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.