Florida Senate - 2022              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 292
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to newborn screenings; amending s.
    3         383.145, F.S.; revising and defining terms; requiring
    4         hospitals and other state-licensed birthing facilities
    5         to test for congenital cytomegalovirus in newborns
    6         within a specified timeframe under certain
    7         circumstances; revising the timeframe in which health
    8         care providers attending home births must make certain
    9         referrals; requiring certain health care providers
   10         practicing in the primary care setting to screen
   11         certain newborns in their care for hearing loss within
   12         a specified timeframe; requiring such providers to
   13         test such newborns for congenital cytomegalovirus
   14         within a specified timeframe under certain
   15         circumstances; revising the timeframe within which
   16         hospitals must complete newborn hearing screenings
   17         that were not completed before discharge due to
   18         temporary staffing or scheduling limitations;
   19         providing that certain test results must be reported
   20         to the Department of Health within a specified
   21         timeframe; deleting a requirement that the parents of
   22         certain newborns be instructed on and provided
   23         specified information; revising a provision related to
   24         Medicaid coverage of newborn hearing screenings and
   25         follow-up reevaluations to delete obsolete language;
   26         deleting a requirement that certain uninsured persons
   27         be provided a list of specified providers; providing
   28         an effective date.
   30  Be It Enacted by the Legislature of the State of Florida:
   32         Section 1. Section 383.145, Florida Statutes, is amended to
   33  read:
   34         383.145 Newborn and infant hearing screening.—
   35         (1) LEGISLATIVE INTENT.—It is the intent of the Legislature
   36  this section is to provide a statewide comprehensive and
   37  coordinated interdisciplinary program of early hearing loss
   38  impairment screening, identification, and follow-up followup
   39  care for newborns. The goal is to screen all newborns for
   40  hearing loss impairment in order to alleviate the adverse
   41  effects of hearing loss on speech and language development,
   42  academic performance, and cognitive development. It is further
   43  the intent of the Legislature that the provisions of this
   44  section act only be implemented to the extent that funds are
   45  specifically included in the General Appropriations Act for
   46  carrying out the purposes of this section.
   47         (2) DEFINITIONS.—As used in this section, the term:
   48         (a) “Audiologist” means a person licensed under part I of
   49  chapter 468 to practice audiology “Agency” means the Agency for
   50  Health Care Administration.
   51         (b) “Department” means the Department of Health.
   52         (c) “Hearing loss impairment” means a hearing loss of 30 dB
   53  HL or greater in the frequency region important for speech
   54  recognition and comprehension in one or both ears, approximately
   55  500 through 4,000 hertz.
   56         (d) “Hospital” means a facility as defined in s.
   57  395.002(13) and licensed under chapter 395 and part II of
   58  chapter 408.
   59         (e) “Infant” means an age range from 30 days through 12
   60  months.
   61         (f)(e) “Licensed health care provider” means a physician or
   62  physician assistant licensed under pursuant to chapter 458; an
   63  osteopathic physician or physician assistant licensed under or
   64  chapter 459; an advanced practice registered nurse, a registered
   65  nurse, or a licensed practical nurse licensed under part I of
   66  pursuant to chapter 464; a midwife licensed under chapter 467;,
   67  or a speech-language pathologist or an audiologist licensed
   68  under part I of pursuant to chapter 468, rendering services
   69  within the scope of his or her license.
   70         (g)(f) “Management” means the habilitation of the hearing
   71  impaired child with hearing loss.
   72         (h)(g) “Newborn” means an age range from birth through 29
   73  days.
   74         (i)“Physician” means a person licensed under chapter 458
   75  to practice medicine or chapter 459 to practice osteopathic
   76  medicine.
   77         (j)(h) “Screening” means a test or battery of tests
   78  administered to determine the need for an in-depth hearing
   79  diagnostic evaluation.
   82         (a) Each licensed hospital or other state-licensed birthing
   83  facility that provides maternity and newborn care services shall
   84  ensure provide that all newborns are, before prior to discharge,
   85  screened for the detection of hearing loss, to prevent the
   86  consequences of unidentified disorders. If a newborn fails the
   87  screening for the detection of hearing loss, the hospital or
   88  other state-licensed birthing facility must administer a test
   89  approved by the United States Food and Drug Administration or
   90  another diagnostically equivalent test on the newborn to screen
   91  for congenital cytomegalovirus before the newborn becomes 21
   92  days of age or before discharge, whichever occurs earlier.
   93         (b) Each licensed birth center that provides maternity and
   94  newborn care services shall ensure provide that all newborns
   95  are, before prior to discharge, referred to an a licensed
   96  audiologist, a physician licensed under chapter 458 or chapter
   97  459, or a hospital, or another other newborn hearing screening
   98  provider, for screening for the detection of hearing loss, to
   99  prevent the consequences of unidentified disorders. The referral
  100  for appointment shall be made within 30 days after discharge.
  101  Written documentation of the referral must be placed in the
  102  newborn’s medical chart.
  103         (c) If the parent or legal guardian of the newborn objects
  104  to the screening, the screening must not be completed. In such
  105  case, the physician, midwife, or other person who is attending
  106  the newborn shall maintain a record that the screening has not
  107  been performed and attach a written objection that must be
  108  signed by the parent or guardian.
