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H 1489

Florida House•In House Committee

Summary

H 1489, “Medical Debt Protection and Comprehensive Health Care for Residents”, was introduced in the House on Jan 9, 2026 by Rep. Dotie Joseph (D) with 2 co-sponsors. It last saw action on Mar 13, 2026: Died in Health Care Facilities & Systems Subcommittee.

Record

Text

H 1489 has 2 co-sponsors.

h1489/introduced.txt
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    HB 1489  2026
A bill to be entitled
An act relating to medical debt protection and
comprehensive health care for residents; providing a
short title; creating s. 381.4011, F.S.; providing a
short title; providing purpose; providing
construction; providing definitions; requiring large
health care facilities to develop written financial
assistance policies; providing requirements for such
policies; providing procedures for determining
eligibility for financial assistance; providing
eligibility criteria; providing publication and notice
requirements relating to financial assistance
policies; providing requirements for translations for
notices relating to such policies; providing billing
and collections rules and prohibitions; providing
requirements for price information; providing
liability for medical debt; providing requirements for
itemized bills; prohibiting information relating to
medical debt from being included in consumer reports,
communicated with and reported to consumer reporting
agencies, and used for certain decisions; prohibiting
medical creditors and medical debt collectors from
engaging in certain acts during health insurance
appeals; limiting interest on medical debt under
certain circumstances; providing applicability;
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requiring written copies of payment plans under
certain circumstances; providing requirements before
payment plans may be declared terminated; requiring
receipts of payment; providing violations; providing
private remedies for patients; prohibiting waivers of
patients' rights; providing for enforcement and
complaint process; providing reporting requirements;
requiring the Office of the Attorney General to post
certain information in a database and publish an
annual consolidated report; providing severability;
creating part IV of ch. 641, F.S., entitled the
"Florida Health Plan"; creating s. 641.71, F.S.;
providing a short title; creating s. 641.72, F.S.;
creating the Florida Health Plan; providing purpose of
the plan; creating s. 641.73, F.S.; providing
definitions; creating s. 641.74, F.S.; providing
eligibility for and coverage of the plan; authorizing
the Florida Health Board to establish financial
arrangements with other states and foreign countries
under certain circumstances; providing duties of the
board relating to plan enrollment; providing
enrollment requirements; creating s. 641.755, F.S.;
authorizing plan enrollees to choose certain health
care providers; providing covered health care
benefits; authorizing the board to expand health care
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benefits under certain circumstances; providing health
care services that are excluded from the plan;
requiring enrollees to have primary care providers and
access to care coordination; authorizing enrollees to
see health care specialists without referral;
authorizing the board to establish a computerized
registry; authorizing the plan to assist enrollees in
choosing primary care providers; prohibiting cost-
sharing requirements from being imposed on enrollees;
creating s. 641.77, F.S.; requiring the board to
secure repeals and waivers of certain provisions of
federal law; requiring the Department of Health and
the Agency for Health Care Administration to provide
assistance to the board; requiring the board to adopt
rules under certain circumstances; providing that the
plan's responsibility for providing health care is
secondary to existing federal programs under certain
circumstances; creating s. 641.78, F.S.; defining the
term "collateral source"; requiring the plan to
collect health care costs from collateral sources
under certain circumstances; requiring the board to
negotiate waivers, seek federal legislation, and make
arrangements to incorporate collateral sources into
the plan; requiring plan enrollees to notify health
care providers of collateral sources and health care
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providers to forward such information to the board;
authorizing the board to take appropriate actions to
recover reimbursement from collateral sources;
requiring collateral sources to pay for health care
services under certain circumstances; providing
specified authority and rights to the board relating
to collateral sources; providing construction;
creating s. 641.791, F.S.; providing that defaults,
underpayments, and late payments of certain
obligations shall result in remedies and penalties;
prohibiting eligibility for health care benefits from
being impaired by such defaults, underpayments, and
late payments; creating s. 641.792, F.S.; providing
eligibility of health care providers for the plan;
prohibiting patient care from being affected by fee
schedules and financial incentives; providing
requirements for the payment system for
noninstitutional providers; providing requirements for
the annual budgets for institutional providers;
prohibiting noninstitutional and institutional
providers that accept payments from the plan from
billing patients; providing requirements for capital
expenditures by noninstitutional and institutional
providers which exceed a specified amount; requiring
the board to establish payment criteria and payment
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methods for care coordination; creating s. 641.793,
F.S.; establishing the Florida Health Board by a
specified date; providing purpose of the board;
providing board membership, terms, and compensation;
providing duties of the board; providing reporting
requirements; creating s. 641.794, F.S.; requiring the
Secretary of Health Care Administration to designate
health planning regions; providing considerations for
such designations; providing requirements for regional
planning boards; providing board membership, terms,
and first meetings with the Florida Health Board;
providing duties of the board; creating s. 641.795,
F.S.; establishing the Office of Health Quality and
Planning; providing purpose and duties of the office;
authorizing the Florida Health Board to convene
advisory panels under certain circumstances; creating
s. 641.796, F.S.; creating the Ombudsman Office for
Patient Advocacy; providing purpose of the office;
providing appointment and qualifications of the
ombudsman; providing duties and authority of the
ombudsman; providing requirements for the office
budget; creating s. 641.797, F.S.; creating the
position of auditor for the plan; providing purpose,
appointment, and duties of the auditor; creating s.
641.798, F.S.; providing applicability of the Code of
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Ethics for Public Officers and Employees; providing
disciplinary actions for failure to comply with the
code of ethics; prohibiting certain persons from
engaging in specified acts or from being employed by
specified entities; creating the Conflict-of-Interest
Committee; providing duties of the committee; creating
s. 641.799, F.S.; providing that the plan policies and
procedures are exempt from the Administrative
Procedure Act; providing procedures and requirements
for adoption of certain rules on plan policies and
procedures; requiring specified persons to regularly
update the Legislature on certain information;
providing a timeline for the operation of the plan;
prohibiting certain health insurance policies and
contracts from being sold in this state on and after a
specified date; requiring an analysis of specified
capital expenditure needs; providing reporting
requirements; providing a contingent effective date.
    Be It Enacted by the Legislature of the State of Florida:
Section 1.       This act may be cited as the "Healthy Florida
    Act."
Section 2.       Section 381.4011, Florida Statutes, is created
    to read:
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381.4011        Financial assistance for patients of large health
    care facilities.—
(1)     SHORT TITLE.—This section may be cited as the "Medical
    Debt Protection Act."
(2)     PURPOSE.—The purpose of this section is to reduce
    burdensome medical debt and to protect patients in their
    dealings with medical creditors, medical debt buyers, and
    medical debt collectors with respect to such debt. This section
    shall be construed as a consumer protection statute and shall be
    liberally and remedially construed to carry out its purposes.
(3)     DEFINITIONS.—As used in this section, the term:
(a)     "Consumer" means a natural person.
(b)     "Consumer reporting agency" means a person or entity
    that, for monetary fees or dues or on a cooperative nonprofit
    basis, regularly engages in whole or in part in the practice of
    assembling or evaluating consumer credit information or other
    information on consumers for the purpose of furnishing consumer
    reports to third parties.
(c)     "External review" means a review of an adverse benefit
    determination, including, but not limited to, a final internal
    adverse benefit determination, conducted pursuant to an
    applicable state external review process, a federal external
    review process as described in 42 U.S.C. s. 300gg-19, a review
    pursuant to 29 U.S.C. s. 1133, a Medicare appeals process, a
    Medicaid appeals process, or another applicable appeals process.
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(d)      "Extraordinary collection action" means any of the
    following:
1.      Selling a consumer's debt to another party, except if,
    before the sale, the medical creditor has entered into a legally
    binding written agreement with the medical debt buyer of the
    debt pursuant to which:
a.      The medical debt buyer or medical debt collector is
    prohibited from engaging in any prohibited collection actions
    listed in subsection (8) to obtain payment for the care;
b.      The medical debt buyer may not charge interest on the
    debt in excess of that described in subsection (14);
c.      The debt is returnable to or recallable by the medical
    creditor upon a determination by the medical creditor or medical
    debt buyer that the consumer is eligible for financial
    assistance; and
d.      If the consumer is determined to be eligible for
    financial assistance and the debt is not returned to or recalled
    by the medical creditor, the medical debt buyer is required to
    adhere to the procedures specified in the agreement that ensures
    that the consumer does not pay, and has no obligation to pay,
    the medical debt buyer and the medical creditor together more
    than the consumer is personally responsible for paying in
    compliance with this section.
2.      Filing a debt collection lawsuit.
3.      Any prohibited collection action.
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(e)      "Financial assistance policy" means a written
    financial assistance policy that includes:
1.      Eligibility criteria for financial assistance,
    including when such assistance covers free or discounted care.
2.      The basis for calculating amounts charged to patients.
3.      The method for applying for financial assistance.
4.      The billing and collections policy containing the
    actions the covered health care provider may take in the event
    of nonpayment, including collections action.
5.      Measures to widely publicize the policy within the
    community to be served by the covered health care provider.
(f)     "Gross charges" means a covered health care provider's
    full, established price for health care services that the
    covered health care provider charges uninsured patients before
    applying any contractual allowances, discounts, or deductions.
    Such price may be referred to elsewhere as standard charges, as
    provided in 42 U.S.C.A. s. 300gg-18, or chargemaster rates.
(g)      "Health care services" means services for the
    diagnosis, prevention, treatment, cure, or relief of a physical,
    dental, behavioral, substance use disorder, or mental health
    condition, illness, injury, or disease. These services include,
    but are not limited to, any procedures, products, devices, or
    medications.
(h)      "Household income" or "income" means income calculated
    by using the methods used to calculate Medicaid eligibility, as
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    set forth at 42 C.F.R. s. 435.603, or a comparable method
    designated by the Department of Children and Families.
(i)      "Internal review" or "internal appeal" means review by
    a health insurance plan or other insurer of an adverse benefit
    determination.
(j)      "Large health care facility" means any the following
    entities:
1.      A hospital licensed under chapter 395, whether a
    nonprofit entity subject to 26 U.S.C. s. 501(c)(3); a hospital
    owned by a county, a municipality, or this state; or a for-
    profit entity that provides health care services.
2.      An outpatient clinic or facility affiliated with a
    hospital, as described in subparagraph 1., or operating under
    the license of a hospital, as described in subparagraph 1.
3.      An ambulatory surgical center licensed under chapter
    395.
4.      A practice that provides outpatient medical,
    behavioral, optical, radiology, laboratory, dental, or other
    health care services with revenues of at least $20,000,000
    annually, and that is licensed or permitted under chapter 395,
    chapter 408, chapter 483, chapter 484, chapter 466, or any other
    chapter that licenses or permits health care facilities.
5.      A licensed health care professional who provides health
    care services in one or more of the settings listed in
    subparagraphs 1.-4., but bills patients independently.
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(k)     "Medical creditor" means an entity that provides
    health care services and to which the patient owes money for
    health care services, or an entity that provided health care
    services and to which the patient previously owed money if the
    medical debt has been purchased by one or more debt buyers.
(l)     "Medical debt" means an obligation or alleged
    obligation of a patient to pay any amount related to the receipt
    of health care services, products, or devices. The term does not
    include debt charged to a credit card or other extension of
    credit unless the credit card or extension of credit is offered
    specifically for the payment of health care services, products,
    or devices.
(m)     "Medical debt buyer" means a person or entity that is
    engaged in the business of purchasing medical debts for
