| 1 | A bill to be entitled |
| 2 | An act relating to provider contracts for health care |
| 3 | services; amending s. 641.315, F.S.; requiring that a |
| 4 | health maintenance organization disclose to the provider |
| 5 | the schedule of fees for which the health maintenance |
| 6 | organization and the provider of health care services have |
| 7 | contracted, including any deviations; providing an |
| 8 | effective date. |
| 9 |
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| 10 | Be It Enacted by the Legislature of the State of Florida: |
| 11 |
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| 12 | Section 1. Subsection (4) of section 641.315, Florida |
| 13 | Statutes, is amended to read: |
| 14 | 641.315 Provider contracts.-- |
| 15 | (4) Whenever a contract exists between a health |
| 16 | maintenance organization and a provider, the health maintenance |
| 17 | organization shall disclose to the provider: |
| 18 | (a) The mailing address or electronic address where claims |
| 19 | should be sent for processing; |
| 20 | (b) The telephone number that a provider may call to have |
| 21 | questions and concerns regarding claims addressed; and |
| 22 | (c) The address of any separate claims-processing centers |
| 23 | for specific types of services; and. |
| 24 | (d) The complete schedule of all fees for which the health |
| 25 | maintenance organization and the provider of health care |
| 26 | services have contracted, including any deviations from the |
| 27 | contracted schedule of fees requested by the health maintenance |
| 28 | organization and agreed upon by the provider of the health care |
| 29 | services. |
| 30 |
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| 31 | A health maintenance organization shall provide to its |
| 32 | contracted providers no less than 30 calendar days' prior |
| 33 | written notice of any changes in the information required in |
| 34 | this subsection. |
| 35 | Section 2. This act shall take effect January 1, 2005. |