2022 Legislature                                   CS for SB 292
    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; providing that a newborn’s primary health
   10         care provider is responsible for coordinating such
   11         referrals under certain circumstances; requiring a
   12         newborn’s primary health care provider to refer the
   13         newborn for testing for congenital cytomegalovirus
   14         under certain circumstances; revising the timeframe
   15         within which hospitals must complete newborn hearing
   16         screenings that were not completed before discharge
   17         due to scheduling or temporary staffing limitations;
   18         requiring that certain test results be reported to the
   19         Department of Health within a specified timeframe;
   20         deleting a requirement that the parents of certain
   21         newborns be instructed on and provided specified
   22         information; deleting obsolete language; deleting a
   23         requirement that certain uninsured persons be provided
   24         a list of specified providers; providing an effective
   25         date.
   27  Be It Enacted by the Legislature of the State of Florida:
   29         Section 1. Section 383.145, Florida Statutes, is amended to
   30  read:
   31         383.145 Newborn and infant hearing screening.—
   32         (1) LEGISLATIVE INTENT.—It is the intent of the Legislature
   33  this section is to provide a statewide comprehensive and
   34  coordinated interdisciplinary program of early hearing loss
   35  impairment screening, identification, and follow-up followup
   36  care for newborns. The goal is to screen all newborns for
   37  hearing loss impairment in order to alleviate the adverse
   38  effects of hearing loss on speech and language development,
   39  academic performance, and cognitive development. It is further
   40  the intent of the Legislature that the provisions of this
   41  section act only be implemented to the extent that funds are
   42  specifically included in the General Appropriations Act for
   43  carrying out the purposes of this section.
   44         (2) DEFINITIONS.—As used in this section, the term:
   45         (a) “Audiologist” means a person licensed under part I of
   46  chapter 468 to practice audiology “Agency” means the Agency for
   47  Health Care Administration.
   48         (b) “Department” means the Department of Health.
   49         (c) “Hearing loss impairment” means a hearing loss of 30 dB
   50  HL or greater in the frequency region important for speech
   51  recognition and comprehension in one or both ears, approximately
   52  500 through 4,000 hertz.
   53         (d) “Hospital” means a facility as defined in s.
   54  395.002(13) and licensed under chapter 395 and part II of
   55  chapter 408.
   56         (e) “Infant” means an age range from 30 days through 12
   57  months.
   58         (f)(e) “Licensed health care provider” means a physician or
   59  physician assistant licensed under pursuant to chapter 458; an
   60  osteopathic physician or physician assistant licensed under or
   61  chapter 459; an advanced practice registered nurse, a registered
   62  nurse, or a licensed practical nurse licensed under part I of
   63  pursuant to chapter 464; a midwife licensed under chapter 467;,
   64  or a speech-language pathologist or an audiologist licensed
   65  under part I of pursuant to chapter 468, rendering services
   66  within the scope of his or her license.
   67         (g)(f) “Management” means the habilitation of the hearing
   68  impaired child with hearing loss.
   69         (h)(g) “Newborn” means an age range from birth through 29
   70  days.
   71         (i)“Physician” means a person licensed under chapter 458
   72  to practice medicine or chapter 459 to practice osteopathic
   73  medicine.
   74         (j)(h) “Screening” means a test or battery of tests
   75  administered to determine the need for an in-depth hearing
   76  diagnostic evaluation.
   79         (a) Each licensed hospital or other state-licensed birthing
   80  facility that provides maternity and newborn care services shall
   81  ensure provide that all newborns are, before prior to discharge,
   82  screened for the detection of hearing loss, to prevent the
   83  consequences of unidentified disorders. If a newborn fails the
   84  screening for the detection of hearing loss, the hospital or
   85  other state-licensed birthing facility must administer a test
   86  approved by the United States Food and Drug Administration or
   87  another diagnostically equivalent test on the newborn to screen
   88  for congenital cytomegalovirus before the newborn becomes 21
   89  days of age or before discharge, whichever occurs earlier.
   90         (b) Each licensed birth center that provides maternity and
   91  newborn care services shall ensure provide that all newborns
   92  are, before prior to discharge, referred to an a licensed
   93  audiologist, a physician licensed under chapter 458 or chapter
   94  459, or a hospital, or another other newborn hearing screening
   95  provider, for screening for the detection of hearing loss, to
   96  prevent the consequences of unidentified disorders. The referral
   97  for appointment must shall be made within 7 30 days after
   98  discharge. Written documentation of the referral must be placed
   99  in the newborn’s medical chart.
  100         (c) If the parent or legal guardian of the newborn objects
  101  to the screening, the screening must not be completed. In such
  102  case, the physician, midwife, or other person who is attending
  103  the newborn shall maintain a record that the screening has not
  104  been performed and attach a written objection that must be
  105  signed by the parent or guardian.
  106         (d) For home births, the health care provider in attendance
  107  is responsible for coordination and referral to an a licensed
  108  audiologist, a hospital, or another other newborn hearing
  109  screening provider. The health care provider in attendance must
  110  make the referral for appointment shall be made within 7 30 days
  111  after the birth. In cases in which the home birth is not
  112  attended by a primary health care provider, the newborn’s
  113  primary health care provider is responsible for coordinating the
  114  a referral to a licensed audiologist, physician licensed
  115  pursuant to chapter 458 or chapter 459, hospital, or other
  116  newborn hearing screening provider must be made by the health
  117  care provider within the first 3 months after the child’s birth.
