state groups.-- |
| 61 | (2) Except as otherwise provided in this part, this part |
| 62 | does not apply to a group health insurance policy issued or |
| 63 | delivered outside this state under which a resident of this |
| 64 | state is provided coverage if: |
| 65 | (c) The policy provides the benefits specified in ss. |
| 66 | 627.419, 627.64185, 627.6574, 627.6575, 627.6579, 627.6612, |
| 67 | 627.66121, 627.66122, 627.6613, 627.667, 627.6675, 627.6691, and |
| 68 | 627.66911. |
| 69 | Section 5. Subsection (41) is added to section 641.31, |
| 70 | Florida Statutes, to read: |
| 71 | 641.31 Health maintenance contracts.-- |
| 72 | (41)(a) A health maintenance organization contract which |
| 73 | provides coverage to a man age 40 or older must provide coverage |
| 74 | for annual screening for prostate cancer for such a man in |
| 75 | accordance with the prostate cancer early detection guidelines |
| 76 | of the National Comprehensive Cancer Network. |
| 77 | (b) The coverage for prostate cancer screening shall |
| 78 | consist, at a minimum, of the following tests: |
| 79 | 1. Prostate-specific antigen blood test. |
| 80 | 2. Digital rectal examination. |
| 81 | (c) If a licensed medical practitioner recommends that a |
| 82 | subscriber undergo a prostate-specific antigen blood test, |
| 83 | coverage may not be denied because that person previously had a |
| 84 | digital rectal exam and the exam results were negative. |
| 85 | (d) The benefits required by this subsection do not limit |
| 86 | diagnostic benefits otherwise allowable under the contract. |
| 87 | Section 6. The Legislature finds that the provisions of |
| 88 | this act fulfill an important state interest. |
| 89 | Section 7. This act shall take effect January 1, 2009, and |
| 90 | shall apply to policies or contracts issued or renewed on or |
| 91 | after that date. |