Florida Senate - 2013 SB 510 By Senator Legg 17-00477A-13 2013510__ 1 A bill to be entitled 2 An act relating to health insurance; amending ss. 3 627.6471 and 641.31, F.S.; requiring health insurers 4 and health maintenance organizations to allow an 5 insured to continue to use the services of preferred 6 providers or network providers on the list of 7 preferred providers or network providers at the time 8 of the insured’s enrollment for a minimum period of 9 time; requiring health maintenance organizations to 10 provide subscribers with a current list of network 11 providers and make the list available for public 12 inspection at certain times and places; requiring 13 health insurers and health maintenance organizations 14 to pay certain providers who have been terminated from 15 a panel for health services provided to insureds under 16 certain circumstances; providing an effective date. 17 18 Be It Enacted by the Legislature of the State of Florida: 19 20 Section 1. Subsection (2) of section 627.6471, Florida 21 Statutes, is amended to read: 22 627.6471 Contracts for reduced rates of payment; 23 limitations; coinsurance and deductibles.— 24 (2) Any insurer issuing a policy of health insurance in 25 this state, which insurance includes coverage for the services 26 of a preferred provider, must provide each policyholder and 27 certificateholder with a current list of preferred providers and 28 must make the list available for public inspection during 29 regular business hours at the principal office of the insurer 30 within the state. An insurer must: 31 (a) Allow any policyholder or certificateholder to continue 32 to use the services of any provider on the preferred provider 33 list on the date of the policyholder’s or certificateholder’s 34 enrollment for at least 1 year after the date of enrollment. 35 (b) Pay any provider who has been terminated from the panel 36 without cause for covered services rendered by the provider to a 37 policyholder or certificateholder who continues to use the 38 services of the provider during the minimum period authorized 39 under paragraph (a). Payment to a terminated provider under this 40 paragraph must be made by an insurer in accordance with the 41 terms of the provider contract in effect on the date of the 42 provider’s termination. 43 Section 2. Subsection (44) is added to section 641.31, 44 Florida Statutes, to read: 45 641.31 Health maintenance contracts.— 46 (44) A health maintenance organization must provide each 47 subscriber with a current list of network providers and must 48 make the list available for public inspection during regular 49 business hours at the principal office of the health maintenance 50 organization within the state. A health maintenance organization 51 must: 52 (a) Allow any subscriber to continue to use the services of 53 any provider on the network provider list on the date of the 54 subscriber’s enrollment for at least 1 year after the date of 55 enrollment. 56 (b) Pay any provider who has been terminated from the panel 57 without cause for covered services rendered by the provider to a 58 subscriber who continues to use the services of the provider 59 during the minimum period authorized under paragraph (a). 60 Payment to a terminated provider under this paragraph must be 61 made by a health maintenance organization in accordance with the 62 terms of the provider contract in effect on the date of the 63 provider’s termination. 64 Section 3. This act shall take effect October 1, 2013.