Florida Senate - 2026                                    SB 1130
       
       
        
       By Senator Massullo
       
       
       
       
       
       11-00698A-26                                          20261130__
    1                        A bill to be entitled                      
    2         An act relating to insurance claims payments to health
    3         care providers; creating s. 627.4193, F.S.; defining
    4         terms; prohibiting payment adjudicators from
    5         downcoding health care services under certain
    6         circumstances; providing exceptions; requiring payment
    7         adjudicators to provide certain information to the
    8         provider; prohibiting payment adjudicators from
    9         downcoding a service under certain circumstances;
   10         prohibiting payment adjudicators for downcoding orders
   11         by a licensed nurse; specifying that payment
   12         adjudicators are solely responsible for certain
   13         violations of law; requiring payment adjudicators to
   14         maintain downcoding policies on their websites;
   15         specifying requirements for such policies; requiring
   16         health insurers to ensure that their downcoding
   17         policies are updated and to ensure compliance with
   18         specified provisions on downcoding; authorizing
   19         investigations and actions against noncompliance;
   20         providing certain presumption in favor of physicians’
   21         determinations regarding diagnoses of patients and
   22         service orders; providing the calculation of interest
   23         on health insurers’ nonpayment or underpayment due to
   24         downcoding; providing a cause of action for health
   25         care providers; amending s. 627.42392, F.S.; defining
   26         terms; revising the definition of the term “health
   27         insurer”; requiring certain utilization review
   28         entities to only use a certain prior authorization
   29         form; deleting provisions related to pharmacy benefits
   30         managers’ or health insurers’ requirement to use a
   31         specified prior authorization form; requiring
   32         utilization review entities to establish and offer a
   33         specified electronic prior authorization process;
   34         specifying requirements for such process; specifying
   35         that the provider is deemed to have supplied all
   36         information necessary for prior authorization under
   37         certain circumstances; specifying that additional
   38         information is deemed unnecessary under certain
   39         circumstances; prohibiting utilization review
   40         entities’ prior authorization process from requiring
   41         information that is not needed; requiring utilization
   42         review entities to disclose all prior authorization
   43         requirements and restrictions; requiring such
   44         requirements and restrictions to be explained in a
   45         specified manner; prohibiting utilization review
   46         entities from implementing certain new requirements or
   47         restrictions; providing exceptions; providing
   48         reporting requirements; requiring the Office of
   49         Insurance Regulation to publish on its website a
   50         report based on such entities’ reports; providing
   51         requirements for adverse determinations made by such
   52         entities on health care providers’ claims; providing a
   53         timeframe for such entities’ determination on claims;
   54         prohibiting prior authorization requirements under
   55         certain circumstances; prohibiting prior authorization
   56         revocations, limits, conditions, and restrictions
   57         under certain circumstances; providing exceptions;
   58         providing a timeframe for the validity of prior
   59         authorizations under certain circumstances; providing
   60         construction; amending ss. 627.6131 and 641.3155,
   61         F.S.; defining terms; revising the definition of the
   62         term “claim”; revising requirements and timeframes for
   63         responses from health insurers and health maintenance
   64         organizations, respectively, to submitted claims;
   65         revising the interest rate on overdue payments of
   66         claims; authorizing health care providers to refuse to
   67         participate in internal dispute resolution processes
   68         under certain circumstances; prohibiting health
   69         insurers and health maintenance organizations,
   70         respectively, from retrospectively, rather than
   71         retroactively, denying claims because of insured and
   72         enrollee ineligibility beyond a specified timeframe;
   73         revising such timeframe; revising applicability;
   74         providing construction; prohibiting health insurers
   75         and health maintenance organizations, respectively,
   76         from requesting or requiring certain information from
   77         health care providers under certain circumstances;
   78         providing causes of action for health care providers
   79         under certain circumstances; amending s. 395.1065,
   80         F.S.; conforming cross-references; providing an
   81         effective date.
   82          
   83  Be It Enacted by the Legislature of the State of Florida:
   84  
   85         Section 1. Section 627.4193, Florida Statutes, is created
   86  to read:
   87         627.4193Restrictions on health insurance reimbursement
   88  downcoding.—
   89         (1)As used in this section, the term:
   90         (a)“Downcode” or “downcoding” means the alteration by a
   91  payment adjudicator of a service code to another service code or
   92  the alteration, addition, or deletion by a payment adjudicator
   93  of a modifier, when the changed code or modifier is associated
   94  with a lower payment amount than the service code or modifier
   95  billed by the provider or facility.
   96         (b)“Health insurer” means any entity that offers health
   97  insurance coverage, whether through a fully insured plan or
   98  self-insured plan or fund, including, as applicable:
   99         1.An authorized health insurer offering health insurance
  100  as defined in s. 624.603, as well as any entity that offers a
  101  commercial self-insurance fund as defined in s. 624.462(2) or
  102  group self-insurance fund as described in s. 624.4621.
  103         2.A health insurer that is subject to any provision of
  104  this chapter, as well as any entity that offers a self-insurance
  105  plan or a group self-insurance plan.
  106         3.A managed care plan as defined in s. 409.962.
  107         4.A health maintenance organization as defined in s.
  108  641.19.
  109         (c)“Medical record” means the comprehensive collection of
  110  documentation, including clinical notes, diagnostic reports, and
  111  other relevant information, which supports the health care
  112  services provided.
  113         (d) “Participation agreement” means a written contract or
  114  agreement between a health insurer and a provider which outlines
  115  the terms and conditions of participation, reimbursement rates,
  116  and other relevant details.
  117         (e)“Payment adjudicator” means a health insurer or any
  118  entity that provides, offers to provide, or administers payment
  119  on behalf of a health insurer, as well any pharmacy benefit
  120  manager as defined in s. 624.490(1), and any other individual or
  121  entity that provides, offers to provide, or administers payment
  122  for hospital services, outpatient services, medical services,
  123  prescription drugs, or other health care services to a person
  124  treated by a health care professional or facility in this state
  125  under a policy, plan, or contract.
  126         (f)“Provider” means any health care professional,
  127  facility, or entity that submits claims for reimbursement for
  128  covered health care services.
  129         (2)Payment adjudicators are prohibited from downcoding a
  130  health care service billed by, or on behalf of, a provider, if
  131  the health care service was ordered by a provider that is in
  132  network with the applicable health insurer, unless such
  133  downcoding is otherwise expressly permitted under the
  134  participation agreement between the health insurer and the
  135  provider.
  136         (3)If downcoding is expressly permitted under the
  137  participation agreement, the payment adjudicator must provide
  138  the following information to the provider before making its
  139  initial payment or notice of denial of payment:
  140         (a)A statement indicating that the service code or
  141  modifier billed by the provider or facility will be downcoded.
  142         (b)An explanation detailing the reasons for downcoding the
  143  claim. This explanation must include a clear description of the
  144  service codes or modifiers that were altered, added, or deleted,
  145  if applicable.
  146         (c)The payment amount that the payment adjudicator would
  147  otherwise make if the service code or modifier is not downcoded.
  148         (d)A statement that the provider may contest the
  149  downcoding of the applicable service code or modifier by filing
  150  a contestation with the payment adjudicator with respect to the
  151  downcoding within 15 days after receipt of the notice of
  152  downcoding.
  153         (e)A statement that by contesting the downcoding of the
  154  applicable service code or modifier, the provider does not waive
  155  any of its legal rights and claims against the health insurer or
  156  payment adjudicator to the fullest extent permissible under law.
  157         (4)Even if the participation agreement expressly permits
  158  downcoding, a payment adjudicator is prohibited from downcoding
  159  a service without first conducting a review of the associated
  160  medical record to ensure the accuracy of the coding change.
  161         (5)A payment adjudicator is prohibited from downcoding for
  162  orders by a licensed nurse.
  163         (6)Notwithstanding any provision in this section, a
  164  payment adjudicator that proceeds to downcode a service code or
  165  modifier, regardless of whether such downcoding is contested by
  166  the provider, is solely responsible for any violations of law
  167  associated with such downcoding.
  168         (7)Payment adjudicators are required to maintain clear and
  169  accessible downcoding policies on their official website. These
  170  policies must include:
  171         (a)An overview of the circumstances under which downcoding
  172  may occur.
  173         (b)The process and criteria used for conducting reviews of
  174  downcoded claims, including the role of medical record review.
  175         (c)Information about the internal mechanisms for ensuring
  176  consistency and accuracy in downcoding practices.
  177         (d)Information regarding the processes for contesting with
  178  the payment adjudicator the downcoding of a service code, which
  179  processes must offer appeal rights for the provider and the
  180  patient, and peer review by a licensed physician before the
  181  downcoding.
  182         (8)Health insurers shall ensure that their downcoding
  183  policies are updated as needed to reflect any changes in
  184  regulations, industry standards, or internal procedures.
  185         (9)Health insurers shall ensure compliance with this
  186  section and shall develop internal procedures to implement and
  187  adhere to the requirements outlined in this section.
  188         (10)Regulatory authorities, including, but not limited to,
  189  the Office of Insurance Regulation, may investigate and take
  190  appropriate actions in cases of noncompliance with this section.
  191         (11)When a particular health care service is ordered by a
  192  licensed physician, there is a presumption that the physician’s
  193  determination regarding the diagnosis of the patient and any
  194  service order by the physician is correct and sufficient, absent
  195  a coding error which the health insurer must first verify with
  196  the physician before downcoding for such error.
  197         (12)If an applicable court, arbitration tribunal, or other
  198  binding legal process determines that a claim was subject to an
  199  inappropriate or impermissible downcoding, whether in breach of
  200  contract, statute, common law, or otherwise, such that
  201  nonpayment or underpayment of the original claim has occurred,
  202  then in accordance with s. 627.6131, interest must be calculated
  203  on the full total amount that should have been paid on the claim
  204  as of the applicable time period for payment specified in s.
  205  627.6131.
  206         (13)For a violation of this section, a provider shall have
  207  a private cause of action to proceed against the health insurer
  208  or payment adjudicator in the applicable tribunal for the
  209  violation.
