Florida Statute 408.50 | Lawyer Caselaw & Research

The 2024 Florida Statutes

Title XXIX
PUBLIC HEALTH

Chapter 408
HEALTH CARE ADMINISTRATION

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F.S. 408.50

408.50 Prospective payment arrangements.—

(1) Hospitals as defined in s. 395.002, and health insurers regulated pursuant to parts VI and VII of chapter 627, shall establish prospective payment arrangements that provide hospitals with financial incentives to contain costs. Each hospital shall enter into a rate agreement with each health insurer which represents 10 percent or more of the private-pay patients of the hospital to establish a prospective payment arrangement. Hospitals and health insurers regulated pursuant to this section shall report annually the results of each specific prospective payment arrangement adopted by each hospital and health insurer to the board. The agency shall report a health insurer’s failure to comply to the Office of Insurance Regulation of the Financial Services Commission, which shall take into account the failure by the health insurer to comply in conjunction with its approval authority under s. 627.410. The agency shall adopt any rules necessary to carry out its responsibilities required by this section.

(2) The prospective payment system established pursuant to this section shall include, at a minimum, the following elements:

(a) A maximum allowable payment amount established for individual hospital products, services, patient diagnoses, patient day, patient admission, or per insured, or any combination thereof, which is preset at the beginning of the budget year of the hospital and fixed for the entirety of that budget year, except when extenuating and unusual circumstances acceptable to the department warrant renegotiation.

(b) Timely payment to the hospital by the insurer or the insured, or both, of the maximum allowable payment amount, as so negotiated by the insurer or group of insurers.

(c) Acceptance by the hospital of the maximum payment amount as payment in full, which shall include any deductible or coinsurance provided for in the insurer’s benefit plan.

(d) Utilization reviews for appropriateness of treatment.

(e) Preadmission screening of nonemergency admissions.

(3) Nothing contained in this section prohibits the inclusion of deductibles, coinsurance, or other cost containment provisions in any health insurance policy.

History.—s. 81, ch. 92-33; s. 438, ch. 2003-261.

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Amendments to 408.50

Arrestable Offenses / Crimes under Fla. Stat. 408.50

Level: Degree
Misdemeanor/Felony: First/Second/Third

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 408.50.

Annotations, Discussions, Cases:

Cases Citing Statute 408.50

Total Results: 6

Saussy v. Saussy

Court: District Court of Appeal of Florida | Date Filed: 1990-05-11

Citation: 560 So. 2d 1385, 1990 WL 60897

Snippet: presented testimony of an expert who testified that $15,408.50 was a reasonable fee. The expert then discussed

Wingold v. Horowitz

Court: District Court of Appeal of Florida | Date Filed: 1973-03-06

Citation: 274 So. 2d 591, 1973 Fla. App. LEXIS 7199

Snippet: discharged. Home Insurance Company v. Dick, 281 U.S. 408, 50 S.Ct. 338, 74 L.Ed. 933; 16 Am.Jur.2d Constitutional

Bateman v. State

Court: Supreme Court of Florida | Date Filed: 1970-07-15

Citation: 238 So. 2d 621, 1970 Fla. LEXIS 2681

Snippet: Louisiana v. Mississippi, 202 U.S. 1, 26 S.Ct. 408, 50 L.Ed. 913, the Court stated: “ ‘The maritime belt

Mounier v. State

Court: Supreme Court of Florida | Date Filed: 1965-04-14

Citation: 178 So. 2d 714

Snippet: Louisiana v. Mississippi, 202 U.S. 1, 26 S.Ct. 408, 50 L.Ed. 913, the Court stated: "The maritime belt

Skiriotes v. State

Court: Supreme Court of Florida | Date Filed: 1940-09-06

Citation: 197 So. 736, 144 Fla. 220, 1940 Fla. LEXIS 1031

Snippet: Louisiana v. Mississippi, 202 U.S. 1,26 Sup. Ct. 408, 50 L.Ed. 913. Both parties to this cause rely on Manchester

State ex rel. Buford v. City of Tampa

Court: Supreme Court of Florida | Date Filed: 1924-09-09

Citation: 88 Fla. 196

Snippet: S.) 337; Broward v. Mabry, 58 Fla. 398, text 408, 50 South. Rep. 826; Brickell v. Trammell, 77 Fla.