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Florida Statute 641.3156 | Lawyer Caselaw & Research
F.S. 641.3156 Case Law from Google Scholar
Statute is currently reporting as:
Link to State of Florida Official Statute Google Search for Amendments to 641.3156

The 2023 Florida Statutes (including Special Session C)

Title XXXVII
INSURANCE
Chapter 641
HEALTH CARE SERVICE PROGRAMS
View Entire Chapter
F.S. 641.3156
641.3156 Treatment authorization; payment of claims.
(1) A health maintenance organization must pay any hospital-service or referral-service claim for treatment for an eligible subscriber which was authorized by a provider empowered by contract with the health maintenance organization to authorize or direct the patient’s utilization of health care services and which was also authorized in accordance with the health maintenance organization’s current and communicated procedures, unless the provider provided information to the health maintenance organization with the willful intention to misinform the health maintenance organization.
(2) A claim for treatment may not be denied if a provider follows the health maintenance organization’s authorization procedures and receives authorization for a covered service for an eligible subscriber, unless the provider provided information to the health maintenance organization with the willful intention to misinform the health maintenance organization.
(3) Emergency services are subject to the provisions of s. 641.513 and are not subject to the provisions of this section.
History.s. 4, ch. 2000-252.

F.S. 641.3156 on Google Scholar

F.S. 641.3156 on Casetext

Amendments to 641.3156


Arrestable Offenses / Crimes under Fla. Stat. 641.3156
Level: Degree
Misdemeanor/Felony: First/Second/Third

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 641.3156.



Annotations, Discussions, Cases:

Cases from cite.case.law:

JOSEPH L. RILEY ANESTHESIA ASSOCIATES, v. STEIN, 27 So. 3d 140 (Fla. Dist. Ct. App. 2010)

. . . direct the provision of JLR’s anesthesia services to Florida Health Care members pursuant to section 641.3156 . . . When the trial court reviewed section 641.3156(1), it found that under that statute a health maintenance . . . performing its medical services, its rights are governed not by section 641.3154(4), but by section 641.3156 . . . Health Care, JLR was not in a contract position with the health maintenance organization, and section 641.3156 . . .

FOUNDATION HEALTH, v. WESTSIDE EKG ASSOCIATES, v. EKG v. EKG, 944 So. 2d 188 (Fla. 2006)

. . . Section 641.3156(1) requires HMOs to pay “any hospital-service or referral-service claim for treatment . . . the provider provided information to the [HMO] with the willful intention to misinform the [HMO].” § 641.3156 . . .

In MANAGED CARE LITIGATION., 135 F. Supp. 2d 1253 (S.D. Fla. 2001)

. . . . § 641.3156 (prohibiting arbitrary denial of claims), Tex. . . .