No. SB 1086
Filed under Insurance.
Health Care Services Jurisdiction and Reimbursement; Providing that health insurance, health maintenance organization coverage, health plan coverage, and travel insurance providers are subject to the jurisdiction of the courts of this state under certain circumstances; defining the terms “emergency services” and “health care provider”; prohibiting health care providers from collecting or attempting to collect from patients any sums owed by insurers and health maintenance organizations, respectively, for emergency services rendered, etc.
Plain English Summary
AI-GENERATEDEmergency care providers can no longer bill a patient for any amount the patient's health insurer, HMO, or health plan owes for that emergency care.
Instead, an out-of-network provider can sue the patient's insurer directly for the reasonable value of the care, a new legal right created by this bill.
Florida courts also gain jurisdiction over any health, HMO, health plan, or travel insurer whose enrollee gets emergency care here, even an insurer with no other ties to the state.
AILets Florida courts exercise jurisdiction over a health, HMO, health plan, or travel insurer that covers a Florida-resident employee, or whose insured patient receives emergency services from a Florida-licensed provider, even if that insurer has no other presence in the state.
AIBars a health care provider from collecting or attempting to collect from a patient any sum that the patient's health or life insurer owes for emergency services, shifting that financial dispute away from the patient.
AIApplies the identical ban to HMO subscribers: a provider may not collect or attempt to collect from the patient any sum the patient's HMO owes for emergency services rendered.
AIGives a nonparticipating provider a new cause of action, in quantum meruit, to recover the reasonable value of emergency services directly from the patient's insurer or HMO, instead of collecting from the patient.
AIApplies the billing ban to any health or life insurer whose policyholder is seen by a Florida provider, regardless of whether that insurer is even licensed to sell insurance in the state.
AIStates that this section is not meant to regulate the price, route, or service of a licensed air ambulance provider, despite air ambulances otherwise fitting the definition of a covered health care provider.
AIMakes clear that the new right to sue an insurer in quantum meruit adds to, rather than replaces, whatever other legal remedies a provider already has.