Florida Senate - 2022                                     SB 292
       By Senator Polsky
       29-00372-22                                            2022292__
    1                        A bill to be entitled                      
    2         An act relating to newborn screenings; amending s.
    3         383.14, F.S.; revising requirements for the Department
    4         of Health’s rules related to newborn screenings;
    5         amending s. 383.145, F.S.; defining terms; requiring
    6         hospitals and other state-licensed birthing facilities
    7         to test for congenital cytomegalovirus in newborns
    8         under certain circumstances; making technical and
    9         conforming changes; providing an effective date.
   11  Be It Enacted by the Legislature of the State of Florida:
   13         Section 1. Paragraph (a) of subsection (2) of section
   14  383.14, Florida Statutes, is amended to read:
   15         383.14 Screening for metabolic disorders, other hereditary
   16  and congenital disorders, and environmental risk factors.—
   17         (2) RULES.—
   18         (a) After consultation with the Genetics and Newborn
   19  Screening Advisory Council, the department shall adopt and
   20  enforce rules requiring that every newborn in this state shall:
   21         1. Before becoming 1 week of age, be subjected to a test
   22  for phenylketonuria;
   23         2. Before becoming 3 weeks of age, be subjected to a test
   24  for congenital cytomegalovirus;
   25         3. Be tested for any condition included on the federal
   26  Recommended Uniform Screening Panel which the council advises
   27  the department should be included under the state’s screening
   28  program. After the council recommends that a condition be
   29  included, the department shall submit a legislative budget
   30  request to seek an appropriation to add testing of the condition
   31  to the newborn screening program. The department shall expand
   32  statewide screening of newborns to include screening for such
   33  conditions within 18 months after the council renders such
   34  advice, if a test approved by the United States Food and Drug
   35  Administration or a test offered by an alternative vendor is
   36  available. If such a test is not available within 18 months
   37  after the council makes its recommendation, the department shall
   38  implement such screening as soon as a test offered by the United
   39  States Food and Drug Administration or by an alternative vendor
   40  is available; and
   41         4.3. At the appropriate age, be tested for such other
   42  metabolic diseases and hereditary or congenital disorders as the
   43  department may deem necessary from time to time.
   44         Section 2. Section 383.145, Florida Statutes, is amended to
   45  read:
   46         383.145 Newborn and infant hearing screening.—
   47         (1) LEGISLATIVE INTENT.—It is the intent of the Legislature
   48  this section is to provide a statewide comprehensive and
   49  coordinated interdisciplinary program of early hearing
   50  impairment screening, identification, and followup care for
   51  newborns. The goal is to screen all newborns for hearing
   52  impairment in order to alleviate the adverse effects of hearing
   53  loss on speech and language development, academic performance,
   54  and cognitive development. It is further the intent of the
   55  Legislature that the provisions of this section act only be
   56  implemented to the extent that funds are specifically included
   57  in the General Appropriations Act for carrying out the purposes
   58  of this section.
   59         (2) DEFINITIONS.—As used in this section, the term:
   60         (a) “Agency” means the Agency for Health Care
   61  Administration.
   62         (b) “Audiologist” means a person licensed under part I of
   63  chapter 468 to practice audiology.
   64         (c) “Department” means the Department of Health.
   65         (d)(c) “Hearing impairment” means a hearing loss of 30 dB
   66  HL or greater in the frequency region important for speech
   67  recognition and comprehension in one or both ears, approximately
   68  500 through 4,000 hertz.
   69         (e)“Hospital” means a facility as defined in s.
   70  395.002(13) and licensed under chapter 395 and part II of
   71  chapter 408.
   72         (f)(d) “Infant” means an age range from 30 days through 12
   73  months.
   74         (g)(e) “Licensed health care provider” means a physician
   75  licensed under pursuant to chapter 458 or chapter 459, a nurse
   76  licensed under pursuant to chapter 464, or an audiologist
   77  licensed under part I of pursuant to chapter 468, rendering
   78  services within the scope of his or her license.
   79         (h)(f) “Management” means the habilitation of the hearing
   80  impaired child.
   81         (i)(g) “Newborn” means an age range from birth through 29
   82  days.
   83         (j)“Physician” means a person licensed under chapter 458
   84  to practice medicine or chapter 459 to practice osteopathic
   85  medicine.
   86         (k)(h) “Screening” means a test or battery of tests
   87  administered to determine the need for an in-depth hearing
   88  diagnostic evaluation.
   91         (a) Each licensed hospital or other state-licensed birthing
   92  facility that provides maternity and newborn care services shall
   93  ensure provide that all newborns are, before prior to discharge,
   94  screened for the detection of hearing loss, to prevent the
   95  consequences of unidentified disorders. If a newborn fails the
   96  screening for the detection of hearing loss, the hospital or
   97  other state-licensed birthing facility must administer a urine
   98  polymerase chain reaction test or other diagnostically
   99  equivalent test on the newborn to screen for congenital
  100  cytomegalovirus.
  101         (b) Each licensed birth center that provides maternity and
  102  newborn care services shall ensure provide that all newborns
  103  are, before prior to discharge, referred to an a licensed
  104  audiologist, a physician licensed under chapter 458 or chapter
  105  459, or a hospital, or another other newborn hearing screening
  106  provider, for screening for the detection of hearing loss, to
  107  prevent the consequences of unidentified disorders. The referral
  108  for appointment must shall be made within 30 days after
  109  discharge. Written documentation of the referral must be placed
  110  in the newborn’s medical chart.
