The bill amends section 408.7057 of the Florida Statutes, which pertains to the statewide provider and health plan claim dispute resolution program. It specifies additional circumstances under which a disputed claim is not subject to review by this program. The amendments include new provisions that exclude claims related to services initiated under specific statutes and those involving out-of-network providers if they have already been submitted for resolution through the federal independent dispute resolution process.

Specifically, the bill adds that claims related to services initiated pursuant to s. 395.1041 or 42 U.S.C. s. 1395dd, as well as those involving out-of-network providers, are not eligible for review if they have been submitted through the federal independent dispute resolution process. Additionally, it removes the previous provision that allowed claims subject to a binding claim-dispute-resolution process provided by contract entered into prior to October 1, 2000, to be excluded from review. The act is set to take effect on July 1, 2026.

Statutes affected:
S 1082 Filed: 408.7057