Senate Bill sb1202c2

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2003                    CS for CS for SB 1202

    By the Committees on Appropriations; Banking and Insurance;
    and Senator Alexander




    309-2532-03

  1                      A bill to be entitled

  2         An act relating to motor vehicle insurance

  3         costs; providing a short title; providing

  4         legislative findings and purpose; amending s.

  5         119.105, F.S.; prohibiting disclosure of

  6         confidential police reports for purposes of

  7         commercial solicitation; amending s. 316.066,

  8         F.S.; requiring the filing of a sworn statement

  9         as a condition to accessing a crash report

10         stating the report will not be used for

11         commercial solicitation; providing a penalty;

12         creating part XIII of ch. 400, F.S., entitled

13         the Health Care Clinic Act; providing for

14         definitions and exclusions; providing for the

15         licensure, inspection, and regulation of health

16         care clinics by the Agency for Health Care

17         Administration; requiring licensure and

18         background screening; providing for clinic

19         inspections; providing rulemaking authority;

20         providing licensure fees; providing fines and

21         penalties for operating an unlicensed clinic;

22         providing for clinic responsibilities with

23         respect to personnel and operations; providing

24         accreditation requirements; providing for

25         injunctive proceedings and agency actions;

26         providing administrative penalties; amending s.

27         456.0375, F.S.; excluding certain entities from

28         clinic registration requirements; providing

29         retroactive application; amending s. 456.072,

30         F.S.; providing that making a claim with

31         respect to personal injury protection which is

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         upcoded or which is submitted for payment of

 2         services not rendered constitutes grounds for

 3         disciplinary action; amending s. 626.7451,

 4         F.S.; providing a per-policy fee to be remitted

 5         to the insurer's Special Investigations Unit,

 6         the Division of Insurance Fraud of the

 7         Department of Financial Services, and the

 8         Office of Statewide Prosecution for purposes of

 9         preventing, detecting, and prosecuting motor

10         vehicle insurance fraud; amending s. 627.732,

11         F.S.; providing definitions; amending s.

12         627.736, F.S.; requiring that medical services

13         be lawfully rendered; providing allowable

14         amounts for specified services; requiring the

15         Department of Health, in consultation with

16         medical boards, to identify certain diagnostic

17         tests; specifying effective dates; providing

18         for application of fee schedules; specifying

19         effective dates; deleting certain provisions

20         governing arbitration; providing for compliance

21         with billing procedures; prohibiting insurers

22         from authorizing physicians to change opinion

23         in reports; providing requirements for

24         physicians with respect to maintaining such

25         reports; expanding provisions providing for a

26         demand letter; providing a medical peer review

27         process; providing requirements for alternative

28         dispute resolution; limiting attorney's fees if

29         matters are not resolved by medical peer review

30         and alternative dispute resolution; authorizing

31         the Financial Services Commission to determine

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         cost savings under personal injury protection

 2         benefits under specified conditions; amending

 3         s. 627.739, F.S.; specifying application of a

 4         deductible amount; amending s. 768.79, F.S.;

 5         specifying applicability of provisions relating

 6         to offer of judgment and demand for judgment;

 7         amending s. 817.234, F.S.; providing that it is

 8         a material omission and insurance fraud for a

 9         physician or other provider to waive a

10         deductible or copayment or not collect the

11         total amount of a charge; increasing the

12         penalties for certain acts of solicitation of

13         accident victims; providing mandatory minimum

14         penalties; prohibiting certain solicitation of

15         accident victims; providing penalties;

16         prohibiting a person from participating in an

17         intentional motor vehicle accident for the

18         purpose of making motor vehicle tort claims;

19         providing penalties, including mandatory

20         minimum penalties; amending s. 817.236, F.S.;

21         increasing penalties for false and fraudulent

22         motor vehicle insurance application; creating

23         s. 817.2361, F.S.; prohibiting the creation or

24         use of false or fraudulent motor vehicle

25         insurance cards; providing penalties; amending

26         s. 921.0022, F.S.; revising the offense

27         severity ranking chart of the Criminal

28         Punishment Code to reflect changes in penalties

29         and the creation of additional offenses under

30         the act; providing legislative intent with

31         respect to the retroactive application of

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         certain provisions; repealing s. 456.0375,

 2         F.S., relating to the regulation of clinics by

 3         the Department of Health; requiring certain

 4         insurers to make a rate filing to conform the

 5         per-policy fee to the requirements of the act;

 6         specifying the application of any increase in

 7         benefits approved by the Financial Services

 8         Commission; providing for application of other

 9         provisions of the act; requiring reports;

10         providing an appropriation and authorizing

11         additional positions; providing effective

12         dates.

13  

14  Be It Enacted by the Legislature of the State of Florida:

15  

16         Section 1.  Florida Motor Vehicle Insurance

17  Affordability Reform Act; legislative findings; purpose.--

18         (1)  This act may be cited as the "Florida Motor

19  Vehicle Insurance Affordability Reform Act."

20         (2)  The Legislature finds and declares that:

21         (a)  The Florida Motor Vehicle No-Fault Law, enacted 32

22  years ago, has provided valuable benefits over the years to

23  consumers in this state. The principle underlying the

24  philosophical basis of the no-fault or personal injury

25  protection (PIP) insurance system is that of a trade-off of

26  one benefit for another, specifically providing medical and

27  other benefits in return for a limitation on the right to sue

28  for nonserious injuries.

29         (b)  The PIP insurance system has provided benefits in

30  the form of medical payments, lost wages, replacement

31  

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  services, funeral payments, and other benefits, without regard

 2  to fault, to consumers injured in automobile accidents.

 3         (c)  However, the goals behind the adoption of the

 4  no-fault law in 1971, which were to quickly and efficiently

 5  compensate accident victims regardless of fault, to reduce the

 6  volume of lawsuits by eliminating minor injuries from the tort

 7  system, and to reduce overall motor vehicle insurance costs,

 8  have been significantly compromised due to the fraud and abuse

 9  that has permeated the PIP insurance market.

10         (d)  Motor vehicle insurance fraud and abuse, other

11  than in the hospital setting, whether in the form of

12  inappropriate medical treatments, inflated claims, staged

13  accidents, solicitation of accident victims, falsification of

14  records, or in any other form, has increased premiums for

15  consumers and must be uncovered and vigorously prosecuted. The

16  problem of inappropriate medical treatment and inflated claims

17  for PIP have generally not occurred in the hospital setting.

18         (e)  The no-fault system has been weakened in part due

19  to certain insurers not adequately or timely compensating

20  injured accident victims or health care providers. In

21  addition, the system has become increasingly litigious with

22  attorneys obtaining large fees by litigating, in certain

23  instances, over relatively small amounts that are in dispute.

24  There is an overwhelming public necessity to expand the

25  provisions of the demand letter, to establish an expedited

26  peer review process for medical issues and an expedited

27  alternative dispute resolution process for other issues, and

28  to minimize litigation costs and fees in order to encourage

29  settlements, decrease litigation, and maintain a healthy

30  insurance market.

31  

                                  5

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (f)  It is a matter of great public importance that, in

 2  order to provide a healthy and competitive automobile

 3  insurance market, consumers be able to obtain affordable

 4  coverage, insurers be entitled to earn an adequate rate of

 5  return, and providers of services be compensated fairly.

