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S 1130

Florida Senate•Failed

Summary

S 1130, “Insurance Claims Payments to Health Care Providers”, was introduced in the Senate on Jan 5, 2026 by Sen. Ralph Massullo (R). It last saw action on Mar 13, 2026: Died in Banking and Insurance.

Record

Text

S 1130 has no co-sponsors and has not gone to a roll call.

s1130/introduced.txt
Florida Senate - 2026  SB 1130
By Senator Massullo
11-00698A-26  20261130__
A bill to be entitled
An act relating to insurance claims payments to health
care providers; creating s. 627.4193, F.S.; defining
terms; prohibiting payment adjudicators from
downcoding health care services under certain
circumstances; providing exceptions; requiring payment
adjudicators to provide certain information to the
provider; prohibiting payment adjudicators from
downcoding a service under certain circumstances;
prohibiting payment adjudicators for downcoding orders
by a licensed nurse; specifying that payment
adjudicators are solely responsible for certain
violations of law; requiring payment adjudicators to
maintain downcoding policies on their websites;
specifying requirements for such policies; requiring
health insurers to ensure that their downcoding
policies are updated and to ensure compliance with
specified provisions on downcoding; authorizing
investigations and actions against noncompliance;
providing certain presumption in favor of physicians’
determinations regarding diagnoses of patients and
service orders; providing the calculation of interest
on health insurers’ nonpayment or underpayment due to
downcoding; providing a cause of action for health
care providers; amending s. 627.42392, F.S.; defining
terms; revising the definition of the term “health
insurer”; requiring certain utilization review
entities to only use a certain prior authorization
form; deleting provisions related to pharmacy benefits
managers’ or health insurers’ requirement to use a
specified prior authorization form; requiring
utilization review entities to establish and offer a
specified electronic prior authorization process;
specifying requirements for such process; specifying
that the provider is deemed to have supplied all
information necessary for prior authorization under
certain circumstances; specifying that additional
information is deemed unnecessary under certain
circumstances; prohibiting utilization review
entities’ prior authorization process from requiring
information that is not needed; requiring utilization
review entities to disclose all prior authorization
requirements and restrictions; requiring such
requirements and restrictions to be explained in a
specified manner; prohibiting utilization review
entities from implementing certain new requirements or
restrictions; providing exceptions; providing
reporting requirements; requiring the Office of
Insurance Regulation to publish on its website a
report based on such entities’ reports; providing
requirements for adverse determinations made by such
entities on health care providers’ claims; providing a
timeframe for such entities’ determination on claims;
prohibiting prior authorization requirements under
certain circumstances; prohibiting prior authorization
revocations, limits, conditions, and restrictions
under certain circumstances; providing exceptions;
providing a timeframe for the validity of prior
authorizations under certain circumstances; providing
construction; amending ss. 627.6131 and 641.3155,
F.S.; defining terms; revising the definition of the
term “claim”; revising requirements and timeframes for
responses from health insurers and health maintenance
organizations, respectively, to submitted claims;
revising the interest rate on overdue payments of
claims; authorizing health care providers to refuse to
participate in internal dispute resolution processes
under certain circumstances; prohibiting health
insurers and health maintenance organizations,
respectively, from retrospectively, rather than
retroactively, denying claims because of insured and
enrollee ineligibility beyond a specified timeframe;
revising such timeframe; revising applicability;
providing construction; prohibiting health insurers
and health maintenance organizations, respectively,
from requesting or requiring certain information from
health care providers under certain circumstances;
providing causes of action for health care providers
under certain circumstances; amending s. 395.1065,
F.S.; conforming cross-references; providing an
effective date.
Be It Enacted by the Legislature of the State of Florida:
Section 1. Section 627.4193, Florida Statutes, is created
to read:
627.4193Restrictions on health insurance reimbursement
downcoding.—
(1)As used in this section, the term:
(a)“Downcode” or “downcoding” means the alteration by a
payment adjudicator of a service code to another service code or
the alteration, addition, or deletion by a payment adjudicator
of a modifier, when the changed code or modifier is associated
with a lower payment amount than the service code or modifier
billed by the provider or facility.
(b)“Health insurer” means any entity that offers health
insurance coverage, whether through a fully insured plan or
self-insured plan or fund, including, as applicable:
1.An authorized health insurer offering health insurance
as defined in s. 624.603, as well as any entity that offers a
commercial self-insurance fund as defined in s. 624.462(2) or
group self-insurance fund as described in s. 624.4621.
2.A health insurer that is subject to any provision of
this chapter, as well as any entity that offers a self-insurance
plan or a group self-insurance plan.
3.A managed care plan as defined in s. 409.962.
4.A health maintenance organization as defined in s.
641.19.
(c)“Medical record” means the comprehensive collection of
documentation, including clinical notes, diagnostic reports, and
other relevant information, which supports the health care
services provided.
(d) “Participation agreement” means a written contract or
agreement between a health insurer and a provider which outlines
the terms and conditions of participation, reimbursement rates,
and other relevant details.
(e)“Payment adjudicator” means a health insurer or any
entity that provides, offers to provide, or administers payment
on behalf of a health insurer, as well any pharmacy benefit
manager as defined in s. 624.490(1), and any other individual or
entity that provides, offers to provide, or administers payment
for hospital services, outpatient services, medical services,
prescription drugs, or other health care services to a person
treated by a health care professional or facility in this state
under a policy, plan, or contract.
(f)“Provider” means any health care professional,
facility, or entity that submits claims for reimbursement for
covered health care services.
(2)Payment adjudicators are prohibited from downcoding a
health care service billed by, or on behalf of, a provider, if
the health care service was ordered by a provider that is in
network with the applicable health insurer, unless such
downcoding is otherwise expressly permitted under the
participation agreement between the health insurer and the
provider.
(3)If downcoding is expressly permitted under the
participation agreement, the payment adjudicator must provide
the following information to the provider before making its
initial payment or notice of denial of payment:
(a)A statement indicating that the service code or
modifier billed by the provider or facility will be downcoded.
(b)An explanation detailing the reasons for downcoding the
claim. This explanation must include a clear description of the
service codes or modifiers that were altered, added, or deleted,
if applicable.
(c)The payment amount that the payment adjudicator would
otherwise make if the service code or modifier is not downcoded.
(d)A statement that the provider may contest the
downcoding of the applicable service code or modifier by filing
a contestation with the payment adjudicator with respect to the
downcoding within 15 days after receipt of the notice of
downcoding.
(e)A statement that by contesting the downcoding of the
applicable service code or modifier, the provider does not waive
any of its legal rights and claims against the health insurer or
payment adjudicator to the fullest extent permissible under law.
(4)Even if the participation agreement expressly permits
downcoding, a payment adjudicator is prohibited from downcoding
a service without first conducting a review of the associated
medical record to ensure the accuracy of the coding change.
(5)A payment adjudicator is prohibited from downcoding for
orders by a licensed nurse.
(6)Notwithstanding any provision in this section, a
payment adjudicator that proceeds to downcode a service code or
modifier, regardless of whether such downcoding is contested by
the provider, is solely responsible for any violations of law
associated with such downcoding.
(7)Payment adjudicators are required to maintain clear and
accessible downcoding policies on their official website. These
policies must include:
(a)An overview of the circumstances under which downcoding
may occur.
(b)The process and criteria used for conducting reviews of
downcoded claims, including the role of medical record review.
(c)Information about the internal mechanisms for ensuring
consistency and accuracy in downcoding practices.
(d)Information regarding the processes for contesting with
the payment adjudicator the downcoding of a service code, which
processes must offer appeal rights for the provider and the
patient, and peer review by a licensed physician before the
downcoding.
(8)Health insurers shall ensure that their downcoding
policies are updated as needed to reflect any changes in
regulations, industry standards, or internal procedures.
(9)Health insurers shall ensure compliance with this
section and shall develop internal procedures to implement and
adhere to the requirements outlined in this section.
(10)Regulatory authorities, including, but not limited to,
the Office of Insurance Regulation, may investigate and take
appropriate actions in cases of noncompliance with this section.
(11)When a particular health care service is ordered by a
licensed physician, there is a presumption that the physician’s
determination regarding the diagnosis of the patient and any
service order by the physician is correct and sufficient, absent
a coding error which the health insurer must first verify with
the physician before downcoding for such error.
(12)If an applicable court, arbitration tribunal, or other
binding legal process determines that a claim was subject to an
inappropriate or impermissible downcoding, whether in breach of
contract, statute, common law, or otherwise, such that
nonpayment or underpayment of the original claim has occurred,
then in accordance with s. 627.6131, interest must be calculated
on the full total amount that should have been paid on the claim
as of the applicable time period for payment specified in s.
627.6131.
(13)For a violation of this section, a provider shall have
a private cause of action to proceed against the health insurer
or payment adjudicator in the applicable tribunal for the
violation.
Section 2. Section 627.42392, Florida Statutes, is amended
to read:
627.42392 Prior authorization.—
(1) As used in this section, the term:
(a)“Adverse determination” means a decision by a health
insurer or utilization review entity that the health care
services rendered, or proposed to be rendered, to a patient are
denied, reduced, or terminated. The term does not include a
decision to deny, reduce, or terminate services that are
determined to have been billed in duplicate bills or that are
confirmed with the provider to have been billed in error.
