Bill Text: FL S0856 | 2015 | Regular Session | Comm Sub


Bill Title: Vision Care Plans

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Failed) 2015-04-28 - Died in Messages [S0856 Detail]

Download: Florida-2015-S0856-Comm_Sub.html
       Florida Senate - 2015                       CS for CS for SB 856
       
       
        
       By the Committees on Rules; and Banking and Insurance; and
       Senator Latvala
       
       
       
       
       595-03409-15                                           2015856c2
    1                        A bill to be entitled                      
    2         An act relating to vision care plans; amending ss.
    3         627.6474, 636.035, and 641.315, F.S.; providing that a
    4         health insurer, a prepaid limited health service
    5         organization, and a health maintenance organization,
    6         respectively, may not require a licensed
    7         ophthalmologist or optometrist to join a network
    8         solely for the purpose of credentialing the licensee
    9         for another vision network; providing that such
   10         insurers and organizations are not prevented by the
   11         act from entering into a contract with another vision
   12         care plan; providing that such insurers and
   13         organizations may not restrict or limit a licensed
   14         ophthalmologist, optometrist, or optician to specific
   15         suppliers of materials or optical laboratories;
   16         providing that such insurers and organizations are not
   17         restricted or limited by the act in determining
   18         certain amounts of coverage or reimbursement;
   19         requiring such insurers’ and organizations’ online
   20         vision care network provider directories to be updated
   21         monthly; providing that a violation of certain
   22         prohibitions in the act constitutes a specified unfair
   23         insurance trade practice; providing an effective date.
   24          
   25  Be It Enacted by the Legislature of the State of Florida:
   26  
   27         Section 1. Subsection (3) is added to section 627.6474,
   28  Florida Statutes, to read:
   29         627.6474 Provider contracts.—
   30         (3)(a) A health insurer may not require an ophthalmologist
   31  licensed pursuant to chapter 458 or chapter 459 or an
   32  optometrist licensed pursuant to chapter 463 to join a network
   33  solely for the purpose of credentialing the licensee for another
   34  insurer’s vision network. This paragraph does not prevent a
   35  health insurer from entering into a contract with another
   36  insurer’s vision care plan to use the vision network.
   37         (b) A health insurer may not restrict or limit an
   38  ophthalmologist licensed pursuant to chapter 458 or chapter 459,
   39  an optometrist licensed pursuant to chapter 463, or an optician
   40  licensed pursuant to part I of chapter 484 to specific suppliers
   41  of materials or optical laboratories. This paragraph does not
   42  restrict or limit a health insurer in determining specific
   43  amounts of coverage or reimbursement for the use of network or
   44  out-of-network suppliers or laboratories.
   45         (c) A health insurer’s online vision care network provider
   46  directory must be updated monthly to reflect the vision care
   47  providers currently participating in the health insurer’s
   48  network.
   49         (d) A knowing violation of paragraph (a) or paragraph (b)
   50  constitutes an unfair insurance trade practice under
   51  s.626.9541(1)(d).
   52         Section 2. Subsection (14) is added to section 636.035,
   53  Florida Statutes, to read:
   54         636.035 Provider arrangements.—
   55         (14)(a) A prepaid limited health service organization may
   56  not require an ophthalmologist licensed pursuant to chapter 458
   57  or chapter 459 or an optometrist licensed pursuant to chapter
   58  463 to join a network solely for the purpose of credentialing
   59  the licensee for another organization’s vision network. This
   60  paragraph does not prevent such organization from entering into
   61  a contract with another organization’s vision care plan to use
   62  the vision network.
   63         (b) A prepaid limited health service organization may not
   64  restrict or limit an ophthalmologist licensed pursuant to
   65  chapter 458 or chapter 459, an optometrist licensed pursuant to
   66  chapter 463, or an optician licensed pursuant to part I of
   67  chapter 484 to specific suppliers of materials or optical
   68  laboratories. This paragraph does not restrict or limit such
   69  organization in determining specific amounts of coverage or
   70  reimbursement for the use of network or out-of-network suppliers
   71  or laboratories.
   72         (c) A prepaid limited health service organization’s online
   73  vision care network provider directory must be updated monthly
   74  to reflect the vision care providers currently participating in
   75  the organization’s network.
   76         (d) A knowing violation of paragraph (a) or paragraph (b)
   77  constitutes an unfair insurance trade practice under s.
   78  626.9541(1)(d).
   79         Section 3.  Subsection (12) is added to section 641.315,
   80  Florida Statutes, to read:
   81         641.315 Provider contracts.—
   82         (12)(a)A health maintenance organization may not require
   83  an ophthalmologist licensed pursuant to chapter 458 or chapter
   84  459 or an optometrist licensed pursuant to chapter 463 to join a
   85  network solely for the purpose of credentialing the licensee for
   86  another organization’s vision network. This paragraph does not
   87  prevent such organization from entering into a contract with
   88  another organization’s vision care plan to use the vision
   89  network.
   90         (b) A health maintenance organization may not restrict or
   91  limit an ophthalmologist licensed pursuant to chapter 458 or
   92  chapter 459, an optometrist licensed pursuant to chapter 463, or
   93  an optician licensed pursuant to part I of chapter 484 to
   94  specific suppliers of materials or optical laboratories. This
   95  paragraph does not restrict or limit such organization in
   96  determining specific amounts of coverage or reimbursement for
   97  the use of network or out-of-network suppliers or laboratories.
   98         (c) A health maintenance organization’s online vision care
   99  network provider directory must be updated monthly to reflect
  100  the vision care providers currently participating in the
  101  organization’s network.
  102         (d) A knowing violation of paragraph (a) or paragraph (b)
  103  constitutes an unfair insurance trade practice under s.
  104  626.9541(1)(d).
  105         Section 4. This act shall take effect July 1, 2015.

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