HB 659 2024
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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 health plans; amending s. 408.7057, 2
F.S.; prohibiting health plans from declining to 3
participate in filed claims; providing defaults 4
against health plans for failure to respond; requiring 5
the Agency for Health Care Administration to provide 6
health plans with notices of failure to pay providers 7
the amounts provided in claim dispute orders under 8
certain circumstances; requiring health plans to pa y 9
providers the amounts provided in claim dispute orders 10
under certain circumstances; providing penalties for 11
failure to pay such amounts; amending s. 627.4302, 12
F.S.; requiring certain health insurance and health 13
maintenance organization benefits -identification cards 14
to include specified information in a certain manner; 15
providing applicability; providing rulemaking 16
authority; amending ss. 627.642, 627.657, and 641.31, 17
F.S.; requiring certain health insurance and health 18
maintenance organization identificatio n cards to 19
include specified information in a certain manner; 20
providing applicability; providing rulemaking 21
authority; providing an effective date. 22
23
Be It Enacted by the Legislature of the State of Florida: 24
25
HB 659 2024
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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
Section 1. Subsection (7) of section 408 .7057, Florida 26
Statutes, is renumbered as subsection (8), subsection (5) is 27
amended, paragraph (i) is added to subsection (2), and a new 28
subsection (7) is added to that section, to read: 29
408.7057 Statewide provider and health plan claim dispute 30
resolution program.— 31
(2) 32
(i) A health plan may not decline to participate in a 33
filed claim. Failure to respond as provided in paragraph (f) 34
shall result in a default against the health plan. 35
(5) The agency shall notify within 7 days the appropriate 36
licensure or certification entity whenever there is : 37
(a) A failure to pay as provided in subsection (7); or 38
(b) A violation of a final order issued by the agency 39
pursuant to this section. 40
(7) A health plan that does not prevail in the agency's 41
order shall pay the provider the amount provided in the order 42
within 35 days after the order is entered. A health plan that 43
does not pay the required amount within this timeframe is 44
subject to a penalty of not more than $500 per day until the 45
amount is paid. 46
Section 2. Subsection (2) of section 627.4302, Florida 47
Statutes, is amended to read: 48
627.4302 Identification cards for processing prescription 49
drug claims.— 50
HB 659 2024
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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
(2) Any health insurer or health maintenance organization 51
and all state and local government entities ent ering into an 52
agreement to provide coverage for prescription drugs on an 53
outpatient basis shall provide a benefits -identification card 54
containing the following information: 55
(a) The name of the claim processor. 56
(b) The electronic-claims payor identification number or 57
the issuer identification number, also referred to as the 58
Banking Identification Number or "BIN," assigned by the American 59
National Standards Institute. 60
(c) The insured's prescription group number. 61
(d) The insured's identificat ion number. 62
(e) The insured's name. 63
(f) The claims submission name and address. 64
(g) The help desk telephone number. 65
(h) The type of plan, only if the plan is filed in this 66
state; an indication that the plan is self -funded; or the name 67
of the network. 68
1. If the plan is subject to state regulation, the 69
identification card must include the letters "FL" on the back 70
left-hand corner of the card, under which a quick response (QR) 71
code must be displayed directing the insured or the subscriber 72
to the consumer services website of the Division of Consumer 73
Services of the department. Based on the plan, the website may 74
display the name of the regulatory entity with relevant contact 75
HB 659 2024
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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
information, including a telephone number or website hyperlink 76
for the entity. The website may also include the following 77
notice: "If your plan card does not display 'FL' on the back 78
left-hand corner of the card, your plan may be regulated by 79
another state, another Florida state agency, or the Federal 80
Government. If you need assistan ce in locating the appropriate 81
regulator for your plan, please visit the Get Insurance Help web 82
page of the Division of Consumer Services." 83
2. Subparagraph 1. applies to benefits -identification 84
cards issued or reissued on or after January 1, 2025. 85
3. The department may adopt rules to implement necessary 86
changes to the consumer services website and hotline of the 87
Division of Consumer Services to best assist insureds or 88
subscribers who are at an impasse with their insurers or health 89
maintenance organizati ons, respectively. 90
(i)(h) Any other information that the entity finds will 91
assist in the processing of the claim. 92
93
The information required in paragraphs (a), (b), (g), and (i) 94
(h) must be provided on the card, unless instruction is provided 95
on the card for ready access to such information by electronic 96
means. 97
Section 3. Paragraph (c) of subsection (3) of section 98
627.642, Florida Statutes, is amended to read: 99
627.642 Outline of coverage. — 100
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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
(3) In addition to the outline of coverage, a policy as 101
specified in s. 627.6699(3)(k) must be accompanied by an 102
identification card that contains, at a minimum: 103
(c) The type of plan , only if the plan is filed in this 104
the state;, an indication that the plan is self -funded;, or the 105
name of the network. 106
