FL S1232

Authorizes insurers to offer voluntary wellness programs with rewards or incentives including merchandise, gift cards, premium discounts, health savings account contributions, or modifications to copayments, deductibles, and coinsurance amounts.

Requires health plan members to provide physician verification of medical conditions that make wellness program participation unreasonably difficult or medically inadvisable to be exempt from participation.

Establishes that claimants and providers denied claims as not medically necessary have the right to appeal to the insurer's licensed physician, with response required within 15 business days.

Requires health insurers and health maintenance organizations to conduct retrospective medical necessity reviews within 30 business days for hospital claims denied due to failure to obtain authorization, and to provide written clinical justification if the service is determined not medically necessary.

Takes effect July 1, 2010.