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Florida Senate
-
2026
SB 114
By
Senator Jones
34-00378-26 2026114__
1 A bill to be entitled
2 An act relating to continuity of care in health
3 insurance contracts; amending s. 627.6474, F.S.;
4 requiring that contracts between a health insurer and
5 a contracted health care practitioner require a
6 specified notice; specifying requirements for such
7 notice; authorizing the Financial Services Commission
8 to adopt rules; providing administrative penalties;
9 requiring a health insurer and a health care
10 practitioner to allow certain policyholders to
11 continue coverage and care for a specified timeframe;
12 requiring the insurer and the health care practitioner
13 to be bound by the terminated contract under certain
14 circumstances; specifying that changes to the contract
15 made within a specified timeframe are effective only
16 under certain circumstances; amending s. 641.315,
17 F.S.; requiring that certain health maintenance
18 organization contracts require a specified notice;
19 specifying requirements for such notice; authorizing
20 the commission to adopt rules; providing
21 administrative penalties; amending s. 641.51, F.S.;
22 requiring a health maintenance organization and a
23 treating provider to allow certain subscribers to
24 continue coverage and care for a specified timeframe;
25 deleting construction; providing an effective date.
26
27 Be It Enacted by the Legislature of the State of Florida:
28
29 Section 1. Subsections (4) and (5) are added to section
30 627.6474, Florida Statutes, to read:
31 627.6474 Provider contracts.—
32
(4)
(a)
A
contract
between a health insurer and a
contracted
33
health care practitioner as defined in s.
456
.
001 must require
34
the health insurer and the contracted health care practitioner
35
to issue a joint written notice to each affected
policyholder
at
36
least 60 days before the effective date of the cancellation or
37
termination of the contract
. The notice must be written in plain
38
language and include
all of the following
:
39
1.
An explanation of the
policyholder
’s rights regarding
40
continuation of care and coverage.
41
2.
Applicable timelines for transition of care.
42
3.
Contact information for the
insurer
, the
practitioner
,
43
and the
office
for questions or complaints
.
44
(b)
The commission may adopt rules to administer
paragraph
45
(a).
The office may impose
an administrative fine of up to
46
$5,000 for each violation
to a
health insurer
or
contracted
47
health care practitioner
that fails to comply with
paragraph
48
(a).
49
(5)
When a contract between an insurer and a treating
50
health care practitioner as defined in s. 456.001 is terminated
51
for any reason, the insurer and the health care practitioner
52
must allow policyholders for whom treatment was active to
53
continue coverage and care, through completion of treatment of a
54
condition for which the policyholder was receiving care at the
55
time of the termination, until the policyholder selects another
56
treating health care practitioner, or during the next open
57
enrollment period offered by the organization, whichever is
58
longer, but not longer than 6 months after termination of the
59
contract. The insurer and the health care practitioner shall
60
allow a policyholder who has initiated a course of prenatal
61
care, regardless of the trimester in which care was initiated,
62
to continue care and coverage until completion of postpartum
63
care. For care continued under this subsection, the insurer and
64
the health care practitioner shall continue to be bound by the
65
terms of the terminated contract. Changes made within 30 days
66
before termination of a contract are effective only if agreed to
67
by both the insurer and the practitioner
.
68 Section 2. Paragraph (a) of subsection (2) of section
69 641.315, Florida Statutes, is amended to read:
70 641.315 Provider contracts.—
71 (2)(a) For all provider contracts executed after October 1,
72 1991, and within 180 days after October 1, 1991, for contracts
73 in existence as of October 1, 1991:
74 1.
The
Contracts must require the provider to give 60 days’
75 advance written notice to the health maintenance organization
76 and the office before canceling the contract with the health
77 maintenance organization for any reason
.
; and
78 2.
Contracts
The contract
must also provide that nonpayment
79 for goods or services rendered by the provider to the health
80 maintenance organization is not a valid reason for avoiding the
81 60-day advance notice of cancellation.
82
3.
Contracts
must require the health maintenance
83
organization and the provider to issue a joint written notice to
84
each affected subscriber
at least 60 days before the effective
85
date of the cancellation or termination of the provider
86
contract
. The notice must be written in plain language and
87
include
all of the following
:
88
a.
An explanation of the subscriber’s rights regarding
89
continuation of care and coverage.
90
b.
Applicable timelines for transition of care.
91
c.
Contact information for the health maintenance
92
organization, the provider, and the Office of Insurance
93
Regulation for questions or complaints
.
94
4.
The commission may adopt rules to administer
95
subparagraph 3. A health maintenance organization or provider
96
that fails to comply with subparagraph 3
.
is subject to an
97
administrative fine
by the office of up to $5,000 for each
98
violation.
99 Section 3. Subsection (8) of section 641.51, Florida
100 Statutes, is amended to read:
101 641.51 Quality assurance program; second medical opinion
102 requirement.—
103 (8) When a contract between an organization and a treating
104 provider is terminated for any reason
other than for cause
, each
105 party shall allow subscribers for whom treatment was active to
106 continue coverage and care
when medically necessary
, through
107 completion of treatment of a condition for which the subscriber
108 was receiving care at the time of the termination, until the
109 subscriber selects another treating provider, or during the next
110 open enrollment period offered by the organization, whichever is
111 longer, but not longer than 6 months after termination of the
112 contract. Each party to the terminated contract shall allow a
113 subscriber who has initiated a course of prenatal care,
114 regardless of the trimester in which care was initiated, to
115 continue care and coverage until completion of postpartum care.
116
This does not prevent a provider from refusing to continue to
117
provide care to a subscriber who is abusive, noncompliant, or in
118
arrears in payments for services provided.
For care continued
119 under this subsection, the organization and the provider shall
120 continue to be bound by the terms of the terminated contract.
121 Changes made within 30 days before termination of a contract are
122 effective only if agreed to by both parties.
123 Section 4. This act shall take effect July 1, 2026.