Syfert Injury Law Firm

Short title.

Declaration of legislative intent, findings, and purposes.

Statutory accounting procedures; transition provisions.

Health maintenance organization subscriber protections.

Definitions.

Applicability of other laws.

Insurance holding companies.

Incorporation required.

Insurance business not authorized.

Limited coverage for home health care authorized.

High-deductible contracts for medical savings accounts.

Provider service network certificate of authority.

Application for certificate.

Conditions precedent to issuance or maintenance of certificate of authority; effect of bankruptcy proceedings.

Minority recruitment and retention plans required.

Issuance of certificate of authority.

Continued eligibility for certificate of authority.

Surplus requirements.

Application of solvency requirements to provider-sponsored organizations and Medicaid provider service networks.

Rehabilitation Administrative Expense Fund.

Florida Health Maintenance Organization Consumer Assistance Plan.

Revocation or cancellation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension.

Administrative, provider, and management contracts.

Contract providers.

Administrative penalty in lieu of suspension or revocation.

Acquisition, merger, or consolidation.

Annual and quarterly reports.

Other reporting requirements.

Examination by the department.

Civil remedy.

Injunction.

Payment of judgment by health maintenance organization.

Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy.

Insolvency protection.

Levy upon deposit limited.

Fees.

Construction and relationship to other laws.

Application of ch. 85-177.

HIV infection and AIDS for contract purposes.

Language used in contracts and advertisements; translations.

Standards for marketing to persons eligible for Medicare.

Health maintenance contracts.

Additional contract contents.

Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

Restrictions upon expulsion or refusal to issue or renew contract.

Charter, bylaw provisions.

Execution of contracts.

Validity of noncomplying contracts.

Construction of contracts.

Delivery of contract; definitions.

Preexisting conditions.

Special enrollment periods.

Prohibiting discrimination against individual participants and beneficiaries based on health status.

Guaranteed renewability of coverage.

Advanced practice registered nurse services.

Shared savings incentive program.

Coverage for organ transplants.

Notice of cancellation of contract.

Disclosures to subscribers; coverage of behavioral health care services.

Nondiscrimination of coverage for certain surgical procedures involving bones or joints.

Coverage for mammograms.

Requirements with respect to breast cancer and routine followup care.

Decreasing inappropriate utilization of emergency care.

Coverage for individuals with developmental disabilities.

Restrictions on use of state and federal funds for state exchanges.

Extension of benefits.

Scope.

Health maintenance contracts; cancer treatment parity; orally administered cancer treatment medications.

Pharmacy benefit manager contracts.

Provider contracts.

Organization liability; provider billing prohibited.

Prompt payment of claims.

Treatment authorization; payment of claims.

Fiscal intermediary services.

Acceptable payments.

Certain words prohibited in name of organization.

Assets, liabilities, and investments.

Adoption of rules; penalty for violation.

Dividends.

Prohibited activities; penalties.

Operational health maintenance organizations; issuance of certificate.

Order to discontinue certain advertising.

Agent licensing and appointment required; exceptions.

Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty.

Unfair methods of competition and unfair or deceptive acts or practices prohibited.

Unfair methods of competition and unfair or deceptive acts or practices defined.

General powers and duties of the department and office.

Defined unfair practices; hearings, witnesses, appearances, production of books, and service of process.

Cease and desist and penalty orders.

Appeals from the department or office.

Penalty for violation of cease and desist orders.

Health maintenance organization anti-fraud plans and investigative units.

Civil liability.

Conversion on termination of eligibility.

Conversion contracts; conditions.

Discrimination against providers prohibited.