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641.17 - Short title. - History.—s. 1, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.18 - Declaration of legislative intent, findings, and purposes. - (1) Faced with the continuation of mounting costs of health...
641.183 - Statutory accounting procedures; transition provisions. - (1) Report assets acquired prior to June 30, 2001, in...
641.185 - Health maintenance organization subscriber protections. - (1) With respect to the provisions of this part and...
641.19 - Definitions. - (1) “Affiliate” means any entity that exercises control over or...
641.201 - Applicability of other laws. - History.—ss. 25, 50, ch. 85-321; s. 3, ch. 87-236; ss....
641.2011 - Insurance holding companies. - History.—s. 76, ch. 2000-318.
641.2015 - Incorporation required. - History.—ss. 7, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.2017 - Insurance business not authorized. - (1) Enter into arrangements whereby the expected cost of health...
641.2018 - Limited coverage for home health care authorized. - (1) Notwithstanding other provisions of this chapter, a health maintenance...
641.20185 - High-deductible contracts for medical savings accounts. - History.—s. 22, ch. 97-179; s. 52, ch. 99-3.
641.2019 - Provider service network certificate of authority. - History.—s. 34, ch. 2011-135.
641.21 - Application for certificate. - (1) Before any entity may operate a health maintenance organization,...
641.215 - Conditions precedent to issuance or maintenance of certificate of authority; effect of bankruptcy proceedings. - (1) As a condition precedent to the issuance or maintenance...
641.217 - Minority recruitment and retention plans required. - (1) Any entity contracting with the Agency for Health Care...
641.22 - Issuance of certificate of authority. - (1) As a condition precedent to the issuance of any...
641.221 - Continued eligibility for certificate of authority. - (1) In order to maintain its eligibility for a certificate...
641.225 - Surplus requirements. - (1) Each health maintenance organization shall at all times maintain...
641.2261 - Application of solvency requirements to provider-sponsored organizations and Medicaid provider service networks. - (1) The solvency requirements of ss. 1855 and 1856 of...
641.227 - Rehabilitation Administrative Expense Fund. - (1) The office shall not issue or permit to exist...
641.228 - Florida Health Maintenance Organization Consumer Assistance Plan. - (1) The office shall not issue a certificate to any...
641.23 - Revocation or cancellation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension. - (1) The maintenance of a valid and current health care...
641.234 - Administrative, provider, and management contracts. - (1) The office may require a health maintenance organization to...
641.2342 - Contract providers. - History.—ss. 9, 24, ch. 88-388; ss. 187, 188, ch. 91-108;...
641.25 - Administrative penalty in lieu of suspension or revocation. - History.—s. 9, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.255 - Acquisition, merger, or consolidation. - (1) Every acquisition of a health maintenance organization shall be...
641.26 - Annual and quarterly reports. - (1) Every health maintenance organization shall, annually within 3 months...
641.261 - Other reporting requirements. - (1) Each authorized health maintenance organization shall provide records and...
641.27 - Examination by the department. - (1) The office shall examine the affairs, transactions, accounts, business...
641.28 - Civil remedy. - History.—s. 12, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.281 - Injunction. - (1) A health maintenance organization is being operated by any...
641.282 - Payment of judgment by health maintenance organization. - History.—ss. 16, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.284 - Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy. - History.—ss. 118, 188, ch. 91-108; s. 4, ch. 91-429; s....
641.285 - Insolvency protection. - (1) Each health maintenance organization shall deposit with the department...
641.286 - Levy upon deposit limited. - History.—ss. 18, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.29 - Fees. - (1) For filing a copy of its application for a...
641.30 - Construction and relationship to other laws. - (1) Every health maintenance organization shall accept the claim form...
641.3005 - Application of ch. 85-177. - History.—s. 48, ch. 85-177; s. 1, ch. 86-286; ss. 187,...
641.3007 - HIV infection and AIDS for contract purposes. - (1) PURPOSE.—The purpose of this section is to prohibit unfair...
641.305 - Language used in contracts and advertisements; translations. - (1)(a) All health maintenance contracts or forms shall be printed...
641.309 - Standards for marketing to persons eligible for Medicare. - (1) Every health maintenance organization marketing coverage to Medicare participants...
641.31 - Health maintenance contracts. - (1) Any entity issued a certificate and otherwise in compliance...
641.3101 - Additional contract contents. - (1) Necessary, on account of the manner in which the...
641.31015 - Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan. - History.—s. 8, ch. 96-223. 1Note.—Also published at s. 627.64725.
641.3102 - Restrictions upon expulsion or refusal to issue or renew contract. - (1) A health maintenance organization that offers individual health maintenance...
641.3103 - Charter, bylaw provisions. - History.—ss. 25, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.3104 - Execution of contracts. - (1) Every health maintenance contract shall be executed in the...
641.3105 - Validity of noncomplying contracts. - (1) Any health maintenance contract, rider, endorsement, attachment, or addendum...
641.3106 - Construction of contracts. - History.—ss. 28, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.3107 - Delivery of contract; definitions. - (1) A health maintenance contract, certificate of coverage, endorsements and...
