Bill Text: FL S1190 | 2015 | Regular Session | Comm Sub
Bill Title: Insurer Solvency
Spectrum: Bipartisan Bill
Status: (Failed) 2015-05-01 - Died in Appropriations Subcommittee on General Government [S1190 Detail]
Download: Florida-2015-S1190-Comm_Sub.html
Florida Senate - 2015 CS for SB 1190 By the Committee on Banking and Insurance; and Senator Lee 597-02405-15 20151190c1 1 A bill to be entitled 2 An act relating to insurer solvency; amending s. 3 624.407, F.S.; revising the amount of surplus which 4 must be possessed by insurers applying for an original 5 certificate of authority; defining the term “health 6 benefit plan”; amending s. 624.408, F.S.; revising the 7 amount of surplus which must be possessed by insurers 8 in order to retain a certificate of authority; 9 authorizing the Office of Insurance Regulation to 10 reduce certain surplus requirements under specified 11 circumstances; defining the term “health benefit 12 plan”; amending s. 624.4085, F.S.; revising the term 13 “life and health insurer” to include specified health 14 maintenance and prepaid limited health service 15 organizations; amending s. 636.043, F.S.; revising the 16 due date and required content for the mandatory annual 17 report of a prepaid limited health service 18 organization to the office; revising the time periods 19 to be covered by such organization’s required 20 quarterly reports to the office; amending s. 641.19, 21 F.S.; defining the term “management services 22 organization”; amending s. 641.201, F.S.; providing 23 that a health maintenance organization is considered 24 an insurer for purposes of specified provisions of law 25 relating to insolvent insurers, requirements for the 26 directors of domestic insurers, the payment of 27 dividends and distributions of other property by 28 domestic stock insurers, penalties for domestic and 29 mutual stock insurers that illegally pay dividends, 30 and certain restrictions on premiums written; 31 providing that health maintenance organizations are 32 considered life and health insurers for purposes of 33 specified provisions of law relating to insurer 34 surplus requirements; amending s. 641.225, F.S.; 35 conforming provisions to changes made by the act; 36 amending s. 641.26, F.S.; revising the due date and 37 required content for the mandatory annual report and 38 audited financial statement of a health maintenance 39 organization which must be submitted to the office; 40 amending s. 641.27, F.S.; revising the annual limit 41 applicable to health maintenance organizations for the 42 examination expenses incurred by the office; amending 43 s. 641.35, F.S.; excluding receivables from a 44 management services organization from being included 45 in the assets of a health maintenance organization for 46 purposes of determining the organization’s financial 47 condition; repealing s. 641.365, F.S., relating to the 48 payment of dividends and distributions of other 49 property by health maintenance organizations; amending 50 ss. 817.234 and 817.50, F.S.; conforming cross 51 references; providing a directive to the Division of 52 Law Revision and Information; providing an effective 53 date. 54 55 Be It Enacted by the Legislature of the State of Florida: 56 57 Section 1. Section 624.407, Florida Statutes, is amended to 58 read: 59 624.407 Surplus required of; newinsurers applying for an 60 original certificate of authority.— 61 (1) To receive authority to transact any one kind or 62 combinations of kinds of insurance, as defined in part V of this 63 chapter, an insurer applying for its original certificate of 64 authority in this state mustshallpossess surplus as to 65 policyholders in at least the following amountgreater of: 66 (a) For a property and casualty insurer, $5 million or 10 67 percent of the insurer’s total liabilities, whichever is 68 greater, except for a domestic insurer that transacts 69 residential property insurance and is: 70 1. Not a wholly owned subsidiary of an insurer domiciled in 71 any other state, which must have a surplus of $15 million. 72 2. A wholly owned subsidiary of an insurer domiciled in any 73 other state, which must have a surplus of $50 million., or $2.574million for any other insurer;75 (b) For a life insurerinsurers, $2.5 million or 4 percent 76 of the insurer’s total liabilities, whichever is greater.;77 (c) For a life and health insurer that will issue a health 78 benefit plan or a long-term care insurance policy on or after 79 the effective date of this act, the greater of: 80 1. The sum of $10 million plus the amount of startup 81 losses, excluding profits, projected to be incurred on the 82 insurer’s startup projection until the projection reflects 83 statutory net profits for 12 consecutive months;insurers,84 2. Four4percent of the insurer’s total liabilities, plus 85 6 percent of the insurer’s liabilities relative to health 86 insurance, based on the insurer’s startup projection; or 87 3. Two percent of the insurer’s total projected premiums 88 relative to health insurance, based on the insurer’s startup 89 projection. 