Bill Text: FL S1160 | 2023 | Regular Session | Introduced

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Bill Title: Payment of Health Insurance Claims

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2023-05-05 - Died in Banking and Insurance [S1160 Detail]

Download: Florida-2023-S1160-Introduced.html

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       Florida Senate - 2023                                    SB 1160
       
       
        
       By Senator Hooper
       
       
       
       
       
       21-01097A-23                                          20231160__
    1                        A bill to be entitled                      
    2         An act relating to the payment of health insurance
    3         claims; amending ss. 627.6131 and 641.3155, F.S.;
    4         prohibiting a health insurer or health maintenance
    5         organization from retroactively denying a claim at any
    6         time because of ineligibility of the insured or
    7         subscriber, respectively; specifying an exception;
    8         providing applicability; providing an effective date.
    9          
   10  Be It Enacted by the Legislature of the State of Florida:
   11  
   12         Section 1. Subsection (11) of section 627.6131, Florida
   13  Statutes, is amended to read:
   14         627.6131 Payment of claims.—
   15         (11) A health insurer may not retroactively deny a claim
   16  because of insured ineligibility at any time, except a health
   17  insurer may retroactively deny a claim for insured ineligibility
   18  within 1 year after the date of payment of the claim if the
   19  provider was convicted of fraud pursuant to s. 817.234. This
   20  subsection applies to policies entered into or renewed on or
   21  after January 1, 2024 more than 1 year after the date of payment
   22  of the claim.
   23         Section 2. Subsection (10) of section 641.3155, Florida
   24  Statutes, is amended to read:
   25         641.3155 Prompt payment of claims.—
   26         (10) A health maintenance organization may not
   27  retroactively deny a claim because of subscriber ineligibility
   28  at any time, except a health maintenance organization may
   29  retroactively deny a claim for subscriber ineligibility within 1
   30  year after the date of payment of the claim if the provider was
   31  convicted of fraud pursuant to s. 817.234. This subsection
   32  applies to contracts entered into or renewed on or after January
   33  1, 2024 more than 1 year after the date of payment of the claim.
   34         Section 3. This act shall take effect July 1, 2023.