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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to newborn screenings; amending s. 2
383.145, F.S.; providing and revising definitions; 3
requiring hospitals and other state -licensed birthing 4
facilities to test for congenital cytomegalovirus in 5
newborns within a specified timeframe under certain 6
circumstances; revising the timeframe within which 7
health care providers attending home births must make 8
referrals; providing that a newborn's primary health 9
care provider is responsible for coordinating such 10
referrals under certain circumstances; requiring a 11
newborn's primary health care provider to refer the 12
newborn for testing for congenital cytomegalovirus 13
under certain circumstances; revising the ti meframe 14
within which hospitals must complete newborn hearing 15
screenings that were not completed before discharge 16
due to scheduling or temporary staffing limitations; 17
requiring that certain test results be reported to the 18
Department of Health within a speci fied timeframe; 19
removing a requirement that the parents of certain 20
newborns be instructed on and provided specified 21
information; removing obsolete language; removing a 22
requirement that certain uninsured persons be provided 23
a list of specified providers; pr oviding an effective 24
date. 25
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Section 383.145, Florida Statutes, is amended 29
to read: 30
383.145 Newborn and infant hearing screening. — 31
(1) LEGISLATIVE INTENT. —It is the intent of the 32
Legislature this section is to provide a statewide comprehensive 33
and coordinated interdisciplinary program of early hearing loss 34
impairment screening, identification, and follow-up followup 35
care for newborns. The goal is to screen all newborns for 36
hearing loss impairment in order to alleviate the adverse 37
effects of hearing loss on speech and language development, 38
academic performance, and cognitive development. It is further 39
the intent of the Legislature that the provisions of this 40
section act only be implemented to the extent that funds are 41
specifically included in the General Appropriations Act for 42
carrying out the purposes of this section. 43
(2) DEFINITIONS.—As used in this section, the term: 44
(a) "Audiologist" means a person licensed under part I of 45
chapter 468 to practice audiology. 46
(a) "Agency" means the Agency for Health Care 47
Administration. 48
(b) "Department" means the Department of Health. 49
(c) "Hearing loss impairment" means a hearing loss of 30 50
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dB HL or greater in the frequency region impor tant 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)(d) "Infant" means an age range from 30 days through 12 57
months. 58
(f)(e) "Licensed health care provider" means a physician 59
or physician assistant licensed under pursuant to chapter 458; 60
an osteopathic physician or physician assistant licensed under 61
or chapter 459; an advanced practice registered nurse, a 62
registered nurse, or a licensed practical nurse licensed under 63
part I of pursuant to chapter 464; a midwife licensed under 64
chapter 467; or a speech -language pathologist , or an audiologist 65
licensed under part I of pursuant to chapter 468, rendering 66
services 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
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administered to determine the need for an in -depth hearing 76
diagnostic evaluation. 77
(3) REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE 78
COVERAGE; REFERRAL FOR ONGOING SERVICES. — 79
(a) Each licensed hospital or other state -licensed 80
birthing facility that provides maternity and newborn care 81
services shall ensure provide that all newborns are, before 82
prior to discharge, screened for the detection of hearing loss , 83
to prevent the consequences of unidentified disorders. If a 84
newborn fails the screening for the detection of hearing loss, 85
the hospital or other state -licensed birthing facility must 86
administer a test approved by the United States Food and Drug 87
Administration or another diagnostically equivalent test on the 88
newborn to screen for congenital cytomegalovirus before the 89
newborn becomes 21 days of age or before discharge, whic hever 90
occurs earlier. 91
(b) Each licensed birth center that provides maternity and 92
newborn care services shall ensure provide that all newborns 93
are, before prior to discharge, referred to an a licensed 94
audiologist, a physician licensed under chapter 458 or chapter 95
459, or a hospital, or another other newborn hearing screening 96
provider, for screening for the detection of hearing loss , to 97
prevent the consequences of unidentified disorders. The referral 98
for appointment must shall be made within 7 30 days after 99
discharge. Written documentation of the referral must be placed 100
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in the newborn's medical chart. 101
(c) If the parent or legal guardian of the newborn objects 102
to the screening, the screening must not be completed. In such 103
case, the physician, midwife, or ot her person who is attending 104
the newborn shall maintain a record that the screening has not 105
been performed and attach a written objection that must be 106
signed by the parent or guardian. 107
(d) For home births, the health care provider in 108
attendance is respons ible for coordination and referral to an a 109
licensed audiologist, a hospital, or another other newborn 110
hearing screening provider. The health care provider in 111
attendance must make the referral for appointment shall be made 112
within 7 30 days after the birth. In cases in which the home 113
birth is not attended by a primary health care provider, the 114
newborn's primary health care provider is responsible for 115
coordinating the a referral to a licensed audiologist, physician 116
licensed pursuant to chapter 458 or chapter 4 59, hospital, or 117
