Florida Senate - 2025                             CS for SB 1842
       
       
        
       By the Committee on Health Policy; and Senator Burton
       
       
       
       
       
       588-02850-25                                          20251842c1
    1                        A bill to be entitled                      
    2         An act relating to out-of-network providers; amending
    3         s. 456.0575, F.S.; requiring a health care
    4         practitioner or his or her employee to confirm whether
    5         a referral provider participates in the provider
    6         network of the patient’s health insurer or health
    7         maintenance organization under certain circumstances;
    8         authorizing the practitioner or his or her employee to
    9         confirm the referral provider’s participation in a
   10         specified manner; providing applicability; requiring a
   11         health care practitioner to notify a patient in
   12         writing that certain services are not covered services
   13         under the patient’s health coverage; requiring that
   14         such notice be documented; providing for health care
   15         practitioner disciplinary action under certain
   16         conditions; authorizing the Department of Health to
   17         adopt rules; providing an effective date.
   18          
   19  Be It Enacted by the Legislature of the State of Florida:
   20  
   21         Section 1. Present subsection (2) of section 456.0575,
   22  Florida Statutes, is redesignated as subsection (3), and a new
   23  subsection (2) is added to that section, to read:
   24         456.0575 Duty to notify patients.—
   25         (2)(a) When providing nonemergency services, as defined in
   26  s. 627.64194, to a patient, and referring the patient to a
   27  provider for nonemergency services, a health care practitioner
   28  or his or her employee must, at the point of service, confirm
   29  whether the referral provider participates in the provider
   30  network of the patient’s health insurer or health maintenance
   31  organization. The practitioner or his or her employee may
   32  confirm the referral provider’s participation by contacting the
   33  referral provider or the patient’s health insurer or health
   34  maintenance organization, as necessary.
   35         (b) The requirements of paragraph (a) do not apply if the
   36  patient declines the practitioner’s offer to make the
   37  confirmation or declines to share with the referral provider the
   38  name and identification number associated with his or her health
   39  insurance policy or health maintenance organization contract.
   40         (c) When making any referral, the practitioner must notify
   41  a patient in writing that services provided by an out-of-network
   42  provider or that are not covered services under the patient’s
   43  health coverage may result in additional cost-sharing
   44  responsibilities for the patient, and such notice must be
   45  documented in the patient’s medical record.
   46         (d) Failure to comply with this subsection, without good
   47  cause, shall result in disciplinary action against the health
   48  care practitioner.
   49         (e) The department may adopt rules to implement this
   50  subsection.
   51         Section 2. This act shall take effect July 1, 2025.