    collection purposes, whether the person or entity collects the
    debt or hires a third party for collection or an attorney at law
    for litigation in order to collect such debt.
(n)     "Medical debt collector" means a person or entity that
    regularly collects or attempts to collect, directly or
    indirectly, medical debts originally owed or due or asserted to
    be owed or due another. The term includes a medical debt buyer
    for all purposes.
(o)     "Patient" means the person who received health care
    services. The term includes a parent if the patient is a minor,
    or a legal guardian if the patient is an adult under
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    guardianship.
(p)      "Patient income" means the household income of the
    patient's family.
(q)      "Prohibited collection actions" means any of the
    following activities when used by a medical creditor or medical
    debt collector to collect debts owed for health care services:
1.      Causing or threatening to cause a consumer's arrest.
2.      Causing or threatening to cause a consumer to be
    subject to a capias or similar warrant.
3.      Obtaining or threatening to obtain a lien on a
    consumer's real property.
4.       Foreclosing or threatening to foreclose on a
    consumer's real property.
5.      Garnishing or threatening to garnish wages or state
    income tax refunds.
6.      Using state or federal tax offsets to seize tax refunds
    or tax credits.
7.      Attaching, seizing, or threatening to attach or seize a
    consumer's bank account.
8.      Furnishing or threatening to furnish information about
    the medical debt to a consumer reporting agency.
(4)      FINANCIAL ASSISTANCE POLICY FOR LARGE HEALTH CARE
    FACILITIES.—
(a)1.       A large health care facility must develop a written
    financial assistance policy that complies with this section and
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    any implementing regulations.
2.      The requirement under subparagraph 1. applies whether
    or not the large health care facility is required to develop a
    financial assistance policy under 26 U.S.C. s. 501(r)-(4) and
    implementing regulations.
(b)      The financial assistance policy required under
    subparagraph (a)1. must, at a minimum, contain the following:
1.      A written explanation of the financial assistance that
    is available for emergency and other medically necessary health
    care services offered by a covered health care provider.
2.      A summary, in plain language, of the financial
    assistance policy which does not exceed two pages in length.
3.      The eligibility criteria for financial assistance and a
    summary of the type of assistance that is available as set forth
    in this section.
4.      The method and application process that patients are to
    use to apply for financial assistance.
5.      The information and documentation the large health care
    facility may require patients to provide as part of the
    application.
6.      The reasonable steps that a health care provider will
    take to determine whether a patient is eligible for financial
    assistance.
7.      The billing and collections policy, including the
    actions that may be taken in the event of nonpayment, which must
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    comply with all applicable provisions of this section and other
    applicable municipal, county, state, or federal laws.
(c)      The financial assistance policy must be approved by
    the owners or governing body of a health care provider. The
    financial assistance policy shall be reviewed and approved on an
    annual basis by the owners or governing board.
(d)      The financial assistance policy must apply to all
    patients who are financially eligible based on income as
    provided in subsection (5). Patients may not be denied financial
    assistance on the basis of residency, health insurance coverage
    status, citizenship or immigration status, or assets or
    prospective assets.
(5)      IMPLEMENTATION OF THE FINANCIAL ASSISTANCE POLICY.—
(a)      In addition to any other actions required by
    applicable municipal, county, state, or federal law, a large
    health care facility must screen all patients for eligibility
    for financial assistance by taking all of the following steps
    before seeking payment for any emergency or medically necessary
    health care services:
1.      Determine whether the patient has health insurance. If
    the patient is uninsured, offer to screen the patient for public
    or private insurance eligibility and offer assistance if the
    patient chooses to apply for public or private insurance. A
    patient's refusal to be screened is not grounds for denying
    financial assistance.
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2.      Offer to screen the patient for other public programs
    that may assist with health care costs. However, a patient's
    refusal to be screened is not grounds for denying financial
    assistance.
3.      If the patient submits an application for financial
    assistance, determine the patient's eligibility for the
    financial assistance plan within 14 days after the patient
    applies for financial assistance, suspending any billing or
    collections actions while eligibility is being determined.
(b)      The following patients qualify for financial
    assistance under the financial assistance plan, which applies to
    any charges for health care services that are not covered by
    insurance and would otherwise be billed to the patient:
1.      Patients with household incomes at or below 300 percent
    of the federal poverty level shall receive free care.
2.      Patients with household incomes above 300 percent, up
    to and including 400 percent, of the federal poverty level shall
    be charged no more than the amount calculated in the following
    manner:
a.      The patient's bill shall be recalculated using the
    Medicare reimbursement rate applicable on the date of service;
    and
b.      The patient shall be charged no more than 25 percent of
    the recalculated bill under sub-subparagraph a.
3.      Patients with household incomes above 400 percent, up
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    to and including 600 percent, of the federal poverty level shall
    receive the same discounts as patients with household incomes
    above 300 percent, up to and including 400 percent, of the
    federal poverty level if the patient and the patient's household
    have incurred medical expenses from the current large health
    care facility's bill and all other medical bills for medically
    necessary health care services received during the previous 12
    months which, in total, exceed 5 percent of the household's
    annual gross income.
4.      In addition to other financial assistance provided
    under this section, patients with household incomes at or below
    400 percent of the federal poverty level may not be required to
    pay more than $2,300 per year in cumulative medical bills to
    large health care facilities. Upon patient request and
    documentation, any health care services that have been delivered
    by one or more large health care facilities after the $2,300
    limit has been met must be provided as free care.
(c)1.       Household income shall be established by the most
    recent tax return, unless the patient chooses to submit pay
    stubs, documentation of public assistance, or documentation of
    household income that the Department of Children and Families
    has identified as a valid form of documentation for the purposes
    of this section. Additional documentation other than proof of
    income may not be required.
2.      If a large health care facility uses a consumer report,
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    as defined in s. 603(d) of the Fair Credit Reporting Act, 15
    U.S.C. s. 1681a(d), or any score or rating based on consumer
    report information, the facility must obtain the consumer's
    consent for such use and must comply with all applicable
    provisions of this section.
3.      A large health care facility may grant financial
    assistance notwithstanding a patient's failure to provide one of
    the required forms of documentation described in the financial
    assistance policy or application form and may rely on, but not
    require, other evidence of eligibility. Proof that the patient
    receives a means-tested benefit from the federal, state, or
    local government is sufficient to establish eligibility for
    financial assistance without additional documentation of income.
4.      A large health care facility must screen, under
    paragraph (a), a patient for presumptive eligibility for
    financial assistance as set forth in paragraph (b). The rules
    and process for screening a patient for presumptive eligibility
    for financial assistance must require a large health care
    facility to inform any patient who is deemed presumptively
    eligible for financial assistance that the large health care
    facility has reduced or eliminated the patient's medical bill,
    specify if any amount is currently outstanding, and explain how
    to apply for additional financial assistance for any remaining
    balance.
5.      If a large health care provider chooses to use credit
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    reports or scores or similar screening tools when determining
    eligibility for financial assistance, the large health care
    provider may:
a.      Use such tools only to make a positive eligibility
    determination, and not to deny financial assistance to any
    patient; and
b.      Obtain credit reports or scores and use the reports or
    scores only for screening if the patient consents by signing a
    stand-alone document granting permission for the credit check,
    which shall be effective for no more than 30 days.
(d)      If a large health care facility receives an
    application for financial assistance from a patient, the
    facility shall notify the patient in writing within 14 days as
    to whether the facility has approved or denied the application.
    The large health care facility shall provide a copy of any
    recalculated bill and calculation of financial assistance
    provided to the patient.
(e)      A large health care facility shall accept and consider
    a patient's application for financial assistance when the
    application is submitted within 1 year after the date of the
    first bill for the provision of the health care services.
    However, if the patient is the subject of collection activity by
    the facility or a medical debt collector, including a lawsuit to
    collect a medical debt, and submits an application for financial
    assistance, the large health care facility shall accept and
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    process the application at any time. If the patient submits a
    financial assistance application to a medical debt collector,
    the medical debt collector shall forward the application to the
    large health care facility within 2 business days, and shall
    cease collection activity until notified by the large health
    care facility of the outcome of the application and any debt
    forgiven or new repayment terms.
(f)     A large health care facility and medical debt
    collector may not charge any interest or late fees to patients
    who qualify for financial assistance.
(g)     A large health care facility and medical debt
    collector shall offer to any patient who qualifies for financial
    assistance a payment plan of not less than 24 months, and may
    not require the patient to make monthly payments that exceed 5
    percent of the household's gross monthly income. Prepayment
    penalties, early payment penalties, or fees are prohibited.
(h)     For a patient who has been found to be eligible for
    financial assistance, the initial payment on a monthly payment
    plan may not be due within the first 90 days after the health
    care services are provided.
(6)     FINANCIAL ASSISTANCE POLICY; PUBLIC EDUCATION AND
    INFORMATION.—
(a)     A large health care facility must do all of the
    following to publicize its financial assistance policy:
1.      Make the financial assistance policy and the financial
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    assistance application form easily accessible online, through
    the large health care facility's website and through any patient
    portal or other online communication portal used by patients of
    the health care provider.
2.      In addition to any other requirements in this section,
    make paper copies of the financial assistance policy and the
    application form available upon request and without charge, both
    by mail and in the large health care facility's office. For
    hospitals, copies should be available, at a minimum, in the
    emergency room, if there is an emergency room, and admissions
    areas.
3.      Notify and inform members of the community served by
    the large health care facility about the financial assistance
    policy in a manner reasonably calculated to reach those members
    who are most likely to require financial assistance with such
    efforts commensurate to the size and income of the facility.
4.      Notify and inform patients who receive care from the
    large health care facility about the financial assistance policy
    by doing all of the following:
a.      Offer a paper copy of the financial assistance policy
    to a patient as part of the patient's first visit or, in the
    case of a hospital facility, during the intake and discharge
    process.
b.      Include a conspicuous written notice on all billing
    statements, whether sent by the large health care facility or a
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    medical debt collector, which notifies and informs patients
    about the availability of financial assistance and includes the
    telephone number of the large health care facility's office or
    department that can provide information about the financial
    assistance policy and application process and the direct website
    address where copies of the financial assistance policy and
    application form may be obtained.
c.      Place conspicuous public displays, or other measures
    reasonably calculated to attract patients' attention, which
    notify and inform patients about the financial assistance policy
    in public locations in the large health care facility's office.
    For hospitals, displays should be posted in the emergency room,
    if there is an emergency room and admissions areas, at a
    minimum.
(b)      In all attempts, whether written or oral, by a medical
    creditor or medical debt collector to collect a medical debt for
    health care services provided by a large health care facility,
    the medical creditor or medical debt collector must inform the