other newborn hearing screening provider must be made by the 118
health care provider within the first 3 months after the child's 119
birth. 120
(e) For home births and births in a licensed birth center, 121
if a newborn is referred to a newborn hearing screening provider 122
and the newborn fails the screening for the detection of hearing 123
loss, the newborn's primary health care provider must refer the 124
newborn for administration of a test approved by the United 125
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States Food and Drug Administration or another diagnostically 126
equivalent test on the newborn to screen for congenital 127
cytomegalovirus. 128
(f)(e) All newborn and infant hearing screenings must 129
shall be conducted by an a licensed audiologist, a physician 130
licensed under chapter 458 or chapter 459 , or an appropriately 131
supervised individual who has completed documented training 132
specifically for newborn hearing screening. Every licensed 133
hospital that provides maternity or newborn care services shall 134
obtain the services of an a licensed audiologist, a physician 135
licensed pursuant to chapter 458 or chapter 459 , or another 136
other newborn hearing screening provider, through employment or 137
contract or written memorandum of understanding, for the 138
purposes of appropriate staff training, screening program 139
supervision, monitoring the scoring and interpretation of test 140
results, rendering of appropriate recommendations, and 141
coordination of appropriate follow-up followup services. 142
Appropriate documentation of the screening completion, results, 143
interpretation, and recommenda tions must be placed in the 144
medical record within 24 hours after completion of the screening 145
procedure. 146
(g)(f) The screening of a newborn's hearing must should be 147
completed before the newborn is discharged from the hospital. 148
However, if the screening is not completed before discharge due 149
to scheduling or temporary staffing limitations, the screening 150
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must be completed within 21 30 days after the birth discharge. 151
Screenings completed after discharge or performed because of 152
initial screening failure must be completed by an audiologist 153
licensed in the state , a physician licensed under chapter 458 or 154
chapter 459, or a hospital, or another other newborn hearing 155
screening provider. 156
(h)(g) Each hospital shall formally designate a lead 157
physician responsible for p rogrammatic oversight for newborn 158
hearing screening. Each birth center shall designate a licensed 159
health care provider to provide such programmatic oversight and 160
to ensure that the appropriate referrals are being completed. 161
(i)(h) When ordered by the tre ating physician, screening 162
of a newborn's hearing must include auditory brainstem 163
responses, or evoked otoacoustic otacoustic emissions, or 164
appropriate technology as approved by the United States Food and 165
Drug Administration. 166
(j) The results of any test conducted pursuant to this 167
section, including, but not limited to, newborn hearing loss 168
screening, congenital cytomegalovirus testing, and any related 169
diagnostic testing, must be reported to the department within 7 170
days after receipt of such results. 171
(i) Newborn hearing screening must be conducted on all 172
newborns in hospitals in this state on birth admission. When a 173
newborn is delivered in a facility other than a hospital, the 174
parents must be instructed on the importance of having the 175
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hearing screening pe rformed and must be given information to 176
assist them in having the screening performed within 3 months 177
after the child's birth. 178
(k)(j) The initial procedure for screening the hearing of 179
the newborn or infant and any medically necessary follow-up 180
followup reevaluations leading to diagnosis shall be a covered 181
benefit for, reimbursable under Medicaid as an expense 182
compensated supplemental to the per diem rate for Medicaid 183
patients enrolled in MediPass or Medicaid patients covered by a 184
fee-for-service fee for service program. For Medicaid patients 185
enrolled in HMOs, providers shall be reimbursed directly by the 186
Medicaid Program Office at the Medicaid rate. This service may 187
not be considered a covered service for the purposes of 188
establishing the payment rate for Medicaid HMOs. All health 189
insurance policies and health maintenance organizations as 190
provided under ss. 627.6416, 627.6579, and 641.31(30), except 191
for supplemental policies that only provide coverage for 192
specific diseases, hospital indemnity, or Medicare supplement, 193
or to the supplemental polices, shall compensate providers for 194
the covered benefit at the contracted rate. Nonhospital -based 195
providers are shall be eligible to bill Medicaid for the 196
professional and technical component of each procedure code. 197
(l)(k) A child who is diagnosed as having a permanent 198
hearing loss must impairment shall be referred to the primary 199
care physician for medical management, treatment, and follow-up 200
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followup services. Furthermore, in accordance with Part C of the 201
Individuals with Disabilities Education Act, Pub. L. No. 108 -202
446, Infants and Toddlers with Disabilities, any child from 203
birth to 36 months of age who is diagnosed as having a hearing 204
loss impairment that requires ongoing special hearing services 205
must be referred to the Children's Medical Services Early 206
Intervention Program serving the geographical area in which the 207
child resides. 208
(l) Any person who is not covered through insurance and 209
cannot afford the costs for testing shall be given a list of 210
newborn hearing screening providers who provide the necessary 211
testing free of charge. 212
Section 2. This act shall take effect January 1, 2023. 213