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





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2427

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
                                   .
                                   .
 1                                 .
                                   .
 2                                 .
                                   .
 3                                 .
                                   .
 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  Representative(s) Bucher and Sobel offered the following:

12

13         Amendment (with title amendment) 

14         On page 12, between lines 22 and 23 of the bill

15

16  insert:

17         (f)  Notwithstanding the provisions of paragraph (d), a

18  health maintenance organization shall only pay a 5 percent

19  simple interest rate for an overdue payment of a claim for

20  voluntarily complying with the contractually provided

21  subscriber rights listed below:

22         1.  A health maintenance organization shall ensure that

23  the health care services provided to its subscribers shall be

24  rendered under reasonable standards of quality of care which

25  are at a minimum consistent with the prevailing standards of

26  medical practice in the community pursuant to ss. 641.495(1)

27  and 641.51.

28         2.  A health maintenance organization subscriber shall

29  receive quality health care from a broad panel of providers,

30  including referrals, preventive care pursuant to s.

31  641.402(1), emergency screening and services pursuant to ss.

                                  1

    File original & 9 copies    05/01/00
    hmo0008                     08:50 pm         02427-0086-501121




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2427

    Amendment No.     (for drafter's use only)





 1  641.31(12) and 641.513, and second opinions pursuant to s.

 2  641.51.

 3         3.  A health maintenance organization subscriber shall

 4  receive assurance that the health maintenance organization has

 5  been independently accredited by a national review

 6  organization pursuant to s. 641.512, and is financially secure

 7  as determined by the state pursuant to ss. 641.221, 641.225,

 8  and 641.228.

 9         4.  A health maintenance organization subscriber shall

10  receive continuity of health care, even after the provider is

11  no longer with the health maintenance organization pursuant to

12  s. 641.51(7).

13         5.  A health maintenance organization subscriber shall

14  receive timely, concise information regarding the health

15  maintenance organization's reimbursement to providers and

16  services pursuant to ss. 641.31 and 641.31015.

17         6.  A health maintenance organization subscriber shall

18  receive the flexibility to transfer to another Florida health

19  maintenance organization, regardless of health status,

20  pursuant to ss. 641.3104, 641.3107, 641.3111, 641.3921,

21  641.3922, and 641.228.

22         7.  A health maintenance organization subscriber shall

23  be eligible for coverage without discrimination against

24  individual participants and beneficiaries of group plans based

25  on health status pursuant to s. 641.31073.

26         8.  A health maintenance organization that issues a

27  group health contract must: provide coverage for preexisting

28  conditions pursuant to s. 641.31071; guarantee renewability of

29  coverage pursuant to s. 641.31074; provide notice of

30  cancellation pursuant to s. 641.3108; provide extension of

31  benefits pursuant to s. 641.3111; provide for conversion on

                                  2

    File original & 9 copies    05/01/00
    hmo0008                     08:50 pm         02427-0086-501121




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2427

    Amendment No.     (for drafter's use only)





 1  termination of eligibility pursuant to s. 641.3921; and

 2  provide for conversion contracts and conditions pursuant to s.

 3  641.3922.

 4         9.  A health maintenance organization subscriber shall

 5  receive timely, and, if necessary, urgent grievances and

 6  appeals within the health maintenance organization pursuant to

 7  ss. 641.228, 641.31(5), 641.47, and 641.511.

 8         10.  A health maintenance organization shall receive

 9  timely and, if necessary, urgent review by an independent

10  state external review organization for unresolved grievances

11  and appeals pursuant to s. 408.7056.

12         11.  A health maintenance organization subscriber shall

13  be given written notice at least 30 days in advance of a rate

14  change pursuant to s. 641.31(3)(b). In the case of a group

15  member, there may be a contractual agreement with the health

16  maintenance organization to have the employer provide the

17  required notice to the individual members of the group

18  pursuant to s. 641.31(3)(b).

19         12.  A health maintenance organization subscriber shall

20  be given a copy of the applicable health maintenance contract,

21  certificate, or member handbook specifying: all the

22  provisions, disclosure, and limitations required pursuant to

23  s. 641.31(1) and (4); the covered services, including those

24  services, medical conditions, and provider types specified in

25  ss. 641.31, 641.31094, 641.31095, 641.31096, 641.51(10), and

26  641.513; and where and in what manner services may be obtained

27  pursuant to s. 641.31(4).

28         13.  The subscriber's right under ss. 641.31 and

29  641.513 to receive emergency services for emergency medical

30  conditions without having to obtain prior authorization or

31  face any other restriction prohibited by law.

                                  3

    File original & 9 copies    05/01/00
    hmo0008                     08:50 pm         02427-0086-501121




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2427

    Amendment No.     (for drafter's use only)





 1         14.  The subscriber's right under ss.641.19 and 641.51

 2  to see a gynecologist or obstetrician without first having to

 3  get a referral from her primary care physician.

 4         15.  The subscriber's right under 641.441 to receive

 5  from the health maintenance organization prompt decisions

 6  about and treatment of life-threatening conditions.

 7         16.  The subscriber's right under ss.641.315 and

 8  641.3903 to a physician who cannot be penalized by the health

 9  maintenance organization for fully informing the subscriber

10  about all medical information that the physician thinks the

11  subscriber needs to know about his or her medical condition

12  and treatment options.

13         17.  The subscriber's right under s. 641.31073 to be

14  free from discrimination in the determination as to the

15  subscriber's eligibility to participate in the plan.

16

17

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 2, line 9

21

22  after the semicolon insert:

23         providing incentive for health maintenance

24         organizations to provide certain rights to

25         subscribers; providing health maintenance

26         organization subscriber protections; requiring

27         that a health maintenance organization observe

28         certain standards in providing health care for

29         subscribers; providing for subscribers to

30         receive quality care from a broad panel of

31         providers, referrals, preventive care,

                                  4

    File original & 9 copies    05/01/00
    hmo0008                     08:50 pm         02427-0086-501121




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2427

    Amendment No.     (for drafter's use only)





 1         emergency screening services, and second

 2         opinions; providing for assurance of

 3         independent accreditation by a national review

 4         organization and financial security of the

 5         organization; providing for continuity of

 6         health care; providing for timely, concise

 7         information regarding reimbursement to

 8         providers and services; providing for

 9         flexibility to transfer to another health

10         maintenance organization within the state;

11         providing for eligibility without

12         discrimination based on health status;

13         providing requirements for health maintenance

14         organizations that issue group health contracts

15         relating to preexisting conditions, contract

16         renewability, cancellation, extension,

17         termination, and conversion; providing for

18         timely, urgent grievances and appeals within

19         the organization; providing for timely and

20         urgent review of grievances and appeals by an

21         independent state external review agency;

22         providing for notice of rate changes; providing

23         for information regarding contract provisions,

24         services, medical conditions, providers, and

25         service delivery;

26

27

28

29

30

31

                                  5

    File original & 9 copies    05/01/00
    hmo0008                     08:50 pm         02427-0086-501121