((LATE FILED FOR: 4/22/2008 5:00:00 PM))Amendment
Bill No. CS/CS/HB 405
Amendment No. 638745
CHAMBER ACTION
Senate House
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1Representative Galvano offered the following:
2
3     Substitute Amendment for Amendment (439835) (with title
4amendment)
5     Remove line(s) 52-214 and insert:
6     Section 2.  Section 627.638, Florida Statutes, is amended
7to read:
8     627.638  Direct payment for hospital, medical services.--
9     (1)  Any health insurance policy insuring against loss or
10expense due to hospital confinement or to medical and related
11services may provide for payment of benefits directly to any
12recognized hospital, licensed ambulance provider, doctor, or
13other person who provided the services, in accordance with the
14provisions of the policy. To comply with this section, the words
15"or to the hospital, licensed ambulance provider, doctor, or
16person rendering services covered by this policy," or similar
17words appropriate to the terms of the policy, shall be added to
18applicable provisions of the policy.
19     (2)  Whenever, in any health insurance claim form, an
20insured specifically authorizes payment of benefits directly to
21any recognized hospital, licensed ambulance provider, physician,
22or dentist, the insurer shall make such payment to the
23designated provider of such services, unless otherwise provided
24in the insurance contract. The insurance contract may not
25prohibit, and claims forms must provide an option for, the
26payment of benefits directly to a licensed hospital, licensed
27ambulance provider, physician, or dentist for care provided
28pursuant to s. 395.1041 or part III of chapter 401. The insurer
29may require written attestation of assignment of benefits.
30Payment to the provider from the insurer may not be more than
31the amount that the insurer would otherwise have paid without
32the assignment.
33     (3)  Any insurer who has contracted with a preferred
34provider, as defined in s. 627.6471(1)(b), for the delivery of
35health care services to its insureds shall make payments
36directly to the preferred provider for such services.
37     Section 3.  Section 627.64731, Florida Statutes, is created
38to read:
39     627.64731  Leasing, renting, or granting access to a
40participating provider.--
41     (1)  As used in this section:
42     (a)  "Contracting entity" means any person or entity that
43is engaged in the act of contracting with participating
44providers and has a direct contract with a participating
45provider for the delivery of health care services or the selling
46or assigning of physicians or physician panels to other health
47care entities.
48     (b)  "Participating provider" means a physician licensed
49under chapter 458, chapter 459, chapter 460, chapter 461, or
50chapter 466 or a physician group practice that has a health care
51contract with a contracting entity and is entitled to
52reimbursement for health care services rendered to an enrollee
53under the health care contract and includes both preferred
54providers as defined in s. 627.6471 and exclusive providers as
55defined in s. 627.6472.
56     (2)  A contracting entity may not sell, lease, rent, or
57otherwise grant access to the health care services of a
58participating provider under a health care contract unless
59expressly authorized by the health care contract. The health
60care contract must specifically provide that it applies to
61network rental arrangements and state that one purpose of the
62contract is selling, renting, or giving the contracting entity's
63rights to the services of the participating provider, including
64other preferred provider organizations.  At the time a health
65care contract is entered into with a participating provider, the
66contracting entity shall, to the extent possible, identify any
67third party to which the contracting entity has granted access
68to the health care services of the participating provider. The
69contracting entity may only sell, lease, rent, or otherwise
70grant access to the participating provider's services to a third
71party that is:
72     (a)  A payor or a third-party administrator or other entity
73responsible for administering claims on behalf of the payor;
74     (b)  A preferred provider organization or preferred
75provider network that receives access to the participating
76provider's services pursuant to an arrangement with the
77preferred provider organization or preferred provider network in
78a contract with the participating provider is required to comply
79with all of the terms, conditions, and affirmative obligations
80to which the originally contracted primary participating
81provider network is bound under its contract with the
82participating provider, including, but not limited to,
83obligations concerning patient steerage and the timeliness and
84manner of reimbursement; or
85     (c)  An entity that is engaged in the business of providing
86electronic claims transport between the contracting entity and
87the payor or third-party administrator and complies with all of
88the applicable terms, conditions, and affirmative obligations of
89the contracting entity's contract with the participating
90provider, including, but not limited to, obligations concerning
91patient steerage and the timeliness and manner of reimbursement.
92     (3)  Upon a request by a participating provider, a
93contracting entity must provide the identity of any third party
94that has been granted access to the health care services of the
95participating provider.