 6         (g)  It is further a matter of great public importance

 7  that, in order to protect the public's health, safety, and

 8  welfare, it is necessary to enact the provisions contained in

 9  this act in order to prevent PIP insurance fraud and abuse and

10  to curb escalating medical, legal, and other related costs,

11  and the Legislature finds that the provisions of this act are

12  the least restrictive actions necessary to achieve this goal.

13         (h)  Therefore, the purpose of this act is to restore

14  the health of the PIP insurance market in Florida by

15  addressing these issues, preserving the no-fault system, and

16  realizing cost-savings for all people in this state.

17         Section 2.  Section 119.105, Florida Statutes, is

18  amended to read:

19         119.105  Protection of victims of crimes or

20  accidents.--Police reports are public records except as

21  otherwise made exempt or confidential by general or special

22  law. Every person is allowed to examine nonexempt or

23  nonconfidential police reports. A No person who comes into

24  possession of exempt or confidential information contained in

25  police reports may not inspects or copies police reports for

26  the purpose of obtaining the names and addresses of the

27  victims of crimes or accidents shall use that any information

28  contained therein for any commercial solicitation of the

29  victims or relatives of the victims of the reported crimes or

30  accidents and may not knowingly disclose such information to

31  any third party for the purpose of such solicitation during

                                  6

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  the period of time that information remains exempt or

 2  confidential. This section does not Nothing herein shall

 3  prohibit the publication of such information to the general

 4  public by any news media legally entitled to possess that

 5  information or the use of such information for any other data

 6  collection or analysis purposes by those entitled to possess

 7  that information.

 8         Section 3.  Paragraph (c) of subsection (3) of section

 9  316.066, Florida Statutes, is amended, and paragraph (f) is

10  added to that subsection, to read:

11         316.066  Written reports of crashes.--

12         (3)

13         (c)  Crash reports required by this section which

14  reveal the identity, home or employment telephone number or

15  home or employment address of, or other personal information

16  concerning the parties involved in the crash and which are

17  received or prepared by any agency that regularly receives or

18  prepares information from or concerning the parties to motor

19  vehicle crashes are confidential and exempt from s. 119.07(1)

20  and s. 24(a), Art. I of the State Constitution for a period of

21  60 days after the date the report is filed. However, such

22  reports may be made immediately available to the parties

23  involved in the crash, their legal representatives, their

24  licensed insurance agents, their insurers or insurers to which

25  they have applied for coverage, persons under contract with

26  such insurers to provide claims or underwriting information,

27  prosecutorial authorities, radio and television stations

28  licensed by the Federal Communications Commission, newspapers

29  qualified to publish legal notices under ss. 50.011 and

30  50.031, and free newspapers of general circulation, published

31  once a week or more often, available and of interest to the

                                  7

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  public generally for the dissemination of news. For the

 2  purposes of this section, the following products or

 3  publications are not newspapers as referred to in this

 4  section: those intended primarily for members of a particular

 5  profession or occupational group; those with the primary

 6  purpose of distributing advertising; and those with the

 7  primary purpose of publishing names and other personally

 8  identifying information concerning parties to motor vehicle

 9  crashes. Any local, state, or federal agency, agent, or

10  employee that is authorized to have access to such reports by

11  any provision of law shall be granted such access in the

12  furtherance of the agency's statutory duties notwithstanding

13  the provisions of this paragraph. Any local, state, or federal

14  agency, agent, or employee receiving such crash reports shall

15  maintain the confidential and exempt status of those reports

16  and shall not disclose such crash reports to any person or

17  entity. As a condition precedent to accessing a Any person

18  attempting to access crash report reports within 60 days after

19  the date the report is filed, a person must present a valid

20  driver's license or other photographic identification, proof

21  of status legitimate credentials or identification that

22  demonstrates his or her qualifications to access that

23  information, and file a written sworn statement with the state

24  or local agency in possession of the information stating that

25  information from a crash report made confidential by this

26  section will not be used for any commercial solicitation of

27  accident victims, or knowingly disclosed to any third party

28  for the purpose of such solicitation, during the period of

29  time that the information remains confidential. In lieu of

30  requiring such photographic identification, proof of

31  qualifications, and written sworn statement, an agency may

                                  8

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  provide crash reports by electronic means to third-party

 2  vendors approved by the Division of Insurance Fraud of the

 3  Department of Financial Services, which vendors contractually

 4  agree and represent that information from a crash report made

 5  confidential by this section will not be used for any

 6  commercial solicitation of accident victims by the vendors, or

 7  knowingly disclosed to any third party for the purpose of such

 8  solicitation, during the period of time that the information

 9  remains confidential, and which vendors contractually agree

10  with the division to provide such crash reports solely to

11  insurers and to obtain from such insurers their agreement and

12  representation to use such reports solely for the adjustment

13  and investigations of claims and underwriting purposes. This

14  subsection does not prevent the dissemination or publication

15  of news to the general public by any legitimate media entitled

16  to access confidential information pursuant to this section. A

17  law enforcement officer as defined in s. 943.10(1) may enforce

18  this subsection. This exemption is subject to the Open

19  Government Sunset Review Act of 1995 in accordance with s.

20  119.15, and shall stand repealed on October 2, 2006, unless

21  reviewed and saved from repeal through reenactment by the

22  Legislature.

23         (d)  Any employee of a state or local agency in

24  possession of information made confidential by this section

25  who knowingly discloses such confidential information to a

26  person not entitled to access such information under this

27  section is guilty of a felony of the third degree, punishable

28  as provided in s. 775.082, s. 775.083, or s. 775.084.

29         (e)  Any person, knowing that he or she is not entitled

30  to obtain information made confidential by this section, who

31  obtains or attempts to obtain such information is guilty of a

                                  9

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  felony of the third degree, punishable as provided in s.

 2  775.082, s. 775.083, or s. 775.084.

 3         (f)  Any person who knowingly uses confidential

 4  information in violation of a filed written sworn statement or

 5  contractual agreement required by this section commits a

 6  felony of the third degree, punishable as provided in s.

 7  775.082, s. 775.083, or s. 775.084.

 8         Section 4.  Effective October 1, 2003, part XIII of

 9  chapter 400, Florida Statutes, consisting of sections 400.901,

10  400.903, 400.905, 400.907, 400.909, 400.911, 400.913, 400.915,

11  400.917, 400.919, and 400.921 is created to read:

12         400.901  Short title; legislative findings.--

13         (1)  This part, consisting of ss. 400.901-400.921, may

14  be cited as the "Health Care Clinic Act."

15         (2)  The Legislature finds that the regulation of

16  health care clinics must be strengthened to prevent

17  significant cost and harm to consumers. The purpose of this

18  part is to provide for the licensure, establishment, and

19  enforcement of basic standards for health care clinics and to

20  provide administrative oversight by the Agency for Health Care

21  Administration.

22         400.903  Definitions.--

23         (1)  "Agency" means the Agency for Health Care

24  Administration.

25         (2)  "Applicant" means an individual owner,

26  corporation, partnership, firm, business, association, or

27  other entity that owns or controls, directly or indirectly, 5

28  percent or more of an interest in the clinic and that applies

29  for a clinic license.