(b)“Electronic prior authorization process” does not
include transmissions through a facsimile machine.
(c)“Emergency health care service” means medical
screening, examination, and evaluation by a physician, or, to
the extent permitted by applicable law, by other appropriate
personnel under the supervision of a physician, to determine
whether an emergency medical condition exists and, if it does,
the care, treatment, or surgery by a physician necessary to
relieve or eliminate the emergency medical condition, within the
service capability of the facility.
(d)“Emergency medical condition” means a medical condition
manifesting itself by acute symptoms of sufficient severity,
including severe pain, such that a prudent layperson who
possesses an average knowledge of health and medicine could
reasonably expect the absence of immediate medical attention to
result in any of the conditions listed in s. 395.002(8).
(e)“Health insurer” means any entity that offers health
insurance coverage, whether through a fully insured plan or
self-insured plan or fund, including, as applicable:
1.An authorized health insurer offering health insurance
as defined in s. 624.603, as well as any entity that offers a
commercial self-insurance fund as defined in s. 624.462(2) or a
group self-insurance fund as described in s. 624.4621.
2.A health insurer that is subject to any provision of
this chapter, as well as any entity that offers a self-insurance
plan or a group self-insurance plan.
3.A managed care plan as defined in s. 409.962.
4.A health maintenance organization as defined in s.
641.19.
(f)“Prior authorization” means the process by which
utilization review entities determine the medical necessity or
medical appropriateness of otherwise covered health care
services before the rendering of such health care services. The
term also includes any requirement by a health insurer or
utilization review entity that an enrollee or a health care
provider notify the health insurer or utilization review entity
before the provision of a health care service.
(g)“Urgent health care service” means a health care
service that, if the timeframe for making a nonexpedited prior
authorization is applied, could, in the opinion of a physician
with knowledge of the patient’s medical condition:
1.Seriously jeopardize the life or health of the patient
or the ability of the patient to regain maximum function; or
2.Subject the patient to severe pain that cannot be
adequately managed without the care, treatment, or prescription
drugs that are the subject of the prior authorization request.
(h)“Utilization review activity” means any activity
prospective to, concurrent with, or retrospective to the
provision of a nonemergency health care service, to determine
whether payment must be made in full or is subject to an adverse
determination. Utilization review activity is prohibited:
1.To the extent restricted or prohibited by an agreement
with a health care provider;
2.For an emergency health care service; or
3.For a service provided to a patient experiencing an
emergency medical condition.
(i)“Utilization review entity” means an entity permitted
under the applicable agreement with a health care provider or
otherwise permitted by a provider that does not have such an
agreement to perform utilization review activities or upon whose
behalf utilization review activities are performed, including,
as applicable:
1.An authorized health insurer offering health insurance
as defined in s. 624.603, as well as any entity that offers a
commercial self-insurance fund as defined in s. 624.462(2) or
group self-insurance fund as described in s. 624.4621.
2.A health insurer that is subject to any provision of
this chapter, as well as any entity that offers a self-insurance
plan or a group self-insurance plan.
3.A managed care plan as defined in s. 409.962.
4.A health maintenance organization as defined in s.
641.19.
5.A pharmacy benefit manager as defined in s. 624.490(1).
6.Any other individual or entity that provides, offers to
provide, or administers payment for hospital services,
outpatient services, medical services, prescription drugs, or
other health care services to a person treated by a health care
professional or facility in this state under a policy, plan,
contract, or fund [“health insurer” means an authorized insurer]
[offering health insurance as defined in s. 624.603, a managed]
[care plan as defined in s. 409.962(10), or a health maintenance]
[organization as defined in s. 641.19(12)].
(2) Notwithstanding any other provision of law, a
utilization review entity that [effective January 1, 2017, or six]
[(6) months after the effective date of the rule adopting the]
[prior authorization form, whichever is later, a health insurer,]
[or a pharmacy benefits manager on behalf of the health insurer,]
[which] does not provide an electronic prior authorization process
for use by its contracted providers may[,][ shall] only use the
prior authorization form that has been approved by the Financial
Services Commission for granting a prior authorization for a
medical procedure, course of treatment, or prescription drug
benefit. Such form must be no longer than [may not exceed] two
pages in length, excluding any instructions or guiding
documentation, and must include all clinical documentation
necessary for the utilization review entity [health insurer] to
make a decision. At a minimum, the form must include[: ][(1)]
sufficient patient information to identify the member, date of
birth, full name, and Health Plan ID number; [(2)] provider name,
address and phone number; [(3)] the medical procedure, course of
treatment, or prescription drug benefit being requested,
including the medical reason therefor, and all services tried
and failed; [(4)] any laboratory documentation required; and [(5)]
an attestation that all information provided is true and
accurate.
(3) The Financial Services Commission, in consultation with
the Agency for Health Care Administration, shall adopt by rule
guidelines for all prior authorization forms which ensure the
general uniformity of such forms.
(4)A utilization review entity shall establish and offer a
secure, interactive online electronic prior authorization
process to accept electronic prior authorization requests. The
electronic prior authorization process must allow a person
seeking a prior authorization the ability to upload
documentation if such documentation is required by the
utilization review entity to adjudicate the prior authorization
request. Once a provider grants a health insurer access to a
patient’s electronic medical record, the provider is deemed to
have supplied all information necessary for prior authorization
of the health care service, including, without limitation, all
information that is reasonably required by the health insurer,
other than for an emergency health care service or for a service
provided to a patient who is experiencing an emergency medical
condition, in advance of the provision of service, and the
health insurer asserts is missing as of the date of such
service. Additional information or documentation, regardless of
whether the utilization review entity requests any additional
information, is deemed unnecessary, and deemed not required, for
prior authorization of the health care service, and any request
for additional information or any position of the utilization
review entity or any third party acting on behalf of the
utilization review entity regarding any lack of information from
the provider is prohibited from being used to deny, pend, or
delay prior authorization of the health care service.
(5)[(4)] Electronic prior authorization approvals do not
preclude benefit verification or medical review by the health
insurer under either the medical or pharmacy benefits.
(6)A utilization review entity’s prior authorization
process is prohibited from requiring information that is not
needed to make a determination or facilitate a determination of
medical necessity of the requested medical procedure, course of
treatment, or prescription drug benefit.
(7)A utilization review entity shall disclose all of its
prior authorization requirements and restrictions, including any
written clinical criteria, in a publicly accessible manner on
its website. These requirements and restrictions must be
explained in detail and in clear and ordinary terms.
(8)A utilization review entity is prohibited from
implementing any new requirements or restrictions and from
making changes to existing requirements or restrictions on
obtaining prior authorization unless:
(a)The changes have been available on a publicly
accessible website for at least 60 days before they are
implemented;
(b)Policyholders and health care providers affected by the
new requirements and restrictions or changes to the requirements
and restrictions are provided with a written notice of the
changes at least 60 days before they are implemented, with such
notice being delivered electronically or by other means as
agreed to by the policyholder or the health care provider; and
(c)All applicable amendments to a provider’s agreement
with the applicable health insurer or utilization review entity
have been obtained and memorialized in a mutually agreed-upon
writing before such implementation.
(9)(a)Utilization review entities shall, by March 31 of
each year, submit a report to the Office of Insurance Regulation
with the following data elements for the prior calendar year:
1.A list of all items and services requiring prior
authorization.
2.The percentage of standard prior authorization requests
approved by the utilization review entity, aggregated by item or
service.
3.The percentage of standard prior authorization requests
denied by the utilization review entity, aggregated by item or
service.
4.The percentage of standard prior authorization requests
approved by the utilization review entity after appeal,
aggregated by item or service.
5.The percentage of prior authorizations when the
timeframe for review was extended and request approved, by item
or service.
6.The percentage of expedited prior authorization requests
approved by the utilization review entity, by item or service.
7.The percentage of expedited prior authorization requests
denied by the utilization review entity, by item or service.
8.The percentage of expedited prior authorization requests
approved by the utilization review entity after appeal, by item
or service.
9.The average and median time between submission of a
request for prior authorization and the utilization review
entity’s decision for standard prior authorizations, by item or
service.
10.The average and median time between submission of a
request for prior authorization and the utilization review
entity’s decision for expedited prior authorizations, by item or
service.
(b)The Office of Insurance Regulation shall, by July 1 of
each year, publish a report on its website detailing the
information in paragraph (a) submitted by utilization review
entities.
(10)Utilization review entities shall ensure that all
adverse determinations are made by a physician licensed under
chapter 458 or chapter 459. The physician:
(a)Must possess a current and valid nonrestricted license
to practice medicine in this state;
(b)Must be of the same specialty as the physician who
typically manages the medical condition or disease or provides
the health care service involved in the request;
(c)Must have at least 5 years of experience treating
patients with the medical condition or disease for which the
health care service is being requested; and
(d)May not have any direct or indirect financial
arrangement with the utilization review entity that rewards or
incentivizes, financially or otherwise, such physician in any
way relating to adverse determinations.
(11)Notice of an adverse determination must be provided by