90 (d) For a life and health insurer that is not subject to 91 paragraph (c), the greater of: 92 1. The sum of $2.5 million; or 93 2. Four percent of the insurer’s total liabilities, plus 6 94 percent of the insurer’s liabilities relative to health 95 insurance. 96 (e) For all other insurers, the greater of $2.5 million or 97other than life insurers and life and health insurers,10 98 percent of the insurer’s total liabilities.; or99(e) Notwithstanding paragraph (a) or paragraph (d), for a100domestic insurer that transacts residential property insurance101and is:1021. Not a wholly owned subsidiary of an insurer domiciled in103any other state, $15 million.1042. A wholly owned subsidiary of an insurer domiciled in any105other state, $50 million.106 (2) Notwithstanding subsection (1), a new insurer may not 107 be required to have surplus as to policyholders greater than 108 $100 million. 109 (3) The requirements of this section shall be based upon 110 all the kinds of insurance actually transacted or to be 111 transacted by the insurer in any and all areas in which it 112 operates, regardless of whetheror notonly a portion of such 113 kinds of insurance are transacted in this state. 114 (4) As to surplus as to policyholders required for 115 qualification to transact one or more kinds of insurance, 116 domestic mutual insurers are governed by chapter 628, and 117 domestic reciprocal insurers are governed by chapter 629. 118 (5) For the purposes of this section, liabilities do not 119 include liabilities required under s. 625.041(5). For purposes 120 of computing minimum surplus as to policyholders pursuant to s. 121 625.305(1), liabilities include liabilities required under s. 122 625.041(5). 123 (6) As used in this section, the term “health benefit plan” 124 has the same meaning as in s. 627.6699. 125 Section 2. Section 624.408, Florida Statutes, is amended to 126 read: 127 624.408 Surplus required for;currentinsurers to maintain 128 a certificate of authority.— 129 (1) To maintain a certificate of authority to transact any 130 one kind or combinations of kinds of insurance, as defined in 131 part V of this chapter, an insurer in this state must at all 132 times maintain surplus as to policyholders in at least the 133 following amountgreater of: 134 (a)Except as provided in paragraphs (e), (f), and (g),135$1.5 million.136(b)For a life insurerinsurers, $1.5 million or 4 percent 137 of the insurer’s total liabilities, whichever is greater. 138 (b) For a life and health insurer that is authorized to 139 issue a health benefit plan or long-term care insurance policy, 140 the greater of: 141 1. Four percent of the insurer’s total liabilities, plus 6 142 percent of the insurer’s liabilities relative to health 143 insurance; 144 2. Two percent of the insurer’s total annualized premium 145 relative to health insurance; or 146 3. If the insurer: 147 a. Does not hold a certificate of authority before the 148 effective date of this act, $10 million; or 149 b. Holds a certificate of authority before the effective 150 date of this act, $1.5 million until June 30, 2017; $3 million 151 on or after July 1, 2017, and until June 30, 2021; $6 million on 152 or after July 1, 2021, and until June 30, 2025; and $10 million 153 on or after July 1, 2025. 154 155 The office may reduce the surplus requirement imposed under sub 156 subparagraph 3.a. or sub-subparagraph 3.b. if the office finds 157 the reduction to be in the public interest because the insurer 158 is not writing new business in this state, the insurer is 159 writing business only within a limited geographic service area, 160 the insurer has premiums in force of less than $1 million 161 annually, or the insurer has a policy count of fewer than 6,000, 162 or because of any other factor relevant to making such a 163 finding. 164 (c) For a life and health insurer that is not subject to 165 paragraph (b)insurers, the greater of: 166 1. The sum of $1.5 million; or 167 2. Four4percent of the insurer’s total liabilities, plus 168 6 percent of the insurer’s liabilities relative to health 169 insurance. 170 (d)For all insurers other than mortgage guaranty insurers,171life insurers, and life and health insurers, 10 percent of the172insurer’s total liabilities.173(e)For a property and casualty insurerinsurers, $4 174 million, except for a property and casualty insurerinsurers175 authorized to underwrite any line of residential property 176 insurance. 