Florida Statutes 636.214 – Provider agreements
Current as of: 2024 | Check for updates
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(1) All providers offering medical services to members under a discount plan must provide such services pursuant to a written agreement. The agreement may be entered into directly by the provider or by a provider network to which the provider belongs.
(2) A provider agreement between a discount plan organization and a provider must provide the following:
(a) A list of the services and products to be provided at a discount.
Terms Used In Florida Statutes 636.214
- Contract: A legal written agreement that becomes binding when signed.
- Discount plan: means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Florida Statutes 636.202
- Discount plan organization: means an entity that, in exchange for fees, dues, charges, or other consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Florida Statutes 636.202
- Medical services: means any care, service, or treatment of illness or dysfunction of, or injury to, the human body, including, but not limited to, physician care, inpatient care, hospital surgical services, emergency services, ambulance services, dental care services, vision care services, mental health services, substance abuse services, chiropractic services, podiatric care services, laboratory services, and medical equipment and supplies. See Florida Statutes 636.202
- Provider: means any person or institution that is contracted, directly or indirectly, with a discount plan organization to provide medical services to members. See Florida Statutes 636.202
- Provider network: means an entity that negotiates on behalf of more than one provider with a discount plan organization to provide medical services to members. See Florida Statutes 636.202
(b) The amount or amounts of the discounts or, alternatively, a fee schedule which reflects the provider’s discounted rates.
(c) A statement that the provider will not charge members more than the discounted rates.
(3) A provider agreement between a discount plan organization and a provider network must require that the provider network have written agreements with its providers which:
(a) Contain the terms described in subsection (2).
(b) Authorize the provider network to contract with the discount plan organization on behalf of the provider.
(c) Require the network to maintain an up-to-date list of its contracted providers and to provide that list on a monthly basis to the discount plan organization.
(4) The discount plan organization shall maintain a copy of each active provider agreement into which it has entered.