| 2 | | - | Florida Senate - 2025 CS for CS for CS for SB 1842 By the Committee on Fiscal Policy; the Appropriations Committee on Health and Human Services; the Committee on Health Policy; and Senator Burton 594-03849-25 20251842c3 1 A bill to be entitled 2 An act relating to health care provider referrals; 3 amending s. 456.053, F.S.; requiring certain health 4 care providers to disclose, in writing, specified 5 information to their patients before making a referral 6 for certain health care services; providing an 7 effective date. 8 9 Be It Enacted by the Legislature of the State of Florida: 10 11 Section 1.Paragraph (j) of subsection (5) of section 12 456.053, Florida Statutes, is amended to read: 13 456.053Financial arrangements between referring health 14 care providers and providers of health care services. 15 (5)PROHIBITED REFERRALS AND CLAIMS FOR PAYMENT.Except as 16 provided in this section: 17 (j)A health care provider who meets the requirements of 18 paragraphs (b) and (i) shall must disclose the following 19 information to his or her patient before making a referral: 20 1.His or her investment interest to his or her patients as 21 provided in s. 456.052; and 22 2.His or her status with the entity in which the health 23 care provider has an investment interest as a nonparticipating 24 provider for nonemergency services, as those terms are defined 25 in s. 627.64194, or to a provider, as defined in s. 641.47, not 26 under contract with the patients health maintenance 27 organization. The disclosure must be in writing and state that 28 the services will be provided on an out-of-network basis, which 29 may result in additional cost-sharing responsibilities for the 30 patient. 31 Section 2.This act shall take effect July 1, 2025. |
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| 2 | + | Florida Senate - 2025 CS for CS for SB 1842 By the Appropriations Committee on Health and Human Services; the Committee on Health Policy; and Senator Burton 603-03460-25 20251842c2 1 A bill to be entitled 2 An act relating to out-of-network providers; amending 3 s. 456.0575, F.S.; requiring a health care 4 practitioner or his or her employee to confirm whether 5 a referral provider participates in the provider 6 network of the patients health insurer or health 7 maintenance organization under certain circumstances; 8 authorizing the practitioner or his or her employee to 9 confirm the referral providers participation in a 10 specified manner; providing applicability; requiring a 11 health care practitioner to notify a patient in 12 writing that certain services are not covered services 13 under the patients health coverage; requiring that 14 such notice be documented; providing for health care 15 practitioner disciplinary action under certain 16 conditions; authorizing the Department of Health to 17 adopt rules; providing an effective date. 18 19 Be It Enacted by the Legislature of the State of Florida: 20 21 Section 1.Present subsection (2) of section 456.0575, 22 Florida Statutes, is redesignated as subsection (3), and a new 23 subsection (2) is added to that section, to read: 24 456.0575Duty to notify patients. 25 (2)(a)When providing nonemergency services, as defined in 26 s. 627.64194, to a patient, and referring the patient to a 27 provider for nonemergency services, a health care practitioner 28 or his or her employee must, at the point of service, confirm 29 whether the referral provider participates in the provider 30 network of the patients health insurer or health maintenance 31 organization. The practitioner or his or her employee may 32 confirm the referral providers participation by contacting the 33 referral provider or the patients health insurer or health 34 maintenance organization, as necessary, or may rely on the 35 online provider directory of the health insurer or health 36 maintenance organization. 37 (b)The requirements of paragraph (a) do not apply if the 38 patient indicates in writing that he or she does not wish the 39 referring health care practitioner to confirm whether other 40 providers participate in the provider network of the patients 41 health insurer or health maintenance organization. 42 (c)When making any referral, the practitioner must notify 43 a patient in writing that services provided by an out-of-network 44 provider or that are not covered services under the patients 45 health coverage may result in additional cost-sharing 46 responsibilities for the patient, and such notice must be 47 documented in the patients medical record. 48 (d)Failure to comply with this subsection, without good 49 cause, shall result in disciplinary action against the health 50 care practitioner. 51 (e)The department may adopt rules to implement this 52 subsection. 53 Section 2.This act shall take effect July 1, 2025. |
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