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FL S1692
Bill
AI Summary
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Requires insurers to reimburse hospital-based physicians (radiologists, anesthesiologists, pathologists, emergency room physicians) at the same percentage rate as preferred/exclusive provider network members when the hospital is in-network but the physician is not.
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Prohibits physicians from collecting fees from patients, pursuing legal action against patients, or reporting patients to credit agencies for services when the insurer is liable, except for applicable copayments or cost-sharing under the insurance contract.
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Limits reimbursement amounts to the lesser of: the physician's charges, usual and customary charges in the community, or mutually agreed amounts.
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Defines "hospital-based physician" as any physician with a hospital contract allowing provision of medical services without patient selection, precluding similar-specialty physicians, or fostering such opportunities.
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Requires insurers and health maintenance organizations to report suspected violations to the Department of Health; takes effect July 1, 2013.
Legislative Description
Health Care Coverage
Last Action
Died in Banking and Insurance
5/3/2013