Statewide Provider and Health Plan Claim Dispute Resolution Program

This bill adds nine specific exemptions to Florida's statewide provider and health plan claim dispute resolution program, clarifying which disputed claims will not be reviewed by the state resolution organization. It directly affects healthcare providers and health plans by excluding certain claims from the dispute process, such as those involving interest payments, Medicaid fair hearings, federal dispute resolution processes, or pre-2000 contracts. Key provisions specify that claims related to federal programs (like Medicare or Medicaid appeals), ongoing court cases, or internal managed care organization grievances will not undergo state review. The bill does not alter the core dispute resolution program but streamlines it by defining excluded scenarios. It takes effect July 1, 2026.