Florida Statutes 627.4234 – Health insurance cost containment provisions required
Current as of: 2023 | Check for updates
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Terms Used In Florida Statutes 627.4234
- Policy: means a written contract of insurance or written agreement for or effecting insurance, or the certificate thereof, by whatever name called, and includes all clauses, riders, endorsements, and papers that are a part thereof. See Florida Statutes 627.402
A health insurance policy or health care services plan which provides medical, hospital, or surgical expense coverage delivered or issued for delivery in this state must contain one or more of the following procedures or provisions to contain health insurance costs or cost increases:
(1) Coinsurance.
(2) Deductible amounts.
(3) Utilization review.
(4) Audits of provider bills to verify that services and supplies billed were furnished and that proper charges were made.
(5) Scheduled benefits.
(6) Benefits for preadmission testing.
(7) Any lawful measure or combination of measures for which the insurer provides to the office information demonstrating that the measure or combination of measures is reasonably expected to have an effect toward containing health insurance costs or cost increases.