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Florida Statute 627.6405 | Lawyer Caselaw & Research
F.S. 627.6405 Case Law from Google Scholar
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The 2023 Florida Statutes (including Special Session C)

Title XXXVII
INSURANCE
Chapter 627
INSURANCE RATES AND CONTRACTS
View Entire Chapter
F.S. 627.6405
627.6405 Decreasing inappropriate utilization of emergency care.
(1) A health insurer shall post on its website, and update annually, information regarding appropriate utilization of emergency care services which shall include, but need not be limited to:
(a) A list of alternative urgent care contracted providers;
(b) The types of services offered by these providers;
(c) At least two examples illustrating the impact on insured and insurer paid amounts of inappropriate utilization of nonemergent services and care in a hospital emergency department setting compared to utilization of nonemergent services and care in an urgent care center;
(d) An interactive tool to locate local in-network and out-of-network urgent care centers; and
(e) What to do in the event of a true emergency.
(2) Health insurers shall develop community emergency department diversion programs. Such programs may include, at the discretion of the insurer, but not be limited to, enlisting providers to be on call to insurers after hours, coordinating care through local community resources, and providing incentives to providers for case management.
(3) As a disincentive for insureds to inappropriately use emergency department services for nonemergency care, health insurers may require higher copayments for urgent care or primary care provided in an emergency department and higher copayments for use of out-of-network emergency departments. Higher copayments may not be charged for the utilization of the emergency department for emergency care. For the purposes of this section, the term “emergency care” has the same meaning as the term “emergency services and care” as defined in s. 395.002(9) and includes services provided to rule out an emergency medical condition.
History.s. 25, ch. 2004-297; s. 4, ch. 2021-112.

F.S. 627.6405 on Google Scholar

F.S. 627.6405 on Casetext

Amendments to 627.6405


Arrestable Offenses / Crimes under Fla. Stat. 627.6405
Level: Degree
Misdemeanor/Felony: First/Second/Third

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 627.6405.



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