CODING: Words stricken are deletions; words underlined are additions.





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1753

    Amendment No. 1 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 5                                           ORIGINAL STAMP BELOW

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11  The Committee on Insurance offered the following:

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13         Amendment (with title amendment) 

14         On page 13, between lines 3 & 4 of the bill

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16  insert:

17         Section 2.  Subsection (6) is added to section 626.883,

18  Florida Statutes, to read:

19         626.883  Administrator as intermediary; collections

20  held in fiduciary capacity; establishment of account;

21  disbursement; payments on behalf of insurer.--

22         (6)  All payments to a health care provider by a fiscal

23  intermediary for noncapitated providers must include an

24  explanation of services being reimbursed which includes, at a

25  minimum, the patient's name, the date of service, the

26  procedure code, the amount of reimbursement, and the

27  identification of the plan on whose behalf the payment is

28  being made.  For capitated providers, the statement of

29  services must include the number of patients covered by the

30  contract, the rate per patient, the total amount of the

31  payment, and the identification of the plan on whose behalf

                                  1

    File original & 9 copies    04/19/99
    hin0002                     06:10 pm         01753-in  -103811




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1753

    Amendment No. 1 (for drafter's use only)





 1  the payment is being made.

 2         Section 3.  Paragraph (a) of subsection (2) of section

 3  641.316, Florida Statutes, 1998 Supplement, is amended to

 4  read:

 5         641.316  Fiscal intermediary services.--

 6         (2)(a)  The term "fiduciary" or "fiscal intermediary

 7  services" means reimbursements received or collected on behalf

 8  of health care professionals for services rendered, patient

 9  and provider accounting, financial reporting and auditing,

10  receipts and collections management, compensation and

11  reimbursement disbursement services, or other related

12  fiduciary services pursuant to health care professional

13  contracts with health maintenance organizations.  All payments

14  to a health care provider by a fiscal intermediary for

15  noncapitated providers must include an explanation of services

16  being reimbursed which includes, at a minimum, the patient's

17  name, the date of service, the procedure code, the amount of

18  reimbursement, and the identification of the plan on whose

19  behalf the payment is being made.  For capitated providers,

20  the statement of services must include the number of patients

21  covered by the contract, the rate per patient, the total

22  amount of the payment, and the identification of the plan on

23  whose behalf the payment is being made.

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25

26  ================ T I T L E   A M E N D M E N T ===============

27  And the title is amended as follows:

28         On page 1, line 10

29

30  after the semicolon insert:

31         amending s. 626.883, F.S.; relating to payments

                                  2

    File original & 9 copies    04/19/99
    hin0002                     06:10 pm         01753-in  -103811




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1753

    Amendment No. 1 (for drafter's use only)





 1         on behalf of insurer; amending s. 641.316,

 2         F.S.; relating to payments to a health care

 3         provider;

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    File original & 9 copies    04/19/99
    hin0002                     06:10 pm         01753-in  -103811