Florida H1015 regulates insurance claims payments to health care providers, focusing on overpayment claims, downcoding, and prior authorization.

Florida H1015 establishes rules for insurance claims payments to health care providers, emphasizing overpayment claims, downcoding, and prior authorization processes. It mandates that health insurers must pay or deny overpayment claims within 90 days, with failure to do so creating an uncontestable obligation to pay. The bill prohibits downcoding health care services unless expressly permitted by an agreement with a health care provider.

Florida H1015 regulates insurance claims payments to health care providers, focusing on overpayment claims, downcoding, and prior authorization.

Florida H1015 establishes rules for insurance claims payments to health care providers, emphasizing overpayment claims, downcoding, and prior authorization processes. It mandates that health insurers must pay or deny overpayment claims within 90 days, with failure to do so creating an uncontestable obligation to pay. The bill prohibits downcoding health care services unless expressly permitted by an agreement with a health care provider.