    patient of any financial assistance policy available through the
    large health care facility.
(7)     FINANCIAL ASSISTANCE POLICIES; LANGUAGE ACCESS.—
(a)      A financial assistance policy must include a notice
    that states the following or substantially similar language:
    "This document contains important information about financial
    assistance for your bill. Contact [insert name and telephone
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    number of large health care facility] for translation
    assistance." The statement must be translated in the 10
    languages most frequently spoken by limited English proficient
    households in the large health care facility's service area, as
    determined by the United States Census Bureau data.
(b)     A large health care facility must accommodate all
    significant populations that have limited English proficiency by
    translating the financial assistance policy and application form
    into the primary languages spoken by such populations. A large
    health care facility satisfies this translation requirement if
    it makes available translations of its financial assistance
    policy and application form in the language spoken by each
    limited English proficiency language group that constitutes the
    lesser of 1,000 individuals or 5 percent of the community served
    by the large health care facility or the population likely to be
    affected or encountered by the large health care facility. A
    large health care facility may determine the percentage or
    number of limited English proficiency individuals in the large
    health care facility's community or likely to be affected or
    encountered by the large health care facility using any
    reasonable method.
(c)     A large health care facility must accommodate any
    patient with limited English proficiency who is part of a
    population that falls below the numerical thresholds established
    in paragraph (b) by providing oral interpretation services to
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    the patient upon request and at no cost to the patient to
    explain the financial assistance policy and the application
    form.
(d)      A large health care facility must accommodate any
    patient with limited English proficiency in answering questions
    from the patient regarding the financial assistance policy, the
    application form, any written determination of eligibility, and
    any other communication regarding financial assistance from the
    large health care facility. A large health care facility may
    accommodate these patients by providing oral interpretation
    services to the patient upon request and at no cost to the
    patient.
(8)     BILLING AND COLLECTIONS RULES, LIMITS ON CREDITORS.—
(a)      A medical creditor or medical debt collector may not
    engage in prohibited collection actions to collect medical debts
    owed for health care services.
(b)      A medical creditor or medical debt collector may not
    engage in any extraordinary collection actions until 180 days
    after the first bill for a medical debt has been sent.
(c)      At least 30 days before taking any permissible
    extraordinary collection actions, a medical creditor or medical
    debt collector must provide to the patient a notice that:
1.      In the case of large health care facilities and medical
    debt collectors collecting debt for health care services
    provided by such facilities, states that financial assistance is
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    available for eligible patients and providing a summary, in
    plain language, of the financial assistance policy.
2.      Identifies the extraordinary collection actions that
    will be initiated in order to obtain payment.
3.      Provides a deadline after which such extraordinary
    collection actions will be initiated, which date is no earlier
    than 30 days after the date of the notice.
(d)      A medical debt collector collecting debt for health
    care services provided by such a large health care facility may
    not engage in extraordinary collection actions during a declared
    state or federal emergency or a public health emergency.
(e)      A large health care facility or a medical debt
    collector collecting debt for health care services provided by
    such a facility may not use any extraordinary collection actions
    unless these actions are described in the large health care
    facility's billing and collections policy.
(f)      If a large health care facility or a medical debt
    collector collecting debt for health care services provided by
    such a facility bills or initiates collection activities and the
    patient is later found eligible for financial assistance, the
    large health care facility or medical debt collector shall
    reverse any permissible extraordinary collection actions or any
    collection activity that were previously permissible and have
    since become prohibited, including, but not limited to:
1.      Deleting any negative reports to consumer reporting
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    agencies.
2.      Dismissing or vacating any collection lawsuits over the
    medical debt.
3.      Removing any wage garnishment orders or state tax
    refund interception requests.
(g)      If the patient has paid any part of the medical debt
    or any of the patient's funds has been seized or levied in
    excess of the amount that the patient owes after application of
    financial assistance, the large health care facility or medical
    debt collector shall refund any excess amount to the patient.
(9)     PRICE INFORMATION.—A large health care facility must
    post price information on its website. The price information
    must be accessible through a link from the website's homepage
    and, at a minimum, must include the following:
(a)      A list of gross charges for all health care services.
(b)      A list of the amount that Medicare would reimburse for
    the health care service, next to the relevant gross charge.
(c)      The titles or descriptions of health care services, in
    plain language that can be understood by an average person.
(10)        LIABILITY FOR MEDICAL DEBT.—
(a)      Parents and legal guardians are jointly liable for any
    medical debt incurred by children under the age of 18.
(b)      A spouse or person may not be held personally liable
    for the medical debt or nursing home debt of any other person
    age 18 or older, or other damages related to the collection of
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    the patient's bill.
(c)     Any admission agreement must comply with applicable
    federal and state laws, including the Nursing Home Reform Law,
    42 U.S.C. s. 1395i-3.
(11)        VERIFICATION UPON WRITTEN OR ORAL REQUEST.—A medical
    creditor or medical debt collector shall provide an itemized
    bill to the patient within 60 days after a request. The itemized
    bill must state:
(a)     The name and address of the medical creditor.
(b)     The date of service.
(c)     The date the medical debt was incurred, if different
    from the date of service.
(d)     A detailed list of the specific health care services
    provided to the patient.
(e)     A list of all health care professionals who treated
    the patient.
(f)     The amount of principal for any medical debt incurred.
(g)     Any adjustment to the bill, such as negotiated
    insurance rates or other discounts.
(h)     The amount of any payments received, whether from the
    patient or any other party.
(i)     Any interest or fees.
(j)     Whether the patient was screened for financial
    assistance.
(k)     Whether the patient was found eligible for financial
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    assistance and, if so, the amount due after all financial
    assistance has been applied to the itemized bill.
(12)        MEDICAL DEBT AND CONSUMER REPORTING AGENCIES.—
(a)      A consumer reporting agency may not make a consumer
    report containing an item of information that the consumer
    reporting agency knows or should know concerns medical debt.
(b)      A person may not communicate with or report any
    information to any consumer reporting agency regarding a medical
    debt.
(c)      A person who uses a consumer report may not use a
    medical debt listed on the report as a negative factor when
    making a credit, employment, or housing decision.
(d)      A medical creditor shall include a provision in any
    contract entered into with a medical debt collect or for the
    purchase or collection of medical debt which prohibits the
    reporting of any portion of such medical debt to a consumer
    reporting agency.
(13)        PROHIBITION AGAINST COLLECTION OF MEDICAL DEBT DURING
    HEALTH INSURANCE APPEALS.—
(a)      A medical creditor or medical debt collector that
    knows or should have known about an internal review, external
    review, or other internal appeal of a health insurance decision
    that is pending or was pending within the previous 180 days may
    not:
1.      Communicate with the patient regarding the unpaid
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    charges for health care services for the purpose of seeking to
    collect the charges; or
2.      Initiate a lawsuit or arbitration proceeding against
    the patient relating to unpaid charges for health care services.
(b)      A medical creditor that knows or should have known
    about an internal review, external review, or other internal
    appeal of a health insurance decision that is pending or was
    pending within the previous 180 days may not refer, place, or
    send the unpaid charges for health care services to a medical
    debt collector, including by selling the debt to a medical debt
    buyer.
(14)        INTEREST ON MEDICAL DEBT.—
(a)      Unless a patient is eligible for financial assistance
    under paragraph (5)(b), and notwithstanding any agreement to the
    contrary, interest on medical debt may not exceed 2 percent per
    annum. Patients eligible for financial assistance may not be
    charged any interest or late fees.
(b)      The rate of interest provided in paragraph (a) also
    applies to any judgments on medical debt, notwithstanding any
    agreement to the contrary.
(15)        MEDICAL DEBT PAYMENT PLANS.—
(a)      A medical creditor or medical debt collector that
    agrees to a payment plan for a medical debt shall provide a
    written copy of the payment plan to the patient within 5
    business days after entering into the payment plan. This plan
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    must prominently disclose the rate of any interest being applied
    to the debt in compliance with subsection (14), and the date by
    which the account will be paid off in full, assuming the
    payments set by the schedule are made without interruption.
(b)      A consumer need not make a payment on the payment plan
    until the written copy has been provided.
(c)1.       A medical debt payment plan may be accelerated or
    declared in default or terminated due to nonpayment only after
    the patient fails to make scheduled payments on the payment plan
    for at least 3 consecutive months.
2.      Before declaring the payment plan terminated, the
    medical creditor or medical debt collector must do all of the
    following:
a.      Make at least three reasonable attempts to contact the
    patient by telephone or by other method preferred by the
    patient.
b.      Provide a written notice informing the patient that the
    payment plan may be terminated and that the patient has the
    opportunity to renegotiate the payment plan.
c.      Attempt to renegotiate the terms of the defaulted
    payment plan, if requested by the patient.
3.      The medical creditor or medical debt collector may not
    commence a civil action against the patient or responsible party
    for nonpayment until at least 90 days after the payment plan is
    declared to be terminated. For purposes of this section, the
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    notice and telephone call to the patient may be made to the last
    known telephone number and address of the patient.
(16)        RECEIPTS FOR PAYMENTS.—Within 10 business days after
    receipt of a payment on a medical debt, a medical creditor or
    medical debt collector, or any agents thereof, receiving the
    payment shall furnish a receipt to the person that made the
    payment. The receipt must show all of the following:
(a)     The date of the provision of the health care service.
(b)     The amount paid.
(c)     The date payment was received.
(d)     The account's balance before the most recent payment.
(e)     The new balance after application of the payment.
(f)     The interest rate and interest accrued since the
    patient's last payment.
(g)     The patient's account number.
(h)     The name of the current owner of the debt and, if
    different, the name of the medical creditor.
(i)     Whether the payment is accepted as payment in full of
    the debt.
(17)        DEBT FORGIVEN BY MEDICAL CREDITOR.—Forgiveness of any
    part of an insured patient's copayment, coinsurance, deductible,
    facility fees, out-of-network charges, or other cost sharing is
    not a breach of contract or other violation of an agreement
    between the medical creditor and the insurer or payor.
(18)        PRIVATE REMEDY.—
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(a)      Collection activity against a patient who the large
    health care facility, medical creditor, or medical debt
    collector knew or should have known was, or should have been,
    eligible for financial assistance is an unfair or deceptive
    trade practice in violation of part II of chapter 501. Any other
    violation of this section by a medical creditor or medical debt
    collector is also an unfair or deceptive trade practice in
    violation of part II of chapter 501.
(b)      A patient may sue for injunctive or other appropriate
    equitable relief to enforce this section.
(c)      The remedies provided in this section are not intended
    to be the exclusive remedies available to a patient, and the
    patient is not required to exhaust any administrative remedies
    provided under this section or any other applicable law.
(d)      A financial assistance policy or agreement between a
    patient and a large health care provider or medical debt
    collector may not contain a provision that, before a dispute
    arises, waives or has the practical effect of waiving the rights
    of the patient to resolve that dispute by obtaining:
1.      Injunctive, declaratory, or other equitable relief;
2.      Multiple or minimum damages as specified by law;
3.      Attorney fees and costs as specified by law; or
4.      A hearing at which a party can present evidence in
    person.
(e)      Any provision in a financial assistance policy or