  210         Section 2. Section 627.42392, Florida Statutes, is amended
  211  to read:
  212         627.42392 Prior authorization.—
  213         (1) As used in this section, the term:
  214         (a)“Adverse determination” means a decision by a health
  215  insurer or utilization review entity that the health care
  216  services rendered, or proposed to be rendered, to a patient are
  217  denied, reduced, or terminated. The term does not include a
  218  decision to deny, reduce, or terminate services that are
  219  determined to have been billed in duplicate bills or that are
  220  confirmed with the provider to have been billed in error.
  221         (b)“Electronic prior authorization process” does not
  222  include transmissions through a facsimile machine.
  223         (c)“Emergency health care service” means medical
  224  screening, examination, and evaluation by a physician, or, to
  225  the extent permitted by applicable law, by other appropriate
  226  personnel under the supervision of a physician, to determine
  227  whether an emergency medical condition exists and, if it does,
  228  the care, treatment, or surgery by a physician necessary to
  229  relieve or eliminate the emergency medical condition, within the
  230  service capability of the facility.
  231         (d)“Emergency medical condition” means a medical condition
  232  manifesting itself by acute symptoms of sufficient severity,
  233  including severe pain, such that a prudent layperson who
  234  possesses an average knowledge of health and medicine could
  235  reasonably expect the absence of immediate medical attention to
  236  result in any of the conditions listed in s. 395.002(8).
  237         (e)“Health insurer” means any entity that offers health
  238  insurance coverage, whether through a fully insured plan or
  239  self-insured plan or fund, including, as applicable:
  240         1.An authorized health insurer offering health insurance
  241  as defined in s. 624.603, as well as any entity that offers a
  242  commercial self-insurance fund as defined in s. 624.462(2) or a
  243  group self-insurance fund as described in s. 624.4621.
  244         2.A health insurer that is subject to any provision of
  245  this chapter, as well as any entity that offers a self-insurance
  246  plan or a group self-insurance plan.
  247         3.A managed care plan as defined in s. 409.962.
  248         4.A health maintenance organization as defined in s.
  249  641.19.
  250         (f)“Prior authorization” means the process by which
  251  utilization review entities determine the medical necessity or
  252  medical appropriateness of otherwise covered health care
  253  services before the rendering of such health care services. The
  254  term also includes any requirement by a health insurer or
  255  utilization review entity that an enrollee or a health care
  256  provider notify the health insurer or utilization review entity
  257  before the provision of a health care service.
  258         (g)“Urgent health care service” means a health care
  259  service that, if the timeframe for making a nonexpedited prior
  260  authorization is applied, could, in the opinion of a physician
  261  with knowledge of the patient’s medical condition:
  262         1.Seriously jeopardize the life or health of the patient
  263  or the ability of the patient to regain maximum function; or
  264         2.Subject the patient to severe pain that cannot be
  265  adequately managed without the care, treatment, or prescription
  266  drugs that are the subject of the prior authorization request.
  267         (h)“Utilization review activity” means any activity
  268  prospective to, concurrent with, or retrospective to the
  269  provision of a nonemergency health care service, to determine
  270  whether payment must be made in full or is subject to an adverse
  271  determination. Utilization review activity is prohibited:
  272         1.To the extent restricted or prohibited by an agreement
  273  with a health care provider;
  274         2.For an emergency health care service; or
  275         3.For a service provided to a patient experiencing an
  276  emergency medical condition.
  277         (i)“Utilization review entity” means an entity permitted
  278  under the applicable agreement with a health care provider or
  279  otherwise permitted by a provider that does not have such an
  280  agreement to perform utilization review activities or upon whose
  281  behalf utilization review activities are performed, including,
  282  as applicable:
  283         1.An authorized health insurer offering health insurance
  284  as defined in s. 624.603, as well as any entity that offers a
  285  commercial self-insurance fund as defined in s. 624.462(2) or
  286  group self-insurance fund as described in s. 624.4621.
  287         2.A health insurer that is subject to any provision of
  288  this chapter, as well as any entity that offers a self-insurance
  289  plan or a group self-insurance plan.
  290         3.A managed care plan as defined in s. 409.962.
  291         4.A health maintenance organization as defined in s.
  292  641.19.
  293         5.A pharmacy benefit manager as defined in s. 624.490(1).
  294         6.Any other individual or entity that provides, offers to
  295  provide, or administers payment for hospital services,
  296  outpatient services, medical services, prescription drugs, or
  297  other health care services to a person treated by a health care
  298  professional or facility in this state under a policy, plan,
  299  contract, or fund “health insurer” means an authorized insurer
  300  offering health insurance as defined in s. 624.603, a managed
  301  care plan as defined in s. 409.962(10), or a health maintenance
  302  organization as defined in s. 641.19(12).
  303         (2) Notwithstanding any other provision of law, a
  304  utilization review entity that effective January 1, 2017, or six
  305  (6) months after the effective date of the rule adopting the
  306  prior authorization form, whichever is later, a health insurer,
  307  or a pharmacy benefits manager on behalf of the health insurer,
  308  which does not provide an electronic prior authorization process
  309  for use by its contracted providers may, shall only use the
  310  prior authorization form that has been approved by the Financial
  311  Services Commission for granting a prior authorization for a
  312  medical procedure, course of treatment, or prescription drug
  313  benefit. Such form must be no longer than may not exceed two
  314  pages in length, excluding any instructions or guiding
  315  documentation, and must include all clinical documentation
  316  necessary for the utilization review entity health insurer to
  317  make a decision. At a minimum, the form must include: (1)
  318  sufficient patient information to identify the member, date of
  319  birth, full name, and Health Plan ID number; (2) provider name,
  320  address and phone number; (3) the medical procedure, course of
  321  treatment, or prescription drug benefit being requested,
  322  including the medical reason therefor, and all services tried
  323  and failed; (4) any laboratory documentation required; and (5)
  324  an attestation that all information provided is true and
  325  accurate.
  326         (3) The Financial Services Commission, in consultation with
  327  the Agency for Health Care Administration, shall adopt by rule
  328  guidelines for all prior authorization forms which ensure the
  329  general uniformity of such forms.
  330         (4)A utilization review entity shall establish and offer a
  331  secure, interactive online electronic prior authorization
  332  process to accept electronic prior authorization requests. The
  333  electronic prior authorization process must allow a person
  334  seeking a prior authorization the ability to upload
  335  documentation if such documentation is required by the
  336  utilization review entity to adjudicate the prior authorization
  337  request. Once a provider grants a health insurer access to a
  338  patient’s electronic medical record, the provider is deemed to
  339  have supplied all information necessary for prior authorization
  340  of the health care service, including, without limitation, all
  341  information that is reasonably required by the health insurer,
  342  other than for an emergency health care service or for a service
  343  provided to a patient who is experiencing an emergency medical
  344  condition, in advance of the provision of service, and the
  345  health insurer asserts is missing as of the date of such
  346  service. Additional information or documentation, regardless of
  347  whether the utilization review entity requests any additional
  348  information, is deemed unnecessary, and deemed not required, for
  349  prior authorization of the health care service, and any request
  350  for additional information or any position of the utilization
  351  review entity or any third party acting on behalf of the
  352  utilization review entity regarding any lack of information from
  353  the provider is prohibited from being used to deny, pend, or
  354  delay prior authorization of the health care service.
  355         (5)(4) Electronic prior authorization approvals do not
  356  preclude benefit verification or medical review by the health
  357  insurer under either the medical or pharmacy benefits.
  358         (6)A utilization review entity’s prior authorization
  359  process is prohibited from requiring information that is not
  360  needed to make a determination or facilitate a determination of
  361  medical necessity of the requested medical procedure, course of
  362  treatment, or prescription drug benefit.
  363         (7)A utilization review entity shall disclose all of its
  364  prior authorization requirements and restrictions, including any
  365  written clinical criteria, in a publicly accessible manner on
  366  its website. These requirements and restrictions must be
  367  explained in detail and in clear and ordinary terms.
  368         (8)A utilization review entity is prohibited from
  369  implementing any new requirements or restrictions and from
  370  making changes to existing requirements or restrictions on
  371  obtaining prior authorization unless:
  372         (a)The changes have been available on a publicly
  373  accessible website for at least 60 days before they are
  374  implemented;
  375         (b)Policyholders and health care providers affected by the
  376  new requirements and restrictions or changes to the requirements
  377  and restrictions are provided with a written notice of the
  378  changes at least 60 days before they are implemented, with such
  379  notice being delivered electronically or by other means as
  380  agreed to by the policyholder or the health care provider; and
  381         (c)All applicable amendments to a provider’s agreement
  382  with the applicable health insurer or utilization review entity
  383  have been obtained and memorialized in a mutually agreed-upon
  384  writing before such implementation.
  385         (9)(a)Utilization review entities shall, by March 31 of
  386  each year, submit a report to the Office of Insurance Regulation
  387  with the following data elements for the prior calendar year:
  388         1.A list of all items and services requiring prior
  389  authorization.
  390         2.The percentage of standard prior authorization requests
  391  approved by the utilization review entity, aggregated by item or
  392  service.
  393         3.The percentage of standard prior authorization requests
  394  denied by the utilization review entity, aggregated by item or
  395  service.
  396         4.The percentage of standard prior authorization requests
  397  approved by the utilization review entity after appeal,
  398  aggregated by item or service.
  399         5.The percentage of prior authorizations when the
  400  timeframe for review was extended and request approved, by item
  401  or service.
  402         6.The percentage of expedited prior authorization requests
  403  approved by the utilization review entity, by item or service.
  404         7.The percentage of expedited prior authorization requests
  405  denied by the utilization review entity, by item or service.
  406         8.The percentage of expedited prior authorization requests
  407  approved by the utilization review entity after appeal, by item
  408  or service.
  409         9.The average and median time between submission of a
  410  request for prior authorization and the utilization review
  411  entity’s decision for standard prior authorizations, by item or
  412  service.
  413         10.The average and median time between submission of a
  414  request for prior authorization and the utilization review
  415  entity’s decision for expedited prior authorizations, by item or
  416  service.
  417         (b)The Office of Insurance Regulation shall, by July 1 of
  418  each year, publish a report on its website detailing the
  419  information in paragraph (a) submitted by utilization review
  420  entities.
