Bill Text: FL S1786 | 2021 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Florida Birth-Related Neurological Injury Compensation Plan
Spectrum: Bipartisan Bill
Status: (Passed) 2021-06-23 - Chapter No. 2021-134 [S1786 Detail]
Download: Florida-2021-S1786-Comm_Sub.html
Bill Title: Florida Birth-Related Neurological Injury Compensation Plan
Spectrum: Bipartisan Bill
Status: (Passed) 2021-06-23 - Chapter No. 2021-134 [S1786 Detail]
Download: Florida-2021-S1786-Comm_Sub.html
Florida Senate - 2021 CS for CS for SB 1786 By the Committees on Appropriations; and Health Policy; and Senators Burgess and Book 576-04462-21 20211786c2 1 A bill to be entitled 2 An act relating to the Florida Birth-Related 3 Neurological Injury Compensation Plan; amending s. 4 766.301, F.S.; revising legislative intent; amending 5 s. 766.303, F.S.; requiring the Florida Birth-Related 6 Neurological Injury Compensation Association to 7 administer the Florida Birth-Related Neurological 8 Injury Compensation Plan in a specified manner; 9 amending s. 766.305, F.S.; requiring that, if a 10 physician is involved in more than one filed claim, 11 the Division of Medical Quality Assurance of the 12 Department of Health review all such claims together 13 when making certain determinations; amending s. 14 766.31, F.S.; revising requirements for the award for 15 compensation for claims under the plan; increasing the 16 maximum amount that may be awarded to the parents or 17 legal guardians of an infant found to have sustained a 18 birth-related neurological injury, as of a specified 19 date; requiring that the maximum award amount be 20 increased by a certain percentage annually; requiring 21 the plan to provide retroactive payments to certain 22 parents or legal guardians which are sufficient to 23 bring the total award to a specified amount; 24 authorizing such payments to be made in a lump sum or 25 periodically; increasing the amount of the death 26 benefit that must be awarded; requiring the plan to 27 act on a request for payment of expenses within a 28 specified timeframe; requiring parents or legal 29 guardians, or their designee, to submit any additional 30 information or documentation requested by the plan 31 within a specified timeframe; requiring the plan to 32 pay or deny a request within a specified timeframe; 33 providing that failure to pay or deny the claim within 34 a specified timeframe results in an uncontestable 35 obligation to pay the claim; amending s. 766.313, 36 F.S.; revising the timeframe within which birth 37 related neurological injury compensation claims must 38 be filed; creating s. 766.3135, F.S.; providing that 39 the Florida Birth-Related Neurological Injury 40 Compensation Association is responsible for 41 reimbursing parents and legal guardians for actual 42 expenses for medically necessary and reasonable 43 services for an injured child; prohibiting the 44 association from holding itself out as the payor of 45 last resort for services under the plan; requiring the 46 association to reimburse parents and legal guardians 47 for services, drugs, equipment, or treatment at a 48 reasonable rate if they submit a certain letter of 49 medical necessity; authorizing the association to 50 establish an independent review process for such 51 reimbursement; requiring parents and legal guardians 52 to submit a certain report to the association for 53 reimbursement of experimental treatments, therapies, 54 or programs; authorizing the association to use its 55 review process to make certain determinations 56 regarding such reimbursement; requiring the 57 association to reimburse parents and legal guardians 58 for experimental treatments, therapies, and programs 59 under certain circumstances; specifying expenses for 60 which parents and legal guardians are eligible to 61 receive reimbursement; providing duties for the 62 association; amending s. 766.314, F.S.; beginning on a 63 specified date, requiring the annual assessments 64 imposed on physicians and certain entities 65 participating in the plan to be increased by a certain 66 percentage annually; creating s. 766.3145, F.S.; 67 requiring association employees to annually sign and 68 submit a conflict-of-interest statement as a condition 69 of employment; requiring prospective employees to sign 70 and submit such statement as a condition of 71 employment; providing that the executive director, the 72 ombudsman, senior managers, and the board of directors 73 are subject to specified provisions; prohibiting board 74 members from voting on measures under certain 75 circumstances; providing procedures and requirements 76 for board members who have a conflict of interest; 77 requiring the executive director, senior managers, and 78 board members to file certain disclosures; requiring 79 the executive director or