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 […]
641.514 – Coverage for air ambulance services.
1641.514 Coverage for air ambulance services.— (1) As used in this section, the term: (a) “Air ambulance service” has the same meaning as provided in s. 401.23. (b) “Health maintenance organization” has the same meaning as provided in s. 641.19(12). (c) “Reasonable reimbursement” means reimbursement that considers the direct cost to provide the air ambulance transportation service to the subscriber, […]
641.515 – Investigation by the agency.
641.515 Investigation by the agency.— (1) The agency shall investigate further any quality of care issue contained in recommendations and reports submitted pursuant to s. 641.511. The agency shall also investigate further any information that indicates that the organization does not meet accreditation standards or the standards of the review organization performing the external quality assurance assessment […]
641.52 – Revocation of certificate; suspension of new enrollment; suspension of the health care provider certificate; administrative fine; notice of action to the office; penalty for use of unlicensed providers.
641.52 Revocation of certificate; suspension of new enrollment; suspension of the health care provider certificate; administrative fine; notice of action to the office; penalty for use of unlicensed providers.— (1) The agency may suspend the authority of an organization to enroll new subscribers or revoke the health care provider certificate of any organization, or order compliance within […]
641.429 – Acceptable payments to prepaid health clinic.
641.429 Acceptable payments to prepaid health clinic.—Each prepaid health clinic may accept payments from governmental agencies, corporations, associations, groups, or individuals, which payments cover all or part of the cost of contracts entered into between the prepaid health clinic and its subscribers. History.—ss. 10, 11, ch. 84-313; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.
641.43 – Provider contracts.
641.43 Provider contracts.—Whenever a prepaid health clinic provides services to subscribers through an arrangement with a provider, there shall be a written contract with the provider. The contract shall include a provision that, if the prepaid health clinic fails to meet its obligation to pay fees for services already rendered by the provider to a subscriber, […]
641.432 – Providers of service; penalty for unauthorized use of providers; interference with judgment prohibited.
641.432 Providers of service; penalty for unauthorized use of providers; interference with judgment prohibited.— (1) Any prepaid health clinic which utilizes the services of a provider who is not licensed or otherwise authorized by law to provide such services is guilty of a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or […]
641.437 – Investigatory power of office.
641.437 Investigatory power of office.—The office has the power to examine and investigate the affairs of every person, entity, or prepaid health clinic in order to determine whether the person, entity, or prepaid health clinic is operating in accordance with the provisions of this part or has been or is engaged in any unfair method of […]
641.438 – Genetic information restrictions.
641.438 Genetic information restrictions.—A prepaid health clinic must comply with the provisions of s. 627.4301. History.—s. 6, ch. 97-182.