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Prompt payment still an issue in Florida

Physicians were not surprised that a large number of plans had violated the prompt-pay laws. Industry executives in the state question the magnitude of the problem.

By Cheryl Jackson, amednews staff. April 15, 2002.

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More than half of Florida's HMOs aren't following the state's prompt-payment law, according to regulators.

The Florida Dept. of Insurance sent notices to 16 of the state's 24 HMOs charging them with not paying claims promptly. The insurance department began reviewing payment information in October 2001 as part of a larger review of HMOs. The state will not release the names of the plans involved until the investigation is completed.

The notices, sent from December 2001 through February, outline violations and request HMOs submit plans to reduce the potential for future violations. Those acknowledging they have violated the law will pay fines.

Florida physicians say they're not surprised that a majority of the plans have been notified about violations.

"It means that doctors do the work, have the authorization and don't get paid," said Dennis S. Agliano, MD, a Tampa otolaryngologist. "As usual, they make the law for prompt pay, then the insurance companies use loopholes to not pay you by saying it's not clean if the T's are not crossed or the I's are not dotted."

Proposals backed by the Florida Medical Assn. and the Florida Hospital Assn. to amend the prompt-payment law died recently. Currently, HMOs have to pay a clean claim within 35 calendar days while other insurers have 45 days to pay. Late payers pay an additional 10% of the bill. [...]