Newborn, infant, and toddler hearing screening.

(1) LEGISLATIVE INTENT.—It is the intent of the Legislature to provide a statewide comprehensive and coordinated interdisciplinary program of early hearing loss screening, identification, and follow-up care for newborns. The goal is to screen all newborns for hearing loss in order to alleviate the adverse effects of hearing loss on speech and language development, academic performance, and cognitive development. It is further the intent of the Legislature that this section only be implemented to the extent that funds are specifically included in the General Appropriations Act for carrying out the purposes of this section.

(2) DEFINITIONS.—As used in this section, the term:

(a) “Audiologist” means a person licensed under part I of chapter 468 to practice audiology.

(b) “Department” means the Department of Health.

(c) “Hearing loss” means a hearing loss of 30 dB HL or greater in the frequency region important for speech recognition and comprehension in one or both ears, approximately 500 through 4,000 hertz.

(d) “Hospital” means a facility as defined in s. 395.002(13) and licensed under chapter 395 and part II of chapter 408.

(e) “Infant” means an age range from 30 days through 12 months.

(f) “Licensed health care provider” means a physician or physician assistant licensed under chapter 458; an osteopathic physician or physician assistant licensed under chapter 459; an advanced practice registered nurse, a registered nurse, or a licensed practical nurse licensed under part I of chapter 464; a midwife licensed under chapter 467; or a speech-language pathologist or an audiologist licensed under part I of chapter 468.

(g) “Management” means the habilitation of the child with hearing loss.

(h) “Newborn” means an age range from birth through 29 days.

(i) “Physician” means a person licensed under chapter 458 to practice medicine or chapter 459 to practice osteopathic medicine.

(j) “Screening” means a test or battery of tests administered to determine the need for an in-depth hearing diagnostic evaluation.

(k) “Toddler” means a child from 12 months to 36 months of age.

(3) REQUIREMENTS FOR SCREENING OF NEWBORNS, INFANTS, AND TODDLERS; INSURANCE COVERAGE; REFERRAL FOR ONGOING SERVICES.—

(a)1. Each hospital or other state-licensed birth facility that provides maternity and newborn care services shall ensure that all newborns are, before discharge, screened for the detection of hearing loss to prevent the consequences of unidentified disorders. If a newborn fails the screening for the detection of hearing loss, the hospital or other state-licensed birth facility must administer a test approved by the United States Food and Drug Administration or another diagnostically equivalent test on the newborn to screen for congenital cytomegalovirus before the newborn becomes 21 days of age or before discharge, whichever occurs earlier.

2. Each hospital that provides neonatal intensive care services shall administer a test approved by the United States Food and Drug Administration or another diagnostically equivalent test to screen for congenital cytomegalovirus in each newborn admitted to the hospital as a result of a premature birth occurring before 35 weeks’ gestation, for cardiac care, or for medical or surgical treatment requiring an anticipated stay of 3 weeks or longer. Such screening must be initiated before the newborn becomes 21 days of age.

3. If a newborn requires transfer to another hospital for a higher level of care, the receiving hospital must initiate the congenital cytomegalovirus screening if it was not already performed by the transferring hospital or birthing facility. For newborns transferred or admitted for intensive and prolonged care, the congenital cytomegalovirus screening must be initiated regardless of whether the newborn failed a hearing screening.

(b) Each licensed birth center that provides maternity and newborn care services shall ensure that all newborns are, before discharge, screened for the detection of hearing loss. Within 7 days after the birth, the licensed birth center must ensure that all newborns who do not pass the hearing screening are referred for an appointment for a test to screen for congenital cytomegalovirus before the newborn becomes 21 days of age. Written documentation of the referral must be placed in the newborn’s medical chart.

(c) If the parent or legal guardian of the newborn objects to the screening, the screening must not be completed. In such case, the physician, midwife, or other person attending the newborn shall maintain a record that the screening has not been performed and attach a written objection that must be signed by the parent or guardian.

