HB 107

1
A bill to be entitled
2An act relating to autism; creating s. 381.986, F.S.;
3requiring that a physician refer a minor to an appropriate
4specialist for screening for autism spectrum disorder
5under certain circumstances; defining the term
6"appropriate specialist"; amending ss. 627.6686 and
7641.31098, F.S.; defining the term "direct patient
8access"; requiring certain insurers and health maintenance
9organizations to provide direct patient access to an
10appropriate specialist for a minimum number of visits per
11year for the screening, evaluation, or diagnosis of autism
12spectrum disorder; providing an effective date.
13
14Be It Enacted by the Legislature of the State of Florida:
15
16     Section 1.  Section 381.986, Florida Statutes, is created
17to read:
18     381.986  Screening for autism spectrum disorder.--
19     (1)  If the parent or legal guardian of a minor who is an
20eligible individual, as defined in s. 627.6686 or s. 641.31098,
21believes that the minor exhibits symptoms of autism spectrum
22disorder, the parent or legal guardian may report his or her
23observation to a physician licensed in this state. The physician
24shall immediately refer the minor to an appropriate specialist
25for the screening for, evaluation of, or diagnosis of autism
26spectrum disorder. This section does not apply to a physician
27providing care under s. 395.1041.
28     (2)  As used in this section, the term "appropriate
29specialist" means a qualified professional who is experienced in
30the evaluation of autism spectrum disorder, who has training in
31validated diagnostic tools, and includes, but is not limited to,
32a person who is licensed in this state as:
33     (a)  A psychologist;
34     (b)  A psychiatrist;
35     (c)  A neurologist;
36     (d)  A developmental or behavioral pediatrician who
37specializes in child neurology; or
38     (e)  A professional whose licensure is deemed appropriate
39by the Children's Medical Services Early Steps Program within
40the Department of Health.
41     Section 2.  Present paragraphs (c), (d), and (e) of
42subsection (2) of section 627.6686, Florida Statutes, are
43redesignated as paragraphs (d), (e), and (f), respectively, a
44new paragraph (c) is added to that subsection, and paragraph (a)
45of subsection (3) of that section is amended, to read:
46     627.6686  Coverage for individuals with autism spectrum
47disorder required; exception.--
48     (2)  As used in this section, the term:
49     (c)  "Direct patient access" means the ability of an
50insured to obtain services from an in-network provider without a
51referral or other authorization before receiving services.
52     (3)  A health insurance plan issued or renewed on or after
53April 1, 2009, shall provide coverage to an eligible individual
54for:
55     (a)  Direct patient access to an appropriate specialist, as
56defined in s. 381.986, for a minimum of three visits per policy
57year for the screening for, evaluation of, or diagnosis Well-
58baby and well-child screening for diagnosing the presence of
59autism spectrum disorder.
60     Section 3.  Present paragraphs (c) and (d) of subsection
61(2) of section 641.31098, Florida Statutes, are redesignated as
62paragraphs (d) and (e), respectively, a new paragraph (c) is
63added to that subsection, and paragraph (a) of subsection (3) of
64that section is amended, to read:
65     641.31098  Coverage for individuals with developmental
66disabilities.--
67     (2)  As used in this section, the term:
68     (c)  "Direct patient access" means the ability of a
69subscriber to obtain services from an in-network provider
70without a referral or other authorization before receiving
71services.
72     (3)  A health maintenance contract issued or renewed on or
73after April 1, 2009, shall provide coverage to an eligible
74individual for:
75     (a)  Direct patient access to an appropriate specialist, as
76defined in s. 381.986, for a minimum of three visits per policy
77year for the screening for, evaluation of, or diagnosis Well-
78baby and well-child screening for diagnosing the presence of
79autism spectrum disorder.
80     Section 4.  This act shall take effect July 1, 2010.


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