Senate Bill 1554
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1554
By Senators Dawson-White, Sullivan, Bronson, Sebesta, Clary,
Saunders, Campbell, Latvala and Cowin
30-652-99
1 A bill to be entitled
2 An act relating to access to obstetrical and
3 gynecological services; amending s. 627.6472,
4 F.S.; requiring an exclusive provider
5 organization to provide direct access to
6 certain services; amending s. 641.31, F.S.;
7 requiring a health maintenance organization to
8 provide direct access to certain services;
9 providing an 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. Subsection (18) is added to section
14 627.6472, Florida Statutes, 1998 Supplement, to read:
15 627.6472 Exclusive provider organizations.--
16 (18)(a) An exclusive provider organization must
17 provide direct patient access to a board-certified or
18 board-eligible obstetrician or gynecologist who is under
19 contract with the exclusive provider organization, if the
20 exclusive provider organization covers obstetrical or
21 gynecological services. As used in this paragraph, the term
22 "direct patient access" means the ability of a subscriber to
23 obtain services without a referral or other authorization
24 before receiving services.
25 (b) An exclusive provider organization may not impose
26 additional coinsurance or deductibles upon a subscriber who
27 obtains services under this subsection unless the copayment or
28 deductible is imposed on all other primary care physician
29 services.
30 Section 2. Subsection (36) is added to section 641.31,
31 Florida Statutes, 1998 Supplement, to read:
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1999 SB 1554
30-652-99
1 641.31 Health maintenance contracts.--
2 (36)(a) A health maintenance organization must provide
3 direct patient access to a board-certified or board-eligible
4 obstetrician or gynecologist who is under contract with the
5 health maintenance organization, if the health maintenance
6 organization covers obstetrical or gynecological services. As
7 used in this paragraph, the term "direct patient access" means
8 the ability of a subscriber to obtain services without a
9 referral or other authorization before receiving services.
10 (b) A health maintenance organization may not impose
11 additional coinsurance or deductibles upon a subscriber who
12 obtains services under this subsection unless the copayment or
13 deductible is imposed on all other primary care physician
14 services.
15 Section 3. This act shall take effect July 1, 1999.
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18 SENATE SUMMARY
19 Requires exclusive provider organizations and health
maintenance organizations to provide direct access to
20 obstetrical and gynecological services, if the
organizations cover such services. Prohibits the
21 imposition of additional coinsurance or deductibles upon
a subscriber for such services.
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