Senate Bill sb1088

    Florida Senate - 2004                                  SB 1088

    By Senator Cowin





    20-764-04

  1                      A bill to be entitled

  2         An act relating to provider contracts for

  3         health care services; amending s. 641.315,

  4         F.S.; requiring that a health maintenance

  5         organization disclose to the provider the

  6         schedule of fees for which the health

  7         maintenance organization and the provider of

  8         health care services have contracted, including

  9         any additional deviations; providing an

10         effective date.

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12  Be It Enacted by the Legislature of the State of Florida:

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14         Section 1.  Subsection (4) of section 641.315, Florida

15  Statutes, is amended to read:

16         641.315 Provider contracts.--

17         (4)  Whenever a contract exists between a health

18  maintenance organization and a provider, the health

19  maintenance organization shall disclose to the provider:

20         (a)  The mailing address or electronic address where

21  claims should be sent for processing;

22         (b)  The telephone number that a provider may call to

23  have questions and concerns regarding claims addressed; and

24         (c)  The address of any separate claims-processing

25  centers for specific types of services; and.

26         (d)  The schedule of fees for which the health

27  maintenance organization and the provider of health care

28  services have contracted, including any additional deviations

29  from the contracted schedule of fees requested by the health

30  maintenance organization and agreed upon by the provider of

31  the health care services.

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 1088
    20-764-04




 1  

 2  A health maintenance organization shall provide to its

 3  contracted providers no less than 30 calendar days' prior

 4  written notice of any changes in the information required in

 5  this subsection.

 6         Section 2.  This act shall take effect upon becoming a

 7  law.

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10                          SENATE SUMMARY

11    Provides that a health maintenance organization must
      disclose to the provider the schedule of fees for which
12    the health maintenance organization and the provider of
      health care services have contracted, including any
13    deviations from the contracted schedule of fees.

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CODING: Words stricken are deletions; words underlined are additions.