Florida Senate - 2016                                     SB 340
       
       
        
       By Senator Latvala
       
       
       
       
       
       20-00036A-16                                           2016340__
    1                        A bill to be entitled                      
    2         An act relating to vision care plans; amending ss.
    3         627.6474, 636.035, and 641.315, F.S.; providing that a
    4         health insurer, a prepaid limited health service
    5         organization, and a health maintenance organization,
    6         respectively, may not require a licensed
    7         ophthalmologist or optometrist to join a network
    8         solely for the purpose of credentialing the licensee
    9         for another vision network; providing that such
   10         insurers and organizations are not prevented by the
   11         act from entering into a contract with another vision
   12         care plan; providing that such insurers and
   13         organizations may not restrict a licensed
   14         ophthalmologist, optometrist, or optician to specific
   15         suppliers of materials or optical laboratories;
   16         providing that such insurers and organizations are not
   17         restricted by the act in determining certain amounts
   18         of coverage or reimbursement; requiring such insurers’
   19         and organizations’ online vision care network provider
   20         directories to be updated monthly; providing that a
   21         violation of certain prohibitions in the act
   22         constitutes a specified unfair insurance trade
   23         practice; providing an effective date.
   24          
   25  Be It Enacted by the Legislature of the State of Florida:
   26  
   27         Section 1. Subsection (3) is added to section 627.6474,
   28  Florida Statutes, to read:
   29         627.6474 Provider contracts.—
   30         (3)(a) A health insurer may not require an ophthalmologist
   31  licensed pursuant to chapter 458 or chapter 459 or an
   32  optometrist licensed pursuant to chapter 463 to join a network
   33  solely for the purpose of credentialing the licensee for another
   34  insurer’s vision network. This paragraph does not prevent a
   35  health insurer from entering into a contract with another
   36  insurer’s vision care plan to use the vision network.
   37         (b) A health insurer may not restrict an ophthalmologist
   38  licensed pursuant to chapter 458 or chapter 459, an optometrist
   39  licensed pursuant to chapter 463, or an optician licensed
   40  pursuant to part I of chapter 484 to specific suppliers of
   41  materials or optical laboratories. This paragraph does not
   42  restrict a health insurer in determining specific amounts of
   43  coverage or reimbursement for the use of network or out-of
   44  network suppliers or laboratories.
   45         (c) A health insurer’s online vision care network provider
   46  directory must be updated monthly to reflect the vision care
   47  providers currently participating in the health insurer’s
   48  network.
   49         (d) A knowing violation of paragraph (a) or paragraph (b)
   50  constitutes an unfair insurance trade practice under s.
   51  626.9541(1)(d).
   52         Section 2. Subsection (14) is added to section 636.035,
   53  Florida Statutes, to read:
   54         636.035 Provider arrangements.—
   55         (14)(a) A prepaid limited health service organization may
   56  not require an ophthalmologist licensed pursuant to chapter 458
   57  or chapter 459 or an optometrist licensed pursuant to chapter
   58  463 to join a network solely for the purpose of credentialing
   59  the licensee for another organization’s vision network. This
   60  paragraph does not prevent such organization from entering into
   61  a contract with another organization’s vision care plan to use
   62  the vision network.
   63         (b) A prepaid limited health service organization may not
   64  restrict an ophthalmologist licensed pursuant to chapter 458 or
   65  chapter 459, an optometrist licensed pursuant to chapter 463, or
   66  an optician licensed pursuant to part I of chapter 484 to
   67  specific suppliers of materials or optical laboratories. This
   68  paragraph does not restrict such organization in determining
   69  specific amounts of coverage or reimbursement for the use of
   70  network or out-of-network suppliers or laboratories.
   71         (c) A prepaid limited health service organization’s online
   72  vision care network provider directory must be updated monthly
   73  to reflect the vision care providers currently participating in
   74  the organization’s network.
   75         (d) A knowing violation of paragraph (a) or paragraph (b)
   76  constitutes an unfair insurance trade practice under s.
   77  626.9541(1)(d).
   78         Section 3.  Subsection (12) is added to section 641.315,
   79  Florida Statutes, to read:
   80         641.315 Provider contracts.—
   81         (12)(a)A health maintenance organization may not require
   82  an ophthalmologist licensed pursuant to chapter 458 or chapter
   83  459 or an optometrist licensed pursuant to chapter 463 to join a
   84  network solely for the purpose of credentialing the licensee for
   85  another organization’s vision network. This paragraph does not
   86  prevent such organization from entering into a contract with
   87  another organization’s vision care plan to use the vision
   88  network.
   89         (b) A health maintenance organization may not restrict an
   90  ophthalmologist licensed pursuant to chapter 458 or chapter 459,
   91  an optometrist licensed pursuant to chapter 463, or an optician
   92  licensed pursuant to part I of chapter 484 to specific suppliers
   93  of materials or optical laboratories. This paragraph does not
   94  restrict such organization in determining specific amounts of
   95  coverage or reimbursement for the use of network or out-of
   96  network suppliers or laboratories.
   97         (c) A health maintenance organization’s online vision care
   98  network provider directory must be updated monthly to reflect
   99  the vision care providers currently participating in the
  100  organization’s network.
  101         (d) A knowing violation of paragraph (a) or paragraph (b)
  102  constitutes an unfair insurance trade practice under s.
  103  626.9541(1)(d).
  104         Section 4. This act shall take effect July 1, 2016.