30         (3)  "Clinic" means an entity at which health care

31  services are provided to individuals and which tenders charges

                                  10

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  for reimbursement for such services. For purposes of this part

 2  the term does not include and the licensure requirements of

 3  this part do not apply to:

 4         (a)  Entities licensed or registered by the state under

 5  chapter 390, chapter 394, chapter 395, chapter 397, this

 6  chapter, chapter 463, chapter 465, chapter 466, chapter 478,

 7  chapter 480, chapter 484, or chapter 651.

 8         (b)  Entities that own, directly or indirectly,

 9  entities licensed or registered by the state pursuant to

10  chapter 390, chapter 394, chapter 395, chapter 397, this

11  chapter, chapter 463, chapter 465, chapter 466, chapter 478,

12  chapter 480, chapter 484, or chapter 651.

13         (c)  Entities that are owned, directly or indirectly,

14  by an entity licensed or registered by the state pursuant to

15  chapter 390, chapter 394, chapter, 395, chapter 397, this

16  chapter, chapter 463, chapter 465, chapter 466, chapter 478,

17  chapter 480, chapter 484, or chapter 651.

18         (d)  Entities that are under common ownership, directly

19  or indirectly, with an entity licensed or registered by the

20  state pursuant to chapter 390, chapter 394, chapter 395,

21  chapter 397, this chapter, chapter 463, chapter 465, chapter

22  466, chapter 478, chapter 480, chapter 484, or chapter 651.

23         (e)  An entity that is exempt from federal taxation

24  under 26 U.S.C. s. 501(c)(3) and any community college or

25  university clinic.

26         (f)  A sole proprietorship, group practice,

27  partnership, or corporation that provides health care services

28  by licensed health care practitioners under chapter 457,

29  chapter 458, chapter 459, chapter 460, chapter 461, chapter

30  462, chapter 463, chapter 466, chapter 467, chapter 484,

31  chapter 486, chapter 490, chapter 491, or part I, part III,

                                  11

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  part X, part XIII, or part XIV of chapter 468, or s. 464.012,

 2  which are wholly owned by a licensed health care practitioner,

 3  or the licensed health care practitioner and the spouse,

 4  parent, or child of a licensed health care practitioner, so

 5  long as one of the owners who is a licensed health care

 6  practitioner is supervising the services performed therein and

 7  is legally responsible for the entity's compliance with all

 8  federal and state laws. However, a health care practitioner

 9  may not supervise services beyond the scope of the

10  practitioner's license.

11         (g)  Clinical facilities affiliated with an accredited

12  medical school at which training is provided for medical

13  students, residents, or fellows.

14         (4)  "Medical director" means a physician who is

15  employed or under contract with a clinic and who maintains a

16  full and unencumbered physician license in accordance with

17  chapter 458, chapter 459, chapter 460, or chapter 461.

18  However, if the clinic is limited to providing health care

19  services pursuant to chapter 457, chapter 484, chapter 486,

20  chapter 490, or chapter 491 or part I, part III, part X, part

21  XIII, or part XIV of chapter 468, the clinic may appoint a

22  health care practitioner licensed under that chapter to serve

23  as a clinic director who is responsible for the clinic's

24  activities. A health care practitioner may not serve as the

25  clinic director if the services provided at the clinic are

26  beyond the scope of that practitioner's license.

27         400.905  License requirements; background screenings;

28  prohibitions.--

29         (1)  Each clinic, as defined in s. 400.903, must be

30  licensed and shall at all times maintain a valid license with

31  the agency. Each clinic location shall be licensed separately

                                  12

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  regardless of whether the clinic is operated under the same

 2  business name or management as another clinic. Mobile clinics

 3  must perform health care services only at a single location.

 4         (2)  The initial clinic license application shall be

 5  filed with the agency by all clinics, as defined in s.

 6  400.903, on or before March 1, 2004. A clinic license must be

 7  renewed biennially.

 8         (3)  Applicants that submit an application on or before

 9  March 1, 2004, which meets all requirements for initial

10  licensure as specified in this section shall receive a

11  temporary license until the completion of an initial

12  inspection verifying that the applicant meets all requirements

13  in rules authorized by s. 400.911. However, a clinic engaged

14  in magnetic resonance imaging services may not receive a

15  temporary license unless it presents evidence satisfactory to

16  the agency that such clinic is making a good-faith effort and

17  substantial progress in seeking accreditation required under

18  s. 400.915.

19         (4)  Application for an initial clinic license or for

20  renewal of an existing license shall be notarized on forms

21  furnished by the agency and must be accompanied by the

22  appropriate license fee as provided in s. 400.911. The agency

23  shall take final action on an initial license application

24  within 60 days after receipt of all required documentation.

25         (5)  The application shall contain information that

26  includes, but need not be limited to, information pertaining

27  to the name, residence and business address, phone number,

28  social security number, and license number of the medical or

29  clinic director, of the licensed medical providers employed or

30  under contract with the clinic, and of each person who,

31  

                                  13

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  directly or indirectly, owns or controls 5 percent or more of

 2  an interest in the clinic.

 3         (6)  The applicant must file with the application

 4  satisfactory proof that the clinic is in compliance with this

 5  part and applicable rules, including:

 6         (a)  A listing of services to be provided either

 7  directly by the applicant or through contractual arrangements

 8  with existing providers;

 9         (b)  The number and discipline of each professional

10  staff member to be employed; and

11         (c)  Proof of financial ability to operate. An

12  applicant must demonstrate financial ability to operate a

13  clinic by submitting a balance sheet and an income and expense

14  statement for the first year of operation which provide

15  evidence of the applicant's having sufficient assets, credit,

16  and projected revenues to cover liabilities and expenses. The

17  applicant shall have demonstrated financial ability to operate

18  if the applicant's assets, credit, and projected revenues meet

19  or exceed projected liabilities and expenses. All documents

20  required under this subsection must be prepared in accordance

21  with generally accepted accounting principles, may be in a

22  compilation form, and the financial statement must be signed

23  by a certified public accountant.

24         (7)  Each applicant for licensure shall comply with the

25  following requirements:

26         (a)  As used in this subsection, the term "applicant"

27  means individuals owning or controlling, directly or

28  indirectly, 5 percent or more of an interest in a clinic; the

29  medical or clinic director, or a similarly titled person who

30  is responsible for the day-to-day operation of the licensed

31  clinic; the financial officer or similarly titled individual

                                  14

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  who is responsible for the financial operation of the clinic;

 2  and licensed medical providers at the clinic.

 3         (b)  Upon receipt of a completed, signed, and dated

 4  application, the agency shall require background screening of

 5  the applicant, in accordance with the level 2 standards for

 6  screening set forth in chapter 435. Proof of compliance with

 7  the level 2 background screening requirements of chapter 435

 8  which has been submitted within the previous 5 years in

 9  compliance with any other health care licensure requirements

10  of this state is acceptable in fulfillment of this paragraph.

11         (c)  Each applicant must submit to the agency, with the

12  application, a description and explanation of any exclusions,

13  permanent suspensions, or terminations of an applicant from

14  the Medicare or Medicaid programs. Proof of compliance with

15  the requirements for disclosure of ownership and control

16  interest under the Medicaid or Medicare programs may be

17  accepted in lieu of this submission. The description and

18  explanation may indicate whether such exclusions, suspensions,

19  or terminations were voluntary or not voluntary on the part of

20  the applicant.

