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Florida Bill Would Require HMO-Provider Dispute Resolution

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NU Online News Service, Oct. 8, 11:00 a.m. A bill prefiled with the Fla. House of Representatives by Rep. Joe Negron (R.-Stuart) for the 2002 legislative year would require the state’s Agency for Health Care Administration to establish a statewide health care provider and health maintenance organization qualification dispute resolution program.

The proposed program would resolve contract disputes between health care providers and HMOs and revise provisions for termination by an HMO of a contract with a provider. The bill would mandate providers to give 60 days’ advance written notice to the HMO and the AHCA before canceling a contract. The dispute would then be submitted to an alternative dispute resolution organization for a ruling. After that, the AHCA would have 30 days to accept or decline the ADR organization’s recommendation.

Under the bill, provider-HMO contracts would have to state that nonpayment for goods or services rendered by a provider to an HMO is not a valid reason for avoiding the 60-day advance notice of cancellation.