96     (4)  A contracting entity that leases, rents, or otherwise
97grants access to the health care services of a participating
98provider must maintain an Internet website or a toll-free
99telephone number through which the provider may obtain a
100listing, updated at least every 90 days, of the third parties
101that have been granted access to the provider's health care
102services.
103     (5)  A contracting entity that leases, rents, or otherwise
104grants access to a participating provider's health care services
105must ensure that an explanation of benefits or remittance advice
106furnished to the participating provider that delivers health
107care services under the health care contract identifies the
108contractual source of any applicable discount.
109     (6)  Subject to applicable continuity of care laws, the
110right of a third party to exercise the rights and
111responsibilities of a contracting entity under a health care
112contract terminates on the day after the termination of the
113participating provider's contract with the contracting entity.
114     (7)  The provisions of this section do not apply if the
115third party that is granted access to a participating provider's
116health care services under a health care contract is:
117     (a)  An employer or other entity providing coverage for
118health care services to the employer's employees or the entity's
119members and the employer or entity has a contract with the
120contracting entity or the contracting entity's affiliate for the
121administration or processing of claims for payment or services
122provided under the health care contract;
123     (b)  An entity providing administrative services to, or
124receiving administrative services from, the contracting entity
125or the contracting entity's affiliate or subsidiary; or
126     (c)  An affiliate or a subsidiary of a contracting entity
127or other entity if operating under the same brand licensee
128program as the contracting entity.
129     (8)  A health care contract may provide for arbitration of
130disputes arising under this section.
131     (9)  A contracting entity shall ensure that all third
132parties to which the contracting entity has sold, rented,
133assigned, or otherwise given access to the participating
134provider's discounted rate comply with the physician contract,
135including all requirements to encourage access to the
136participating provider, and pay the provider pursuant to the
137rates of payment and methodology set forth in that contract,
138unless otherwise agreed to by a participating provider.
139     (10)  A contracting entity is deemed in compliance with
140this section when the insured's identification card provides,
141written or electronically, information that identifies the
142preferred provider network or networks to be utilized to
143reimburse the provider for covered services.
144     (11)  This section shall not apply to a contract between a
145contracting entity and a discount medical plan organization
146licensed or exempt under part II of chapter 636.
147     Section 4.  Present subsections (11), (12), and (13) of
148section 627.662, Florida Statutes, are renumbered as subsections
149(12), (13), and (14), respectively, and a new subsection (11) is
150added to that section, to read:
151     627.662  Other provisions applicable.--The following
152provisions apply to group health insurance, blanket health
153insurance, and franchise health insurance:
154     (11)  Section 627.64731, relating to leasing, renting, or
155granting access to a preferred provider or exclusive provider.
156     Section 5.  Paragraph (v) of subsection (3) of section
157627.6699, Florida Statutes, is amended to read:
158     627.6699  Employee Health Care Access Act.--
159     (3)  DEFINITIONS.--As used in this section, the term:
160     (v)  "Small employer" means, in connection with a health
161benefit plan with respect to a calendar year and a plan year,
162any person, sole proprietor, self-employed individual,
163independent contractor, firm, corporation, partnership, or
164association that is actively engaged in business, has its
165principal place of business in this state, employed an average
166of at least 1 but not more than 50 eligible employees on
167business days during the preceding calendar year the majority of
168whom were employed in this state, and employs at least 1
169employee on the first day of the plan year, and is not formed
170primarily for purposes of purchasing insurance. In determining
171the number of eligible employees, companies that are an
172affiliated group as defined in s. 1504(a) of the Internal
173Revenue Code of 1986, as amended, shall be considered a single
174employer. For purposes of this section, a sole proprietor, an
175independent contractor, or a self-employed individual is
176considered a small employer only if all of the conditions and
177criteria established in this section are met.
178     Section 6.  Subsection (41) is added to section 641.31,
179Florida Statutes, to read:
180     641.31  Health maintenance contracts.--
181     (41)  Whenever, in any health maintenance organization
182claim form, a subscriber specifically authorizes payment of
183benefits directly to any hospital, ambulance provider,
184physician, or dentist, the health maintenance organization shall
185make such payment to the designated provider of such services,
186provided any benefits are due to the subscriber under the terms
187of the agreement between the subscriber and the health
188maintenance organization. The health maintenance organization
189contract may not prohibit, and claims forms must provide an
190option for, the payment of benefits directly to a licensed
191hospital, ambulance provider, physician, or dentist for covered
192services provided, for services provided pursuant to s.
