CODING: Words stricken are deletions; words underlined are additions.
SENATE AMENDMENT
Bill No. CS/CS/HB 591, 2nd Eng.
Amendment No. ___
CHAMBER ACTION
Senate House
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11 Senator King moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 41, between lines 14 and 15,
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16 insert:
17 Section 19. Subsection (39) is added to section
18 641.31, Florida Statutes, to read:
19 641.31 Health maintenance contracts.--
20 (39) A health maintenance organization contract may
21 not prohibit or restrict a subscriber from receiving inpatient
22 services in a contracted hospital from a contracted primary
23 care or admitting physician if such services are determined by
24 the organization to be medically necessary and covered
25 services under the organization's contract with the contract
26 holder.
27 Section 20. Subsection (11) is added to section
28 641.315, Florida Statutes, to read:
29 641.315 Provider contracts.--
30 (11) A contract between a health maintenance
31 organization and a contracted primary care or admitting
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SENATE AMENDMENT
Bill No. CS/CS/HB 591, 2nd Eng.
Amendment No. ___
1 physician may not contain any provision that prohibits such
2 physician from providing inpatient services in a contracted
3 hospital to a subscriber if such services are determined by
4 the organization to be medically necessary and covered
5 services under the organization's contract with the contract
6 holder.
7 Section 21. Subsection (5) is added to section
8 641.3155, Florida Statutes, to read:
9 641.3155 Provider contracts; payment of claims.--
10 (5) A health maintenance organization shall pay a
11 contracted primary care or admitting physician, pursuant to
12 such physician's contract, for providing inpatient services in
13 a contracted hospital to a subscriber, if such services are
14 determined by the organization to be medically necessary and
15 covered services under the organization's contract with the
16 contract holder; provided, however, that the physician shall
17 not be reimbursed twice for the same service.
18 Section 22. Sections 19 through 21 shall take effect
19 July 1, 2000, and shall apply to provider contracts entered
20 into or renewed on or after that date.
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22 (Redesignate subsequent sections.)
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26 And the title is amended as follows:
27 On page 3, line 11, after the semicolon
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30 An act relating to health care; amending ss.
31 641.31, 641.315, and 641.3155, F.S.;
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SENATE AMENDMENT
Bill No. CS/CS/HB 591, 2nd Eng.
Amendment No. ___
1 prohibiting a health maintenance organization
2 from restricting a provider's ability to
3 provide inpatient hospital services to a
4 subscriber; requiring payment for medically
5 necessary inpatient hospital services;
6 providing a limitation;
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