Florida Statutes
Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)
641.18 - Declaration of legislative intent, findings, and purposes.


(1) Faced with the continuation of mounting costs of health care, coupled with the state’s interest in high-quality care, the Legislature has determined that there is a need to explore alternative methods for the delivery of health care services, with a view toward achieving greater efficiency and economy in providing these services.
(2) Health maintenance organizations, consisting of prepaid health care plans, hereinafter referred to as “plans,” are developing rapidly in many communities. Through these organizations, structured in various forms, health care services are provided directly to a group of people who make regular premium payments.
(3) These plans, when properly operated, emphasize effective cost and quality controls.
(4) It shall be the policy of this state to:
(a) Eliminate legal barriers to the organization, promotion, and expansion of comprehensive prepaid health care plans.
(b) Recognize that prepaid comprehensive health care plans shall be exempt from operation of the insurance laws of this state except in the manner and to the extent set forth in this part.
(c) Ensure that comprehensive prepaid health care plans deliver high-quality health care.

(5) Although it is the intent of this act to provide an opportunity for the development of health maintenance organizations, there is no intent to impair the present system for the delivery of health services.
(6) The Legislature has determined that the operation of a health maintenance organization without a subsisting certificate of authority or the renewal, issuance, or delivery of a health maintenance contract without a subsisting certificate of authority constitutes a danger to the citizens of this state and exposes any subscriber to immediate and irreparable injury, loss, or damage.
History.—s. 2, ch. 72-264; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 779, 804, 809(1st), ch. 82-243; s. 5, ch. 85-177; ss. 187, 188, ch. 91-108; s. 4, ch. 91-429.

Structure Florida Statutes

Florida Statutes

Title XXXVII - Insurance

Chapter 641 - Health Care Service Programs

Part I - Health Maintenance Organizations (Ss. 641.17-641.3923)

641.17 - Short title.

641.18 - Declaration of legislative intent, findings, and purposes.

641.183 - Statutory accounting procedures; transition provisions.

641.185 - Health maintenance organization subscriber protections.

641.19 - Definitions.

641.201 - Applicability of other laws.

641.2011 - Insurance holding companies.

641.2015 - Incorporation required.

641.2017 - Insurance business not authorized.

641.2018 - Limited coverage for home health care authorized.

641.20185 - High-deductible contracts for medical savings accounts.

641.2019 - Provider service network certificate of authority.

641.21 - Application for certificate.

641.215 - Conditions precedent to issuance or maintenance of certificate of authority; effect of bankruptcy proceedings.

641.217 - Minority recruitment and retention plans required.

641.22 - Issuance of certificate of authority.

641.221 - Continued eligibility for certificate of authority.

641.225 - Surplus requirements.

641.2261 - Application of solvency requirements to provider-sponsored organizations and Medicaid provider service networks.

641.227 - Rehabilitation Administrative Expense Fund.

641.228 - Florida Health Maintenance Organization Consumer Assistance Plan.

641.23 - Revocation or cancellation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension.

641.234 - Administrative, provider, and management contracts.

641.2342 - Contract providers.

641.25 - Administrative penalty in lieu of suspension or revocation.

641.255 - Acquisition, merger, or consolidation.

641.26 - Annual and quarterly reports.

641.261 - Other reporting requirements.

641.27 - Examination by the department.

641.28 - Civil remedy.

641.281 - Injunction.

641.282 - Payment of judgment by health maintenance organization.

641.284 - Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy.

641.285 - Insolvency protection.

641.286 - Levy upon deposit limited.

641.29 - Fees.

641.30 - Construction and relationship to other laws.

641.3005 - Application of ch. 85-177.

641.3007 - HIV infection and AIDS for contract purposes.

641.305 - Language used in contracts and advertisements; translations.

641.309 - Standards for marketing to persons eligible for Medicare.

641.31 - Health maintenance contracts.

641.3101 - Additional contract contents.

641.31015 - Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

641.3102 - Restrictions upon expulsion or refusal to issue or renew contract.

641.3103 - Charter, bylaw provisions.

641.3104 - Execution of contracts.

641.3105 - Validity of noncomplying contracts.

641.3106 - Construction of contracts.

641.3107 - Delivery of contract; definitions.

641.31071 - Preexisting conditions.

641.31072 - Special enrollment periods.

641.31073 - Prohibiting discrimination against individual participants and beneficiaries based on health status.

641.31074 - Guaranteed renewability of coverage.

641.31075 - Advanced practice registered nurse services.

641.31076 - Shared savings incentive program.

641.31077 - Coverage for organ transplants.

641.3108 - Notice of cancellation of contract.

641.31085 - Disclosures to subscribers; coverage of behavioral health care services.

641.31094 - Nondiscrimination of coverage for certain surgical procedures involving bones or joints.

641.31095 - Coverage for mammograms.

641.31096 - Requirements with respect to breast cancer and routine followup care.

641.31097 - Decreasing inappropriate utilization of emergency care.

641.31098 - Coverage for individuals with developmental disabilities.

641.31099 - Restrictions on use of state and federal funds for state exchanges.

641.3111 - Extension of benefits.

641.312 - Scope.

641.313 - Health maintenance contracts; cancer treatment parity; orally administered cancer treatment medications.

641.314 - Pharmacy benefit manager contracts.

641.315 - Provider contracts.

641.3154 - Organization liability; provider billing prohibited.

641.3155 - Prompt payment of claims.

641.3156 - Treatment authorization; payment of claims.

641.316 - Fiscal intermediary services.

641.32 - Acceptable payments.

641.33 - Certain words prohibited in name of organization.

641.35 - Assets, liabilities, and investments.

641.36 - Adoption of rules; penalty for violation.

641.365 - Dividends.

641.37 - Prohibited activities; penalties.

641.38 - Operational health maintenance organizations; issuance of certificate.

641.385 - Order to discontinue certain advertising.

641.386 - Agent licensing and appointment required; exceptions.

641.39001 - Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty.

641.3901 - Unfair methods of competition and unfair or deceptive acts or practices prohibited.

641.3903 - Unfair methods of competition and unfair or deceptive acts or practices defined.

641.3905 - General powers and duties of the department and office.

641.3907 - Defined unfair practices; hearings, witnesses, appearances, production of books, and service of process.

641.3909 - Cease and desist and penalty orders.

641.3911 - Appeals from the department or office.

641.3913 - Penalty for violation of cease and desist orders.

641.3915 - Health maintenance organization anti-fraud plans and investigative units.

641.3917 - Civil liability.

641.3921 - Conversion on termination of eligibility.

641.3922 - Conversion contracts; conditions.

641.3923 - Discrimination against providers prohibited.