e-mail to the health care provider that initiated the prior
authorization and to the patient. Notice required under this
subsection must include:
(a)The name, title, e-mail address, and telephone number
of the physician responsible for making the adverse
determination.
(b)Any written clinical criteria and any internal rule,
guideline, or protocol on which the utilization review entity
relied when making the adverse determination and the reasons
those provisions apply to the patient’s specific medical
circumstance.
(c)Information for the patient and the patient’s health
care provider which describes the procedure through which the
patient or health care provider may request a copy of any report
developed by personnel performing the review that led to the
adverse determination.
(d)Information that explains to the patient and the
patient’s health care provider the manner in which to appeal the
adverse determination.
(12)If a utilization review entity requires prior
authorization of a nonurgent health care service, the
utilization review entity must grant a prior authorization or
make an adverse determination and notify the patient and the
patient’s health care provider of the decision within 72 hours
after obtaining all necessary information to grant the prior
authorization or make the adverse determination. For purposes of
this subsection, the term “necessary information” includes the
results of any face-to-face clinical evaluation or second
opinion that may be required.
(13)A utilization review entity shall grant an expedited
prior authorization or make an expedited adverse determination
concerning an urgent health care service and notify the patient
and the patient’s health care provider of such expedited prior
authorization or adverse determination no later than 24 hours
after receiving all information needed to complete the review of
the requested urgent health care service.
(14)(a)A utilization review entity is prohibited from
requiring prior authorization for:
1.Prehospital transportation;
2.Provision of an emergency health care service; or
3.Provision of a service to a patient who is experiencing
an emergency medical condition.
(b)A utilization review entity is prohibited from
conducting utilization review activity, and from making any
adverse determinations, to the extent restricted or prohibited
by an agreement with a health care provider. A utilization
review entity is prohibited from performing any utilization
review activity, and from making any adverse determinations,
with respect to:
1.An emergency health care service; or
2.A service provided to a patient who experiences an
emergency medical condition.
(15)A utilization review entity is prohibited from
requiring prior authorization, and from making any adverse
determinations, for the provision of medications for opioid use
disorder. For purposes of this subsection, the term “medications
for opioid use disorder” means the use of medications, commonly
prescribed in combination with counseling and behavioral
therapies, to provide a comprehensive approach to the treatment
of opioid use disorder. FDA-approved medications used to treat
opioid addiction include, but are not limited to, methadone,
buprenorphine, alone or in combination with naloxone, and
extended-release injectable naltrexone. Types of behavioral
therapies include, but are not limited to, individual therapy,
group counseling, family behavior therapy, motivational
incentives, and other modalities.
(16)A utilization review entity is prohibited from
revoking, limiting, conditioning, or restricting a prior
authorization if care is provided within 45 business days after
the date the health care provider receives the prior
authorization. A utilization review entity must pay, or cause
payment to be made to, the health care provider, without any
prepayment review or prepayment audit before such payment, at
the contracted payment rate for a health care service provided
by the health care provider per the prior authorization, unless:
(a)The health care provider knowingly and materially
misrepresented the health care service in the prior
authorization request with the specific intent to deceive and
obtain an unlawful payment from the utilization review entity;
(b)The health care service was no longer a covered
benefit, and medical necessity did not constitute a basis for
such noncovered benefit status, on the day the health care
service was provided, and the utilization review entity notified
the health care provider in writing of these facts before the
health care service was provided;
(c)The authorized service was never performed; or
(d)The patient was no longer enrolled under the applicable
health plan and, on that basis, was not eligible for health care
coverage from the applicable health insurer or self-insured plan
on the day the care was provided, and the utilization review
entity notified the health care provider in writing of these
facts before the health care service was provided.
(17)If a utilization review entity requires a prior
authorization for a health care service for the treatment of a
chronic or long-term care condition, the prior authorization
must remain valid for the length of the treatment, and the
utilization review entity is prohibited from requiring the
patient to obtain a prior authorization again for the health
care service.
(18)A utilization review entity is prohibited from
imposing an additional prior authorization requirement with
respect to a surgical or otherwise invasive procedure, or any
item furnished as part of the surgical or invasive procedure, if
the procedure or item is furnished during the perioperative
period of another procedure for which prior authorization was
granted by the health insurer.
(19)If there is a change in coverage or approval criteria
for a previously authorized health care service, the change in
coverage or approval criteria is prohibited from adversely
affecting an enrollee who received prior authorization before
the effective date of the change for the remainder of the
enrollee’s plan year.
(20)A utilization review entity shall continue to honor a
prior authorization it has granted to an enrollee when the
enrollee changes products under the same health insurer.
(21)Any failure by a utilization review entity to comply
with the deadlines and other requirements specified in this
section will result in any health care services subject to
review being automatically deemed authorized by the utilization
review entity.
(22)Except as otherwise provided in paragraphs (16)(a)
(d), prior authorization constitutes a conclusive determination
of the medical necessity of the authorized health care service
and an irrevocable obligation to pay for such authorized health
care service.
(23)(a)This section prohibits an agreement with a health
care provider to restrict, limit, prohibit, or substitute a
utilization review activity or prior authorization.
(b)Nothing in this section may be construed to:
1.Limit in any way the restrictions or prohibitions on
adverse determinations under an agreement with a health care
provider, nor to imply permission for, or applicability of,
adverse determinations for emergency health care services.
2.Restrict, limit, or prohibit in any way prior
authorizations under an agreement between a provider and a
utilization review entity, nor to restrict, limit, or prohibit a
provider’s rights to contest, reject, or oppose any prior
authorization activities.
(24)For a violation of this section, a provider shall have
a private cause of action to proceed against the health insurer
or utilization review entity in the applicable tribunal for the
violation.
Section 3. Section 627.6131, Florida Statutes, is amended
to read:
627.6131 Prompt payment of claims.—
(1) The contract must [shall] include the following
provision: “Time of Payment of Claims: After receiving written
proof of loss, the health insurer shall [will] pay monthly all
claims. Claims [benefits then due for ...(type of benefit)....]
[Benefits] for any other loss covered by this policy shall [will] be
paid as soon as the health insurer receives proper written
proof.”
(2) As used in this section, the term:
(a) “Claim” for a noninstitutional provider means a paper
HCFA 1500 claim form, or its successor, or an electronic billing
instrument submitted to the health insurer’s designated location
that consists of the ANSI ASC X12N 837P standard [HCFA 1500] data
set, or its successor, that has all mandatory entries for a
physician licensed under chapter 458, chapter 459, chapter 460,
chapter 461, or chapter 463, or psychologists licensed under
chapter 490 or any appropriate billing instrument as designated
by the provider that has all mandatory entries for any other
noninstitutional provider. For institutional providers, “claim”
means a paper CMS-1450 claim form, or its successor, or an
electronic billing instrument submitted to the health insurer’s
designated location that consists of the ANSI ASC X12N 837I
standard [UB-92 data] set, or its successor, with entries stated
as mandatory by the National Uniform Billing Committee.
(b)“Clean claim” means a completed form, or completed
electronic billing instrument, containing all information
required under the applicable form or electronic billing
instrument, as well as information reasonably required by the
health insurer, other than for emergency services and care as
defined in s. 395.002, in advance of the provision of service by
the health insurer to substantiate the claim.
(c)“Electronic medical record” means the digital record of
a patient’s information that may be accessed through electronic
means, via portal or other method of electronic access, which
may include information regarding the patient’s medical history,
medical condition, medical treatment, laboratory results,
diagnostic reports, and clinical notes.
(d)“Emergency health care services” has the same meaning
as “emergency services and care” as defined in s. 395.002.
(e)“Health insurer” means any entity that offers health
insurance coverage, whether through a fully insured plan or a
self-insured plan or fund, including, as applicable:
1.An authorized health insurer offering health insurance
as defined in s. 624.603, as well as any entity that offers a
commercial self-insurance fund as defined in s. 624.462(2) or a
group self-insurance fund as described in s. 624.4621.
2.A health insurer that is subject to any provision of
this chapter, as well as any entity that offers a self-insurance
plan or a group self-insurance plan.
(f)“Insured ineligibility” means that the insured was no
longer enrolled in the health plan at the time of receiving the
applicable service.
(g)“Overpayment” means payment made upon a claim that is:
1.Billed in error;
2.A duplicate claim; or
3.Billed for a service rendered to a patient despite
insured ineligibility.
A request for overpayment is limited to a billing error,
duplicate bill, or insured ineligibility.
(3) All claims for payment or overpayment, whether
electronic or nonelectronic:
(a) Are considered received on the date the claim is
received by the health insurer at its designated claims-receipt
location or the date the [claim for] overpayment claim is received
by the provider at its designated location.
(b) As to providers’ claims for payment, must be mailed or
electronically transferred to the primary health insurer within
6 months after the following have occurred:
1. Discharge for inpatient services or the date of service
for outpatient services; and
2. The provider has been furnished with the correct name
and address of the patient’s health insurer.
All providers’ claims for payment, whether electronic or
nonelectronic, must be mailed or electronically transferred to
the secondary health insurer within 45 [90] days after final