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    other written agreement violating paragraph (d) is void and
    unenforceable. A court may refuse to enforce other provisions of
    the financial assistance policy or other written agreement as
    equity may require.
(19)        PROHIBITION OF WAIVER OF RIGHTS.—Any waiver by a
    patient of any protection provided by or any right of the
    patient or other person under this section is void and may not
    be enforced by any court or any other person. A large health
    care facility may not circumvent the responsibilities and
    protections of this section by requiring prepayment for medical
    care.
(20)        ENFORCEMENT.—
(a)     The Office of the Attorney General may enforce this
    section and may adopt any regulation or rules necessary or
    appropriate to carry out the purpose of this section, to provide
    for the protection of patients, and to assist market
    participants in interpreting this section.
(b)     The Office of the Attorney General shall establish a
    complaint process whereby an aggrieved consumer or any member of
    the public may file a complaint against a medical creditor or
    medical debt collector who violates any provision of this
    section. All complaints shall be considered public records.
(21)        ANNUAL REPORTS AND DATABASE.—
(a)     On or before July 1 of each year, beginning July 1,
    2028, each large health care provider shall file its financial
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    assistance policy and an annual report with the Legislature and
    the Office of the Attorney General pursuant to procedures that
    the Office of the Attorney General shall establish.
(b)      The Office of the Attorney General shall post each
    report and financial assistance policy in a searchable database
    accessible on the Internet.
(c)      The Office of the Attorney General shall prepare an
    annual consolidated report and shall make it available to the
    public. The report must include the following information for
    the time period of July 1 of the prior year to July of that
    year:
1.      The total number of patients who applied for financial
    assistance.
2.      The total number of patients who received financial
    assistance.
3.      The total number of patients who were denied financial
    assistance.
4.      Deidentified demographic information for patients who
    received financial assistance, including zip code, race,
    language, gender, and disability status, to the extent that such
    data is available from the large health care facility.
5.      The total amount of financial assistance provided to
    patients.
6.      The types of collection practices used.
7.      The amounts of money collected with each of these
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    collection practices, in dollars and by percentage of the large
    health care facility's annual revenue.
(22)        SEVERABILITY.—If any provision of this section or its
    application to any person or circumstance is held invalid, that
    provision or its application is severable and does not affect
    the validity of the other provisions or applications of this
    section.
Section 3.        Part IV of chapter 641, Florida Statutes,
    consisting of ss. 641.71-641.799, Florida Statutes, is created
    and entitled the "Florida Health Plan."
Section 4.        Section 641.71, Florida Statutes, is created to
    read:
641.71       Short title.—This part may be cited as the "Florida
    Health Plan."
Section 5.        Section 641.72, Florida Statutes, is created to
    read:
641.72       Purpose.—There is created the Florida Health Plan.
    The purpose of the Florida Health Plan is to keep residents of
    this state healthy and to provide the best quality of health
    care by:
(1)     Ensuring that all residents of this state, regardless
    of immigration status, are covered.
(2)     Covering all necessary care, including dental; vision;
    hearing; mental health; reproductive care, including abortion
    services and prenatal and postpartum care; gender-affirming
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    health care, including medication and treatment; substance use
    disorder treatment; prescription drugs; durable medical
    equipment and supplies; and long-term care and home care,
    including long-term services and supports in home and community-
    based settings.
(3)     Allowing patients to choose their health care
    providers.
(4)     Reducing costs by negotiating fair prices and cutting
    administrative bureaucracy, through measures such as a global
    budget approach to institutional providers, and not by
    restricting or denying care.
(5)     Being affordable to all patients through financing
    based on a patient's ability to pay and the elimination of
    premiums, copayments, deductibles, and out-of-pocket expenses at
    the point of service.
(6)     Focusing on preventive care and early intervention to
    improve health.
(7)     Ensuring that there are enough health care providers
    to guarantee timely access to care.
(8)     Continuing this state's leadership in medical
    education, research, and technology.
(9)     Providing adequate and timely payments to health care
    providers.
(10)        Using a simple funding and payment system.
(11)        Providing a just transition for a displaced workforce
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    affected by changes.
Section 6.       Section 641.73, Florida Statutes, is created to
    read:
641.73      Definitions.—As used in this part, the term:
(1)     "Board" means the Florida Health Board established in
    s. 641.793.
(2)     "Institutional provider" means an inpatient hospital,
    nursing facility, rehabilitation facility, or any other health
    care facility that provides overnight care.
(3)     "Medically necessary" means comprehensive services or
    supplies needed to promote health and to prevent, diagnose, or
    treat a particular patient's medical condition. The
    comprehensive services and supplies must meet accepted standards
    of medical practice within a health care provider's professional
    peer group.
(4)     "Noninstitutional provider" means an individual
    provider, group practice, clinic, outpatient surgical center,
    imaging center, or any other health care facility that does not
    provide overnight care.
(5)     "Plan" means the Florida Health Plan created in s.
    641.72.
(6)     "Resident of this state" means an individual who has
    had a principal place of domicile in this state for more than 6
    consecutive months, who has registered to vote in this state,
    who has made a statement of domicile pursuant to s. 222.17, or
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    who has filed for homestead tax exemption on property in this
    state.
Section 7.       Section 641.74, Florida Statutes, is created to
    read:
641.74      Eligibility for and enrollment in the Florida
    Health Plan.—
(1)     ELIGIBILITY.—
(a)     All residents of this state, regardless of immigration
    status, are eligible for the Florida Health Plan.
(b)     Coverage for emergency care for a resident of this
    state which is obtained out of state must be at prevailing local
    rates where the care is provided. Coverage for nonemergency care
    obtained out of state must be according to rates and conditions
    established by the Florida Health Board. The board may require
    that a resident of this state be transported back to this state
    when prolonged treatment of an emergency condition is necessary
    and when that transport will not adversely affect the patient's
    care or condition.
(c)     A nonresident visiting this state shall be billed by
    the board for all services received under the plan. The board
    may enter into intergovernmental arrangements or contracts with
    other states and foreign countries to provide reciprocal
    coverage for temporary visitors.
(d)     The board shall extend eligibility to nonresidents
    employed in this state under a premium schedule set by the
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    board.
(e)      For a business outside of this state which employs
    residents of this state, the board shall apply for a federal
    waiver to collect the employer contribution mandated by federal
    law.
(f)      A retiree who is covered under the plan and who elects
    to reside outside of this state is eligible for benefits under
    the terms and conditions of the retiree's employer-employee
    contract.
(g)      The board may establish financial arrangements with
    other states and foreign countries in order to facilitate
    meeting the terms of the contracts described in paragraph (f).
    Payments for care provided by non-Florida health care providers
    to retirees who are covered under the plan shall be reimbursed
    at rates established by the board. Health care providers who
    accept any payment from the plan for a covered service may not
    bill the patient for the covered service.
(h)1.       A person is presumed eligible for coverage under the
    plan, and a health care provider shall provide health care
    services as if the person is eligible for coverage under the
    plan, if the person:
a.      Is a minor;
b.      Arrives at a health care facility unconscious,
    comatose, or otherwise unable to document eligibility or to act
    on the person's own behalf because of the person's physical or
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    mental condition; or
c.      Is involuntarily committed to an acute psychiatric
    facility or to a hospital with psychiatric beds which provides
    for involuntary commitment.
2.      All health care facilities subject to state and federal
    provisions governing emergency medical treatment must comply
    with subparagraph 1.
(2)      ENROLLMENT.—The board shall establish a procedure to
    enroll residents of this state and provide each with
    identification that may be used by health care providers to
    confirm eligibility for services. The application for enrollment
    may not be more than two pages.
Section 8.       Section 641.755, Florida Statutes, is created
    to read:
641.755      Benefits.—
(1)     A person covered under the Florida Health Plan may
    choose to receive services from any qualified, licensed health
    care provider that participates in the plan.
(2)      Except for the exclusions provided in subsection (4),
    covered health care benefits under the plan include all
    prescribed medically necessary care, which includes:
(a)      Inpatient and outpatient health care facility
    services.
(b)      Inpatient and outpatient licensed health care provider
    services.
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(c)      Diagnostic imaging, laboratory services, and other
     diagnostic and evaluative services.
(d)      Durable medical equipment, appliances, and assistive
     technology, including, but not limited to, prescribed
     prosthetics, eye care, and hearing aids and their repair,
     technical support, and customization required for individual
     use.
(e)      Inpatient and outpatient rehabilitative care.
(f)      Emergency care services.
(g)      Necessary transportation for health care services:
1.      As covered under Medicaid or Medicare; or
2.      For persons with disabilities, older persons with
     functional limitations, and low-income persons.
(h)      Child and adult immunizations and preventive care.
(i)      Health and wellness education for chronic or
     preventative care as provided by licensed health care providers.
(j)      Reproductive health care, including abortion services,
     contraceptives, and prenatal and postpartum care.
(k)      Childbirth and maternity care, including doula
     services and care in freestanding childbirth centers.
(l)      Gender-affirming health care, including medication and
     treatment.
(m)      Holistic licensed health care services such as
     chiropractic, acupressure, acupuncture, massage, and nutritional
1000      services.
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1001  (n)     Mental health services, including substance use
1002      disorder treatment, services in substance use disorder treatment
1003      facilities, and mental health care provided by licensed or
1004      certified mental health providers such as licensed
1005      psychologists, licensed mental health counselors, licensed
1006      professional counselors, licensed clinical social workers,
1007      certified master social workers, rehabilitation support service
1008      providers, and any providers that the board deems eligible.
1009  (o)     Dental care, including diagnostics and restoration and
1010      durable equipment such as braces and mouthguards.
1011  (p)     Vision care.
1012  (q)     Hearing care.
1013  (r)     Prescription drugs.
1014  (s)     Podiatric care.
1015  (t)     Therapies that are shown by the National Institutes of
1016      Health National Center for Complementary and Integrative Health
1017      to be safe and effective.
1018  (u)     Blood and blood products.
1019  (v)     Dialysis.
1020  (w)     Licensed qualified adult day care.
1021  (x)     Rehabilitative and habilitative services.
1022  (y)     Ancillary health care or social services previously
1023      covered by this state's qualified public health programs.
1024  (z)     Case management and care coordination.
1025  (aa)        Language interpretation and translation for health
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1026      care services, including sign language and Braille or other
1027      services needed for persons with communication barriers.
1028  (bb)        Services provided by qualified community health
1029      workers.
1030  (cc)        Health care and long-term supportive services,
1031      including in a home or community-based setting, assisted living
1032      facility, and nursing home, with home health care providers,
1033      home health aides, and palliative and hospice care.
1034  (dd) Any item or service described in this subsection which
1035      is furnished using telehealth, to the extent practicable.
1036  (3)     The Florida Health Board may expand health care
1037      benefits beyond the minimum benefits described in subsection (2)
1038      if the expansion meets the intent of this part and when there
1039      are sufficient funds to cover the expansion.
1040  (4)     The following health care services are excluded from
1041      coverage by the plan:
1042  (a)     Treatments and procedures primarily for cosmetic
1043      purposes, unless required to correct a congenital defect or to
1044      restore or correct a part of the body that has been altered as a
1045      result of an injury, a disease, or a surgery or unless
1046      determined to be medically necessary by a qualified, licensed