21         (d)  A license may not be granted to a clinic if the

22  applicant has been found guilty of, regardless of

23  adjudication, or has entered a plea of nolo contendere or

24  guilty to, any offense prohibited under the level 2 standards

25  for screening set forth in chapter 435, or a violation of

26  insurance fraud under s. 817.234, within the past 5 years. If

27  the applicant has been convicted of an offense prohibited

28  under the level 2 standards or insurance fraud in any

29  jurisdiction, the applicant must show that his or her civil

30  rights have been restored prior to submitting an application.

31  

                                  15

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (e)  The agency may deny or revoke licensure if the

 2  applicant has falsely represented any material fact or omitted

 3  any material fact from the application required by this part.

 4         (8)  Requested information omitted from an application

 5  for licensure, license renewal, or transfer of ownership must

 6  be filed with the agency within 21 days after receipt of the

 7  agency's request for omitted information, or the application

 8  shall be deemed incomplete and shall be withdrawn from further

 9  consideration.

10         (9)  The failure to file a timely renewal application

11  shall result in a late fee charged to the facility in an

12  amount equal to 50 percent of the current license fee.

13         400.907  Clinic inspections; emergency suspension;

14  costs.--

15         (1)  Any authorized officer or employee of the agency

16  shall make inspections of the clinic as part of the initial

17  license application or renewal application. The application

18  for a clinic license issued under this part or for a renewal

19  license constitutes permission for an appropriate agency

20  inspection to verify the information submitted on or in

21  connection with the application or renewal.

22         (2)  An authorized officer or employee of the agency

23  may make unannounced inspections of clinics licensed pursuant

24  to this part as are necessary to determine that the clinic is

25  in compliance with this part and with applicable rules. A

26  licensed clinic shall allow full and complete access to the

27  premises and to billing records or information to any

28  representative of the agency who makes an inspection to

29  determine compliance with this part and with applicable rules.

30         (3)  Failure by a clinic licensed under this part to

31  allow full and complete access to the premises and to billing

                                  16

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  records or information to any representative of the agency who

 2  makes a request to inspect the clinic to determine compliance

 3  with this part or failure by a clinic to employ a qualified

 4  medical director or clinic director constitutes a ground for

 5  emergency suspension of the license by the agency pursuant to

 6  s. 120.60(6).

 7         (4)  In addition to any administrative fines imposed,

 8  the agency may assess a fee equal to the cost of conducting a

 9  complaint investigation.

10         400.909  License renewal; transfer of ownership;

11  provisional license.--

12         (1)  An application for license renewal must contain

13  information as required by the agency.

14         (2)  Ninety days before the expiration date, an

15  application for renewal must be submitted to the agency.

16         (3)  The clinic must file with the renewal application

17  satisfactory proof that it is in compliance with this part and

18  applicable rules. If there is evidence of financial

19  instability, the clinic must submit satisfactory proof of its

20  financial ability to comply with the requirements of this

21  part.

22         (4)  When transferring the ownership of a clinic, the

23  transferee must submit an application for a license at least

24  60 days before the effective date of the transfer.

25         (5)  The license may not be sold, leased, assigned, or

26  otherwise transferred, voluntarily or involuntarily, and is

27  valid only for the clinic owners and location for which

28  originally issued.

29         (6)  A clinic against whom a revocation or suspension

30  proceeding is pending at the time of license renewal may be

31  issued a provisional license effective until final disposition

                                  17

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  by the agency of such proceedings. If judicial relief is

 2  sought from the final disposition, the agency that has

 3  jurisdiction may issue a temporary permit for the duration of

 4  the judicial proceeding.

 5         400.911  Rulemaking authority; license fees.--

 6         (1)  The agency shall adopt rules necessary to

 7  administer the clinic administration, regulation, and

 8  licensure program, including rules establishing the specific

 9  licensure requirements, procedures, forms, and fees. It shall

10  adopt rules establishing a procedure for the biennial renewal

11  of licenses. The rules shall specify the expiration dates of

12  licenses, the process of tracking compliance with financial

13  responsibility requirements, and any other conditions of

14  renewal required by law or rule.

15         (2)  The agency shall adopt rules specifying

16  limitations on the number of licensed clinics and licensees

17  for which a medical director or a clinic director may assume

18  responsibility for purposes of this part. In determining the

19  quality of supervision a medical director or a clinic director

20  can provide, the agency shall consider the number of clinic

21  employees, the clinic location, and the health care services

22  provided by the clinic.

23         (3)  License application and renewal fees must be

24  reasonably calculated by the agency to cover its costs in

25  carrying out its responsibilities under this part, including

26  the cost of licensure, inspection, and regulation of clinics,

27  and must be of such amount that the total fees collected do

28  not exceed the cost of administering and enforcing compliance

29  with this part. Clinic licensure fees are nonrefundable and

30  may not exceed $2,000. The agency shall adjust the license fee

31  annually by not more than the change in the Consumer Price

                                  18

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  Index based on the 12 months immediately preceding the

 2  increase. All fees collected under this part must be deposited

 3  in the Health Care Trust Fund for the administration of this

 4  part.

 5         400.913  Unlicensed clinics; penalties; fines;

 6  verification of licensure status.--

 7         (1)  It is unlawful to own, operate, or maintain a

 8  clinic without obtaining a license under this part.

 9         (2)  Any person who owns, operates, or maintains an

10  unlicensed clinic commits a felony of the third degree,

11  punishable as provided in s. 775.082, s. 775.083, or s.

12  775.084. Each day of continued operation is a separate

13  offense.

14         (3)  Any person found guilty of violating subsection

15  (2) a second or subsequent time commits a felony of the second

16  degree, punishable as provided under s. 775.082, s. 775.083,

17  or s. 775.084. Each day of continued operation is a separate

18  offense.

19         (4)  Any person who owns, operates, or maintains an

20  unlicensed clinic due to a change in this part or a

21  modification in agency rules within 6 months after the

22  effective date of such change or modification and who, within

23  10 working days after receiving notification from the agency,

24  fails to cease operation or apply for a license under this

25  part commits a felony of the third degree, punishable as

26  provided in s. 775.082, s. 775.083, or s. 775.084. Each day of

27  continued operation is a separate offense.

28         (5)  Any clinic that fails to cease operation after

29  agency notification may be fined for each day of noncompliance

30  pursuant to this part.

31  

                                  19

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (6)  When a person has an interest in more than one

 2  clinic, and fails to obtain a license for any one of these

 3  clinics, the agency may revoke the license, impose a

 4  moratorium, or impose a fine pursuant to this part on any or

 5  all of the licensed clinics until such time as the unlicensed

 6  clinic is licensed or ceases operation.

 7         (7)  Any person aware of the operation of an unlicensed

 8  clinic must report that facility to the agency.

 9         (8)  Any health care provider who is aware of the

10  operation of an unlicensed clinic shall report that facility

11  to the agency. Failure to report a clinic that the provider

12  knows or has reasonable cause to suspect is unlicensed shall

13  be reported to the provider's licensing board.

14         (9)  The agency may not issue a license to a clinic

15  that has any unpaid fines assessed under this part.

