CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
Bill No. HB 913
Amendment No. (for drafter's use only)
CHAMBER ACTION
Senate House
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5 ORIGINAL STAMP BELOW
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11 Representative(s) Casey offered the following:
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13 Amendment (with title amendment)
14 Remove from the bill: Everything after the enacting clause
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16 and insert in lieu thereof:
17 Section 1. Present subsections (4), (5), (6), (7),
18 (8), (9), and (10) of section 641.51, Florida Statutes, are
19 redesignated as subsections (5), (6), (7), (8), (9), (10), and
20 (11), respectively, and a new subsection (4) is added to that
21 section to read:
22 641.51 Quality assurance program; second medical
23 opinion requirement.--
24 (4) The organization shall ensure that only a
25 physician licensed under chapter 458 or chapter 459; or an
26 M.D. or D.O. physician with an active, unencumbered license in
27 another state with similar licensing requirements may render
28 an adverse determination regarding a service provided by a
29 physician licensed in this state. The organization shall
30 submit to the treating provider and the subscriber written
31 notification regarding the organization's adverse
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HOUSE AMENDMENT
Bill No. HB 913
Amendment No. (for drafter's use only)
1 determination within 2 working days after the subscriber or
2 provider is notified of the adverse determination. The written
3 notification must include the utilization review criteria or
4 benefits provisions used in the adverse determination,
5 identify the physician who rendered the adverse determination,
6 and be signed by an authorized representative of the
7 organization or the physician who renders the adverse
8 determination. The organization must include with the
9 notification of an adverse determination information
10 concerning the appeal process for adverse determinations.
11 Section 2. This act shall take effect July 1, 2000.
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14 ================ T I T L E A M E N D M E N T ===============
15 And the title is amended as follows:
16 remove from the title of the bill: the entire title
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18 and insert in lieu thereof:
19 A bill to be entitled
20 An act relating to adverse determinations;
21 amending s. 641.51, F.S., relating to quality
22 assurance program requirements for certain
23 managed-care organizations; allowing the
24 rendering of adverse determinations by
25 physicians licensed in Florida or states with
26 similar requirements; requiring the submission
27 of facts and documentation pertaining to
28 rendered adverse determinations; providing
29 timeframe for organizations to submit facts and
30 documentation to providers and subscribers in
31 writing; requiring an authorized representative
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hbd0001 11:14 am 00913-0022-541491
HOUSE AMENDMENT
Bill No. HB 913
Amendment No. (for drafter's use only)
1 to sign the notification; providing an
2 effective date.
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File original & 9 copies 04/18/00
hbd0001 11:14 am 00913-0022-541491