PART I. HEALTH MAINTENANCE ORGANIZATIONS

SECTION 641.17. Short title.

SECTION 641.18. Declaration of legislative intent, findings, and purposes.

SECTION 641.183. Statutory accounting procedures; transition provisions.

SECTION 641.185. Health maintenance organization subscriber protections.

SECTION 641.19. Definitions.

SECTION 641.201. Applicability of other laws.

SECTION 641.2011. Insurance holding companies.

SECTION 641.2015. Incorporation required.

SECTION 641.2017. Insurance business not authorized.

SECTION 641.2018. Limited coverage for home health care authorized.

SECTION 641.20185. High-deductible contracts for medical savings accounts.

SECTION 641.2019. Provider service network certificate of authority.

SECTION 641.21. Application for certificate.

SECTION 641.215. Conditions precedent to issuance or maintenance of certificate of authority; effect of bankruptcy proceedings.

SECTION 641.217. Minority recruitment and retention plans required.

SECTION 641.22. Issuance of certificate of authority.

SECTION 641.221. Continued eligibility for certificate of authority.

SECTION 641.225. Surplus requirements.

SECTION 641.2261. Application of solvency requirements to provider-sponsored organizations and Medicaid provider service networks.

SECTION 641.227. Rehabilitation Administrative Expense Fund.

SECTION 641.228. Florida Health Maintenance Organization Consumer Assistance Plan.

SECTION 641.23. Revocation or cancellation of certificate of authority; suspension of enrollment of new subscribers; terms of suspension.

SECTION 641.234. Administrative, provider, and management contracts.

SECTION 641.2342. Contract providers.

SECTION 641.25. Administrative penalty in lieu of suspension or revocation.

SECTION 641.255. Acquisition, merger, or consolidation.

SECTION 641.26. Annual and quarterly reports.

SECTION 641.261. Other reporting requirements.

SECTION 641.27. Examination by the department.

SECTION 641.28. Civil remedy.

SECTION 641.281. Injunction.

SECTION 641.282. Payment of judgment by health maintenance organization.

SECTION 641.284. Liquidation, rehabilitation, reorganization, and conservation; exclusive methods of remedy.

SECTION 641.285. Insolvency protection.

SECTION 641.286. Levy upon deposit limited.

SECTION 641.29. Fees.

SECTION 641.30. Construction and relationship to other laws.

SECTION 641.3005. Application of ch. 85-177.

SECTION 641.3007. HIV infection and AIDS for contract purposes.

SECTION 641.305. Language used in contracts and advertisements; translations.

SECTION 641.309. Standards for marketing to persons eligible for Medicare.

SECTION 641.31. Health maintenance contracts.

SECTION 641.3101. Additional contract contents.

SECTION 641.31015. Health maintenance organization or exclusive provider organization; disclosure of terms and conditions of plan.

SECTION 641.3102. Restrictions upon expulsion or refusal to issue or renew contract.

SECTION 641.3103. Charter, bylaw provisions.

SECTION 641.3104. Execution of contracts.

SECTION 641.3105. Validity of noncomplying contracts.

SECTION 641.3106. Construction of contracts.

SECTION 641.3107. Delivery of contract; definitions.

SECTION 641.31071. Preexisting conditions.

SECTION 641.31072. Special enrollment periods.

SECTION 641.31073. Prohibiting discrimination against individual participants and beneficiaries based on health status.

SECTION 641.31074. Guaranteed renewability of coverage.

SECTION 641.31075. Advanced practice registered nurse services.

SECTION 641.31076. Shared savings incentive program.

SECTION 641.31077. Coverage for organ transplants.

SECTION 641.3108. Notice of cancellation of contract.

SECTION 641.31094. Nondiscrimination of coverage for certain surgical procedures involving bones or joints.

SECTION 641.31095. Coverage for mammograms.

SECTION 641.31096. Requirements with respect to breast cancer and routine followup care.

SECTION 641.31097. Decreasing inappropriate utilization of emergency care.

SECTION 641.31098. Coverage for individuals with developmental disabilities.

SECTION 641.31099. Restrictions on use of state and federal funds for state exchanges.

SECTION 641.3111. Extension of benefits.

SECTION 641.312. Scope.

SECTION 641.313. Health maintenance contracts; cancer treatment parity; orally administered cancer treatment medications.

SECTION 641.314. Pharmacy benefit manager contracts.

SECTION 641.315. Provider contracts.

SECTION 641.3154. Organization liability; provider billing prohibited.

SECTION 641.3155. Prompt payment of claims.

SECTION 641.3156. Treatment authorization; payment of claims.

SECTION 641.316. Fiscal intermediary services.

SECTION 641.32. Acceptable payments.

SECTION 641.33. Certain words prohibited in name of organization.

SECTION 641.35. Assets, liabilities, and investments.

SECTION 641.36. Adoption of rules; penalty for violation.

SECTION 641.365. Dividends.

SECTION 641.37. Prohibited activities; penalties.

SECTION 641.38. Operational health maintenance organizations; issuance of certificate.

SECTION 641.385. Order to discontinue certain advertising.

SECTION 641.386. Agent licensing and appointment required; exceptions.

SECTION 641.39001. Soliciting or accepting new or renewal health maintenance contracts by insolvent or impaired health maintenance organization prohibited; penalty.

SECTION 641.3901. Unfair methods of competition and unfair or deceptive acts or practices prohibited.