16         400.915  Clinic responsibilities.--

17         (1)  Each clinic shall appoint a medical director or

18  clinic director who shall agree in writing to accept legal

19  responsibility for the following activities on behalf of the

20  clinic. The medical director or the clinic director shall:

21         (a)  Have signs identifying the medical director or

22  clinic director posted in a conspicuous location within the

23  clinic readily visible to all patients.

24         (b)  Ensure that all practitioners providing health

25  care services or supplies to patients maintain a current

26  active and unencumbered Florida license.

27         (c)  Review any patient referral contracts or

28  agreements executed by the clinic.

29         (d)  Ensure that all health care practitioners at the

30  clinic have active appropriate certification or licensure for

31  the level of care being provided.

                                  20

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (e)  Serve as the clinic records owner as defined in s.

 2  456.057.

 3         (f)  Ensure compliance with the recordkeeping, office

 4  surgery, and adverse incident reporting requirements of

 5  chapter 456, the respective practice acts, and rules adopted

 6  under this part.

 7         (g)  Conduct systematic reviews of clinic billings to

 8  ensure that the billings are not fraudulent or unlawful. Upon

 9  discovery of an unlawful charge, the medical director or

10  clinic director shall take immediate corrective action.

11         (2)  Any business that becomes a clinic after

12  commencing operations must, within 5 days after becoming a

13  clinic, file a license application under this part and shall

14  be subject to all provisions of this part applicable to a

15  clinic.

16         (3)  Any contract to serve as a medical director or a

17  clinic director entered into or renewed by a physician or a

18  licensed health care practitioner in violation of this part is

19  void as contrary to public policy. This subsection shall apply

20  to contracts entered into or renewed on or after March 1,

21  2004.

22         (4)  All charges or reimbursement claims made by or on

23  behalf of a clinic that is required to be licensed under this

24  part, but that is not so licensed, or that is otherwise

25  operating in violation of this part, are unlawful charges, and

26  therefore are noncompensable and unenforceable.

27         (5)  Any person establishing, operating, or managing an

28  unlicensed clinic otherwise required to be licensed under this

29  part, or any person who knowingly files a false or misleading

30  license application or license renewal application, or false

31  or misleading information related to such application or

                                  21

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  department rule, commits a felony of the third degree,

 2  punishable as provided in s. 775.082, s. 775.083, or s.

 3  775.084.

 4         (6)  Any licensed health care provider who violates

 5  this part is subject to discipline in accordance with this

 6  chapter and his or her respective practice act.

 7         (7)  The agency may fine, or suspend or revoke the

 8  license of, any clinic licensed under this part for operating

 9  in violation of the requirements of this part or the rules

10  adopted by the agency.

11         (8)  The agency shall investigate allegations of

12  noncompliance with this part and the rules adopted under this

13  part.

14         (9)  Any person or entity providing health care

15  services which is not a clinic, as defined under s. 400.903,

16  may voluntarily apply for licensure under its exempt status

17  with the agency on a form that sets forth its name or names

18  and addresses, a statement of the reasons why it cannot be

19  defined as a clinic, and other information deemed necessary by

20  the agency.

21         (10)  The clinic shall display its license in a

22  conspicuous location within the clinic readily visible to all

23  patients.

24         (11)(a)  Each clinic engaged in magnetic resonance

25  imaging services must be accredited by the Joint Commission on

26  Accreditation of Healthcare Organizations, the American

27  College of Radiology, or the Accreditation Association for

28  Ambulatory Health Care, within 1 year after licensure.

29  However, a clinic may request a single, 6-month extension if

30  it provides evidence to the agency establishing that, for good

31  cause shown, such clinic can not be accredited within 1 year

                                  22

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  after licensure, and that such accreditation will be completed

 2  within the 6-month extension.

 3         (b)  The agency may disallow the application of any

 4  entity formed for the purpose of avoiding compliance with the

 5  accreditation provisions of this subsection and whose

 6  principals were previously principals of an entity that was

 7  unable to meet the accreditation requirements within the

 8  specified timeframes. The agency may adopt rules as to the

 9  accreditation of magnetic resonance imaging clinics.

10         (12)  The agency shall give full faith and credit

11  pertaining to any past variance and waiver granted to a

12  magnetic resonance imaging clinic from Rule 64-2002, Florida

13  Administrative Code, by the Department of Health, until

14  September 2004. After that date, such clinic must request a

15  variance and waiver from the agency under s. 120.542.

16         400.917  Injunctions.--

17         (1)  The agency may institute injunctive proceedings in

18  a court of competent jurisdiction in order to:

19         (a)  Enforce the provisions of this part or any minimum

20  standard, rule, or order issued or entered into pursuant to

21  this part if the attempt by the agency to correct a violation

22  through administrative fines has failed; if the violation

23  materially affects the health, safety, or welfare of clinic

24  patients; or if the violation involves any operation of an

25  unlicensed clinic.

26         (b)  Terminate the operation of a clinic if a violation

27  of any provision of this part, or any rule adopted pursuant to

28  this part, materially affects the health, safety, or welfare

29  of clinic patients.

30         (2)  Such injunctive relief may be temporary or

31  permanent.

                                  23

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (3)  If action is necessary to protect clinic patients

 2  from life-threatening situations, the court may allow a

 3  temporary injunction without bond upon proper proof being

 4  made. If it appears by competent evidence or a sworn,

 5  substantiated affidavit that a temporary injunction should

 6  issue, the court, pending the determination on final hearing,

 7  shall enjoin operation of the clinic.

 8         400.919  Agency actions.--Administrative proceedings

 9  challenging agency licensure enforcement action shall be

10  reviewed on the basis of the facts and conditions that

11  resulted in the agency action.

12         400.921  Agency administrative penalties.--

13         (1)  The agency may impose administrative penalties

14  against clinics of up to $5,000 per violation for violations

15  of the requirements of this part. In determining if a penalty

16  is to be imposed and in fixing the amount of the fine, the

17  agency shall consider the following factors:

18         (a)  The gravity of the violation, including the

19  probability that death or serious physical or emotional harm

20  to a patient will result or has resulted, the severity of the

21  action or potential harm, and the extent to which the

22  provisions of the applicable laws or rules were violated.

23         (b)  Actions taken by the owner, medical director, or

24  clinic director to correct violations.

25         (c)  Any previous violations.

26         (d)  The financial benefit to the clinic of committing

27  or continuing the violation.

28         (2)  Each day of continuing violation after the date

29  fixed for termination of the violation, as ordered by the

30  agency, constitutes an additional, separate, and distinct

31  violation.

                                  24

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (3)  Any action taken to correct a violation shall be

 2  documented in writing by the owner, medical director, or

 3  clinic director of the clinic and verified through followup

 4  visits by agency personnel. The agency may impose a fine and,

 5  in the case of an owner-operated clinic, revoke or deny a

 6  clinic's license when a clinic medical director or clinic

 7  director fraudulently misrepresents actions taken to correct a

 8  violation.

 9         (4)  For fines that are upheld following administrative

10  or judicial review, the violator shall pay the fine, plus

11  interest at the rate as specified in s. 55.03, for each day

12  beyond the date set by the agency for payment of the fine.

