Bill targets health insurer coverage limits
- February 10, 2015
- / News Service of Florida
- / government
Dubbing it the "Right Medicine, Right Time Act," a Senate Republican filed a proposal Monday that takes aim at coverage limits by health insurers. The proposal (SB 784), filed by Sen. Don Gaetz, R-Niceville, would require insurers to meet a standard before using such methods as prior authorization to limit access to services.
"A coverage limitation imposed by the insurer at the point of service must be supported by sufficient clinical evidence proving that the limitation does not inhibit timely diagnosis or effective treatment of the specific illness or condition for the covered patient,'' part of the bill says.
Also, the proposal would create a "Clinical Practices Review Commission." Among other things, the commission would determine "whether sufficient clinical evidence exists for a proposed coverage limitation imposed by the insurer at the point of service."
Gaetz, who served as Senate president from 2012 to 2014, has often been aligned politically with the Florida Medical Association, an influential physicians' lobby.
The bill will be considered during the legislative session that starts March 3.
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