SECTION 641.3903. Unfair methods of competition and unfair or deceptive acts or practices defined.

SECTION 641.3905. General powers and duties of the department and office.

SECTION 641.3907. Defined unfair practices; hearings, witnesses, appearances, production of books, and service of process.

SECTION 641.3909. Cease and desist and penalty orders.

SECTION 641.3911. Appeals from the department or office.

SECTION 641.3913. Penalty for violation of cease and desist orders.

SECTION 641.3915. Health maintenance organization anti-fraud plans and investigative units.

SECTION 641.3917. Civil liability.

SECTION 641.3921. Conversion on termination of eligibility.

SECTION 641.3922. Conversion contracts; conditions.

SECTION 641.3923. Discrimination against providers prohibited.

PART II. PREPAID HEALTH CLINICS

SECTION 641.40. Short title.

SECTION 641.401. Declaration of legislative intent, findings, and purposes.

SECTION 641.4015. Part exclusive; applicability of other laws.

SECTION 641.402. Definitions.

SECTION 641.403. Rulemaking authority.

SECTION 641.405. Application for certificate of authority to operate prepaid health clinic.

SECTION 641.406. Issuance of certificate of authority.

SECTION 641.4065. Insurance business not authorized.

SECTION 641.407. Minimum surplus.

SECTION 641.408. Use of certain words prohibited in the name of a prepaid health clinic.

SECTION 641.409. Insolvency protection.

SECTION 641.4091. Levy upon deposit; limitation.

SECTION 641.41. Annual report of prepaid health clinic; administrative penalty.

SECTION 641.411. Other reporting requirements.

SECTION 641.412. Fees.

SECTION 641.414. Investment of funds of prepaid health clinic.

SECTION 641.416. Acquisition.

SECTION 641.418. Examination of prepaid health clinic by the office.

SECTION 641.419. Rehabilitation, liquidation, conservation, or dissolution of prepaid health clinic.

SECTION 641.42. Prepaid health clinic contracts.

SECTION 641.421. Language used in contracts and advertisements; translations.

SECTION 641.422. Contract provisions incorporating charter or bylaw provisions.

SECTION 641.423. Execution of contracts.

SECTION 641.424. Validity of noncomplying contracts.

SECTION 641.425. Construction of contracts.

SECTION 641.426. Delivery of contract to subscriber.

SECTION 641.427. Notice of cancellation, termination, or nonrenewal of contract.

SECTION 641.428. Nondiscrimination of coverage for certain surgical procedures involving bones or joints.

SECTION 641.429. Acceptable payments to prepaid health clinic.

SECTION 641.43. Provider contracts.

SECTION 641.432. Providers of service; penalty for unauthorized use of providers; interference with judgment prohibited.

SECTION 641.437. Investigatory power of office.

SECTION 641.438. Genetic information restrictions.

SECTION 641.44. Unfair methods of competition and unfair or deceptive acts or practices prohibited.

SECTION 641.441. Unfair methods of competition and unfair or deceptive acts or practices defined.

SECTION 641.442. Penalty for operation of prepaid health clinic, or issuance, delivery, or renewal of prepaid health clinic contract, without certificate of authority.

SECTION 641.443. Temporary restraining orders.

SECTION 641.444. Injunction.

SECTION 641.445. Defined practices; hearings, witnesses, appearances, production of books, and service of process.

SECTION 641.446. Cease and desist and penalty orders.

SECTION 641.447. Appeal from order.

SECTION 641.448. Penalty for violation of cease and desist order.

SECTION 641.45. Revocation or cancellation of certificate of authority; suspension of authority to enroll new subscribers; terms of suspension.

SECTION 641.452. Administrative penalty in lieu of suspension or revocation of certificate of authority.

SECTION 641.453. Civil liability.

SECTION 641.454. Civil action to enforce prepaid health clinic contract; attorney’s fees; court costs.

SECTION 641.455. Disposition of moneys collected under this part.

SECTION 641.457. Exemption for certain operational prepaid health clinics.

SECTION 641.459. Construction and relationship to other laws.

PART III. HEALTH CARE SERVICES

SECTION 641.47. Definitions.

SECTION 641.48. Purpose and application of part.

SECTION 641.49. Certification of health maintenance organization and prepaid health clinic as health care providers; application procedure.

SECTION 641.495. Requirements for issuance and maintenance of certificate.

SECTION 641.51. Quality assurance program; second medical opinion requirement.

SECTION 641.511. Subscriber grievance reporting and resolution requirements.

SECTION 641.512. Accreditation and external quality assurance assessment.

SECTION 641.513. Requirements for providing emergency services and care.

SECTION 641.514. Coverage for air ambulance services.

SECTION 641.515. Investigation by the agency.

SECTION 641.52. Revocation of certificate; suspension of new enrollment; suspension of the health care provider certificate; administrative fine; notice of action to the office; penalty for use of unlicensed providers.

SECTION 641.54. Information disclosure.

SECTION 641.545. Subscriber risk assessments; requirements.

SECTION 641.55. Internal risk management program.

SECTION 641.56. Rulemaking authority.

SECTION 641.57. Disposition of moneys collected under this part.

SECTION 641.58. Regulatory assessment; levy and amount; use of funds; tax returns; penalty for failure to pay.

SECTION 641.59. Psychotherapeutic services; records and reports.

SECTION 641.61. Subscriber satisfaction assessment.

SECTION 641.62. Chronic diseases among subscriber populations.