§ 627.6405, Fla. Stat. · Part VI. HEALTH INSURANCE POLICIES
Decreasing inappropriate utilization of emergency care.
Text — 2026 Florida Statutes
(1) A health insurer shall post on its website, and update annually, information regarding appropriate utilization of emergency care services which shall include, but need not be limited to:
(a) A list of alternative urgent care contracted providers;
(b) The types of services offered by these providers;
(c) At least two examples illustrating the impact on insured and insurer paid amounts of inappropriate utilization of nonemergent services and care in a hospital emergency department setting compared to utilization of nonemergent services and care in an urgent care center;
(d) An interactive tool to locate local in-network and out-of-network urgent care centers; and
(e) What to do in the event of a true emergency.
(2) Health insurers shall develop community emergency department diversion programs. Such programs may include, at the discretion of the insurer, but not be limited to, enlisting providers to be on call to insurers after hours, coordinating care through local community resources, and providing incentives to providers for case management.
(3) As a disincentive for insureds to inappropriately use emergency department services for nonemergency care, health insurers may require higher copayments for urgent care or primary care provided in an emergency department and higher copayments for use of out-of-network emergency departments. Higher copayments may not be charged for the utilization of the emergency department for emergency care. For the purposes of this section, the term “emergency care” has the same meaning as the term “emergency services and care” as defined in s. 395.002(9) and includes services provided to rule out an emergency medical condition.
Notes and commentary — not statutory text
History
s. 25, ch. 2004-297; s. 4, ch. 2021-112.
Source of truth
- Edition
- 2026 Florida Statutes
- Official file
- https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0627/0627.html
- Text hash
- sha256 a11c46ecc0e342499e1dd5201e23c02b60ad5bd570d605799d6bbcbb81ff96a1
- Composed by
- compose_v2.py 2026-10-04: the Legislature's structured HTML read in document order; verify_v2.py's independent reading agrees character for character
- composed from the Legislature's structured HTML (one source of text; no PDF extraction); a second, independent reading of the same bytes agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
The Florida Statutes
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.