Bill > H1449

This bill amends Florida Statute 408.7057 to expand the types of health insurance claim disputes that are exempt from review by the statewide provider and health plan claim dispute resolution program, which is a process for resolving disagreements between healthcare providers and health plans over payment for services. Specifically, the bill adds a new exemption for out-of-network hospital services that are initiated under specific federal laws (42 U.S.C. s. 1395dd, also known as EMTALA, which requires hospitals to provide emergency care regardless of ability to pay, and Florida Statute 395.1041) and have already been submitted for resolution through a federal independent dispute resolution process, provided the claim is for $50,000 or less. This means that if a claim for out-of-network hospital services meets these criteria, it will not be reviewed by the state's dispute resolution program. The bill also includes an effective date of July 1, 2026.