1. If the plan is subject to state regulation, the 107
identification card must include the letters "FL" on the back 108
left-hand corner of the card, under which a quick response (QR) 109
code must be displayed directing the insured to the consumer 110
services website of the Di vision of Consumer Services of the 111
department. Based on the plan, the website may display the name 112
of the regulatory entity with relevant contact information, 113
including a telephone number or website hyperlink for the 114
entity. The website may also include th e following notice: "If 115
your plan card does not display 'FL' on the back left -hand 116
corner of the card, your plan may be regulated by another state, 117
another Florida state agency, or the Federal Government. If you 118
need assistance in locating the appropriate regulator for your 119
plan, please visit the Get Insurance Help web page of the 120
Division of Consumer Services." 121
2. Subparagraph 1. applies to identification cards issued 122
or reissued on or after January 1, 2025. 123
3. The department may adopt rules to impleme nt necessary 124
changes to the consumer services website and hotline of the 125
HB 659 2024
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Division of Consumer Services to best assist insureds who are at 126
an impasse with their insurers. 127
128
The identification card must present the information in a 129
readily identifiable manner or, alternatively, the information 130
may be embedded on the card and available through magnetic 131
stripe or smart card. The information may also be provided 132
through other electronic technology. 133
Section 4. Paragraph (c) of subsection (2) of section 134
627.657, Florida Statutes, is amended to read: 135
627.657 Provisions of group health insurance policies. — 136
(2) The medical policy as specified in s. 627.6699(3)(k) 137
must be accompanied by an identification card that contains, at 138
a minimum: 139
(c) The type of plan , only if the plan is filed in the 140
state;, an indication that the plan is self -funded;, or the name 141
of the network. 142
1. If the plan is subject to state regulation, the 143
identification card must include the letters "FL" on the back 144
left-hand corner of the car d, under which a quick response (QR) 145
code must be displayed directing the insured or the subscriber 146
to the consumer services website of the Division of Consumer 147
Services of the department. Based on the plan, the website may 148
display the name of the regulato ry entity with relevant contact 149
information, including a telephone number or website hyperlink 150
HB 659 2024
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for the entity. The website may also include the following 151
notice: "If your plan card does not display 'FL' on the back 152
left-hand corner of the card, your plan m ay be regulated by 153
another state, another Florida state agency, or the Federal 154
Government. If you need assistance in locating the appropriate 155
regulator for your plan, please visit the Get Insurance Help web 156
page of the Division of Consumer Services." 157
2. Subparagraph 1. applies to identification cards issued 158
or reissued on or after January 1, 2025. 159
3. The department may adopt rules to implement necessary 160
changes to the consumer services website and hotline of the 161
Division of Consumer Services to best ass ist insureds who are at 162
an impasse with their insurers. 163
164
The identification card must present the information in a 165
readily identifiable manner or, alternatively, the information 166
may be embedded on the card and available through magnetic 167
stripe or smart card. The information may also be provided 168
through other electronic technology. 169
Section 5. Paragraph (c) of subsection (42) of section 170
641.31, Florida Statutes, is amended to read: 171
641.31 Health maintenance contracts. — 172
(42) The contract, certificat e, or member handbook must be 173
accompanied by an identification card that contains, at a 174
minimum: 175
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(c) A statement that the health plan is a health 176
maintenance organization. Only a health plan with a certificate 177
of authority issued under this chapter may b e identified as a 178
health maintenance organization. 179
1. If the plan is subject to state regulation, the 180
identification card must include the letters "FL" on the back 181
left-hand corner of the card, under which a quick response (QR) 182
code must be displayed dir ecting the insured or the subscriber 183
to the consumer services website of the Division of Consumer 184
Services of the department. Based on the plan, the website may 185
display the name of the regulatory entity with relevant contact 186
information, including a teleph one number or website hyperlink 187
for the entity. The website may also include the following 188
notice: "If your plan card does not display 'FL' on the back 189
left-hand corner of the card, your plan may be regulated by 190
another state, another Florida state agency, or the Federal 191
Government. If you need assistance in locating the appropriate 192
regulator for your plan, please visit the help web page of the 193
Division of Consumer Services." 194
2. Subparagraph 1. applies to identification cards issued 195
or reissued on or afte r January 1, 2025. 196
3. The department may adopt rules to implement necessary 197
changes to the consumer services website and hotline of the 198
Division of Consumer Services to best assist subscribers who are 199
at an impasse with their health maintenance organizat ions. 200
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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
201
The identification card must present the information in a 202
readily identifiable manner or, alternatively, the information 203
may be embedded on the card and available through magnetic 204
stripe or smart card. The information may also be provided 205
through other electronic technology. 206
Section 6. This act shall take effect January 1, 2025. 207