Florida Senate - 2026                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1082
       
       
       
       
       
       
                                Ì715760'Î715760                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Banking and Insurance (Grall) recommended the
       following:
       
    1         Senate Amendment (with directory and title amendments)
    2  
    3         Between lines 43 and 44
    4  insert:
    5         (d) Health plans subject to this section must include in
    6  their payment or remittance advice to a health care provider a
    7  statement that the health plan is a state-regulated plan under
    8  this section.
    9         (g)(f) The resolution organization shall require the
   10  respondent in the claim dispute to submit all documentation in
   11  support of its position within 15 days after receiving a request
   12  from the resolution organization for supporting documentation.
   13  The resolution organization may extend the time if appropriate.
   14  Failure to submit the supporting documentation within such time
   15  period shall result in a default against the health plan or
   16  provider. Once a claim dispute has been submitted and determined
   17  to be eligible for review by the resolution organization, a
   18  respondent may not avoid a default by declining to participate
   19  in the process. In the event of such a default, the resolution
   20  organization shall issue its written recommendation to the
   21  agency that a default be entered against the defaulting entity.
   22  The written recommendation shall include a recommendation to the
   23  agency that the defaulting entity shall pay the entity
   24  submitting the claim dispute the full amount of the claim
   25  dispute, plus all accrued interest, and shall be considered a
   26  nonprevailing party for the purposes of this section.
   27  
   28  ====== D I R E C T O R Y  C L A U S E  A M E N D M E N T ======
   29  And the directory clause is amended as follows:
   30         Delete lines 12 - 13
   31  and insert:
   32         Section 1. Present paragraphs (d) through (h) of subsection
   33  (2) of section 408.7057, Florida Statutes, are redesignated as
   34  paragraphs (e) through (i), respectively, a new paragraph (d) is
   35  added to that subsection, and paragraph (b) and present
   36  paragraph (f) of that subsection are amended, to read:
   37  
   38  ================= T I T L E  A M E N D M E N T ================
   39  And the title is amended as follows:
   40         Delete line 7
   41  and insert:
   42         dispute resolution program; requiring that health
   43         plans subject to the program include a specified
   44         statement in payment and remittance advice to health
   45         care providers; providing that once a disputed claim
   46         has been submitted to the program and deemed eligible
   47         for review, a respondent may not avoid a default by
   48         declining to participate in the process; providing an
   49         effective