Bill Amendment: FL S0856 | 2015 | Regular Session

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: Vision Care Plans

Status: 2015-04-28 - Died in Messages [S0856 Detail]

Download: Florida-2015-S0856-Senate_Committee_Amendment_490478.html

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       Florida Senate - 2015                        COMMITTEE AMENDMENT
       Bill No. CS for SB 856
       
       
       
       
       
       
                                Ì490478NÎ490478                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Rules (Latvala) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (3) is added to section 627.6474,
    6  Florida Statutes, to read:
    7         627.6474 Provider contracts.—
    8         (3)(a) A health insurer may not require an ophthalmologist
    9  licensed pursuant to chapter 458 or chapter 459 or an
   10  optometrist licensed pursuant to chapter 463 to join a network
   11  solely for the purpose of credentialing the licensee for another
   12  insurer’s vision network. This paragraph does not prevent a
   13  health insurer from entering into a contract with another
   14  insurer’s vision care plan to use the vision network.
   15         (b) A health insurer may not restrict or limit an
   16  ophthalmologist licensed pursuant to chapter 458 or chapter 459,
   17  an optometrist licensed pursuant to chapter 463, or an optician
   18  licensed pursuant to part I of chapter 484 to specific suppliers
   19  of materials or optical laboratories. This paragraph does not
   20  restrict or limit a health insurer in determining specific
   21  amounts of coverage or reimbursement for the use of network or
   22  out-of-network suppliers or laboratories.
   23         (c) A health insurer’s online vision care network provider
   24  directory must be updated monthly to reflect the vision care
   25  providers currently participating in the health insurer’s
   26  network.
   27         (d) A knowing violation of paragraph (a) or paragraph (b)
   28  constitutes an unfair insurance trade practice under
   29  s.626.9541(1)(d).
   30         Section 2. Subsection (14) is added to section 636.035,
   31  Florida Statutes, to read:
   32         636.035 Provider arrangements.—
   33         (14)(a) A prepaid limited health service organization may
   34  not require an ophthalmologist licensed pursuant to chapter 458
   35  or chapter 459 or an optometrist licensed pursuant to chapter
   36  463 to join a network solely for the purpose of credentialing
   37  the licensee for another organization’s vision network. This
   38  paragraph does not prevent such organization from entering into
   39  a contract with another organization’s vision care plan to use
   40  the vision network.
   41         (b) A prepaid limited health service organization may not
   42  restrict or limit an ophthalmologist licensed pursuant to
   43  chapter 458 or chapter 459, an optometrist licensed pursuant to
   44  chapter 463, or an optician licensed pursuant to part I of
   45  chapter 484 to specific suppliers of materials or optical
   46  laboratories. This paragraph does not restrict or limit such
   47  organization in determining specific amounts of coverage or
   48  reimbursement for the use of network or out-of-network suppliers
   49  or laboratories.
   50         (c) A prepaid limited health service organization’s online
   51  vision care network provider directory must be updated monthly
   52  to reflect the vision care providers currently participating in
   53  the organization’s network.
   54         (d) A knowing violation of paragraph (a) or paragraph (b)
   55  constitutes an unfair insurance trade practice under s.
   56  626.9541(1)(d).
   57         Section 3. Subsection (12) is added to section 641.315,
   58  Florida Statutes, to read:
   59         641.315 Provider contracts.—
   60         (12)(a) A health maintenance organization may not require
   61  an ophthalmologist licensed pursuant to chapter 458 or chapter
   62  459 or an optometrist licensed pursuant to chapter 463 to join a
   63  network solely for the purpose of credentialing the licensee for
   64  another organization’s vision network. This paragraph does not
   65  prevent such organization from entering into a contract with
   66  another organization’s vision care plan to use the vision
   67  network.
   68         (b) A health maintenance organization may not restrict or
   69  limit an ophthalmologist licensed pursuant to chapter 458 or
   70  chapter 459, an optometrist licensed pursuant to chapter 463, or
   71  an optician licensed pursuant to part I of chapter 484 to
   72  specific suppliers of materials or optical laboratories. This
   73  paragraph does not restrict or limit such organization in
   74  determining specific amounts of coverage or reimbursement for
   75  the use of network or out-of-network suppliers or laboratories.
   76         (c) A health maintenance organization’s online vision care
   77  network provider directory must be updated monthly to reflect
   78  the vision care providers currently participating in the
   79  organization’s network.
   80         (d) A knowing violation of paragraph (a) or paragraph (b)
   81  constitutes an unfair insurance trade practice under s.
   82  626.9541(1)(d).
   83         Section 4. This act shall take effect on January 1, 2016.
   84  
   85  ================= T I T L E  A M E N D M E N T ================
   86  And the title is amended as follows:
   87         Delete everything before the enacting clause
   88  and insert:
   89                        A bill to be entitled                      
   90         An act relating to vision care plans; amending ss.
   91         627.6474, 636.035, and 641.315, F.S.; providing that a
   92         health insurer, a prepaid limited health service
   93         organization, and a health maintenance organization,
   94         respectively, may not require a licensed
   95         ophthalmologist or optometrist to join a network
   96         solely for the purpose of credentialing the licensee
   97         for another vision network; providing that such
   98         insurers and organizations are not prevented by the
   99         act from entering into a contract with another vision
  100         care plan; providing that such insurers or
  101         organizations may not restrict or limit a licensed
  102         ophthalmologist, optometrist, or optician to specific
  103         suppliers of materials or optical laboratories;
  104         providing that such insurers and organizations are not
  105         restricted or limited by the act in determining
  106         certain amounts of coverage or reimbursement;
  107         requiring such insurers’ and organizations’ online
  108         vision care network provider directories to be updated
  109         monthly; providing that a violation of certain
  110         prohibitions in the act constitutes a specified unfair
  111         insurance trade practice; providing an effective date.