The 2023 Florida Statutes (including Special Session C)

Title XXXVII
INSURANCE

Chapter 627
INSURANCE RATES AND CONTRACTS

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F.S. 627.4234

627.4234 Health insurance cost containment provisions required.—A health insurance policy or health care services plan which provides medical, hospital, or surgical expense coverage delivered or issued for delivery in this state must contain one or more of the following procedures or provisions to contain health insurance costs or cost increases:

(1) Coinsurance.

(2) Deductible amounts.

(3) Utilization review.

(4) Audits of provider bills to verify that services and supplies billed were furnished and that proper charges were made.

(5) Scheduled benefits.

(6) Benefits for preadmission testing.

(7) Any lawful measure or combination of measures for which the insurer provides to the office information demonstrating that the measure or combination of measures is reasonably expected to have an effect toward containing health insurance costs or cost increases.

History.—ss. 4, 10, ch. 84-235; ss. 40, 114, ch. 92-318; s. 1121, ch. 2003-261.

F.S. 627.4234 on Google Scholar

F.S. 627.4234 on Casetext

Amendments to 627.4234

Arrestable Offenses / Crimes under Fla. Stat. 627.4234

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

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 627.4234.

Annotations, Discussions, Cases:

Cases from cite.case.law:

KONDELL, v. BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC., 187 F. Supp. 3d 1348 (S.D. Fla. 2016)

. . . . § 627.4234 (including “utilization review” among the list of cost-containment procedures and provisions . . .

In MANAGED CARE LITIGATION., 135 F. Supp. 2d 1253 (S.D. Fla. 2001)

. . . . § 627.4234 (Health care plans “must contain one or more ... procedure or provisions to contain health . . .