Florida Senate - 2020 CS for SB 1556 By the Committee on Banking and Insurance; and Senator Bean 597-03516-20 20201556c1 1 A bill to be entitled 2 An act relating to nondiscrimination in organ 3 transplants; creating s. 765.523, F.S.; defining 4 terms; prohibiting certain entities from making 5 certain determinations or engaging in certain actions 6 related to organ transplants solely on the basis of an 7 individual’s disability; specifying an instance where 8 certain entities may consider an individual’s 9 disability, with an exception; requiring certain 10 entities to make reasonable modifications in their 11 policies, practices, and procedures under certain 12 circumstances, with an exception; providing criteria 13 for such modifications; requiring certain entities to 14 take certain necessary steps to ensure an individual 15 with a disability is not denied services, with 16 exceptions; providing a cause of action for injunctive 17 and other relief; providing construction; creating ss. 18 627.64197, 627.65736, and 641.31075, F.S.; prohibiting 19 insurers, nonprofit health care service plans, and 20 health maintenance organizations that provide coverage 21 for organ transplants from denying coverage solely on 22 the basis of an individual’s disability under certain 23 circumstances; providing construction; defining the 24 term “organ transplant”; providing an effective date. 25 26 Be It Enacted by the Legislature of the State of Florida: 27 28 Section 1. Section 765.523, Florida Statutes, is created to 29 read: 30 765.523 Discrimination in access to anatomical gifts and 31 organ transplants prohibited.— 32 (1) As used in this section, the term: 33 (a) “Auxiliary aids and services” means: 34 1. Qualified interpreters or other effective methods of 35 making aurally delivered materials available to individuals with 36 hearing impairments. 37 2. Qualified readers, recorded texts, texts in an 38 accessible electronic format, or other effective methods of 39 making visually delivered materials available to individuals 40 with visual impairments. 41 3. Supported decisionmaking services, including any of the 42 following: 43 a. The use of a support person to assist an individual in 44 making medical decisions, communicating information to the 45 individual, or ascertaining his or her wishes. 46 b. The provision of information to a person designated by 47 the individual, consistent with federal and state laws governing 48 the disclosure of health information. 49 c. Measures used to ensure that the individual’s guardian 50 or legal representative, if any, is included in decisions 51 involving the individual’s health care and that medical 52 decisions are in accordance with the individual’s own expressed 53 interests. 54 d. Any other aid or service that is used to provide 55 information in a format that is readily understandable and 56 accessible to individuals with cognitive, neurological, 57 developmental, or intellectual disabilities. 58 (b) “Covered entity” means any of the following: 59 1. A licensed health care practitioner as defined in s. 60 456.001. 61 2. A health care facility as defined in s. 408.07. 62 3. Any other entity responsible for potential recipients of 63 an anatomical gift or organ transplant. 64 (c) “Disability” has the same meaning as “developmental 65 disability” and “intellectual disability” as those terms are 66 defined in s. 393.063. 67 (d) “Organ transplant” means the transplantation or 68 transfusion of a part of a human body into the body of another 69 individual for the purpose of treating or curing a medical 70 condition. 71 (e) “Qualified individual” means an individual who has a 72 disability and meets the clinical eligibility requirements for 73 the receipt of an anatomical gift or an organ transplant, 74 regardless of: 75 1. The support networks available to the individual; 76 2. The provision of auxiliary aids and services; or 77 3. Reasonable modifications to the policies, practices, or 78 procedures of a covered entity pursuant to subsection (4). 79 (2) A covered entity may not do any of the following solely 80 on the basis of an individual’s disability: 81 (a) Consider a qualified individual ineligible to receive 82 an anatomical gift or organ transplant. 83 (b) Deny medical or other services related to an organ 84 transplant, including evaluation, surgery, counseling, and 85 posttransplant treatment and services. 86 (c) Refuse to refer the individual to an organ procurement 87 organization or a related specialist for the purpose of 88 evaluation or receipt of an organ transplant. 89 (d) Refuse to place a qualified individual on an organ 90 transplant waiting list. 91 (e) Place a qualified individual at a lower priority 92 position on an organ transplant waiting list than the position 93 at which the qualified individual would have been placed if not 94 for the disability. 