  109         (d) For home births, the health care provider in attendance
  110  is responsible for coordination and referral to an a licensed
  111  audiologist, a physician, a hospital, or another other newborn
  112  hearing screening provider. The referral for appointment must
  113  shall be made within 7 30 days after the birth. In cases in
  114  which the home birth is not attended by a primary health care
  115  provider, a referral to a licensed audiologist, physician
  116  licensed pursuant to chapter 458 or chapter 459, hospital, or
  117  other newborn hearing screening provider must be made by the
  118  health care provider within the first 3 months after the child’s
  119  birth.
  120         (e) Each licensed health care provider practicing in the
  121  primary care setting must ensure that a newborn in his or her
  122  care whose birth was not attended by a health care provider is
  123  screened for hearing loss within 21 days after the birth. If a
  124  newborn fails the screening for the detection of hearing loss,
  125  the licensed health care provider must administer a test
  126  approved by the United States Food and Drug Administration or
  127  another diagnostically equivalent test on the newborn to screen
  128  for congenital cytomegalovirus before the newborn becomes 21
  129  days of age.
  130         (f) All newborn and infant hearing screenings must shall be
  131  conducted by an a licensed audiologist, a physician licensed
  132  under chapter 458 or chapter 459, or an appropriately supervised
  133  individual who has completed documented training specifically
  134  for newborn hearing screening. Every licensed hospital that
  135  provides maternity or newborn care services shall obtain the
  136  services of an a licensed audiologist, a physician licensed
  137  pursuant to chapter 458 or chapter 459, or another other newborn
  138  hearing screening provider, through employment or contract or
  139  written memorandum of understanding, for the purposes of
  140  appropriate staff training, screening program supervision,
  141  monitoring the scoring and interpretation of test results,
  142  rendering of appropriate recommendations, and coordination of
  143  appropriate follow-up followup services. Appropriate
  144  documentation of the screening completion, results,
  145  interpretation, and recommendations must be placed in the
  146  medical record within 24 hours after completion of the screening
  147  procedure.
  148         (g)(f) The screening of a newborn’s hearing must should be
  149  completed before the newborn is discharged from the hospital.
  150  However, if the screening is not completed before discharge due
  151  to scheduling or temporary staffing limitations, the screening
  152  must be completed within 21 30 days after the birth discharge.
  153  Screenings completed after discharge or performed because of
  154  initial screening failure must be completed by an audiologist
  155  licensed in the state, a physician licensed under chapter 458 or
  156  chapter 459, or a hospital, or another other newborn hearing
  157  screening provider.
  158         (h)(g) Each hospital shall formally designate a lead
  159  physician responsible for programmatic oversight for newborn
  160  hearing screening. Each birth center shall designate a licensed
  161  health care provider to provide such programmatic oversight and
  162  to ensure that the appropriate referrals are being completed.
  163         (i)(h) When ordered by the treating physician, screening of
  164  a newborn’s hearing must include auditory brainstem responses,
  165  or evoked otoacoustic otacoustic emissions, or appropriate
  166  technology as approved by the United States Food and Drug
  167  Administration.
  168         (j)(i)The results of any test conducted pursuant to this
  169  section, including, but not limited to, newborn hearing loss
  170  screening, congenital cytomegalovirus testing, and any related
  171  diagnostic testing, must be reported to the department within 7
  172  days after receipt of such results Newborn hearing screening
  173  must be conducted on all newborns in hospitals in this state on
  174  birth admission. When a newborn is delivered in a facility other
  175  than a hospital, the parents must be instructed on the
  176  importance of having the hearing screening performed and must be
  177  given information to assist them in having the screening
  178  performed within 3 months after the child’s birth.
  179         (k)(j) The initial procedure for screening the hearing of
  180  the newborn or infant and any medically necessary follow-up
  181  followup reevaluations leading to diagnosis shall be a covered
  182  benefit for, reimbursable under Medicaid as an expense
  183  compensated supplemental to the per diem rate for Medicaid
  184  patients enrolled in MediPass or Medicaid patients covered by a
  185  fee for service program. For Medicaid patients enrolled in HMOs,
  186  providers shall be reimbursed directly by the Medicaid Program
  187  Office at the Medicaid rate. This service may not be considered
  188  a covered service for the purposes of establishing the payment
  189  rate for Medicaid HMOs. All health insurance policies and health
  190  maintenance organizations as provided under ss. 627.6416,
  191  627.6579, and 641.31(30), except for supplemental policies that
  192  only provide coverage for specific diseases, hospital indemnity,
  193  or Medicare supplement, or to the supplemental polices, shall
  194  compensate providers for the covered benefit at the contracted
  195  rate. Nonhospital-based providers are shall be eligible to bill
  196  Medicaid for the professional and technical component of each
  197  procedure code.
  198         (l)(k) A child who is diagnosed as having a permanent
  199  hearing loss must impairment shall be referred to the primary
  200  care physician for medical management, treatment, and follow-up
  201  followup services. Furthermore, in accordance with Part C of the
  202  Individuals with Disabilities Education Act, Pub. L. No. 108
  203  446, Infants and Toddlers with Disabilities, any child from
  204  birth to 36 months of age who is diagnosed as having a hearing
  205  loss impairment that requires ongoing special hearing services
  206  must be referred to the Children’s Medical Services Early
  207  Intervention Program serving the geographical area in which the
  208  child resides.
  209         (l) Any person who is not covered through insurance and
  210  cannot afford the costs for testing shall be given a list of
  211  newborn hearing screening providers who provide the necessary
  212  testing free of charge.
  213         Section 2. This act shall take effect January 1, 2023.