Bill Text: FL S0932 | 2024 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Coverage for Diagnostic and Supplemental Breast Examinations

Spectrum: Bipartisan Bill

Status: (Failed) 2024-03-08 - Died in Messages [S0932 Detail]

Download: Florida-2024-S0932-Introduced.html

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       Florida Senate - 2024                                     SB 932
       
       
        
       By Senator Berman
       
       
       
       
       
       26-01578-24                                            2024932__
    1                        A bill to be entitled                      
    2         An act relating to coverage for diagnostic and
    3         supplemental breast examinations; amending s. 110.123,
    4         F.S.; prohibiting the state group insurance program
    5         from imposing any enrollee cost-sharing liability with
    6         respect to coverage for diagnostic breast examinations
    7         and supplemental breast examinations; creating ss.
    8         627.64181, 627.66131, and 641.31093, F.S.; defining
    9         terms; prohibiting the imposition of cost-sharing
   10         requirements for diagnostic and supplemental breast
   11         examinations by individual accident and health
   12         insurance policies; group, blanket, or franchise
   13         accident and health insurance policies; and health
   14         maintenance contracts, respectively, which provide
   15         such coverage; providing applicability; authorizing
   16         the Financial Services Commission to adopt rules;
   17         providing an effective date.
   18          
   19  Be It Enacted by the Legislature of the State of Florida:
   20  
   21         Section 1. Paragraph (c) of subsection (3) of section
   22  110.123, Florida Statutes, is amended to read:
   23         110.123 State group insurance program.—
   24         (3) STATE GROUP INSURANCE PROGRAM.—
   25         (c)1. Notwithstanding any provision in this section to the
   26  contrary, it is the intent of the Legislature that the
   27  department shall be responsible for all aspects of the purchase
   28  of health care for state employees under the state group health
   29  insurance plan or plans, TRICARE supplemental insurance plans,
   30  and the health maintenance organization plans. Responsibilities
   31  shall include, but not be limited to, the development of
   32  requests for proposals or invitations to negotiate for state
   33  employee health benefits, the determination of health care
   34  benefits to be provided, and the negotiation of contracts for
   35  health care and health care administrative services. Prior to
   36  the negotiation of contracts for health care services, the
   37  Legislature intends that the department shall develop, with
   38  respect to state collective bargaining issues, the health
   39  benefits and terms to be included in the state group health
   40  insurance program. The department shall adopt rules necessary to
   41  perform its responsibilities pursuant to this section. The
   42  department is responsible for the contract management and day
   43  to-day management of the state employee health insurance
   44  program, including, but not limited to, employee enrollment,
   45  premium collection, payment to health care providers, and other
   46  administrative functions related to the program.
   47         2. In any contract or plan for state employee health
   48  benefits which provides coverage for diagnostic breast
   49  examinations or supplemental breast examinations, as those terms
   50  are defined in s. 627.64181(1), the state group insurance
   51  program may not impose any enrollee cost-sharing liability.
   52         Section 2. Section 627.64181, Florida Statutes, is created
   53  to read:
   54         627.64181 Coverage for diagnostic and supplemental breast
   55  examinations; cost-sharing requirements prohibited.—
   56         (1) As used in this section, the term:
   57         (a) “Cost-sharing requirement” means an insured’s
   58  deductible, coinsurance, copayment, or similar out-of-pocket
   59  expense.
   60         (b) “Diagnostic breast examination” means a medically
   61  necessary and appropriate examination of the breast, including,
   62  but not limited to, an examination using diagnostic mammography,
   63  breast magnetic resonance imaging, or breast ultrasound, which
   64  is used to evaluate an abnormality that is seen or suspected
   65  from a screening examination for breast cancer.
   66         (c) “Supplemental breast examination” means a medically
   67  necessary and appropriate examination of the breast, including,
   68  but not limited to, an examination using breast magnetic
   69  resonance imaging or breast ultrasound, which is:
