Florida Senate - 2016 COMMITTEE AMENDMENT
Bill No. CS for CS for SB 1442
Ì386262,Î386262
LEGISLATIVE ACTION
Senate . House
Comm: WD .
02/25/2016 .
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The Committee on Appropriations (Grimsley and Negron)
recommended the following:
1 Senate Amendment (with title amendment)
2
3 Between lines 146 and 147
4 insert:
5 Section 8. Subsection (11) of section 627.6131, Florida
6 Statutes, is amended to read:
7 627.6131 Payment of claims.—
8 (11) A health insurer may not retroactively deny a claim
9 because of insured ineligibility:
10 (a) At any time, if the health insurer verified the
11 eligibility of an insured at the time of treatment and provided
12 an authorization number.
13 (b) More than 1 year after the date of payment of the
14 claim.
15 Between lines 277 and 278
16 insert:
17 Section 13. Subsection (10) of section 641.3155, Florida
18 Statutes, is amended to read:
19 641.3155 Prompt payment of claims.—
20 (10) A health maintenance organization may not
21 retroactively deny a claim because of subscriber ineligibility:
22 (a) At any time, if the health maintenance organization
23 verified the eligibility of a subscriber at the time of
24 treatment and provided an authorization number.
25 (b) More than 1 year after the date of payment of the
26 claim.
27
28 ================= T I T L E A M E N D M E N T ================
29 And the title is amended as follows:
30 Delete lines 2 - 42
31 and insert:
32 An act relating to health care services; amending s.
33 395.003, F.S.; requiring hospitals, ambulatory
34 surgical centers, specialty hospitals, and urgent care
35 centers to comply with certain provisions as a
36 condition of licensure; amending s. 395.301, F.S.;
37 requiring a hospital to post on its website certain
38 information regarding its contracts with health
39 insurers, health maintenance organizations, and health
40 care practitioners and practice groups and specified
41 notice to patients and prospective patients; amending
42 s. 408.7057, F.S.; providing requirements for
43 settlement offers between certain providers and health
44 plans in a specified dispute resolution program;
45 requiring a final order to be subject to judicial
46 review; amending ss. 456.072, 458.331, and 459.015,
47 F.S.; providing additional acts that constitute
48 grounds for denial of a license or disciplinary
49 action, to which penalties apply; amending s.
50 626.9541, F.S.; specifying an additional unfair method
51 of competition and unfair or deceptive act or
52 practice; amending s. 627.6131, F.S.; prohibiting a
53 health insurer from retroactively denying a claim
54 under specified circumstances; creating s. 627.64194,
55 F.S.; defining terms; providing that an insurer is
56 solely liable for payment of certain fees to a
57 nonparticipating provider; providing limitations and
58 requirements for reimbursements by an insurer to a
59 nonparticipating provider; providing that certain
60 disputes relating to reimbursement of a
61 nonparticipating provider shall be resolved in a court
62 of competent jurisdiction or through a specified
63 voluntary dispute resolution process; amending s.
64 627.6471, F.S.; requiring an insurer that issues a
65 policy including coverage for the services of a
66 preferred provider to post on its website certain
67 information about participating providers and
68 physicians; requiring that specified notice be
69 included in policies issued after a specified date
70 which provide coverage for the services of a preferred
71 provider; amending s. 627.662, F.S.; providing
72 applicability of provisions relating to coverage for
73 services and payment collection limitations to group
74 health insurance, blanket health insurance, and
75 franchise health insurance; amending s. 641.3155,
76 F.S.; prohibiting a health maintenance organization
77 from retroactively denying a claim under specified
78 circumstances; providing