| 1 | Representative Glorioso offered the following: |
| 2 |
|
| 3 | Amendment (with title amendment) |
| 4 | Between lines 81-82 and insert: |
| 5 | Section 2. Subsection (5) is added to section 627.4239,, |
| 6 | Florida Statutes, to read: |
| 7 | 627.4239 Coverage for use of drugs in treatment of |
| 8 | cancer.-- |
| 9 | (4) ANNUAL REPORTS.-- |
| 10 | (a) Where coverage for routine patient care costs |
| 11 | associated with care provided in a phase 1, 2, 3, or 4 cancer |
| 12 | clinical trial is denied, a carrier shall, after consulting |
| 13 | academic and community oncologists involved in cancer care and |
| 14 | clinical research, submit to the office of insurance regulation |
| 15 | in a format prescribed by rule, an annual report that shall |
| 16 | include: |
| 17 | 1. The number of denials for coverage of routine patient |
| 18 | care cost as defined in paragraph (c) in cancer clinical trials. |
| 19 | 2. A comparison of the costs of routine patient care |
| 20 | provided in the trials in question compared to the costs of |
| 21 | standard therapies for the same diagnosis. |
| 22 | (b) The annual reports required under paragraph (a) shall |
| 23 | be provided by the Office of Insurance Regulation to the |
| 24 | Governor, the Senate President, the Speaker of the House of |
| 25 | Representatives, and the Secretary of the Agency for Health Care |
| 26 | Administration no later than 30 days prior to the regular |
| 27 | legislative session. |
| 28 | (c) For purposes of this section, the term "routine |
| 29 | patient care cost" means physician fees, laboratory expenses, |
| 30 | and expenses associated with the hospitalization, administration |
| 31 | of treatment, and evaluation of a patient during the course of |
| 32 | treatment which are consistent with usual and customary patterns |
| 33 | and standards of care incurred whenever an enrollee, subscriber, |
| 34 | or insured receives medical care associated with an approved |
| 35 | cancer clinical trial, and which would be covered if such items |
| 36 | and services were provided other than in connection with an |
| 37 | approved cancer clinical trial but does not include the direct |
| 38 | cost of the clinical trial. |
| 39 |
|
| 40 |
|
| 41 |
|
| 42 |
|
| 43 |
|
| 44 | ----------------------------------------------------- |
| 45 | T I T L E A M E N D M E N T |
| 46 | Remove line(s) 12 and insert: |
| 47 | credibility criteria for the rate adjustment; amending s. |
| 48 | 627.4239, F.S.; providing annual reporting requirements; |
| 49 | providing a definition; providing an |
| 50 |
|