Bill Text: FL S0358 | 2019 | Regular Session | Introduced
Bill Title: Health Insurance Coverage for Enteral Formulas
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2019-05-03 - Died in Appropriations [S0358 Detail]
Download: Florida-2019-S0358-Introduced.html
Florida Senate - 2019 SB 358 By Senator Stargel 22-00607A-19 2019358__ 1 A bill to be entitled 2 An act relating to health insurance coverage for 3 enteral formulas; amending s. 627.42395, F.S.; 4 revising criteria for the required coverage of enteral 5 formulas under specified health insurance policies; 6 requiring the state group insurance program to provide 7 coverage for certain enteral formulas and amino-acid 8 based elemental formulas; making technical changes; 9 providing applicability; providing an effective date. 10 11 Be It Enacted by the Legislature of the State of Florida: 12 13 Section 1. Section 627.42395, Florida Statutes, is amended 14 to read: 15 627.42395 Coverage for certain prescription and 16 nonprescription enteral formulas.— 17 (1) Notwithstanding any otherprovision oflaw, any health 18 insurance policy delivered or issued for delivery,to any person 19 in this state or any group, blanket, or franchise health 20 insurance policy delivered or issued for delivery in this state 21 mustshallmake available to the policyholder as part of the 22 application, for an appropriate additional premium, coverage for 23 prescription and nonprescription enteral formulas for home use 24 which are ordered orphysicianprescribed by a physician 25 licensed under chapter 458 or chapter 459 as medically necessary 26 for the treatment of inherited diseases of amino acid, organic 27 acid, carbohydrate, or fat metabolism as well as malabsorption 28 originating from congenital defects present at birth or acquired 29 during the neonatal period. Coverage for inherited diseases of 30 amino acidacidsand organic acid metabolism mustacidsshall31 include food products modified to be low protein, in an amount 32 not to exceed $2,500 annually for any insured individual, 33 through the age of 24. This subsectionsectionapplies to any 34 person or family notwithstanding the existence of any 35 preexisting condition. 36 (2) Notwithstanding subsection (1), the state group 37 insurance program administered under s. 110.123 must provide 38 coverage for prescription and nonprescription enteral formulas 39 and amino-acid-based elemental formulas, regardless of the 40 method of delivery or intake, for home use which are ordered or 41 prescribed by a physician licensed under chapter 458 or chapter 42 459 as medically necessary for the treatment of: 43 (a) Eosinophilic disorders; 44 (b) Food protein-induced enterocolitis syndrome; 45 (c) Inherited diseases of amino acid, organic acid, 46 carbohydrate, or fat metabolism; or 47 (d) Malabsorption originating from congenital defects 48 present at birth, acquired during the neonatal period, or 49 diagnosed later in life. 50 Section 2. The amendment to s. 627.42395, Florida Statutes, 51 made by this act applies to health insurance policies and state 52 group health insurance plans beginning on or after January 1, 53 2020. 54 Section 3. This act shall take effect July 1, 2019.