Florida Senate - 2026 SB 114
By Senator Jones
34-00378-26 2026114__
1 A bill to be entitled
2 An act relating to continuity of care in health
3 insurance contracts; amending s. 627.6474, F.S.;
4 requiring that contracts between a health insurer and
5 a contracted health care practitioner require a
6 specified notice; specifying requirements for such
7 notice; authorizing the Financial Services Commission
8 to adopt rules; providing administrative penalties;
9 requiring a health insurer and a health care
10 practitioner to allow certain policyholders to
11 continue coverage and care for a specified timeframe;
12 requiring the insurer and the health care practitioner
13 to be bound by the terminated contract under certain
14 circumstances; specifying that changes to the contract
15 made within a specified timeframe are effective only
16 under certain circumstances; amending s. 641.315,
17 F.S.; requiring that certain health maintenance
18 organization contracts require a specified notice;
19 specifying requirements for such notice; authorizing
20 the commission to adopt rules; providing
21 administrative penalties; amending s. 641.51, F.S.;
22 requiring a health maintenance organization and a
23 treating provider to allow certain subscribers to
24 continue coverage and care for a specified timeframe;
25 deleting construction; providing an effective date.
26
27 Be It Enacted by the Legislature of the State of Florida:
28
29 Section 1. Subsections (4) and (5) are added to section
30 627.6474, Florida Statutes, to read:
31 627.6474 Provider contracts.—
32 (4)(a) A contract between a health insurer and a contracted
33 health care practitioner as defined in s. 456.001 must require
34 the health insurer and the contracted health care practitioner
35 to issue a joint written notice to each affected policyholder at
36 least 60 days before the effective date of the cancellation or
37 termination of the contract. The notice must be written in plain
38 language and include all of the following:
39 1. An explanation of the policyholder’s rights regarding
40 continuation of care and coverage.
41 2. Applicable timelines for transition of care.
42 3. Contact information for the insurer, the practitioner,
43 and the office for questions or complaints.
44 (b) The commission may adopt rules to administer paragraph
45 (a). The office may impose an administrative fine of up to
46 $5,000 for each violation to a health insurer or contracted
47 health care practitioner that fails to comply with paragraph
48 (a).
49 (5) When a contract between an insurer and a treating
50 health care practitioner as defined in s. 456.001 is terminated
51 for any reason, the insurer and the health care practitioner
52 must allow policyholders for whom treatment was active to
53 continue coverage and care, through completion of treatment of a
54 condition for which the policyholder was receiving care at the
55 time of the termination, until the policyholder selects another
56 treating health care practitioner, or during the next open
57 enrollment period offered by the organization, whichever is
58 longer, but not longer than 6 months after termination of the
59 contract. The insurer and the health care practitioner shall
60 allow a policyholder who has initiated a course of prenatal
61 care, regardless of the trimester in which care was initiated,
62 to continue care and coverage until completion of postpartum
63 care. For care continued under this subsection, the insurer and
64 the health care practitioner shall continue to be bound by the
65 terms of the terminated contract. Changes made within 30 days
66 before termination of a contract are effective only if agreed to
67 by both the insurer and the practitioner.
68 Section 2. Paragraph (a) of subsection (2) of section
69 641.315, Florida Statutes, is amended to read:
70 641.315 Provider contracts.—
71 (2)(a) For all provider contracts executed after October 1,
72 1991, and within 180 days after October 1, 1991, for contracts
73 in existence as of October 1, 1991:
74 1. The Contracts must require the provider to give 60 days’
75 advance written notice to the health maintenance organization
76 and the office before canceling the contract with the health
77 maintenance organization for any reason.; and
78 2. Contracts The contract must also provide that nonpayment
79 for goods or services rendered by the provider to the health
80 maintenance organization is not a valid reason for avoiding the
81 60-day advance notice of cancellation.
82 3. Contracts must require the health maintenance
83 organization and the provider to issue a joint written notice to
84 each affected subscriber at least 60 days before the effective
85 date of the cancellation or termination of the provider
86 contract. The notice must be written in plain language and
87 include all of the following:
88 a. An explanation of the subscriber’s rights regarding
89 continuation of care and coverage.
90 b. Applicable timelines for transition of care.
91 c. Contact information for the health maintenance
92 organization, the provider, and the Office of Insurance
93 Regulation for questions or complaints.
94 4. The commission may adopt rules to administer
95 subparagraph 3. A health maintenance organization or provider
96 that fails to comply with subparagraph 3. is subject to an
97 administrative fine by the office of up to $5,000 for each
98 violation.
99 Section 3. Subsection (8) of section 641.51, Florida
100 Statutes, is amended to read:
101 641.51 Quality assurance program; second medical opinion
102 requirement.—
103 (8) When a contract between an organization and a treating
104 provider is terminated for any reason other than for cause, each
105 party shall allow subscribers for whom treatment was active to
106 continue coverage and care when medically necessary, through
107 completion of treatment of a condition for which the subscriber
108 was receiving care at the time of the termination, until the
109 subscriber selects another treating provider, or during the next
110 open enrollment period offered by the organization, whichever is
111 longer, but not longer than 6 months after termination of the
112 contract. Each party to the terminated contract shall allow a
113 subscriber who has initiated a course of prenatal care,
114 regardless of the trimester in which care was initiated, to
115 continue care and coverage until completion of postpartum care.
116 This does not prevent a provider from refusing to continue to
117 provide care to a subscriber who is abusive, noncompliant, or in
118 arrears in payments for services provided. For care continued
119 under this subsection, the organization and the provider shall
120 continue to be bound by the terms of the terminated contract.
121 Changes made within 30 days before termination of a contract are
122 effective only if agreed to by both parties.
123 Section 4. This act shall take effect July 1, 2026.