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House Bill 0399er

House Bill 0399er

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    ENROLLED

    2000 Legislature                    CS/HB 399, First Engrossed



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  2         An act relating to newborn hearing screening;

  3         providing legislative intent; providing

  4         definitions; providing requirements for

  5         screening newborns for hearing impairment;

  6         providing for certain insurance and managed

  7         care coverage; providing for referral for

  8         ongoing services; providing a contingent

  9         effective date.

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11  Be It Enacted by the Legislature of the State of Florida:

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13         Section 1.  Newborn hearing screening.--

14         (1)  LEGISLATIVE INTENT.--The intent of this section is

15  to provide a statewide comprehensive and coordinated

16  interdisciplinary program of early hearing impairment

17  screening, identification, and followup care for newborns. The

18  goal is to screen all newborns for hearing impairment in order

19  to alleviate the adverse effects of hearing loss on speech and

20  language development, academic performance, and cognitive

21  development. It is further the intent of the Legislature that

22  the provisions of this act only be implemented to the extent

23  that funds are specifically included in the General

24  Appropriations Act for carrying out the purposes of this

25  section.

26         (2)  DEFINITIONS.--

27         (a)  "Agency" means the Agency for Health Care

28  Administration.

29         (b)  "Department" means the Department of Health.

30         (c)  "Hearing impairment" means a hearing loss of 30 dB

31  HL or greater in the frequency region important for speech


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    2000 Legislature                    CS/HB 399, First Engrossed



  1  recognition and comprehension in one or both ears,

  2  approximately 500 through 4,000 hertz.

  3         (d)  "Infant" means an age range from 30 days through

  4  12 months.

  5         (e)  "Licensed health care provider" means a physician

  6  licensed pursuant to chapter 458 or chapter 459, a nurse

  7  licensed pursuant to chapter 464, or an audiologist licensed

  8  pursuant to chapter 468, rendering services within the scope

  9  of his or her license.

10         (f)  "Management" means the habilitation of the

11  hearing-impaired child.

12         (g)  "Newborn" means an age range from birth through 29

13  days.

14         (h)  "Screening" means a test or battery of tests

15  administered to determine the need for an in-depth hearing

16  diagnostic evaluation.

17         (3)  REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE

18  COVERAGE; REFERRAL FOR ONGOING SERVICES.--

19         (a)  Each licensed hospital or other state-licensed

20  birthing facility that provides maternity and newborn care

21  services shall provide that all newborns are, prior to

22  discharge, screened for the detection of hearing loss, to

23  prevent the consequences of unidentified disorders.

24         (b)  Each licensed birth center that provides maternity

25  and newborn care services shall provide that all newborns are,

26  prior to discharge, referred to a licensed audiologist, a

27  physician licensed under chapter 458 or chapter 459, or a

28  hospital or other newborn hearing screening provider, for

29  screening for the detection of hearing loss, to prevent the

30  consequences of unidentified disorders. The referral for

31  appointment shall be made within 30 days after discharge.


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    2000 Legislature                    CS/HB 399, First Engrossed



  1  Written documentation of the referral must be placed in the

  2  newborn's medical chart.

  3         (c)  If the parent or legal guardian of the newborn

  4  objects to the screening, the screening must not be completed.

  5  In such case, the physician, midwife, or other person who is

  6  attending the newborn shall maintain a record that the

  7  screening has not been performed and attach a written

  8  objection that must be signed by the parent or guardian.

  9         (d)  For home births, the health care provider in

10  attendance is responsible for coordination and referral to a

11  licensed audiologist, hospital, or other newborn hearing

12  screening provider. The referral for appointment shall be made

13  within 30 days after the birth. In cases in which the home

14  birth is not attended by a primary health care provider, a

15  referral to a licensed audiologist, physician licensed

16  pursuant to chapter 458 or chapter 459, hospital, or other

17  newborn hearing screening provider must be made by the health

18  care provider within the first 3 months after the child's

19  birth.

