Florida Senate - 2026                                      SB 46
       
       
        
       By Senator Sharief
       
       
       
       
       
       35-00008A-26                                            202646__
    1                        A bill to be entitled                      
    2         An act relating to nonparticipating and out-of-network
    3         nurse registries and home health agencies; creating
    4         ss. 110.1236, 409.9055, 409.9755, 627.64744, and
    5         641.3152, F.S.; prohibiting state group health
    6         insurance plans and state-contracted health
    7         maintenance organizations, the Agency for Health Care
    8         Administration, Medicaid managed care plans,
    9         individual health insurers, and health maintenance
   10         organizations, respectively, and any persons
   11         responsible for administering claims on behalf of such
   12         plans, organizations, agency, or insurers, from
   13         restricting participants, recipients, enrollees,
   14         policyholders, and subscribers from obtaining care
   15         from nonparticipating or out-of-network licensed nurse
   16         registries or home health agencies; prohibiting such
   17         entities and plans from steering, requiring, or unduly
   18         influencing selection of nurse registries or home
   19         health agencies; requiring that nonparticipating or
   20         out-of-network nurse registries and home health
   21         agencies be reimbursed at the same rate as in-network
   22         providers; amending s. 627.662, F.S.; revising
   23         applicability for group health insurance, blanket
   24         health insurance, and franchise health insurance;
   25         providing an effective date.
   26          
   27  Be It Enacted by the Legislature of the State of Florida:
   28  
   29         Section 1. Section 110.1236, Florida Statutes, is created
   30  to read:
   31         110.1236 State group health insurance plan prohibited
   32  practices; nonparticipating and out-of-network nurse registries
   33  and home health agencies.—A state group health insurance plan,
   34  state-contracted HMO, or other insurance plan under the state
   35  group insurance program, or any person responsible for
   36  administering claims on behalf of the state group health
   37  insurance plan, state-contracted HMO, or other insurance plan
   38  under the state group insurance program, may not restrict
   39  participants from obtaining care from nonparticipating or out
   40  of-network nurse registries or home health agencies licensed
   41  under part III of chapter 400. Such plans, entities, or persons
   42  may not steer, require, or unduly influence a participant to use
   43  preferred or in-network nurse registries or home health
   44  agencies. Nonparticipating and out-of-network nurse registries
   45  and home health agencies licensed under part III of chapter 400
   46  must be reimbursed at the same rate as in-network providers for
   47  equivalent services under the plan.
   48         Section 2. Section 409.9055, Florida Statutes, is created
   49  to read:
   50         409.9055 Medicaid prohibited practices; nonparticipating
   51  and out-of-network nurse registries and home health agencies.
   52  The agency, or any person responsible for administering claims
   53  on behalf of the agency, may not restrict Medicaid recipients
   54  from obtaining care from nonparticipating or out-of-network
   55  nurse registries or home health agencies licensed under part III
   56  of chapter 400. The agency or person may not steer, require, or
   57  unduly influence a Medicaid recipient to use preferred or
   58  participating nurse registries or home health agencies.
   59  Nonparticipating and out-of-network nurse registries and home
   60  health agencies licensed under part III of chapter 400 must be
   61  reimbursed at the same rate as participating or in-network
   62  providers for equivalent services under the plan.
   63         Section 3. Section 409.9755, Florida Statutes, is created
   64  to read:
   65         409.9755 Managed care plan prohibited practices;
   66  nonparticipating and out-of-network nurse registries and home
   67  health agencies.—A Medicaid managed care plan, or any person
   68  responsible for administering claims on behalf of the plan, may
   69  not restrict enrollees from obtaining care from nonparticipating
   70  or out-of-network nurse registries or home health agencies
   71  licensed under part III of chapter 400. Such plan or person may
   72  not steer, require, or unduly influence an enrollee to use
   73  preferred or participating nurse registries or home health
   74  agencies. Nonparticipating and out-of-network nurse registries
   75  and home health agencies licensed under part III of chapter 400
   76  must be reimbursed at the same rate as participating or in
   77  network providers for equivalent services under the plan.
   78         Section 4. Section 627.64744, Florida Statutes, is created
   79  to read:
   80         627.64744 Policy prohibitions; nonparticipating and out-of
   81  network nurse registries and home health agencies.—Any health
   82  insurer issuing a policy of health insurance in this state, or
   83  any person responsible for administering claims on behalf of
   84  such insurer, may not restrict policyholders from obtaining care
   85  from nonparticipating or out-of-network nurse registries or home
   86  health agencies licensed under part III of chapter 400.
   87  Notwithstanding s. 627.6471, such insurer or person may not
   88  steer, require, or unduly influence a policyholder to use
   89  preferred or in-network nurse registries or home health
   90  agencies. Notwithstanding s. 627.64194, nonparticipating and
   91  out-of-network nurse registries and home health agencies
   92  licensed under part III of chapter 400 must be reimbursed at the
   93  same rate as preferred or in-network providers for equivalent
   94  services under the policy.
   95         Section 5. Subsection (16) is added to section 627.662,
   96  Florida Statutes, to read:
   97         627.662 Other provisions applicable.—The following
   98  provisions apply to group health insurance, blanket health
   99  insurance, and franchise health insurance:
  100         (16) Section 627.64744, relating to policy prohibitions and
  101  nonparticipating and out-of-network nurse registries and home
  102  health agencies.
  103         Section 6. Section 641.3152, Florida Statutes, is created
  104  to read:
  105         641.3152 Policy prohibitions; nonparticipating and out-of
  106  network nurse registries and home health agencies.—A health
  107  maintenance organization providing health services in this
  108  state, or any person responsible for administering claims on
  109  behalf of such organization, may not restrict subscribers from
  110  obtaining care from nonparticipating or out-of-network nurse
  111  registries or home health agencies licensed under part III of
  112  chapter 400. Such organization or person may not steer, require,
  113  or unduly influence a subscriber to use preferred or in-network
  114  nurse registries or home health agencies. Notwithstanding s.
  115  627.64194, nonparticipating and out-of-network nurse registries
  116  and home health agencies licensed under part III of chapter 400
  117  must be reimbursed at the same rate as preferred or in-network
  118  providers for equivalent services under the contract.
  119         Section 7. This act shall take effect July 1, 2026.