1047      health care provider in the plan.
1048  (b)     Services of a health care provider or facility that is
1049      not licensed, certified, or accredited by this state. The
1050      licensure, certification, or accreditation requirements do not
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1051      apply to health care providers or facilities that provide
1052      services to residents of this state who require medical
1053      attention while traveling out of state.
1054  (5)(a)      All plan enrollees must have a primary care
1055      provider and must have access to care coordination.
1056  (b)     A plan enrollee does not need a referral to see a
1057      health care specialist.
1058  (c)     The board may establish a computerized registry to
1059      assist enrollees in identifying appropriate providers, and the
1060      plan may assist an enrollee with choosing a primary care
1061      provider if the enrollee so chooses.
1062  (6)     The plan may not impose a deductible, copayment,
1063      coinsurance, or any other cost-sharing requirement on an
1064      enrollee with respect to a covered benefit.
1065  Section 9.       Section 641.77, Florida Statutes, is created to
1066      read:
1067  641.77      Federal preemption.—
1068  (1)     The Florida Health Board shall secure a repeal or a
1069      waiver of any provision of federal law that preempts any
1070      provision of this part. The Department of Health and the Agency
1071      for Health Care Administration shall provide all necessary
1072      assistance to the board to secure any repeal or waiver.
1073  (2)(a) The board shall, under the state innovation waivers
1074      under s. 1332 of the federal Patient Protection and Affordable
1075      Care Act, Pub. L. No. 111-148, as amended, request to repeal or
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1076      waive any of the following provisions to the extent necessary to
1077      implement this part:
1078  1.      Title 42 of the United States Code, ss. 18021-18024.
1079  2.      Title 42 of the United States Code, ss. 18031-18033.
1080  3.      Title 42 of the United States Code, s. 18071.
1081  4.      Section 5000A of the Internal Revenue Code of 1986, as
1082      amended.
1083  (b)      If a repeal or a waiver of a federal law or regulation
1084      cannot be secured, the board shall adopt rules, or seek
1085      conforming state legislation, consistent with federal law, in an
1086      effort to best fulfill the purposes of this part.
1087  (c)      The Florida Health Plan's responsibility for providing
1088      health care is secondary to existing federal programs for health
1089      care services to the extent that funding for these programs is
1090      not transferred or that the transfer is delayed beyond the date
1091      on which initial benefits are provided under the plan.
1092  Section 10.  Section 641.78, Florida Statutes, is created
1093      to read:
1094  641.78      Subrogation.—
1095  (1)(a)      As used in this section, the term "collateral
1096      source" includes:
1097  1.      A health insurance policy, health maintenance contract,
1098      continuing care contract, and prepaid health clinic contract,
1099      and the medical components of motor vehicle insurance,
1100      homeowner's insurance, and other forms of insurance.
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1101  2.      The medical components of worker's compensation.
1102  3.      A pension plan and retiree health care benefits.
1103  4.      An employer plan.
1104  5.      An employee benefit contract.
1105  6.      A government benefit program.
1106  7.      A judgment for damages for personal injury.
1107  8.      The state of last domicile for individuals moving to
1108      Florida for medical care who have extraordinary medical needs.
1109  9.      Any third party who is or may be liable to an
1110      individual for health care services or costs.
1111  (b)      The term does not include:
1112  1.      A contract or plan that is subject to federal
1113      preemption.
1114  2.      Any governmental unit, agency, or service to the extent
1115      that subrogation is prohibited by law.
1116  (2)      When other payers for health care have been
1117      terminated, the plan shall collect health care costs from a
1118      collateral source if health care services provided to a patient
1119      are, or may be, covered services under the collateral source
1120      available to the patient, or if the patient has a right of
1121      action for compensation permitted under law.
1122  (3)      The board shall negotiate waivers, seek federal
1123      legislation, or make other arrangements to incorporate
1124      collateral sources into the plan.
1125  (4)      If a person who receives health care services under
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1126      the plan is entitled to coverage, reimbursement, indemnity, or
1127      other compensation from a collateral source, the person must
1128      notify the health care provider and provide information
1129      identifying the collateral source, the nature and extent of
1130      coverage or entitlement, and other relevant information. The
1131      health care provider shall forward this information to the
1132      board. The person entitled to coverage, reimbursement,
1133      indemnity, or other compensation from a collateral source must
1134      provide additional information as requested by the board.
1135  (a)     The plan shall seek reimbursement from the collateral
1136      source for services provided to the person and may take
1137      appropriate action, including legal proceedings, to recover the
1138      reimbursement. Upon demand, the collateral source shall pay the
1139      sum that it would have paid or spent on behalf of the person for
1140      the health care services provided by the plan.
1141  (b)     In addition to any other right to recovery provided in
1142      this section, the board has the same right to recover the
1143      reasonable value of health care benefits from the collateral
1144      source.
1145  (c)     If the collateral source is exempt from subrogation or
1146      the obligation to reimburse the plan, the board may require that
1147      the person who is entitled to health care services from the
1148      collateral source first seek those services from the collateral
1149      source before seeking the services from the plan.
1150  (5)     To the extent permitted by federal law, the board has
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1151      the same right of subrogation over contractual retiree health
1152      care benefits provided by employers as other contracts allowing
1153      the plan to recover the cost of health care services provided to
1154      a person covered by the retiree health care benefits, unless
1155      arrangements are made to transfer the revenues of the health
1156      care benefits directly to the plan.
1157  (6)     A collateral source is not excluded from the
1158      obligations imposed by this section by virtue of a contract or
1159      relationship with a governmental unit, agency, or service.
1160  Section 11.  Section 641.791, Florida Statutes, is created
1161      to read:
1162  641.791     Defaults, underpayments, and late payments.—
1163  (1)     Defaults, underpayments, or late payments of any
1164      premium or other obligation imposed by this part shall result in
1165      the remedies and penalties provided by law, except as provided
1166      in this part.
1167  (2)     Eligibility for health care benefits may not be
1168      impaired by any default, underpayment, or late payment of any
1169      premium or other obligation imposed by this part.
1170  Section 12.  Section 641.792, Florida Statutes, is created
1171      to read:
1172  641.792     Provider payments.—
1173  (1)     All health care providers licensed to practice in this
1174      state may participate in the Florida Health Plan. The Florida
1175      Health Board may determine the eligibility of any other health
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1176      care providers to participate in the plan.
1177  (a)     A participating health care provider shall comply with
1178      all federal laws and regulations governing referral fees and fee
1179      splitting, including, but not limited to, 42 U.S.C. ss. 1320a-7b
1180      and 1395nn, whether reimbursed by federal funds or not.
1181  (b)     A fee schedule or financial incentive may not
1182      adversely affect the care a patient receives or the care a
1183      health provider recommends.
1184  (2)     The board shall establish and oversee a fair and
1185      efficient payment system for noninstitutional providers.
1186  (a)     The board shall pay noninstitutional providers based
1187      on rates negotiated with noninstitutional providers. The rates
1188      must take into account the need to address the shortage of
1189      noninstitutional providers.
1190  (b)     Noninstitutional providers that accept any payment
1191      from the plan for a covered health care service may not bill the
1192      patient for the covered health care service.
1193  (c)     Noninstitutional providers shall be paid within 30
1194      business days for claims filed following procedures established
1195      by the board.
1196  (3)     The board shall set an annual budget for each
1197      institutional provider, which consists of an operating and a
1198      capital budget, to cover the institutional provider's
1199      anticipated health care services for the following year based on
1200      past performance and projected changes in prices and health care
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1201      service levels.
1202  (a)     The annual budget for each individual institutional
1203      provider must be set separately. The board may not set a joint
1204      budget for a group of more than one institutional provider nor
1205      for a parent corporation that owns or operates one or more
1206      institutional providers.
1207  (b)     Institutional providers that accept any payment from
1208      the plan for a covered health care service may not bill the
1209      patient for the covered health care service.
1210  (4)(a)      The board shall periodically develop a capital
1211      investment plan that will serve as a guide in determining the
1212      annual budgets of institutional providers and in deciding
1213      whether to approve applications for approval of capital
1214      expenditures by noninstitutional providers.
1215  (b)     Institutional and noninstitutional providers that
1216      propose to make capital purchases in excess of $500,000 must
1217      obtain board approval. The board may alter the threshold
1218      expenditure level that triggers the requirement to submit
1219      information on capital expenditures. Institutional providers
1220      must propose these expenditures and submit the required
1221      information as part of the annual budget they submit to the
1222      board. Noninstitutional providers must apply to the board for
1223      approval of these expenditures. The board must respond to
1224      capital expenditure applications in a timely manner.
1225  (5)     The board shall establish payment criteria and payment
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1226      methods for care coordination for patients, especially those
1227      with chronic illness and complex medical needs.
1228  Section 13.  Section 641.793, Florida Statutes, is created
1229      to read:
1230  641.793      Florida Health Board.—
1231  (1)      By December 1, 2026, the Florida Health Board shall be
1232      established to promote the delivery of high-quality, coordinated
1233      health care services that enhance health; prevent illness,
1234      disease, and disability; slow the progression of chronic
1235      diseases; and improve personal health management. The board
1236      shall administer the Florida Health Plan. The board shall
1237      oversee the Office of Health Quality and Planning established in
1238      s. 641.795.
1239  (2)(a)      The board shall consist of at least 15 members,
1240      including the representatives selected by the regional planning
1241      boards established in s. 641.794. These representatives shall
1242      appoint the following additional members to serve on the board:
1243  1.      One patient member and one employer member.
1244  2.      Seven representatives of labor organizations who
1245      represent health care workers or social workers.
1246  3.      Five health care providers consisting of one physician,
1247      one registered nurse, one mental health provider, one dentist,
1248      and one health care facility director.
1249  (b)      Each member shall take the oath of office to uphold
1250      the Constitution of the United States and the Constitution of
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1251      the State of Florida and to operate the plan in the public
1252      interest by upholding the underlying principles of this part.
1253  (c)      Board members shall serve 4 years; however, for the
1254      purpose of providing staggered terms, of the initial
1255      appointments, those members appointed by the representatives of
1256      regional planning boards shall serve 2-year terms.
1257  (d)      The board shall set a board member's compensation, not
1258      to exceed the salary paid under state law to a commissioner on
1259      the Florida Public Service Commission. The board shall select
1260      the chair from among its membership.
1261  (e)1.       A board member may be removed by a two-thirds vote
1262      of the members voting on removal. After receiving notice and
1263      hearing, a member may be removed for malfeasance or nonfeasance
1264      in performance of the member's duties.
1265  2.      Conviction of any criminal behavior, regardless of how
1266      much time has lapsed, is grounds for immediate removal.
1267  (3)      The board shall:
1268  (a)      Ensure that all of the requirements of the plan are
1269      met.
1270  (b)      Hire a chief executive officer for the plan, who must
1271      take the oath described in paragraph (2)(b).
1272  (c)      Hire a director for the Office of Health Quality and
1273      Planning, who must take the oath described in paragraph (2)(b).
1274  (d)      Provide technical assistance to the regional planning
1275      boards.
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1276  (e)     Conduct investigations and inquiries and require the
1277      submission of information, documents, and records that the board
1278      considers necessary to carry out the purposes of this part.
1279  (f)     Establish a process for the board to receive concerns,
1280      opinions, ideas, and recommendations of the public regarding all
1281      aspects of the plan and the means of addressing those concerns.
