Senate Bill 2146

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    Florida Senate - 1998                                  SB 2146

    By Senator Silver





    38-641-98

  1                      A bill to be entitled

  2         An act relating to managed care

  3         nondiscrimination; amending ss. 408.706,

  4         627.6472, F.S.; creating s. 641.3923, F.S.;

  5         prohibiting accountable health partnerships,

  6         exclusive provider organizations, and health

  7         maintenance organizations from discriminating

  8         with respect to participation, reimbursement,

  9         or indemnification as to any provider who is

10         acting within the scope of the provider's

11         licensure and certification; providing an

12         effective date.

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14  Be It Enacted by the Legislature of the State of Florida:

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16         Section 1.  Subsection (14) is added to section

17  408.706, Florida Statutes, to read:

18         408.706  Community health purchasing alliances;

19  accountable health partnerships.--

20         (14)  An accountable health partnership may not

21  discriminate with respect to participation, reimbursement, or

22  indemnification as to any provider who is acting within the

23  scope of the provider's licensure and certification under

24  applicable state law, solely on the basis of such licensure or

25  certification. This subsection does not prohibit a plan from

26  including providers only to the extent necessary to meet the

27  needs of the plan's enrollees or from establishing any measure

28  designed to maintain quality and control costs consistent with

29  the responsibilities of the plan.

30         Section 2.  Subsection (17) is added to section

31  627.6472, Florida Statutes, to read:

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    Florida Senate - 1998                                  SB 2146
    38-641-98




  1         627.6472  Exclusive provider organizations.--

  2         (17)  An exclusive provider organization may not

  3  discriminate with respect to participation, reimbursement, or

  4  indemnification as to any provider who is acting within the

  5  scope of the provider's licensure and certification under

  6  applicable state law, solely on the basis of such licensure or

  7  certification. This subsection does not prohibit a plan from

  8  including providers only to the extent necessary to meet the

  9  needs of the plan's enrollees or from establishing any measure

10  designed to maintain quality and control costs consistent with

11  the responsibilities of the plan.

12         Section 3.  Section 641.3923, Florida Statutes, is

13  created to read:

14         641.3923  Discrimination against providers

15  prohibited.--A health maintenance organization may not

16  discriminate with respect to participation, reimbursement, or

17  indemnification as to any provider who is acting within the

18  scope of the provider's licensure and certification under

19  applicable state law, solely on the basis of such licensure or

20  certification. This section does not prohibit a plan from

21  including providers only to the extent necessary to meet the

22  needs of the plan's enrollees or from establishing any measure

23  designed to maintain quality and control costs consistent with

24  the responsibilities of the plan.

25         Section 4.  This act shall take effect upon becoming a

26  law.

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    Florida Senate - 1998                                  SB 2146
    38-641-98




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  2                          SENATE SUMMARY

  3    Prohibits accountable health partnerships, exclusive
      provider organizations, and health maintenance
  4    organizations from discriminating with respect to
      participation, reimbursement, or indemnification as to
  5    any health care provider who is acting within the scope
      of the provider's licensure and certification.
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