641.3005 – Application of ch. 85-177.
641.3005 Application of ch. 85-177.—This act shall take effect October 1, 1985, and shall apply to all health maintenance organizations that have obtained certificates of authority before, on, or after this date, unless otherwise provided in this act. Any provision of this act necessitating a change in a health maintenance contract shall apply to contracts issued […]
641.234 – Administrative, provider, and management contracts.
641.234 Administrative, provider, and management contracts.— (1) The office may require a health maintenance organization to submit any contract for administrative services, contract with a provider other than an individual physician, contract for management services, and contract with an affiliated entity to the office. (2) After review of a contract the office may order the health maintenance organization […]
641.3007 – HIV infection and AIDS for contract purposes.
641.3007 HIV infection and AIDS for contract purposes.— (1) PURPOSE.—The purpose of this section is to prohibit unfair practices in a health maintenance organization contract with respect to exposure to the human immunodeficiency virus infection and related matters, and thereby reduce the possibility that a health maintenance organization subscriber or applicant may suffer unfair discrimination when subscribing […]
641.2342 – Contract providers.
641.2342 Contract providers.—Each health maintenance organization shall file, upon the request of the office, financial statements for all contract providers of comprehensive health care services who have assumed, through capitation or other means, more than 10 percent of the health care risks of the health maintenance organization. However, this provision shall not apply to any individual […]
641.305 – Language used in contracts and advertisements; translations.
641.305 Language used in contracts and advertisements; translations.— (1)(a) All health maintenance contracts or forms shall be printed in English. (b) If the negotiations by a health maintenance organization with a member leading up to the effectuation of a health maintenance contract are conducted in a language other than English, the health maintenance organization shall supply to the […]
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 […]