  111         (c) If the parent or legal guardian of the newborn objects
  112  to the screening, the screening may must not be completed. In
  113  such case, the physician, midwife, or other person who is
  114  attending the newborn shall maintain a record that the screening
  115  has not been performed and attach a written objection that must
  116  be signed by the parent or guardian.
  117         (d) For home births, the health care provider in attendance
  118  is responsible for coordination and referral to an a licensed
  119  audiologist, a physician, a hospital, or another other newborn
  120  hearing screening provider. The referral for appointment must
  121  shall be made within 30 days after the birth. In cases in which
  122  the home birth is not attended by a primary health care
  123  provider, a referral to an a licensed audiologist, a physician
  124  licensed pursuant to chapter 458 or chapter 459, a hospital, or
  125  another other newborn hearing screening provider must be made by
  126  the health care provider within the first 3 months after the
  127  child’s birth.
  128         (e) All newborn and infant hearing screenings must shall be
  129  conducted by an a licensed audiologist, a physician licensed
  130  under chapter 458 or chapter 459, or an appropriately supervised
  131  individual who has completed documented training specifically
  132  for newborn hearing screening. Every licensed hospital that
  133  provides maternity or newborn care services shall obtain the
  134  services of an a licensed audiologist, a physician licensed
  135  pursuant to chapter 458 or chapter 459, or another other newborn
  136  hearing screening provider, through employment or contract or
  137  written memorandum of understanding, for the purposes of
  138  appropriate staff training, screening program supervision,
  139  monitoring the scoring and interpretation of test results,
  140  rendering of appropriate recommendations, and coordination of
  141  appropriate followup services. Appropriate documentation of the
  142  screening completion, results, interpretation, and
  143  recommendations must be placed in the medical record within 24
  144  hours after completion of the screening procedure.
  145         (f) The screening of a newborn’s hearing must should be
  146  completed before the newborn is discharged from the hospital.
  147  However, if the screening is not completed before discharge due
  148  to scheduling or temporary staffing limitations, the screening
  149  must be completed within 30 days after discharge. Screenings
  150  completed after discharge or performed because of initial
  151  screening failure must be completed by an audiologist licensed
  152  in the state, a physician licensed under chapter 458 or chapter
  153  459, or a hospital, or another other newborn hearing screening
  154  provider.
  155         (g) Each hospital shall formally designate a lead physician
  156  responsible for programmatic oversight for newborn hearing
  157  screening. Each birth center shall designate a licensed health
  158  care provider to provide such programmatic oversight and to
  159  ensure that the appropriate referrals are being completed.
  160         (h) When ordered by the treating physician, screening of a
  161  newborn’s hearing must include auditory brainstem responses, or
  162  evoked otacoustic emissions, or appropriate technology as
  163  approved by the United States Food and Drug Administration.
  164         (i) Newborn hearing screening must be conducted on all
  165  newborns in hospitals in this state on birth admission. When a
  166  newborn is delivered in a facility other than a hospital, the
  167  parents must be instructed on the importance of having the
  168  hearing screening performed and must be given information to
  169  assist them in having the screening performed within 3 months
  170  after the child’s birth.
  171         (j) The initial procedure for screening the hearing of the
  172  newborn or infant and any medically necessary followup
  173  reevaluations leading to diagnosis shall be a covered benefit,
  174  reimbursable under Medicaid as an expense compensated
  175  supplemental to the per diem rate for Medicaid patients enrolled
  176  in MediPass or Medicaid patients covered by a fee for service
  177  program. For Medicaid patients enrolled in HMOs, providers shall
  178  be reimbursed directly by the Medicaid Program Office at the
  179  Medicaid rate. This service may not be considered a covered
  180  service for the purposes of establishing the payment rate for
  181  Medicaid HMOs. All health insurance policies and health
  182  maintenance organizations as provided under ss. 627.6416,
  183  627.6579, and 641.31(30), except for supplemental policies that
  184  only provide coverage for specific diseases, hospital indemnity,
  185  or Medicare supplement, or to the supplemental polices, shall
  186  compensate providers for the covered benefit at the contracted
  187  rate. Nonhospital-based providers are shall be eligible to bill
  188  Medicaid for the professional and technical component of each
  189  procedure code.
  190         (k) A child who is diagnosed as having a permanent hearing
  191  impairment must shall be referred to the primary care physician
  192  for medical management, treatment, and followup services.
  193  Furthermore, in accordance with Part C of the Individuals with
  194  Disabilities Education Act, Pub. L. No. 108-446, Infants and
  195  Toddlers with Disabilities, any child from birth to 36 months of
  196  age who is diagnosed as having a hearing impairment that
  197  requires ongoing special hearing services must be referred to
  198  the Children’s Medical Services Early Intervention Program
  199  serving the geographical area in which the child resides.
  200         (l) Any person who is not covered through insurance and
  201  cannot afford the costs for testing must shall be given a list
  202  of newborn hearing screening providers who provide the necessary
  203  testing free of charge.
  204         Section 3. This act shall take effect July 1, 2022.