Bill Summary

by Black

Insurance Claims Payments to Health Care Providers: Requires AHCA to establish program to assist health care providers & health plans in resolving claims of denied prior authorization requests; provides that program is mandatory; revises list of claims that are not reviewed by program; prohibits respondents from avoiding default by refusing to participate in review process; prohibits contracts between health care providers & health insurers & HMOs from specifying credit card payments to providers as only acceptable method for payments; authorizes use of electronic funds transfers by health insurers & HMOs for payments to providers; provides notification requirements; prohibits health insurers & HMOs from charging fees for automated clearinghouse transfers as claims payments to providers; prohibits health insurers & HMOs from denying claims subsequently submitted by providers for procedures that were included in prior authorizations; provides exceptions. Effective Date: July 1, 2026

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