Florida Statutes § 408.7056

“Subscriber Assistance Program under the public health law”

The Agency for Health Care Administration’s Subscriber Program is a program established to provide assistance to health maintenance organization or prepaid health clinic enrollees who received an adverse determination of their grievances. The Subscriber Program must review all grievances within 60 days after receipt and make a determination whether the grievance will be heard. After a hearing, the program must make a determination within 15 business days.

Grievances that pose an immediate and serious threat to an individual’s health have priority over other grievances. For these urgent grievances, the program must make a decision within 45 days after the date the grievance is filed.

Grievances that pose an immediate and emergent threat to an individual’s health may receive an emergency hearing. The program must make a determination within 24 hours after the hearing.

The Agency for Health Care Administration and the Office of Insurance Regulation may impose sanctions or fines on a health maintenance organization or prepaid health clinic for any violations.