20.3 Unfair Trade Practices
The penalties in Florida for violating the Unfair Trade Practices Act are probation, suspension, or revocation of licensure or HMO Certificate of Authority and up to $200,000. If the violation is one of a criminal nature, penalties can result in imprisonment.
With regard to HMOs, what activities are deemed to be unfair trade practices under Florida law?
1. Misrepresentation and false advertising of HMO contracts
2. False information and false advertising in general
3. Defamation
4. False statements and entries
5. Unfair claim settlement practices
6. Failure to maintain claim handling procedures
7. Operating without a subsisting certificate of authority
8. Misrepresentations in HMO applications
9. Twisting
10. Illegal dealing in premiums
11. False claims; obtaining money dishonestly
12. Prohibited discriminatory practices
13. Misrepresentation in availability of providers
14. Adverse action against a provider
15. Rebating (except after July 1, 2011, an HMO issuing group or individual health benefit plans may offer rewards and incentives for participating in a voluntary wellness or health improvement program.)