determination by the primary health insurer. A provider’s claim
is considered submitted on the date it is electronically
transferred or mailed.
(c) Must not duplicate a claim previously submitted unless
it is determined that the original claim was not received or is
otherwise lost.
(4) For all electronically submitted claims, a health
insurer shall:
(a) Within 24 hours after the beginning of the next
business day after receipt of the claim, provide to the
electronic source submitting the claim an electronic
acknowledgment of the receipt of the claim, accompanied by a
statement indicating the health insurer’s position as to whether
the claim is a clean claim or is missing any information that is
required under the applicable electronic billing instrument, as
described in paragraph (2)(a), or that was reasonably required
by the health insurer, other than for emergency health care
services, in advance of the provision of service to substantiate
[to the electronic source submitting] the claim, and the health
insurer asserts is missing as of the date of service.
(b) Within 15 [20] days after receipt of the claim, pay the
claim or notify a provider or designee if a claim is denied or
contested. Notice of the health­ insurer’s action on the claim
and payment of the claim is considered to be made on the date
the notice or payment was received by the provider [mailed] or
electronically transferred.
(c)1. Notification of the health insurer’s determination of
a contested claim must be accompanied by an itemized list of any
[additional] information that is required under the applicable
billing instrument, as described in paragraph (2)(a), or that
was reasonably required by the health insurer, other than for
emergency health care services, in advance of the provision of
service to substantiate the claim, and the health insurer
asserts is missing as of the date of such service [or documents]
[the insurer can reasonably determine are necessary to process]
[the claim].
2. A provider must submit the additional information or
documentation, as specified on the itemized list, within 30 [35]
days after receipt of the notification of contestation unless,
within the 30-day period, the provider notifies the health
insurer of the provider’s position that a clean claim has been
submitted. Additional information is considered submitted on the
date it is electronically transferred or mailed. The health
insurer is prohibited from requesting [may not request] duplicate
documents.
(d) For purposes of this subsection, electronic means of
transmission of claims, notices, documents, forms, and payments
shall be used to the greatest extent possible by the health
insurer and the provider.
(e) A claim contested by the health insurer must be paid or
denied within 30 [90] days after receipt of the additional
information requested [claim]. Failure to pay or deny a claim
within 90 [120] days after receipt of the claim, regardless of
whether contested by the health insurer, creates an
uncontestable obligation to pay the claim as submitted by the
provider.
(5) For all nonelectronically submitted claims, a health
insurer shall:
(a) Within 15 days following receipt of the claim [Effective]
[November 1, 2003], provide to the provider or its designee:
1.An acknowledgment of receipt of the claim, accompanied
by a statement indicating the health insurer’s position as to
whether the claim is a clean claim or the claim is missing any
information that is required under the applicable paper billing
form, as described in paragraph (2)(a), or that was reasonably
required by the health insurer, other than for emergency health
care services, in advance of the provision of service to
substantiate the claim, and the health insurer asserts is
missing as of the date of service; or
2. [within 15 days after receipt of the claim to the]
[provider or provide a provider within 15 days after receipt with]
Electronic access to the status of the [a] submitted claim, which
status must indicate the health insurer’s position as to whether
the claim is a clean claim or missing any information described
in subparagraph 1.
(b) Within 30 [40] days after receipt of the claim, pay the
claim or notify a provider or designee if a claim is denied or
contested. Notice of the health insurer’s action on the claim
and payment of the claim is considered to be made on the date
the notice or payment was received by the provider [mailed] or
electronically transferred.
(c)1. Notification of the health insurer’s determination of
a contested claim must be accompanied by an itemized list of any
[additional] information that is required under the applicable
form or billing instrument, as described in paragraph (2)(a), or
that was reasonably required by the health insurer, other than
for emergency health care services, in advance of the provision
of service to substantiate the claim, and the health insurer
asserts is missing as of the date of such service [or documents]
[the insurer can reasonably determine are necessary to process]
[the claim].
2. A provider must submit the additional information or
documentation, as specified on the itemized list, within 30 [35]
days after receipt of the notification of contestation unless,
within the 30-day period, the provider notifies the health
insurer of its position that a clean claim has been submitted.
Additional information is considered submitted on the date it is
electronically transferred or mailed. The health insurer is
prohibited from requesting [may not request] duplicate documents.
(d) For purposes of this subsection, electronic means of
transmission of claims, notices, documents, forms, and payments
must [shall] be used to the greatest extent possible by the health
insurer and the provider.
(e) A claim contested by the health insurer must be paid or
denied within 30 [120] days after receipt of the additional
information requested [claim]. Failure to pay or deny a claim
within 90 [140] days after receipt of the claim, regardless of
whether contested by the health insurer, creates an
uncontestable obligation to pay the claim as submitted by the
provider.
(6)Regardless of whether a claim has been submitted
electronically or nonelectronically, and notwithstanding any
other provision of this section:
(a)Once a provider grants a health insurer access to a
patient’s electronic medical record, the provider is deemed to
have supplied all information necessary to pay the claim,
including, without limitation, all information that is required
under the applicable billing instrument and that was reasonably
required by the health insurer, other than for emergency health
care services, in advance of the provision of service to
substantiate the claim. Additional information or documentation,
regardless of whether the health insurer requests any additional
information, is deemed unnecessary, and deemed not required for
payment of the claim, and any request for additional
information, and any position of the health insurer or any third
party acting on behalf of the health insurer regarding any lack
of information from the provider, is prohibited from being used
to deny, reduce, offset, withhold, pend, or delay payment of the
claim.
(b)If notice of access to the electronic medical record
has been provided to the health insurer, the claim must be paid
or denied within 30 days of such notice to the health insurer.
Failure to pay or deny a claim for which the health insurer has
been provided notice of access to the electronic medical record
within 75 days after receipt of such notice creates an
uncontestable obligation to pay the claim as submitted by the
provider.
(7)[(6)] If a health insurer determines that it has made an
overpayment to a provider for services rendered to an insured,
the health insurer must make an overpayment [a] claim for such
overpayment to the provider’s designated location. A health
insurer that makes an overpayment [a] claim [for overpayment] to a
provider under this section shall give the provider a written or
electronic statement specifying the basis for the retrospective
[retroactive] denial or payment adjustment. The health insurer
must also identify the claim or claims, or portion thereof, as
to which the health insurer alleges overpayment [claim], and the
specific invoice number submitted with or on the claim [portion]
[thereof, for which a claim for overpayment is submitted]. Except
as provided in subparagraph (a)3., there may be no denial,
reduction, offset, withholding, pending, or delay of payment, or
other negative impact, regardless of whether by the health
insurer or any third party acting on behalf of such health
insurer, on payment of any other claim of the provider on the
basis of the overpayment allegation.
(a) If an overpayment determination is the result of
retrospective [retroactive] review or retrospective audit [of]
[coverage decisions or payment levels not related to fraud], a
health insurer must [shall] adhere to the following procedures:
1. All overpayment claims [for overpayment] must be received
by the [submitted to a] provider within 18 [30] months after the
health insurer’s payment of the claim. A provider must pay,
deny, or contest the health insurer’s [claim for] overpayment
claim within 40 days after the receipt of the overpayment claim.
All contested overpayment claims [for overpayment] must be paid or
denied within 120 days after receipt of the overpayment claim.
Failure to pay or deny an overpayment [and] claim within 140 days
after receipt creates an uncontestable obligation to pay the
overpayment claim.
2. A provider that denies or contests a health insurer’s
overpayment claim [for overpayment] or any portion of an
overpayment [a] claim shall notify the health insurer, in writing,
within 40 [35] days after the provider receives the overpayment
claim that such overpayment [the] claim [for overpayment] is
contested or denied. The notice that the overpayment claim [for]
[overpayment] is denied or contested must identify the denied or
contested portion of the overpayment claim and the specific
reason for contesting or denying the overpayment claim and, if
contested, must include a request for additional information. If
the health insurer submits additional information, the health
insurer must, within 35 days after receipt of the request, mail
or electronically transfer the information to the provider. The
provider shall pay or deny the overpayment claim [for overpayment]
within 45 days after receipt of the information. The notice from
the provider regarding denial or contestation of the overpayment
claim is considered made on the date the notice is mailed or
electronically transferred by the provider.
3. The health insurer is prohibited from denying, reducing,
offsetting, withholding, pending, or delaying [may not reduce]
payment to the provider for other services unless the provider
agrees to the denial, reduction, offset, withholding, pending,
or delay of payment in writing or fails to respond to the health
insurer’s overpayment claim as required by this paragraph.
4. Payment of an overpayment claim is considered made on
the date the payment was mailed or electronically transferred.
An overdue payment of a claim bears simple interest at the rate
of 12 percent per year. Interest on an overdue payment for an
overpayment [a] claim [for an overpayment] begins to accrue when the
overpayment claim should have been paid[, denied, or contested].
(b) An overpayment [A] claim is prohibited [for overpayment]
[shall not be permitted] beyond 18 [30] months after the health
insurer’s payment of a claim, except that overpayment claims [for]
[overpayment] may be sought beyond that time from providers
convicted of fraud pursuant to s. 817.234.
(8)[(7)] Payment of a claim is considered made on the date
the payment was mailed or electronically transferred. An overdue
