Florida Senate - 2020                        COMMITTEE AMENDMENT
       Bill No. SB 1836
       
       
       
       
       
       
                                Ì539144+Î539144                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/17/2020           .                                
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       The Committee on Governmental Oversight and Accountability
       (Bean) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (l) is added to subsection (3) of
    6  section 408.05, Florida Statutes, to read:
    7         408.05 Florida Center for Health Information and
    8  Transparency.—
    9         (3) HEALTH INFORMATION TRANSPARENCY.—In order to
   10  disseminate and facilitate the availability of comparable and
   11  uniform health information, the agency shall perform the
   12  following functions:
   13         (l)By July 1 of each year, publish a report identifying
   14  the health care services with the most significant price
   15  variation both statewide and regionally.
   16         Section 2. Paragraph (e) of subsection (2) and paragraph
   17  (e) of subsection (3) of section 627.6387, Florida Statutes, are
   18  amended to read:
   19         627.6387 Shared savings incentive program.—
   20         (2) As used in this section, the term:
   21         (e) “Shoppable health care service” means a lower-cost,
   22  high-quality nonemergency health care service for which a shared
   23  savings incentive is available for insureds under a health
   24  insurer’s shared savings incentive program. Shoppable health
   25  care services may be provided within or outside this state and
   26  include, but are not limited to:
   27         1. Clinical laboratory services.
   28         2. Infusion therapy.
   29         3. Inpatient and outpatient surgical procedures.
   30         4. Obstetrical and gynecological services.
   31         5. Inpatient and outpatient nonsurgical diagnostic tests
   32  and procedures.
   33         6. Physical and occupational therapy services.
   34         7. Radiology and imaging services.
   35         8. Prescription drugs.
   36         9. Services provided through telehealth.
   37         10.Any additional services published by the Agency for
   38  Health Care Administration that have the most significant price
   39  variation pursuant to s. 408.05(3)(l).
   40         (3) A health insurer may offer a shared savings incentive
   41  program to provide incentives to an insured when the insured
   42  obtains a shoppable health care service from the health
   43  insurer’s shared savings list. An insured may not be required to
   44  participate in a shared savings incentive program. A health
   45  insurer that offers a shared savings incentive program must:
   46         (e) At least quarterly, credit or deposit the shared
   47  savings incentive amount to the insured’s account as a return or
   48  reduction in premium, or credit the shared savings incentive
   49  amount to the insured’s flexible spending account, health
   50  savings account, or health reimbursement account, or reward the
   51  insured directly with cash or a cash equivalent such that the
   52  amount does not constitute income to the insured.
   53         Section 3. Paragraph (e) of subsection (2) and paragraph
   54  (e) of subsection (3) of section 627.6648, Florida Statutes, are
   55  amended to read:
   56         627.6648 Shared savings incentive program.—
   57         (2) As used in this section, the term:
   58         (e) “Shoppable health care service” means a lower-cost,
   59  high-quality nonemergency health care service for which a shared
   60  savings incentive is available for insureds under a health
   61  insurer’s shared savings incentive program. Shoppable health
   62  care services may be provided within or outside this state and
   63  include, but are not limited to:
   64         1. Clinical laboratory services.
   65         2. Infusion therapy.
   66         3. Inpatient and outpatient surgical procedures.
   67         4. Obstetrical and gynecological services.
   68         5. Inpatient and outpatient nonsurgical diagnostic tests
   69  and procedures.
   70         6. Physical and occupational therapy services.
   71         7. Radiology and imaging services.
   72         8. Prescription drugs.
   73         9. Services provided through telehealth.
   74         10.Any additional services published by the Agency for
   75  Health Care Administration that have the most significant price
   76  variation pursuant to s. 408.05(3)(l).
   77         (3) A health insurer may offer a shared savings incentive
   78  program to provide incentives to an insured when the insured
   79  obtains a shoppable health care service from the health
   80  insurer’s shared savings list. An insured may not be required to
   81  participate in a shared savings incentive program. A health
   82  insurer that offers a shared savings incentive program must:
   83         (e) At least quarterly, credit or deposit the shared
   84  savings incentive amount to the insured’s account as a return or
   85  reduction in premium, or credit the shared savings incentive
   86  amount to the insured’s flexible spending account, health
   87  savings account, or health reimbursement account, or reward the
   88  insured directly with cash or a cash equivalent such that the
   89  amount does not constitute income to the insured.
   90         Section 4. Paragraph (e) of subsection (2) and paragraph
   91  (e) of subsection (3) of section 641.31076, Florida Statutes,
   92  are amended to read:
   93         641.31076 Shared savings incentive program.—
   94         (2) As used in this section, the term:
   95         (e) “Shoppable health care service” means a lower-cost,
   96  high-quality nonemergency health care service for which a shared
   97  savings incentive is available for subscribers under a health
   98  maintenance organization’s shared savings incentive program.
   99  Shoppable health care services may be provided within or outside
  100  this state and include, but are not limited to:
  101         1. Clinical laboratory services.
  102         2. Infusion therapy.
  103         3. Inpatient and outpatient surgical procedures.
  104         4. Obstetrical and gynecological services.
  105         5. Inpatient and outpatient nonsurgical diagnostic tests
  106  and procedures.
  107         6. Physical and occupational therapy services.
  108         7. Radiology and imaging services.
  109         8. Prescription drugs.
  110         9. Services provided through telehealth.
  111         10.Any additional services published by the Agency for
  112  Health Care Administration that have the most significant price
  113  variation pursuant to s. 408.05(3)(l).
  114         (3) A health maintenance organization may offer a shared
  115  savings incentive program to provide incentives to a subscriber
  116  when the subscriber obtains a shoppable health care service from
  117  the health maintenance organization’s shared savings list. A
  118  subscriber may not be required to participate in a shared
  119  savings incentive program. A health maintenance organization
  120  that offers a shared savings incentive program must:
  121         (e) At least quarterly, credit or deposit the shared
  122  savings incentive amount to the subscriber’s account as a return
  123  or reduction in premium, or credit the shared savings incentive
  124  amount to the subscriber’s flexible spending account, health
  125  savings account, or health reimbursement account, or reward the
  126  subscriber directly with cash or a cash equivalent such that the
  127  amount does not constitute income to the subscriber.
  128         Section 5. This act shall take effect January 1, 2021.
  129  
  130  ================= T I T L E  A M E N D M E N T ================
  131  And the title is amended as follows:
  132         Delete everything before the enacting clause
  133  and insert:
  134                        A bill to be entitled                      
  135         An act relating to health insurance benefits; amending
  136         s. 408.05, F.S.; requiring the Agency for Health Care
  137         Administration to publish by a specified date an
  138         annual report identifying certain health care
  139         services; amending ss. 627.6387, 627.6648, and
  140         641.31076, F.S.; revising the definition of the term
  141         “shoppable health care service”; revising duties of
  142         certain health insurers and health maintenance
  143         organizations; providing an effective date.