  421         (10)Utilization review entities shall ensure that all
  422  adverse determinations are made by a physician licensed under
  423  chapter 458 or chapter 459. The physician:
  424         (a)Must possess a current and valid nonrestricted license
  425  to practice medicine in this state;
  426         (b)Must be of the same specialty as the physician who
  427  typically manages the medical condition or disease or provides
  428  the health care service involved in the request;
  429         (c)Must have at least 5 years of experience treating
  430  patients with the medical condition or disease for which the
  431  health care service is being requested; and
  432         (d)May not have any direct or indirect financial
  433  arrangement with the utilization review entity that rewards or
  434  incentivizes, financially or otherwise, such physician in any
  435  way relating to adverse determinations.
  436         (11)Notice of an adverse determination must be provided by
  437  e-mail to the health care provider that initiated the prior
  438  authorization and to the patient. Notice required under this
  439  subsection must include:
  440         (a)The name, title, e-mail address, and telephone number
  441  of the physician responsible for making the adverse
  442  determination.
  443         (b)Any written clinical criteria and any internal rule,
  444  guideline, or protocol on which the utilization review entity
  445  relied when making the adverse determination and the reasons
  446  those provisions apply to the patient’s specific medical
  447  circumstance.
  448         (c)Information for the patient and the patient’s health
  449  care provider which describes the procedure through which the
  450  patient or health care provider may request a copy of any report
  451  developed by personnel performing the review that led to the
  452  adverse determination.
  453         (d)Information that explains to the patient and the
  454  patient’s health care provider the manner in which to appeal the
  455  adverse determination.
  456         (12)If a utilization review entity requires prior
  457  authorization of a nonurgent health care service, the
  458  utilization review entity must grant a prior authorization or
  459  make an adverse determination and notify the patient and the
  460  patient’s health care provider of the decision within 72 hours
  461  after obtaining all necessary information to grant the prior
  462  authorization or make the adverse determination. For purposes of
  463  this subsection, the term “necessary information” includes the
  464  results of any face-to-face clinical evaluation or second
  465  opinion that may be required.
  466         (13)A utilization review entity shall grant an expedited
  467  prior authorization or make an expedited adverse determination
  468  concerning an urgent health care service and notify the patient
  469  and the patient’s health care provider of such expedited prior
  470  authorization or adverse determination no later than 24 hours
  471  after receiving all information needed to complete the review of
  472  the requested urgent health care service.
  473         (14)(a)A utilization review entity is prohibited from
  474  requiring prior authorization for:
  475         1.Prehospital transportation;
  476         2.Provision of an emergency health care service; or
  477         3.Provision of a service to a patient who is experiencing
  478  an emergency medical condition.
  479         (b)A utilization review entity is prohibited from
  480  conducting utilization review activity, and from making any
  481  adverse determinations, to the extent restricted or prohibited
  482  by an agreement with a health care provider. A utilization
  483  review entity is prohibited from performing any utilization
  484  review activity, and from making any adverse determinations,
  485  with respect to:
  486         1.An emergency health care service; or
  487         2.A service provided to a patient who experiences an
  488  emergency medical condition.
  489         (15)A utilization review entity is prohibited from
  490  requiring prior authorization, and from making any adverse
  491  determinations, for the provision of medications for opioid use
  492  disorder. For purposes of this subsection, the term “medications
  493  for opioid use disorder” means the use of medications, commonly
  494  prescribed in combination with counseling and behavioral
  495  therapies, to provide a comprehensive approach to the treatment
  496  of opioid use disorder. FDA-approved medications used to treat
  497  opioid addiction include, but are not limited to, methadone,
  498  buprenorphine, alone or in combination with naloxone, and
  499  extended-release injectable naltrexone. Types of behavioral
  500  therapies include, but are not limited to, individual therapy,
  501  group counseling, family behavior therapy, motivational
  502  incentives, and other modalities.
  503         (16)A utilization review entity is prohibited from
  504  revoking, limiting, conditioning, or restricting a prior
  505  authorization if care is provided within 45 business days after
  506  the date the health care provider receives the prior
  507  authorization. A utilization review entity must pay, or cause
  508  payment to be made to, the health care provider, without any
  509  prepayment review or prepayment audit before such payment, at
  510  the contracted payment rate for a health care service provided
  511  by the health care provider per the prior authorization, unless:
  512         (a)The health care provider knowingly and materially
  513  misrepresented the health care service in the prior
  514  authorization request with the specific intent to deceive and
  515  obtain an unlawful payment from the utilization review entity;
  516         (b)The health care service was no longer a covered
  517  benefit, and medical necessity did not constitute a basis for
  518  such noncovered benefit status, on the day the health care
  519  service was provided, and the utilization review entity notified
  520  the health care provider in writing of these facts before the
  521  health care service was provided;
  522         (c)The authorized service was never performed; or
  523         (d)The patient was no longer enrolled under the applicable
  524  health plan and, on that basis, was not eligible for health care
  525  coverage from the applicable health insurer or self-insured plan
  526  on the day the care was provided, and the utilization review
  527  entity notified the health care provider in writing of these
  528  facts before the health care service was provided.
  529         (17)If a utilization review entity requires a prior
  530  authorization for a health care service for the treatment of a
  531  chronic or long-term care condition, the prior authorization
  532  must remain valid for the length of the treatment, and the
  533  utilization review entity is prohibited from requiring the
  534  patient to obtain a prior authorization again for the health
  535  care service.
  536         (18)A utilization review entity is prohibited from
  537  imposing an additional prior authorization requirement with
  538  respect to a surgical or otherwise invasive procedure, or any
  539  item furnished as part of the surgical or invasive procedure, if
  540  the procedure or item is furnished during the perioperative
  541  period of another procedure for which prior authorization was
  542  granted by the health insurer.
  543         (19)If there is a change in coverage or approval criteria
  544  for a previously authorized health care service, the change in
  545  coverage or approval criteria is prohibited from adversely
  546  affecting an enrollee who received prior authorization before
  547  the effective date of the change for the remainder of the
  548  enrollee’s plan year.
  549         (20)A utilization review entity shall continue to honor a
  550  prior authorization it has granted to an enrollee when the
  551  enrollee changes products under the same health insurer.
  552         (21)Any failure by a utilization review entity to comply
  553  with the deadlines and other requirements specified in this
  554  section will result in any health care services subject to
  555  review being automatically deemed authorized by the utilization
  556  review entity.
  557         (22)Except as otherwise provided in paragraphs (16)(a)
  558  (d), prior authorization constitutes a conclusive determination
  559  of the medical necessity of the authorized health care service
  560  and an irrevocable obligation to pay for such authorized health
  561  care service.
  562         (23)(a)This section prohibits an agreement with a health
  563  care provider to restrict, limit, prohibit, or substitute a
  564  utilization review activity or prior authorization.
  565         (b)Nothing in this section may be construed to:
  566         1.Limit in any way the restrictions or prohibitions on
  567  adverse determinations under an agreement with a health care
  568  provider, nor to imply permission for, or applicability of,
  569  adverse determinations for emergency health care services.
  570         2.Restrict, limit, or prohibit in any way prior
  571  authorizations under an agreement between a provider and a
  572  utilization review entity, nor to restrict, limit, or prohibit a
  573  provider’s rights to contest, reject, or oppose any prior
  574  authorization activities.
  575         (24)For a violation of this section, a provider shall have
  576  a private cause of action to proceed against the health insurer
  577  or utilization review entity in the applicable tribunal for the
  578  violation.
  579         Section 3. Section 627.6131, Florida Statutes, is amended
  580  to read:
  581         627.6131 Prompt payment of claims.—
  582         (1) The contract must shall include the following
  583  provision: “Time of Payment of Claims: After receiving written
  584  proof of loss, the health insurer shall will pay monthly all
  585  claims. Claims benefits then due for ...(type of benefit)....
  586  Benefits for any other loss covered by this policy shall will be
  587  paid as soon as the health insurer receives proper written
  588  proof.”
  589         (2) As used in this section, the term:
  590         (a) “Claim” for a noninstitutional provider means a paper
  591  HCFA 1500 claim form, or its successor, or an electronic billing
  592  instrument submitted to the health insurer’s designated location
  593  that consists of the ANSI ASC X12N 837P standard HCFA 1500 data
  594  set, or its successor, that has all mandatory entries for a
  595  physician licensed under chapter 458, chapter 459, chapter 460,
  596  chapter 461, or chapter 463, or psychologists licensed under
  597  chapter 490 or any appropriate billing instrument as designated
  598  by the provider that has all mandatory entries for any other
  599  noninstitutional provider. For institutional providers, “claim”
  600  means a paper CMS-1450 claim form, or its successor, or an
  601  electronic billing instrument submitted to the health insurer’s
  602  designated location that consists of the ANSI ASC X12N 837I
  603  standard UB-92 data set, or its successor, with entries stated
  604  as mandatory by the National Uniform Billing Committee.
  605         (b)“Clean claim” means a completed form, or completed
  606  electronic billing instrument, containing all information
  607  required under the applicable form or electronic billing
  608  instrument, as well as information reasonably required by the
  609  health insurer, other than for emergency services and care as
  610  defined in s. 395.002, in advance of the provision of service by
  611  the health insurer to substantiate the claim.
  612         (c)“Electronic medical record” means the digital record of
  613  a patient’s information that may be accessed through electronic
  614  means, via portal or other method of electronic access, which
  615  may include information regarding the patient’s medical history,
  616  medical condition, medical treatment, laboratory results,
  617  diagnostic reports, and clinical notes.
  618         (d)“Emergency health care services” has the same meaning
  619  as “emergency services and care” as defined in s. 395.002.
  620         (e)“Health insurer” means any entity that offers health
  621  insurance coverage, whether through a fully insured plan or a
  622  self-insured plan or fund, including, as applicable:
  623         1.An authorized health insurer offering health insurance
  624  as defined in s. 624.603, as well as any entity that offers a
  625  commercial self-insurance fund as defined in s. 624.462(2) or a
  626  group self-insurance fund as described in s. 624.4621.
  627         2.A health insurer that is subject to any provision of
  628  this chapter, as well as any entity that offers a self-insurance
  629  plan or a group self-insurance plan.
