(1) All providers offering medical services to members under a discount plan must provide such services pursuant to a written agreement. The agreement may be entered into directly by the provider or by a provider network to which the provider belongs.
(2) A provider agreement between a discount plan organization and a provider must provide the following:
(a) A list of the services and products to be provided at a discount.
(b) The amount or amounts of the discounts or, alternatively, a fee schedule which reflects the provider’s discounted rates.
(c) A statement that the provider will not charge members more than the discounted rates.
(3) A provider agreement between a discount plan organization and a provider network must require that the provider network have written agreements with its providers which:
(a) Contain the terms described in subsection (2).
(b) Authorize the provider network to contract with the discount plan organization on behalf of the provider.
(c) Require the network to maintain an up-to-date list of its contracted providers and to provide that list on a monthly basis to the discount plan organization.
(4) The discount plan organization shall maintain a copy of each active provider agreement into which it has entered.
History.—s. 31, ch. 2004-297; s. 9, ch. 2005-232; s. 8, ch. 2017-112.
Structure Florida Statutes
Chapter 636 - Prepaid Limited Health Service Organizations and Discount Plan Organizations
Part II - Discount Plan Organizations (Ss. 636.202-636.244)
636.205 - Issuance of license; denial.
636.206 - Examinations and investigations.
636.207 - Applicability of part.
636.208 - Fees; charges; reimbursement.
636.210 - Prohibited activities of a discount plan organization.
636.214 - Provider agreements.
636.220 - Minimum capital requirements.
636.223 - Administrative penalty.
636.224 - Notice of change of name or address of discount plan organization.
636.226 - Provider name listing.
636.228 - Marketing of discount plans.
636.230 - Bundling discount plans with other products.
636.234 - Service of process on a discount plan organization.
636.236 - Surety bond or security deposit.