Florida Senate - 2022                        COMMITTEE AMENDMENT
       Bill No. SB 296
       
       
       
       
       
       
                                Ì536352#Î536352                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Health Policy (Garcia) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete line 126
    4  and insert:
    5         Section 4. Present subsection (7) of section 627.6471,
    6  Florida Statutes, is redesignated as subsection (8) and amended,
    7  and a new subsection (7) is added to that section, to read:
    8         627.6471 Contracts for reduced rates of payment;
    9  limitations; coinsurance and deductibles.—
   10         (7) Notwithstanding s. 627.64194, an insurer issuing a
   11  health insurance policy in this state, upon request by an
   12  insured, must apply payments for a service provided by a
   13  nonpreferred provider toward an insured’s deductible and out-of
   14  pocket maximum as if the service had been provided by a
   15  preferred network provider, if:
   16         (a) The service provided to the insured by the nonpreferred
   17  provider is within the scope of services covered by the policy;
   18  and
   19         (b) The nonpreferred provider’s billed amount for the
   20  service is equal to or less than the allowed amount for the
   21  service for preferred providers under the plan or the statewide
   22  average for the service as listed on the Florida Health Price
   23  Finder website administered by the Agency for Health Care
   24  Administration.
   25         (8)(7) Any policy issued under this section after January
   26  1, 2023 2017, must include the following disclosure: “WARNING:
   27  LIMITED BENEFITS MAY WILL BE PAID WHEN NONPARTICIPATING
   28  PROVIDERS ARE USED. You should be aware that when you elect to
   29  utilize the services of a nonparticipating provider for a
   30  covered nonemergency service, benefit payments to the provider
   31  may are not be based upon the amount the provider charges.
   32  Unless you request otherwise, the basis of the payment will be
   33  determined according to your policy’s out-of-network
   34  reimbursement benefit. Nonparticipating providers may bill
   35  insureds for any difference in the amount. YOU MAY BE REQUIRED
   36  TO PAY MORE THAN THE COINSURANCE OR COPAYMENT AMOUNT.
   37  Participating providers have agreed to accept discounted
   38  payments for services with no additional billing to you other
   39  than coinsurance, copayment, and deductible amounts. You may
   40  obtain further information about the providers who have
   41  contracted with your insurance plan by consulting your insurer’s
   42  website or contacting your insurer or agent directly.”
   43         Section 5. Section 627.65701, Florida Statutes, is created
   44  to read:
   45         627.65701 Services provided by nonpreferred providers.
   46  Notwithstanding s. 627.64194, an insurer issuing a group,
   47  blanket, or franchise health insurance policy in this state,
   48  upon request by an insured, must apply payments for a service
   49  provided by a nonpreferred provider toward an insured’s
   50  deductible and out-of-pocket maximum as if the service had been
   51  provided by a preferred network provider, if:
   52         (1) The service provided to the insured by the nonpreferred
   53  provider is within the scope of services covered by the policy;
   54  and
   55         (2) The nonpreferred provider’s billed amount for the
   56  service is equal to or less than the allowed amount for the
   57  service for preferred providers under the plan or the statewide
   58  average for the service as listed on the Florida Health Price
   59  Finder website administered by the Agency for Health Care
   60  Administration.
   61         Section 6. This act shall take effect January 1, 2023.
   62  
   63  ================= T I T L E  A M E N D M E N T ================
   64  And the title is amended as follows:
   65         Delete line 27
   66  and insert:
   67         express written consent of the creditor; amending s.
   68         627.6471, F.S.; requiring certain health insurers to
   69         apply payments for services provided by nonpreferred
   70         providers toward insureds’ deductibles and out-of
   71         pocket maximums if certain conditions are met;
   72         revising the required disclosure for certain policies;
   73         creating s. 627.65701, F.S.; requiring certain group,
   74         blanket, or franchise health insurers to apply
   75         payments for services provided by nonpreferred
   76         providers toward an insureds’ deductibles and out-of
   77         pocket maximums if certain conditions are met;
   78         providing an