(1) Insurers, health maintenance organizations, and nonprofit health care services plans transacting group health insurance or providing prepaid health care in this state shall make available to the policyholder as part of the application for any such policy of insurance issued or delivered in this state or contract executed or operative in this state the level of benefits specified in subsection (2) for the necessary care and treatment of substance abuse impaired persons, subject to the right of the applicant for a group policy or contract to select any alternative benefits or level of benefits as may be offered by the insurer, health maintenance organization, or plan. For the purposes of this section, the term “substance abuse impaired” has the same meaning ascribed in s. 397.311.
(2) Inpatient benefits or outpatient benefits shall consist of:
(a) Basic benefit.—Intensive treatment program for the treatment of substance abuse impaired persons.
(b) Limitations.—
1. Benefits shall be available only to covered individuals in a group health plan.
2. There shall be a minimum lifetime benefit of $2,000.
3. There shall be allowable a maximum of 44 outpatient visits.
4. The maximum benefit payable for an outpatient visit shall not exceed $35.
5. Detoxification shall not be considered as a benefit under the outpatient program.
(3) The benefits provided under this section are applicable only if treatment is provided by, or under the supervision of, or is prescribed by, a licensed physician or licensed psychologist and if services are provided in a program that is accredited by an accrediting organization whose standards incorporate comparable regulations required by this state or that is approved by this state.
History.—ss. 1, 2, 3, ch. 79-392; s. 2, ch. 81-318; ss. 522, 523, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 114, ch. 83-216; s. 114, ch. 92-318; s. 35, ch. 93-39; s. 13, ch. 2013-93.
Structure Florida Statutes
Chapter 627 - Insurance Rates and Contracts
Part VII - Group, Blanket, and Franchise Health Insurance Policies (Ss. 627.651-627.66997)
627.651 - Group contracts and plans of self-insurance must meet group requirements.
627.6512 - Exemption of certain group health insurance policies.
627.6515 - Out-of-state groups.
627.652 - Group health insurance; definitions.
627.6525 - Short-term health insurance.
627.654 - Labor union, association, and small employer health alliance groups.
627.6551 - Teacher and student groups.
627.6561 - Preexisting conditions.
627.65612 - Limit on preexisting conditions.
627.65615 - Special enrollment periods.
627.6562 - Dependent coverage.
627.65626 - Insurance rebates for healthy lifestyles.
627.6563 - Full-time employment defined.
627.657 - Provisions of group health insurance policies.
627.6571 - Guaranteed renewability of coverage.
627.6572 - Pharmacy benefit manager contracts.
627.65735 - Nondiscrimination of coverage for surgical procedures.
627.65736 - Coverage for organ transplants.
627.65745 - Diabetes treatment services.
627.6575 - Coverage for newborn children.
627.65755 - Dental procedures; anesthesia and hospitalization coverage.
627.6579 - Coverage for child health supervision services.
627.658 - Use of dividends, refunds, rate reductions, commissions, service fees; premium rates.
627.659 - Blanket health insurance; eligible groups.
627.660 - Conditions and provisions of blanket health insurance policies.
627.661 - School accident insurance claims; policy service.
627.6612 - Coverage for surgical procedures and devices incident to mastectomy.
627.66121 - Coverage for length of stay and outpatient postsurgical care.
627.66122 - Requirements with respect to breast cancer and routine followup care.
627.6613 - Coverage for mammograms.
627.6615 - Children with disabilities; continuation of coverage under group policy.
627.6616 - Coverage for ambulatory surgical center service.
627.6617 - Coverage for home health care services.
627.6618 - Payment of acupuncture benefits to certified acupuncturists.
627.662 - Other provisions applicable.
627.6621 - Advanced practice registered nurse services.
627.663 - Franchise health insurance.
627.664 - Assignment of incidents of ownership in group, blanket, or franchise health policies.
627.6645 - Notification of cancellation, expiration, nonrenewal, or change in rates.
627.6646 - Cancellation or nonrenewal prohibited.
627.6648 - Shared savings incentive program.
627.667 - Extension of benefits.
627.6675 - Conversion on termination of eligibility.
627.668 - Optional coverage for mental and nervous disorders required; exception.
627.6686 - Coverage for individuals with autism spectrum disorder required; exception.
627.669 - Optional coverage required for substance abuse impaired persons; exception.
627.6691 - Coverage for osteoporosis screening, diagnosis, treatment, and management.
627.66911 - Required coverage for cleft lip and cleft palate.
627.6692 - Florida Health Insurance Coverage Continuation Act.
627.6699 - Employee Health Care Access Act.
627.66996 - Restrictions on use of state and federal funds for state exchanges.