13         (5)  Any unlicensed clinic that continues to operate

14  after agency notification is subject to a $1,000 fine per day.

15         (6)  Any licensed clinic whose owner, medical director,

16  or clinic director concurrently operates an unlicensed clinic

17  shall be subject to an administrative fine of $5,000 per day.

18         (7)  Any clinic whose owner fails to apply for a

19  change-of-ownership license in accordance with s. 400.909 and

20  operates the clinic under the new ownership is subject to a

21  fine of $5,000.

22         (8)  The agency, as an alternative to or in conjunction

23  with an administrative action against a clinic for violations

24  of this part and adopted rules, shall make a reasonable

25  attempt to discuss each violation and recommended corrective

26  action with the owner, medical director, or clinic director of

27  the clinic, prior to written notification. The agency, instead

28  of fixing a period within which the clinic shall enter into

29  compliance with standards, may request a plan of corrective

30  action from the clinic which demonstrates a good-faith effort

31  

                                  25

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  to remedy each violation by a specific date, subject to the

 2  approval of the agency.

 3         (9)  Administrative fines paid by any clinic under this

 4  section shall be deposited into the Health Care Trust Fund.

 5         Section 5.  Paragraph (b) of subsection (1) of section

 6  456.0375, Florida Statutes, is amended to read:

 7         456.0375  Registration of certain clinics;

 8  requirements; discipline; exemptions.--

 9         (1)

10         (b)  For purposes of this section, the term "clinic"

11  does not include and the registration requirements herein do

12  not apply to:

13         1.  Entities licensed or registered by the state

14  pursuant to chapter 390, chapter 394, chapter 395, chapter

15  397, chapter 400, chapter 463, chapter 465, chapter 466,

16  chapter 478, chapter 480, or chapter 484, or chapter 651.

17         2.  Entities that own, directly or indirectly, entities

18  licensed or registered by the state pursuant to chapter 390,

19  chapter 394, chapter 395, chapter 397, chapter 400, chapter

20  463, chapter 465, chapter 466, chapter 478, chapter 480,

21  chapter 484, or chapter 651.

22         3.  Entities that are owned, directly or indirectly, by

23  an entity licensed or registered by the state pursuant to

24  chapter 390, chapter 394, chapter 395, chapter 397, chapter

25  400, chapter 463, chapter 465, chapter 466, chapter 478,

26  chapter 480, chapter 484, or chapter 651.

27         4.  Entities that are under common ownership, directly

28  or indirectly, with an entity licensed or registered by the

29  state pursuant to chapter 390, chapter 394, chapter 395,

30  chapter 397, chapter 400, chapter 463, chapter 465, chapter

31  466, chapter 478, chapter 480, chapter 484, or chapter 651.

                                  26

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         5.2.  Entities exempt from federal taxation under 26

 2  U.S.C. s. 501(c)(3) and community college and university

 3  clinics.

 4         6.3.  Sole proprietorships, group practices,

 5  partnerships, or corporations that provide health care

 6  services by licensed health care practitioners pursuant to

 7  chapters 457, 458, 459, 460, 461, 462, 463, 466, 467, 484,

 8  486, 490, 491, or part I, part III, part X, part XIII, or part

 9  XIV of chapter 468, or s. 464.012, which are wholly owned by

10  licensed health care practitioners or the licensed health care

11  practitioner and the spouse, parent, or child of a licensed

12  health care practitioner, so long as one of the owners who is

13  a licensed health care practitioner is supervising the

14  services performed therein and is legally responsible for the

15  entity's compliance with all federal and state laws. However,

16  no health care practitioner may supervise services beyond the

17  scope of the practitioner's license.

18         7.  Clinical facilities affiliated with an accredited

19  medical school at which training is provided for medical

20  students, residents, or fellows.

21         Section 6.  Paragraphs (dd) and (ee) are added to

22  subsection (1) of section 456.072, Florida Statutes, to read:

23         456.072  Grounds for discipline; penalties;

24  enforcement.--

25         (1)  The following acts shall constitute grounds for

26  which the disciplinary actions specified in subsection (2) may

27  be taken:

28         (dd)  With respect to making a personal injury

29  protection claim as required by s. 627.736, intentionally

30  submitting a claim, statement, or bill that has been upcoded.

31  "Upcoding" means an action that submits a billing code that

                                  27

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  would result in payment greater in amount than would be paid

 2  using a billing code that accurately describes the services

 3  performed. "Upcoding" does not include an otherwise lawful

 4  bill by an independent diagnostic testing facility, as defined

 5  in s. 627.732, which globally combines both technical and

 6  professional components for services listed in that

 7  definition, if the amount of the global bill is not more than

 8  the components if billed separately; however, payment of such

 9  a bill constitutes payment in full for all components of such

10  service.

11         (ee)  With respect to making a personal injury

12  protection claim as required by s. 627.736, intentionally

13  submitting a claim, statement, or bill for payment of services

14  that were not rendered.

15         Section 7.  Subsection (11) of section 626.7451,

16  Florida Statutes, is amended to read:

17         626.7451  Managing general agents; required contract

18  provisions.--No person acting in the capacity of a managing

19  general agent shall place business with an insurer unless

20  there is in force a written contract between the parties which

21  sets forth the responsibility for a particular function,

22  specifies the division of responsibilities, and contains the

23  following minimum provisions:

24         (11)  A licensed managing general agent, when placing

25  business with an insurer under this code, may charge a

26  per-policy fee not to exceed $40 $25.  In no instance shall

27  the aggregate of per-policy fees for a placement of business

28  authorized under this section, when combined with any other

29  per-policy fee charged by the insurer, result in per-policy

30  fees which exceed the aggregate amount of $40 $25.  The

31  per-policy fee shall be a component of the insurer's rate

                                  28

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  filing and shall be fully earned. A managing general agent

 2  that collects a per-policy fee shall remit a minimum of $5 per

 3  policy to the insurer for the funding of a Special

 4  Investigations Unit dedicated to the prevention of insurance

 5  fraud; $2 per policy to the Division of Insurance Fraud of the

 6  Department of Financial Services, which shall be dedicated to

 7  the prevention and detection of insurance fraud; and $3 per

 8  policy to the Office of Statewide Prosecution, which shall be

 9  dedicated to the prosecution of insurance fraud. Any insurer

10  that writes directly without a managing general agent and that

11  charges a per-policy fee may charge an additional policy fee

12  up to $5 per policy to fund its Special Investigations Unit,

13  which shall be dedicated to the prevention of insurance fraud;

14  up to $2 per policy to be remitted to the Division of

15  Insurance Fraud of the Department of Financial Services, which

16  shall be dedicated to the prevention and detection of

17  insurance fraud; and up to $3 per policy to the Office of

18  Statewide Prosecution, which shall be dedicated to the

19  prosecution of insurance fraud.

20  

21  For the purposes of this section and ss. 626.7453 and

22  626.7454, the term "controlling person" or "controlling" has

23  the meaning set forth in s. 625.012(5)(b)1., and the term

24  "controlled person" or "controlled" has the meaning set forth

25  in s. 625.012(5)(b)2.

