Florida Senate - 2015 SENATOR AMENDMENT Bill No. CS for CS for CS for SB 532 Ì821318%Î821318 LEGISLATIVE ACTION Senate . House . . . Floor: WD . 04/28/2015 02:06 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Latvala moved the following: 1 Senate Amendment (with title amendment) 2 3 Between lines 594 and 595 4 insert: 5 Section 18. 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 19. 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 20. 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 21. 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 line 83 89 and insert: 90 amending ss. 627.6474, 636.035, and 641.315, F.S.; 91 providing that a health insurer, a prepaid limited 92 health service organization, and a health maintenance 93 organization, respectively, may not require a licensed 94 ophthalmologist or optometrist to join a network 95 solely for the purpose of credentialing the licensee 96 for another vision network; providing that such 97 insurers and organizations are not prevented by the 98 act from entering into a contract with another vision 99 care plan; providing that such insurers and 100 organizations may not restrict or limit a licensed 101 ophthalmologist, optometrist, or optician to specific 102 suppliers of materials or optical laboratories; 103 providing that such insurers and organizations are not 104 restricted or limited by the act in determining 105 certain amounts of coverage or reimbursement; 106 requiring such insurers’ and organizations’ online 107 vision care network provider directories to be updated 108 monthly; providing that a violation of certain 109 prohibitions in the act constitutes a specified unfair 110 insurance trade practice; providing effective dates.