Florida Senate - 2022                        COMMITTEE AMENDMENT
       Bill No. SB 292
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

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