193395.1041, and for ambulance transport and treatment provided
194pursuant to part III of chapter 401. The attestation of
195assignment of benefits may be in written or electronic form.
196Payment to the provider from the health maintenance organization
197may not be more than the amount that the insurer would otherwise
198have paid without the assignment. Nothing in this subsection
199affects the applicability of ss. 641.3154 and 641.513 with
200respect to services provided and payment for such services
201provided pursuant to this subsection.
202     Section 7.  Subsections (18) and (19) are added to section
203627.6131, Florida Statutes, to read:
204     627.6131  Payment of claims.--
205     (18)  Notwithstanding the 30-month period provided in
206subsection (6), all claims for overpayment submitted to a
207provider licensed under chapter 458, chapter 459, chapter 460,
208chapter 461, or chapter 466 must be submitted to the provider
209within 12 months after the health insurer's payment of the
210claim. A claim for overpayment shall not be permitted beyond 12
211months after the health insurer's payment of a claim, except
212claims for overpayment may be sought beyond that time from
213providers convicted of fraud pursuant to s. 817.234.
214     (19)  Notwithstanding any other provision of this section,
215all claims for underpayment from a provider licensed under
216chapter 458, chapter 459, chapter 460, chapter 461, or chapter
217466 must be submitted to the insurer within 12 months after the
218health insurer's payment of the claim. A claim for underpayment
219shall not be permitted beyond 12 months after the health
220insurer's payment of a claim.
221     Section 8.  Subsections (16) and (17) are added to section
222641.3155, Florida Statutes, to read:
223     641.3155  Prompt payment of claims.--
224     (16)  Notwithstanding the 30-month period provided in
225subsection (5), all claims for overpayment submitted to a
226provider licensed under chapter 458, chapter 459, chapter 460,
227chapter 461, or chapter 466 must be submitted to the provider
228within 12 months after the health maintenance organization's
229payment of the claim. A claim for overpayment shall not be
230permitted beyond 12 months after the health maintenance
231organization's payment of a claim, except claims for overpayment
232may be sought beyond that time from providers convicted of fraud
233pursuant to s. 817.234.
234     (17)  Notwithstanding any other provision of this section,
235all claims for underpayment from a provider licensed under
236chapter 458, chapter 459, chapter 460, chapter 461, or chapter
237466 must be submitted to the health maintenance organization
238within 12 months after the health maintenance organization's
239payment of the claim. A claim for underpayment shall not be
240permitted beyond 12 months after the health maintenance
241organization's payment of a claim.
242     Section 9.  This act shall take effect November 1, 2008,
243and applies to contracts entered into, issued, or renewed on or
244after that date, and the amendments made by this act to sections
245627.6131 and 641.3155, Florida Statutes, apply to claims
246payments made on or after November 1, 2008.
247
248
249
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250
T I T L E  A M E N D M E N T
251     Remove line(s) 7-36 and insert:
252circumstances; amending s. 627.638, F.S.; authorizing the
253payment of health insurance policy benefits directly to a
254licensed ambulance provider; requiring that an insurer make
255payments directly to the preferred provider for the delivery of
256health care services; creating s. 627.64731, F.S.; providing
257definitions; providing requirements, limitations, and procedures
258for leasing, renting, or granting access to participating
259providers by third parties; providing exceptions; providing for
260arbitration; prohibiting third party access to certain services
261under certain circumstances; providing exceptions; providing
262application; amending s. 627.662, F.S.; applying the
263requirements for the rent, lease, or granting of access to the
264health care services of a preferred provider or exclusive
265provider under a health care contract to group health insurance,
266blanket health insurance, and franchise health insurance
267policies; amending s. 627.6699, F.S.; revising the definition of
268the term "small employer"; amending s. 641.31; requiring health
269maintenance organizations to pay benefits directly to certain
270providers under certain circumstances; prohibiting health
271maintenance contracts from prohibiting and requiring claims form
272to provide the option for payment of benefits directly to
273certain providers; amending ss. 627.6131 and 641.3155, F.S.;
274providing requirements for and prohibitions against filing
275claims for overpayments and claims for underpayments with
276insurers and health maintenance organizations; providing
277applicability; providing an effective date.


CODING: Words stricken are deletions; words underlined are additions.