Florida Senate - 2015                          SENATOR AMENDMENT
       Bill No. CS/CS/CS/HB 165, 1st Eng.
       
       
       
       
       
       
                                Ì835268HÎ835268                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                  Floor: WD            .                                
             04/22/2015 02:35 PM       .                                
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       Senator Latvala moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete line 447
    4  and insert:
    5         Section 10. Effective January 1, 2016, subsection (3) is
    6  added to section 627.6474, Florida Statutes, to read:
    7         627.6474 Provider contracts.—
    8         (3)(a) A health insurer may not require an ophthalmologist
    9  licensed pursuant to chapter 458 or chapter 459 or an
   10  optometrist licensed pursuant to chapter 463 to join a network
   11  solely for the purpose of credentialing the licensee for another
   12  insurer’s vision network. This paragraph does not prevent a
   13  health insurer from entering into a contract with another
   14  insurer’s vision care plan to use the vision network.
   15         (b) A health insurer may not restrict or limit an
   16  ophthalmologist licensed pursuant to chapter 458 or chapter 459,
   17  an optometrist licensed pursuant to chapter 463, or an optician
   18  licensed pursuant to part I of chapter 484 to specific suppliers
   19  of materials or optical laboratories. This paragraph does not
   20  restrict or limit a health insurer in determining specific
   21  amounts of coverage or reimbursement for the use of network or
   22  out-of-network suppliers or laboratories.
   23         (c) A health insurer’s online vision care network provider
   24  directory must be updated monthly to reflect the vision care
   25  providers currently participating in the health insurer’s
   26  network.
   27         (d) A knowing violation of paragraph (a) or paragraph (b)
   28  constitutes an unfair insurance trade practice under s.
   29  626.9541(1)(d).
   30         Section 11. Effective January 1, 2016, subsection (14) is
   31  added to section 636.035, Florida Statutes, to read:
   32         636.035 Provider arrangements.—
   33         (14)(a) A prepaid limited health service organization may
   34  not require an ophthalmologist licensed pursuant to chapter 458
   35  or chapter 459 or an optometrist licensed pursuant to chapter
   36  463 to join a network solely for the purpose of credentialing
   37  the licensee for another organization’s vision network. This
   38  paragraph does not prevent such organization from entering into
   39  a contract with another organization’s vision care plan to use
   40  the vision network.
   41         (b) A prepaid limited health service organization may not
   42  restrict or limit an ophthalmologist licensed pursuant to
   43  chapter 458 or chapter 459, an optometrist licensed pursuant to
   44  chapter 463, or an optician licensed pursuant to part I of
   45  chapter 484 to specific suppliers of materials or optical
   46  laboratories. This paragraph does not restrict or limit such
   47  organization in determining specific amounts of coverage or
   48  reimbursement for the use of network or out-of-network suppliers
   49  or laboratories.
   50         (c) A prepaid limited health service organization’s online
   51  vision care network provider directory must be updated monthly
   52  to reflect the vision care providers currently participating in
   53  the organization’s network.
   54         (d) A knowing violation of paragraph (a) or paragraph (b)
   55  constitutes an unfair insurance trade practice under s.
   56  626.9541(1)(d).
   57         Section 12. Effective January 1, 2016, subsection (12) is
   58  added to section 641.315, Florida Statutes, to read:
   59         641.315 Provider contracts.—
   60         (12)(a)A health maintenance organization may not require
   61  an ophthalmologist licensed pursuant to chapter 458 or chapter
   62  459 or an optometrist licensed pursuant to chapter 463 to join a
   63  network solely for the purpose of credentialing the licensee for
   64  another organization’s vision network. This paragraph does not
   65  prevent such organization from entering into a contract with
   66  another organization’s vision care plan to use the vision
   67  network.
   68         (b) A health maintenance organization may not restrict or
   69  limit an ophthalmologist licensed pursuant to chapter 458 or
   70  chapter 459, an optometrist licensed pursuant to chapter 463, or
   71  an optician licensed pursuant to part I of chapter 484 to
   72  specific suppliers of materials or optical laboratories. This
   73  paragraph does not restrict or limit such organization in
   74  determining specific amounts of coverage or reimbursement for
   75  the use of network or out-of-network suppliers or laboratories.
