Florida legislation · 2026 Regular Session
Florida H1097: Health Insurer Accountability
Status: Failed, March 13, 2026
Requires health plan to participate in filed claim dispute; provides penalties for failure to respond to claim; requires AHCA to notify certain entity within specified timeframe when health plan fails to pay provider; requires health plan to pay provider within specified timeframe after agency's order; provides credentialing requirements for managed care plan; requires each managed care plan to identify to agency & OIR any ownership interest of affiliation of any kind with certain entities; provides requirements for identification of such information; removes provision requiring results of certain audit reports to be dispositive; requires managed care contracts to include provider notifications regarding certain denials of coverage; prohibits insurer from denying certain claims; provides notification requirements & penalties.
What the bill says
An act relating to health insurer accountability; amending s. 408.7057, F.S.; requiring a health plan to participate in a filed claim dispute; providing penalties for failure to respond to a claim; requiring the Agency for Health Care Administration to notify a certain entity within a specified timeframe when a health plan fails to pay a provider under certain circumstances; requiring a health plan to pay a provider within a specified timeframe after the agency's order; providing penalties; amending s. 409.967, F.S.…
From the introduced text, January 7, 2026:
A bill to be entitled An act relating to health insurer accountability; amending s. 408.7057, F.S.; requiring a health plan to participate in a filed claim dispute; providing penalties for failure to respond to a claim; requiring the Agency for Health Care Administration to notify a certain entity within a specified timeframe when a health plan fails to pay a provider under certain circumstances; requiring a health plan to pay a provider within a specified timeframe after the agency's order; providing penalties; amending s. 409.967, F.S.; providing credentialing requirements for a managed care plan; requiring each managed care plan to identify to the agency and the Office of Insurance Regulation any ownership interest or affiliation of any kind with certain entities; providing requirements for the identification of such information; requiring each managed care plan to report specified information to the agency and the office in writing within a specified timeframe; removing a provision requiring the results of certain audit reports to be dispositive; amending s. 409.975, F.S.; requiring managed care contracts to include provider notifications regarding certain denials of coverage; amending ss. 627.6131 and 641.315, F.S.; words underlined are additions. hb1097-00 FLORIDAHOUSEOFREPRESENTATIVES HB 1097 2026 prohibiting an insurer from denying certain claims under certain circumstances; providing notification requirements and penalties; amending ss. 409.973 and 409.9855, F.S.; conforming cross-references; providing an …
Sponsors
- Berfield, Kimberly (R, HD-058) · primary sponsor
- Gonzalez Pittman, Karen (R, HD-065)
Latest actions
- : Died in Health Care Facilities & Systems Subcommittee
- : 1st Reading (Original Filed Version)
- : Now in Health Care Facilities & Systems Subcommittee
- : Referred to Health & Human Services Committee
- : Referred to Insurance & Banking Subcommittee
- : Referred to Health Care Facilities & Systems Subcommittee
- : Filed
Common questions
- What is H1097?
- H1097 is a bill in the Florida Legislature (2026 Regular Session): Health Insurer Accountability.
- What does H1097 do?
- In its own words: An act relating to health insurer accountability; amending s. 408.7057, F.S.; requiring a health plan to participate in a filed claim dispute; providing penalties for failure to respond to a claim; requiring the Agency for Health Care Administration to notify a certain entity within a specified timeframe when a health plan fails to pay a provider under certain circumstances; requiring a health plan to pay a provider within a specified timeframe after the agency's order; providing penalties; amending s. 409.967, F.S.…
- What is the status of H1097?
- Failed as of March 13, 2026. Latest action: Died in Health Care Facilities & Systems Subcommittee (March 13, 2026).
- Who sponsored H1097?
- Berfield, Kimberly (R, HD-058), with 1 co-sponsor.
- Where is the official record for H1097?
- On the Florida Legislature website: https://www.flsenate.gov/Session/Bill/2026/1097
Source: official Florida record. Tracked by Delilah, AI for legislation across all 50 states and Congress.