Florida Senate - 2009                              CS for SB 308
       
       
       
       By the Committee on Health Regulation; and Senator Ring
       
       
       
       
       588-04449-09                                           2009308c1
    1                        A bill to be entitled                      
    2         An act relating to autism; creating s. 381.986, F.S.;
    3         requiring that a physician refer a minor to an
    4         appropriate specialist for screening for autism
    5         spectrum disorder under certain circumstances;
    6         defining the term “appropriate specialist”; amending
    7         ss. 627.6686 and 641.31098, F.S.; requiring certain
    8         insurers and health maintenance organizations to
    9         provide direct patient access to an appropriate
   10         specialist for screening, evaluation of, or diagnosis
   11         for autism spectrum disorder; defining the term
   12         “direct patient access”; requiring the insurer’s
   13         policy or the health maintenance organization’s
   14         contract to provide a minimum number of visits per
   15         year for the screening, evaluation of, or diagnosis
   16         for autism spectrum disorder; providing an effective
   17         date.
   18  
   19  Be It Enacted by the Legislature of the State of Florida:
   20  
   21         Section 1. Section 381.986, Florida Statutes, is created to
   22  read:
   23         381.986 Screening, evaluation of, or diagnosis for autism
   24  spectrum disorder.—
   25         (1) If the parent or legal guardian of a minor who is an
   26  eligible individual, as defined in s. 627.6686 or s. 641.31098,
   27  believes that the minor exhibits symptoms of autism spectrum
   28  disorder, the parent or legal guardian may report his or her
   29  observation to a physician licensed in this state. The physician
   30  shall immediately refer the minor to an appropriate specialist
   31  for screening, evaluation of, or diagnosis for autism spectrum
   32  disorder. This section does not apply to a physician providing
   33  care under s. 395.1041.
   34         (2) As used in this section, the term “appropriate
   35  specialist” means a qualified professional who is experienced in
   36  the evaluation of autism spectrum disorder, who has training in
   37  validated diagnostic tools, and includes, but is not limited to,
   38  a person who is licensed in this state as:
   39         (a) A psychologist;
   40         (b) A psychiatrist;
   41         (c) A neurologist;
   42         (d) A developmental or behavioral pediatrician and who
   43  specializes in child neurology;
   44         (e) A speech language pathologist;
   45         (f) An occupational therapist; or
   46         (g) A professional whose licensure is deemed appropriate by
   47  the Children’s Medical Services Early Steps Program within the
   48  Department of Health.
   49         Section 2. Subsection (11) is added to section 627.6686,
   50  Florida Statutes, to read:
   51         627.6686 Coverage for individuals with autism spectrum
   52  disorder required; exception.—
   53         (11) Notwithstanding any provision of this section to the
   54  contrary, an insurer shall provide direct patient access for
   55  screening, evaluation of, or diagnosis for autism spectrum
   56  disorder to an appropriate specialist, as defined in s. 381.986.
   57  As used in this subsection, the term “direct patient access”
   58  means the ability of a subscriber or insured to obtain services
   59  from an in-network provider without a referral or other
   60  authorization before receiving services. The insurer’s policy
   61  shall, pursuant to this subsection, provide a minimum of three
   62  visits per policy year for the screening, evaluation of, or
   63  diagnosis for autism spectrum disorder.
   64         Section 3. Subsection (10) is added to section 641.31098,
   65  Florida Statutes, to read:
   66         641.31098 Coverage for individuals with developmental
   67  disabilities.—
   68         (10) Notwithstanding any provision of this section to the
   69  contrary, a health maintenance organization shall provide direct
   70  patient access for screening, evaluation of, or diagnosis for
   71  autism spectrum disorder to an appropriate specialist, as
   72  defined in s. 381.986. As used in this subsection, the term
   73  “direct patient access” means the ability of a subscriber or
   74  insured to obtain services from an in-network provider without a
   75  referral or other authorization before receiving services. The
   76  health maintenance organization’s contract shall, pursuant to
   77  this subsection, provide a minimum of three visits per policy
   78  year for the screening, evaluation of, or diagnosis for autism
   79  spectrum disorder.
   80         Section 4. This act shall take effect July 1, 2009.