   76         (c) A health maintenance organization’s online vision care
   77  network provider directory must be updated monthly to reflect
   78  the vision care providers currently participating in the
   79  organization’s network.
   80         (d) A knowing violation of paragraph (a) or paragraph (b)
   81  constitutes an unfair insurance trade practice under s.
   82  626.9541(1)(d).
   83         Section 13. Except as otherwise expressly provided in this
   84  act, this act shall take effect July 1, 2015.
   85  
   86  ================= T I T L E  A M E N D M E N T ================
   87  And the title is amended as follows:
   88         Delete lines 2 - 48
   89  and insert:
   90         An act relating to insurance; amending s. 627.062,
   91         F.S.; restricting to certain property rate filings a
   92         requirement that the chief executive officer or chief
   93         financial officer and chief actuary of a property
   94         insurer certify the information contained in a rate
   95         filing; amending s. 627.0628, F.S.; requiring an
   96         insurer to employ in certain rate filings actuarial
   97         methods, principles, standards, models, or output
   98         ranges found by the Florida Commission on Hurricane
   99         Loss Projection Methodology to be accurate or reliable
  100         in determining probable maximum loss levels;
  101         authorizing an insurer to employ a model in a rate
  102         filing until 120 days after the expiration of the
  103         commission’s acceptance of that model; prohibiting
  104         insurers from modifying or adjusting the model after
  105         the commission finds the model to be accurate or
  106         reliable in determining probable maximum loss levels;
  107         amending s. 627.0645, F.S.; exempting commercial
  108         nonresidential multiperil insurance from annual base
  109         rate filing; amending s. 627.3518, F.S.; conforming a
  110         cross-reference; amending s. 627.4133, F.S.;
  111         increasing the amount of prior notice required with
  112         respect to the nonrenewal, cancellation, or
  113         termination of certain insurance policies; deleting
  114         certain provisions that require extended periods of
  115         prior notice with respect to the nonrenewal,
  116         cancellation, or termination of certain insurance
  117         policies; prohibiting the cancellation of certain
  118         policies that have been in effect for a specified
  119         amount of time except under certain circumstances;
  120         amending s. 627.7074, F.S.; revising notification
  121         requirements for participation in the neutral
  122         evaluation program; amending s. 627.736, F.S.;
  123         revising the period for applicability of certain
  124         Medicare fee schedules or payment limitations;
  125         exempting certain federally certified entities from
  126         the requirement to be licensed in order to receive
  127         reimbursement under the Florida Motor Vehicle No-Fault
  128         Law; amending s. 627.744, F.S.; revising preinsurance
  129         inspection requirements for private passenger motor
  130         vehicles; amending s. 631.65, F.S.; authorizing,
  131         rather than prohibiting, an advertisement or a
  132         solicitation to use the existence of the Florida
  133         Insurance Guaranty Association to sell, solicit, or
  134         induce the purchase of certain insurance if the
  135         advertisement or solicitation explains specified
  136         coverage limits; amending ss. 627.6474, 636.035, and
  137         641.315, F.S.; providing that a health insurer, a
  138         prepaid limited health service organization, and a
  139         health maintenance organization, respectively, may not
  140         require a licensed ophthalmologist or optometrist to
  141         join a network solely for the purpose of credentialing
  142         the licensee for another vision network; providing
  143         that such insurers and organizations are not prevented
  144         by the act from entering into a contract with another
  145         vision care plan; providing that such insurers and
  146         organizations may not restrict or limit a licensed
  147         ophthalmologist, optometrist, or optician to specific
  148         suppliers of materials or optical laboratories;
  149         providing that such insurers and organizations are not
  150         restricted or limited by the act in determining
  151         certain amounts of coverage or reimbursement;
  152         requiring such insurers’ and organizations’ online
  153         vision care network provider directories to be updated
  154         monthly; providing that a violation of certain
  155         prohibitions in the act constitutes a specified unfair
  156         insurance trade practice; providing effective dates.