Senate Bill 1196
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1196
By Senator Forman
32-31-98
1 A bill to be entitled
2 An act relating to health care for low-income
3 persons; providing legislative intent with
4 respect to access to health care services for
5 low-income employees of small employers and
6 self-employed individuals; providing
7 definitions; authorizing community health
8 purchasing alliances in a specified county to
9 contract, under a pilot project, with provider
10 networks for clinic-based health care services
11 for low-income employees of small employers,
12 self-employed individuals, and dependents of
13 low-income employees and self-employed
14 individuals; requiring the Agency for Health
15 Care Administration to adopt rules for
16 eligibility requirements and for administrative
17 and accounting standards; requiring the
18 Department of Insurance to adopt by rule
19 requirements for licensure, financial reserves,
20 and financial solvency; providing an effective
21 date.
22
23 Be It Enacted by the Legislature of the State of Florida:
24
25 Section 1. Provider networks; pilot program for health
26 care services in Broward County.--
27 (1) The Legislature finds there is insufficient group
28 health insurance coverage available for low-income employees
29 who work for small employers or for self-employed individuals,
30 that these uninsured employees and their dependents represent
31 a significant portion of the uncompensated costs of health
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1196
32-31-98
1 care providers, and that uninsured employees have impaired
2 access to health care services and a correspondingly low
3 health status. It is therefore the intent of the Legislature
4 to create a pilot project in Broward County to ensure access
5 to health care services by low-income employees who work for
6 small employers and by self-employed individuals.
7 (2) As used in this section, the term "small employer"
8 has the meaning ascribed in section 627.6699, Florida
9 Statutes.
10 (3) A community health purchasing alliance may, in
11 addition to its other powers and duties:
12 (a) Directly contract with a provider network to
13 provide clinic-based health care services, including
14 preventive and comprehensive health care services, to
15 low-income employees of small employers, self-employed
16 individuals, or dependents of low-income employees and
17 self-employed individuals.
18 (b) Directly market provider network services to
19 low-income employees of small employers, self-employed
20 individuals, dependents of low-income employees and
21 self-employed individuals, or small employers, and may enroll
22 such individuals or small employers as members of the provider
23 network.
24 (4) The Agency for Health Care Administration shall:
25 (a) Establish by rule eligibility requirements for
26 low-income employees of small employers, self-employed
27 individuals, and dependents of low-income employees and
28 self-employed individuals, and shall establish grievance
29 procedures.
30
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CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 1998 SB 1196
32-31-98
1 (b) License provider networks located in Broward
2 County which contract to provide services under this section
3 and meet quality-of-care standards established by agency rule.
4 (c) Adopt standards for quality of care for preventive
5 and comprehensive health care services which are consistent
6 with prevailing standards for medical practice in the
7 community.
8 (d) In consultation with the Department of Insurance,
9 adopt rules that establish administrative and accounting
10 standards necessary for an efficient contractual relationship
11 between a community health purchasing alliance located in
12 Broward County and a provider network located in Broward
13 County.
14 (5) In consultation with the agency, the Department of
15 Insurance shall adopt rules that provide requirements for the
16 provider networks with respect to state licensure, financial
17 reserves, and financial solvency. The standards must ensure
18 the solvency of provider networks to protect the members of
19 the community health purchasing alliance from loss due to the
20 insolvency or financial instability of a provider network.
21 Section 2. This act shall take effect July 1, 1998.
22
23 *****************************************
24 SENATE SUMMARY
25 Provides for a pilot project to be established in Broward
County under which a community health purchasing alliance
26 may directly contract with a provider network for the
purpose of providing clinic-based health services for
27 low-income employees of small employers, self-employed
individuals, and the dependents of those employees and
28 individuals. Requires the Agency for Health Care
Administration and the Department of Insurance to adopt
29 rules for administering the pilot project, including
eligibility requirements for employees, quality-of-care
30 standards for health care services, and administrative
and accounting standards for provider networks.
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