177 (e)(f)For a residential property insurer: 178 1.insurersNot holding a certificate of authority before 179 July 1, 2011, $15 million. 180 2.(g) For residential property insurersHolding a 181 certificate of authority before July 1, 2011, $5 millionand182 until June 30, 2016, $5 million; $10 million on or after July 1, 183 2016, and until June 30, 2021, $10 million; and $15 million on 184 or after July 1, 2021, $15 million. 185 186 The office may reduce the surplus requirement under this 187 paragraphin paragraphs (f) and (g)if the insurer is not 188 writing new business, has premiums in force of less than $1 189 million per year in residential property insurance, or is a 190 mutual insurance company. 191 (f) For all other insurers, the greater of $1.5 million or 192 10 percent of the insurer’s total liabilities. 193 (2) For purposes of this section, liabilities do not 194 include liabilities required under s. 625.041(5). For purposes 195 of computing minimum surplus as to policyholders pursuant to s. 196 625.305(1), liabilities include liabilities required under s. 197 625.041(5). 198 (3) This section does not require an insurer to have 199 surplus as to policyholders greater than $100 million. 200 (4) A mortgage guaranty insurer shall maintain a minimum 201 surplus as required by s. 635.042. 202 (5) As used in this section, the term “health benefit plan” 203 has the same meaning as in s. 627.6699. 204 Section 3. Effective July 1, 2015, paragraph (g) of 205 subsection (1) of section 624.4085, Florida Statutes, is amended 206 to read: 207 624.4085 Risk-based capital requirements for insurers.— 208 (1) As used in this section, the term: 209 (g) “Life and health insurer” means an insurer authorized 210 or eligible under the Florida Insurance Code to underwrite life 211 or health insurance. The term also includes: 212 1. A property and casualty insurer that writes accident and 213 health insurance only. 214 2. Effective January 1, 2015,the term also includesa 215 health maintenance organization that is authorized in this state 216 and one or more other states, jurisdictions, or countries and a 217 prepaid limited health service organization that is authorized 218 in this state and one or more other states, jurisdictions, or 219 countries. 220 3. A health maintenance organization and a prepaid limited 221 health service organization initially authorized in this state 222 on or after July 1, 2015, and not authorized in any other state, 223 jurisdiction, or country. 224 225 As used in this paragraph, the term “health maintenance 226 organization” has the same meaning as in s. 641.19 and the term 227 “prepaid limited health service organization” has the same 228 meaning as in s. 636.003. 229 Section 4. Effective July 1, 2015, subsection (1), 230 paragraph (a) of subsection (2), and subsections (4) and (6) of 231 section 636.043, Florida Statutes, are amended to read: 232 636.043 Annual, quarterly, and miscellaneous reports.— 233 (1) Each prepaid limited health service organization must 234 file an annual report with the office on or before March 1 of 235 each year showing its condition on the last day of the 236 immediately preceding calendar year. Theannually, within 3237months after the end of its fiscal year, areport must be 238 verified by the notarized oath of at least two officers covering 239 the preceding calendar year.Any organization licensed prior to240October 1, 1993, shall not be required to file a financial241statement, as required by paragraph (2)(a), based on statutory242accounting principles until the first annual report for fiscal243years ending after December 31, 1994.244 (2) TheSuchreport must be on forms prescribed by the 245 commission and must include: 246 (a)1. Astatutoryfinancial statement of the organization 247 prepared in accordance with statutory accounting principles and 248 filed by electronic means in a computer-readable format 249 acceptable to the office, including its balance sheet, income250statement, and statement of changes in cash flow for the251preceding year, certified by an independent certified public252accountant, or a consolidated audited financial statement of its253parent company prepared on the basis of statutory accounting254principles, certified by an independent certified public255accountant, attached to which must be consolidating financial256statements of the parent company, including the prepaid limited257health service organization. 258 2. Any entity subject to this chapter may make written 259 application to the office for approval to file audited financial 260 statements prepared in accordance with generally accepted 261 accounting principles in lieu of statutory financial statements. 