  118         (e) For home births and births in a licensed birth center,
  119  if a newborn is referred to a newborn hearing screening provider
  120  and the newborn fails the screening for the detection of hearing
  121  loss, the newborn’s primary health care provider must refer the
  122  newborn for administration of a test approved by the United
  123  States Food and Drug Administration or another diagnostically
  124  equivalent test on the newborn to screen for congenital
  125  cytomegalovirus.
  126         (f) All newborn and infant hearing screenings must shall be
  127  conducted by an a licensed audiologist, a physician licensed
  128  under chapter 458 or chapter 459, or an appropriately supervised
  129  individual who has completed documented training specifically
  130  for newborn hearing screening. Every licensed hospital that
  131  provides maternity or newborn care services shall obtain the
  132  services of an a licensed audiologist, a physician licensed
  133  pursuant to chapter 458 or chapter 459, or another other newborn
  134  hearing screening provider, through employment or contract or
  135  written memorandum of understanding, for the purposes of
  136  appropriate staff training, screening program supervision,
  137  monitoring the scoring and interpretation of test results,
  138  rendering of appropriate recommendations, and coordination of
  139  appropriate follow-up followup services. Appropriate
  140  documentation of the screening completion, results,
  141  interpretation, and recommendations must be placed in the
  142  medical record within 24 hours after completion of the screening
  143  procedure.
  144         (g)(f) The screening of a newborn’s hearing must should be
  145  completed before the newborn is discharged from the hospital.
  146  However, if the screening is not completed before discharge due
  147  to scheduling or temporary staffing limitations, the screening
  148  must be completed within 21 30 days after the birth discharge.
  149  Screenings completed after discharge or performed because of
  150  initial screening failure must be completed by an audiologist
  151  licensed in the state, a physician licensed under chapter 458 or
  152  chapter 459, or a hospital, or another other newborn hearing
  153  screening provider.
  154         (h)(g) Each hospital shall formally designate a lead
  155  physician responsible for programmatic oversight for newborn
  156  hearing screening. Each birth center shall designate a licensed
  157  health care provider to provide such programmatic oversight and
  158  to ensure that the appropriate referrals are being completed.
  159         (i)(h) When ordered by the treating physician, screening of
  160  a newborn’s hearing must include auditory brainstem responses,
  161  or evoked otoacoustic otacoustic emissions, or appropriate
  162  technology as approved by the United States Food and Drug
  163  Administration.
  164         (j)(i)The results of any test conducted pursuant to this
  165  section, including, but not limited to, newborn hearing loss
  166  screening, congenital cytomegalovirus testing, and any related
  167  diagnostic testing, must be reported to the department within 7
  168  days after receipt of such results Newborn hearing screening
  169  must be conducted on all newborns in hospitals in this state on
  170  birth admission. When a newborn is delivered in a facility other
  171  than a hospital, the parents must be instructed on the
  172  importance of having the hearing screening performed and must be
  173  given information to assist them in having the screening
  174  performed within 3 months after the child’s birth.
  175         (k)(j) The initial procedure for screening the hearing of
  176  the newborn or infant and any medically necessary follow-up
  177  followup reevaluations leading to diagnosis shall be a covered
  178  benefit for, reimbursable under Medicaid as an expense
  179  compensated supplemental to the per diem rate for Medicaid
  180  patients enrolled in MediPass or Medicaid patients covered by a
  181  fee-for-service fee for service program. For Medicaid patients
  182  enrolled in HMOs, providers shall be reimbursed directly by the
  183  Medicaid Program Office at the Medicaid rate. This service may
  184  not be considered a covered service for the purposes of
  185  establishing the payment rate for Medicaid HMOs. All health
  186  insurance policies and health maintenance organizations as
  187  provided under ss. 627.6416, 627.6579, and 641.31(30), except
  188  for supplemental policies that only provide coverage for
  189  specific diseases, hospital indemnity, or Medicare supplement,
  190  or to the supplemental polices, shall compensate providers for
  191  the covered benefit at the contracted rate. Nonhospital-based
  192  providers are shall be eligible to bill Medicaid for the
  193  professional and technical component of each procedure code.
  194         (l)(k) A child who is diagnosed as having a permanent
  195  hearing loss must impairment shall be referred to the primary
  196  care physician for medical management, treatment, and follow-up
  197  followup services. Furthermore, in accordance with Part C of the
  198  Individuals with Disabilities Education Act, Pub. L. No. 108
  199  446, Infants and Toddlers with Disabilities, any child from
  200  birth to 36 months of age who is diagnosed as having a hearing
  201  loss impairment that requires ongoing special hearing services
  202  must be referred to the Children’s Medical Services Early
  203  Intervention Program serving the geographical area in which the
  204  child resides.
  205         (l) Any person who is not covered through insurance and
  206  cannot afford the costs for testing shall be given a list of
  207  newborn hearing screening providers who provide the necessary
  208  testing free of charge.
  209         Section 2. This act shall take effect January 1, 2023.