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Fla. Stat. § 627.4234

Health insurance cost containment provisions required

Known as the Alonzo Mourning Access to Care Act

The act spans §§ 627.011 to 627.9913 (628 sections).

Applied in 1 court decision — leading case 187 F. Supp. 3d 1348 - Kondell v. Blue Cross & Blue Shield of Florida, Inc. (2016)

Most recently applied in 187 F. Supp. 3d 1348 - Kondell v. Blue Cross & Blue Shield of Florida, Inc. (May 2016)

History.--ss. 4, 10, ch. 84-235; ss. 40, 114, ch. 92-318; s. 1121, ch. 2003-261.

A health insurance policy or health care services plan which provides medical, hospital, or surgical expense coverage delivered or issued for delivery in this state must contain one or more of the following procedures or provisions to contain health insurance costs or cost increases:

(1) Coinsurance.

(2) Deductible amounts.

(3) Utilization review.

(4) Audits of provider bills to verify that services and supplies billed were furnished and that proper charges were made.

(5) Scheduled benefits.

(6) Benefits for preadmission testing.

(7) Any lawful measure or combination of measures for which the insurer provides to the office information demonstrating that the measure or combination of measures is reasonably expected to have an effect toward containing health insurance costs or cost increases.

Official source: Online Sunshine (Florida Legislature). Reproduced from public-domain Florida statutes; confirm against the official source for the current text. Not legal advice.