Florida Senate - 2012 SB 1052 By Senator Ring 32-00926-12 20121052__ 1 A bill to be entitled 2 An act relating to newborn screening for congenital 3 heart disease; creating s. 383.146, F.S.; providing 4 definitions; providing requirements for screening 5 newborns for congenital heart disease; providing for 6 certain insurance and managed care coverage; providing 7 for referral for ongoing services; authorizing the 8 Department of Health to adopt rules to implement the 9 screening; providing powers and duties of the 10 department; providing an effective date. 11 12 WHEREAS, congenital heart disease is the most common birth 13 defect in infants, affecting 8 out of every 1,000 newborn 14 babies, and 15 WHEREAS, early detection of congenital heart disease is 16 crucial to the health of a newborn baby because, if the 17 condition goes undiagnosed, it can cause major problems later in 18 the child’s life, and 19 WHEREAS, pulse oximetry is a noninvasive method of 20 monitoring the oxygen level in the blood and is recommended as a 21 method of screening a patient for congenital heart disease, and 22 WHEREAS, physical exertion and participation in sports can 23 cause excess stress on the heart and, if the disease is not 24 detected and is severe enough, participation in strenuous 25 activity can result in death, NOW, THEREFORE, 26 27 Be It Enacted by the Legislature of the State of Florida: 28 29 Section 1. Section 383.146, Florida Statutes, is created to 30 read: 31 383.146 Newborn screening for congenital heart disease.— 32 (1) DEFINITIONS.—As used in this section, the term: 33 (a) “Department” means the Department of Health. 34 (b) “Newborn” means an age range from birth through 29 35 days. 36 (c) “Screening” means a test or battery of tests 37 administered to determine whether a newborn has congenital heart 38 disease. 39 (2) REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE 40 COVERAGE; REFERRAL FOR ONGOING SERVICES.— 41 (a) Each licensed hospital or other state-licensed birthing 42 facility that provides maternity and newborn care services shall 43 provide that all newborns are, prior to discharge, screened for 44 congenital heart disease. 45 (b) Each licensed birth center that provides maternity and 46 newborn care services shall provide that all newborns are, prior 47 to discharge, referred to a physician licensed under chapter 458 48 or chapter 459 or a hospital for screening for the detection of 49 congenital heart disease. The referral for appointment shall be 50 made within 10 days after discharge. Written documentation of 51 the referral must be placed in the newborn’s medical chart. 52 (c) If the parent or legal guardian of the newborn objects 53 to the screening, the screening must not be completed 54 notwithstanding any other provision of this section. In such 55 case, the physician, midwife, or other person who is attending 56 the newborn shall maintain a record that the screening has not 57 been performed and attach a written objection that must be 58 signed by the parent or guardian. 59 (d) For home births, the health care provider in attendance 60 is responsible for the coordination and referral to a physician 61 licensed under chapter 458 or chapter 459 or a hospital. The 62 referral for appointment shall be made within 10 days after the 63 birth. In cases in which the home birth is not attended by a 64 primary health care provider, a referral to a physician licensed 65 pursuant to chapter 458 or chapter 459 or a hospital must be 66 made by the health care provider within 10 days after the 67 child’s birth. 68 (e) All newborn and infant screenings shall be conducted by 69 a physician licensed under chapter 458 or chapter 459. 70 Appropriate documentation of the screening completion, results, 71 interpretation, and recommendations must be placed in the 72 medical record within 24 hours after completion of the screening 73 procedure. 74 (f) The screening of a newborn for congenital heart disease 75 must be completed before the newborn is discharged from the 76 hospital. 77 (g) Each hospital shall formally designate a lead physician 78 responsible for programmatic oversight for newborn congenital 79 heart disease screening. Each licensed birth center shall 80 designate a licensed health care provider to provide such 81 programmatic oversight and to ensure that the appropriate 82 referrals are being completed. 83 (h) By October 1, 2012, congenital heart disease screening 84 must be conducted on all newborns in hospitals in this state on 85 birth admission. When a newborn is delivered in a facility other 86 than a hospital, the parents must be instructed on the 87 importance of having the screening performed and must be given 88 information to assist them in having the screening performed 89 within 10 days after the child’s birth. 90 (i) The initial procedure for screening of the newborn for 91 congenital heart disease and any medically necessary followup 92 reevaluations leading to diagnosis shall be a covered benefit, 93 reimbursable under Medicaid as an expense compensated 94 supplemental to the per diem rate for Medicaid patients enrolled 95 in MediPass or Medicaid patients covered by a fee for service 96 program. For Medicaid patients enrolled in health maintenance 97 organizations, providers shall be reimbursed directly by the 98 Medicaid Program Office at the Medicaid rate. This service may 99 not be considered a covered service for the purposes of 100 establishing the payment rate for Medicaid health maintenance 101 organizations. All health insurance policies and health 102 maintenance organizations as provided under ss. 627.6416, 103 627.6579, and 641.31(30), except for supplemental policies that 104 only provide coverage for specific diseases, hospital indemnity, 105 or Medicare supplement, or to the supplemental polices, shall 106 compensate providers for the covered benefit at the contracted 107 rate. Nonhospital-based providers shall be eligible to bill 108 Medicaid for the professional and technical component of each 109 procedure code. 110 (3) RULES.—After consultation with the Genetics and Newborn 111 Screening Advisory Council, the department shall adopt and 112 enforce rules requiring that every newborn in this state be 113 subjected to a test for congenital heart disease. The department 114 shall adopt such additional rules as are necessary for the 115 administration of this section, including rules providing 116 definitions of terms, rules relating to the methods used and 117 time or times for testing as accepted medical practice 118 indicates, rules relating to charging and collecting fees for 119 the administration of the newborn screening program authorized 120 by this section, rules for processing requests and releasing 121 test and screening results, and rules requiring mandatory 122 reporting of the results of tests and screenings for this 123 condition to the department. 124 (4) POWERS AND DUTIES OF THE DEPARTMENT.—The department 125 shall administer and provide services authorized pursuant to 126 this section and shall: 127 (a) Ensure the availability and quality of the necessary 128 laboratory tests and materials. 129 (b) Furnish all physicians, county health departments, 130 perinatal centers, birthing centers, and hospitals forms on 131 which the results of tests for congenital heart disease shall be 132 reported to the department. 133 (c) Have the authority to charge and collect fees 134 sufficient to administer the newborn screening program 135 authorized under this section. 136 Section 2. This act shall take effect July 1, 2012.