The bill amends section 408.7057 of the Florida Statutes, which governs the statewide provider and health plan claim dispute resolution program. It specifies additional circumstances under which a disputed claim is not eligible for review under this program. The amendments include the addition of new exclusions for claims related to services initiated under specific statutes and those involving out-of-network providers, provided they meet the criteria for resolution through the federal independent dispute resolution process.

Specifically, the bill introduces new provisions that exclude claims related to services initiated pursuant to s. 395.1041 or 42 U.S.C. s. 1395dd, as well as claims from out-of-network providers, from the dispute resolution program if they have been submitted for federal independent dispute resolution. Additionally, it removes the previous exclusion regarding claims subject to a binding claim-dispute-resolution process established by contract prior to October 1, 2000. The act is set to take effect on July 1, 2026.

Statutes affected:
S 1082 Filed: 408.7057
S 1082 c1: 408.7057