1282  (g)     Conduct activities the board considers necessary to
1283      carry out the purposes of this part.
1284  (h)     Collaborate with the Department of Health and with the
1285      Agency for Health Care Administration to ensure that each health
1286      care facility performance is monitored and deficient practices
1287      are recognized and corrected in a timely manner.
1288  (i)     Establish conflict-of-interest standards that prohibit
1289      health care providers from receiving financial benefit from
1290      their medical decisions outside of board reimbursement,
1291      including any financial benefit for referring a patient for a
1292      service, product, or health care provider or for prescribing,
1293      ordering, or recommending a drug, product, or service.
1294  (j)     Establish conflict-of-interest standards related to
1295      pharmaceuticals and medical equipment, supplies, and devices,
1296      and their marketing to a health care provider, so that the
1297      health care provider does not receive any incentive to
1298      prescribe, administer, or use a product or service.
1299  (k)     Require all electronic health records used by health
1300      care providers to be fully interoperable with the open source
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1301      electronic health records system used by the United States
1302      Department of Veterans Affairs.
1303  (l)     Provide financial help and assistance in retraining
1304      and job placement to workers in this state who may be displaced
1305      because of the administrative efficiencies of the plan.
1306  (m)     Ensure that assistance is provided to all workers and
1307      communities that may be affected by provisions in this part.
1308  (n)     Work with the Department of Commerce to ensure that
1309      funding and program services are promptly and efficiently
1310      provided to all affected workers. The Department of Commerce
1311      shall monitor and report on a regular basis on the status of
1312      displaced workers.
1313  (o)     Adopt rules, policies, and procedures as necessary to
1314      carry out the duties assigned under this part.
1315  (4)     Before submitting a state innovation waivers
1316      application under s. 1332 of the federal Patient Protection and
1317      Affordable Care Act, Pub. L. No. 111-148, as amended, the board
1318      must do all of the following, as required by federal law:
1319  (a)     Conduct, or contract for, any actuarial analyses and
1320      actuarial certifications necessary to support the board's
1321      estimates that the waiver will comply with the comprehensive
1322      coverage, affordability, and scope of coverage requirements in
1323      federal law.
1324  (b)     Conduct or contract for any necessary economic
1325      analyses needed to support the board's estimates that the waiver
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1326      will comply with the comprehensive coverage, affordability,
1327      scope of coverage, and federal deficit requirements in federal
1328      law. These analyses must include:
1329  1.      A detailed 10-year budget plan.
1330  2.      A detailed analysis regarding the estimated impact of
1331      the waiver on health insurance coverage in this state.
1332  (c)      Establish a detailed draft implementation timeline for
1333      the waiver plan.
1334  (d)      Establish quarterly, annual, and cumulative targets
1335      for the comprehensive coverage, affordability, scope of
1336      coverage, and federal deficit requirements in federal law.
1337  (5)      The board has the following financial duties:
1338  (a)      Approve statewide and regional budgets.
1339  (b)      Negotiate and establish payment rates for health care
1340      providers through their professional associations.
1341  (c)      Monitor compliance with all budgets and payment rates
1342      and take action to achieve compliance to the extent authorized
1343      by law.
1344  (d)      Pay claims for medical products or services as
1345      negotiated and, if deemed necessary, issue requests for
1346      proposals from nonprofit business corporations in this state for
1347      a contract to process claims.
1348  (e)      Seek federal approval to bill another state for health
1349      care coverage provided to a patient from out of state who comes
1350      to this state for long-term care or other costly treatment when
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1351      the patient's home state fails to provide such coverage, unless
1352      a reciprocal agreement with the patient's home state to provide
1353      similar coverage to residents of this state relocating to that
1354      state can be negotiated.
1355  (f)      Implement fraud prevention measures necessary to
1356      protect the operation of the plan.
1357  (g)      Work to ensure appropriate cost control by:
1358  1.      Instituting aggressive public health measures, early
1359      intervention and preventive care, health and wellness education,
1360      and promotion of personal health improvement.
1361  2.      Making changes in the delivery of health care services
1362      and administration that improve efficiency and care quality.
1363  3.      Minimizing administrative costs.
1364  4.      Ensuring that the delivery system does not contain
1365      excess capacity.
1366  5.      Negotiating the lowest possible prices for prescription
1367      drugs, medical equipment, and health care services.
1368  (6)      The board has the following management duties:
1369  (a)      Develop and implement enrollment procedures for the
1370      plan.
1371  (b)      Implement and review eligibility standards for the
1372      plan.
1373  (c)      Arrange for health care services to be provided at
1374      convenient locations to serve communities in need in the same
1375      manner as federally qualified health centers, including ensuring
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1376      the availability of school nurses so that all students have
1377      access to health care, immunizations, and preventive care at
1378      public schools and encouraging health care providers to provide
1379      services at easily accessible locations.
1380  (d)     Make recommendations, when needed, to the Legislature
1381      about changes in the geographic boundaries of the health
1382      planning regions.
1383  (e)     Establish an electronic claim and payment system for
1384      the plan.
1385  (f)     Monitor the operation of the plan through consumer
1386      surveys and regular data collection and evaluation activities,
1387      including evaluations of the adequacy and quality of services
1388      provided under the plan, the need for changes in the benefit
1389      package, the cost of each type of service, and the effectiveness
1390      of cost control measures under the plan.
1391  (g)     Disseminate information and establish a health care
1392      website to provide information to the public about the plan,
1393      including health care providers and facilities, and state and
1394      regional planning board meetings and activities.
1395  (h)     Collaborate with public health agencies, schools, and
1396      community clinics.
1397  (i)     Ensure that plan policies and health care providers,
1398      including public health care providers, support all residents of
1399      this state in achieving and maintaining maximum physical and
1400      mental health.
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1401  (7)     The board, in conjunction with the office and
1402      administrative staff of the plan's chief executive officer, has
1403      the following policy duties:
1404  (a)     Develop and implement cost control and quality
1405      assurance procedures.
1406  (b)     Ensure strong public health services, including
1407      education and community prevention and clinical services.
1408  (c)     Ensure a continuum of coordinated high-quality primary
1409      to tertiary care to all residents of this state.
1410  (d)     Implement policies to ensure that all residents of
1411      this state receive culturally and linguistically competent care.
1412  (8)     The board shall determine the feasibility of self-
1413      insuring health care providers for malpractice and shall
1414      establish a self-insurance system and create a special fund for
1415      payment of losses incurred if the board determines self-insuring
1416      health care providers would reduce costs.
1417  (9)     By July 1 of each year, the board shall report to the
1418      President of the Senate, the Speaker of the House of
1419      Representatives, and ranking members of the committees having
1420      cognizance over health care issues on:
1421  (a)     The performance of the plan.
1422  (b)     The fiscal condition and need for payment adjustment.
1423  (c)     Any needed changes in geographic boundaries of the
1424      health planning regions.
1425  (d)     Any recommendations for statutory changes.
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1426  (e)     Receipts of revenues from all sources.
1427  (f)     Whether current year goals and priorities are met.
1428  (g)     Future goals and priorities.
1429  (h)     Major new technology and prescription drugs.
1430  (i)     Other circumstances that may affect the cost or
1431      quality of health care.
1432  Section 14.  Section 641.794, Florida Statutes, is created
1433      to read:
1434  641.794     Health planning regions.—
1435  (1)     By August 1, 2026, the Secretary of Health Care
1436      Administration shall designate health planning regions within
1437      this state which are composed of geographically contiguous areas
1438      grouped on the basis of the following considerations:
1439  (a)     Patterns of use of health care services.
1440  (b)     Health care resources, including workforce resources.
1441  (c)     Health care needs of the population, including public
1442      health needs.
1443  (d)     Geography.
1444  (e)     Population and demographic characteristics.
1445  (f)     Other considerations the board deems appropriate.
1446  (2)     Each health planning region is administered by a
1447      regional planning board. A minimum of eight regional planning
1448      boards shall be created, and all regional planning boards shall
1449      be created by October 1, 2026.
1450  (a)     Each regional planning board shall consist of:
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1451  1.      One county commissioner per county, selected by the
1452      county commission for each health planning region consisting of
1453      at least five counties; or
1454  2.      Three county commissioners per county, selected by the
1455      county commission for each health planning region consisting of
1456      four counties or less.
1457  (b)      A county commission may designate a representative to
1458      act as a member of the regional planning board in the member's
1459      absence.
1460  (c)      Each regional planning board shall select the chair
1461      from among its membership.
1462  (d)      Regional planning board members shall serve for 4-year
1463      terms; however, for the purpose of providing staggered terms, of
1464      the initial appointments, at least half of the board members
1465      shall be appointed to 2-year terms. Board members may receive
1466      per diem for meetings.
1467  (e)      The Secretary of Health Care Administration, or his or
1468      her designee, shall convene the first meeting of each regional
1469      planning board with the Florida Health Board within 30 days
1470      after the regional planning board is established.
1471  (3)      A regional planning board's duties shall consist of:
1472  (a)      Recommending health standards, goals, priorities, and
1473      guidelines for the health planning region.
1474  (b)      Preparing an operating and capital budget for the
1475      health planning region to recommend to the Florida Health Board.
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1476  (c)      Collaborating with local public health care agencies
1477      to:
1478  1.      Educate consumers and health care providers on public
1479      health programs, goals, and the means of reaching those goals.
1480  2.      Implement public health and wellness initiatives.
1481  (d)      Hiring a regional health planning director.
1482  (e)      Ensuring that all parts of the health planning region
1483      have access to a 24-hour nurse hotline and to 24-hour urgent
1484      care clinics.
1485  Section 15.  Section 641.795, Florida Statutes, is created
1486      to read:
1487  641.795      Office of Health Quality and Planning.—The Florida
1488      Health Board shall establish the Office of Health Quality and
1489      Planning to assess the quality, access, and funding adequacy of
1490      the Florida Health Plan. The Office of Health Quality and
1491      Planning shall:
1492  (1)      Make annual recommendations to the board on the
1493      overall direction of the plan on the following subjects:
1494  (a)      Overall effectiveness of the plan in addressing public
1495      health and wellness.
1496  (b)      Access to health care.
1497  (c)      Quality improvement.
1498  (d)      Efficiency of administration.
1499  (e)      Adequacy of the budget and funding.
1500  (f)      Appropriateness of payments to health care providers.
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1501  (g)     Capital expenditure needs.
1502  (h)     Long-term health care.
1503  (i)     Mental health and substance abuse services.
1504  (j)     Staffing levels and working conditions in health care
1505      facilities.
1506  (k)     Identification of the number and mix of health care
1507      facilities and providers necessary to meet the needs of the
1508      plan.
1509  (l)     Care for chronically ill patients.
1510  (m)     Health care provider training on promoting the use of
1511      advance directives with patients to enable patients to obtain
1512      the health care of their choice.
1513  (n)     Research needs.
1514  (o)     Integration of disease management programs into health
1515      care delivery.
1516  (2)     Analyze shortages in the health care workforce that is
1517      required to meet the needs of the population and develop plans
1518      to meet those needs in collaboration with regional planners and
1519      educational institutions.
1520  (3)     Analyze methods of paying health care providers and
1521      make recommendations to improve the quality of health care
1522      services and to control costs.
1523  (4) Assist in coordination of the plan and public health
1524      programs.
1525  (5)     Assess and evaluate health care benefits by:
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1526  (a)     Considering health care benefit additions to the plan
1527      and evaluating the additions based on evidence of clinical