his or her designee to 80 notify specified individuals of the reporting 81 requirements; requiring the executive director or his 82 or her designee to submit, at least quarterly, a list 83 of specified individuals to the Commission on Ethics; 84 prohibiting employees and board members from accepting 85 gifts or expenditures from certain individuals; 86 providing penalties; prohibiting certain senior 87 managers and executive directors from representing 88 persons or entities before the association for a 89 specified timeframe; amending s. 766.315, F.S.; 90 revising membership of the plan’s board of directors; 91 prohibiting certain appointed directors from voting on 92 board matters relating to a claim if they were named 93 in the petition for the claim; requiring the board of 94 directors to employ an ombudsman for a specified 95 purpose; providing duties of the ombudsman; requiring 96 the association to submit an annual report to the 97 Governor and the Legislature by a specified date; 98 providing requirements for the report; requiring that 99 the first report include a certain actuarial report; 100 providing requirements for the actuarial report; 101 requiring the Auditor General to conduct a performance 102 audit of the association and plan; providing 103 requirements for the audit; requiring the Auditor 104 General to release the audit by a specified date; 105 providing for future repeal; providing applicability; 106 providing an effective date. 107 108 Be It Enacted by the Legislature of the State of Florida: 109 110 Section 1. Subsection (2) of section 766.301, Florida 111 Statutes, is amended to read: 112 766.301 Legislative findings and intent.— 113 (2) It is the intent of the Legislature to provide 114 compensation, on a no-fault basis, for a limited class of 115 catastrophic injuries that result in unusually high costs for 116 custodial care and rehabilitation. This plan shall apply only to 117 birth-related neurological injuries and is not intended to serve 118 as the payor of last resort for claims arising out of such 119 injuries. It is not the intent of the Legislature to shield 120 physicians who engage in willful misconduct, gross negligence, 121 or recklessness or to preclude individuals from filing 122 legitimate claims of medical malpractice against such 123 physicians. 124 Section 2. Subsection (4) is added to section 766.303, 125 Florida Statutes, to read: 126 766.303 Florida Birth-Related Neurological Injury 127 Compensation Plan; exclusiveness of remedy.— 128 (4) The Florida Birth-Related Neurological Injury 129 Compensation Association shall administer the plan in a manner 130 that promotes and protects the health and best interests of 131 children with birth-related neurological injuries who have been 132 accepted into the plan, and the association shall strive to 133 ensure that all of their medically reasonable needs are being 134 met. 135 Section 3. Subsection (5) of section 766.305, Florida 136 Statutes, is amended to read: 137 766.305 Filing of claims and responses; medical 138 disciplinary review.— 139 (5) Upon receipt of such petition, the Division of Medical 140 Quality Assurance shall review the information therein and 141 determine whether it involved conduct by a physician licensed 142 under chapter 458 or an osteopathic physician licensed under 143 chapter 459 whichthatis subject to disciplinary action. If a 144 physician is involved in more than one filed claim, the division 145 also must review the circumstances of all such claims together 146 to determine whether the physician’s conduct establishes a 147 pattern of practice subject to disciplinary action. Section 148 456.073 applies in such cases, in which case the provisions of149s. 456.073shall apply. 150 Section 4. Subsections (1) and (2) of section 766.31, 151 Florida Statutes, are amended to read: 152 766.31 Administrative law judge awards for birth-related 153 neurological injuries; notice of award.— 154 (1) Upon determining that an infant has sustained a birth 155 related neurological injury and that obstetrical services were 156 delivered by a participating physician at the birth, the 157 administrative law judge shall make an award providing 158 compensation for the following items relative to such injury: 159 (a) Actual expenses for medically necessary and reasonable 160 medical and hospital, habilitative and training, family 161 residential or custodial care, professional residential, and 162 custodial care and service, for medically necessary drugs, 163 special equipment, and facilities, and for related travel. At a 164 minimum, compensation must be provided for the following actual 165 expenses: 166 1. Diapers and baby formula for the infant from the time of 167 birth and pureed baby food or other baby food for the infant at 168 the appropriate age or developmental stage. 