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Senate Targets Denial Of Insurance Claims

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

The Florida Senate on Saturday unanimously approved a bill that would curb the ability of health insurers and HMOs to retroactively deny claims.

Under current law, health plans can retroactively deny claims up to one year after payment if patients are determined to be ineligible. A Senate staff analysis said that can lead to financial risks for doctors if patients don’t ultimately pay the claims.

But the bill (SB 162), filed by Sen. Greg Steube, R-Sarasota, would bar retroactive denials of claims if insurers or HMOs verify eligibility at the time patients are treated and if the health plans provide authorization numbers.

A similar House bill (HB 217) has been approved by the Health Innovation Subcommittee and Appropriations Committee and is in the Health & Human Services Committee. The annual legislative session is scheduled to end Friday.