Florida Senate - 2017                                     SB 102
       
       
        
       By Senator Steube
       
       23-00267-17                                            2017102__
    1                        A bill to be entitled                      
    2         An act relating to the payment of health care claims;
    3         amending s. 627.6131, F.S.; prohibiting a health
    4         insurer from retroactively denying a claim under
    5         specified circumstances; amending s. 641.3155, F.S.;
    6         prohibiting a health maintenance organization from
    7         retroactively denying a claim under specified
    8         circumstances; providing an effective date.
    9          
   10  Be It Enacted by the Legislature of the State of Florida:
   11  
   12         Section 1. Subsection (11) of section 627.6131, Florida
   13  Statutes, is amended to read:
   14         627.6131 Payment of claims.—
   15         (11) A health insurer may not retroactively deny a claim
   16  because of insured ineligibility:
   17         (a) At any time, if the health insurer verified the
   18  eligibility of an insured at the time of treatment and provided
   19  an authorization number.
   20         (b) More than 1 year after the date of payment of the
   21  claim.
   22         Section 2. Subsection (10) of section 641.3155, Florida
   23  Statutes, is amended to read:
   24         641.3155 Prompt payment of claims.—
   25         (10) A health maintenance organization may not
   26  retroactively deny a claim because of subscriber ineligibility:
   27         (a) At any time, if the health maintenance organization
   28  verified the eligibility of an insured at the time of treatment
   29  and provided an authorization number.
   30         (b) More than 1 year after the date of payment of the
   31  claim.
   32         Section 3. This act shall take effect July 1, 2017.