169 2. A total annual benefit of up to $5,000 for immediate 170 family members who reside with the infant for psychotherapeutic 171 services obtained from providers licensed under chapter 490 or 172 chapter 491. 173 3. Transportation reimbursement for all necessary trips to 174 the pharmacy each month for prescription fills for the infant. 175 (b) However, the following expenses are not subject to 176 compensationsuch expenses shall not include: 177 1. Expenses for items or services that the infant has 178 received, or is entitled to receive, under the laws of any state 179 or the Federal Government, except to the extent such exclusion 180 may be prohibited by federal law. 181 2. Expenses for items or services that the infant has 182 received, or is contractually entitled to receive, from any 183 prepaid health plan, health maintenance organization, or other 184 private insuring entity. 185 3. Expenses for which the infant has received 186 reimbursement, or for which the infant is entitled to receive 187 reimbursement, under the laws of any state or the Federal 188 Government, except to the extent such exclusion may be 189 prohibited by federal law. 190 4. Expenses for which the infant has received 191 reimbursement, or for which the infant is contractually entitled 192 to receive reimbursement, pursuant to the provisions of any 193 health or sickness insurance policy or other private insurance 194 program. 195 (c) Expenses included underthisparagraph (a) may not 196 exceedshall be limited toreasonable charges prevailing in the 197 same community for similar treatment of injured persons when 198 such treatment is paid for by the injured person. 199 (d)1.a.(b)1.Periodic payments of an award to the parents 200 or legal guardians of the infant found to have sustained a 201 birth-related neurological injury, which award mayshallnot 202 exceed $100,000. However, at the discretion of the 203 administrative law judge, such award may be made in a lump sum. 204 Beginning on January 1, 2021, the award may not exceed $250,000, 205 and each January 1 thereafter the maximum award authorized under 206 this paragraph shall increase by 3 percent. 207 b. Parents or legal guardians who received an award 208 pursuant to this section before January 1, 2021, and whose child 209 currently receives benefits under the plan must receive a 210 retroactive payment in an amount sufficient to bring the total 211 award paid to the parents or legal guardians pursuant to sub 212 subparagraph a. to $250,000. This additional payment may be made 213 in a lump sum or in periodic payments as designated by the 214 parents or legal guardians. 215 2. Death benefit for the infant in an amount of $50,000 216$10,000. 217 (e)(c)Reasonable expenses incurred in connection with the 218 filing of a claim under ss. 766.301-766.316, including 219 reasonable attorneyattorney’sfees, which areshall besubject 220 to the approval and award of the administrative law judge. In 221 determining an award for attorneyattorney’sfees, the 222 administrative law judge shall consider the following factors: 223 1. The time and labor required, the novelty and difficulty 224 of the questions involved, and the skill requisite to perform 225 the legal services properly. 226 2. The fee customarily charged in the locality for similar 227 legal services. 228 3. The time limitations imposed by the claimant or the 229 circumstances. 230 4. The nature and length of the professional relationship 231 with the claimant. 232 5. The experience, reputation, and ability of the lawyer or 233 lawyers performing services. 234 6. The contingency or certainty of a fee. 235 236 Should there be a final determination of compensability, and the 237 claimants accept an award under this section, the claimants are 238shallnotbeliable for any expenses, including attorney 239attorney’sfees, incurred in connection with the filing of a 240 claim under ss. 766.301-766.316 other than those expenses 241 awarded under this section. 242 (2) The award shall require the immediate payment of 243 expenses previously incurred and shall require that future 244 expenses be paid as incurred. 245 (a) Within 20 days after the receipt of a request for 246 payment of expenses, the plan must pay the expenses or notify 247 the parents or legal guardians, or their designee, that specific 248 additional information or documentation is needed to evaluate 249 the request or that the request for payment of the expenses is 250 being denied. 251 (b) Parents or legal guardians, or their designee, must 252 submit any additional information or documentation requested by 253 the plan within 35 days after receipt of the notification by the 254 plan that additional information or documentation is needed. 