641.31072 – Special enrollment periods.
641.31072 Special enrollment periods.— (1) A health maintenance organization that issues a group health insurance policy shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the contract, or a dependent of such an employee if the dependent is eligible but not enrolled for coverage under such terms, to enroll for […]
641.31073 – Prohibiting discrimination against individual participants and beneficiaries based on health status.
641.31073 Prohibiting discrimination against individual participants and beneficiaries based on health status.— (1) Subject to subsection (2), a health maintenance organization that offers group health insurance coverage may not establish rules for eligibility, including continued eligibility, of an individual to enroll under the terms of the contract based on any of the following health-status-related factors in relation […]
641.31074 – Guaranteed renewability of coverage.
641.31074 Guaranteed renewability of coverage.— (1) Except as otherwise provided in this section, a health maintenance organization that issues a health insurance contract must renew or continue in force such coverage at the option of the contract holder. (2) A health maintenance organization may nonrenew or discontinue a contract based only on one or more of the following […]
641.31075 – Advanced practice registered nurse services.
641.31075 Advanced practice registered nurse services.—A health maintenance contract that is delivered, issued, or renewed in this state on or after January 1, 2021, may not require a subscriber to receive services from an advanced practice registered nurse registered under s. 464.0123 in place of a physician. History.—s. 32, ch. 2020-9.
641.31076 – Shared savings incentive program.
641.31076 Shared savings incentive program.— (1) This section and ss. 627.6387 and 627.6648 may be cited as the “Patient Savings Act.” (2) As used in this section, the term: (a) “Health care provider” means a hospital or facility licensed under chapter 395; an entity licensed under chapter 400; a health care practitioner as defined in s. 456.001; a blood […]
641.25 – Administrative penalty in lieu of suspension or revocation.
641.25 Administrative penalty in lieu of suspension or revocation.—If the office finds that one or more grounds exist for the revocation or suspension of a certificate issued under this part, the office may, in lieu of revocation or suspension, impose a fine upon the health maintenance organization. With respect to any nonwillful violation, the fine must […]
641.255 – Acquisition, merger, or consolidation.
641.255 Acquisition, merger, or consolidation.— (1) Every acquisition of a health maintenance organization shall be subject to the provisions of s. 628.4615. However, in the case of a health maintenance organization organized as a for-profit corporation, the provisions of s. 628.451 govern with respect to any merger or consolidation; and, in the case of a health maintenance […]
641.26 – Annual and quarterly reports.
641.26 Annual and quarterly reports.— (1) Every health maintenance organization shall, annually within 3 months after the end of its fiscal year, or within an extension of time therefor as the office, for good cause, may grant, in a form prescribed by the commission, file a report with the office, verified by the oath of two officers […]
641.261 – Other reporting requirements.
641.261 Other reporting requirements.— (1) Each authorized health maintenance organization shall provide records and information to the Agency for Health Care Administration pursuant to s. 409.910(20) and (21) for the sole purpose of identifying potential coverage for claims filed with the agency and its fiscal agents for payment of medical services under the Medicaid program. (2) Any information […]
641.27 – Examination by the department.
641.27 Examination by the department.— (1) The office shall examine the affairs, transactions, accounts, business records, and assets of any health maintenance organization as often as it deems it expedient for the protection of the people of this state, but not less frequently than once every 5 years. However, except when the medical records are requested and […]