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. Subsections (4) through (10) of section
18 641.51, Florida Statutes, are redesignated as subsections (5)
19 through (11), respectively, and a new subsection (4) is added
20 to said section to read:
21 641.51 Quality assurance program; second medical
22 opinion requirement.--
23 (4) The organization shall ensure that only a
24 physician licensed under chapter 458 or chapter 459 or an
25 allopathic or osteopathic physician with an active,
26 unencumbered license in another state with similar licensing
27 requirements may render an adverse determination regarding a
28 service provided by a physician licensed in this state. The
29 organization shall submit to the treating provider and the
30 subscriber written notification regarding the organization's
31 adverse determination within 2 working days after the
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File original & 9 copies 04/26/00
hbd0011 08:34 am 00913-0022-740143
HOUSE AMENDMENT
Bill No. HB 913
Amendment No. (for drafter's use only)
1 subscriber or provider is notified of the adverse
2 determination. The written notification must include the
3 utilization review criteria or benefits provisions used in the
4 adverse determination, identify the physician who rendered the
5 adverse determination, and be signed by an authorized
6 representative of the organization or the physician who
7 rendered the adverse determination. The organization must
8 include with the notification of an adverse determination
9 information concerning the appeal process for adverse
10 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: everything before the
17 enacting clause
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19 and insert in lieu thereof:
20 A bill to be entitled
21 An act relating to adverse determinations;
22 amending s. 641.51, F.S., relating to quality
23 assurance program requirements for certain
24 managed care organizations; allowing the
25 rendering of adverse determinations by
26 physicians licensed in Florida or states with
27 similar requirements; requiring the submission
28 of facts and documentation pertaining to
29 rendered adverse determinations; providing
30 timeframe for organizations to submit facts and
31 documentation to providers and subscribers in
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File original & 9 copies 04/26/00
hbd0011 08:34 am 00913-0022-740143
HOUSE AMENDMENT
Bill No. HB 913
Amendment No. (for drafter's use only)
1 writing; requiring an authorized representative
2 to sign the notification; providing an
3 effective date.
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File original & 9 copies 04/26/00
hbd0011 08:34 am 00913-0022-740143