FL H1097

Health plans must participate in filed claim disputes through the statewide dispute resolution program, with failure to respond resulting in default judgment against the plan

Health plans that lose a dispute must pay providers within 35 days of the agency's order, with penalties of up to $500 per day for non-payment

Managed care plans must decide on provider contracts within 30 calendar days of receiving credentialing information, and update internal systems within 15 days of contract execution; claims become eligible for payment retroactive to the credentialing application date

Managed care plans must disclose to the Agency for Health Care Administration and Office of Insurance Regulation all ownership interests or affiliations with providers, pharmacy services, diagnostics, care coordination, and administrative services entities, with changes reported within 60 days

Insurers cannot deny previously authorized health care services unless they have notified both the insured and the treating provider of coverage status changes or benefit limitations; failure to notify precludes denial of payment