Florida Senate - 2015 COMMITTEE AMENDMENT
Bill No. SB 856
Ì298990RÎ298990
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
03/17/2015 .
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The Committee on Banking and Insurance (Montford) recommended
the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Subsection (3) is added to section 627.6474,
6 Florida Statutes, to read:
7 627.6474 Provider contracts.—
8 (3)(a) A contract between a health insurer or the insurer’s
9 third-party administrator and:
10 1. An ophthalmologist licensed pursuant to chapter 458 or
11 chapter 459 or an optometrist licensed pursuant to chapter 463
12 may not require such licensee to:
13 a. Provide vision care services as a condition of
14 participating as a provider of any other type of service to an
15 insured; or
16 b. Purchase a material or service used by the licensee from
17 an entity in which the insurer or the insurer’s third-party
18 administrator has a direct or indirect ownership, financial, or
19 controlling interest.
20 2. An optician licensed pursuant to part I of chapter 484
21 may not require such licensee to purchase a material used by the
22 licensee from an entity in which the insurer or the insurer’s
23 third-party administrator has a direct or indirect ownership,
24 financial, or controlling interest.
25 (b) A violation of this subsection constitutes an unfair
26 insurance trade practice under s. 626.9541(1)(d).
27 Section 2. Subsection (14) is added to section 636.035,
28 Florida Statutes, to read:
29 636.035 Provider arrangements.—
30 (14)(a) A contract between a prepaid limited health service
31 organization or the organization’s third party administrator
32 and:
33 1. An ophthalmologist licensed pursuant to chapter 458 or
34 chapter 459 or an optometrist licensed pursuant to chapter 463
35 may not require such licensee to:
36 a. Provide vision care services as a condition of
37 participating as a provider of any other type of service to a
38 subscriber; or
39 b. Purchase a material or service used by the licensee from
40 an entity in which the organization or organization’s third
41 party administrator has a direct or indirect ownership,
42 financial, or controlling interest.
43 2. An optician licensed pursuant to part I of chapter 484
44 may not require such licensee to purchase a material used by the
45 licensee from an entity in which the organization or
46 organization’s third-party administrator has a direct or
47 indirect ownership, financial, or controlling interest.
48 (b) A violation of this subsection constitutes an unfair
49 insurance trade practice under s. 626.9541(1)(d).
50 Section 3. Subsection (12) is added to section 641.315,
51 Florida Statutes, to read:
52 641.315 Provider contracts.—
53 (12)(a) A contract between a health maintenance
54 organization or the organization’s third-party administrator
55 and:
56 1. An ophthalmologist licensed pursuant to chapter 458 or
57 chapter 459 or an optometrist licensed pursuant to chapter 463
58 may not require such licensee to:
59 a. Provide vision care services as a condition of
60 participating as a provider of any other type of service to a
61 subscriber; or
62 b. Purchase a material or service used by the licensee from
63 an entity in which the organization or organization’s third
64 party administrator has a direct or indirect ownership,
65 financial, or controlling interest.
66 2. An optician licensed pursuant to part I of chapter 484
67 may not require such licensee to purchase a material used by the
68 licensee from an entity in which the organization or
69 organization’s third-party administrator has a direct or
70 indirect ownership, financial, or controlling interest.
71 (b) A violation of this subsection constitutes an unfair
72 insurance trade practice under s. 626.9541(1)(d).
73 Section 4. This act shall take effect July 1, 2015.
74
75
76 ================= T I T L E A M E N D M E N T ================
77 And the title is amended as follows:
78 Delete everything before the enacting clause
79 and insert:
80 A bill to be entitled
81 An act relating to health provider contracts; amending
82 ss. 627.6474, 636.035, and 641.315, F.S.; providing
83 that a contract between a health insurer, a prepaid
84 limited health service organization, or a health
85 maintenance organization, respectively, or a third
86 party administrator thereof, and a licensed
87 ophthalmologist or optometrist may not require the
88 licensee to provide vision care services as a
89 condition of providing any other service or to
90 purchase certain materials or services from specified
91 entities; providing that a contract between a health
92 insurer, a prepaid limited health service
93 organization, or a health maintenance organization,
94 respectively, or a third-party administrator thereof,
95 and a licensed optician may not require the licensee
96 to purchase certain materials from specified entities;
97 providing that a violation of the act’s prohibitions
98 constitutes a specified unfair insurance trade
99 practice; providing an effective date.