H1097 · Health Insurer Accountability

Health Insurer Accountability; Requires health plan to participate in filed claim dispute; provides penalties for failure to respond to claim; requires AHCA to notify certain entity within specified timeframe when health plan fails to pay provider; requires health plan to pay provider within specified timeframe after agency's order; provides credentialing requirements for managed care plan; requires each managed care plan to identify to agency & OIR any ownership interest of affiliation of any kind with certain entities; provides requirements for identification of such information; removes provision requiring results of certain audit reports to be dispositive; requires managed care contracts to include provider notifications regarding certain denials of coverage; prohibits insurer from denying certain claims; provides notification requirements & penalties.