HB 575 2023
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hb0575-00
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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 coverage for diagnostic and 2
supplemental breast examinations; amending s. 110.123, 3
F.S.; prohibiting the state group insurance program 4
from imposing any enrollee cost -sharing liability with 5
respect to coverage for diagnostic breast examinations 6
and supplemental breast examinations; defining the 7
terms "diagnostic breast examination" and 8
"supplemental breast examination"; creating ss. 9
627.64181, 627.66131, and 641.31093, F.S.; defining 10
terms; prohibiting the imposition of cost -sharing 11
requirements for diagnostic and supplemental breast 12
examinations by individual accident and health 13
insurance policies; group, blanket, and franchise 14
accident or health insurance policies; and health 15
maintenance contracts, respectively, which provide 16
such coverage; authorizing the Financial Services 17
Commission to adopt rules; providing an effective 18
date. 19
20
Be It Enacted by the Legislature of the State of Florida: 21
22
Section 1. Subsection (15) is added to section 110.123, 23
Florida Statutes, to read: 24
110.123 State group insurance program. — 25
HB 575 2023
CODING: Words stricken are deletions; words underlined are additions.
hb0575-00
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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
(15) COVERAGE FOR DIAGNOSTIC AND SUPPLEMENTAL BREAST 26
EXAMINATIONS.—The state group insurance program may not impose 27
any enrollee cost-sharing liability with respect to coverage for 28
diagnostic breast examinations and supplemental breast 29
examinations. As used in this subsection, the terms "diagnostic 30
breast examination" and "supplemental breast examination" have 31
the same meanings as in s. 627.64181(1). 32
Section 2. Section 627.64181, Florida Statutes, is created 33
to read: 34
627.64181 Coverage for diagnostic and supplemental breast 35
examinations; cost-sharing requirements prohibited. — 36
(1) As used in this section, the term: 37
(a) "Cost-sharing requirement" means an insured's 38
deductible, coinsurance, copayment, or other out -of-pocket 39
expense. 40
(b) "Diagnostic breast examination" means a medically 41
necessary and appropriate examination of the breast, including 42
an examination using dia gnostic mammography, breast magnetic 43
resonance imaging, or breast ultrasound, which is used to 44
evaluate an abnormality: 45
1. Seen or suspected from a screening examination for 46
breast cancer; or 47
2. Detected by another means of examination. 48
(c) "Supplemental breast examination" means a medically 49
necessary and appropriate examination of the breast, including 50
HB 575 2023
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hb0575-00
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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
an examination using breast magnetic resonance imaging or breast 51
ultrasound, which is: 52
1. Used to screen for breast cancer when there is no 53
abnormality seen or suspected; and 54
2. Based on personal or family medical history or 55
additional factors that may increase the individual's risk of 56
breast cancer. 57
(2) An accident or health insurance policy issued, 58
amended, delivered, or renewed on or after January 1, 2024, 59
which provides coverage for diagnostic breast examinations and 60
supplemental breast examinations shall not impose any cost -61
sharing requirement with respect to such coverage. 62
(3) The commission may adopt rules to administer this 63
section. 64
Section 3. Section 627.66131, Florida Statutes, is created 65
to read: 66
627.66131 Coverage for diagnostic and supplemental breast 67
examinations; cost-sharing requirements prohibited. — 68
(1) As used in this section, the terms "cost -sharing 69
requirement," "diagnostic breast examination," and "supplemental 70
breast examination" have the same meanings as in s. 71
627.64181(1). 72
(2) A group, blanket, or franchise accident or health 73
insurance policy issued, amended, delivered, or renewed on or 74
after January 1, 2024, w hich provides coverage for diagnostic 75
HB 575 2023
CODING: Words stricken are deletions; words underlined are additions.
hb0575-00
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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
breast examinations and supplemental breast examinations shall 76
not impose any cost-sharing requirement with respect to such 77
coverage. 78
(3) The commission may adopt rules to administer this 79
section. 80
Section 4. Section 641.31093, Florida Statutes, is created 81
to read: 82
641.31093 Coverage for diagnostic and supplemental breast 83
examinations; cost-sharing requirements prohibited. — 84
(1) As used in this section, the term: 85
(a) "Cost-sharing requirement" means a subscrib er's 86
deductible, coinsurance, copayment, or other out -of-pocket 87
expense. 88
(b) "Diagnostic breast examination" has the same meaning 89
as in s. 627.64181(1). 90
(c) "Supplemental breast examination" has the same meaning 91
as in s. 627.64181(1). 92
(2) A health maintenance contract issued, amended, 93
delivered, or renewed on or after January 1, 2024, which 94
provides coverage for diagnostic breast examinations and 95
supplemental breast examinations shall not impose any cost -96
sharing requirement with respect to such covera ge. 97
(3) The commission may adopt rules to administer this 98
section. 99
Section 5. This act shall take effect July 1, 2023. 100