Bill No. CS/HB 7081
Amendment No. 804871
Senate House

1Representative Ausley offered the following:
3     Amendment to Amendment (830641)
4     Remove lines 95-140 and insert:
5     1.  Plans are offered as guaranteed issue to enrollees,
6subject to exclusions for preexisting conditions approved by the
7office and the agency, such exclusions for preexisting
8conditions to be limited to no more than 12 months.
9     2.  Plans are portable, such that the enrollee remains
10covered regardless of employment status or the cost-sharing of
12     3.  Plans may provide for cost containment through limits
13on the number of services, caps on benefit payments, and
14copayments for services.
15     4.  A Cover Florida health plan entity makes all benefit
16plan and marketing materials available in English and Spanish.
17     5.  In order to provide for consumer choice, Cover Florida
18health plan entities develop two alternative benefit option
19plans having different cost and benefit levels, including at
20least one plan that provides catastrophic coverage.
21     6.  Plans without catastrophic coverage provide coverage
22options for the following services, including, but not limited
24     a.  Preventive health services, including preventive
25screenings, annual health assessments, and well-care and well-
26woman services, including mammograms, screenings for cervical
27cancer, noninvasive colorectal or prostate screenings,
28immunizations, prenatal care, and labor and delivery.
29     b.  Incentives for routine, preventive care.
30     c.  Office visits for the diagnosis and treatment of
31illness or injury.
32     d.  Office surgery, including anesthesia.
33     e.  Services related to behavioral health services.
34     f.  Durable medical equipment and prosthetics.
35     g.  Diabetic supplies.
36     7.  Plans providing catastrophic coverage, at a minimum,
37provide coverage options for all of the services listed under
38subparagraph 6., and in addition include, but are not limited
39to, coverage options for:
40     a.  Inpatient hospital stays.
41     b.  Hospital emergency care services.
42     c.  Urgent care services.
43     d.  Outpatient facility services, outpatient surgery, and
44outpatient diagnostic services.
45     8.  Plans offer prescription drug benefit coverage on all
46plans, or use a prescription drug manager, such as the Florida
47Discount Drug Card Program.
48     9.  Plans provide, in enrollment materials, plain-language
49information on policy benefit coverage, benefit limits, cost-
50sharing requirements, and exclusions and a clear representation
51of what is not covered in the plan, including how choosing a
52plan could affect current rights under federal and state laws.

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