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HMO Group Slams Bill, Compares It To Obamacare

Florida Legislature
Florida House of Representatives
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

In an attempt to kill a bill that would limit its members from retroactively denying claims, the Florida Association of Health Plans issued a statement Tuesday calling a House proposal (HB 217) “nothing more than a codification” into state law of a federal Obamacare policy.

Filed by Rep. Bill Hager, R-Delray Beach, the bill would prevent HMOs and insurance companies from retroactively denying claims after patient eligibility has been confirmed and authorization numbers have been provided. The limitation on retroactive denials would apply to any group or individual HMO policy issued on or after Jan. 1, 2019. It would not impact Medicaid managed-care plans.

The House Appropriations Committee is slated to take up the bill Wednesday, and the Senate also is poised to pass its version (SB 162), filed by Sen. Greg Steube, R-Sarasota.

“This legislation is nothing more than a codification into Florida law of a controversial policy created by the Affordable Care Act,” Audrey Brown, president and CEO of the Florida Association of Health Plans, said in a prepared statement.

The Affordable Care Act, better known as Obamacare, gives insurance customers a three-month grace period before their policies are canceled, so long as the customers previously paid at least one month’s premium. During the first month, the insurer must pay all appropriate claims for services. For the second and third months, insurers can notify health-care providers that payment of claims may be denied.

In her statement, Brown said the bill would allow people who do not pay premiums to game the system and would require health plans and employers to absorb the costs. The bill has been a priority for the Florida Medical Association and other medical organizations for several years in the Legislature. It generally has been supported by the Senate but has faced an uphill battle in the House.