   70         1. Used to screen for breast cancer when there is no
   71  abnormality seen or suspected; and
   72         2. Based on personal or family medical history or
   73  additional factors that may increase the person’s risk of breast
   74  cancer.
   75         (2) An accident or health insurance policy issued, amended,
   76  delivered, or renewed on or after January 1, 2025, which
   77  provides coverage for diagnostic breast examinations and
   78  supplemental breast examinations may not impose any cost-sharing
   79  requirement with respect to such coverage.
   80         (3) If, under federal law, the application of subsection
   81  (2) would result in health savings account ineligibility under
   82  s. 223 of the Internal Revenue Code, the prohibition under
   83  subsection (2) applies only to health savings account qualified
   84  high-deductible health plans with respect to the deductible of
   85  such a plan after the person has satisfied the minimum
   86  deductible under s. 223 of the Internal Revenue Code, except
   87  with respect to items or services that are preventive care
   88  pursuant to s. 223(c)(2)(C) of the Internal Revenue Code, in
   89  which case the requirements of s. 223(c)(2)(A) of the Internal
   90  Revenue Code apply regardless of whether the minimum deductible
   91  under s. 223 of the Internal Revenue Code has been satisfied.
   92         (4) The commission may adopt rules to administer this
   93  section.
   94         Section 3. Section 627.66131, Florida Statutes, is created
   95  to read:
   96         627.66131 Coverage for diagnostic and supplemental breast
   97  examinations; cost-sharing requirements prohibited.—
   98         (1) As used in this section, the terms “cost-sharing
   99  requirement,” “diagnostic breast examination,” and “supplemental
  100  breast examination” have the same meanings as in s.
  101  627.64181(1).
  102         (2) A group, blanket, or franchise accident or health
  103  insurance policy issued, amended, delivered, or renewed on or
  104  after January 1, 2025, which provides coverage for diagnostic
  105  breast examinations and supplemental breast examinations may not
  106  impose any cost-sharing requirement with respect to such
  107  coverage.
  108         (3) If, under federal law, the application of subsection
  109  (2) would result in health savings account ineligibility under
  110  s. 223 of the Internal Revenue Code, the prohibition under
  111  subsection (2) applies only to health savings account qualified
  112  high-deductible health plans with respect to the deductible of
  113  such a plan after the person has satisfied the minimum
  114  deductible under s. 223 of the Internal Revenue Code, except
  115  with respect to items or services that are preventive care
  116  pursuant to s. 223(c)(2)(C) of the Internal Revenue Code, in
  117  which case the requirements of s. 223(c)(2)(A) of the Internal
  118  Revenue Code apply regardless of whether the minimum deductible
  119  under s. 223 of the Internal Revenue Code has been satisfied.
  120         (4) The commission may adopt rules to administer this
  121  section.
  122         Section 4. Section 641.31093, Florida Statutes, is created
  123  to read:
  124         641.31093 Coverage for diagnostic and supplemental breast
  125  examinations; cost-sharing requirements prohibited.—
  126         (1)  As used in this section, the terms “cost-sharing
  127  requirement,” “diagnostic breast examination,” and “supplemental
  128  breast examination” have the same meanings as in s.
  129  627.64181(1).
  130         (2) A health maintenance contract issued, amended,
  131  delivered, or renewed on or after January 1, 2025, which
  132  provides coverage for diagnostic breast examinations and
  133  supplemental breast examinations may not impose any cost-sharing
  134  requirement with respect to such coverage.
  135         (3) If, under federal law, the application of subsection
  136  (2) would result in health savings account ineligibility under
  137  s. 223 of the Internal Revenue Code, the prohibition under
  138  subsection (2) applies only to health savings account qualified
  139  high-deductible health plans with respect to the deductible of
  140  such a plan after the person has satisfied the minimum
  141  deductible under s. 223 of the Internal Revenue Code, except
  142  with respect to items or services that are preventive care
  143  pursuant to s. 223(c)(2)(C) of the Internal Revenue Code, in
  144  which case the requirements of s. 223(c)(2)(A) of the Internal
  145  Revenue Code apply regardless of whether the minimum deductible
  146  under s. 223 of the Internal Revenue Code has been satisfied.
  147         (4) The commission may adopt rules to administer this
  148  section.
  149         Section 5. This act shall take effect July 1, 2024.