262 The office shall approve the application if it finds it to be in 263 the best interest of the subscribers. An application for 264 exemption is required each year and must be filed with the 265 office at least 2 months prior to the end of the fiscal year for 266 which the exemption is being requested. 267 (4)(a) Each authorized prepaid limited health service 268 organization must file a quarterly report for each calendar 269 quarter. The report for the quarter ending March 31 shall be 270 filed with the office on or before May 15, the report for the 271 quarter ending June 30 shall be filed on or before August 15, 272 and the report for the quarter ending September 30 shall be 273 filed on or before November 15. The quarterly report must be 274 verified by the notarized oath of two officers of the 275 organizationwithin 45 days after the end of the quarter. The 276 report mustshallcontain: 277 1.(a)A financial statement prepared in accordance with 278 statutory accounting principles. Any entity licensed before 279 October 1, 1993, isshallnotberequired to file a financial 280 statement based on statutory accounting principles until the 281 first quarterly filing after the entity files its annual 282 financial statement based on statutory accounting principles as 283 required by subsection (1). 284 2.(b)A listing of providers. 285 3.(c)Such other information relating to the performance of 286 the prepaid limited health service organization as is reasonably 287 required by the commission or office. 288 (b) On or before June 1, each authorized prepaid limited 289 health service organization shall annually file with the office 290 an audited financial statement of the organization for the 291 preceding year ending December 31. The office may require the 292 organization to file an audited financial report earlier than 293 June 1 upon notifying the organization at least 90 days in 294 advance. The audited financial statement must include: 295 1. A balance sheet, income statement, and statement of 296 changes in cash flow for the preceding year, all of which must 297 be certified by an independent certified public accountant; or 298 2. A consolidated audited financial statement of the 299 organization’s parent company, prepared on the basis of 300 statutory accounting principles, which must be certified by an 301 independent certified public accountant and to which are 302 attached the consolidated financial statements of the parent 303 company, including those of the prepaid limited health service 304 organization. 305 306 Beginning with the financial statement filed for the year ending 307 December 31, 2015, the audited financial statement or 308 consolidated audited financial statement required by this 309 paragraph is subject to commission rules applicable to insurer 310 audits. 311 (6) Each authorized prepaid limited health service 312 organization shall retain an independent certified public 313 accountant, hereinafter referred to as “CPA,”who agrees by 314 written contract with the prepaid limited health service 315 organization to comply withthe provisions ofthis act. The 316 contract must state that: 317 (a) The independent certified public accountant mustCPA318willprovide to the prepaid limited health service organization 319 audited statutory financial statements consistent with this act. 320 (b) Any determination by the independent certified public 321 accountantCPAthat the prepaid limited health service 322 organization does not meet minimum surplus requirements as set 323 forth in this act mustwillbe stated by the independent 324 certified public accountantCPA, in writing, in the audited 325 financial statement. 326 (c) The completed workpapers and any written communications 327 between the independent certified public accountantCPAand the 328 prepaid limited health service organization relating to the 329 audit of the prepaid limited health service organization must 330willbe made available for review on a visual-inspection-only 331 basis by the office at the offices of the prepaid limited health 332 service organization, at the office, or at any other reasonable 333 place as mutually agreed between the office and the prepaid 334 limited health service organization. The independent certified 335 public accountantCPAmust retain for review the workpapers and 336 written communications for a period of not less than 6 years. 337 Section 5. Present subsections (14) through (22) of section 338 641.19, Florida Statutes, are redesignated as subsections (15) 339 through (23), respectively, and a new subsection (14) is added 340 to that section, to read: 341 641.19 Definitions.