payment of a claim bears simple interest of 15 [12] percent per
year, to be calculated on the full total amount that should have
been paid on the claim within the applicable time period
specified in this section. If an applicable court, arbitration
tribunal, or other binding legal process determines that a claim
that was paid at a lesser amount should have been paid at a full
total amount, whether under a breach of contract legal claim, a
legal claim under a statutory private cause of action, or other
basis, the 15 percent per year interest must be calculated on
the full total amount, rather than upon the difference between
the full total amount and the amount that was actually paid. If
an applicable court, arbitration tribunal, or other binding
legal process determines that a claim was subject to an
inappropriate or impermissible denial or partial denial, whether
in a breach of contract, statute, common law, or otherwise,
interest must be calculated on the full total amount that should
have been paid on the claim within the applicable time period
for payment specified in this section, and the act of denial or
partial denial is deemed not to have in any way tolled the time
period for such payment. Interest on the full total amount that
should have been paid on the claim within the applicable time
period specified in this section [an overdue payment for a claim]
[or for any portion of a claim] begins to accrue when the claim
should have been paid[, denied, or contested]. The interest must
be paid along with, and in addition to, the payment for the
satisfaction of the full total amount of the claim, as
determined by an applicable court, arbitration tribunal, or
other binding legal process [is payable with the payment of the]
[claim].
(9)[(8)] For all contracts entered into or renewed on or
after October 1, 2002, a health insurer’s internal dispute
resolution process related to a denied claim not under active
review by a mediator, arbitrator, or third-party dispute entity
must be finalized within 60 days after the receipt of the
provider’s request for review or appeal. Notwithstanding any
provision of this section, when the provider and health insurer
disagree as to interpretation of contractual or statutory
language, the provider is not required to participate in the
health insurer’s internal dispute resolution process.
(10)[(9)] A provider or any representative of a provider,
regardless of whether the provider is under contract with the
health insurer, is prohibited from collecting or attempting [may]
[not collect or attempt] to collect money from, maintaining
[maintain] any action at law against, or reporting [report] to a
credit agency an insured for payment of covered services for
which the health insurer contested or denied the provider’s
claim. This prohibition applies during the pendency of any claim
for payment made by the provider to the health insurer for
payment of the services or internal dispute resolution process
to determine whether the health insurer is liable for the
services. For a claim, this pendency applies from the date the
claim or a portion of the claim is denied to the date of the
completion of the health insurer’s internal dispute resolution
process, not to exceed 60 days. This subsection does not
prohibit the collection by the provider of copayments,
coinsurance, or deductible amounts due the provider.
[(10)][The provisions of this section may not be waived,]
[voided, or nullified by contract.]
(11) A health insurer is prohibited from retrospectively
denying [may not retroactively deny] a claim because of insured
ineligibility more than 90 days [1 year] after the date of payment
of the claim.
(12) A health insurer must [shall] pay a contracted primary
care or admitting physician, pursuant to such physician’s
contract, for providing inpatient services in a contracted
hospital to an insured if such services are determined by such
physician [the health insurer] to be medically necessary and,
regardless of the health plan’s determination of medical
necessity, are otherwise covered services under the health
insurer’s contract with the contract holder.
(13) Upon written notification by an insured, a health [an]
insurer shall investigate any claim of improper billing of the
insured by a physician, hospital, or other health care provider
for a health care service alleged to not actually have been
received. The health insurer shall determine whether [if] the
insured actually received the applicable service [was properly]
[billed for only those procedures and services that the insured]
[actually received]. If the health insurer determines that the
insured did not actually receive the applicable service [has been]
[improperly billed], the health insurer must [shall] notify the
insured and the provider of its findings and must [shall] reduce
the amount of payment to the provider by the amount for the
service that was not actually received [determined to be]
[improperly billed]. [If a reduction is made due to such]
[notification by the insured, the insurer shall pay to the]
[insured 20 percent of the amount of the reduction up to $500].
(14) A permissible error ratio of 5 percent is established
for health insurer’s claims payment violations of paragraphs
(4)(a), (b), (c), and (e) and (5)(a), (b), (c), and (e). If the
error ratio of a particular health insurer does not exceed the
permissible error ratio of 5 percent for an audit period, no
fine may [shall] be assessed for the noted claims violations for
the audit period. The error ratio is [shall be] determined by
dividing the number of claims with violations found on a
statistically valid sample of claims for the audit period by the
total number of claims in the sample. If the error ratio exceeds
the permissible error ratio of 5 percent, a fine may be assessed
according to s. 624.4211 for those claims payment violations
which exceed the error ratio. Notwithstanding the provisions of
this section, the office may fine a health insurer for claims
payment violations of paragraphs (4)(e) and (5)(e) which create
an uncontestable obligation to pay the claim as submitted by the
provider. The office shall refrain from imposing a [not] fine upon
a health insurer [insurers] for violations which the office
determines were due to circumstances beyond the health insurer’s
control.
(15) This section is applicable only to a major medical
expense health insurance policy as defined in s. 627.643(2)(e)
offered by a group or an individual health insurer licensed
under [pursuant to] chapter 624, including a preferred provider
policy under s. 627.6471 and an exclusive provider organization
under s. 627.6472 or a group or individual insurance contract
that only provides direct payments to dentists for enumerated
dental services, or other health insurance coverage, policy, or
fund, regardless of whether fully insured or self-insured,
offered or administered by a health insurer.
(16) Notwithstanding paragraph (4)(b), where an electronic
pharmacy claim is submitted to a pharmacy benefits manager
acting on behalf of a health insurer, the pharmacy benefits
manager shall, within 30 days of receipt of the claim, pay the
claim or notify a provider or designee if a claim is denied or
contested. Notice of the health insurer’s action on the claim
and payment of the claim is considered to be made on the date
the notice or payment was received by the provider [mailed] or
electronically transferred.
(17) Notwithstanding paragraph (5)(a), effective November
1, 2003, where a nonelectronic pharmacy claim is submitted to a
pharmacy benefits manager acting on behalf of a health insurer,
the pharmacy benefits manager shall provide acknowledgment of
receipt of the claim within 30 days after receipt of the claim
to the provider or provide a provider within 30 days after
receipt with electronic access to the status of a submitted
claim.
(18) Notwithstanding the 18-month [30-month] period provided
in subsection (7) [(6)], all overpayment claims [for overpayment]
submitted to a provider licensed under chapter 395, chapter 458,
 1000  chapter 459, chapter 460, chapter 461, chapter 463, chapter 466,
 1001  or chapter 490 must be submitted to the provider within 12
 1002  months after the health insurer’s payment of the claim. An
 1003  overpayment [A] claim to a provider licensed under chapter 395,
 1004  chapter 458, chapter 459, chapter 460, chapter 461, chapter 463,
 1005  chapter 466, or chapter 490 is prohibited [for overpayment may]
 1006  [not be permitted] beyond 12 months after the health insurer’s
 1007  payment of a claim, except that overpayment claims [for]
 1008  [overpayment] may be sought beyond that time from providers
 1009  convicted of fraud pursuant to s. 817.234.
 1010  (19) Notwithstanding any other provision of this section,
 1011  all claims for underpayment from a provider licensed under
 1012  chapter 395, chapter 458, chapter 459, chapter 460, chapter 461,
 1013  or chapter 466 must be submitted to the health insurer within 12
 1014  months after the health insurer’s payment of the claim. A claim
 1015  for underpayment by a provider licensed under chapter 395,
 1016  chapter 458, chapter 459, chapter 460, chapter 461, or chapter
 1017  466 is prohibited [may not be permitted] beyond 12 months after
 1018  the health insurer’s payment of a claim.
 1019  (20)Nothing in this section shall be interpreted to limit,
 1020  restrict, or negatively impact any legal claim by a provider or
 1021  health insurer for breach of contract, statutory or regulatory
 1022  violation, or a common-law cause of action, nor to shorten or
 1023  otherwise negatively impact the statute of limitations timeframe
 1024  for bringing any such legal claim.
 1025  (21)A health insurer is prohibited from requesting
 1026  information from a contracted or noncontracted provider which
 1027  does not apply to the medical condition at issue for the
 1028  purposes of adjudicating a clean claim.
 1029  (22)A health insurer is prohibited from requesting a
 1030  contracted or noncontracted provider to resubmit claim
 1031  information that the contracted or noncontracted provider can
 1032  document it has already provided to the health insurer or that
 1033  is contained inside the electronic medical record to which the
 1034  health insurer has been provided access.
 1035  (23)Notwithstanding any other provision of this section, a
 1036  health insurer is prohibited from requiring any information from
 1037  a provider before the provision of emergency health care
 1038  services as a condition of payment of a claim, as a basis for
 1039  denying, delaying, offsetting, withholding, or reducing payment
 1040  of a claim, or in contesting whether the claim is a clean claim.
 1041  (24)For a violation of this section, a provider shall have
 1042  a private cause of action to proceed against the health insurer
 1043  in the applicable tribunal for the violation.
 1044  (25)[(20)](a) A contract between a health insurer and a
 1045  dentist licensed under chapter 466 for the provision of services
 1046  to an insured is prohibited from specifying [may not specify]
 1047  credit card payment as the only acceptable method for payments
 1048  from the health insurer to the dentist.
 1049  (b) When a health insurer employs the method of claims
 1050  payment to a dentist through electronic funds transfer,
 1051  including, but not limited to, virtual credit card payment, the
 1052  health insurer shall notify the dentist as provided in this
 1053  paragraph and obtain the dentist’s consent before employing the
 1054  electronic funds transfer. The dentist’s consent described in
 1055  this paragraph applies to the dentist’s entire practice. For the
 1056  purpose of this paragraph, the dentist’s consent, which may be
