THE BILL ITSELF
SB 114
Continuity of Care in Health Insurance Contracts
Florida Senate - 2026 SB 114 By Senator Jones 34-00378-26 2026114__
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A bill to be entitled
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An act relating to continuity of care in health
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insurance contracts; amending s. 627.6474, F.S.;
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requiring that contracts between a health insurer and
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a contracted health care practitioner require a
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specified notice; specifying requirements for such
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notice; authorizing the Financial Services Commission
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to adopt rules; providing administrative penalties;
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requiring a health insurer and a health care
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practitioner to allow certain policyholders to
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continue coverage and care for a specified timeframe;
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requiring the insurer and the health care practitioner
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to be bound by the terminated contract under certain
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circumstances; specifying that changes to the contract
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made within a specified timeframe are effective only
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under certain circumstances; amending s. 641.315,
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F.S.; requiring that certain health maintenance
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organization contracts require a specified notice;
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specifying requirements for such notice; authorizing
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the commission to adopt rules; providing
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administrative penalties; amending s. 641.51, F.S.;
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requiring a health maintenance organization and a
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treating provider to allow certain subscribers to
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continue coverage and care for a specified timeframe;
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deleting construction; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Subsections (4) and (5) are added to section
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627.6474, Florida Statutes, to read:
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627.6474 Provider contracts.—
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(4)(a) A contract between a health insurer and a contracted
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health care practitioner as defined in s. 456.001 must require
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the health insurer and the contracted health care practitioner
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to issue a joint written notice to each affected policyholder at
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least 60 days before the effective date of the cancellation or
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termination of the contract. The notice must be written in plain
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language and include all of the following:
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1. An explanation of the policyholder’s rights regarding
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continuation of care and coverage.
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2. Applicable timelines for transition of care.
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3. Contact information for the insurer, the practitioner,
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and the office for questions or complaints.
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(b) The commission may adopt rules to administer paragraph
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(a). The office may impose an administrative fine of up to
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$5,000 for each violation to a health insurer or contracted
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health care practitioner that fails to comply with paragraph
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(a).
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(5) When a contract between an insurer and a treating
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health care practitioner as defined in s. 456.001 is terminated
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for any reason, the insurer and the health care practitioner
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must allow policyholders for whom treatment was active to
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continue coverage and care, through completion of treatment of a
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condition for which the policyholder was receiving care at the
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time of the termination, until the policyholder selects another
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treating health care practitioner, or during the next open
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enrollment period offered by the organization, whichever is
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longer, but not longer than 6 months after termination of the
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contract. The insurer and the health care practitioner shall
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allow a policyholder who has initiated a course of prenatal
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care, regardless of the trimester in which care was initiated,
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to continue care and coverage until completion of postpartum
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care. For care continued under this subsection, the insurer and
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the health care practitioner shall continue to be bound by the
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terms of the terminated contract. Changes made within 30 days
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before termination of a contract are effective only if agreed to
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by both the insurer and the practitioner.
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Section 2. Paragraph (a) of subsection (2) of section
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641.315, Florida Statutes, is amended to read:
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641.315 Provider contracts.—
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(2)(a) For all provider contracts executed after October 1,
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1991, and within 180 days after October 1, 1991, for contracts
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in existence as of October 1, 1991:
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1. The Contracts must require the provider to give 60 days’
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advance written notice to the health maintenance organization
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and the office before canceling the contract with the health
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maintenance organization for any reason . ; and
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2. Contracts The contract must also provide that nonpayment
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for goods or services rendered by the provider to the health
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maintenance organization is not a valid reason for avoiding the
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60-day advance notice of cancellation.
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3. Contracts must require the health maintenance
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organization and the provider to issue a joint written notice to
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each affected subscriber at least 60 days before the effective
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date of the cancellation or termination of the provider
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contract. The notice must be written in plain language and
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include all of the following:
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a. An explanation of the subscriber’s rights regarding
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continuation of care and coverage.
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b. Applicable timelines for transition of care.
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c. Contact information for the health maintenance
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organization, the provider, and the Office of Insurance
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Regulation for questions or complaints.
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4. The commission may adopt rules to administer
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subparagraph 3. A health maintenance organization or provider
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that fails to comply with subparagraph 3. is subject to an
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administrative fine by the office of up to $5,000 for each
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violation.
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Section 3. Subsection (8) of section 641.51, Florida
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Statutes, is amended to read:
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641.51 Quality assurance program; second medical opinion
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requirement.—
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(8) When a contract between an organization and a treating
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provider is terminated for any reason other than for cause , each
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party shall allow subscribers for whom treatment was active to
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continue coverage and care when medically necessary , through
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completion of treatment of a condition for which the subscriber
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was receiving care at the time of the termination, until the
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subscriber selects another treating provider, or during the next
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open enrollment period offered by the organization, whichever is
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longer, but not longer than 6 months after termination of the
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contract. Each party to the terminated contract shall allow a
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subscriber who has initiated a course of prenatal care,
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regardless of the trimester in which care was initiated, to
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continue care and coverage until completion of postpartum care.
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This does not prevent a provider from refusing to continue to
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provide care to a subscriber who is abusive, noncompliant, or in
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arrears in payments for services provided. For care continued
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under this subsection, the organization and the provider shall
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continue to be bound by the terms of the terminated contract.
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Changes made within 30 days before termination of a contract are
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effective only if agreed to by both parties.
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Section 4. This act shall take effect July 1, 2026.