Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. SB 1842
       
       
       
       
       
       
                                Barcode 795776                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Comm: UNFAV           .                                
                  04/18/2013           .                                
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       The Committee on Appropriations (Sobel) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 111 - 143
    4  and insert:
    5         (2) When reviewing forms filed by health insurers or health
    6  maintenance organizations pursuant to s. 627.410 or s. 641.31(3)
    7  for compliance with state law, the office shall also review such
    8  forms for compliance with PPACA. If the office determines that a
    9  form does not comply with PPACA, the office shall notify the
   10  insurer or organization of the reason for noncompliance. If the
   11  insurer or organization does not demonstrate that such form or
   12  its replacement complies with PPACA within 30 days after such
   13  notification, the office shall report such potential violation
   14  to the federal Department of Health and Human Services, except
   15  that the office may elect not to report potential violations it
   16  determines are de minimis. The review of forms by the office
   17  under this subsection does not include review of the rates,
   18  rating practices, or the relationship of benefits to the rate.
   19         (3) When performing market conduct examinations or
   20  investigations of health insurers or health maintenance
   21  organizations as authorized under s. 624.307, s. 624.311, or s.
   22  641.3905 for compliance with state law, the office shall include
   23  compliance with PPACA within the scope of such examinations or
   24  investigations. If the office determines that an insurer’s or
   25  organization’s operations do not comply with PPACA, the office
   26  shall notify the insurer or organization of the reason for such
   27  determination. If the insurer or organization does not
   28  demonstrate compliance with PPACA within 30 days after such
   29  notification, the office shall report such potential violation
   30  to the federal Department of Health and Human Services, except
   31  that the office may elect not to report potential violations it
   32  determines are de minimis.
   33         (4) The department’s Division of Consumer Services shall
   34  respond to complaints by consumers relating to a requirement of
   35  PPACA as authorized under s. 20.121(2)(h), and shall report
   36  apparent or potential violations to the office and to the
   37  federal Department of Health and Human Services.
   38         (5) A determination made by the office or department
   39  pursuant to this section regarding compliance with PPACA does
   40  not constitute a determination that affects the substantial
   41  interests of any party for purposes of chapter 120.
   42         (6) The office and department shall maintain on their
   43  respective websites an updated list of all potential or apparent
   44  violations of PPACA reported to the federal Department of Health
   45  and Human Services pursuant to this section.
   46  
   47  ================= T I T L E  A M E N D M E N T ================
   48         And the title is amended as follows:
   49         Delete lines 7 - 18
   50  and insert:
   51         requiring the Office of Insurance Regulation to review
   52         forms and perform market conduct examinations for
   53         compliance with PPACA and to report potential
   54         violations to the federal Department of Health and
   55         Human Services; requiring the Division of Consumer
   56         Services of the Department of Financial Services to
   57         respond to complaints related to PPACA and to report
   58         violations to the office and the Department of Health
   59         and Human Services; providing that certain
   60         determinations by the office or the Department of
   61         Financial Services are not subject to certain
   62         challenges under ch. 120, F.S.; requiring the office
   63         and department to maintain a list of reported
   64         violations on their websites; amending ss. 624.34,