648.01 Definitions. In this chapter: (1) “Care management organization” means an entity described in s. 46.284 (3m). (2) “Department” means the department of health services. (3) “Enrollee” has the meaning given in s. 46.2805 (3). (4) “Permittee” means a care management organization issued a permit under this chapter. History: 2009 a. 28.
648.03 Applicability of other laws. Notwithstanding s. 600.01 (1) (b) 10. a., ss. 600.01, 600.02, 600.03, and 600.12 apply to this chapter. History: 2009 a. 28.
648.05 Permit. (1) Permit required. After December 31, 2009, no care management organization may provide services to its enrollees without a permit under this chapter. (2) Application. A care management organization applying for a permit shall submit all of the following information in the format required by the commissioner: (a) The names, addresses and occupations […]
648.10 Powers and duties of the commissioner. The commissioner may do any of the following: (1) Promulgate rules that are necessary to carry out the intent of this chapter, including, after consulting with the department, standards for the financial condition of care management organizations. (2) Use the authority granted under ss. 601.41, 601.42, 601.43, 601.44, […]
648.15 Reports and replies. (1) Reports. The commissioner may require from any care management organization any of the following: (a) Statements, reports, answers to questionnaires, and other information in whatever reasonable form the commissioner designates and at such reasonable intervals as the commissioner chooses, or from time to time. (b) Full explanation of the programming […]
648.20 Examinations. (1) Power to examine. (a) To inform himself or herself about a matter related to the enforcement of this chapter, the commissioner may examine the affairs and condition of any permittee. (b) So far as reasonably necessary for an examination under par. (a), the commissioner may examine the accounts, records, or documents so […]
648.25 Conducting examinations. (1) Order of examination. For each examination under s. 648.20, the commissioner shall issue an order stating the scope of the examination and designating the examiner in charge. Upon demand, a copy of the order shall be provided to the examinee. (2) Access to examinee. Any examiner authorized by the commissioner shall, […]
648.27 Costs. (1) Costs to be paid by care management organizations. Permittees shall pay the reasonable estimate of costs of examinations under s. 648.20, of review of applications under s. 648.05, and of analysis and financial monitoring of care management organizations by the commissioner and the department, including overhead and fixed costs, by a system […]
648.30 Nondisclosure of information. (1) Types of information. The office may refuse to disclose and may prevent any other person from disclosing any of the following: (a) Testimony, reports, records, and information that are obtained, produced, or created in the course of an inquiry under s. 648.15. (b) Testimony, reports, records, and information that are […]
648.35 Enforcement procedure. (1) Injunctions and restraining orders. The commissioner may commence an action in circuit court in the name of the state to restrain by temporary or permanent injunction or by temporary restraining order any violation of this chapter, any rule promulgated under this chapter, or any order issued under s. 648.10 (2). The […]
648.45 Affiliates of permittee. (1) Information. A permittee and a person attempting to acquire or having control of a permittee, shall report to the commissioner the information concerning the permittee, its affiliates, and the person attempting to acquire control of the permittee that the commissioner requires by rule. The commissioner may promulgate rules prescribing the […]
648.50 Management changes. (1) Approval required. No proposed plan of merger or other plan for acquisition of control of a permittee may be executed unless the commissioner, after consulting with the department, approves the plan. (2) Grounds for approval. The commissioner shall approve the plan under this section if the commissioner finds, after a hearing, […]
648.55 Commissioner’s summary orders. (1) The commissioner, after consulting with the department, may make and serve an order on a permittee, requiring it to stop providing services under the department contract, or to take corrective measures, without notice and before hearing, if it appears to the commissioner that irreparable harm to the property or business […]
648.65 Enrollee immunity. (1) Immunity. An enrollee of a care management organization is not liable for health care, service, equipment, or supply charges that are covered under the care management organization’s contract with the department. (2) Prohibited recovery attempts. No person may bill, charge, collect a deposit from, seek compensation from, file or threaten to […]
648.75 Insolvency funding. (1) Deposit required. A permittee shall deposit an amount established by the contract with the department, and not less than $250,000, using the procedures under s. 601.13. (2) Release of deposit. A deposit under this section may be released only with the approval of the commissioner, after consulting with the department, by […]