Florida Senate - 2016                          SENATOR AMENDMENT
       Bill No. CS for CS for CS for SB 1442
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 2/AD/2R         .                                
             03/02/2016 11:14 AM       .                                
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       Senator Negron moved the following:
       
    1         Senate Substitute for Amendment (418906) (with title
    2  amendment)
    3  
    4         Before line 50
    5  insert:
    6         Section 1. Subsection (11) of section 627.6131, Florida
    7  Statutes, is amended to read:
    8         627.6131 Payment of claims.—
    9         (11) A health insurer may not retroactively deny a claim
   10  because of insured ineligibility:
   11         (a) At any time, if the health insurer verified the
   12  eligibility of an insured who is not a recipient of advance
   13  payments of the federal premium tax credit and the insurer
   14  issued an authorization for payment to a provider.
   15         (b) For services authorized by the insurer and rendered
   16  during the first 30 days of a federally required grace period
   17  when an insured is a recipient of advance payments of the
   18  federal premium tax credit.
   19         (c) More than 1 year after the date of payment of the
   20  claim.
   21         Section 2. Subsection (10) of section 641.3155, Florida
   22  Statutes, is amended to read:
   23         641.3155 Prompt payment of claims.—
   24         (10) A health maintenance organization may not
   25  retroactively deny a claim because of subscriber ineligibility:
   26         (a) At any time, if the health maintenance organization
   27  verified the eligibility of a subscriber who is not a recipient
   28  of advance payments of the federal premium tax credit and the
   29  health maintenance organization issued an authorization for
   30  payment to a provider.
   31         (b) For services authorized by the health maintenance
   32  organization and rendered during the first 30 days of a
   33  federally required grace period when a subscriber is a recipient
   34  of advance payments of the federal premium tax credit.
   35         (c) More than 1 year after the date of payment of the
   36  claim.
   37  
   38  ================= T I T L E  A M E N D M E N T ================
   39  And the title is amended as follows:
   40         Delete lines 2 - 3
   41  and insert:
   42         An act relating to health care services; amending s.
   43         627.6131, F.S.; prohibiting a health insurer from
   44         retroactively denying a claim under specified
   45         circumstances; amending s. 641.3155, F.S.; prohibiting
   46         a health maintenance organization from retroactively
   47         denying a claim under specified circumstances;
   48         amending s. 395.003, F.S.; requiring