1528      efficacy.
1529  (b)     Establishing a process and criteria by which health
1530      care providers may request authorization to provide health care
1531      services and treatments that are not included in the plan
1532      benefit set, such as experimental health care treatments.
1533  (c)     Evaluating proposals to increase the efficiency and
1534      effectiveness of the health delivery system, and making
1535      recommendations to the board based on the cost-effectiveness of
1536      the proposals.
1537  (d)     Identifying complementary and alternative health care
1538      modalities that have been shown to be safe and effective.
1539  (6)     The board may convene advisory panels as needed to
1540      assess the quality, access, and funding adequacy of the plan.
1541  Section 16.  Section 641.796, Florida Statutes, is created
1542      to read:
1543  641.796     Ombudsman Office for Patient Advocacy.—
1544  (1)     The Ombudsman Office for Patient Advocacy is created
1545      to represent the interests of consumers of health care and to
1546      help residents of this state secure the health care services and
1547      health care benefits to which they are entitled under this part.
1548      The Ombudsman Office for Patient Advocacy shall also advocate on
1549      behalf of enrollees of the Florida Health Plan.
1550  (2)     The Ombudsman Office for Patient Advocacy shall be
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1551      headed by the ombudsman, who shall be appointed by the Secretary
1552      of Health Care Administration. The ombudsman shall serve in the
1553      unclassified service and may be removed only for just cause. The
1554      ombudsman must be selected without regard to political
1555      affiliation and must be knowledgeable about and have experience
1556      in health care services and administration. A person may not
1557      serve as ombudsman while holding another public office.
1558  (a)      The ombudsman may gather information about decisions
1559      and acts of the Florida Health Board and about any matters
1560      related to the board, health care providers, and health care
1561      programs.
1562  (b)      The ombudsman shall:
1563  1.      Ensure that patient advocacy services are available to
1564      all residents of this state.
1565  2.      Establish and maintain the grievance system according
1566      to subsection (3).
1567  3.      Receive, evaluate, and respond to consumer complaints
1568      about the plan.
1569  4.      Establish a process to receive recommendations from the
1570      public about ways to improve the plan.
1571  5.      Develop educational and informational guides that
1572      describe consumer rights and responsibilities.
1573  6.      Ensure that the guides described in subparagraph 5. are
1574      widely available to consumers and available in health care
1575      provider offices and facilities.
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1576  7.      Prepare an annual report about the consumer's
1577      perspective on the performance of the plan, including
1578      recommendations for needed improvements.
1579  (3)      The ombudsman shall establish a grievance system for
1580      complaints. The system must provide a process that ensures
1581      adequate consideration of plan enrollee grievances and
1582      appropriate remedies.
1583  (a)      The ombudsman may refer any complaint that does not
1584      pertain to compliance with this part to the federal Centers for
1585      Medicare and Medicaid Services or any other appropriate local,
1586      state, and federal government entity for investigation and
1587      resolution.
1588  (b)      A health care provider or an employee of a health care
1589      provider may join with, or otherwise assist, a complainant in
1590      submitting a complaint to the ombudsman. A health care provider
1591      or an employee of a health care provider who, in good faith,
1592      joins with or assists a complainant in submitting a complaint is
1593      subject to protections and remedies under this part or under
1594      general law.
1595  (c)      In reviewing a complaint, the ombudsman may require a
1596      health care provider or the board to submit any information the
1597      ombudsman deems necessary.
1598  (d)1.       The ombudsman shall send a written notice of the
1599      final disposition of the complaint and the reasons for the
1600      decision to:
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1601  a.      The complainant;
1602  b.      Any health care provider or employee of a health care
1603      provider who joins with or assists the complainant in submitting
1604      the complaint; and
1605  c.      The board,
1606
1607      within 30 calendar days after receipt of the complaint, unless
1608      the ombudsman determines that additional time is reasonably
1609      necessary to fully and fairly evaluate the relevant grievance.
1610  2.      The ombudsman's order of corrective action is binding
1611      on the plan. A decision of the ombudsman is subject to de novo
1612      review by the district court.
1613  (4)      The budget for the Ombudsman Office for Patient
1614      Advocacy shall be determined by the Legislature and shall be
1615      independent from the board.
1616  (5)      The ombudsman shall establish offices to provide
1617      convenient access to residents of this state.
1618  Section 17.  Section 641.797, Florida Statutes, is created
1619      to read:
1620  641.797      Auditor for the Florida Health Plan.—
1621  (1)      There is created in the Office of the Auditor General
1622      the position of auditor for the Florida Health Plan to prevent
1623      health care fraud and abuse of the plan. The auditor for the
1624      Florida Health Plan shall be appointed by the Auditor General.
1625  (2)      The auditor for the Florida Health Plan shall:
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1626  (a)     Investigate, audit, and review the financial and
1627      business records of the plan.
1628  (b)     Investigate, audit, and review the financial and
1629      business records of individuals, public and private agencies and
1630      institutions, and private corporations that provide services or
1631      products to the plan which are reimbursed by the plan.
1632  (c)     Investigate allegations of misconduct on the part of
1633      an employee or appointee of the Florida Health Board and on the
1634      part of any health care provider that is reimbursed by the plan,
1635      and report any findings of misconduct to the Attorney General.
1636  (d)     Investigate fraud and abuse.
1637  (e)     Arrange for the collection and analysis of data needed
1638      to investigate inappropriate use of a product or service that is
1639      reimbursed by the plan.
1640  (f)     Annually report recommendations for improvements to
1641      the plan to the board.
1642  Section 18.  Section 641.798, Florida Statutes, is created
1643      to read:
1644  641.798     Ethics and conflicts of interest; Conflict of
1645      Interest Committee.—
1646  (1)     The Code of Ethics for Public Officers and Employees
1647      under part III of chapter 112 applies to the employees and the
1648      chief executive officer of the Florida Health Plan, the
1649      employees and members of the Florida Health Board, the employees
1650      and members of the regional planning boards and the regional
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1651      health planning directors, the employees and the director of the
1652      Office of Health Quality and Planning, the employees and the
1653      ombudsman of the Ombudsman Office for Patient Advocacy, and the
1654      auditor for the Florida Health Plan. Failure to comply with the
1655      code of ethics under part III of chapter 112 is grounds for
1656      disciplinary action, which may include termination of employment
1657      or removal from the board.
1658  (2)     In order to avoid the appearance of political bias or
1659      impropriety, the chief executive officer of the plan may not:
1660  (a)     Engage in leadership of, or employment by, a political
1661      party or political organization.
1662  (b)     Publicly endorse a political candidate.
1663  (c)     Contribute to a political candidate, political party,
1664      or political organization.
1665  (d)     Attempt to avoid compliance with this subsection by
1666      making a contribution through a spouse or other family member.
1667  (3)     In order to avoid a conflict of interest, a person
1668      specified in subsection (1) may not be employed by a health care
1669      provider or a pharmaceutical, health insurance, or medical
1670      supply company while holding the position specified in
1671      subsection (1), except for the five health care provider members
1672      appointed to the Florida Health Board by the representatives of
1673      regional planning boards under s. 641.793(2)(a)2. These five
1674      members may be employed by a health care provider, but not by a
1675      pharmaceutical, health insurance, or medical supply company
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1676      while serving on the board.
1677  (4)     The board shall establish a Conflict-of-Interest
1678      Committee to develop standards of practice for persons or
1679      entities doing business with the plan, including, but not
1680      limited to, board members, health care providers, and medical
1681      suppliers.
1682  (a)     The committee shall establish guidelines on the duty
1683      to disclose to the committee the existence of any financial
1684      interest and all material facts related to a financial interest.
1685  (b)     The committee shall review all proposed transactions
1686      and arrangements that involve the plan. In considering a
1687      proposed transaction or arrangement, if the committee determines
1688      a conflict of interest exists, the committee must investigate
1689      alternatives to the proposed transaction or arrangement. After
1690      exercising due diligence, the committee shall determine whether
1691      the plan can obtain with reasonable efforts a more advantageous
1692      transaction or arrangement with a person or entity which would
1693      not give rise to a conflict of interest. If the committee
1694      determines that a more advantageous transaction or arrangement
1695      is not reasonably possible under the circumstances, the
1696      committee shall make a recommendation to the board on whether
1697      the transaction or arrangement is in the best interest of the
1698      plan, and whether the transaction is fair and reasonable. The
1699      committee shall provide to the board all material information
1700      used to make the recommendation. After reviewing all relevant
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1701      information, the board shall decide whether to approve the
1702      transaction or arrangement.
1703  Section 19.  Section 641.799, Florida Statutes, is created
1704      to read:
1705  641.799      Florida Health Plan policies and procedures;
1706      rulemaking.—
1707  (1)     The Florida Health Plan policies and procedures are
1708      exempt from the Administrative Procedure Act.
1709  (2)(a)      If the board determines that a rule should be
1710      adopted under this part to establish, modify, or revoke a policy
1711      or procedure, the board must publish in the state register the
1712      proposed rule and must afford interested persons a period of 30
1713      days after publication to submit written data or comments.
1714  (b)     On or before the last day of the 30-day period
1715      provided for the submission of written data or comments under
1716      paragraph (a), any interested person may file with the board
1717      written objections to the proposed rule, stating the grounds for
1718      objection and requesting a public hearing on those objections.
1719      Within 30 days after the last day for submitting written data or
1720      comments, the board shall publish in the state register a notice
1721      specifying the rule to which objections have been filed and a
1722      hearing requested and specifying a time and place for the
1723      hearing.
1724  (c)     Within 60 days after the expiration of the period
1725      provided for the submission of written data or comments, or
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1726      within 60 days after the completion of any hearing, the board
1727      shall issue a rule adopting, modifying, or revoking a policy or
1728      procedure, or make a determination that a rule should not be
1729      adopted. The rule may contain a provision delaying its effective
1730      date for such period as the board determines is necessary.
1731  Section 20.  (1)       The Director of the Office of Financial
1732      Regulation of the Department of Financial Services and the chief
1733      executive officer of the Florida Health Plan shall regularly
1734      update the Legislature on the status of the planning,
1735      implementation, and financing of this act.
1736  (2)     The Florida Health Plan must be operational by July 1,
1737      2028.
1738  (3)     On and after the day the Florida Health Plan becomes
1739      operational, a health insurance policy, a health maintenance
1740      contract, a continuing care contract, a prepaid health clinic
1741      contract, or any policy or contract that offers coverage for
1742      services covered by the Florida Health Plan may not be sold in
1743      this state.
1744  (4)     The Office of the Inspector General of the Agency for
1745      Health Care Administration shall prepare an analysis of this
1746      state's capital expenditure needs for the purpose of assisting
1747      the Florida Health Board in adopting the statewide capital
1748      budget for the year following implementation. The Office of the
1749      Inspector General shall submit this analysis to the board.
1750  (5)     By July 1, 2027, the Department of Commerce shall
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1751      provide to the Florida Health Board, the Governor, and the
1752      chairs and ranking members of the legislative committees with
1753      jurisdiction over health, human services, and commerce a report
1754      determining the appropriations and legislation necessary to
1755      assist all affected individuals and communities through the
1756      transition to the Florida Health Plan.
1757  Section 21.  This act shall take effect July 1, 2026, but
1758      only if HB 1491 or similar legislation is adopted in the same
1759      legislative session or an extension thereof and becomes a law.
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                                                                                                        hb1489-00