—As used in this part, the term: 342 (14) “Management services organization” means an entity 343 that provides one or more medical practice management services 344 to health care providers, including, but not limited to, 345 administrative, financial, operational, personnel, records 346 management, educational, compliance, and managed care services. 347 Section 6. Section 641.201, Florida Statutes, is amended to 348 read: 349 641.201 Applicability of other laws.— 350 (1) Except as provided in this part, health maintenance 351 organizations areshall begoverned bythe provisions ofthis 352 part and part III of this chapter and areshall beexempt from 353 all other provisions of the Florida Insurance Code except those 354provisions of the Florida Insurance Codethat are explicitly 355 made applicable to health maintenance organizations. 356 (2) Health maintenance organizations are considered 357 insurers for purposes of: 358 (a) Sections 624.4073, 628.231, 628.371, and 628.391. 359 (b) Section 624.4095, except that: 360 1. The ratio of actual or projected annual gross written 361 premiums to current or projected surplus as to policyholders for 362 a health maintenance organization holding a certificate of 363 authority before the effective date of this act, may not exceed 364 30 to 1 on or after July 1, 2017, until June 30, 2021; 20 to 1 365 on or after July 1, 2021, until June 30, 2025; and 10 to 1 on or 366 after July 1, 2025. 367 2. In calculating the premium-to-surplus ratio of a health 368 maintenance organization pursuant to s. 624.4095(1), actual or 369 projected risk revenue must be added to actual or projected 370 written premiums. 371 (3) Health maintenance organizations are considered life 372 and health insurers for purposes of ss. 624.407 and 624.408. 373 Section 7. Subsections (1) and (2) of section 641.225, 374 Florida Statutes, are amended to read: 375 641.225 Surplus requirements.— 376 (1) Each health maintenance organization shall at all times 377 maintain a minimum surplus as provided in s. 624.408in an378amount that is the greater of $1,500,000, or 10 percent of total379liabilities, or 2 percent of total annualized premium. 380 (2) The office mayshallnot issue a certificate of 381 authority, except as provided in subsection (3), unless the 382 health maintenance organization has at least theaminimum 383 surplus required in s. 624.407in an amount which is the greater384of:385(a) Ten percent of their total liabilities based on their386startup projection as set forth in this part;387(b) Two percent of their total projected premiums based on388their startup projection as set forth in this part; or389(c) $1,500,000, plus all startup losses, excluding profits,390projected to be incurred on their startup projection until the391projection reflects statutory net profits for 12 consecutive392months. 393 Section 8. Effective July 1, 2015, subsections (1), (3), 394 and (5) of section 641.26, Florida Statutes, are amended to 395 read: 396 641.26 Annual and quarterly reports.— 397 (1) EachEveryhealth maintenance organization must file an 398 annual report with the office on or before March 1 of each year 399 showing its condition on the last day of the immediately 400 preceding calendar year. The report must beshall, annually401within 3 months after the end of its fiscal year, or within an402extension of time therefor as the office, for good cause, may403grant, in a form prescribed by the commission, file a report404with the office,verified by the notarized oath of two officers 405 of the organization or, if not a corporation, of two persons who 406 are principal managing directors of the affairs of the 407 organization, on a form prescribed by the commission. For good 408 cause, the office may grant the organization an extension of 409 time to file the report. The report mustproperly notarized,410showing its condition on the last day of the immediately411preceding reporting period. Such report shallinclude: 412 (a) A financial statement of the health maintenance 413 organization filed by electronic means in a computer-readable 414 form using a format acceptable to the office. 415 (b) A financial statement of the health maintenance 416 organization filed on forms acceptable to the office. 417(c) An audited financial statement of the health418maintenance organization, including its balance sheet and a419statement of operations for the preceding year certified by an420independent certified public accountant, prepared in accordance421with statutory accounting principles.422 (c)(d)The number of health maintenance contracts issued 423 and outstanding and the number of health maintenance contracts 424 terminated. 