HIPAA - Florida

Summary of differences between federal and state regulations

Federal HIPAA portability provisions limit exclusions for preexisting conditions; prohibit discrimination against employees and dependents based on their health status; and allow a special opportunity to enroll in a new plan to individuals in certain circumstances.

States are allowed to go beyond the federal requirements. Florida law provides a list of what does not constitute creditable coverage, and what may be counted as creditable coverage if certain requirements are met.

Also, routine follow-up care to determine whether a breast cancer has recurred in a person who has been previously determined to be free of breast cancer does not constitute medical advice, diagnosis, care, or treatment for purposes of determining preexisting conditions unless evidence of breast cancer is found during or as a result of the follow-up care.

State

Contact

Florida Department of Financial Services, Office of Insurance Regulation

Regulations

Florida Statute Title XXXVII, Chapter 627, Part VI – Preexisting conditions (§627.6045)

Florida Statute Title XXXVII, Chapter 627, Part VI - Requirements with respect to breast cancer and routine followup care (§627.6419)

Federal

Contact

Centers for Medicare & Medicaid Services

Regulations

45 CFR Parts 160 - 164

29 CFR 2590.701-1 et seq.

29 USC chapter 18, §1181