  630         (f)“Insured ineligibility” means that the insured was no
  631  longer enrolled in the health plan at the time of receiving the
  632  applicable service.
  633         (g)“Overpayment” means payment made upon a claim that is:
  634         1.Billed in error;
  635         2.A duplicate claim; or
  636         3.Billed for a service rendered to a patient despite
  637  insured ineligibility.
  638  
  639  A request for overpayment is limited to a billing error,
  640  duplicate bill, or insured ineligibility.
  641         (3) All claims for payment or overpayment, whether
  642  electronic or nonelectronic:
  643         (a) Are considered received on the date the claim is
  644  received by the health insurer at its designated claims-receipt
  645  location or the date the claim for overpayment claim is received
  646  by the provider at its designated location.
  647         (b) As to providers’ claims for payment, must be mailed or
  648  electronically transferred to the primary health insurer within
  649  6 months after the following have occurred:
  650         1. Discharge for inpatient services or the date of service
  651  for outpatient services; and
  652         2. The provider has been furnished with the correct name
  653  and address of the patient’s health insurer.
  654  
  655  All providers’ claims for payment, whether electronic or
  656  nonelectronic, must be mailed or electronically transferred to
  657  the secondary health insurer within 45 90 days after final
  658  determination by the primary health insurer. A provider’s claim
  659  is considered submitted on the date it is electronically
  660  transferred or mailed.
  661         (c) Must not duplicate a claim previously submitted unless
  662  it is determined that the original claim was not received or is
  663  otherwise lost.
  664         (4) For all electronically submitted claims, a health
  665  insurer shall:
  666         (a) Within 24 hours after the beginning of the next
  667  business day after receipt of the claim, provide to the
  668  electronic source submitting the claim an electronic
  669  acknowledgment of the receipt of the claim, accompanied by a
  670  statement indicating the health insurer’s position as to whether
  671  the claim is a clean claim or is missing any information that is
  672  required under the applicable electronic billing instrument, as
  673  described in paragraph (2)(a), or that was reasonably required
  674  by the health insurer, other than for emergency health care
  675  services, in advance of the provision of service to substantiate
  676  to the electronic source submitting the claim, and the health
  677  insurer asserts is missing as of the date of service.
  678         (b) Within 15 20 days after receipt of the claim, pay the
  679  claim or notify a provider or designee if a claim is denied or
  680  contested. Notice of the health­ insurer’s action on the claim
  681  and payment of the claim is considered to be made on the date
  682  the notice or payment was received by the provider mailed or
  683  electronically transferred.
  684         (c)1. Notification of the health insurer’s determination of
  685  a contested claim must be accompanied by an itemized list of any
  686  additional information that is required under the applicable
  687  billing instrument, as described in paragraph (2)(a), or that
  688  was reasonably required by the health insurer, other than for
  689  emergency health care services, in advance of the provision of
  690  service to substantiate the claim, and the health insurer
  691  asserts is missing as of the date of such service or documents
  692  the insurer can reasonably determine are necessary to process
  693  the claim.
  694         2. A provider must submit the additional information or
  695  documentation, as specified on the itemized list, within 30 35
  696  days after receipt of the notification of contestation unless,
  697  within the 30-day period, the provider notifies the health
  698  insurer of the provider’s position that a clean claim has been
  699  submitted. Additional information is considered submitted on the
  700  date it is electronically transferred or mailed. The health
  701  insurer is prohibited from requesting may not request duplicate
  702  documents.
  703         (d) For purposes of this subsection, electronic means of
  704  transmission of claims, notices, documents, forms, and payments
  705  shall be used to the greatest extent possible by the health
  706  insurer and the provider.
  707         (e) A claim contested by the health insurer must be paid or
  708  denied within 30 90 days after receipt of the additional
  709  information requested claim. Failure to pay or deny a claim
  710  within 90 120 days after receipt of the claim, regardless of
  711  whether contested by the health insurer, creates an
  712  uncontestable obligation to pay the claim as submitted by the
  713  provider.
  714         (5) For all nonelectronically submitted claims, a health
  715  insurer shall:
  716         (a) Within 15 days following receipt of the claim Effective
  717  November 1, 2003, provide to the provider or its designee:
  718         1.An acknowledgment of receipt of the claim, accompanied
  719  by a statement indicating the health insurer’s position as to
  720  whether the claim is a clean claim or the claim is missing any
  721  information that is required under the applicable paper billing
  722  form, as described in paragraph (2)(a), or that was reasonably
  723  required by the health insurer, other than for emergency health
  724  care services, in advance of the provision of service to
  725  substantiate the claim, and the health insurer asserts is
  726  missing as of the date of service; or
  727         2.within 15 days after receipt of the claim to the
  728  provider or provide a provider within 15 days after receipt with
  729  Electronic access to the status of the a submitted claim, which
  730  status must indicate the health insurer’s position as to whether
  731  the claim is a clean claim or missing any information described
  732  in subparagraph 1.
  733         (b) Within 30 40 days after receipt of the claim, pay the
  734  claim or notify a provider or designee if a claim is denied or
  735  contested. Notice of the health insurer’s action on the claim
  736  and payment of the claim is considered to be made on the date
  737  the notice or payment was received by the provider mailed or
  738  electronically transferred.
  739         (c)1. Notification of the health insurer’s determination of
  740  a contested claim must be accompanied by an itemized list of any
  741  additional information that is required under the applicable
  742  form or billing instrument, as described in paragraph (2)(a), or
  743  that was reasonably required by the health insurer, other than
  744  for emergency health care services, in advance of the provision
  745  of service to substantiate the claim, and the health insurer
  746  asserts is missing as of the date of such service or documents
  747  the insurer can reasonably determine are necessary to process
  748  the claim.
  749         2. A provider must submit the additional information or
  750  documentation, as specified on the itemized list, within 30 35
  751  days after receipt of the notification of contestation unless,
  752  within the 30-day period, the provider notifies the health
  753  insurer of its position that a clean claim has been submitted.
  754  Additional information is considered submitted on the date it is
  755  electronically transferred or mailed. The health insurer is
  756  prohibited from requesting may not request duplicate documents.
  757         (d) For purposes of this subsection, electronic means of
  758  transmission of claims, notices, documents, forms, and payments
  759  must shall be used to the greatest extent possible by the health
  760  insurer and the provider.
  761         (e) A claim contested by the health insurer must be paid or
  762  denied within 30 120 days after receipt of the additional
  763  information requested claim. Failure to pay or deny a claim
  764  within 90 140 days after receipt of the claim, regardless of
  765  whether contested by the health insurer, creates an
  766  uncontestable obligation to pay the claim as submitted by the
  767  provider.
  768         (6)Regardless of whether a claim has been submitted
  769  electronically or nonelectronically, and notwithstanding any
  770  other provision of this section:
  771         (a)Once a provider grants a health insurer access to a
  772  patient’s electronic medical record, the provider is deemed to
  773  have supplied all information necessary to pay the claim,
  774  including, without limitation, all information that is required
  775  under the applicable billing instrument and that was reasonably
  776  required by the health insurer, other than for emergency health
  777  care services, in advance of the provision of service to
  778  substantiate the claim. Additional information or documentation,
  779  regardless of whether the health insurer requests any additional
  780  information, is deemed unnecessary, and deemed not required for
  781  payment of the claim, and any request for additional
  782  information, and any position of the health insurer or any third
  783  party acting on behalf of the health insurer regarding any lack
  784  of information from the provider, is prohibited from being used
  785  to deny, reduce, offset, withhold, pend, or delay payment of the
  786  claim.
  787         (b)If notice of access to the electronic medical record
  788  has been provided to the health insurer, the claim must be paid
  789  or denied within 30 days of such notice to the health insurer.
  790  Failure to pay or deny a claim for which the health insurer has
  791  been provided notice of access to the electronic medical record
  792  within 75 days after receipt of such notice creates an
  793  uncontestable obligation to pay the claim as submitted by the
  794  provider.
  795         (7)(6) If a health insurer determines that it has made an
  796  overpayment to a provider for services rendered to an insured,
  797  the health insurer must make an overpayment a claim for such
  798  overpayment to the provider’s designated location. A health
  799  insurer that makes an overpayment a claim for overpayment to a
  800  provider under this section shall give the provider a written or
  801  electronic statement specifying the basis for the retrospective
  802  retroactive denial or payment adjustment. The health insurer
  803  must also identify the claim or claims, or portion thereof, as
  804  to which the health insurer alleges overpayment claim, and the
  805  specific invoice number submitted with or on the claim portion
  806  thereof, for which a claim for overpayment is submitted. Except
  807  as provided in subparagraph (a)3., there may be no denial,
  808  reduction, offset, withholding, pending, or delay of payment, or
  809  other negative impact, regardless of whether by the health
  810  insurer or any third party acting on behalf of such health
  811  insurer, on payment of any other claim of the provider on the
  812  basis of the overpayment allegation.
  813         (a) If an overpayment determination is the result of
  814  retrospective retroactive review or retrospective audit of
  815  coverage decisions or payment levels not related to fraud, a
  816  health insurer must shall adhere to the following procedures:
  817         1. All overpayment claims for overpayment must be received
  818  by the submitted to a provider within 18 30 months after the
  819  health insurer’s payment of the claim. A provider must pay,
  820  deny, or contest the health insurer’s claim for overpayment
  821  claim within 40 days after the receipt of the overpayment claim.
  822  All contested overpayment claims for overpayment must be paid or
  823  denied within 120 days after receipt of the overpayment claim.
  824  Failure to pay or deny an overpayment and claim within 140 days
  825  after receipt creates an uncontestable obligation to pay the
  826  overpayment claim.
  827         2. A provider that denies or contests a health insurer’s
  828  overpayment claim for overpayment or any portion of an
  829  overpayment a claim shall notify the health insurer, in writing,
  830  within 40 35 days after the provider receives the overpayment
  831  claim that such overpayment the claim for overpayment is
  832  contested or denied. The notice that the overpayment claim for
  833  overpayment is denied or contested must identify the denied or
  834  contested portion of the overpayment claim and the specific
  835  reason for contesting or denying the overpayment claim and, if
  836  contested, must include a request for additional information. If
  837  the health insurer submits additional information, the health
  838  insurer must, within 35 days after receipt of the request, mail
  839  or electronically transfer the information to the provider. The
  840  provider shall pay or deny the overpayment claim for overpayment
  841  within 45 days after receipt of the information. The notice from
  842  the provider regarding denial or contestation of the overpayment
  843  claim is considered made on the date the notice is mailed or
  844  electronically transferred by the provider.
