Fla. Stat. ch. 641 – Health Care Service Programs | Midpage

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Florida Statutes

Chapter 641

Fla. Stat. ch. 641

Health Care Service Programs

641.17Short title 641.18Declaration of legislative intent, findings, and purposes 641.185Health maintenance organization subscriber protections 641.19Definitions 641.201Applicability of other laws 641.2011Insurance holding companies 641.2015Incorporation required 641.2017Insurance business not authorized 641.2018Limited coverage for home health care authorized 641.20185High-deductible contracts for medical savings accounts 641.21Application for certificate 641.215Conditions precedent to issuance or maintenance of certificate of authority; effect of bankruptcy proceedings 641.217Minority recruitment and retention plans required 641.22Issuance of certificate of authority 641.221Continued eligibility for certificate of authority 641.225Surplus requirements 641.2261Application of federal solvency requirements to provider-sponsored organizations 641.227Rehabilitation Administrative Expense Fund 641.228Florida Health Maintenance Organization Consumer Assistance Plan 641.23Revocation or cancellation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension 641.234Administrative, provider, and management contracts 641.2342Contract providers 641.25Administrative penalty in lieu of suspension or revocation 641.255Acquisition, merger, or consolidation 641.26Annual report 641.261Other reporting requirements 641.27Examination by the department 641.28Civil remedy 641.281Injunction 641.282Payment of judgment by health maintenance organization 641.284Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy 641.285Insolvency protection 641.286Levy upon deposit limited 641.29Fees 641.30Construction and relationship to other laws 641.3005Application of ch. 85-177 641.3007Human immunodeficiency virus infection and acquired immune deficiency syndrome for contract purposes 641.305Language used in contracts and advertisements; translations 641.309Standards for marketing to persons eligible for Medicare 641.31Health maintenance contracts 641.3101Additional contract contents 641.31015Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan 641.3102Restrictions upon expulsion or refusal to issue or renew contract 641.3103Charter, bylaw provisions 641.3104Execution of contracts 641.3105Validity of noncomplying contracts 641.3106Construction of contracts 641.3107Delivery of contract 641.31071Preexisting conditions 641.31072Special enrollment periods 641.31073Prohibiting discrimination against individual participants and beneficiaries based on health status 641.31074Guaranteed renewability of coverage 641.3108Notice of cancellation of contract 641.31094Nondiscrimination of coverage for certain surgical procedures involving bones or joints 641.31095Coverage for mammograms 641.31096Requirements with respect to breast cancer and routine followup care 641.3111Extension of benefits 641.315Provider contracts 641.3154Organization liability; provider billing prohibited 641.3155Payment of claims 641.3156Treatment authorization; payment of claims 641.316Fiscal intermediary services 641.32Acceptable payments 641.33Certain words prohibited in name of organization 641.35Assets, liabilities, and investments 641.36Adoption of rules; penalty for violation 641.365Dividends 641.37Prohibited activities; penalties 641.38Operational health maintenance organizations; issuance of certificate 641.385Order to discontinue certain advertising 641.386Agent licensing and appointment required; exceptions 641.39001Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty 641.3901Unfair methods of competition and unfair or deceptive acts or practices prohibited 641.3903Unfair methods of competition and unfair or deceptive acts or practices defined 641.3905General powers and duties of the department 641.3907Defined unfair practices; hearings, witnesses, appearances, production of books, and service of process 641.3909Cease and desist and penalty orders 641.3911Appeals from the department 641.3913Penalty for violation of cease and desist orders 641.3915Health maintenance organization anti-fraud plans and investigative units 641.3917Civil liability 641.3921Conversion on termination of eligibility 641.3922Conversion contracts; conditions 641.3923Discrimination against providers prohibited 641.40Short title 641.401Declaration of legislative intent, findings, and purposes 641.4015Part exclusive; applicability of other laws 641.402Definitions 641.403Rulemaking authority 641.405Application for certificate of authority to operate prepaid health clinic 641.406Issuance of certificate of authority 641.4065Insurance business not authorized 641.407Minimum surplus 641.408Use of certain words prohibited in the name of a prepaid health clinic 641.409Insolvency protection 641.4091Levy upon deposit; limitation 641.41Annual report of prepaid health clinic; administrative penalty 641.411Other reporting requirements 641.412Fees 641.414Investment of funds of prepaid health clinic 641.416Acquisition 641.418Examination of prepaid health clinic by the department 641.419Rehabilitation, liquidation, conservation, or dissolution of prepaid health clinic 641.42Prepaid health clinic contracts 641.421Language used in contracts and advertisements; translations 641.422Contract provisions incorporating charter or bylaw provisions 641.423Execution of contracts 641.424Validity of noncomplying contracts 641.425Construction of contracts 641.426Delivery of contract to subscriber 641.427Notice of cancellation, termination, or nonrenewal of contract 641.428Nondiscrimination of coverage for certain surgical procedures involving bones or joints 641.429Acceptable payments to prepaid health clinic 641.43Provider contracts 641.432Providers of service; penalty for unauthorized use of providers; interference with judgment prohibited 641.437Investigatory power of department 641.438Genetic information restrictions 641.44Unfair methods of competition and unfair or deceptive acts or practices prohibited 641.441Unfair methods of competition and unfair or deceptive acts or practices defined 641.442Penalty for operation of prepaid health clinic, or issuance, delivery, or renewal of prepaid health clinic contract, without certificate of authority 641.443Temporary restraining orders 641.444Injunction 641.445Defined practices; hearings, witnesses, appearances, production of books, and service of process 641.446Cease and desist and penalty orders 641.447Appeal from departmental order 641.448Penalty for violation of cease and desist order 641.45Revocation or cancellation of certificate of authority; suspension of authority to enroll new subscribers; terms of suspension 641.452Administrative penalty in lieu of suspension or revocation of certificate of authority 641.453Civil liability 641.454Civil action to enforce prepaid health clinic contract; attorney's fees; court costs 641.455Disposition of moneys collected under this part 641.457Exemption for certain operational prepaid health clinics 641.459Construction and relationship to other laws 641.47Definitions 641.48Purpose and application of part 641.49Certification of health maintenance organization and prepaid health clinic as health care providers; application procedure 641.495Requirements for issuance and maintenance of certificate 641.51Quality assurance program; second medical opinion requirement 641.511Subscriber grievance reporting and resolution requirements 641.512Accreditation and external quality assurance assessment 641.513Requirements for providing emergency services and care 641.515Investigation by the agency 641.52Revocation of certificate; suspension of new enrollment; suspension of the health care provider certificate; administrative fine; notice of action to the Department of Insurance; penalty for use of unlicensed providers 641.54Information disclosure 641.545Subscriber risk assessments; requirements 641.55Internal risk management program 641.56Rulemaking authority 641.57Disposition of moneys collected under this part 641.58Regulatory assessment; levy and amount; use of funds; tax returns; penalty for failure to pay 641.59Psychotherapeutic services; records and reports 641.60Statewide Managed Care Ombudsman Committee 641.61Subscriber satisfaction assessment 641.62Chronic diseases among subscriber populations 641.65District managed care ombudsman committees 641.67Statewide or district managed care ombudsman committee; exemption from public records requirements; exceptions 641.68Statewide or district managed care ombudsman committee; exemption from public meeting requirements 641.70Agency duties relating to the Statewide Managed Care Ombudsman Committee and the district managed care ombudsman committees 641.75Immunity from liability; limitation on testimony