Senate Bill 1534c1
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    Florida Senate - 2000                           CS for SB 1534
    By the Committee on Banking and Insurance; and Senator Geller
    311-2169-00
  1                      A bill to be entitled
  2         An act relating to health maintenance
  3         organizations; amending s. 641.201, F.S.;
  4         clarifying applicability of the Florida
  5         Insurance Code to health maintenance
  6         organizations; amending s. 641.234, F.S.;
  7         providing conditions under which the Department
  8         of Insurance may order a health maintenance
  9         organization to cancel a contract; amending s.
10         641.27, F.S.; providing for payment by a health
11         maintenance organization of fees to outside
12         examiners appointed by the Department of
13         Insurance; creating s. 641.226, F.S.; providing
14         for application of federal solvency
15         requirements to provider-sponsored
16         organizations; creating s. 641.39, F.S.;
17         prohibiting the solicitation or acceptance of
18         contracts by insolvent or impaired health
19         maintenance organizations; providing a criminal
20         penalty; creating s. 641.2011, F.S.; providing
21         that part IV of ch. 628, F.S., applies to
22         health maintenance organizations; providing an
23         effective date.
24
25  Be It Enacted by the Legislature of the State of Florida:
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27         Section 1.  Section 641.201, Florida Statutes, is
28  amended to read:
29         641.201  Applicability of other laws.--Except as
30  provided in this part, health maintenance organizations shall
31  be governed by the provisions of this part and part III of
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    Florida Senate - 2000                           CS for SB 1534
    311-2169-00
  1  this chapter and shall be exempt from all other provisions of
  2  the Florida Insurance Code except those provisions of the
  3  Florida Insurance Code that are explicitly made applicable to
  4  health maintenance organizations.
  5         Section 2.  Section 641.234, Florida Statutes, is
  6  amended to read:
  7         641.234  Administrative, provider, and management
  8  contracts.--
  9         (1)  The department may require a health maintenance
10  organization to submit any contract for administrative
11  services, contract with a provider other than an individual
12  physician, contract for management services, and contract with
13  an affiliated entity to the department.
14         (2)  After review of a contract the department may
15  order the health maintenance organization to cancel the
16  contract in accordance with the terms of the contract and
17  applicable law if it determines:
18         (a)  That the fees to be paid by the health maintenance
19  organization under the contract are so unreasonably high as
20  compared with similar contracts entered into by the health
21  maintenance organization or as compared with similar contracts
22  entered into by other health maintenance organizations in
23  similar circumstances that the contract is detrimental to the
24  subscribers, stockholders, investors, or creditors of the
25  health maintenance organization; or.
26         (b)  That the contract is with an entity that is not
27  licensed under state statutes, if such license is required, or
28  is not in good standing with the applicable regulatory agency.
29         (3)  All contracts for administrative services,
30  management services, provider services other than individual
31  physician contracts, and with affiliated entities entered into
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    Florida Senate - 2000                           CS for SB 1534
    311-2169-00
  1  or renewed by a health maintenance organization on or after
  2  October 1, 1988, shall contain a provision that the contract
  3  shall be canceled upon issuance of an order by the department
  4  pursuant to this section.
  5         Section 3.  Subsection (2) of section 641.27, Florida
  6  Statutes, is amended to read:
  7         641.27  Examination by the department.--
  8         (2)  The department may contract, at reasonable fees
  9  for work performed, with qualified, impartial outside sources
10  to perform audits or examinations or portions thereof
11  pertaining to the qualification of an entity for issuance of a
12  certificate of authority or to determine continued compliance
13  with the requirements of this part, in which case the payment
14  must be made, directly to the contracted examiner by the
15  health maintenance organization examined, in accordance with
16  the rates and terms agreed to by the department and the
17  examiner. Any contracted assistance shall be under the direct
18  supervision of the department.  The results of any contracted
19  assistance shall be subject to the review of, and approval,
20  disapproval, or modification by, the department.
21         Section 4.  Section 641.226, Florida Statutes, is
22  created to read:
23         641.226  Application of federal solvency requirements
24  to provider-sponsored organizations.--The solvency
25  requirements of sections 1855 and 1856 of the Balanced Budget
26  Act of 1997 and rules adopted by the Secretary of the United
27  States Department of Health and Human Services apply to a
28  health maintenance organization that is a provider-sponsored
29  organization rather than the solvency requirements of this
30  part. However, if the provider-sponsored organization does not
31  meet the solvency requirements of this part, the organization
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    Florida Senate - 2000                           CS for SB 1534
    311-2169-00
  1  is limited to the issuance of Medicare+Choice plans to
  2  eligible individuals. For the purposes of this section, the
  3  terms "Medicare+Choice plans," "provider-sponsored
  4  organizations," and "solvency requirements" have the same
  5  meaning as defined in the federal act and federal rules and
  6  regulations.
  7         Section 5.  Section 641.39, Florida Statutes, is
  8  created to read:
  9         641.39  Soliciting or accepting new or renewal health
10  maintenance contracts by insolvent or impaired health
11  maintenance organization prohibited; penalty.--
12         (1)  Whether or not delinquency proceedings as to a
13  health maintenance organization have been or are to be
14  initiated, a director or officer of a health maintenance
15  organization, except with the written permission of the
16  Department of Insurance, may not authorize or permit the
17  health maintenance organization to solicit or accept new or
18  renewal health maintenance contracts or provider contracts in
19  this state after the director or officer knew, or reasonably
20  should have known, that the health maintenance organization
21  was insolvent or impaired. As used in this section, the term
22  "impaired" means that the health maintenance organization does
23  not meet the requirements of s. 641.225.
24         (2)  Any director or officer who violates this section
25  is guilty of a felony of the third degree, punishable as
26  provided in s. 775.082, s. 775.083, or s. 775.084.
27         Section 6.  Section 641.2011, Florida Statutes, is
28  created to read:
29         641.2011  Insurance holding companies.--Part IV of
30  chapter 628 applies to health maintenance organizations
31  licensed under part I of chapter 641.
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    Florida Senate - 2000                           CS for SB 1534
    311-2169-00
  1         Section 7.  This act shall take effect July 1, 2000.
  2
  3          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  4                         Senate Bill 1534
  5
  6  Removes the provision specifying that health maintenance
    organizations (HMOs) remain ultimately liable to providers
  7  regardless of the terms of the health care risk contract.
  8  Deletes the requirements that HMOs utilize independent
    actuaries and reserve or otherwise secure obligations under
  9  health care risk contracts.
10  Removes the requirement that HMOs annually report a summary of
    all contracts with entities which have assumed more than 1
11  percent of the health care risk of the HMO. Deletes the
    provision which repealed the law requiring HMOs to annually
12  report contracts with entities that assumed more than 10
    percent of such risk of the HMO.
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    Deletes the provision allowing subscribers, providers and HMOs
14  to request a rehearing of a grievance before the Statewide
    Provider and Subscriber Assistance Panel.
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    Removes the provision authorizing HMO subscribers and
16  providers to request a summary administrative hearing and
    removes the provision assessing costs and attorney's fees if
17  an HMO subscriber and provider brings a frivolous
    administrative action.
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