ENROLLED
       2009 Legislature                   CS for SB 1122, 1st Engrossed
       
       
       
       
       
       
                                                             20091122er
    1  
    2         An act relating to health insurance; amending s.
    3         627.638, F.S.; requiring that an insurer make payment
    4         to the designated provider of services whenever an
    5         insured, using any health insurance claim form,
    6         specifically authorizes payment of benefits directly
    7         to any recognized hospital, licensed ambulance
    8         provider, physician, dentist, or other person who
    9         provided the services in accordance with the
   10         provisions of the policy; deleting an exception;
   11         providing that the insurance contract may not prohibit
   12         payment of benefits directly to such providers;
   13         requiring that claims forms provide an option for such
   14         payment; providing for the repeal of the amendments
   15         made by the act if the Office of Program Policy
   16         Analysis and Government Accountability finds that such
   17         amendments have caused the third-party administrator
   18         of the state group health plan to suffer a net loss of
   19         physicians and an increase in costs to the plan;
   20         providing an effective date.
   21  
   22  Be It Enacted by the Legislature of the State of Florida:
   23  
   24         Section 1. Subsection (2) of section 627.638, Florida
   25  Statutes, is amended to read:
   26         627.638 Direct payment for hospital, medical services.—
   27         (2) Whenever, in any health insurance claim form, an
   28  insured specifically authorizes payment of benefits directly to
   29  any recognized hospital, licensed ambulance provider, physician,
   30  or dentist, or other person who provided the services in
   31  accordance with the provisions of the policy, the insurer shall
   32  make such payment to the designated provider of such services,
   33  unless otherwise provided in the insurance contract. The
   34  insurance contract may not prohibit, and claims forms must
   35  provide an option for, the payment of benefits directly to a
   36  licensed hospital, licensed ambulance provider, physician, or
   37  dentist, or other person who provided the services in accordance
   38  with the provisions of the policy for care provided pursuant to
   39  s. 395.1041 or part III of chapter 401. The insurer may require
   40  written attestation of assignment of benefits. Payment to the
   41  provider from the insurer may not be more than the amount that
   42  the insurer would otherwise have paid without the assignment.
   43         Section 2. The amendments made by this act to s.
   44  627.638(2), Florida Statutes, are repealed on July 1, 2012, if
   45  the Office of Program Policy Analysis and Government
   46  Accountability finds, in a study to be presented to the
   47  President of the Senate and the Speaker of the House of
   48  Representatives by March 1, 2012, that the amendments made by
   49  this act have caused the third-party administrator of the state
   50  group health plan to suffer a net loss of physicians from its
   51  preferred provider plan network and, as a direct result, caused
   52  an increase in costs to the state group health plan. If such a
   53  finding is made, the text of s. 627.638(2), Florida Statutes,
   54  shall revert to that in existence on June 30, 2009, except that
   55  any amendments to such text enacted other than by this act shall
   56  be preserved and continue to operate to the extent that such
   57  amendments are not dependent upon the portions of such text
   58  which are repealed pursuant to this section.
   59         Section 3. This act shall take effect July 1, 2009.