 1057  given through e-mail, must bear the signature of the dentist.
 1058  Such signature includes an electronic or digital signature if
 1059  the form of signature is recognized as a valid signature under
 1060  applicable federal law or state contract law or an act that
 1061  demonstrates express consent, including, but not limited to,
 1062  checking a box indicating consent. The health insurer or dentist
 1063  is prohibited from requiring [may not require] that a dentist’s
 1064  consent as described in this paragraph be made on a patient-by
 1065  patient basis. The notification provided by the health insurer
 1066  to the dentist must include all of the following:
 1067  1. The fees, if any, associated with the electronic funds
 1068  transfer.
 1069  2. The available methods of payment of claims by the health
 1070  insurer, with clear instructions to the dentist on how to select
 1071  an alternative payment method.
 1072  (c) A health insurer that pays a claim to a dentist through
 1073  automated clearinghouse transfer is prohibited from charging [may]
 1074  [not charge] a fee solely to transmit the payment to the dentist
 1075  unless the dentist has consented to the fee.
 1076  (d) This subsection applies to contracts delivered, issued,
 1077  or renewed on or after January 1, 2025.
 1078  (e) The office has all rights and powers to enforce this
 1079  subsection as provided by s. 624.307.
 1080  (f) The commission may adopt rules to implement this
 1081  subsection.
 1082  (26)[(21)](a) A health insurer is prohibited from denying [may]
 1083  [not deny] any claim subsequently submitted by a dentist licensed
 1084  under chapter 466 for procedures specifically included in a
 1085  prior authorization unless at least one of the following
 1086  circumstances applies for each procedure denied:
 1087  1. Benefit limitations, such as annual maximums and
 1088  frequency limitations not applicable at the time of the prior
 1089  authorization, are reached subsequent to issuance of the prior
 1090  authorization.
 1091  2. The documentation provided by the person submitting the
 1092  claim fails to support the claim as originally authorized.
 1093  3. Subsequent to the issuance of the prior authorization,
 1094  new procedures are provided to the patient or a change in the
 1095  condition of the patient occurs such that the prior authorized
 1096  procedure would no longer be considered medically necessary,
 1097  based on the prevailing standard of care.
 1098  4. Subsequent to the issuance of the prior authorization,
 1099  new procedures are provided to the patient or a change in the
 1100  patient’s condition occurs such that the prior authorized
 1101  procedure would at that time have required disapproval pursuant
 1102  to the terms and conditions for coverage under the patient’s
 1103  plan in effect at the time the prior authorization was issued.
 1104  5. The denial of the claim was due to one of the following:
 1105  a. Another payor is responsible for payment.
 1106  b. The dentist has already been paid for the procedures
 1107  identified in the claim.
 1108  c. The claim was submitted fraudulently, or the prior
 1109  authorization was based in whole or material part on erroneous
 1110  information provided to the health insurer by the dentist,
 1111  patient, or other person not related to the health insurer.
 1112  d. The person receiving the procedure was not eligible to
 1113  receive the procedure on the date of service.
 1114  e. The services were provided during the grace period
 1115  established under s. 627.608 or applicable federal regulations,
 1116  and the dental insurer notified the provider that the patient
 1117  was in the grace period when the provider requested eligibility
 1118  or enrollment verification from the dental insurer, if such
 1119  request was made.
 1120  (b) This subsection applies to all contracts delivered,
 1121  issued, or renewed on or after January 1, 2025.
 1122  (c) The office has all rights and powers to enforce this
 1123  subsection as provided by s. 624.307.
 1124  (d) The commission may adopt rules to implement this
 1125  subsection.
 1126  Section 4. Section 641.3155, Florida Statutes, is amended
 1127  to read:
 1128  641.3155 Prompt payment of claims.—
 1129  (1) As used in this section, the term:
 1130  (a) “Claim” for a noninstitutional provider means a paper
 1131  HCFA 1500 claim form, or its successor, or an electronic billing
 1132  instrument submitted to the health maintenance organization’s
 1133  designated location that consists of the ANSI ASC X12N 837P
 1134  standard [HCFA 1500] data set, or its successor, that has all
 1135  mandatory entries for a physician licensed under chapter 458,
 1136  chapter 459, chapter 460, chapter 461, or chapter 463, or
 1137  psychologists licensed under chapter 490 or any appropriate
 1138  billing instrument as designated by the provider that has all
 1139  mandatory entries for any other noninstitutional provider. For
 1140  institutional providers, “claim” means a paper CMS-1450 claim
 1141  form, or its successor, or an electronic billing instrument
 1142  submitted to the health maintenance organization’s designated
 1143  location that consists of the ANSI ASC X12N 837I standard [UB-92]
 1144  data set or its successor with entries stated as mandatory by
 1145  the National Uniform Billing Committee.
 1146  (b)“Clean claim” means a completed form, or completed
 1147  electronic billing instrument, containing all information
 1148  required under the applicable form or electronic billing
 1149  instrument, as well as information reasonably required by the
 1150  health maintenance organization, other than for emergency
 1151  services and care as defined in s. 641.19, in advance of the
 1152  provision of service by the health maintenance organization to
 1153  substantiate the claim.
 1154  (c)“Electronic medical record” means the digital record of
 1155  a patient’s information that may be accessed through electronic
 1156  means, via portal or other method of electronic access, which
 1157  may include information regarding the patient’s medical history,
 1158  medical condition, medical treatment, laboratory results,
 1159  diagnostic reports, and clinical notes.
 1160  (d)“Emergency health care service” has the same meaning as
 1161  “emergency services and care” as defined in s. 641.19.
 1162  (e)“Enrollee ineligibility” means that the enrollee was no
 1163  longer enrolled in the health maintenance organization at the
 1164  time of receiving the applicable service.
 1165  (f)“Overpayment” means payment made upon a claim that is:
 1166  1.Billed in error;
 1167  2.A duplicate claim; or
 1168  3.Billed for a service rendered to a patient despite
 1169  enrollee ineligibility.
 1170
 1171  A request for overpayment is limited to a billing error,
 1172  duplicate bill, or enrollee ineligibility.
 1173  (2) All claims for payment or overpayment, whether
 1174  electronic or nonelectronic:
 1175  (a) Are considered received on the date the claim is
 1176  received by the health maintenance organization at its
 1177  designated claims-receipt location or the date the overpayment [a]
 1178  claim [for overpayment] is received by the provider at its
 1179  designated location.
 1180  (b) As to providers’ claims for payment, must be mailed or
 1181  electronically transferred to the primary organization within 6
 1182  months after the following have occurred:
 1183  1. Discharge for inpatient services or the date of service
 1184  for outpatient services; and
 1185  2. The provider has been furnished with the correct name
 1186  and address of the patient’s health maintenance organization.
 1187
 1188  All providers’ claims for payment, whether electronic or
 1189  nonelectronic, must be mailed or electronically transferred to
 1190  the secondary organization within 45 [90] days after final
 1191  determination by the primary organization. A provider’s claim is
 1192  considered submitted on the date it is electronically
 1193  transferred or mailed.
 1194  (c) Must not duplicate a claim previously submitted unless
 1195  it is determined that the original claim was not received or is
 1196  otherwise lost.
 1197  (3) For all electronically submitted claims, a health
 1198  maintenance organization shall:
 1199  (a) Within 24 hours after the beginning of the next
 1200  business day after receipt of the claim, provide to the
 1201  electronic source submitting the claim an electronic
 1202  acknowledgment of the receipt of the claim, accompanied by a
 1203  statement indicating the health maintenance organization’s
 1204  position as to whether the claim is a clean claim or whether the
 1205  claim is missing any information that is required under the
 1206  applicable electronic billing instrument described in paragraph
 1207  (1)(a) or that was reasonably required by the health maintenance
 1208  organization, other than for emergency health care services, in
 1209  advance of the provision of service to substantiate [to the]
 1210  [electronic source submitting] the claim, and the health
 1211  maintenance organization asserts is missing as of the date of
 1212  service.
 1213  (b) Within 15 [20] days after receipt of the claim, pay the
 1214  claim or notify a provider or designee if a claim is denied or
 1215  contested. Notice of the health maintenance organization’s
 1216  action on the claim and payment of the claim is considered to be
 1217  made on the date the notice or payment was received by the
 1218  provider [mailed] or electronically transferred.
 1219  (c)1. Notification of the health maintenance organization’s
 1220  determination of a contested claim must be accompanied by an
 1221  itemized list of any [additional] information required under the
 1222  applicable billing instrument described in paragraph (1)(a) or
 1223  that was reasonably required by the health maintenance
 1224  organization, other than for emergency health care services, in
 1225  advance of the provision of service to substantiate the claim,
 1226  and the health maintenance organization asserts is missing as of
 1227  the date of such service [or documents the insurer can reasonably]
 1228  [determine are necessary to process the claim].
 1229  2. A provider must submit the additional information or
 1230  documentation, as specified on the itemized list, within 30 [35]
 1231  days after receipt of the notification of contestation unless,
 1232  within the 30-day period, the provider notifies the health
 1233  maintenance organization of the provider’s position that a clean
 1234  claim has been submitted. Additional information is considered
 1235  submitted on the date it is electronically transferred or
 1236  mailed. The health maintenance organization is prohibited from
 1237  requesting [may not request] duplicate documents.
 1238  (d) For purposes of this subsection, electronic means of
 1239  transmission of claims, notices, documents, forms, and payment
 1240  shall be used to the greatest extent possible by the health
 1241  maintenance organization and the provider.
 1242  (e) A claim contested by the health maintenance
 1243  organization must be paid or denied within 30 [90] days after
 1244  receipt of the additional information requested [claim]. Failure
 1245  to pay or deny a claim within 90 [120] days after receipt of the
 1246  claim, regardless of whether contested by the health maintenance
 1247  organization, creates an uncontestable obligation to pay the
 1248  claim.
 1249  (4) For all nonelectronically submitted claims, a health
 1250  maintenance organization shall:
 1251  (a) Within 15 days following receipt of the claim [Effective]