(d) For home births, the health care provider in attendance is responsible for coordination and referral to an audiologist, a hospital, or another newborn hearing screening provider. The health care provider in attendance must make the referral for appointment within 7 days after the birth. In cases in which the home birth is not attended by a health care provider, the newborn’s primary health care provider is responsible for coordinating the referral.

(e) For home births and births in a licensed birth center, if a newborn is referred to a newborn hearing screening provider and the newborn fails the screening for the detection of hearing loss, the newborn’s primary health care provider must refer the newborn for administration of a test approved by the United States Food and Drug Administration or another diagnostically equivalent test on the newborn to screen for congenital cytomegalovirus.

(f) All newborn and infant hearing screenings must be conducted by an audiologist, a physician, or an appropriately supervised individual who has completed documented training specifically for newborn hearing screening. Every hospital that provides maternity or newborn care services shall obtain the services of an audiologist, a physician, or another newborn hearing screening provider, through employment or contract or written memorandum of understanding, for the purposes of appropriate staff training, screening program supervision, monitoring the scoring and interpretation of test results, rendering of appropriate recommendations, and coordination of appropriate follow-up services. Appropriate documentation of the screening completion, results, interpretation, and recommendations must be placed in the medical record within 24 hours after completion of the screening procedure.

(g) The screening of a newborn’s hearing must be completed before the newborn is discharged from the hospital or licensed birth center. However, if the screening is not completed before discharge due to scheduling or temporary staffing limitations, the screening must be completed within 21 days after the birth. Screenings completed after discharge or performed because of initial screening failure must be completed by an audiologist, a physician, a hospital, or another newborn hearing screening provider.

(h) Each hospital shall formally designate a lead physician responsible for programmatic oversight for newborn hearing screening. Each birth center shall designate a licensed health care provider to provide such programmatic oversight and to ensure that the appropriate referrals are being completed.

(i) When ordered by the treating physician, screening of a newborn’s, infant’s, or toddler’s hearing must include auditory brainstem responses, or evoked otoacoustic emissions, or appropriate technology as approved by the United States Food and Drug Administration.

(j) The results of any test conducted pursuant to this section, including, but not limited to, newborn hearing loss screening, congenital cytomegalovirus testing, and any related diagnostic testing, must be reported to the department within 7 days after receipt of such results.

(k) The initial procedures for the congenital cytomegalovirus screening and the hearing screening of the newborn or infant and any medically necessary follow-up reevaluations leading to diagnosis are covered benefits for Medicaid patients covered by a fee-for-service program. For Medicaid patients enrolled in HMOs, providers must be reimbursed directly by the Medicaid Program Office at the Medicaid rate. This service is not considered a covered service for the purposes of establishing the payment rate for Medicaid HMOs. All health insurance policies and health maintenance organizations as provided under ss. 627.6416, 627.6579, and 641.31(30), except for supplemental policies that only provide coverage for specific diseases, hospital indemnity, or Medicare supplement, or to the supplemental policies, must compensate providers for the covered benefit at the contracted rate. Nonhospital-based providers are eligible to bill Medicaid for the professional and technical component of each procedure code.

(l) A child diagnosed as having permanent hearing loss or a congenital cytomegalovirus infection must be referred to the primary care physician for medical management, treatment, and follow-up services. Furthermore, in accordance with Part C of the Individuals with Disabilities Education Act, Pub. L. No. 108-446, Infants and Toddlers with Disabilities, any child from birth to 36 months of age diagnosed as having hearing loss that requires ongoing special hearing services must be referred to the Children’s Medical Services Early Intervention Program serving the geographical area in which the child resides. A child diagnosed with a congenital cytomegalovirus infection without hearing loss must be referred to the Children’s Medical Services Early Intervention Program and be deemed eligible for a baseline evaluation and any medically necessary follow-up reevaluations and monitoring.