641.31071 - Preexisting conditions. - (1) As used in this section, the term: (a) “Enrollment...
641.31072 - Special enrollment periods. - (1) A health maintenance organization that issues a group health...
641.31073 - Prohibiting discrimination against individual participants and beneficiaries based on health status. - (1) Subject to subsection (2), a health maintenance organization that...
641.31074 - Guaranteed renewability of coverage. - (1) Except as otherwise provided in this section, a health...
641.31075 - Advanced practice registered nurse services. - History.—s. 32, ch. 2020-9.
641.31076 - Shared savings incentive program. - (1) This section and ss. 627.6387 and 627.6648 may be...
641.31077 - Coverage for organ transplants. - History.—s. 4, ch. 2020-139.
641.3108 - Notice of cancellation of contract. - (1) Except for nonpayment of premium or termination of eligibility,...
641.31085 - Disclosures to subscribers; coverage of behavioral health care services. - (1) A health maintenance organization shall make all of the...
641.31094 - Nondiscrimination of coverage for certain surgical procedures involving bones or joints. - History.—s. 5, ch. 96-361.
641.31095 - Coverage for mammograms. - (1) Every health maintenance contract issued or renewed on or...
641.31096 - Requirements with respect to breast cancer and routine followup care. - History.—s. 11, ch. 97-48.
641.31097 - Decreasing inappropriate utilization of emergency care. - (1) The Legislature finds and declares it to be of...
641.31098 - Coverage for individuals with developmental disabilities. - (1) This section and s. 627.6686 may be cited as...
641.31099 - Restrictions on use of state and federal funds for state exchanges. - (1) A health maintenance contract under which coverage is purchased...
641.3111 - Extension of benefits. - (1) Every group health maintenance contract shall provide that termination...
641.312 - Scope. - History.—s. 13, ch. 2012-44; s. 108, ch. 2013-15; s. 24,...
641.313 - Health maintenance contracts; cancer treatment parity; orally administered cancer treatment medications. - (1) As used in this section, the term: (a) “Cancer...
641.314 - Pharmacy benefit manager contracts. - (1) As used in this section, the term: (a) “Maximum...
641.315 - Provider contracts. - (1) Each contract between a health maintenance organization and a...
641.3154 - Organization liability; provider billing prohibited. - (1) If a health maintenance organization is liable for services...
641.3155 - Prompt payment of claims. - (1) As used in this section, the term “claim” for...
641.3156 - Treatment authorization; payment of claims. - (1) A health maintenance organization must pay any hospital-service or...
641.316 - Fiscal intermediary services. - (1) It is the intent of the Legislature, through the...
641.32 - Acceptable payments. - History.—s. 16, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.33 - Certain words prohibited in name of organization. - (1) No entity certificated as a health maintenance organization, other...
641.35 - Assets, liabilities, and investments. - (1) ASSETS.—In any determination of the financial condition of a...
641.36 - Adoption of rules; penalty for violation. - History.—s. 20, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.365 - Dividends. - (1)(a) A health maintenance organization shall not pay any dividend...
641.37 - Prohibited activities; penalties. - (1) Any person or entity which knowingly renews, issues, or...
641.38 - Operational health maintenance organizations; issuance of certificate. - History.—s. 23, ch. 72-264; s. 3, ch. 76-168; s. 1,...
641.385 - Order to discontinue certain advertising. - History.—s. 8, ch. 84-313; s. 188, ch. 91-108; s. 4,...
641.386 - Agent licensing and appointment required; exceptions. - (1) With respect to a health maintenance contract, no person...
641.39001 - Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty. - (1) Whether or not delinquency proceedings as to a health...
641.3901 - Unfair methods of competition and unfair or deceptive acts or practices prohibited. - History.—ss. 35, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.3903 - Unfair methods of competition and unfair or deceptive acts or practices defined. - (1) MISREPRESENTATION AND FALSE ADVERTISING OF HEALTH MAINTENANCE CONTRACTS.—Knowingly making,...
641.3905 - General powers and duties of the department and office. - History.—ss. 37, 47, ch. 85-177; ss. 128, 187, 188, ch....
641.3907 - Defined unfair practices; hearings, witnesses, appearances, production of books, and service of process. - (1) Whenever the department or office has reason to believe...
641.3909 - Cease and desist and penalty orders. - (1) Suspension or revocation of the health maintenance organization’s certificate...
641.3911 - Appeals from the department or office. - History.—ss. 40, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.3913 - Penalty for violation of cease and desist orders. - (1) A monetary penalty of not more than $200,000 as...
641.3915 - Health maintenance organization anti-fraud plans and investigative units. - History.—s. 4, ch. 99-204; ss. 4, 14, ch. 2017-178.
641.3917 - Civil liability. - History.—ss. 42, 47, ch. 85-177; ss. 187, 188, ch. 91-108;...
641.3921 - Conversion on termination of eligibility. - (1) Failure to pay any required premium or contribution unless...
641.3922 - Conversion contracts; conditions. - (1) TIME LIMIT.—Written application for the converted contract shall be...
641.3923 - Discrimination against providers prohibited. - History.—s. 2, ch. 98-285; s. 77, ch. 2018-106.