255 Additional information is considered submitted on the date it is 256 mailed or electronically submitted to the plan. 257 (c) A request for payment of expenses must be paid or 258 denied within 90 days after receipt of the request. Failure to 259 pay or deny the claim within 120 days after receipt of the 260 request creates an uncontestable obligation to pay the expenses. 261 Section 5. Section 766.313, Florida Statutes, is amended to 262 read: 263 766.313 Limitation on claim.—Any claim for compensation 264 under ss. 766.301-766.316 whichthatis filed more than 85265 years after the birth of an infant alleged to have a birth 266 related neurological injury isshall bebarred. 267 Section 6. Section 766.3135, Florida Statutes, is created 268 to read: 269 766.3135 Plan services.— 270 (1) Pursuant to an award under s. 766.31(1), the 271 association is responsible for reimbursement of actual expenses 272 for medically necessary and reasonable services for a child 273 under the plan. The plan is not intended to serve as the payor 274 of last resort and the association may not hold itself out as 275 such. 276 (a) The association must reimburse the parents or legal 277 guardians of a child under the plan for any service, drug, 278 equipment, or treatment at a reasonable rate if they submit a 279 letter of medical necessity from the child’s physician or other 280 treating health care provider for such service, drug, equipment, 281 or treatment. 282 (b) The association may establish an independent review 283 process that uses medical experts to review such requests after 284 reimbursement to determine whether the physician’s or health 285 care provider’s determination of medical necessity was 286 reasonable. If the review finds that such determination was not 287 reasonable, the association may ask the parents or legal 288 guardians to provide a letter of medical necessity from a second 289 health care provider. If such letter is provided, the 290 association may not take further action. If the parents or legal 291 guardians are unable to provide a second letter, the association 292 may debit the reimbursement from future reimbursements. 293 (c) For experimental treatments, therapies, or programs, 294 the parents or legal guardians of the child must submit a report 295 of medical necessity from the physician or other health care 296 provider which details the medical necessity for the 297 experimental treatment, therapy, or program and provides proof 298 that it has shown objective, observable, and demonstrable 299 medical benefits to other patients similarly situated to the 300 child under the plan. The association may use its review process 301 established under paragraph (b) to conclude whether the report 302 reasonably supports the determination of medical necessity. If 303 the review finds that such determination is not reasonable, the 304 association may require the parents or legal guardians to 305 provide a second report from a different health care provider. 306 If such report is provided, the association must reimburse the 307 parents or legal guardians for the experimental treatment, 308 therapy, or program, as applicable. If the parents or legal 309 guardians are unable to provide a second report, the association 310 is not required to provide reimbursement. 311 (2) Parents or legal guardians of a child under the plan 312 are eligible for reimbursement of expenses for any of the 313 following, at a minimum: 314 (a) Medical, dental, and hospital care; habilitative 315 services and training; mental health services; music or art 316 therapy; family residential or custodial care; and professional 317 residential and custodial care and services. Reimbursement for 318 private nursing services or attendant care under this paragraph 319 must be provided at a rate at least equal to the state or 320 federal minimum wage, whichever is greater, and must be 321 reimbursed at the same rate regardless of the setting in which 322 the services or care is provided. 323 (b) Medically necessary drugs, special equipment, and 324 facilities. 325 (c) Family support services for immediate family members 326 living with the child, including, but not limited to, mental 327 health services. 328 (d) Travel expenses related to the child’s care. The 329 association may not limit the amount or type of travel which may 330 be reimbursed or differentiate reimbursement rates based on the 331 purpose of such travel, provided that it is related to the 332 child’s care. 333 (e) Entertainment and other promotion of the child’s mental 334 and emotional well-being. The parents or legal guardians of the 335 child are entitled to a reimbursement of at least $1,500 per 336 year under this paragraph. 337 (f) Nutrition and hygiene needs of the child. The 338 association may not limit reimbursement for diapers, baby food, 339 or formula if such items are appropriate for the child’s age or 340 developmental stage. 