Requires large health care facilities to develop written financial assistance policies; provides financial assistance eligibility criteria; provides billing & collections rules & prohibitions; prohibits information relating to medical debt from being included in consumer reports, communicated with & reported to consumer reporting agencies, & used for certain decisions; prohibits medical creditors & medical debt collectors from engaging in certain acts during health insurance appeals; limits interest on medical debt under certain circumstances; creates Florida Health Plan; provides eligibility for & coverage of plan; authorizes Florida Health Board to establish financial arrangements with other states & foreign countries; authorizes plan enrollees to choose certain health care providers to have primary care providers & access to care coordination; authorizes enrollees to see health care specialists without referral; requires board to secure repeals & waivers of certain provisions of federal law; provides that plan's responsibility for providing health care is secondary to existing federal programs; requires plan to collect health care costs from collateral sources; prohibits patient care from being affected by fee schedules & financial incentives; prohibits noninstitutional & institutional providers that accept payments from plan from billing patients; provides requirements for capital expenditures by noninstitutional & institutional providers which exceed specified amount; requires Secretary of Health Care Administration to designate health planning regions; provides considerations for such designations; provides requirements for regional planning boards; prohibits certain health insurance policies & contracts from being sold in this state on & after specified date.

Sponsors

Rep. Dotie Joseph (D) sponsors H 1489, and 2 members have co-sponsored it.

Committees

H 1489 went before 1 committee: Health Care Facilities & Systems Subcommittee.

Health Care Facilities & Systems Subcommittee
Health Care Facilities & Systems Subcommittee
Referred to · Jan 15, 2026

History

H 1489 has taken 7 actions since Jan 9, 2026, the latest on Mar 13, 2026.

ChamberAction
Mar 13, 2026
House
Died in Health Care Facilities & Systems Subcommittee
Jan 15, 2026
House
Referred to Health Care Facilities & Systems Subcommittee
Jan 15, 2026
House
Referred to Health Care Budget Subcommittee
Jan 15, 2026
House
Referred to Health & Human Services Committee
Jan 15, 2026
House
Now in Health Care Facilities & Systems Subcommittee

Votes

H 1489 has not gone to a roll call.

Source: flsenate.gov · legiscan.com