CS/HB 1335 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1335-01-c1
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to the payment of health insurance 2
claims; amending ss. 627.6131 and 641.3155, F.S.; 3
prohibiting a health insurer or health maintenance 4
organization from retroactively denying a claim at any 5
time because of ineligibility of the insured or 6
subscriber, respectively; specifying an exception; 7
providing applicability of the prohibition to 8
contracts entered into or renewed on or after a 9
specified date; providing nonapplicability of the 10
prohibition to Medicaid managed care plans; providing 11
an effective date. 12
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Be It Enacted by the Legislature of the State of Florida: 14
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Section 1. Subsection (11) of section 627.6131, Florida 16
Statutes, is amended to read: 17
627.6131 Payment of claims. — 18
(11) A health insurer may not retroactively deny a claim 19
because of insured ineligibility at any time, except a health 20
insurer may retroactively deny a claim for insured ineligibility 21
within 1 year after the da te of payment of the claim if the 22
provider was convicted of fraud pursuant to s. 817.234. This 23
subsection applies to policies entered into or renewed on or 24
after January 1, 2024 more than 1 year after the date of payment 25
CS/HB 1335 2023
CODING: Words stricken are deletions; words underlined are additions.
hb1335-01-c1
Page 2 of 2
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
of the claim. 26
Section 2. Subsection (10) of section 641.3155, Florida 27
Statutes, is amended to read: 28
641.3155 Prompt payment of claims. — 29
(10) A health maintenance organization may not 30
retroactively deny a claim because of subscriber ineligibility 31
at any time, except a health maintena nce organization may 32
retroactively deny a claim for subscriber ineligibility within 1 33
year after the date of payment of the claim if the provider was 34
convicted of fraud pursuant to s. 817.234. This subsection 35
applies to contracts entered into or renewed on or after January 36
1, 2024. This subsection does not apply to Medicaid managed care 37
plans under part IV of chapter 409 more than 1 year after the 38
date of payment of the claim . 39
Section 3. This act shall take effect July 1, 2023. 40