Politics May Change FL Health Insurance Rates

The Florida health insurance industry could undergo some massive changes in coming months. Last month, at the end of the state’s legislative session, lawmakers introduced a bill that could alter the way health care is paid for in the Sunshine state. Lawmakers and doctors insist it’s a way to improve and streamline Florida health insurance, insurers beg to differ.

Up to now, Florida health insurance provider Blue Cross Blue Shield has only made direct payments to those doctors inside their PPO networks. The state’s largest insurer claims negotiating payments with doctors in their networks assists them in keeping costs low. The bill at hand seeks to change that, allowing doctors outside of the PPO networks to receive direct payments.

Opponents of the bill claim this will cause Florida health insurance rates to rise as Blue Cross Blue Shield will lose its negotiation powers with providers. BCBS representatives claim the measure will create an exodus of providers from their PPO network. Supporters claim the bill will address a number of issues related to the current system of payments.

Currently those on Blue Cross Blue Shield Florida health insurance are paid directly if they use an out-of-network provider. The patient is then responsible themselves to use this payment for reimbursing the provider. Concerns stem from allegations that some patients use these direct payments for other expenses, even illicit drug purchases. Doctors in Florida support the bill saying it will cut down on administrative costs for them, thus reducing costs for the patient.

Doctors and other providers lobbied hard during this Spring to bring this bill to fruition. Some argue their attempts are so they can gain negotiating power over Blue Cross Blue Shield and Florida health insurance rates. Others claim this bill will save millions in administrative costs across the state, simply by changing the address on the reimbursement check.

With a growing elderly population, due namely to incoming Snowbirds and other out-of-state retirees of the Baby-Boomer generation, controlling Florida health insurance rates has become a top priority for state officials. It is still unclear as to what Florida Governor Charlie Crist (R) will do with the bill. Crist has until near the end of June to sign the bill. With both a father and a sister who are doctors, it is anyone’s guess as to whether or not Crist will sign the proposed legislation into law. These changes to Florida health insurance also comes amidst massive changes proposed at the federal level by those in the House and Senate.

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