Florida Senate - 2013 COMMITTEE AMENDMENT Bill No. SB 1842 Barcode 431718 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Appropriations Subcommittee on Health and Human Services (Sobel) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 111 - 143 4 and insert: 5 (2) When reviewing forms filed by health insurers or health 6 maintenance organizations pursuant to s. 627.410 or s. 641.31(3) 7 for compliance with state law, the office shall also review such 8 forms for compliance with PPACA. If the office determines that a 9 form does not comply with PPACA, the office shall notify the 10 insurer or organization of the reason for noncompliance. If the 11 insurer or organization does not demonstrate that such form or 12 its replacement complies with PPACA within 30 days after such 13 notification, the office shall report such potential violation 14 to the federal Department of Health and Human Services, except 15 that the office may elect not to report potential violations it 16 determines are de minimis. The review of forms by the office 17 under this subsection does not include review of the rates, 18 rating practices, or the relationship of benefits to the rate. 19 (3) When performing market conduct examinations or 20 investigations of health insurers or health maintenance 21 organizations as authorized under s. 624.307, s. 624.311, or s. 22 641.3905 for compliance with state law, the office shall include 23 compliance with PPACA within the scope of such examinations or 24 investigations. If the office determines that an insurer’s or 25 organization’s operations do not comply with PPACA, the office 26 shall notify the insurer or organization of the reason for such 27 determination. If the insurer or organization does not 28 demonstrate compliance with PPACA within 30 days after such 29 notification, the office shall report such potential violation 30 to the federal Department of Health and Human Services, except 31 that the office may elect not to report potential violations it 32 determines are de minimis. 33 (4) The department’s Division of Consumer Services shall 34 respond to complaints by consumers relating to a requirement of 35 PPACA as authorized under s. 20.121(2)(h), and shall report 36 apparent or potential violations to the office and to the 37 federal Department of Health and Human Services. 38 (5) A determination made by the office or department 39 pursuant to this section regarding compliance with PPACA does 40 not constitute a determination that affects the substantial 41 interests of any party for purposes of chapter 120. 42 (6) The office and department shall maintain on their 43 respective websites an updated list of all potential or apparent 44 violations of PPACA reported to the federal Department of Health 45 and Human Services pursuant to this section. 46 47 ================= T I T L E A M E N D M E N T ================ 48 And the title is amended as follows: 49 Delete lines 7 - 18 50 and insert: 51 requiring the Office of Insurance Regulation to review 52 forms and perform market conduct examinations for 53 compliance with PPACA and to report potential 54 violations to the federal Department of Health and 55 Human Services; requiring the Division of Consumer 56 Services of the Department of Financial Services to 57 respond to complaints related to PPACA and to report 58 violations to the office and the Department of Health 59 and Human Services; providing that certain 60 determinations by the office or the Department of 61 Financial Services are not subject to certain 62 challenges under ch. 120, F.S.; requiring the office 63 and department to maintain a list of reported 64 violations on their websites; amending ss. 624.34,