HB 1101 2025
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hb1101-00
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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 out -of-network providers; amending 2
s. 456.0575, F.S.; requiring a health care 3
practitioner to notify a patient in writing upon 4
referring the patient to certain providers; providing 5
requirements for such notice; providing for health 6
care practitioner disciplinary action under certain 7
conditions; amending s. 627.6471, F.S.; requiring 8
certain health insurers to apply payments for services 9
provided by nonpreferred providers toward insureds' 10
deductibles and out-of-pocket maximums if specified 11
conditions are met; providing 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 (2) of section 456.05 75, Florida 16
Statutes, is renumbered as subsection (3), and a new subsection 17
(2) is added to that section to read: 18
456.0575 Duty to notify patients. — 19
(2) A health care practitioner shall notify a patient in 20
writing upon referring the patient to a nonpar ticipating 21
provider for nonemergency services, as those terms are defined 22
in s. 627.64194(1), or to a provider, as defined in s. 641.47, 23
that is not under contract with the patient's health maintenance 24
organization. Such notice must state that the services will be 25
HB 1101 2025
CODING: Words stricken are deletions; words underlined are additions.
hb1101-00
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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
provided on an out-of-network basis, which may result in 26
additional cost-sharing responsibilities for the patient, and 27
such notice must be documented in the patient's medical record. 28
Failure to comply with this subsection, without good cause, 29
shall result in disciplinary action against the health care 30
practitioner. 31
Section 2. Subsection (7) of section 627.6471, Florida 32
Statutes, is renumbered as subsection (8), and a new subsection 33
(7) is added to that section to read: 34
627.6471 Contracts for reduced rates of payment; 35
limitations; coinsurance and deductibles. — 36
(7) Any insurer issuing a policy of health insurance in 37
this state shall apply the payment for a service provided to an 38
insured by a nonpreferred provider toward the insured's 39
deductible and out-of-pocket maximum as if the service had been 40
provided by a preferred provider if all of the following apply: 41
(a) The insured requests that the insurer apply the 42
payment for the service provided to the insured by the 43
nonpreferred provider toward the insured's deductible and out -44
of-pocket maximum. 45
(b) The service provided to the insured by the 46
nonpreferred provider is within the scope of services covered 47
under the insured's policy. 48
(c) The amount that the nonpreferred provider charged the 49
insured for the service is the same as or less than: 50
HB 1101 2025
CODING: Words stricken are deletions; words underlined are additions.
hb1101-00
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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
1. The average amount that the insured's preferred 51
provider network charges for the service; or 52
2. The statewide average amount for the service based on 53
data reported on the Florida Health Price Finder w ebsite. 54
Section 3. This act shall take effect July 1, 2025. 55