Florida 2025 Regular Session

Florida House Bill H1531 Compare Versions

Only one version of the bill is available at this time.

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10	10	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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14	14	A bill to be entitled 1
15	15	An act relating to emergency preparedness for life -2
16	16	sustaining medical services; amending s. 252.358, 3
17	17	F.S.; requiring specified entities, plans, and 4
18	18	programs to enact flexibilities and waivers during an 5
19	19	emergency; defining the terms "emergency" and "life -6
20	20	sustaining medical services"; specifying the 7
21	21	flexibilities and waivers such specified entities, 8
22	22	plans, and programs must enact; providing when such 9
23	23	flexibilities and waivers become effective; 10
24	24	authorizing the time period for such flexibilities and 11
25	25	waivers to be extended by the Office of Insurance 12
26	26	Regulation or the Agency for Health Care 13
27	27	Administration; providing construction; providing an 14
28	28	effective date. 15
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30	30	Be It Enacted by the Legislature of the State of Florida: 17
31	31	18
32	32	Section 1. Section 252.358, Florida Statutes, is amended 19
33	33	to read: 20
34	34	252.358 Emergency preparedness for life -sustaining medical 21
35	35	services Emergency-preparedness prescription medication 22
36	36	refills.— 23
37	37	(1) In order to preserve access to life -sustaining medical 24
38	38	services during an emergency, all health insurers, managed care 25
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47	47	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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51	51	organizations, and other entities that are licensed by the 26
52	52	Office of Insurance Regulation ; plans participating in the state 27
53	53	Medicaid managed care program; and any other health care 28
54	54	insurance program administered, regulated, or licensed by this 29
55	55	state shall enact the flexibilities and waivers identified in 30
56	56	this section, as well as any additional flexibilities or waivers 31
57	57	designated by the Offi ce of Insurance Regulation and the Agency 32
58	58	for Health Care Administration, as applicable. 33
59	59	(2) As used in this section, the term: 34
60	60	(a) "Emergency" means that a county: 35
61	61	1. Is under a state of emergency declared by an executive 36
62	62	order or proclamation issue d by the Governor under chapter 252; 37
63	63	2. Is under a hurricane warning issued by the National 38
64	64	Weather Service; or 39
65	65	3. Has activated the county's emergency operations center 40
66	66	and its emergency management plan. 41
67	67	(b) "Life-sustaining medical services" means hospital 42
68	68	care, skilled nursing care, inpatient rehabilitation, long -term 43
69	69	acute care and other post -acute care needs, durable medical 44
70	70	equipment and supplies, home health services, hospital services, 45
71	71	nursing facility services, chemotherapy, dialysis services , and 46
72	72	other care that is deemed by the provider as medically 47
73	73	necessary. 48
74	74	(3) All health insurers, managed care organizations, and 49
75	75	other entities that are licensed by the Office of Insurance 50
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84	84	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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88	88	Regulation; all plans participating in the state Medicaid 51
89	89	managed care program; and any other health care insurance 52
90	90	program administered, regulated, or licensed by this state must 53
91	91	enact all of the following flexibilities and waivers during an 54
92	92	emergency: 55
93	93	(a) A waiver on the and provide prescription medication 56
94	94	coverage as part of a policy or contract shall waive time 57
95	95	restrictions on prescription medication refills, which include 58
96	96	suspension of electronic "refill too soon" edits to pharmacies, 59
97	97	to enable insureds or subscribers to refill prescriptions in 60
98	98	advance, if there are authorized refills remaining . All 61
99	99	entities, plans, and programs identified in subsection (1) , and 62
100	100	shall authorize payment to pharmacies for at least a 30 -day 63
101	101	supply of any prescription medication, regardless of the date 64
102	102	upon which the prescription had m ost recently been filled by a 65
103	103	pharmacist. 66
104	104	(b) A waiver on all prior authorization, utilization 67
105	105	management, and concurrent review requirements for patients who 68
106	106	need life-sustaining medical services. 69
107	107	(c) A waiver on transfer authorizations. 70
108	108	(d) A waiver on the time requirements for filing a notice 71
109	109	of admission for at least 30 days after the emergency ends. 72
110	110	(e) A waiver on filing and appeal deadlines and timeframes 73
111	111	during the emergency. Such deadlines and timeframes will resume 74
112	112	the day after the emergency ends. 75
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125	125	(f) An extension of the time requirements on 76
126	126	authorizations or precertifications that were provided to a 77
127	127	patient before the emergency until 30 days after the emergency 78
128	128	ends. 79
129	129	(g) A waiver of out -of-network costs for patients who are 80
130	130	displaced after an emergency. 81
131	131	(h) Reimbursement to hospitals for the care provided to 82
132	132	patients because an emergency delayed patient discharge. 83
133	133	(4) The flexibilities and waivers required under 84
134	134	subsection (3) become effective , when the following conditions 85
135	135	occur: 86
136	136	(a)(1) The person seeking life-sustaining medical services 87
137	137	the prescription medication refill resides in a county that is 88
138	138	in an emergency as defined in paragraph (2)(a) : 89
139	139	(a) Is under a hurricane warning issued by the National 90
140	140	Weather Service; 91
141	141	(b) Is declared to be under a state of emergency in an 92
142	142	executive order issued by the Governor; or 93
143	143	(c) Has activated its emergency operations center and its 94
144	144	emergency management plan . 95
145	145	(b)(2) The life-sustaining medical services are 96
146	146	prescription medication refill is requested within 30 days after 97
147	147	the origination date of the emergency as defined in paragraph 98
148	148	(2)(a) conditions stated in this section or until such emergency 99
149	149	is conditions are terminated by the issuing authority or no 100
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158	158	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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162	162	longer exists exist. 101
163	163	(5) The time period for flexibilities and waivers the 102
164	164	waiver of prescription medication refills may be extended in 15 - 103
165	165	or 30-day increments by emergency orders issued by the Office of 104
166	166	Insurance Regulation or the Agency for Health Care 105
167	167	Administration. 106
168	168	(6) This section does not excuse or exempt an insured or a 107
169	169	subscriber from compliance with all other terms of the policy or 108
170	170	contract providing life-sustaining medical services prescription 109
171	171	medication coverage. 110
172	172	Section 2. This act shall take effect July 1, 2025. 111