Florida Senate - 2013                                     SB 510
       
       
       
       By Senator Legg
       
       
       
       
       17-00477A-13                                           2013510__
    1                        A bill to be entitled                      
    2         An act relating to health insurance; amending ss.
    3         627.6471 and 641.31, F.S.; requiring health insurers
    4         and health maintenance organizations to allow an
    5         insured to continue to use the services of preferred
    6         providers or network providers on the list of
    7         preferred providers or network providers at the time
    8         of the insured’s enrollment for a minimum period of
    9         time; requiring health maintenance organizations to
   10         provide subscribers with a current list of network
   11         providers and make the list available for public
   12         inspection at certain times and places; requiring
   13         health insurers and health maintenance organizations
   14         to pay certain providers who have been terminated from
   15         a panel for health services provided to insureds under
   16         certain circumstances; providing an effective date.
   17  
   18  Be It Enacted by the Legislature of the State of Florida:
   19  
   20         Section 1. Subsection (2) of section 627.6471, Florida
   21  Statutes, is amended to read:
   22         627.6471 Contracts for reduced rates of payment;
   23  limitations; coinsurance and deductibles.—
   24         (2) Any insurer issuing a policy of health insurance in
   25  this state, which insurance includes coverage for the services
   26  of a preferred provider, must provide each policyholder and
   27  certificateholder with a current list of preferred providers and
   28  must make the list available for public inspection during
   29  regular business hours at the principal office of the insurer
   30  within the state. An insurer must:
   31         (a) Allow any policyholder or certificateholder to continue
   32  to use the services of any provider on the preferred provider
   33  list on the date of the policyholder’s or certificateholder’s
   34  enrollment for at least 1 year after the date of enrollment.
   35         (b) Pay any provider who has been terminated from the panel
   36  without cause for covered services rendered by the provider to a
   37  policyholder or certificateholder who continues to use the
   38  services of the provider during the minimum period authorized
   39  under paragraph (a). Payment to a terminated provider under this
   40  paragraph must be made by an insurer in accordance with the
   41  terms of the provider contract in effect on the date of the
   42  provider’s termination.
   43         Section 2. Subsection (44) is added to section 641.31,
   44  Florida Statutes, to read:
   45         641.31 Health maintenance contracts.—
   46         (44) A health maintenance organization must provide each
   47  subscriber with a current list of network providers and must
   48  make the list available for public inspection during regular
   49  business hours at the principal office of the health maintenance
   50  organization within the state. A health maintenance organization
   51  must:
   52         (a) Allow any subscriber to continue to use the services of
   53  any provider on the network provider list on the date of the
   54  subscriber’s enrollment for at least 1 year after the date of
   55  enrollment.
   56         (b) Pay any provider who has been terminated from the panel
   57  without cause for covered services rendered by the provider to a
   58  subscriber who continues to use the services of the provider
   59  during the minimum period authorized under paragraph (a).
   60  Payment to a terminated provider under this paragraph must be
   61  made by a health maintenance organization in accordance with the
   62  terms of the provider contract in effect on the date of the
   63  provider’s termination.
   64         Section 3. This act shall take effect October 1, 2013.