641.62 – Chronic diseases among subscriber populations.
641.62 Chronic diseases among subscriber populations.—Each organization must: (1) Annually study its subscriber population to determine the most prevalent chronic diseases of its subscribers, design intervention strategies to reduce the morbidities and mortalities associated with at least two prevalent chronic diseases, measure the outcomes of the interventions implemented, and modify the interventions, if necessary, to improve their […]
641.57 – Disposition of moneys collected under this part.
641.57 Disposition of moneys collected under this part.—Fees, administrative penalties, examination expenses, and other sums collected by the Agency for Health Care Administration under this part shall be deposited to the credit of the Health Care Trust Fund to be administered by the agency and shall be used to defray the expenses of the agency in […]
641.58 – Regulatory assessment; levy and amount; use of funds; tax returns; penalty for failure to pay.
641.58 Regulatory assessment; levy and amount; use of funds; tax returns; penalty for failure to pay.— (1) In addition to any other license or excise tax now or hereafter imposed, and such taxes as may be imposed under other statutes, there is hereby assessed and imposed upon every organization authorized to engage in business in this state, […]
641.59 – Psychotherapeutic services; records and reports.
641.59 Psychotherapeutic services; records and reports.—A health maintenance organization or prepaid health clinic, as defined in this chapter, must maintain strict confidentiality against unauthorized or inadvertent disclosure of confidential information to persons inside or outside the health maintenance organization or prepaid health clinic regarding psychotherapeutic services provided to subscribers by psychotherapists licensed under chapter 490 or […]
641.61 – Subscriber satisfaction assessment.
641.61 Subscriber satisfaction assessment.—Each organization must establish systems for: (1) Assessing subscriber satisfaction with providers, particularly primary care physicians; (2) Sharing subscriber-satisfaction indicators and scores with providers; (3) Publicly acknowledging providers with high positive subscriber-satisfaction scores; (4) Addressing behaviors of providers with low subscriber-satisfaction scores; and (5) Assessing subscriber access and physician availability. History.—s. 41, ch. 96-199.
641.495 – Requirements for issuance and maintenance of certificate.
641.495 Requirements for issuance and maintenance of certificate.— (1) The agency shall issue a health care provider certificate to an applicant filing a completed application in conformity with ss. 641.48 and 641.49, upon payment of the prescribed fee, and upon the agency’s being satisfied that the applicant has the ability to provide quality of care consistent with […]
641.51 – Quality assurance program; second medical opinion requirement.
641.51 Quality assurance program; second medical opinion requirement.— (1) The organization shall ensure that the health care services provided to subscribers shall be rendered under reasonable standards of quality of care consistent with the prevailing standards of medical practice in the community. (2) Each organization shall have an ongoing internal quality assurance program for its health care services. […]
641.511 – Subscriber grievance reporting and resolution requirements.
641.511 Subscriber grievance reporting and resolution requirements.— (1) Every organization must have a grievance procedure available to its subscribers for the purpose of addressing complaints and grievances. Every organization must notify its subscribers that a subscriber must submit a grievance within 1 year after the date of occurrence of the action that initiated the grievance. An organization […]
641.512 – Accreditation and external quality assurance assessment.
641.512 Accreditation and external quality assurance assessment.— (1)(a) To promote the quality of health care services provided by health maintenance organizations and prepaid health clinics in this state, the office shall require each health maintenance organization and prepaid health clinic to be accredited within 1 year of the organization’s receipt of its certificate of authority and to […]
641.513 – Requirements for providing emergency services and care.
641.513 Requirements for providing emergency services and care.— (1) In providing for emergency services and care as a covered service, a health maintenance organization may not: (a) Require prior authorization for the receipt of prehospital transport or treatment or for emergency services and care. (b) Indicate that emergencies are covered only if care is secured within a certain period […]