341 (3) The association is also responsible for the following: 342 (a) Providing ongoing transportation assistance for the 343 life of the child. The association must provide parents or legal 344 guardians with a reliable method of transportation for the care 345 of the child or reimburse the cost of upgrading an existing 346 vehicle to accommodate the child’s needs. The mode of 347 transportation must take into account the special accommodations 348 required for the specific child. The association may not limit 349 such transportation assistance based on the child’s age or 350 weight. 351 (b) Providing ongoing housing assistance for the life of 352 the child. Such assistance includes, but is not limited to: 353 1. Payment assistance for rent and utilities to cover the 354 cost of any increase due to the accommodation of the child’s 355 condition and medical needs. 356 2. Reimbursement of moving costs. 357 3. Payment assistance for home construction costs up to 358 $100,000. 359 (c) Establishing an online network portal for parents and 360 legal guardians of children under the plan to support one 361 another and exchange information and resources. Access to the 362 online network must be provided at no cost to parents and legal 363 guardians. 364 Section 7. Paragraph (a) of subsection (5) of section 365 766.314, Florida Statutes, is amended to read: 366 766.314 Assessments; plan of operation.— 367 (5)(a) Beginning January 1, 1990, the persons and entities 368 listed in paragraphs (4)(b) and (c), except those persons or 369 entities who are specifically excluded from said provisions, as 370 of the date determined in accordance with the plan of operation, 371 taking into account persons licensed subsequent to the payment 372 of the initial assessment, shall pay an annual assessment in the 373 amount equal to the initial assessments provided in paragraphs 374 (4)(b) and (c). If payment of the annual assessment by a 375 physician is received by the association by January 31 of any 376 calendar year, the physician shall qualify as a participating 377 physician for that entire calendar year. If the payment is 378 received after January 31 of any calendar year, the physician 379 shall qualify as a participating physician for that calendar 380 year only from the date the payment was received by the 381 association. Beginning on January 1, 2022, and on each January 1 382 thereafter, the annual assessment shall increase by 3 percent. 383 On January 1, 1991, and on each January 1 thereafter, the 384 association shall determine the amount of additional assessments 385 necessary pursuant to subsection (7), in the manner required by 386 the plan of operation, subject to any increase determined to be 387 necessary by the Office of Insurance Regulation pursuant to 388 paragraph (7)(b). On July 1, 1991, and on each July 1 389 thereafter, the persons and entities listed in paragraphs (4)(b) 390 and (c), except those persons or entities who are specifically 391 excluded from said provisions, shall pay the additional 392 assessments which were determined on January 1. Beginning 393 January 1, 1990, the entities listed in paragraph (4)(a), 394 including those licensed on or after October 1, 1988, shall pay 395 an annual assessment of $50 per infant delivered during the 396 prior calendar year. The additional assessments which were 397 determined on January 1, 1991, pursuant tothe provisions of398 subsection (7) areshallnotbedue and payable by the entities 399 listed in paragraph (4)(a) until July 1. 400 Section 8. Section 766.3145, Florida Statutes, is created 401 to read: 402 766.3145 Code of ethics.— 403 (1) On or before July 1 of each year, employees of the 404 association must sign and submit a statement attesting that they 405 do not have a conflict of interest as defined in part III of 406 chapter 112. As a condition of employment, all prospective 407 employees must sign and submit to the association a conflict-of 408 interest statement. 409 (2) The executive director, the ombudsman, senior managers, 410 and members of the board of directors are subject to part III of 411 chapter 112, including, but not limited to, the code of ethics 412 and the public disclosure and reporting of financial interests 413 requirements of s. 112.3145. For purposes of applying part III 414 of chapter 112 to activities of the executive director, senior 415 managers, and members of the board of directors, those persons 416 are considered public officers or employees and the association 417 is considered their agency. A board member may not vote on any 418 measure that would inure to his or her special private gain or 419 loss and, notwithstanding s. 112.3143(2), may not vote on any 420 measure that he