HB 1097: Health Insurer Accountability
GENERAL BILL by Berfield
Health Insurer Accountability; Requires health plan to participate in filed claim dispute; provides penalties for failure to respond to claim; requires AHCA to notify certain entity within specified timeframe when health plan fails to pay provider; requires health plan to pay provider within specified timeframe after agency's order; provides credentialing requirements for managed care plan; requires each managed care plan to identify to agency & OIR any ownership interest of affiliation of any kind with certain entities; provides requirements for identification of such information; removes provision requiring results of certain audit reports to be dispositive; requires managed care contracts to include provider notifications regarding certain denials of coverage; prohibits insurer from denying certain claims; provides notification requirements & penalties.
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Bill History
Date Chamber Action 1/7/2026 House • Filed
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HB 1097, Original Filed Version (Current Bill Version) Posted 1/7/2026 at 9:32 AM
Bill Text: PDF Analyses: None Citations - Statutes (7)
Citation Catchline Location in Bill Location In Bill Help 408.7057 Statewide provider and health plan claim dispute resolution program. Page 2 (pdf) 409.967 Managed care plan accountability. Page 3 (pdf) 409.973 Benefits. Page 7 (pdf) 409.975 Managed care plan accountability. Page 6 (pdf) 409.9855 Pilot program for individuals with developmental disabilities. Page 8 (pdf) 627.6131 Payment of claims. Page 6 (pdf) 641.315 Provider contracts. Page 6 (pdf)