The Legislature has determined that the operation of a health maintenance organization without a subsisting certificate of authority or the renewal, issuance, or delivery of a health maintenance contract without a subsisting certificate of authority constitutes a danger to the citizens of this state and exposes any subscriber to immediate and irreparable injury, loss, or damage. Any such activities, oral or written, shall include a statement that the entity does not possess a valid certificate of authority and cannot enter into health maintenance contracts until such time as it has been issued a certificate of authority by the office. A health maintenance organization issuing or delivering in this state a health maintenance contract that provides prescription drug coverage shall offer medication synchronization to allow a subscriber to align at least once in a plan year the refill dates for prescription drugs covered by the health maintenance contract. A provider that denies or contests a health maintenance organization’s claim for overpayment or any portion of a claim shall notify the organization, in writing, within 35 days after the provider receives the claim that the claim for overpayment is contested or denied.
Report assets acquired prior to June 30, 2001, in accordance with s. A comprehensive feasibility study, performed by a certified actuary in conjunction with a certified public accountant. The health maintenance organization shall implement a process for dispensing prescription drugs to a subscriber for the purpose of aligning the refill dates of such drugs, and such medication synchronization may be available only through a network pharmacy. The notice that the claim for overpayment is denied or contested must identify the contested portion of the claim and the specific reason for contesting or denying the claim and, if contested, must include a request for additional information.
641.35, Florida Statutes (2000), through December 31, 2005. The study shall be for the greater of 3 years or until the health maintenance organization has been projected to be profitable for 12 consecutive months. A controlled substance, a prescription drug dispensed in an unbreakable package, or a multidose unit of a prescription drug may not be partially filled for the purpose of aligning refill dates. If the organization submits additional information, the organization must, within 35 days after receipt of the request, mail or electronically transfer the information to the provider.
See alsobarrage jamming; electronic warfare; jamming; spot jamming.acoustic warfare — (*) Action involving the use of underwater acoustic energy todetermine, exploit, reduce, or prevent hostile use of the underwater acoustic spectrumand actions which retain friendly use of the underwater acoustic spectrum. Authority to execute these agreements lieswith the Secretary of Defense, and may or may not be delegated.
Governed by legalguidelines, these agreements are used for contingencies, peacekeeping operations,unforeseen emergencies, or exercises to correct logistic deficiencies that cannot beadequately corrected by national means. (JP 4-08)action phase — In an amphibious operation, the period of time between the arrival of thelanding forces of the amphibious force in the operational area and the accomplishmentof their mission.
See alsoresponsibility.accounting line designator — A five-character code, consisting of the target desiredground zero designator and the striking command suffix, to indicate a specific nuclearstrike by a specified weapon delivery system on a target objective to the operation plan. The use of acoustic warfare support measures involves nointentional underwater acoustic emission and is generally not detectable by the enemy. See also target acquisition.acquisition and cross-servicing agreement — Agreements negotiated on a bilateral basiswith US allies or coalition partners that allow US forces to exchange most commontypes of support, including food, fuel, transportation, ammunition, and equipment.
Also called ALD.acoustic jamming — The deliberate radiation or reradiation of mechanical orelectroacoustic signals with the objectives of obliterating or obscuring signals that theenemy is attempting to receive and of disrupting enemy weapons systems. Authority to negotiate these agreements is usually delegated to the combatantcommander by the Secretary of Defense.
Faced with the continuation of mounting costs of health care, coupled with the state’s interest in high-quality care, the Legislature has determined that there is a need to explore alternative methods for the delivery of health care services, with a view toward achieving greater efficiency and economy in providing these services. A certified actuary shall: As to any applicant whose business plan indicates that it will receive Medicaid funds, a list of all contracts and agreements and any information relative to any payment or agreement to pay, directly or indirectly, a consultant fee, a broker fee, a commission, or other fee or charge related in any way to the application for a certificate of authority or the issuance of a certificate of authority, including, but not limited to, the name of the person or entity paying the fee; the name of the person or entity receiving the fee; the date of payment; and a brief description of the work performed. The attestation of assignment of benefits may be in written or electronic form. If an overpayment determination is the result of retroactive review or audit of coverage decisions or payment levels not related to fraud, a health maintenance organization shall adhere to the following procedures: All claims for overpayment must be submitted to a provider within 30 months after the health maintenance organization’s payment of the claim.