or she knows would inure to the special private 421 gain or loss of any principal by whom he or she is retained or 422 to the parent organization or subsidiary of a corporate 423 principal by which he or she is retained, other than an agency 424 as defined in s. 112.312; or that he or she knows would inure to 425 the special private gain or loss of a relative or business 426 associate of the public officer. Before the vote is taken, such 427 member shall publicly state to the board the nature of his or 428 her interest in the matter from which he or she is abstaining 429 from voting and, within 15 days after the vote occurs, disclose 430 the nature of his or her interest as a public record in a 431 memorandum filed with the person responsible for recording the 432 minutes of the meeting, who shall incorporate the memorandum in 433 the minutes. The executive director, senior managers, and board 434 members are also required to file such disclosures with the 435 Commission on Ethics and the Office of Insurance Regulation. The 436 executive director of the association or his or her designee 437 shall notify each existing and newly appointed member of the 438 board of directors and senior managers of his or her duty to 439 comply with the reporting requirements of part III of chapter 440 112. At least quarterly, the executive director or his or her 441 designee shall submit to the Commission on Ethics a list of 442 names of the members of the board of directors and senior 443 managers who are subject to the public disclosure requirements 444 under s. 112.3145. 445 (3) Notwithstanding s. 112.3148, s. 112.3149, or any other 446 law, an employee or board member may not knowingly accept, 447 directly or indirectly, any gift or expenditure from a person or 448 entity, or an employee or representative of such person or 449 entity, which has a contractual relationship with the 450 association or which is under consideration for a contract. 451 (4) An employee or board member who fails to comply with 452 subsection (2) or subsection (3) is subject to penalties 453 provided under ss. 112.317 and 112.3173. 454 (5) Any senior manager or executive director of the 455 association who is employed on or after January 1, 2022, 456 regardless of the date of hire, who subsequently retires or 457 terminates employment is prohibited from representing another 458 person or entity before the association for 2 years after 459 retirement or termination of employment from the association. 460 Section 9. Paragraphs (a) and (c) of subsection (1), 461 paragraph (a) of subsection (2), and paragraph (i) of subsection 462 (4) of section 766.315, Florida Statutes, are amended, and 463 subsection (6) is added to that section, to read: 464 766.315 Florida Birth-Related Neurological Injury 465 Compensation Association; board of directors.— 466 (1)(a) The Florida Birth-Related Neurological Injury 467 Compensation Plan shall be governed by a board of sevenfive468 directors which shall be known as the Florida Birth-Related 469 Neurological Injury Compensation Association. The association is 470 not a state agency, board, or commission. Notwithstandingthe471provision ofs. 15.03, the association is authorized to use the 472 state seal. 473 (c) The Chief Financial Officer shall appoint the 474 directors, ensuring that at least one board member is a woman, 475shall be appointed by the Chief Financial Officeras follows: 476 1. One citizen representative. 477 2. One representative of participating physicians. 478 3. One representative of hospitals. 479 4. One representative of casualty insurers. 480 5. One representative of physicians other than 481 participating physicians. 482 6. One parent or legal guardian representative of an 483 injured infant under the plan. 484 7. One representative of an advocacy organization for 485 children with disabilities. 486 (2)(a) The Chief Financial Officer may select the 487 representative of the participating physicians from a list of at 488 least three names recommended by the American Congress of 489 Obstetricians and Gynecologists, District XII; the 490 representative of hospitals from a list of at least three names 491 recommended by the Florida Hospital Association; the 492 representative of casualty insurers from a list of at least 493 three names, one of which is recommended by the American 494 Insurance Association, one of which is recommended by the 495 Florida Insurance Council, and one of which is recommended by 496 the Property Casualty Insurers Association of America; and the 497 representative of physicians, other than participating 498 physicians, from a list of three names recommended by the 499 Florida Medical Association and a list of three names 500 recommended by the Florida Osteopathic Medical Association. 