FL H0877

Creates section 627.42393 of Florida Statutes to regulate health insurer fail-first protocols, which are written policies specifying the order in which medical procedures, treatments, or prescription drugs must be used.

Requires health insurers to publish protocol exception procedures on their websites and provide them in writing, including descriptions of how to request exceptions, timeframes for decisions, and conditions for granting exceptions.

Establishes decision timeframes: 3 business days for non-urgent care situations and 24 hours for urgent care situations from obtaining a completed protocol exception request.

Mandates health insurers grant protocol exception requests when the preceding treatment is contraindicated, likely to cause harm, expected to be ineffective based on medical history, or previously failed or was ineffective for the insured.

Authorizes health insurers to request relevant medical records from insureds to support protocol exception requests; takes effect July 1, 2017.