Florida insurers forced to honor assignment of benefits

An intense legislative campaign ended with the governor's signature on a law requiring insurers to pay out-of-network physicians directly.

By Emily Berry — Posted July 8, 2009

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Florida has become the latest of only a handful of states that require health insurers to pay out-of-network physicians directly rather than send reimbursements to patients.

The state's new assignment-of-benefits law took effect July 1.

Florida Gov. Charlie Crist was lobbied hard by health insurers who wanted him to veto the bill, but in the end he followed the will of the Legislature, said Florida Medical Assn. spokeswoman Lynne Takacs.

"We're pretty proud of it," she said. "It was a David-versus-Goliath-type effort." Physicians who supported the legislation sent more than 1,000 letters to Crist, she said.

Health insurers, including BlueCross BlueShield of Florida, lobbied against the bill at the capital and with TV ads, warning it would cost the company and prompt increased balance billing.

"Our concern on the part of some of our members still is that direct payment to providers is an important benefit from a provider contracting with a health plan," said Jim Bracher, executive vice president of the Florida Assn. of Health Plans, which opposed the bill.

"That benefit will be lost, and you're faced with the possibility you have providers leaving your network and more persons will be getting balance billed."

In the letter accompanying his June 10 signature, the governor said he hoped the new law would ensure that patients could access care in or out of a health plan's network.

"I am pleased that this legislation removes a health care access barrier that hindered a provider's right to receive payment for rendering services," the letter said.

Florida passed reforms last year that included a requirement to pay network physicians directly. But a section of that bill that would have required paying out-of-network doctors directly was removed during the legislative session, because it "threatened to torpedo the whole bill," Takacs said.

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