Florida Senate - 2021                                    SB 1388
       
       
        
       By Senator Harrell
       
       
       
       
       
       25-01465-21                                           20211388__
    1                        A bill to be entitled                      
    2         An act relating to payment of health insurance claims;
    3         amending s. 627.6131, F.S.; prohibiting health
    4         insurers, at any time, from retroactively denying a
    5         claim because of the ineligibility of the insured if
    6         the insurer verified the insured’s eligibility at the
    7         time of treatment or provided an authorization number;
    8         amending s. 641.3155, F.S.; prohibiting health
    9         maintenance organizations, at any time, from
   10         retroactively denying a claim because of the
   11         ineligibility of the subscriber if the health
   12         maintenance organization verified the subscriber’s
   13         eligibility at the time of treatment or provided an
   14         authorization number; providing an effective date.
   15          
   16  Be It Enacted by the Legislature of the State of Florida:
   17  
   18         Section 1. Subsection (11) of section 627.6131, Florida
   19  Statutes, is amended to read:
   20         627.6131 Payment of claims.—
   21         (11) A health insurer may not retroactively deny a claim
   22  because of insured ineligibility:
   23         (a) More than 1 year after the date of payment of the
   24  claim; or
   25         (b) At any time, if the health insurer verified the
   26  insured’s eligibility at the time of treatment or provided an
   27  authorization number.
   28         Section 2. Subsection (10) of section 641.3155, Florida
   29  Statutes, is amended to read:
   30         641.3155 Prompt payment of claims.—
   31         (10) A health maintenance organization may not
   32  retroactively deny a claim because of subscriber ineligibility:
   33         (a) More than 1 year after the date of payment of the
   34  claim; or
   35         (b) At any time, if the health maintenance organization
   36  verified the subscriber’s eligibility at the time of treatment
   37  or provided an authorization number.
   38         Section 3. This act shall take effect January 1, 2022.