Florida S1130 aims to regulate insurance claims payments to health care providers, focusing on downcoding, prior authorization, and prompt payment.

Florida S1130 establishes regulations for insurance claims payments to health care providers. It prohibits payment adjudicators from downcoding health care services under certain circumstances, requiring them to provide specific information to providers. The bill also mandates that utilization review entities disclose all prior authorization requirements and restrictions on their websites. It sets timeframes for responding to claims and contesting overpayments, and establishes a permissible error ratio for claims payment violations.

Florida S1130 aims to regulate insurance claims payments to health care providers, focusing on downcoding, prior authorization, and prompt payment.

Florida S1130 establishes regulations for insurance claims payments to health care providers. It prohibits payment adjudicators from downcoding health care services under certain circumstances, requiring them to provide specific information to providers. The bill also mandates that utilization review entities disclose all prior authorization requirements and restrictions on their websites. It sets timeframes for responding to claims and contesting overpayments, and establishes a permissible error ratio for claims payment violations.