SB 162-Relating to Payment of Healthcare Claims

On Saturday, March 3rd, SB 162, by Senator Greg Steube (R-Sarasota) was read for a third time on the Senate floor after being temporarily postponed multiple times, and passed by a vote of 37 yeas to 0 nays.

This bill prohibits health insurers and health maintenance organizations (HMOs) from retroactively denying a claim at any time if the insurer or HMO verified the eligibility of an insured or subscriber at the time of treatment and provided an authorization number, regardless of if the insured has paid their premiums prior to that claim rendering them ineligible for coverage.

SB 162 is in House messages.

AIF opposes legislation removing insurers ability to retroactively deny claims, even those that have not paid their premiums. This legislation would raise costs on employers who would be required to pay health care expenses of people who are no longer employees, and consumers would bear the burden of paying the high costs of fraud, waste and abuse that would occur in the system.

 

SB 8 & HB 21-Relating to Controlled Substances

On Wednesday, March 7th, SB 8 by Senator Lizbeth Benacquisto (R-Ft. Myers) was laid on the table and substituted with HB 21 by Representative Jim Boyd (R-Bradenton). The House bill was amended to reflect the Senate version of the bill, which includes language that prohibits health insurers from utilizing protocols such as prior authorization and step therapy. As stated in previous reports, because of these inclusions which undermine the intent of the bill, AIF is neutral on the bill.

On Thursday, March 8th, HB 21 was read for a third time on the Senate floor and passed as amended by a vote of 37 yeas to 0 nays.

On Friday, March 9th, the House amended HB 21 as passed by the Senate to remove the language that prohibits health insurers from using protocols such as prior authorization and provide specific appropriations to the bill. HB 21 passed the House floor as amended by a vote of 99 yeas to 0 nays and was sent back to the Senate to concur on the bill as amended. The Senate concurred to HB 21 as amended by the House and was passed by a vote of 37 yeas to 0 nays.

This bill addresses opioid abuse by expanding the use of the Prescription Drug Monitoring Program (PDMP), increasing regulation of prescribers and dispensers, and aligning state criminal statutes with federal law. The bill limits the prescription for a Schedule II opioid to alleviate acute pain to a three-day supply, or a seven-day supply if deemed medically necessary by the prescriber.

The bill also requires the Department of Health (DOH) to adopt rules establishing guidelines for prescribing controlled substances for acute pain, similar to those for chronic pain. Additionally, the bill also requires a health care practitioner authorized to prescribe controlled substances to complete a board-approved 2-hour continuing education course on safely and effectively prescribing controlled substances, and to review a patient’s PDMP history prior to prescribing or dispensing a controlled substance.

HB 21 will now go on to the desk of the Governor.

AIF supports legislative efforts that aim to curb opioid abuse and addiction that is currently running rampant through the state affecting Florida’s families and businesses.