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Florida Statutes § 641.3903

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“Unfair methods of competition and unfair or deceptive acts or practices defined under the Health Maintenance Organization Act”

Health maintenance organizations are prohibited from engaging in the following unfair methods of competition and unfair or deceptive acts or practices:

  • Misrepresentation and false advertising of health maintenance contracts;
  • False information and advertising generally;
  • Defamation;
  • False statements and reports filed to government agencies and to the public;
  • Unfair claim settlement practices;
  • Failure to maintain complaint-handling procedures;
  • Operating without an active certificate of authority;
  • Misrepresentation in health maintenance organization applications;
  • Illegal dealings in premiums, excess or reduced charges for health maintenance coverage;
  • False claims, obtaining or retaining money dishonestly;
  • Discriminating against Medicaid recipients or enrollees who sought medical care after domestic violence;
  • Misleading potential enrollees regarding the availability of providers;
  • Retaliating against a health care provider; and
  • Offering rewards or incentives to encourage enrollees to participate in a wellness or health improvement program.

Related laws:

Florida Statutes § 627.6699

Florida Statutes § 627.6475


Current as of June 2015