HOUSE AMENDMENT Bill No. HB 1573 CS
1	CHAMBER ACTION
2	Senate House
3	.
4	.
5	.
6
7
8
9
10
11
12	Representative Farkas offered the following:
13
14	Amendment (with title amendment)
15	Between lines 571 and 572, and insert:
16
17	Section 12. Section 641.3101, Florida Statutes, is amended
18	to read:
19	641.3101 Additional contract contents.—
20	(1)A health maintenance contract may contain additional
21	provisions not inconsistent with this part which are:
22	(a)(1)Necessary, on account of the manner in which the
23	organization is constituted or operated, in order to state the
24	rights and obligations of the parties to the contract; or
25	(b)(2)Desired by the organization and neither prohibited
26	by law nor in conflict with any provisions required to be
27	included therein.
28	(2) A health maintenance contract that uses a specific
29	methodology for payment of claims shall comply with s. 627.6044.
30	The method used for determining the payment of claims shall be
31	included in filings made pursuant to s. 641.31(3) and may not be
32	changed unless such change is filed under s. 641.31(3). Upon the
33	effective date of such a filing, the payment methodology
34	contained therein shall govern, notwithstanding any other
35	provision of law. A health maintenance organization’s compliance
36	with the provisions of this section shall constitute a defense
37	against any claim by subscribers or providers pertaining to
38	methodology of payment.
39
40
41	================= T I T L E A M E N D M E N T =================
42	Remove lines 59, and insert:
43
44	criteria and limits; amending s. 641.3101, F.S.; providing a
45	compliance requirement for health maintenance contracts using a
46	specific payment of claims methodology; providing for
47	compliance; providing that compliance constitutes a defense
48	against specified claims; creating s. 641.31075, F.S.; providing
49