 1252  [November 1, 2003], provide to the provider, or designee, who
 1253  submitted the claim:
 1254  1.An acknowledgment of receipt of the claim, accompanied
 1255  by a statement indicating the health maintenance organization’s
 1256  position as to whether the claim is a clean claim or the claim
 1257  is missing any information that is required under the applicable
 1258  paper billing form, as described in paragraph (1)(a), or that
 1259  was reasonably required by the health maintenance organization,
 1260  other than for emergency health care services, in advance of the
 1261  provision of service to substantiate the claim, and the health
 1262  maintenance organization asserts is missing as of the date of
 1263  service; or
 1264  2. [within 15 days after receipt of the claim to the]
 1265  [provider or designee or provide a provider or designee within 15]
 1266  [days after receipt with] Electronic access to the status of the [a]
 1267  submitted claim, which status must indicate the health
 1268  maintenance organization’s position as to whether the claim is a
 1269  clean claim or missing any information described in subparagraph
 1270  1.
 1271  (b) Within 30 [40] days after receipt of the claim, pay the
 1272  claim or notify a provider or designee if a claim is denied or
 1273  contested. Notice of the health maintenance organization’s
 1274  action on the claim and payment of the claim is considered to be
 1275  made on the date the notice or payment was received by the
 1276  provider [mailed] or electronically transferred.
 1277  (c)1. Notification of the health maintenance organization’s
 1278  determination of a contested claim must be accompanied by an
 1279  itemized list of any [additional] information required under the
 1280  applicable form or billing instrument described in paragraph
 1281  (1)(a), or that was reasonably required by the health
 1282  maintenance organization, other than for emergency health care
 1283  services, in advance of the provision of service to substantiate
 1284  the claim, and the health maintenance organization asserts is
 1285  missing as of the date of such service [or documents the]
 1286  [organization can reasonably determine are necessary to process]
 1287  [the claim].
 1288  2. A provider must submit the additional information or
 1289  documentation, as specified on the itemized list, within 30 [35]
 1290  days after receipt of the notification of contestation unless,
 1291  within the 30-day period, the provider notifies the health
 1292  maintenance organization of the provider’s position that a clean
 1293  claim has been submitted. Additional information is considered
 1294  submitted on the date it is electronically transferred or
 1295  mailed. The health maintenance organization is prohibited from
 1296  requesting [may not request] duplicate documents.
 1297  (d) For purposes of this subsection, electronic means of
 1298  transmission of claims, notices, documents, forms, and payments
 1299  must [shall] be used to the greatest extent possible by the health
 1300  maintenance organization and the provider.
 1301  (e) A claim contested by the health maintenance
 1302  organization must be paid or denied within 30 [120] days after
 1303  receipt of the additional information requested [claim]. Failure
 1304  to pay or deny a claim within 90 [140] days after receipt of the
 1305  claim, regardless of whether contested by the health maintenance
 1306  organization, creates an uncontestable obligation to pay the
 1307  claim as submitted by the provider.
 1308  (5)Regardless of whether a claim has been submitted
 1309  electronically or nonelectronically, and notwithstanding any
 1310  other provision of this section:
 1311  (a)Once a provider grants a health maintenance
 1312  organization access to a patient’s electronic medical record,
 1313  the provider is deemed to have supplied all information
 1314  necessary to pay the claim, including, without limitation, all
 1315  information that is required under the applicable billing
 1316  instrument and that was reasonably required by the health
 1317  maintenance organization, other than for emergency health care
 1318  services, in advance of the provision of service to substantiate
 1319  the claim. Additional information or documentation, regardless
 1320  of whether the health maintenance organization requests any
 1321  additional information, is deemed unnecessary and deemed not
 1322  required for payment of the claim, and any request for
 1323  additional information, and any position of the health
 1324  maintenance organization or any third party acting on behalf of
 1325  the health maintenance organization regarding any lack of
 1326  information from the provider, is prohibited from being used to
 1327  deny, reduce, offset, withhold, pend, or delay payment of the
 1328  claim.
 1329  (b)If notice of access to the electronic medical record
 1330  has been provided to the health maintenance organization, the
 1331  claim must be paid or denied within 30 days of such notice to
 1332  the health maintenance organization. Failure to pay or deny a
 1333  claim, for which the health maintenance organization has been
 1334  provided notice of access to the electronic medical record
 1335  within 75 days after receipt of such notice, creates an
 1336  uncontestable obligation to pay the claim as submitted by the
 1337  provider.
 1338  (6)[(5)] If a health maintenance organization determines that
 1339  it has made an overpayment to a provider for services rendered
 1340  to an enrollee [a subscriber], the health maintenance organization
 1341  must make an overpayment [a] claim for such overpayment to the
 1342  provider’s designated location. A health maintenance
 1343  organization that makes an overpayment [a] claim [for overpaymen]t
 1344  to a provider under this section shall give the provider a
 1345  written or electronic statement specifying the basis for the
 1346  retrospective [retroactive] denial or payment adjustment. The
 1347  health maintenance organization must also identify the claim or
 1348  claims, or [overpayment claim] portion thereof, as to which the
 1349  health maintenance organization alleges overpayment, and the
 1350  specific invoice number submitted with or on the claim, as well
 1351  as the specific line items on the bill that are subject to the
 1352  overpayment claim [for which a claim for overpayment is]
 1353  [submitted]. Except as provided in subparagraph (a)3., there may
 1354  be no denial, reduction, offset, withholding, pending, or delay
 1355  of payment, or other negative impact, regardless of whether by
 1356  the health maintenance organization or any third party acting on
 1357  behalf of such health maintenance organization, on payment of
 1358  any other claim of the provider on the basis of the overpayment
 1359  allegation.
 1360  (a) If an overpayment determination is the result of
 1361  retrospective [retroactive] review or retrospective audit [of]
 1362  [coverage decisions or payment levels not related to fraud], a
 1363  health maintenance organization must [shall] adhere to the
 1364  following procedures:
 1365  1. All overpayment claims [for overpayment] must be received
 1366  by the [submitted to a] provider within 18 [30] months after the
 1367  health maintenance organization’s payment of the claim. A
 1368  provider must pay, deny, or contest the health maintenance
 1369  organization’s overpayment claim [for overpayment] within 40 days
 1370  after the receipt of the overpayment claim. All contested
 1371  overpayment claims [for overpayment] must be paid or denied within
 1372  120 days after receipt of the overpayment claim. Failure to pay
 1373  or deny an overpayment [and] claim within 140 days after receipt
 1374  creates an uncontestable obligation to pay the overpayment
 1375  claim.
 1376  2. A provider that denies or contests a health maintenance
 1377  organization’s overpayment claim [for overpayment] or any portion
 1378  of an overpayment [a] claim shall notify the health maintenance
 1379  organization, in writing, within 40 [35] days after the provider
 1380  receives the overpayment claim that the overpayment claim [for]
 1381  [overpayment] is contested or denied. The notice that the
 1382  overpayment claim [for overpayment] is denied or contested must
 1383  identify the denied or contested portion of the claim and the
 1384  specific reason for contesting or denying the overpayment claim
 1385  and, if contested, must include a request for additional
 1386  information. If the health maintenance organization submits
 1387  additional information, the health maintenance organization
 1388  must, within 35 days after receipt of the request, mail or
 1389  electronically transfer the information to the provider. The
 1390  provider shall pay or deny the overpayment claim [for overpayment]
 1391  within 45 days after receipt of the information. The notice from
 1392  the provider regarding denial or contestation of the overpayment
 1393  claim is considered made on the date the notice is mailed or
 1394  electronically transferred by the provider.
 1395  3. The health maintenance organization is prohibited from
 1396  denying, reducing, offsetting, withholding, pending, or delaying
 1397  [may not reduce] payment to the provider for other services unless
 1398  the provider agrees to the denial, reduction, offset,
 1399  withholding, pending, or delay of payment in writing or fails to
 1400  respond to the health maintenance organization’s overpayment
 1401  claim as required by this paragraph.
 1402  4. Payment of an overpayment claim is considered made on
 1403  the date the payment was mailed or electronically transferred.
 1404  An overdue payment of a claim bears simple interest at the rate
 1405  of 12 percent per year. Interest on an overdue payment for an
 1406  overpayment [a] claim [for an overpayment payment] begins to accrue
 1407  when the overpayment claim should have been paid[, denied, or]
 1408  [contested].
 1409  (b) An overpayment [A] claim is prohibited [for overpayment]
 1410  [shall not be permitted] beyond 18 [30] months after the health
 1411  maintenance organization’s payment of a claim, except that
 1412  overpayment claims [for overpayment] may be sought beyond that
 1413  time from providers convicted of fraud pursuant to s. 817.234.
 1414  (7)[(6)] Payment of a claim is considered made on the date
 1415  the payment was mailed or electronically transferred to the
 1416  provider. An overdue payment of a claim bears simple interest of
 1417  15 [12] percent per year, to be calculated on the full total
 1418  amount that should have been paid on the claim within the
 1419  applicable time period specified in this section. If an
 1420  applicable court, arbitration tribunal, or other binding legal
 1421  process determines that a claim that was paid at a lesser amount
 1422  should have been paid at a full total amount, whether under a
 1423  breach of contract legal claim, a legal claim under a statutory
 1424  private cause of action, or other basis, the 15 percent per year
 1425  interest must be calculated on the full total amount, rather
 1426  than upon the difference between the full total amount and the
 1427  amount that was actually paid. If an applicable court,
 1428  arbitration tribunal, or other binding legal process determines
 1429  that a claim was subject to an inappropriate or impermissible
 1430  denial or partial denial, whether in a breach of contract,
 1431  statute, common law, or otherwise, interest must be calculated
 1432  on the full total amount that should have been paid on the claim
 1433  within the applicable time period for payment specified in this