26         Section 8.  Subsection (1) of section 627.732, Florida

27  Statutes, is amended, and subsections (8) through (19) are

28  added to that section, to read:

29         627.732  Definitions.--As used in ss. 627.730-627.7405,

30  the term:

31  

                                  29

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (1)  "Broker" means any person not possessing a license

 2  under chapter 395, chapter 400, chapter 458, chapter 459,

 3  chapter 460, chapter 461, or chapter 641 who charges or

 4  receives compensation for any use of medical equipment and is

 5  not the 100-percent owner or the 100-percent lessee of such

 6  equipment. For purposes of this section, such owner or lessee

 7  may be an individual, a corporation, a partnership, or any

 8  other entity and any of its 100-percent-owned affiliates and

 9  subsidiaries. For purposes of this subsection, the term

10  "lessee" means a long-term lessee under a capital or operating

11  lease, but does not include a part-time lessee. The term

12  "broker" does not include a hospital or physician management

13  company whose medical equipment is ancillary to the practices

14  managed, a debt collection agency, or an entity that has

15  contracted with the insurer to obtain a discounted rate for

16  such services; nor does the term include a management company

17  that has contracted to provide general management services for

18  a licensed physician or health care facility and whose

19  compensation is not materially affected by the usage or

20  frequency of usage of medical equipment or an entity that is

21  100-percent owned by one or more hospitals or physicians. The

22  term "broker" does not include a person or entity that

23  certifies, upon request of an insurer, that:

24         (a)  It is a clinic registered under s. 456.0375;

25         (b)  It is a 100-percent owner of medical equipment;

26  and

27         (c)  The owner's only part-time lease of medical

28  equipment for personal injury protection patients is on a

29  temporary basis not to exceed 30 days in a 12-month period,

30  and such lease is solely for the purposes of necessary repair

31  or maintenance of the 100-percent-owned medical equipment or

                                  30

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  pending the arrival and installation of the newly purchased or

 2  a replacement for the 100-percent-owned medical equipment, or

 3  for patients for whom, because of physical size or

 4  claustrophobia, it is determined by the medical director or

 5  clinical director to be medically necessary that the test be

 6  performed in medical equipment that is open-style. The leased

 7  medical equipment cannot be used by patients who are not

 8  patients of the registered clinic for medical treatment of

 9  services. Any person or entity making a false certification

10  under this subsection commits insurance fraud as defined in s.

11  817.234. However, the 30-day period provided in this paragraph

12  may be extended for an additional 60 days as applicable to

13  magnetic resonance imaging equipment if the owner certifies

14  that the extension otherwise complies with this paragraph.

15         (8)  "Certify" means to swear or attest to being true

16  or represented in writing.

17         (9)  "Countersigned" means a second or verifying

18  signature, as on a previously signed document, and is not

19  satisfied by the statement "signature on file" or any similar

20  statement.

21         (10)  "Immediate personal supervision," as it relates

22  to the performance of medical services by nonphysicians not in

23  a hospital, means that an individual licensed to perform the

24  medical service or provide the medical supplies must be

25  present within the confines of the physical structure where

26  the medical services are performed or where the medical

27  supplies are provided such that the licensed individual can

28  physically see the activities of all employees and respond

29  immediately to any emergencies if needed.

30         (11)  "Incident," with respect to services considered

31  as incident to a physician's professional service, for a

                                  31

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  physician licensed under chapter 458, chapter 459, chapter

 2  460, or chapter 461, if not furnished in a hospital, means

 3  such services must be an integral, even if incidental, part of

 4  a covered physician's service.

 5         (12)  "Knowingly" means that a person, with respect to

 6  information, has actual knowledge of the information; acts in

 7  deliberate ignorance of the truth or falsity of the

 8  information; or acts in reckless disregard of the information,

 9  and proof of specific intent to defraud is not required.

10         (13)  "Lawful" or "lawfully" means in compliance with

11  all applicable criminal, civil, and administrative

12  requirements of state and federal law related to the provision

13  of medical services or treatment.

14         (14)  "Hospital" means a facility that, at the time

15  services or treatment were rendered, was licensed under

16  chapter 395.

17         (15)  "Properly completed" means providing truthful,

18  complete, and accurate responses to each applicable request

19  for information or statement by a means that may lawfully be

20  provided and that complies with this section, or as agreed by

21  the parties.

22         (16)  "Render," with respect to the license required in

23  the performance of medical services or treatment, means to

24  have properly licensed personnel actually physically perform

25  the medical service or physically transfer the supplies to the

26  insured incident to the provider's professional services. The

27  term does not include scheduling medical services or ordering

28  medical supplies for the insured.

29         (17)  "Upcoding" means an action that submits a billing

30  code that would result in payment greater in amount than would

31  be paid using a billing code that accurately describes the

                                  32

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  services performed. The term does not include an otherwise

 2  lawful bill by an independent diagnostic treating facility,

 3  which globally combines both technical and professional

 4  components for services listed in that definition, if the

 5  amount of the global bill is not more than the components if

 6  billed separately; however, payment of such a bill constitutes

 7  payment in full for all components of such service.

 8         (18)  "Unbundling" means an action that submits a

 9  billing code that is properly billed under one billing code,

10  but that has been separated into two or more billing codes,

11  and would result in payment greater in amount than would be

12  paid using one billing code.

13         (19)  "Independent diagnostic testing facility" means a

14  fixed facility that performs the technical component of

15  magnetic resonance imaging, static radiographs (static X ray),

16  computer tomography, positron emission tomography, and also

17  provides the professional components of such services through

18  either an employee or independent contractor, if:

19         (a)  No person ordering or prescribing such services

20  has any financial interest in the facility providing such

21  services and no such person receives any consideration

22  directly or indirectly from such facility for ordering or

23  prescribing such services; and

24         (b)  The facility does not directly or indirectly

25  provide therapy or treatment services to patients for which it

26  also provides such diagnostic services.

27         Section 9.  Subsections (3), (4), (5), (6), (7), (8),

28  (10), and (11) of section 627.736, Florida Statutes, are

29  amended, present subsection (12) of that section is

30  redesignated as subsection (14) and amended, and new

31  

                                  33

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  subsections (12), (13), and (15) are added to that section, to

 2  read:

 3         627.736  Required personal injury protection benefits;

 4  exclusions; priority; claims.--

 5         (3)  INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN

 6  TORT CLAIMS.--No insurer shall have a lien on any recovery in

 7  tort by judgment, settlement, or otherwise for personal injury

 8  protection benefits, whether suit has been filed or settlement

 9  has been reached without suit.  An injured party who is

10  entitled to bring suit under the provisions of ss.

11  627.730-627.7405, or his or her legal representative, shall

12  have no right to recover any damages for which personal injury

13  protection benefits are paid or payable. The plaintiff may

14  prove all of his or her special damages notwithstanding this

15  limitation, but if special damages are introduced in evidence,

16  the trier of facts, whether judge or jury, shall not award

17  damages for personal injury protection benefits paid or

18  payable.  In all cases in which a jury is required to fix

19  damages, the court shall instruct the jury that the plaintiff

20  shall not recover such special damages for personal injury

21  protection benefits paid or payable.

22         (4)  BENEFITS; WHEN DUE.--Benefits due from an insurer

23  under ss. 627.730-627.7405 shall be primary, except that

24  benefits received under any workers' compensation law shall be

25  credited against the benefits provided by subsection (1) and

26  shall be due and payable as loss accrues, upon receipt of

27  reasonable proof of such loss and the amount of expenses and

28  loss incurred which are covered by the policy issued under ss.

