Coverage for the Treatment of Stuttering; Authorizes AHCA to pay for certain services & devices as treatment of stuttering for Medicaid recipients; authorizes speech therapy in person & via telehealth as treatment for stuttering; authorizes agency to include use of certain communication technologies, applications, & platforms for such telehealth treatment; requires certain individual health insurance policies, group health insurance policies, & health maintenance contracts to provide coverage for specified services & devices as treatment for stuttering; authorizes speech therapy in person & via telehealth.
Small Independent Special Fire Control Districts; Defining the term “small independent special fire control district”; authorizing the governing body of a small independent special fire control district to apply for participation in the state group health insurance and prescription drug programs; requiring the Department of Management Services to conduct a certain actuarial analysis; requiring that such analysis be paid for by the small independent special fire control district, etc.
Coverage for Treatment of Stuttering; Authorizing the Agency for Health Care Administration to pay for certain services and devices as a treatment for stuttering for Medicaid recipients; authorizing speech therapy in person and via telehealth as a treatment for stuttering; requiring certain individual health insurance policies, group health insurance policies, and health maintenance contracts, respectively, to provide coverage for specified services and devices as treatments for stuttering, etc.
Cost-sharing Requirements for Diabetes Management; Prohibiting health insurance policies from imposing a cost-sharing requirement exceeding a certain amount for a 30-day supply of insulin or any diabetes device or diabetic ketoacidosis device, etc.
SB 64 revises Florida's definition of "medical review committee" to include more healthcare entities like mental health facilities, substance abuse programs, pharmacy quality committees, and insurer review groups. It clarifies that committee proceedings and records generally cannot be used as evidence in malpractice lawsuits against healthcare providers, protecting confidentiality during peer reviews. The bill also specifies that information already available from other sources remains discoverable, and committee members cannot be questioned about their committee testimony in court. This applies to committees evaluating care quality, treatment appropriateness, or cost reasonableness across hospitals, clinics, and health systems. The changes take effect July 1, 2026.
Continuity of Care in Health Insurance Contracts; Requiring that contracts between a health insurer and a contracted health care practitioner require a specified notice; requiring a health insurer and a health care practitioner to allow certain policyholders to continue coverage and care for a specified timeframe; requiring that certain health maintenance organization contracts require a specified notice; requiring a health maintenance organization and a treating provider to allow certain subscribers to continue coverage and care for a specified timeframe, etc.
Nonparticipating and Out-of-network Nurse Registries and Home Health Agencies; Prohibiting state group health insurance plans and state-contracted health maintenance organizations, the Agency for Health Care Administration, Medicaid managed care plans, individual health insurers, and health maintenance organizations, respectively, and any persons responsible for administering claims on behalf of such plans, organizations, agency, or insurers, from restricting participants, recipients, enrollees, policyholders, and subscribers from obtaining care from nonparticipating or out-of-network licensed nurse registries or home health agencies; revising applicability for group health insurance, blanket health insurance, and franchise health insurance, etc.
Cost-sharing Requirements for Insulin and Diabetes Supplies; Prohibits health insurance policies from imposing cost-sharing requirements that exceed specified amount for 30 days of insulin & diabetes supplies.
Coverage for Mammograms and Supplemental Breast Cancer Screenings; Requires AHCA to provide coverage for yearly mammograms & yearly supplemental breast cancer screenings for certain women; revises coverages for mammograms under certain individual accident & health insurance policies, group, blanket, & franchise accident & health insurance policies, & health maintenance contracts; requires coverages for supplemental breast cancer screenings under such policies & contracts under certain circumstances.
Mandatory Human Reviews of Insurance Claim Denials ; Authorizes workers' compensation carriers, insurers &HMOs to use artificial intelligence systems & machine learning systems to assist in processing claims; prohibits use of artificial intelligence or machine learning systems as sole basis for determining whether to reduce claim payment or deny claim or portion of claim; requires that decisions to deny claim or portion of claim or reduce claim be made by qualified human professionals; authorizes OIR to conduct market conduct examinations & investigations.
