No. SB 740
Filed under Insurance.
Comprehensive Health Care for Residents; Creating the “Florida Health Plan”; authorizing the Florida Health Board to establish certain financial arrangements with other states and foreign countries under certain circumstances; prohibiting cost-sharing requirements from being imposed on enrollees; providing that defaults, underpayments, and late payments of certain obligations result in certain remedies and penalties; providing for eligible health care providers to participate in the plan; creating the Office of Health Quality and Planning, etc.
Plain English Summary
AI-GENERATEDThe plan covers every state resident, regardless of immigration status, for dental, vision, hearing, mental health, reproductive and gender-affirming care, and long-term care, with no premiums, deductibles, copayments, or coinsurance.
Enrollees pick any participating provider and need no referral to see a specialist. Providers who take any plan payment can never bill the patient for the rest of the cost.
A new Florida Health Board and at least eight regional planning boards run the plan, set provider budgets, and negotiate payment rates. A separate ombudsman and auditor handle complaints and fraud.
Once the plan is running, insurers may no longer sell any policy covering the same services anywhere in the state, phasing out private health coverage within about two years of enactment.
AIAnyone who has lived in Florida more than six months, registered to vote there, filed a homestead exemption, or declared domicile under state law qualifies for the plan. Immigration status cannot be used to deny eligibility.
AIEnrollees pay nothing out of pocket at the point of service for any benefit the plan covers. No cost-sharing mechanism of any kind may be attached to a covered service.
AIOnce the Florida Health Plan is operational, no insurer, HMO, or prepaid health clinic may sell a policy covering anything the plan already covers. Because the plan's benefit list is comprehensive, this reaches nearly all private health coverage sold in the state.
AIA provider that accepts any payment from the plan for a covered service gives up the right to collect anything further from the patient for that same service.
AIThe board does not follow Florida's normal rulemaking law when adopting plan rules. Instead it publishes proposed rules for a 30-day comment period and may hold a hearing on objections, a process the statute itself defines rather than incorporating the standard one.
AIA hospital or other provider planning to spend more than $500,000 on capital equipment or facilities must first get the Florida Health Board's approval, and the board can move that dollar threshold on its own.
AIIf a patient's care is also covered by another insurer, an employer plan, a liability judgment, or another collateral source, the plan must first try to collect its costs from that other source before absorbing them itself.