501 However, the Chief Financial Officer is not required to make an 502 appointment from among the nominees of the respective 503 associations. A participating physician who is named in a 504 pending petition for a claim may not be appointed to the board. 505 An appointed director who is a participating physician may not 506 vote on any board matter relating to a claim accepted for an 507 award for compensation if the physician was named in the 508 petition for the claim. 509 (4) The board of directors shall have the power to: 510 (i) Employ or retain such persons as are necessary to 511 perform the administrative and financial transactions and 512 responsibilities of the plan and to perform other necessary and 513 proper functions not prohibited by law. 514 1. The board of directors shall employ an ombudsman who 515 will serve at the pleasure of, and must report directly to, the 516 board and who will act as an advocate for the parents and legal 517 guardians of plan participants. 518 2. The ombudsman shall do all of the following: 519 a. Provide information and assistance, outreach, and 520 education to parents and legal guardians of plan participants 521 regarding plan benefits and community, state, and federal 522 government resources. 523 b. Investigate complaints of parents or legal guardians of 524 plan participants regarding the operation of the plan. 525 c. Provide an annual report to the board regarding the 526 ombudsman’s activities, the disposition of complaints, and any 527 recommendations to improve the operations of the plan and the 528 delivery of benefits to participants. 529 (6) On or before January 31, 2022, and by each January 31 530 thereafter, the association shall submit an annual report to the 531 Governor, the President of the Senate, and the Speaker of the 532 House of Representatives. The report must include: 533 (a) The number of petitions filed for compensation with the 534 division, the number of claimants awarded compensation, the 535 number of claimants denied compensation, and the reasons for the 536 denial of compensation. 537 (b) The number and dollar amount of paid and denied 538 compensation for expenses by category and the reasons for any 539 denied compensation for expenses by category. 540 (c) The average turnaround time for paying or denying 541 compensation for expenses. 542 (d) Legislative recommendations to improve the program. 543 (e) A summary of any pending or resolved litigation during 544 the year which affects the plan. 545 (f) For the initial report due on or before January 31, 546 2022, an actuarial report conducted by an independent actuary 547 that provides an analysis of the estimated costs of implementing 548 the following changes to the plan: 549 1. Reducing the minimum birth weight eligibility for a 550 participant in the plan from 2,500 grams to 2,000 grams. 551 2. Revising the eligibility of participation in the plan by 552 providing that an infant must be permanently and substantially 553 mentally or physically impaired, rather than permanently and 554 substantially mentally and physically impaired. 555 3. Increasing the annual special benefit or quality of life 556 benefit from $500 to $2,500 per calendar year. 557 Section 10. The Auditor General shall conduct a performance 558 audit of the association and plan to evaluate management’s 559 performance in administering the laws, policies, and procedures 560 governing the operations of the association and plan in an 561 efficient and effective manner. 562 (1) The audit must include evaluations of all of the 563 following: 564 (a) The protocols used for the payment of expenses, 565 including standards for determining medical necessity and 566 reasonableness of requests for medical care, services, or other 567 benefits provided under the plan and the timeliness of the 568 payment of expenses. 569 (b) The effectiveness of the association’s outreach to 570 inform parents and legal guardians of participants of available 571 benefits and any changes in benefits and processes to resolve 572 disputes regarding the payment of expenses internally. 573 (c) The efficacy of the current processes for the 574 procurement of goods and services. 575 (d) The internal controls of the plan and association. 576 (2) The Auditor General shall release the audit by January 577 15, 2022. 578 Section 11. Sections 766.301-766.316, Florida Statutes, are 579 repealed on December 31, 2026, unless reviewed and saved from 580 repeal by the Legislature. 581 Section 12. The amendments made to s. 766.31(1)(d)1.a. and 582 2., Florida Statutes, by this act apply to all claims filed 583 under s. 766.305, Florida Statutes, for which an award was made 584 through entry of final order under s. 766.31(1), Florida 585 Statutes, on or after January 1, 2021. 586 Section 13. This act shall take effect July 1, 2021.