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Florida Statute 641.515 - Full Text and Legal Analysis
Florida Statute 641.515 | Lawyer Caselaw & Research
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The 2025 Florida Statutes

Title XXXVII
INSURANCE
Chapter 641
HEALTH CARE SERVICE PROGRAMS
View Entire Chapter
641.515 Investigation by the agency.
(1) The agency shall investigate further any quality of care issue contained in recommendations and reports submitted pursuant to s. 641.511. The agency shall also investigate further any information that indicates that the organization does not meet accreditation standards or the standards of the review organization performing the external quality assurance assessment pursuant to reports submitted under s. 641.512. Every organization shall submit its books and records and take other appropriate action as may be necessary to facilitate an examination. The agency shall have access to the organization’s medical records of individuals and records of employed and contracted physicians, with the consent of the subscriber or by court order, as necessary to administer this part.
(2) The reports and the records prepared or obtained under this section or s. 641.512 by the agency or by an outside source may be used by the agency in enforcing the requirements of this part and in disciplinary proceedings. Except as otherwise provided in this section, any patient-identifying information contained in these records and reports is confidential and exempt from s. 119.07(1).
(3) If the agency, through its examination or through any investigation, has a reasonable belief that conduct by a staff member or any other employee of an organization may constitute grounds for disciplinary action by the appropriate regulatory board, the agency shall report this fact to such regulatory board.
(4) The agency shall promulgate rules imposing upon physicians and hospitals performing services for a health maintenance organization standards of care generally applicable to physicians and hospitals.
History.ss. 21, 27, ch. 87-236; ss. 187, 188, ch. 91-108; ss. 88, 91, ch. 91-282; s. 4, ch. 91-429; s. 1, ch. 93-85; s. 34, ch. 96-199; s. 399, ch. 96-406; s. 60, ch. 99-3; s. 116, ch. 2018-24.

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Amendments to 641.515


Annotations, Discussions, Cases:

Cases Citing Statute 641.515

Total Results: 2  |  Sort by: Relevance  |  Newest First

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State, Agency for Health Care Admin. v. PCA Fam. Health Plan, Inc., 695 So. 2d 737 (Fla. Dist. Ct. App. 1996).

Published | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 10318, 1996 WL 511529

BARFIELD, Chief Judge. In this appeal and cross-appeal from a final summary judgment and a final order of the circuit court, we are asked to interpret section 641.515(2), Florida Statutes (1993), to determine the meaning of the words “any identifying information”, and determine whether the confidentiality exemption of section 641.515(2) extends to the investigation of a Medicaid provider pursuant to section 409.913(7)(d)....
...We further hold that the trial court erred in not extending the confidentiality exemption to the investigation of an HMO as a Medicaid provider. The plain meaning of “any identifying information” (emphasis added) does not permit the inclusion of some identifying information and the exclusion of other such information. Section 641.515(2) reads: The reports and records prepared or obtained under this section or s....
...119.07(1). This exemption is subject to the Open Government Sunset Review Act in accordance with s. 119.14. This section does not differentiate between an individual and an HMO. *739 The trial court should have extended the confidentiality exemption of section 641.515(2) to the investigation of an HMO according to section 409.913(7)(d), which reads: The complaint and all information obtained pursuant to an investigation of a Medicaid provider, or the authorized representative or agent of a provider...
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Ago (Fla. Att'y Gen. 1994).

Published | Florida Attorney General Reports

...Harold D. Lewis General Counsel Agency for Health Care Administration 325 John Knox Road, Suite 301 Tallahassee, Florida 32303-4131 Dear Mr. Lewis: You ask substantially the following question: Does the term "identifying information" as provided in section 641.515 (2), Florida Statutes, refer only to information that identifies patients and the complainant or does it also include the names of the health maintenance organization and its staff? In sum: Until this matter is legislatively or judicially clarified, it appears that the term "identifying information" in section 641.515 (2), Florida Statutes, should be narrowly construed to refer to information that identifies individuals and not health maintenance organizations....
...alth clinics deliver high-quality health care to their subscribers." 1 In order to achieve this purpose, Part III requires oversight of health maintenance organizations (HMOs) and prepaid health clinics in order for them to do business in Florida. 2 Section 641.515 (1) and (2), Florida Statutes, provides: (1) The [Agency for Health Care Administration] shall investigate further any quality of care issue contained in recommendations and reports submitted pursuant to ss....
...Health Care Administration (agency) as a result of investigating subscriber grievances or accreditation findings confidential and exempt from the Public Records Law. While the term "identifying information" is broad, it is necessary in interpreting section 641.515 (2), Florida Statutes, to consider the intent and purpose underlying the enactment of Part III, Chapter 641 , Florida Statutes. As expressed in section 641.48 , Florida Statutes, supra, the purpose of this legislation is to ensure the quality of health care provided to subscribers. 3 Section 641.515 , Florida Statutes, seeks to accomplish this purpose by requiring agency investigation of unresolved subscriber quality of care grievances and accreditation and external quality assurance assessments. As an exemption to the Public Records Law, section 641.515 (2), Florida Statutes, should be narrowly construed and limited to its stated purpose....
...rary to the provisions of Chapter 455 , Florida Statutes, which requires confidentiality until after a finding of probable cause. Thus, until this matter is legislatively or judicially clarified, it appears that the term "identifying information" in section 641.515 (2), Florida Statutes, should be narrowly construed to refer to information that identifies individuals and not the HMO. You also ask whether such information must still be redacted when the report is used in a disciplinary proceeding. The statute is silent as to any limitation on the exemption prescribed in section 641.515 (2), Florida Statutes....
...1988); Tribune Company v. Public Records, 493 So.2d 480 (Fla. 2d DCA 1986), review denied sub nom., Gillum v. Tribune Company, 503 So.2d 327 (Fla. 1987). And see, Lorei v. Smith, 464 So.2d 1330 (Fla. 2d DCA 1985), review denied, 475 So.2d 695 (Fla. 1985). 5 Section 641.515 (3), Florida Statutes....

This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. For legal consultation, call 904-383-7448.