  845         3. The health insurer is prohibited from denying, reducing,
  846  offsetting, withholding, pending, or delaying may not reduce
  847  payment to the provider for other services unless the provider
  848  agrees to the denial, reduction, offset, withholding, pending,
  849  or delay of payment in writing or fails to respond to the health
  850  insurer’s overpayment claim as required by this paragraph.
  851         4. Payment of an overpayment claim is considered made on
  852  the date the payment was mailed or electronically transferred.
  853  An overdue payment of a claim bears simple interest at the rate
  854  of 12 percent per year. Interest on an overdue payment for an
  855  overpayment a claim for an overpayment begins to accrue when the
  856  overpayment claim should have been paid, denied, or contested.
  857         (b) An overpayment A claim is prohibited for overpayment
  858  shall not be permitted beyond 18 30 months after the health
  859  insurer’s payment of a claim, except that overpayment claims for
  860  overpayment may be sought beyond that time from providers
  861  convicted of fraud pursuant to s. 817.234.
  862         (8)(7) Payment of a claim is considered made on the date
  863  the payment was mailed or electronically transferred. An overdue
  864  payment of a claim bears simple interest of 15 12 percent per
  865  year, to be calculated on the full total amount that should have
  866  been paid on the claim within the applicable time period
  867  specified in this section. If an applicable court, arbitration
  868  tribunal, or other binding legal process determines that a claim
  869  that was paid at a lesser amount should have been paid at a full
  870  total amount, whether under a breach of contract legal claim, a
  871  legal claim under a statutory private cause of action, or other
  872  basis, the 15 percent per year interest must be calculated on
  873  the full total amount, rather than upon the difference between
  874  the full total amount and the amount that was actually paid. If
  875  an applicable court, arbitration tribunal, or other binding
  876  legal process determines that a claim was subject to an
  877  inappropriate or impermissible denial or partial denial, whether
  878  in a breach of contract, statute, common law, or otherwise,
  879  interest must be calculated on the full total amount that should
  880  have been paid on the claim within the applicable time period
  881  for payment specified in this section, and the act of denial or
  882  partial denial is deemed not to have in any way tolled the time
  883  period for such payment. Interest on the full total amount that
  884  should have been paid on the claim within the applicable time
  885  period specified in this section an overdue payment for a claim
  886  or for any portion of a claim begins to accrue when the claim
  887  should have been paid, denied, or contested. The interest must
  888  be paid along with, and in addition to, the payment for the
  889  satisfaction of the full total amount of the claim, as
  890  determined by an applicable court, arbitration tribunal, or
  891  other binding legal process is payable with the payment of the
  892  claim.
  893         (9)(8) For all contracts entered into or renewed on or
  894  after October 1, 2002, a health insurer’s internal dispute
  895  resolution process related to a denied claim not under active
  896  review by a mediator, arbitrator, or third-party dispute entity
  897  must be finalized within 60 days after the receipt of the
  898  provider’s request for review or appeal. Notwithstanding any
  899  provision of this section, when the provider and health insurer
  900  disagree as to interpretation of contractual or statutory
  901  language, the provider is not required to participate in the
  902  health insurer’s internal dispute resolution process.
  903         (10)(9) A provider or any representative of a provider,
  904  regardless of whether the provider is under contract with the
  905  health insurer, is prohibited from collecting or attempting may
  906  not collect or attempt to collect money from, maintaining
  907  maintain any action at law against, or reporting report to a
  908  credit agency an insured for payment of covered services for
  909  which the health insurer contested or denied the provider’s
  910  claim. This prohibition applies during the pendency of any claim
  911  for payment made by the provider to the health insurer for
  912  payment of the services or internal dispute resolution process
  913  to determine whether the health insurer is liable for the
  914  services. For a claim, this pendency applies from the date the
  915  claim or a portion of the claim is denied to the date of the
  916  completion of the health insurer’s internal dispute resolution
  917  process, not to exceed 60 days. This subsection does not
  918  prohibit the collection by the provider of copayments,
  919  coinsurance, or deductible amounts due the provider.
  920         (10)The provisions of this section may not be waived,
  921  voided, or nullified by contract.
  922         (11) A health insurer is prohibited from retrospectively
  923  denying may not retroactively deny a claim because of insured
  924  ineligibility more than 90 days 1 year after the date of payment
  925  of the claim.
  926         (12) A health insurer must shall pay a contracted primary
  927  care or admitting physician, pursuant to such physician’s
  928  contract, for providing inpatient services in a contracted
  929  hospital to an insured if such services are determined by such
  930  physician the health insurer to be medically necessary and,
  931  regardless of the health plan’s determination of medical
  932  necessity, are otherwise covered services under the health
  933  insurer’s contract with the contract holder.
  934         (13) Upon written notification by an insured, a health an
  935  insurer shall investigate any claim of improper billing of the
  936  insured by a physician, hospital, or other health care provider
  937  for a health care service alleged to not actually have been
  938  received. The health insurer shall determine whether if the
  939  insured actually received the applicable service was properly
  940  billed for only those procedures and services that the insured
  941  actually received. If the health insurer determines that the
  942  insured did not actually receive the applicable service has been
  943  improperly billed, the health insurer must shall notify the
  944  insured and the provider of its findings and must shall reduce
  945  the amount of payment to the provider by the amount for the
  946  service that was not actually received determined to be
  947  improperly billed. If a reduction is made due to such
  948  notification by the insured, the insurer shall pay to the
  949  insured 20 percent of the amount of the reduction up to $500.
  950         (14) A permissible error ratio of 5 percent is established
  951  for health insurer’s claims payment violations of paragraphs
  952  (4)(a), (b), (c), and (e) and (5)(a), (b), (c), and (e). If the
  953  error ratio of a particular health insurer does not exceed the
  954  permissible error ratio of 5 percent for an audit period, no
  955  fine may shall be assessed for the noted claims violations for
  956  the audit period. The error ratio is shall be determined by
  957  dividing the number of claims with violations found on a
  958  statistically valid sample of claims for the audit period by the
  959  total number of claims in the sample. If the error ratio exceeds
  960  the permissible error ratio of 5 percent, a fine may be assessed
  961  according to s. 624.4211 for those claims payment violations
  962  which exceed the error ratio. Notwithstanding the provisions of
  963  this section, the office may fine a health insurer for claims
  964  payment violations of paragraphs (4)(e) and (5)(e) which create
  965  an uncontestable obligation to pay the claim as submitted by the
  966  provider. The office shall refrain from imposing a not fine upon
  967  a health insurer insurers for violations which the office
  968  determines were due to circumstances beyond the health insurer’s
  969  control.
  970         (15) This section is applicable only to a major medical
  971  expense health insurance policy as defined in s. 627.643(2)(e)
  972  offered by a group or an individual health insurer licensed
  973  under pursuant to chapter 624, including a preferred provider
  974  policy under s. 627.6471 and an exclusive provider organization
  975  under s. 627.6472 or a group or individual insurance contract
  976  that only provides direct payments to dentists for enumerated
  977  dental services, or other health insurance coverage, policy, or
  978  fund, regardless of whether fully insured or self-insured,
  979  offered or administered by a health insurer.
  980         (16) Notwithstanding paragraph (4)(b), where an electronic
  981  pharmacy claim is submitted to a pharmacy benefits manager
  982  acting on behalf of a health insurer, the pharmacy benefits
  983  manager shall, within 30 days of receipt of the claim, pay the
  984  claim or notify a provider or designee if a claim is denied or
  985  contested. Notice of the health insurer’s action on the claim
  986  and payment of the claim is considered to be made on the date
  987  the notice or payment was received by the provider mailed or
  988  electronically transferred.
  989         (17) Notwithstanding paragraph (5)(a), effective November
  990  1, 2003, where a nonelectronic pharmacy claim is submitted to a
  991  pharmacy benefits manager acting on behalf of a health insurer,
  992  the pharmacy benefits manager shall provide acknowledgment of
  993  receipt of the claim within 30 days after receipt of the claim
  994  to the provider or provide a provider within 30 days after
  995  receipt with electronic access to the status of a submitted
  996  claim.
  997         (18) Notwithstanding the 18-month 30-month period provided
  998  in subsection (7) (6), all overpayment claims for overpayment
  999  submitted to a provider licensed under chapter 395, chapter 458,
 1000  chapter 459, chapter 460, chapter 461, chapter 463, chapter 466,
 1001  or chapter 490 must be submitted to the provider within 12
 1002  months after the health insurer’s payment of the claim. An
 1003  overpayment A claim to a provider licensed under chapter 395,
 1004  chapter 458, chapter 459, chapter 460, chapter 461, chapter 463,
 1005  chapter 466, or chapter 490 is prohibited for overpayment may
 1006  not be permitted beyond 12 months after the health insurer’s
 1007  payment of a claim, except that overpayment claims for
 1008  overpayment may be sought beyond that time from providers
 1009  convicted of fraud pursuant to s. 817.234.
 1010         (19) Notwithstanding any other provision of this section,
 1011  all claims for underpayment from a provider licensed under
 1012  chapter 395, chapter 458, chapter 459, chapter 460, chapter 461,
 1013  or chapter 466 must be submitted to the health insurer within 12
 1014  months after the health insurer’s payment of the claim. A claim
 1015  for underpayment by a provider licensed under chapter 395,
 1016  chapter 458, chapter 459, chapter 460, chapter 461, or chapter
 1017  466 is prohibited may not be permitted beyond 12 months after
 1018  the health insurer’s payment of a claim.
 1019         (20)Nothing in this section shall be interpreted to limit,
 1020  restrict, or negatively impact any legal claim by a provider or
 1021  health insurer for breach of contract, statutory or regulatory
 1022  violation, or a common-law cause of action, nor to shorten or
 1023  otherwise negatively impact the statute of limitations timeframe
 1024  for bringing any such legal claim.