95 (3)(a) A covered entity may take an individual’s disability 96 into account if, following an individualized evaluation of him 97 or her, a physician finds the individual’s disability to be 98 medically significant to the provision of the anatomical gift or 99 organ transplant, but only to the extent that the covered entity 100 is making treatment or coverage recommendations or decisions for 101 the individual. 102 (b) If an individual has the necessary support system to 103 assist him or her in complying with posttransplant medical 104 requirements, a covered entity may not consider the individual’s 105 inability to independently comply with the posttransplant 106 medical requirements to be medically significant for the 107 purposes of paragraph (a). 108 (4) A covered entity shall make reasonable modifications to 109 policies, practices, or procedures when the modifications are 110 necessary to allow an individual with a disability access to 111 services, including transplant-related counseling, information, 112 coverage, or treatment, unless the covered entity can 113 demonstrate that making the modifications would fundamentally 114 alter the nature of the services. Such modifications shall 115 include, but not be limited to, communication with the persons 116 responsible for supporting the individual with his or her 117 postsurgical and posttransplant care, including medication. Such 118 modifications shall also consider the support networks available 119 to the individual, including, but not limited to, family, 120 friends, and home and community-based services coverage when 121 determining whether the individual is able to comply with 122 posttransplant medical requirements. 123 (5) A covered entity shall take such steps as may be 124 necessary to ensure that an individual with a disability is not 125 denied services, including transplant-related counseling, 126 information, coverage, or treatment, due to the absence of 127 auxiliary aids and services, unless the covered entity can 128 demonstrate that taking the steps would fundamentally alter the 129 nature of the services being offered or would result in an undue 130 burden on the covered entity. 131 (6) If a covered entity violates this section, the 132 qualified individual who is affected by the violation may bring 133 an action in the appropriate circuit court for injunctive or 134 other equitable relief. 135 (7) This section may not be construed to require a covered 136 entity to make a referral or recommendation for or perform a 137 medically inappropriate organ transplant. 138 Section 2. Section 627.64197, Florida Statutes, is created 139 to read: 140 627.64197 Coverage for organ transplants.—A health 141 insurance policy issued, delivered, or renewed on or after July 142 1, 2020, in this state by an insurer which provides coverage for 143 organ transplants on an expense-incurred basis may not deny 144 coverage for an organ transplant solely on the basis of an 145 insured’s disability. This section may not be construed to 146 require such insurer to provide coverage for an organ transplant 147 that is not medically necessary. For purposes of this section, 148 the term “organ transplant” has the same meaning as in s. 149 765.523. 150 Section 3. Section 627.65736, Florida Statutes, is created 151 to read: 152 627.65736 Coverage for organ transplants.—A group health 153 insurance policy delivered, issued, or renewed on or after July 154 1, 2020, in this state by an insurer or nonprofit health care 155 services plan which provides coverage for organ transplants on 156 an expense-incurred basis may not deny coverage for an organ 157 transplant solely on the basis of an insured’s disability. This 158 section may not be construed to require such insurer or 159 nonprofit health care service plan to provide coverage for an 160 organ transplant that is not medically necessary. For purposes 161 of this section, the term “organ transplant” has the same 162 meaning as in s. 765.523. 163 Section 4. Section 641.31075, Florida Statutes, is created 164 to read: 165 641.31075 Coverage for organ transplants.—A health 166 maintenance contract issued or renewed on or after July 1, 2020, 167 in this state by a health maintenance organization which 168 provides coverage for organ transplants may not deny coverage 169 for an organ transplant solely on the basis of a subscriber’s 170 disability. This section may not be construed to require such 171 health maintenance organization to provide coverage for an organ 172 transplant that is not medically necessary. For purposes of this 173 section, the term “organ transplant” has the same meaning as in 174 s. 765.523. 175 Section 5. This act shall take effect July 1, 2020.