20         (e)  All newborn and infant hearing screenings shall be

21  conducted by a licensed audiologist, physician licensed under

22  chapter 458 or chapter 459, or appropriately supervised

23  individual who has completed documented training specifically

24  for newborn hearing screening. Every licensed hospital that

25  provides maternity or newborn care services shall obtain the

26  services of a licensed audiologist, physician licensed

27  pursuant to chapter 458 or chapter 459, or other newborn

28  hearing screening provider, through employment or contract or

29  written memorandum of understanding, for the purposes of

30  appropriate staff training, screening program supervision,

31  monitoring the scoring and interpretation of test results,


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  1  rendering of appropriate recommendations, and coordination of

  2  appropriate followup services. Appropriate documentation of

  3  the screening completion, results, interpretation, and

  4  recommendations must be placed in the medical record within 24

  5  hours after completion of the screening procedure.

  6         (f)  The screening of a newborn's hearing should be

  7  completed before the newborn is discharged from the hospital.

  8  If the screening is not completed before discharge due to

  9  scheduling or temporary staffing limitations, the screening

10  must be completed within 30 days after discharge. Screenings

11  completed after discharge or performed because of initial

12  screening failure must be completed by an audiologist licensed

13  in the state, a physician licensed under chapter 458 or

14  chapter 459, or a hospital or other newborn hearing screening

15  provider.

16         (g)  Each hospital shall formally designate a lead

17  physician responsible for programmatic oversight for newborn

18  hearing screening. Each birth center shall designate a

19  licensed health care provider to provide such programmatic

20  oversight and to ensure that the appropriate referrals are

21  being completed.

22         (h)  When ordered by the treating physician, screening

23  of a newborn's hearing must include auditory brainstem

24  responses, or evoked otacoustic emissions, or appropriate

25  technology as approved by the United States Food and Drug

26  Administration.

27         (i)  By October 1, 2000, newborn hearing screening must

28  be conducted on all newborns in hospitals in this state on

29  birth admission. When a newborn is delivered in a facility

30  other than a hospital, the parents must be instructed on the

31  importance of having the hearing screening performed and must


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  1  be given information to assist them in having the screening

  2  performed within 3 months after the child's birth.

  3         (j)  The initial procedure for screening the hearing of

  4  the newborn or infant and any medically necessary followup

  5  reevaluations leading to diagnosis shall be a covered benefit,

  6  reimbursable under Medicaid as an expense compensated

  7  supplemental to the per diem rate for Medicaid patients

  8  enrolled in MediPass or Medicaid patients covered by a fee for

  9  service program.   For Medicaid patients enrolled in HMOs,

10  providers shall be reimbursed directly by the Medicaid Program

11  Office at the Medicaid rate.  This service may not be

12  considered a covered service for the purposes of establishing

13  the payment rate for Medicaid HMOs.  All health insurance

14  policies and health maintenance organizations as provided

15  under ss. 627.6416, 627.6579, and 641.31(30), Florida

16  Statutes, except for supplemental policies that only provide

17  coverage for specific diseases, hospital indemnity, or

18  Medicare supplement, or to the supplemental polices, shall

19  compensate providers for the covered benefit at the contracted

20  rate.  Non-hospital-based providers shall be eligible to bill

21  Medicaid for the professional and technical component of each

22  procedure code.

23         (k)  Any child who is diagnosed as having a permanent

24  hearing impairment shall be referred to the primary care

25  physician for medical management, treatment, and followup

26  services.  Furthermore, in accordance with Pub. L. No. 105-17,

27  The Infants and Toddlers Program, Individuals with

28  Disabilities Education Act, any child from birth to 36 months

29  of age who is diagnosed as having a hearing impairment that

30  requires ongoing special hearing services must be referred to

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  1  the Children's Medical Services Early Intervention Program

  2  serving the geographical area in which the child resides.

  3         (l)  Any person who is not covered through insurance

  4  and cannot afford the costs for testing shall be given a list

  5  of newborn hearing screening providers who provide the

  6  necessary testing free of charge.

  7         Section 2.  This act shall take effect July 1, 2000.

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