425 (d)(e)The number and amount of damage claims for medical 426 injury initiated against the health maintenance organization and 427 any of the providers engaged by it during the reporting year, 428 broken down into claims with and without formal legal process, 429 and the disposition, if any, of each such claim. 430 (e)(f)An actuarial certification that: 431 1. The health maintenance organization is actuarially 432 sound, which certification mustshallconsider the rates, 433 benefits, and expenses of, and any other funds available for the 434 payment of obligations of, the organization. 435 2. The rates being charged or to be charged are actuarially 436 adequate to the end of the period for which rates have been 437 guaranteed. 438 3. Incurred but not reported claims and claims reported but 439 not fully paid have been adequately provided for. 440 4. The health maintenance organization has adequately 441 provided for all obligations required by s. 641.35(3)(a). 442(g) A report prepared by the certified public accountant443and filed with the office describing material weaknesses in the444health maintenance organization’s internal control structure as445noted by the certified public accountant during the audit. The446report must be filed with the annual audited financial report as447required in paragraph (c). The health maintenance organization448shall provide a description of remedial actions taken or449proposed to correct material weaknesses, if the actions are not450described in the independent certified public accountant’s451report.452 (f)(h)Such other information relating to the performance 453 of health maintenance organizations as is required by the 454 commission or office. 455 (3)(a) EachEveryhealth maintenance organization shall 456 file quarterly, for the first three calendar quarters of each 457 year, an unaudited financial statement of the organization as 458 described in paragraphs (1)(a) and (b). The statement for the 459 quarter ending March 31 shall be filed with the office on or 460 before May 15, the statement for the quarter ending June 30 461 shall be filed on or before August 15, and the statement for the 462 quarter ending September 30 shall be filed on or before November 463 15. The quarterly report mustshallbe verified by the notarized 464 oath of two officers of the organization, properly notarized. 465 (b) Each health maintenance organization shall file 466 annually, for the preceding year ending December 31, an audited 467 financial statement of the organization. The statement for the 468 year ending December 31 must be filed with the office on or 469 before the following June 1. The office may require a health 470 maintenance organization to file an audited financial report 471 earlier than June 1 upon notifying the organization at least 90 472 days in advance. The audited financial statement must include a 473 balance sheet and statement of operations for the preceding year 474 certified by an independent certified public accountant and must 475 be prepared in accordance with statutory accounting principles. 476 The audited financial statement filed for the year ending 477 December 31, 2015, is subject to commission rules applicable to 478 insurer audits. 479 (5) Each authorized health maintenance organization shall 480 retain an independent certified public accountant, referred to481in this section as “CPA,”who agrees by written contract with 482 the health maintenance organization to comply withthe483provisionsofthis part. 484 (a) The independent certified public accountantCPAshall 485 provide to the health maintenance organizationHMOaudited 486 financial statements consistent with this part. 487 (b) Any determination by the independent certified public 488 accountantCPAthat the health maintenance organization does not 489 meet minimum surplus requirements as set forth in this part must 490shallbe stated by the independent certified public accountant 491CPA, in writing, in the audited financial statement. 492 (c) The completed work papers and any written 493 communications between the independent certified public 494 accountantCPAfirm and the health maintenance organization 495 relating to the audit of the health maintenance organization 496 shall be made available for review on a visual-inspection-only 497 basis by the office at the offices of the health maintenance 498 organization, at the office, or at any other reasonable place as 499 mutually agreed between the office and the health maintenance 500 organization. The independent certified public accountantCPA501 must retain for review the work papers and written 502 communications for a period of not less than 6 years. 