Florida Senate - 2015 SENATOR AMENDMENT
Bill No. CS for CS for SB 258
Ì196180&Î196180
LEGISLATIVE ACTION
Senate . House
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Senator Latvala moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete line 431
4 and insert:
5 Section 11. Effective January 1, 2016, subsection (3) is
6 added to section 627.6474, Florida Statutes, to read:
7 627.6474 Provider contracts.—
8 (3)(a) A health insurer may not require an ophthalmologist
9 licensed pursuant to chapter 458 or chapter 459 or an
10 optometrist licensed pursuant to chapter 463 to join a network
11 solely for the purpose of credentialing the licensee for another
12 insurer’s vision network. This paragraph does not prevent a
13 health insurer from entering into a contract with another
14 insurer’s vision care plan to use the vision network.
15 (b) A health insurer may not restrict or limit an
16 ophthalmologist licensed pursuant to chapter 458 or chapter 459,
17 an optometrist licensed pursuant to chapter 463, or an optician
18 licensed pursuant to part I of chapter 484 to specific suppliers
19 of materials or optical laboratories. This paragraph does not
20 restrict or limit a health insurer in determining specific
21 amounts of coverage or reimbursement for the use of network or
22 out-of-network suppliers or laboratories.
23 (c) A health insurer’s online vision care network provider
24 directory must be updated monthly to reflect the vision care
25 providers currently participating in the health insurer’s
26 network.
27 (d) A knowing violation of paragraph (a) or paragraph (b)
28 constitutes an unfair insurance trade practice under s.
29 626.9541(1)(d).
30 Section 12. Effective January 1, 2016, subsection (14) is
31 added to section 636.035, Florida Statutes, to read:
32 636.035 Provider arrangements.—
33 (14)(a) A prepaid limited health service organization may
34 not require an ophthalmologist licensed pursuant to chapter 458
35 or chapter 459 or an optometrist licensed pursuant to chapter
36 463 to join a network solely for the purpose of credentialing
37 the licensee for another organization’s vision network. This
38 paragraph does not prevent such organization from entering into
39 a contract with another organization’s vision care plan to use
40 the vision network.
41 (b) A prepaid limited health service organization may not
42 restrict or limit an ophthalmologist licensed pursuant to
43 chapter 458 or chapter 459, an optometrist licensed pursuant to
44 chapter 463, or an optician licensed pursuant to part I of
45 chapter 484 to specific suppliers of materials or optical
46 laboratories. This paragraph does not restrict or limit such
47 organization in determining specific amounts of coverage or
48 reimbursement for the use of network or out-of-network suppliers
49 or laboratories.
50 (c) A prepaid limited health service organization’s online
51 vision care network provider directory must be updated monthly
52 to reflect the vision care providers currently participating in
53 the organization’s network.
54 (d) A knowing violation of paragraph (a) or paragraph (b)
55 constitutes an unfair insurance trade practice under s.
56 626.9541(1)(d).
57 Section 13. Effective January 1, 2016, subsection (12) is
58 added to section 641.315, Florida Statutes, to read:
59 641.315 Provider contracts.—
60 (12)(a) A health maintenance organization may not require
61 an ophthalmologist licensed pursuant to chapter 458 or chapter
62 459 or an optometrist licensed pursuant to chapter 463 to join a
63 network solely for the purpose of credentialing the licensee for
64 another organization’s vision network. This paragraph does not
65 prevent such organization from entering into a contract with
66 another organization’s vision care plan to use the vision
67 network.
68 (b) A health maintenance organization may not restrict or
69 limit an ophthalmologist licensed pursuant to chapter 458 or
70 chapter 459, an optometrist licensed pursuant to chapter 463, or
71 an optician licensed pursuant to part I of chapter 484 to
72 specific suppliers of materials or optical laboratories. This
73 paragraph does not restrict or limit such organization in
74 determining specific amounts of coverage or reimbursement for
75 the use of network or out-of-network suppliers or laboratories.
76 (c) A health maintenance organization’s online vision care
77 network provider directory must be updated monthly to reflect
78 the vision care providers currently participating in the
79 organization’s network.
80 (d) A knowing violation of paragraph (a) or paragraph (b)
81 constitutes an unfair insurance trade practice under s.
82 626.9541(1)(d).
83 Section 14. Except as otherwise expressly provided in this
84 act, this act shall take effect July 1, 2015.
85
86 ================= T I T L E A M E N D M E N T ================
87 And the title is amended as follows:
88 Delete lines 2 - 43
89 and insert:
90 An act relating to insurance; amending s. 627.0628,
91 F.S.; requiring an insurer to employ in certain rate
92 filings actuarial methods, principles, standards,
93 models, or output ranges found by the Florida
94 Commission on Hurricane Loss Projection Methodology to
95 be accurate or reliable in determining probable
96 maximum loss levels; authorizing an insurer to employ
97 a model in a rate filing until 120 days after the
98 expiration of the commission’s acceptance of that
99 model; deleting a provision that required insurers to
100 employ a specified model in a rate filing made more
101 than 60 days after the commission found the model to
102 be accurate or reliable; amending s. 627.0651, F.S.;
103 revising provisions for the making and use of rates
104 for motor vehicle insurance; amending s. 627.3518,
105 F.S.; conforming a cross-reference; amending s.
106 627.4133, F.S.; increasing the amount of prior notice
107 required with respect to the nonrenewal, cancellation,
108 or termination of certain insurance policies; deleting
109 certain provisions that require extended periods of
110 prior notice with respect to the nonrenewal,
111 cancellation, or termination of certain insurance
112 policies; prohibiting the cancellation of certain
113 policies that have been in effect for a specified
114 amount of time except under certain circumstances;
115 amending s. 627.4137, F.S.; adding licensed company
116 adjusters to the list of persons who may respond to a
117 claimant’s written request for information relating to
118 liability insurance coverage; amending s. 627.421,
119 F.S.; authorizing a policyholder of personal lines
120 insurance to affirmatively elect delivery of policy
121 documents by electronic means; amending s. 627.7074,
122 F.S.; revising notification requirements for
123 participation in the neutral evaluation program;
124 amending s. 627.736, F.S.; revising the applicability
125 of certain Medicare fee schedules or payment
126 limitations; defining the term “service year”;
127 amending s. 627.744, F.S.; revising the preinsurance
128 inspection requirements for private passenger motor
129 vehicles; repealing s. 631.65, F.S., relating to
130 prohibited advertisement or solicitation; amending ss.
131 627.6474, 636.035, and 641.315, F.S.; providing that a
132 health insurer, a prepaid limited health service
133 organization, and a health maintenance organization,
134 respectively, may not require a licensed
135 ophthalmologist or optometrist to join a network
136 solely for the purpose of credentialing the licensee
137 for another vision network; providing that such
138 insurers and organizations are not prevented by the
139 act from entering into a contract with another vision
140 care plan; providing that such insurers and
141 organizations may not restrict or limit a licensed
142 ophthalmologist, optometrist, or optician to specific
143 suppliers of materials or optical laboratories;
144 providing that such insurers and organizations are not
145 restricted or limited by the act in determining
146 certain amounts of coverage or reimbursement;
147 requiring such insurers’ and organizations’ online
148 vision care network provider directories to be updated
149 monthly; providing that a violation of certain
150 prohibitions in the act constitutes a specified unfair
151 insurance trade practice; providing effective dates.