CODING: Words stricken are deletions; words underlined are additions.
SENATE AMENDMENT
Bill No. SB 834
Amendment No.
CHAMBER ACTION
Senate House
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11 Senator Brown-Waite moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 2, line 22 through page 4, line 19, delete
15 those lines
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17 and insert:
18 Section 3. Subsection (7) of section 641.315, Florida
19 Statutes, 1996 Supplement, is redesignated as subsection (9),
20 new subsections (7) and (8) are added, and subsection (6) is
21 amended to read:
22 641.315 Provider contracts.--
23 (6)(a) For All provider contracts executed after
24 October 1, 1991, and within 180 days after October 1, 1991,
25 for contracts in existence as of October 1, 1991:
26 1. The contracts must contain terms that require the
27 provider to give provide that the provider shall provide 60
28 days' advance written notice to the health maintenance
29 organization and the department before canceling the contract
30 with the health maintenance organization for any reason; and
31 2. The contract must also provide that nonpayment for
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SENATE AMENDMENT
Bill No. SB 834
Amendment No.
1 goods or services rendered by the provider to the health
2 maintenance organization shall not be a valid reason for
3 avoiding the 60-day advance notice of cancellation.
4 (b) For all provider contracts executed after July 1,
5 1997, and by January 1, 1998, for contracts in existence as of
6 July 1, 1997, the governing body of a health maintenance
7 organization may not terminate or fail to renew a contract
8 with a health care provider unless the governing body provides
9 the health care provider with notice of the proposed contract
10 termination or nonrenewal, which must include a written
11 explanation of the reasons for the proposed contract
12 termination or nonrenewal and notice of an opportunity for a
13 hearing as provided in this section. This section does not
14 apply if the case involves imminent harm to a patient's health
15 or if the termination is based on a final disciplinary action
16 by the provider's licensing board, or other governmental
17 agency, which restricts the authorization of the health care
18 provider to practice.
19 (b) For all provider contracts executed after October
20 1, 1996, and within 180 days after October 1, 1996, for
21 contracts in existence as of October 1, 1996, the contracts
22 must provide that the health maintenance organization will
23 provide 60 days' advance written notice to the provider and
24 the department before canceling, without cause, the contract
25 with the provider, except in a case in which a patient's
26 health is subject to imminent danger or a physician's ability
27 to practice medicine is effectively impaired by an action by
28 the Board of Medicine or other governmental agency.
29 (c) The notice of a proposed contract termination or
30 nonrenewal must include:
31 1. The reasons for the proposed action.
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Amendment No.
1 2. Notice that the health care provider has the right
2 to request a hearing before a panel appointed by the governing
3 body of the health maintenance organization.
4 3. A time limit of at least 30 days within which the
5 health care provider may request a hearing.
6 (d) If the health care provider requests a hearing,
7 the governing body of the health maintenance organization must
8 provide the health care provider with a written notice that
9 states:
10 1. The place, time, and date of the hearing, which
11 must commence not less than 30 days and not more than 60 days
12 after the date the health maintenance organization received
13 the request for a hearing.
14 2. The names of each witness, if any, expected to
15 testify at the hearing on behalf of the health maintenance
16 organization.
17 (7)(a) The hearing must be conducted by a panel
18 comprised of three persons appointed by the governing body of
19 the health maintenance organization. At least one person on
20 the panel must be a clinical peer in the same discipline and
21 the same or similar specialty as the health care provider. The
22 panel may consist of more than three persons. However, the
23 number of clinical peers on the panel must constitute
24 one-third or more of the total membership of the panel.
25 (b) The panel must render a decision on the proposed
26 contract termination or nonrenewal in a timely manner. The
27 decision must include the panel's recommendation as to whether
28 the governing body of the health maintenance organization
29 should continue or renew the provider's contract;
30 provisionally continue or renew the provider's contract,
31 subject to conditions set forth by the governing body;
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1 terminate the provider's contract; or not renew the provider's
2 contract.
3 (8)(a) The governing body of the health maintenance
4 organization, after considering the recommendation of the
5 panel, shall render its decision within 30 days after issuance
6 of the panel's recommendation. The decision by the governing
7 body must include continuation or renewal of the provider's
8 contract; provisional continuation or renewal of the
9 provider's contract, subject to conditions set forth by the
10 governing body; or termination or nonrenewal of the provider's
11 contract.
12 (b) A health care provider's contract may not be
13 terminated or not renewed sooner than 90 days after the date
14 the health care provider received notice of the termination or
15 nonrenewal.
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18 ================ T I T L E A M E N D M E N T ===============
19 And the title is amended as follows:
20 On page 1, lines 8 through 18, delete those lines
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22 and insert:
23 providers of health care services; amending s.
24 641.315, F.S.; deleting obsolete dates and
25 revising language; requiring that the governing
26 body of a health maintenance organization
27 provide notice and the opportunity for a
28 hearing before terminating or failing to renew
29 the contract of a health care provider;
30 providing for applicability; providing certain
31 exceptions; deleting certain due process
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Bill No. SB 834
Amendment No.
1 procedural guidelines; providing notice
2 requirements; providing requirements for the
3 hearing panel appointed by the health
4 maintenance organization; requiring that the
5 governing body of the health maintenance
6 organization render a final decision within a
7 specified time; providing an effective
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