Sickle Cell Coordinated Access Network; established.

The document structure was changed from a final enacted format to a draft substitute format, adding headers like 'Amendment in the Nature of a Substitute' and page numbers.

The requirement for sickle cell specialists to be available for telehealth consultation was changed from 'extended coverage' to 'at all times', indicating a stricter availability standard in the substitute text.

The deadline for the Commissioner to submit recommendations was changed from December 1, 2026, to December 1, 2027, likely to align with the new effective date.

The effective date for the bill was removed from the substitute text, whereas the original enrolled version specified an effective date of July 1, 2027.

The requirement for sickle cell specialists to be available for telehealth was changed from 'at all times' to 'for extended coverage,' indicating a shift toward a planned, sustainable service model rather than an immediate, unlimited mandate.

A new provision was added requiring the State Health Commissioner to submit recommendations on the network's extended coverage plan to legislative committee chairs by December 1, 2026.

The effective date for the provisions of this act was set to July 1, 2027, providing a delay before the new requirements take full effect.

The document layout was converted from a continuous text block to a multi-page format with line numbers, headers, and spacing adjustments, but no policy content was added, removed, or altered.

The document layout was updated to include a 'House Substitute' header, page numbers, and a bill ID number, while the substantive text of the bill was preserved.