CS/HB 535

1
A bill to be entitled
2An act relating to health insurance; amending s. 627.4236,
3F.S.; revising the definition of the term "bone marrow
4transplant"; amending ss. 627.642, 627.657, and 641.31,
5F.S.; requiring an identification card containing
6specified information to be given to insureds under health
7benefit plans and group health insurance policies and
8persons having health care services through health
9maintenance contracts; providing applicability; providing
10for an exception to certain identification card
11requirements for cards issued before a certain date;
12providing an effective date.
13
14Be It Enacted by the Legislature of the State of Florida:
15
16     Section 1.  Subsection (1) of section 627.4236, Florida
17Statutes, is amended to read:
18     627.4236  Coverage for bone marrow transplant procedures.--
19     (1)  As used in this section, the term "bone marrow
20transplant" means human blood precursor cells administered to a
21patient to restore normal hematological and immunological
22functions following ablative or nonablative therapy with
23curative or life-prolonging intent. Human blood precursor cells
24may be obtained from the patient in an autologous transplant or
25from a medically acceptable related or unrelated donor, and may
26be derived from bone marrow, circulating blood, or a combination
27of bone marrow and circulating blood. If chemotherapy is an
28integral part of the treatment involving bone marrow
29transplantation, the term "bone marrow transplant" includes both
30the transplantation and the chemotherapy.
31     Section 2.  Subsection (3) is added to section 627.642,
32Florida Statutes, to read:
33     627.642  Outline of coverage.--
34     (3)  In addition to the outline of coverage, a policy as
35specified in s. 627.6699(3)(k) must be accompanied by an
36identification card that contains, at a minimum:
37     (a)  The name of the organization issuing the policy or the
38name of the organization administering the policy, whichever
39applies.
40     (b)  The name of the contract holder.
41     (c)  The type of plan only if the plan is filed in the
42state, an indication that the plan is self-funded, or the name
43of the network.
44     (d)  The member identification number, contract number, and
45policy or group number, if applicable.
46     (e)  A contact phone number or electronic address for
47authorizations and admission certifications.
48     (f)  A phone number or electronic address whereby the
49covered person or hospital, physician, or other person rendering
50services covered by the policy may obtain benefits verification
51and information in order to estimate patient financial
52responsibility, in compliance with privacy rules under the
53Health Insurance Portability and Accountability Act.
54     (g)  The national plan identifier, in accordance with the
55compliance date set forth by the federal Department of Health
56and Human Services.
57
58The identification card must present the information in a
59readily identifiable manner or, alternatively, the information
60may be embedded on the card and available through magnetic
61stripe or smart card. The information may also be provided
62through other electronic technology.
63     Section 3.  Present subsection (2) of section 627.657,
64Florida Statutes, is renumbered as subsection (3), and a new
65subsection (2) is added to that section to read:
66     627.657  Provisions of group health insurance policies.--
67     (2)  The medical policy as specified in s. 627.6699(3)(k)
68must be accompanied by an identification card that contains, at
69a minimum:
70     (a)  The name of the organization issuing the policy or
71name of the organization administering the policy, whichever
72applies.
73     (b)  The name of the certificateholder.
74     (c)  The type of plan only if the plan is filed in the
75state, an indication that the plan is self-funded, or the name
76of the network.
77     (d)  The member identification number, contract number, and
78policy or group number, if applicable.
79     (e)  A contact phone number or electronic address for
80authorizations and admission certifications.
81     (f)  A phone number or electronic address whereby the
82covered person or hospital, physician, or other person rendering
83services covered by the policy may obtain benefits verification
84and information in order to estimate patient financial
85responsibility, in compliance with privacy rules under the
86Health Insurance Portability and Accountability Act.
87     (g)  The national plan identifier, in accordance with the
88compliance date set forth by the federal Department of Health
89and Human Services.
90
91The identification card must present the information in a
92readily identifiable manner or, alternatively, the information
93may be embedded on the card and available through magnetic
94stripe or smart card. The information may also be provided
95through other electronic technology.
96     Section 4.  Subsection (41) is added to section 641.31,
97Florida Statutes, to read:
98     641.31  Health maintenance contracts.--
99     (41)  The contract, certificate, or member handbook must be
100accompanied by an identification card that contains, at a
101minimum:
102     (a)  The name of the organization offering the contract or
103name of the organization administering the contract, whichever
104applies.
105     (b)  The name of the subscriber.
106     (c)  A statement that the health plan is a health
107maintenance organization. Only a health plan with a certificate
108of authority issued under this chapter may be identified as a
109health maintenance organization.
110     (d)  The member identification number, contract number, and
111group number, if applicable.
112     (e)  A contact phone number or electronic address for
113authorizations and admission certifications.
114     (f)  A phone number or electronic address whereby the
115covered person or hospital, physician, or other person rendering
116services covered by the contract may obtain benefits
117verification and information in order to estimate patient
118financial responsibility, in compliance with privacy rules under
119the Health Insurance Portability and Accountability Act.
120     (g)  The national plan identifier, in accordance with the
121compliance date set forth by the federal Department of Health
122and Human Services.
123
124The identification card must present the information in a
125readily identifiable manner or, alternatively, the information
126may be embedded on the card and available through magnetic
127stripe or smart card. The information may also be provided
128through other electronic technology.
129     Section 5.  Notwithstanding the provisions of this act,
130companies that contract with this state, pursuant to s. 110.123,
131Florida Statutes, to provide medical services to enrollees in
132the state group insurance program are not required to update any
133identification card issued to such enrollee prior to January 1,
1342009, in order to conform with this act. Identification cards
135for enrollees in the state group insurance program issued on or
136after January 1, 2009, must contain all information required by
137this act.
138     Section 6.  This act shall take effect January 1, 2009, and
139shall apply to identification cards issued for policies or
140certificates issued or renewed on or after that date.


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