Bill Text: FL S0302 | 2010 | Regular Session | Comm Sub
Bill Title: Dentists/Contracts [CPSC]
Sponsorship: Slight Partisan Bill (Republican 2-1)
Status: (Failed) 2010-04-30 - Died in Committee on Commerce [S0302 Detail]
Download: Florida-2010-S0302-Comm_Sub.html
Florida Senate - 2010 CS for SB 302 By the Committee on Banking and Insurance; and Senators Jones, Gaetz, and Sobel 597-04816-10 2010302c1 1 A bill to be entitled 2 An act relating to dentists; amending s. 627.6474, 3 F.S.; prohibiting contracts between health insurers 4 and dentists from containing certain fee requirements 5 set by the insurer under certain circumstances; 6 providing a definition; providing application; 7 amending s. 636.035, F.S.; prohibiting contracts 8 between prepaid limited health service organizations 9 and dentists from containing certain fee requirements 10 set by the organization under certain circumstances; 11 providing a definition; providing application; 12 amending s. 641.315, F.S.; prohibiting contracts 13 between health maintenance organizations and dentists 14 from containing certain fee requirements set by the 15 organization under certain circumstances; providing a 16 definition; providing application; providing an 17 effective date. 18 19 Be It Enacted by the Legislature of the State of Florida: 20 21 Section 1. Section 627.6474, Florida Statutes, is amended 22 to read: 23 627.6474 Provider contracts.— 24 (1) A health insurer mayshallnot require a contracted 25 health care practitioner as defined in s. 456.001(4) to accept 26 the terms of other health care practitioner contracts with the 27 insurer or any other insurer, or health maintenance 28 organization, under common management and control with the 29 insurer, including Medicare and Medicaid practitioner contracts 30 and those authorized by s. 627.6471, s. 627.6472, s. 636.035, or 31 s. 641.315, except for a practitioner in a group practice as 32 defined in s. 456.053 who must accept the terms of a contract 33 negotiated for the practitioner by the group, as a condition of 34 continuation or renewal of the contract. Any contract provision 35 that violates this section is void. A violation of this section 36 is not subject to the criminal penalty specified in s. 624.15. 37 (2) A contract between a health insurer and a dentist 38 licensed under chapter 466 for the provision of services to 39 patients may not contain any provision that requires the dentist 40 to provide services to the insured under such contract at a fee 41 set by the health insurer unless such services are covered 42 services under the applicable contract. As used in this 43 subsection, the term “covered services” means services 44 reimbursable under the applicable contract, subject to such 45 contractual limitations on benefits, such as deductibles, 46 coinsurance, and copayments, as may apply. This subsection 47 applies to all contracts entered into or renewed on or after 48 July 1, 2010. 49 Section 2. Subsection (13) is added to section 636.035, 50 Florida Statutes, to read: 51 636.035 Provider arrangements.— 52 (13) A contract between a prepaid limited health service 53 organization and a dentist licensed under chapter 466 for the 54 provision of services to subscribers of the prepaid limited 55 health service organization may not contain any provision that 56 requires the dentist to provide services to subscribers of the 57 prepaid limited health service organization at a fee set by the 58 prepaid limited health service organization unless such services 59 are covered services under the applicable contract. As used in 60 this subsection, the term “covered services” means services 61 reimbursable under the applicable contract, subject to such 62 contractual limitations on benefits, such as deductibles, 63 coinsurance, and copayments, as may apply. This subsection 64 applies to all contracts entered into or renewed on or after 65 July 1, 2010. 66 Section 3. Subsection (11) is added to section 641.315, 67 Florida Statutes, to read: 68 641.315 Provider contracts.— 69 (11) A contract between a health maintenance organization 70 and a dentist licensed under chapter 466 for the provision of 71 services to subscribers of the health maintenance organization 72 may not contain any provision that requires the dentist to 73 provide services to subscribers of the health maintenance 74 organization at a fee set by the health maintenance organization 75 unless such services are covered services under the applicable 76 contract. As used in this subsection, the term “covered 77 services” means services reimbursable under the applicable 78 contract, subject to such contractual limitations on subscriber 79 benefits, such as deductibles, coinsurance, and copayments, as 80 may apply. This subsection applies to all contracts entered into 81 or renewed on or after July 1, 2010. 82 Section 4. This act shall take effect July 1, 2010.
