| 1 | Representative Galvano offered the following: |
| 2 |
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| 3 | Amendment (with directory and title amendments) |
| 4 | Remove lines lines 159-214 and insert: |
| 5 | (16) Notwithstanding the 30-month period provided in |
| 6 | subsection (5), all claims for overpayment submitted to a |
| 7 | provider licensed under chapter 458, chapter 459, chapter 460, |
| 8 | chapter 461, or chapter 466 must be submitted to the provider |
| 9 | within 12 months after the health maintenance organization's |
| 10 | payment of the claim. A claim for overpayment shall not be |
| 11 | permitted beyond 12 months after the health maintenance |
| 12 | organization's payment of a claim, except that claims for |
| 13 | overpayment may be sought beyond that time from providers |
| 14 | convicted of fraud pursuant to s. 817.234. |
| 15 | (17) Notwithstanding any other provision of this section, |
| 16 | all claims for underpayment from a provider licensed under |
| 17 | chapter 458, chapter 459, chapter 460, chapter 461, or chapter |
| 18 | 466 must be submitted to the health maintenance organization |
| 19 | within 12 months after the health maintenance organization's |
| 20 | payment of the claim. A claim for underpayment shall not be |
| 21 | permitted beyond 12 months after the health maintenance |
| 22 | organization's payment of a claim. |
| 23 |
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| 24 | ====== D I R E C T O R Y A M E N D M E N T ===== |
| 25 | Remove lines 156-157 and insert: |
| 26 | Section 6. Subsections (16) and (17) are added to section |
| 27 | 641.3155, Florida Statutes, to read: |
| 28 |
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| 29 | ----------------------------------------------------- |
| 30 | ----------------------------------------------------- |
| 31 | T I T L E A M E N D M E N T |
| 32 | Remove lines 34-36 and insert: |
| 33 | 641.3155, F.S.; providing time limitations for and prohibitions |
| 34 | against submitting certain claims for overpayment and claims for |
| 35 | underpayment; providing an effective date. |