 1025         (21)A health insurer is prohibited from requesting
 1026  information from a contracted or noncontracted provider which
 1027  does not apply to the medical condition at issue for the
 1028  purposes of adjudicating a clean claim.
 1029         (22)A health insurer is prohibited from requesting a
 1030  contracted or noncontracted provider to resubmit claim
 1031  information that the contracted or noncontracted provider can
 1032  document it has already provided to the health insurer or that
 1033  is contained inside the electronic medical record to which the
 1034  health insurer has been provided access.
 1035         (23)Notwithstanding any other provision of this section, a
 1036  health insurer is prohibited from requiring any information from
 1037  a provider before the provision of emergency health care
 1038  services as a condition of payment of a claim, as a basis for
 1039  denying, delaying, offsetting, withholding, or reducing payment
 1040  of a claim, or in contesting whether the claim is a clean claim.
 1041         (24)For a violation of this section, a provider shall have
 1042  a private cause of action to proceed against the health insurer
 1043  in the applicable tribunal for the violation.
 1044         (25)(20)(a) A contract between a health insurer and a
 1045  dentist licensed under chapter 466 for the provision of services
 1046  to an insured is prohibited from specifying may not specify
 1047  credit card payment as the only acceptable method for payments
 1048  from the health insurer to the dentist.
 1049         (b) When a health insurer employs the method of claims
 1050  payment to a dentist through electronic funds transfer,
 1051  including, but not limited to, virtual credit card payment, the
 1052  health insurer shall notify the dentist as provided in this
 1053  paragraph and obtain the dentist’s consent before employing the
 1054  electronic funds transfer. The dentist’s consent described in
 1055  this paragraph applies to the dentist’s entire practice. For the
 1056  purpose of this paragraph, the dentist’s consent, which may be
 1057  given through e-mail, must bear the signature of the dentist.
 1058  Such signature includes an electronic or digital signature if
 1059  the form of signature is recognized as a valid signature under
 1060  applicable federal law or state contract law or an act that
 1061  demonstrates express consent, including, but not limited to,
 1062  checking a box indicating consent. The health insurer or dentist
 1063  is prohibited from requiring may not require that a dentist’s
 1064  consent as described in this paragraph be made on a patient-by
 1065  patient basis. The notification provided by the health insurer
 1066  to the dentist must include all of the following:
 1067         1. The fees, if any, associated with the electronic funds
 1068  transfer.
 1069         2. The available methods of payment of claims by the health
 1070  insurer, with clear instructions to the dentist on how to select
 1071  an alternative payment method.
 1072         (c) A health insurer that pays a claim to a dentist through
 1073  automated clearinghouse transfer is prohibited from charging may
 1074  not charge a fee solely to transmit the payment to the dentist
 1075  unless the dentist has consented to the fee.
 1076         (d) This subsection applies to contracts delivered, issued,
 1077  or renewed on or after January 1, 2025.
 1078         (e) The office has all rights and powers to enforce this
 1079  subsection as provided by s. 624.307.
 1080         (f) The commission may adopt rules to implement this
 1081  subsection.
 1082         (26)(21)(a) A health insurer is prohibited from denying may
 1083  not deny any claim subsequently submitted by a dentist licensed
 1084  under chapter 466 for procedures specifically included in a
 1085  prior authorization unless at least one of the following
 1086  circumstances applies for each procedure denied:
 1087         1. Benefit limitations, such as annual maximums and
 1088  frequency limitations not applicable at the time of the prior
 1089  authorization, are reached subsequent to issuance of the prior
 1090  authorization.
 1091         2. The documentation provided by the person submitting the
 1092  claim fails to support the claim as originally authorized.
 1093         3. Subsequent to the issuance of the prior authorization,
 1094  new procedures are provided to the patient or a change in the
 1095  condition of the patient occurs such that the prior authorized
 1096  procedure would no longer be considered medically necessary,
 1097  based on the prevailing standard of care.
 1098         4. Subsequent to the issuance of the prior authorization,
 1099  new procedures are provided to the patient or a change in the
 1100  patient’s condition occurs such that the prior authorized
 1101  procedure would at that time have required disapproval pursuant
 1102  to the terms and conditions for coverage under the patient’s
 1103  plan in effect at the time the prior authorization was issued.
 1104         5. The denial of the claim was due to one of the following:
 1105         a. Another payor is responsible for payment.
 1106         b. The dentist has already been paid for the procedures
 1107  identified in the claim.
 1108         c. The claim was submitted fraudulently, or the prior
 1109  authorization was based in whole or material part on erroneous
 1110  information provided to the health insurer by the dentist,
 1111  patient, or other person not related to the health insurer.
 1112         d. The person receiving the procedure was not eligible to
 1113  receive the procedure on the date of service.
 1114         e. The services were provided during the grace period
 1115  established under s. 627.608 or applicable federal regulations,
 1116  and the dental insurer notified the provider that the patient
 1117  was in the grace period when the provider requested eligibility
 1118  or enrollment verification from the dental insurer, if such
 1119  request was made.
 1120         (b) This subsection applies to all contracts delivered,
 1121  issued, or renewed on or after January 1, 2025.
 1122         (c) The office has all rights and powers to enforce this
 1123  subsection as provided by s. 624.307.
 1124         (d) The commission may adopt rules to implement this
 1125  subsection.
 1126         Section 4. Section 641.3155, Florida Statutes, is amended
 1127  to read:
 1128         641.3155 Prompt payment of claims.—
 1129         (1) As used in this section, the term:
 1130         (a) “Claim” for a noninstitutional provider means a paper
 1131  HCFA 1500 claim form, or its successor, or an electronic billing
 1132  instrument submitted to the health maintenance organization’s
 1133  designated location that consists of the ANSI ASC X12N 837P
 1134  standard HCFA 1500 data set, or its successor, that has all
 1135  mandatory entries for a physician licensed under chapter 458,
 1136  chapter 459, chapter 460, chapter 461, or chapter 463, or
 1137  psychologists licensed under chapter 490 or any appropriate
 1138  billing instrument as designated by the provider that has all
 1139  mandatory entries for any other noninstitutional provider. For
 1140  institutional providers, “claim” means a paper CMS-1450 claim
 1141  form, or its successor, or an electronic billing instrument
 1142  submitted to the health maintenance organization’s designated
 1143  location that consists of the ANSI ASC X12N 837I standard UB-92
 1144  data set or its successor with entries stated as mandatory by
 1145  the National Uniform Billing Committee.
 1146         (b)“Clean claim” means a completed form, or completed
 1147  electronic billing instrument, containing all information
 1148  required under the applicable form or electronic billing
 1149  instrument, as well as information reasonably required by the
 1150  health maintenance organization, other than for emergency
 1151  services and care as defined in s. 641.19, in advance of the
 1152  provision of service by the health maintenance organization to
 1153  substantiate the claim.
 1154         (c)“Electronic medical record” means the digital record of
 1155  a patient’s information that may be accessed through electronic
 1156  means, via portal or other method of electronic access, which
 1157  may include information regarding the patient’s medical history,
 1158  medical condition, medical treatment, laboratory results,
 1159  diagnostic reports, and clinical notes.
 1160         (d)“Emergency health care service” has the same meaning as
 1161  “emergency services and care” as defined in s. 641.19.
 1162         (e)“Enrollee ineligibility” means that the enrollee was no
 1163  longer enrolled in the health maintenance organization at the
 1164  time of receiving the applicable service.
 1165         (f)“Overpayment” means payment made upon a claim that is:
 1166         1.Billed in error;
 1167         2.A duplicate claim; or
 1168         3.Billed for a service rendered to a patient despite
 1169  enrollee ineligibility.
 1170  
 1171  A request for overpayment is limited to a billing error,
 1172  duplicate bill, or enrollee ineligibility.
 1173         (2) All claims for payment or overpayment, whether
 1174  electronic or nonelectronic:
 1175         (a) Are considered received on the date the claim is
 1176  received by the health maintenance organization at its
 1177  designated claims-receipt location or the date the overpayment a
 1178  claim for overpayment is received by the provider at its
 1179  designated location.
 1180         (b) As to providers’ claims for payment, must be mailed or
 1181  electronically transferred to the primary organization within 6
 1182  months after the following have occurred:
 1183         1. Discharge for inpatient services or the date of service
 1184  for outpatient services; and
 1185         2. The provider has been furnished with the correct name
 1186  and address of the patient’s health maintenance organization.
 1187  
 1188  All providers’ claims for payment, whether electronic or
 1189  nonelectronic, must be mailed or electronically transferred to
 1190  the secondary organization within 45 90 days after final
 1191  determination by the primary organization. A provider’s claim is
 1192  considered submitted on the date it is electronically
 1193  transferred or mailed.
 1194         (c) Must not duplicate a claim previously submitted unless
 1195  it is determined that the original claim was not received or is
 1196  otherwise lost.
 1197         (3) For all electronically submitted claims, a health
 1198  maintenance organization shall:
 1199         (a) Within 24 hours after the beginning of the next
 1200  business day after receipt of the claim, provide to the
 1201  electronic source submitting the claim an electronic
 1202  acknowledgment of the receipt of the claim, accompanied by a
 1203  statement indicating the health maintenance organization’s
 1204  position as to whether the claim is a clean claim or whether the
 1205  claim is missing any information that is required under the
 1206  applicable electronic billing instrument described in paragraph
 1207  (1)(a) or that was reasonably required by the health maintenance
 1208  organization, other than for emergency health care services, in
 1209  advance of the provision of service to substantiate to the
 1210  electronic source submitting the claim, and the health
 1211  maintenance organization asserts is missing as of the date of
 1212  service.
 1213         (b) Within 15 20 days after receipt of the claim, pay the
 1214  claim or notify a provider or designee if a claim is denied or
 1215  contested. Notice of the health maintenance organization’s
 1216  action on the claim and payment of the claim is considered to be
 1217  made on the date the notice or payment was received by the
 1218  provider mailed or electronically transferred.
