CODING: Words stricken are deletions; words underlined are additions.House Bill 1809
Florida House of Representatives - 1997 HB 1809
By Representative Mackenzie
1 A bill to be entitled
2 An act relating to community health purchasing
3 alliances; amending s. 408.702, F.S.; providing
4 immunity from liability for members of the
5 board of directors of a community health
6 purchasing alliance, and its employees and
7 agents, in the performance of the board's
8 duties; correcting a cross reference; amending
9 s. 408.703, F.S.; providing that a small
10 employer member of an alliance remains eligible
11 for coverage for a specified period following
12 an expansion of business; creating s. 408.7059,
13 F.S.; establishing a pilot project in Broward
14 County to provide health care services to
15 certain uninsured persons; providing certain
16 authority to community health purchasing
17 alliances; providing for licensure of provider
18 networks contracting to provide services under
19 the pilot project; providing rulemaking
20 authority to the Agency for Health Care
21 Administration and the Department of Insurance;
22 repealing s. 408.705, F.S., relating to the
23 boards of directors of community health
24 purchasing alliances; providing an effective
25 date.
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27 Be It Enacted by the Legislature of the State of Florida:
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29 Section 1. Subsection (1) and paragraph (j) of
30 subsection (6) of section 408.702, Florida Statutes, are
31 amended to read:
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1 408.702 Community health purchasing alliance;
2 establishment.--
3 (1) There is hereby created a community health
4 purchasing alliance in each of the 11 health service planning
5 districts established under s. 408.032(5). Each alliance must
6 be operated as a state-chartered, nonprofit private
7 organization organized pursuant to chapter 617. There shall be
8 no liability on the part of, and no cause of action of any
9 nature shall arise against, any member of the board of
10 directors of a community health purchasing alliance, or its
11 employees or agents, for any action taken by the board in the
12 performance of its powers and duties under ss. 408.70-408.706.
13 (6) Each community health purchasing alliance has the
14 following powers, duties, and responsibilities:
15 (j) Ensuring that accountable health partnerships have
16 grievance procedures to be used in resolving disputes between
17 members and an accountable health partnership. A member may
18 appeal to the alliance any grievance that is not resolved by
19 the accountable health partnership. An accountable health
20 partnership that is a health maintenance organization must
21 follow the grievance procedures established in ss. 408.7056
22 and 641.31(5) and 641.311.
23 Section 2. Subsection (6) is added to section 408.703,
24 Florida Statutes, to read:
25 408.703 Small employer members of community health
26 purchasing alliances; eligibility requirements.--
27 (6) Notwithstanding any other law, if a small employer
28 member loses eligibility to purchase health care through a
29 community health purchasing alliance solely because the
30 business of the small employer member expands to more than 50
31 eligible employees, the small employer member may, at its next
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1 renewal date, purchase coverage through the alliance for an
2 additional year.
3 Section 3. Section 408.7059, Florida Statutes, is
4 created to read:
5 408.7059 Pilot project for health care services.--
6 (1) The Legislature finds there is insufficient group
7 health insurance coverage available to low-income employees
8 and self-employed persons, and their dependents, that such
9 uninsured individuals represent a significant portion of the
10 uncompensated costs of health care providers, and that
11 uninsured individuals have impaired access to health care
12 services and correspondingly low health status. It is,
13 therefore, the intent of the Legislature to create a pilot
14 project in Broward County that will serve to ensure access to
15 health care services to low-income employees and self-employed
16 persons, who are uninsured, and their dependents.
17 (2) For purposes of this section, "community health
18 purchasing alliance" and "provider network" are limited to
19 those entities in Broward County.
20 (3) A community health purchasing alliance may, in
21 addition to its other powers and duties:
22 (a) Directly contract with provider networks to
23 provide clinic-based health care services that include both
24 preventive and comprehensive care to low-income employees and
25 self-employed persons, who are uninsured, and their
26 dependents.
27 (b) Directly market such provider network services to
28 low-income employees and self-employed persons, who are
29 uninsured, and their dependents, and enroll such individuals
30 as members.
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1 (4)(a) The agency shall establish by rule the
2 eligibility requirements for low-income employees and
3 self-employed persons, and their dependents, and establish
4 grievance procedures for members.
5 (b) The agency shall license provider networks
6 contracting to provide services under this section that meet
7 quality of care standards as set forth by rule of the agency.
8 The agency shall adopt standards for quality of care for
9 preventive and comprehensive health care services consistent
10 with prevailing standards for medical practice in the
11 community.
12 (c) The agency shall consult with the department in
13 the development of rules to be adopted by the agency that
14 establish administrative and accounting standards necessary
15 for an efficient contractual relationship between the
16 community health purchasing alliance and provider networks.
17 (5) The department shall consult with the agency in
18 the development of rules to be adopted by the department that
19 provide state licensure, financial reserve requirements, and
20 solvency standards for the provider networks. The standards
21 shall ensure the solvency of provider networks so as to
22 protect the community health purchasing alliance members from
23 loss due to the insolvency or financial instability of a
24 provider network.
25 Section 4. Section 408.705, Florida Statutes, is
26 repealed.
27 Section 5. This act shall take effect upon becoming a
28 law.
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2 HOUSE SUMMARY
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Provides that the board of directors of a community
4 health purchasing alliance, and its employees or agents,
are not liable for actions taken in performing the duties
5 and functions of the board. Provides that a small
employer member of an alliance may continue to purchase
6 health care through the alliance for 1 year if the
business expands to more than 50 eligible employees.
7 Provides for establishment of a pilot project in Broward
County to provide health care services to low-income
8 employees and self-employed persons, who are uninsured,
and their dependents, through community health purchasing
9 alliances and provider networks in the county. Authorizes
alliances to contract with networks, market network
10 services, and enroll members, under the pilot project.
Directs the Agency for Health Care Administration to
11 adopt certain quality of care standards and to license
networks providing services under the pilot project.
12 Provides rulemaking authority of the agency and the
Department of Insurance with respect to operation of the
13 pilot project. Repeals s. 408.705, F.S., which specifies
the composition of a board of directors of a community
14 health purchasing alliance and provides certain other
requirements for the board.
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