 1434  section, and the act of denial or partial denial is deemed not
 1435  to have in any way tolled the time period for such payment.
 1436  Interest on the full total amount that should have been paid on
 1437  the claim within the applicable time period specified in this
 1438  section [an overdue payment for a claim or for any portion of a]
 1439  [claim] begins to accrue when the claim should have been paid[,]
 1440  [denied, or contested]. The interest must be paid along with, and
 1441  in addition to, the payment for the satisfaction of the full
 1442  total amount of the claim, as determined by an applicable court,
 1443  arbitration tribunal, or other binding legal process [is payable]
 1444  [with the payment of the claim].
 1445  (8)[(7)] For all contracts entered into or renewed on or
 1446  after October 1, 2002, a health maintenance organization’s
 1447  internal dispute resolution process related to a denied claim
 1448  not under active review by a mediator, arbitrator, or third
 1449  party dispute entity must be finalized within 60 days after the
 1450  receipt of the provider’s request for review or appeal.
 1451  Notwithstanding any provision of this section, if the provider
 1452  and health maintenance organization disagree as to the
 1453  interpretation of contractual or statutory language, the
 1454  provider is not required to participate in the health
 1455  maintenance organization’s internal dispute resolution process.
 1456  (9)[(8)] A provider or any representative of a provider,
 1457  regardless of whether the provider is under contract with the
 1458  health maintenance organization, is prohibited from collecting
 1459  or attempting [may not collect or attempt] to collect money from,
 1460  maintaining [maintain] any action at law against, or reporting
 1461  [report] to a credit agency an enrollee [a subscriber] for payment
 1462  of covered services for which the health maintenance
 1463  organization contested or denied the provider’s claim. This
 1464  prohibition applies during the pendency of any claim for payment
 1465  made by the provider to the health maintenance organization for
 1466  payment of the services or internal dispute resolution process
 1467  to determine whether the health maintenance organization is
 1468  liable for the services. For a claim, this pendency applies from
 1469  the date the claim or a portion of the claim is denied to the
 1470  date of the completion of the health maintenance organization’s
 1471  internal dispute resolution process, not to exceed 60 days. This
 1472  subsection does not prohibit collection by the provider of
 1473  copayments, coinsurance, or deductible amounts due the provider.
 1474  [(9)][The provisions of this section may not be waived,]
 1475  [voided, or nullified by contract.]
 1476  (10) A health maintenance organization is prohibited from
 1477  retrospectively denying [may not retroactively deny] a claim
 1478  because of enrollee [subscriber] ineligibility more than 90 days [1]
 1479  [year] after the date of payment of the claim.
 1480  (11) A health maintenance organization must [shall] pay a
 1481  contracted primary care or admitting physician, pursuant to such
 1482  physician’s contract, for providing inpatient services in a
 1483  contracted hospital to an enrollee [a subscriber] if such services
 1484  are determined by the primary care physician or admitting
 1485  physician [health maintenance organization] to be medically
 1486  necessary and such services are covered services under the
 1487  health maintenance organization’s contract with the contract
 1488  holder.
 1489  (12) A permissible error ratio of 5 percent is established
 1490  for health maintenance organizations’ claims payment violations
 1491  of paragraphs (3)(a), (b), (c), and (e) and (4)(a), (b), (c),
 1492  and (e). If the error ratio of a particular health maintenance
 1493  organization [insurer] does not exceed the permissible error ratio
 1494  of 5 percent for an audit period, no fine may [shall] be assessed
 1495  for the noted claims violations for the audit period. The error
 1496  ratio is [shall be] determined by dividing the number of claims
 1497  with violations found on a statistically valid sample of claims
 1498  for the audit period by the total number of claims in the
 1499  sample. If the error ratio exceeds the permissible error ratio
 1500  of 5 percent, a fine may be assessed according to s. 624.4211
 1501  for those claims payment violations which exceed the error
 1502  ratio. Notwithstanding the provisions of this section, the
 1503  office may fine a health maintenance organization for claims
 1504  payment violations of paragraphs (3)(e) and (4)(e) which create
 1505  an uncontestable obligation to pay the claim as submitted by the
 1506  provider. The office shall refrain from imposing a [not] fine upon
 1507  a health maintenance organization [organizations] for violations
 1508  which the office determines were due to circumstances beyond the
 1509  organization’s control.
 1510  (13) This section applies [shall apply] to all claims or any
 1511  portion of a claim submitted for payment for services provided
 1512  to an enrollee [by] a[ health maintenance organization subscriber]
 1513  under a health maintenance organization plan, or submitted for
 1514  payment for services provided to an enrollee under a self
 1515  insured plan or fund, or fully-insured plan or fund, offered by
 1516  a person or an entity, when a health maintenance organization is
 1517  involved in the administration, or claims-processing activities,
 1518  relating to such plan or fund [subscriber contract to the]
 1519  [organization for payment].
 1520  (14) Notwithstanding paragraph (3)(b), where an electronic
 1521  pharmacy claim is submitted to a pharmacy benefits manager
 1522  acting on behalf of a health maintenance organization, the
 1523  pharmacy benefits manager must [shall], within 30 days after [of]
 1524  receipt of the claim, pay the claim or notify a provider or
 1525  designee if a claim is denied or contested. Notice of the health
 1526  maintenance organization’s action on the claim and payment of
 1527  the claim is considered to be made on the date the notice or
 1528  payment was received by the provider [mailed] or electronically
 1529  transferred.
 1530  (15) Notwithstanding paragraph (4)(a), effective November
 1531  1, 2003, where a nonelectronic pharmacy claim is submitted to a
 1532  pharmacy benefits manager acting on behalf of a health
 1533  maintenance organization, the pharmacy benefits manager shall
 1534  provide acknowledgment of receipt of the claim within 30 days
 1535  after receipt of the claim to the provider or provide a provider
 1536  within 30 days after receipt with electronic access to the
 1537  status of a submitted claim.
 1538  (16) Notwithstanding the 18-month [30-month] period provided
 1539  in subsection (6) [(5)], all claims for overpayment submitted to a
 1540  provider licensed under chapter 395, chapter 458, chapter 459,
 1541  chapter 460, chapter 461, chapter 463, chapter 466, or chapter
 1542  490 must be submitted to the provider within 12 months after the
 1543  health maintenance organization’s payment of the claim. An
 1544  overpayment [A] claim to a provider licensed under chapter 395,
 1545  458, chapter 459, chapter 460, chapter 461, chapter 463, chapter
 1546  466, or chapter 490 is prohibited [for overpayment may not be]
 1547  [permitted] beyond 12 months after the health maintenance
 1548  organization’s payment of a claim, except that claims for
 1549  overpayment may be sought beyond that time from providers
 1550  convicted of fraud pursuant to s. 817.234.
 1551  (17) Notwithstanding any other provision of this section,
 1552  all claims for underpayment from a provider licensed under
 1553  chapter 395, chapter 458, chapter 459, chapter 460, chapter 461,
 1554  or chapter 466 must be submitted to the health maintenance
 1555  organization within 12 months after the health maintenance
 1556  organization’s payment of the claim. A claim for underpayment by
 1557  a provider licensed under chapter 395, chapter 458, chapter 459,
 1558  chapter 460, chapter 461, or chapter 466 is prohibited [may not]
 1559  [be permitted] beyond 12 months after the health maintenance
 1560  organization’s payment of a claim.
 1561  (18)Nothing in this section may be interpreted to limit,
 1562  restrict, or negatively impact any legal claim by a provider or
 1563  health maintenance organization for breach of contract,
 1564  statutory or regulatory violation, or a common-law cause of
 1565  action, nor to shorten or otherwise negatively impact the
 1566  statute of limitations timeframe for bringing any such legal
 1567  claim.
 1568  (19)A health insurer is prohibited from requesting
 1569  information from a contracted or noncontracted provider which
 1570  does not apply to the medical condition at issue for the
 1571  purposes of adjudicating a clean claim.
 1572  (20)A health maintenance organization is prohibited from
 1573  requesting a contracted or noncontracted provider to resubmit
 1574  claim information that the contracted or noncontracted provider
 1575  can document it has already provided to the health maintenance
 1576  organization or that is contained inside the electronic medical
 1577  record to which the health maintenance organization has been
 1578  provided access.
 1579  (21)Notwithstanding any other provision of this section, a
 1580  health maintenance organization is prohibited from requiring any
 1581  information from a provider before the provision of emergency
 1582  health care services as a condition of payment of a claim, as a
 1583  basis for denying, delaying, offsetting, withholding, or
 1584  reducing payment of a claim, or in contesting whether the claim
 1585  is a clean claim.
 1586  (22)For a violation of this section, a provider shall have
 1587  a private cause of action to proceed against the health
 1588  maintenance organization in the applicable tribunal for the
 1589  violation.
 1590  Section 5. Paragraph (c) of subsection (2) of section
 1591  395.1065, Florida Statutes, is amended to read:
 1592  395.1065 Criminal and administrative penalties;
 1593  moratorium.—
 1594  (2)
 1595  (c) The agency may impose an administrative fine for the
 1596  violation of s. 641.3154 or, if sufficient claims due to a
 1597  provider from a health maintenance organization do not exist to
 1598  enable the take-back of an overpayment, as provided under s.
 1599  641.3155(6) [s. 641.3155(5)], for the violation of s. 641.3155(6)
 1600  [s. 641.3155(5)]. The administrative fine for a violation cited in
 1601  this paragraph shall be in the amounts specified in s.
 1602  641.52(5), and the provisions of paragraph (a) do not apply.
 1603  Section 6. This act shall take effect July 1, 2026.

Prohibiting payment adjudicators from downcoding health care services under certain circumstances; specifying that payment adjudicators are solely responsible for certain violations of law; requiring certain utilization review entities to only use a certain prior authorization form; revising the definition of the term "claim", etc.

Sponsors

Sen. Ralph Massullo (R) sponsors S 1130 alone.

Ralph Massullo

Sen. · R–11 · Sponsor

History

S 1130 has taken 4 actions since Jan 5, 2026, the latest on Mar 13, 2026.

ChamberAction
Mar 13, 2026
Senate
Died in Banking and Insurance
Jan 13, 2026
Senate
Introduced
Jan 12, 2026
Senate
Referred to Banking and Insurance; Appropriations Committee on Agriculture, Environment, and General Government; Fiscal Policy
Jan 5, 2026
Senate
Filed

Votes

S 1130 has not gone to a roll call.

Source: flsenate.gov · legiscan.com