Florida Senate - 2017                              CS for SB 102
       
       
        
       By the Committee on Rules; and Senators Steube and Farmer
       
       
       
       
       
       595-04125-17                                           2017102c1
    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; providing applicability;
    6         amending s. 641.3155, F.S.; prohibiting a health
    7         maintenance organization from retroactively denying a
    8         claim under specified circumstances; providing
    9         applicability; exempting certain Medicaid managed care
   10         plans; providing an effective date.
   11          
   12  Be It Enacted by the Legislature of the State of Florida:
   13  
   14         Section 1. Subsection (11) of section 627.6131, Florida
   15  Statutes, is amended to read:
   16         627.6131 Payment of claims.—
   17         (11) A health insurer may not retroactively deny a claim
   18  because of insured ineligibility:
   19         (a) At any time, if the health insurer verified the
   20  eligibility of an insured at the time of treatment and provided
   21  an authorization number. This paragraph applies to policies
   22  entered into or renewed on or after January 1, 2018.
   23         (b) More than 1 year after the date of payment of the
   24  claim.
   25         Section 2. Subsection (10) of section 641.3155, Florida
   26  Statutes, is amended to read:
   27         641.3155 Prompt payment of claims.—
   28         (10) A health maintenance organization may not
   29  retroactively deny a claim because of subscriber ineligibility:
   30         (a) At any time, if the health maintenance organization
   31  verified the eligibility of a subscriber at the time of
   32  treatment and provided an authorization number. This paragraph
   33  applies to contracts entered into or renewed on or after January
   34  1, 2018. This paragraph does not apply to Medicaid managed care
   35  plans pursuant to part IV of chapter 409.
   36         (b) More than 1 year after the date of payment of the
   37  claim.
   38         Section 3. This act shall take effect July 1, 2017.