503 (d) The independent certified public accountantCPAshall 504 provide to the office a written report describing material 505 weaknesses in the health maintenance organization’s internal 506 control structure as noted during the audit. The report must be 507 filed with the annual audited financial statement required under 508 paragraph (3)(b). The health maintenance organization must 509 provide a description of remedial actions taken or proposed to 510 be taken to correct material weaknesses, if the actions are not 511 described in the written report provided to the office by the 512 independent certified public accountant. 513 Section 9. Effective July 1, 2015, section 641.27, Florida 514 Statutes, is amended to read: 515 641.27 Examination by the officedepartment.— 516 (1) The office shall examine the affairs, transactions, 517 accounts, business records, and assets of any health maintenance 518 organization as often as it deems it expedient for the 519 protection of the people of this state, but not less frequently 520 than once every 5 years. However, except when the medical 521 records are requested and copies furnished pursuant to s. 522 456.057, medical records of individuals and records of 523 physicians providing service under contract to the health 524 maintenance organization areshallnotbesubject to audit, 525 although they may be subject to subpoena by court order upon a 526 showing of good cause. For the purpose of examinations, the 527 office may administer oaths to and examine the officers and 528 agents of a health maintenance organization concerning its 529 business and affairs. The examination of each health maintenance 530 organization by the office shall be subject to the same terms 531 and conditions as apply to insurers under chapter 624. In no 532 event shall expenses of all examinations exceed a maximum of 533 $100,000$50,000for any 1-year period. Any rehabilitation, 534 liquidation, conservation, or dissolution of a health 535 maintenance organization shall be conducted under the 536 supervision of the department, which shall have all power with 537 respect thereto granted to it under the laws governing the 538 rehabilitation, liquidation, reorganization, conservation, or 539 dissolution of life insurance companies. 540 (2) The office may contract, at reasonable fees for work 541 performed, with qualified, impartial outside sources to perform 542 audits or examinations or portions thereof pertaining to the 543 qualification of an entity for issuance of a certificate of 544 authority or to determine continued compliance with the 545 requirements of this part, in which case the payment must be 546 made directly to the contracted examiner by the health 547 maintenance organization examined, in accordance with the rates 548 and terms agreed to by the office and the examiner. Any 549 contracted assistance shall be under the direct supervision of 550 the office. The results of any contracted assistance areshall551besubject to the review of, and approval, disapproval, or 552 modification by, the office. 553 Section 10. Paragraph (j) is added to subsection (2) of 554 section 641.35, Florida Statutes, to read: 555 641.35 Assets, liabilities, and investments.— 556 (2) ASSETS NOT ALLOWED.—In addition to assets impliedly 557 excluded by the provisions of subsection (1), the following 558 assets areexpresslyshallnotbeallowed as assets in any 559 determination of the financial condition of a health maintenance 560 organization: 561 (j) Beginning on or after January 1, 2016, any receivables 562 from a management services organization pursuant to contract 563 with the health maintenance organization. 564 Section 11. Section 641.365, Florida Statutes, is repealed. 565 Section 12. Paragraph (b) of subsection (2) of section 566 817.234, Florida Statutes, is amended to read: 567 817.234 False and fraudulent insurance claims.— 568 (2) 569 (b) In addition to any other provision of law, systematic 570 upcoding by a provider, as defined in s. 641.19(14), with the 571 intent to obtain reimbursement otherwise not due from an insurer 572 is punishable as provided in s. 641.52(5). 573 Section 13. Subsection (1) of section 817.50, Florida 574 Statutes, is amended to read: 575 817.50 Fraudulently obtaining goods, services, etc., from a 576 health care provider.— 577 (1) Whoever shall, willfully and with intent to defraud, 578 obtain or attempt to obtain goods, products, merchandise, or 579 services from any health care provider in this state, as defined 580 in s. 641.19(14), commits a misdemeanor of the second degree, 581 punishable as provided in s. 775.082 or s. 775.083. 582 Section 14. The Division of Law Revision and Information is 583 directed to replace the phrase “the effective date of this act” 584 where it occurs in this act with the date the act becomes a law. 585 Section 15. Except as otherwise provided, this act shall 586 take effect upon becoming a law.