No. HB 577
Filed under Insurance.
Continuity of Care in Health Insurance Contracts; Requires that contracts between individual health insurer, group, blanket, or franchise health insurer & HMO & contracted health care practitioner require specified notice to affected policyholders & subscribers before cancellation or termination of contracts; provides administrative penalties; requires health insurer, HMO & health care practitioner to allow certain policyholders & subscribers to continue coverage & care for specified timeframe; requires insurer & health care practitioner to be bound by terminated contract.
Plain English Summary
AI-GENERATEDThis bill gives patients on group, blanket, or franchise health plans, typically employer-sponsored coverage, the same continuation-of-care rights it creates for individual health insurance policies.
When any of these insurers ends its contract with a doctor, both sides must give patients 60 days' written notice, and patients already in treatment can keep it going for up to 6 months under the old contract's terms.
For HMOs specifically, this continuation duty now applies even after a for-cause termination, and providers lose their express right to cut off care to abusive, noncompliant, or non-paying patients.
AICreates an entirely new statute, section 627.65713, requiring the same termination notice and continuation-of-care protections for contracts between group, blanket, or franchise health insurers and their contracted practitioners, alongside the individual-policy version added elsewhere in this bill.
AIRequires a health insurer and a contracted practitioner to jointly notify each affected policyholder at least 60 days before ending their contract, explaining the policyholder's continuation-of-care rights, transition timelines, and where to direct questions or complaints. The office may fine either side up to $5,000 per violation for failing to comply.
AIRequires the insurer and practitioner to let a policyholder already in active treatment keep that care and coverage through completion of the condition being treated, until the policyholder picks a new practitioner or the next open enrollment period, whichever is longer, capped at 6 months after termination.
AIWhile a policyholder's care continues after termination, the insurer and practitioner remain bound by the terminated contract's own terms, including presumably its payment rates, rather than new terms either side might prefer.
AIRequires an HMO and its contracted provider to jointly notify each affected subscriber at least 60 days before ending their contract, on the same terms as the new insurer-side notice, backed by the same up-to-$5,000 per-violation fine.
AIStrikes the exception that let an HMO and provider skip continuation of care when the provider's contract was terminated for cause, so the duty to let patients finish treatment now applies regardless of why the contract ended.
AIDeletes the sentence that let a provider refuse to keep treating a subscriber who was abusive, noncompliant, or behind on payments, removing that express exception to the continuation-of-care duty.
AIA policyholder who has started prenatal care, in any trimester, keeps coverage and care with the terminated practitioner through completion of postpartum care, a separate rule from the 6-month cap that governs other conditions, and this same language appears in both new statutes.