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2022 Florida Statutes (including 2022C, 2022D, 2022A, and 2023B)

Title X PUBLIC OFFICERS, EMPLOYEES, AND RECORDS
Chapter 110 STATE EMPLOYMENT Entire Chapter
SECTION 12303
State group insurance program; additional benefits; price transparency program; reporting.
F.S. 110.12303
110.12303 State group insurance program; additional benefits; price transparency program; reporting.—
(1) In addition to the comprehensive package of health insurance and other benefits required or authorized to be included in the state group insurance program, the package of benefits may also include products and services offered by:
(a) Prepaid limited health service organizations authorized pursuant to part I of chapter 636.
(b) Discount medical plan organizations authorized pursuant to part II of chapter 636.
(c) Prepaid health clinics licensed under part II of chapter 641.
(d) Licensed health care providers, including hospitals and other health care facilities, health care clinics, and health professionals, who sell service contracts and arrangements for a specified amount and type of health services.
(e) Provider organizations, including service networks, group practices, professional associations, and other incorporated organizations of providers, who sell service contracts and arrangements for a specified amount and type of health services.
(f) Entities that provide specific health services in accordance with applicable state law and sell service contracts and arrangements for a specified amount and type of health services.
(g) Entities that provide health services or treatments through a bidding process.
(h) Entities that provide health services or treatments through the bundling or aggregating of health services or treatments.
(i) Entities that provide international prescription services.
(j) Entities that provide optional participation in a Medicare Advantage Prescription Drug Plan.
(k) Entities that provide other innovative and cost-effective health service delivery methods.
(2)(a) The department shall contract with at least one entity that provides comprehensive pricing and inclusive services for surgery and other medical procedures which may be accessed at the option of the enrollee. The contract shall require:
1. The entity to have procedures and evidence-based standards to ensure the inclusion of only high-quality health care providers.
2. The entity to provide assistance to the enrollee in accessing and coordinating care.
3. The entity to provide cost savings to the state group insurance program to be shared with both the state and the enrollee. Cost savings to an enrollee must, unless prohibited by first-dollar coverage rules under applicable tax law, include a waiver of enrollee cost-sharing liability for surgery and other medical procedures. Cost savings may additionally include amounts payable to an enrollee or beneficiary as follows:
a. Credited to the enrollee’s flexible spending account;
b. Credited to the enrollee’s health savings account;
c. Credited to the enrollee’s health reimbursement account; or
d. Paid as additional health plan reimbursements.
4. The entity, in conjunction with the department, to provide an educational campaign for enrollees to learn about the services offered by the entity.
(b) On or before January 15 of each year, the department shall report to the Governor, the President of the Senate, and the Speaker of the House of Representatives on the participation level and cost-savings to both the enrollee and the state resulting from the contract or contracts described in this subsection.
(3) The department shall contract with an entity that provides enrollees with online information on the cost and quality of health care services and providers, allows an enrollee to shop for health care services and providers, and rewards the enrollee by sharing savings generated by the enrollee’s choice of services or providers. The contract shall require the entity to:
(a) Establish an Internet-based, consumer-friendly platform that educates and informs enrollees about the price and quality of health care services and providers, including the average amount paid in each county for health care services and providers. The average amounts paid for such services and providers may be expressed for service bundles, which include all products and services associated with a particular treatment or episode of care, or for separate and distinct products and services.
(b) Allow enrollees to shop for health care services and providers using the price and quality information provided on the Internet-based platform.
(c) Permit a certified bargaining agent of state employees to provide educational materials and counseling to enrollees regarding the Internet-based platform.
(d) Identify the savings realized to the enrollee and state if the enrollee chooses high-quality, lower-cost health care services or providers, and facilitate a shared savings payment to the enrollee. The amount of shared savings shall be determined by a methodology approved by the department and shall maximize value-based purchasing by enrollees. The amount payable to the enrollee may be:
1. Credited to the enrollee’s flexible spending account;
2. Credited to the enrollee’s health savings account;
3. Credited to the enrollee’s health reimbursement account; or
4. Paid as additional health plan reimbursements not exceeding the amount of the enrollee’s out-of-pocket medical expenses.
(4) The department shall offer, as a voluntary supplemental benefit option, international prescription services that offer safe maintenance medications at a reduced cost to enrollees and that meet the standards of the United States Food and Drug Administration personal importation policy.
History.—s. 2, ch. 2017-88; s. 2, ch. 2019-100; s. 8, ch. 2022-4; s. 2, ch. 2022-160.