Bill Text: FL S0190 | 2010 | Regular Session | Introduced
Bill Title: Breast Cancer Treatment [WPSC]
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2010-04-30 - Died in Committee on Banking and Insurance [S0190 Detail]
Download: Florida-2010-S0190-Introduced.html
Florida Senate - 2010 SB 190 By Senator Joyner 18-00001-10 2010190__ 1 A bill to be entitled 2 An act relating to breast cancer treatment; providing 3 a short title; amending ss. 627.64171, 627.66121, and 4 641.31, F.S.; including lymph node dissections under 5 provisions prescribing the length of hospital stay 6 relating to a mastectomy and the outpatient 7 postsurgical followup care that specified health 8 insurers and health maintenance organizations must 9 cover; limiting application; providing an effective 10 date. 11 12 Be It Enacted by the Legislature of the State of Florida: 13 14 Section 1. This act may be cited as the “Mary B. Hooks 15 Act.” 16 Section 2. Subsections (1) and (2) and paragraph (a) of 17 subsection (4) of section 627.64171, Florida Statutes, are 18 amended to read: 19 627.64171 Coverage for length of stay and outpatient 20 postsurgical care.— 21 (1) Any health insurance policy that is issued, amended, 22 delivered, or renewed in this state which provides coverage for 23 breast cancer treatment may not limit inpatient hospital 24 coverage for lymph node dissections or mastectomies to any 25 period that is less than that determined by the treating 26 physician to be medically necessary in accordance with 27 prevailing medical standards and after consultation with the 28 insured patient. 29 (2) Any health insurance policy that provides coverage for 30 lymph node dissections or mastectomies under subsection (1) must 31 also provide coverage for outpatient postsurgical followup care 32 in keeping with prevailing medical standards by a licensed 33 health care professional qualified to provide postsurgical lymph 34 node dissection or mastectomy care. The treating physician, 35 after consultation with the insured patient, may choose that the 36 outpatient care be provided at the most medically appropriate 37 setting, which may include the hospital, treating physician’s 38 office, outpatient center, or home of the insured patient. 39 (4)(a) This section does not require an insured patient to 40 have a lymph node dissection orthemastectomy in the hospital 41 or stay in the hospital for a fixed period of time following the 42 lymph node dissection or mastectomy. 43 Section 3. Subsections (1) and (2) and paragraph (a) of 44 subsection (4) of section 627.66121, Florida Statutes, are 45 amended to read: 46 627.66121 Coverage for length of stay and outpatient 47 postsurgical care.— 48 (1) Any group, blanket, or franchise accident or health 49 insurance policy that is issued, amended, delivered, or renewed 50 in this state which provides coverage for breast cancer 51 treatment may not limit inpatient hospital coverage for lymph 52 node dissections or mastectomies to any period that is less than 53 that determined by the treating physician to be medically 54 necessary in accordance with prevailing medical standards and 55 after consultation with the insured patient. 56 (2) Any group, blanket, or franchise accident or health 57 insurance policy that provides coverage for lymph node 58 dissections or mastectomies under subsection (1) must also 59 provide coverage for outpatient postsurgical followup care in 60 keeping with prevailing medical standards by a licensed health 61 care professional qualified to provide postsurgical lymph node 62 dissection or mastectomy care. The treating physician, after 63 consultation with the insured patient, may choose that the 64 outpatient care be provided at the most medically appropriate 65 setting, which may include the hospital, treating physician’s 66 office, outpatient center, or home of the insured patient. 67 (4)(a) This section does not require an insured patient to 68 have a lymph node dissection orthemastectomy in the hospital 69 or stay in the hospital for a fixed period of time following the 70 lymph node dissection or mastectomy. 71 Section 4. Paragraphs (a) and (c) of subsection (31) of 72 section 641.31, Florida Statutes, are amended to read: 73 641.31 Health maintenance contracts.— 74 (31)(a) Health maintenance contracts that provide coverage, 75 benefits, or services for breast cancer treatment may not limit 76 inpatient hospital coverage for lymph node dissections or 77 mastectomies to any period that is less than that determined by 78 the treating physician under contract with the health 79 maintenance organization to be medically necessary in accordance 80 with prevailing medical standards and after consultation with 81 the covered patient. Such contract must also provide coverage 82 for outpatient postsurgical followup care in keeping with 83 prevailing medical standards by a licensed health care 84 professional under contract with the health maintenance 85 organization qualified to provide postsurgical lymph node 86 dissection or mastectomy care. The treating physician under 87 contract with the health maintenance organization, after 88 consultation with the covered patient, may choose that the 89 outpatient care be provided at the most medically appropriate 90 setting, which may include the hospital, treating physician’s 91 office, outpatient center, or home of the covered patient. 92 (c)1. This subsection does not require a covered patient to 93 have a lymph node dissection orthemastectomy in the hospital 94 or stay in the hospital for a fixed period of time following the 95 lymph node dissection or mastectomy. 96 2. This subsection does not prevent a contract from 97 imposing deductibles, coinsurance, or other cost sharing in 98 relation to benefits pursuant to this subsection, except that 99 such cost sharing shall not exceed cost sharing with other 100 benefits. 101 Section 5. This act shall take effect July 1, 2010.