 1219         (c)1. Notification of the health maintenance organization’s
 1220  determination of a contested claim must be accompanied by an
 1221  itemized list of any additional information required under the
 1222  applicable billing instrument described in paragraph (1)(a) or
 1223  that was reasonably required by the health maintenance
 1224  organization, other than for emergency health care services, in
 1225  advance of the provision of service to substantiate the claim,
 1226  and the health maintenance organization asserts is missing as of
 1227  the date of such service or documents the insurer can reasonably
 1228  determine are necessary to process the claim.
 1229         2. A provider must submit the additional information or
 1230  documentation, as specified on the itemized list, within 30 35
 1231  days after receipt of the notification of contestation unless,
 1232  within the 30-day period, the provider notifies the health
 1233  maintenance organization of the provider’s position that a clean
 1234  claim has been submitted. Additional information is considered
 1235  submitted on the date it is electronically transferred or
 1236  mailed. The health maintenance organization is prohibited from
 1237  requesting may not request duplicate documents.
 1238         (d) For purposes of this subsection, electronic means of
 1239  transmission of claims, notices, documents, forms, and payment
 1240  shall be used to the greatest extent possible by the health
 1241  maintenance organization and the provider.
 1242         (e) A claim contested by the health maintenance
 1243  organization must be paid or denied within 30 90 days after
 1244  receipt of the additional information requested claim. Failure
 1245  to pay or deny a claim within 90 120 days after receipt of the
 1246  claim, regardless of whether contested by the health maintenance
 1247  organization, creates an uncontestable obligation to pay the
 1248  claim.
 1249         (4) For all nonelectronically submitted claims, a health
 1250  maintenance organization shall:
 1251         (a) Within 15 days following receipt of the claim Effective
 1252  November 1, 2003, provide to the provider, or designee, who
 1253  submitted the claim:
 1254         1.An acknowledgment of receipt of the claim, accompanied
 1255  by a statement indicating the health maintenance organization’s
 1256  position as to whether the claim is a clean claim or the claim
 1257  is missing any information that is required under the applicable
 1258  paper billing form, as described in paragraph (1)(a), or that
 1259  was reasonably required by the health maintenance organization,
 1260  other than for emergency health care services, in advance of the
 1261  provision of service to substantiate the claim, and the health
 1262  maintenance organization asserts is missing as of the date of
 1263  service; or
 1264         2.within 15 days after receipt of the claim to the
 1265  provider or designee or provide a provider or designee within 15
 1266  days after receipt with Electronic access to the status of the a
 1267  submitted claim, which status must indicate the health
 1268  maintenance organization’s position as to whether the claim is a
 1269  clean claim or missing any information described in subparagraph
 1270  1.
 1271         (b) Within 30 40 days after receipt of the claim, pay the
 1272  claim or notify a provider or designee if a claim is denied or
 1273  contested. Notice of the health maintenance organization’s
 1274  action on the claim and payment of the claim is considered to be
 1275  made on the date the notice or payment was received by the
 1276  provider mailed or electronically transferred.
 1277         (c)1. Notification of the health maintenance organization’s
 1278  determination of a contested claim must be accompanied by an
 1279  itemized list of any additional information required under the
 1280  applicable form or billing instrument described in paragraph
 1281  (1)(a), or that was reasonably required by the health
 1282  maintenance organization, other than for emergency health care
 1283  services, in advance of the provision of service to substantiate
 1284  the claim, and the health maintenance organization asserts is
 1285  missing as of the date of such service or documents the
 1286  organization can reasonably determine are necessary to process
 1287  the claim.
 1288         2. A provider must submit the additional information or
 1289  documentation, as specified on the itemized list, within 30 35
 1290  days after receipt of the notification of contestation unless,
 1291  within the 30-day period, the provider notifies the health
 1292  maintenance organization of the provider’s position that a clean
 1293  claim has been submitted. Additional information is considered
 1294  submitted on the date it is electronically transferred or
 1295  mailed. The health maintenance organization is prohibited from
 1296  requesting may not request duplicate documents.
 1297         (d) For purposes of this subsection, electronic means of
 1298  transmission of claims, notices, documents, forms, and payments
 1299  must shall be used to the greatest extent possible by the health
 1300  maintenance organization and the provider.
 1301         (e) A claim contested by the health maintenance
 1302  organization must be paid or denied within 30 120 days after
 1303  receipt of the additional information requested claim. Failure
 1304  to pay or deny a claim within 90 140 days after receipt of the
 1305  claim, regardless of whether contested by the health maintenance
 1306  organization, creates an uncontestable obligation to pay the
 1307  claim as submitted by the provider.
 1308         (5)Regardless of whether a claim has been submitted
 1309  electronically or nonelectronically, and notwithstanding any
 1310  other provision of this section:
 1311         (a)Once a provider grants a health maintenance
 1312  organization access to a patient’s electronic medical record,
 1313  the provider is deemed to have supplied all information
 1314  necessary to pay the claim, including, without limitation, all
 1315  information that is required under the applicable billing
 1316  instrument and that was reasonably required by the health
 1317  maintenance organization, other than for emergency health care
 1318  services, in advance of the provision of service to substantiate
 1319  the claim. Additional information or documentation, regardless
 1320  of whether the health maintenance organization requests any
 1321  additional information, is deemed unnecessary and deemed not
 1322  required for payment of the claim, and any request for
 1323  additional information, and any position of the health
 1324  maintenance organization or any third party acting on behalf of
 1325  the health maintenance organization regarding any lack of
 1326  information from the provider, is prohibited from being used to
 1327  deny, reduce, offset, withhold, pend, or delay payment of the
 1328  claim.
 1329         (b)If notice of access to the electronic medical record
 1330  has been provided to the health maintenance organization, the
 1331  claim must be paid or denied within 30 days of such notice to
 1332  the health maintenance organization. Failure to pay or deny a
 1333  claim, for which the health maintenance organization has been
 1334  provided notice of access to the electronic medical record
 1335  within 75 days after receipt of such notice, creates an
 1336  uncontestable obligation to pay the claim as submitted by the
 1337  provider.
 1338         (6)(5) If a health maintenance organization determines that
 1339  it has made an overpayment to a provider for services rendered
 1340  to an enrollee a subscriber, the health maintenance organization
 1341  must make an overpayment a claim for such overpayment to the
 1342  provider’s designated location. A health maintenance
 1343  organization that makes an overpayment a claim for overpayment
 1344  to a provider under this section shall give the provider a
 1345  written or electronic statement specifying the basis for the
 1346  retrospective retroactive denial or payment adjustment. The
 1347  health maintenance organization must also identify the claim or
 1348  claims, or overpayment claim portion thereof, as to which the
 1349  health maintenance organization alleges overpayment, and the
 1350  specific invoice number submitted with or on the claim, as well
 1351  as the specific line items on the bill that are subject to the
 1352  overpayment claim for which a claim for overpayment is
 1353  submitted. Except as provided in subparagraph (a)3., there may
 1354  be no denial, reduction, offset, withholding, pending, or delay
 1355  of payment, or other negative impact, regardless of whether by
 1356  the health maintenance organization or any third party acting on
 1357  behalf of such health maintenance organization, on payment of
 1358  any other claim of the provider on the basis of the overpayment
 1359  allegation.
 1360         (a) If an overpayment determination is the result of
 1361  retrospective retroactive review or retrospective audit of
 1362  coverage decisions or payment levels not related to fraud, a
 1363  health maintenance organization must shall adhere to the
 1364  following procedures:
 1365         1. All overpayment claims for overpayment must be received
 1366  by the submitted to a provider within 18 30 months after the
 1367  health maintenance organization’s payment of the claim. A
 1368  provider must pay, deny, or contest the health maintenance
 1369  organization’s overpayment claim for overpayment within 40 days
 1370  after the receipt of the overpayment claim. All contested
 1371  overpayment claims for overpayment must be paid or denied within
 1372  120 days after receipt of the overpayment claim. Failure to pay
 1373  or deny an overpayment and claim within 140 days after receipt
 1374  creates an uncontestable obligation to pay the overpayment
 1375  claim.
 1376         2. A provider that denies or contests a health maintenance
 1377  organization’s overpayment claim for overpayment or any portion
 1378  of an overpayment a claim shall notify the health maintenance
 1379  organization, in writing, within 40 35 days after the provider
 1380  receives the overpayment claim that the overpayment claim for
 1381  overpayment is contested or denied. The notice that the
 1382  overpayment claim for overpayment is denied or contested must
 1383  identify the denied or contested portion of the claim and the
 1384  specific reason for contesting or denying the overpayment claim
 1385  and, if contested, must include a request for additional
 1386  information. If the health maintenance organization submits
 1387  additional information, the health maintenance organization
 1388  must, within 35 days after receipt of the request, mail or
 1389  electronically transfer the information to the provider. The
 1390  provider shall pay or deny the overpayment claim for overpayment
 1391  within 45 days after receipt of the information. The notice from
 1392  the provider regarding denial or contestation of the overpayment
 1393  claim is considered made on the date the notice is mailed or
 1394  electronically transferred by the provider.
 1395         3. The health maintenance organization is prohibited from
 1396  denying, reducing, offsetting, withholding, pending, or delaying
 1397  may not reduce payment to the provider for other services unless
 1398  the provider agrees to the denial, reduction, offset,
 1399  withholding, pending, or delay of payment in writing or fails to
 1400  respond to the health maintenance organization’s overpayment
 1401  claim as required by this paragraph.
 1402         4. Payment of an overpayment claim is considered made on
 1403  the date the payment was mailed or electronically transferred.
 1404  An overdue payment of a claim bears simple interest at the rate
 1405  of 12 percent per year. Interest on an overdue payment for an
 1406  overpayment a claim for an overpayment payment begins to accrue
 1407  when the overpayment claim should have been paid, denied, or
 1408  contested.
 1409         (b) An overpayment A claim is prohibited for overpayment
 1410  shall not be permitted beyond 18 30 months after the health
 1411  maintenance organization’s payment of a claim, except that
 1412  overpayment claims for overpayment may be sought beyond that
 1413  time from providers convicted of fraud pursuant to s. 817.234.
