House Bill 2253
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 2253
By Representative Rayson
1 A bill to be entitled
2 An act relating to the district managed care
3 ombudsman committees; amending s. 641.65, F.S.;
4 revising procedure for receipt, investigation,
5 and resolution of complaints within a
6 district's jurisdiction; revising conditions
7 for committee visits to the site of a
8 complaint; amending s. 641.70, F.S.; revising
9 requirements for support services to be
10 provided by the Agency for Health Care
11 Administration to the committees; providing an
12 appropriation; providing an 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. Paragraphs (b) and (c) of subsection (6) of
17 section 641.65, Florida Statutes, are amended to read:
18 641.65 District managed care ombudsman committees.--
19 (6) Each district committee or member of the
20 committee:
21 (b) Shall receive complaints regarding quality of care
22 directly from a complainant within its jurisdiction and shall
23 investigate and act on the complaint to seek resolution. If
24 the committee cannot resolve the complaint, the complaint
25 shall immediately be referred to the agency for agency action
26 and final resolution from the agency, and may assist the
27 agency with the resolution of complaints.
28 (c) Shall conduct visits, following the approval of no
29 less than three members of the committee, to the site of any
30 complaints within its jurisdiction as it finds appropriate May
31 conduct site visits with the agency, as the agency determines
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CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 2253
288-211-99
1 is appropriate. A complaint may be referred by the agency to
2 the committee, as to whether an enrollee's managed care
3 program may have inappropriately denied the enrollee a covered
4 medical service, may be inappropriately delaying the provision
5 of a covered medical service to the enrollee, or is providing
6 substandard covered medical services. The committee shall
7 establish and follow uniform criteria in reviewing information
8 and receiving complaints.
9 Section 2. Subsection (2) of section 641.70, Florida
10 Statutes, is amended to read:
11 641.70 Agency duties relating to the Statewide Managed
12 Care Ombudsman Committee and the district managed care
13 ombudsman committees.--
14 (2) The agency for Health Care Administration shall
15 provide a meeting place for district committees in agency
16 offices and shall provide the necessary administrative staff
17 and equipment, such as computers, desks, telephones, and
18 supplies, and a hotline telephone number publicized throughout
19 each district support to assist the statewide committee and
20 district committees in performing their duties and
21 responsibilities, within available resources.
22 Section 3. There is hereby appropriated from the
23 General Revenue Fund to the Agency for Health Care
24 Administration sufficient funds to provide the services
25 described in s. 641.70(2), Florida Statutes, as amended by
26 this act, to each district managed care ombudsman committee
27 for the performance of its duties and responsibilities.
28 Section 4. This act shall take effect July 1, 1999.
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CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1999 HB 2253
288-211-99
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2 HOUSE SUMMARY
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Provides circumstances under which the district managed
4 care ombudsman committees, rather than the Agency for
Health Care Administration, shall receive complaints
5 directly, investigate them, seek to resolve them, and
conduct site visits. Provides for referral of unresolved
6 complaints to the agency. Revises requirements for the
support services the agency must provide the committees.
7 Provides an appropriation.
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