 1414         (7)(6) Payment of a claim is considered made on the date
 1415  the payment was mailed or electronically transferred to the
 1416  provider. An overdue payment of a claim bears simple interest of
 1417  15 12 percent per year, to be calculated on the full total
 1418  amount that should have been paid on the claim within the
 1419  applicable time period specified in this section. If an
 1420  applicable court, arbitration tribunal, or other binding legal
 1421  process determines that a claim that was paid at a lesser amount
 1422  should have been paid at a full total amount, whether under a
 1423  breach of contract legal claim, a legal claim under a statutory
 1424  private cause of action, or other basis, the 15 percent per year
 1425  interest must be calculated on the full total amount, rather
 1426  than upon the difference between the full total amount and the
 1427  amount that was actually paid. If an applicable court,
 1428  arbitration tribunal, or other binding legal process determines
 1429  that a claim was subject to an inappropriate or impermissible
 1430  denial or partial denial, whether in a breach of contract,
 1431  statute, common law, or otherwise, interest must be calculated
 1432  on the full total amount that should have been paid on the claim
 1433  within the applicable time period for payment specified in this
 1434  section, and the act of denial or partial denial is deemed not
 1435  to have in any way tolled the time period for such payment.
 1436  Interest on the full total amount that should have been paid on
 1437  the claim within the applicable time period specified in this
 1438  section an overdue payment for a claim or for any portion of a
 1439  claim begins to accrue when the claim should have been paid,
 1440  denied, or contested. The interest must be paid along with, and
 1441  in addition to, the payment for the satisfaction of the full
 1442  total amount of the claim, as determined by an applicable court,
 1443  arbitration tribunal, or other binding legal process is payable
 1444  with the payment of the claim.
 1445         (8)(7) For all contracts entered into or renewed on or
 1446  after October 1, 2002, a health maintenance organization’s
 1447  internal dispute resolution process related to a denied claim
 1448  not under active review by a mediator, arbitrator, or third
 1449  party dispute entity must be finalized within 60 days after the
 1450  receipt of the provider’s request for review or appeal.
 1451  Notwithstanding any provision of this section, if the provider
 1452  and health maintenance organization disagree as to the
 1453  interpretation of contractual or statutory language, the
 1454  provider is not required to participate in the health
 1455  maintenance organization’s internal dispute resolution process.
 1456         (9)(8) A provider or any representative of a provider,
 1457  regardless of whether the provider is under contract with the
 1458  health maintenance organization, is prohibited from collecting
 1459  or attempting may not collect or attempt to collect money from,
 1460  maintaining maintain any action at law against, or reporting
 1461  report to a credit agency an enrollee a subscriber for payment
 1462  of covered services for which the health maintenance
 1463  organization contested or denied the provider’s claim. This
 1464  prohibition applies during the pendency of any claim for payment
 1465  made by the provider to the health maintenance organization for
 1466  payment of the services or internal dispute resolution process
 1467  to determine whether the health maintenance organization is
 1468  liable for the services. For a claim, this pendency applies from
 1469  the date the claim or a portion of the claim is denied to the
 1470  date of the completion of the health maintenance organization’s
 1471  internal dispute resolution process, not to exceed 60 days. This
 1472  subsection does not prohibit collection by the provider of
 1473  copayments, coinsurance, or deductible amounts due the provider.
 1474         (9)The provisions of this section may not be waived,
 1475  voided, or nullified by contract.
 1476         (10) A health maintenance organization is prohibited from
 1477  retrospectively denying may not retroactively deny a claim
 1478  because of enrollee subscriber ineligibility more than 90 days 1
 1479  year after the date of payment of the claim.
 1480         (11) A health maintenance organization must shall pay a
 1481  contracted primary care or admitting physician, pursuant to such
 1482  physician’s contract, for providing inpatient services in a
 1483  contracted hospital to an enrollee a subscriber if such services
 1484  are determined by the primary care physician or admitting
 1485  physician health maintenance organization to be medically
 1486  necessary and such services are covered services under the
 1487  health maintenance organization’s contract with the contract
 1488  holder.
 1489         (12) A permissible error ratio of 5 percent is established
 1490  for health maintenance organizations’ claims payment violations
 1491  of paragraphs (3)(a), (b), (c), and (e) and (4)(a), (b), (c),
 1492  and (e). If the error ratio of a particular health maintenance
 1493  organization insurer does not exceed the permissible error ratio
 1494  of 5 percent for an audit period, no fine may shall be assessed
 1495  for the noted claims violations for the audit period. The error
 1496  ratio is shall be determined by dividing the number of claims
 1497  with violations found on a statistically valid sample of claims
 1498  for the audit period by the total number of claims in the
 1499  sample. If the error ratio exceeds the permissible error ratio
 1500  of 5 percent, a fine may be assessed according to s. 624.4211
 1501  for those claims payment violations which exceed the error
 1502  ratio. Notwithstanding the provisions of this section, the
 1503  office may fine a health maintenance organization for claims
 1504  payment violations of paragraphs (3)(e) and (4)(e) which create
 1505  an uncontestable obligation to pay the claim as submitted by the
 1506  provider. The office shall refrain from imposing a not fine upon
 1507  a health maintenance organization organizations for violations
 1508  which the office determines were due to circumstances beyond the
 1509  organization’s control.
 1510         (13) This section applies shall apply to all claims or any
 1511  portion of a claim submitted for payment for services provided
 1512  to an enrollee by a health maintenance organization subscriber
 1513  under a health maintenance organization plan, or submitted for
 1514  payment for services provided to an enrollee under a self
 1515  insured plan or fund, or fully-insured plan or fund, offered by
 1516  a person or an entity, when a health maintenance organization is
 1517  involved in the administration, or claims-processing activities,
 1518  relating to such plan or fund subscriber contract to the
 1519  organization for payment.
 1520         (14) Notwithstanding paragraph (3)(b), where an electronic
 1521  pharmacy claim is submitted to a pharmacy benefits manager
 1522  acting on behalf of a health maintenance organization, the
 1523  pharmacy benefits manager must shall, within 30 days after of
 1524  receipt of the claim, pay the claim or notify a provider or
 1525  designee if a claim is denied or contested. Notice of the health
 1526  maintenance organization’s action on the claim and payment of
 1527  the claim is considered to be made on the date the notice or
 1528  payment was received by the provider mailed or electronically
 1529  transferred.
 1530         (15) Notwithstanding paragraph (4)(a), effective November
 1531  1, 2003, where a nonelectronic pharmacy claim is submitted to a
 1532  pharmacy benefits manager acting on behalf of a health
 1533  maintenance organization, the pharmacy benefits manager shall
 1534  provide acknowledgment of receipt of the claim within 30 days
 1535  after receipt of the claim to the provider or provide a provider
 1536  within 30 days after receipt with electronic access to the
 1537  status of a submitted claim.
 1538         (16) Notwithstanding the 18-month 30-month period provided
 1539  in subsection (6) (5), all claims for overpayment submitted to a
 1540  provider licensed under chapter 395, chapter 458, chapter 459,
 1541  chapter 460, chapter 461, chapter 463, chapter 466, or chapter
 1542  490 must be submitted to the provider within 12 months after the
 1543  health maintenance organization’s payment of the claim. An
 1544  overpayment A claim to a provider licensed under chapter 395,
 1545  458, chapter 459, chapter 460, chapter 461, chapter 463, chapter
 1546  466, or chapter 490 is prohibited for overpayment may not be
 1547  permitted beyond 12 months after the health maintenance
 1548  organization’s payment of a claim, except that claims for
 1549  overpayment may be sought beyond that time from providers
 1550  convicted of fraud pursuant to s. 817.234.
 1551         (17) Notwithstanding any other provision of this section,
 1552  all claims for underpayment from a provider licensed under
 1553  chapter 395, chapter 458, chapter 459, chapter 460, chapter 461,
 1554  or chapter 466 must be submitted to the health maintenance
 1555  organization within 12 months after the health maintenance
 1556  organization’s payment of the claim. A claim for underpayment by
 1557  a provider licensed under chapter 395, chapter 458, chapter 459,
 1558  chapter 460, chapter 461, or chapter 466 is prohibited may not
 1559  be permitted beyond 12 months after the health maintenance
 1560  organization’s payment of a claim.
 1561         (18)Nothing in this section may be interpreted to limit,
 1562  restrict, or negatively impact any legal claim by a provider or
 1563  health maintenance organization for breach of contract,
 1564  statutory or regulatory violation, or a common-law cause of
 1565  action, nor to shorten or otherwise negatively impact the
 1566  statute of limitations timeframe for bringing any such legal
 1567  claim.
 1568         (19)A health insurer is prohibited from requesting
 1569  information from a contracted or noncontracted provider which
 1570  does not apply to the medical condition at issue for the
 1571  purposes of adjudicating a clean claim.
 1572         (20)A health maintenance organization is prohibited from
 1573  requesting a contracted or noncontracted provider to resubmit
 1574  claim information that the contracted or noncontracted provider
 1575  can document it has already provided to the health maintenance
 1576  organization or that is contained inside the electronic medical
 1577  record to which the health maintenance organization has been
 1578  provided access.
 1579         (21)Notwithstanding any other provision of this section, a
 1580  health maintenance organization is prohibited from requiring any
 1581  information from a provider before the provision of emergency
 1582  health care services as a condition of payment of a claim, as a
 1583  basis for denying, delaying, offsetting, withholding, or
 1584  reducing payment of a claim, or in contesting whether the claim
 1585  is a clean claim.
 1586         (22)For a violation of this section, a provider shall have
 1587  a private cause of action to proceed against the health
 1588  maintenance organization in the applicable tribunal for the
 1589  violation.
 1590         Section 5. Paragraph (c) of subsection (2) of section
 1591  395.1065, Florida Statutes, is amended to read:
 1592         395.1065 Criminal and administrative penalties;
 1593  moratorium.—
 1594         (2)
 1595         (c) The agency may impose an administrative fine for the
 1596  violation of s. 641.3154 or, if sufficient claims due to a
 1597  provider from a health maintenance organization do not exist to
 1598  enable the take-back of an overpayment, as provided under s.
 1599  641.3155(6) s. 641.3155(5), for the violation of s. 641.3155(6)
 1600  s. 641.3155(5). The administrative fine for a violation cited in
 1601  this paragraph shall be in the amounts specified in s.
 1602  641.52(5), and the provisions of paragraph (a) do not apply.
 1603         Section 6. This act shall take effect July 1, 2026.