29  627.730-627.7405. When the Agency for Health Care

30  Administration provides, pays, or becomes liable for medical

31  assistance under the Medicaid program related to injury,

                                  34

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  sickness, disease, or death arising out of the ownership,

 2  maintenance, or use of a motor vehicle, benefits under ss.

 3  627.730-627.7405 shall be subject to the provisions of the

 4  Medicaid program.

 5         (a)  An insurer may require written notice to be given

 6  as soon as practicable after an accident involving a motor

 7  vehicle with respect to which the policy affords the security

 8  required by ss. 627.730-627.7405.

 9         (b)  Personal injury protection insurance benefits paid

10  pursuant to this section shall be overdue if not paid within

11  30 days after the insurer is furnished written notice of the

12  fact of a covered loss and of the amount of same. Written

13  notice for medical benefits, except for services or treatment

14  rendered in a hospital, shall not be considered to have been

15  provided to the insurer unless all the requirements of

16  paragraphs (5)(e) and (f) are met and all of the medical

17  treatment records applicable to the billing for which payment

18  is being requested have been provided to the insurer, to the

19  extent requested by the insurer pursuant to subsection (6). If

20  such written notice is not furnished to the insurer as to the

21  entire claim, any partial amount supported by written notice

22  is overdue if not paid within 30 days after such written

23  notice is furnished to the insurer.  Any part or all of the

24  remainder of the claim that is subsequently supported by

25  written notice is overdue if not paid within 30 days after

26  such written notice is furnished to the insurer. When an

27  insurer pays only a portion of a claim or rejects a claim, the

28  insurer shall provide at the time of the partial payment or

29  rejection an itemized specification of each item that the

30  insurer had reduced, omitted, or declined to pay and any

31  information that the insurer desires the claimant to consider

                                  35

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  related to the medical necessity of the denied treatment or to

 2  explain the reasonableness of the reduced charge, provided

 3  that this shall not limit the introduction of evidence at

 4  trial; and the insurer shall include the name and address of

 5  the person to whom the claimant should respond and a claim

 6  number to be referenced in future correspondence.  However,

 7  notwithstanding the fact that written notice has been

 8  furnished to the insurer, any payment shall not be deemed

 9  overdue when the insurer has reasonable proof to establish

10  that the insurer is not responsible for the payment. For the

11  purpose of calculating the extent to which any benefits are

12  overdue, payment shall be treated as being made on the date a

13  draft or other valid instrument which is equivalent to payment

14  was placed in the United States mail in a properly addressed,

15  postpaid envelope or, if not so posted, on the date of

16  delivery. This paragraph does not preclude or limit the

17  ability of the insurer to assert that the claim was unrelated,

18  was not medically necessary, or was unreasonable or that the

19  amount of the charge was in excess of that permitted under, or

20  in violation of, subsection (5). Such assertion by the insurer

21  may be made at any time, including after payment of the claim

22  or after the 30-day time period for payment set forth in this

23  paragraph.

24         (c)  All overdue payments shall bear simple interest at

25  the rate established by the Comptroller under s. 55.03 or the

26  rate established in the insurance contract, whichever is

27  greater, for the year in which the payment became overdue,

28  calculated from the date the insurer was furnished with

29  written notice of the amount of covered loss. Interest shall

30  be due at the time payment of the overdue claim is made.

31  

                                  36

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (d)  The insurer of the owner of a motor vehicle shall

 2  pay personal injury protection benefits for:

 3         1.  Accidental bodily injury sustained in this state by

 4  the owner while occupying a motor vehicle, or while not an

 5  occupant of a self-propelled vehicle if the injury is caused

 6  by physical contact with a motor vehicle.

 7         2.  Accidental bodily injury sustained outside this

 8  state, but within the United States of America or its

 9  territories or possessions or Canada, by the owner while

10  occupying the owner's motor vehicle.

11         3.  Accidental bodily injury sustained by a relative of

12  the owner residing in the same household, under the

13  circumstances described in subparagraph 1. or subparagraph 2.,

14  provided the relative at the time of the accident is domiciled

15  in the owner's household and is not himself or herself the

16  owner of a motor vehicle with respect to which security is

17  required under ss. 627.730-627.7405.

18         4.  Accidental bodily injury sustained in this state by

19  any other person while occupying the owner's motor vehicle or,

20  if a resident of this state, while not an occupant of a

21  self-propelled vehicle, if the injury is caused by physical

22  contact with such motor vehicle, provided the injured person

23  is not himself or herself:

24         a.  The owner of a motor vehicle with respect to which

25  security is required under ss. 627.730-627.7405; or

26         b.  Entitled to personal injury benefits from the

27  insurer of the owner or owners of such a motor vehicle.

28         (e)  If two or more insurers are liable to pay personal

29  injury protection benefits for the same injury to any one

30  person, the maximum payable shall be as specified in

31  subsection (1), and any insurer paying the benefits shall be

                                  37

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  entitled to recover from each of the other insurers an

 2  equitable pro rata share of the benefits paid and expenses

 3  incurred in processing the claim.

 4         (f)  It is a violation of the insurance code for an

 5  insurer to fail to timely provide benefits as required by this

 6  section with such frequency as to constitute a general

 7  business practice.

 8         (g)  Benefits shall not be due or payable to or on the

 9  behalf of an insured person if that person has committed, by a

10  material act or omission, any insurance fraud relating to

11  personal injury protection coverage under his or her policy,

12  if the fraud is admitted to in a sworn statement by the

13  insured or if it is established in a court of competent

14  jurisdiction. Any insurance fraud shall void all coverage

15  arising from the claim related to such fraud under the

16  personal injury protection coverage of the insured person who

17  committed the fraud, irrespective of whether a portion of the

18  insured person's claim may be legitimate, and any benefits

19  paid prior to the discovery of the insured person's insurance

20  fraud shall be recoverable by the insurer from the person who

21  committed insurance fraud in their entirety. An insurer is

22  entitled to its costs and attorney's fees in any action in

23  which it prevails in enforcing its right of recovery under

24  this paragraph.

25         (5)  CHARGES FOR TREATMENT OF INJURED PERSONS.--

26         (a)  Any physician, hospital, clinic, or other person

27  or institution lawfully rendering treatment to an injured

28  person for a bodily injury covered by personal injury

29  protection insurance may charge the insurer and injured party

30  only a reasonable amount pursuant to this section for the

31  services and supplies rendered, and the insurer providing such

                                  38

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  coverage may pay for such charges directly to such person or

 2  institution lawfully rendering such treatment, if the insured

 3  receiving such treatment or his or her guardian has

 4  countersigned the properly completed invoice, bill, or claim

 5  form approved by the Department of Insurance upon which such

 6  charges are to be paid for as having actually been rendered,

 7  to the best knowledge of the insured or his or her guardian.

 8  In no event, however, may such a charge be in excess of the

 9  amount the person or institution customarily charges for like

10  services or supplies or has agreed to accept or intends to

11  collect as full reimbursement from the particular patient in

12  cases involving no insurance.

13         (b)1.  An insurer or insured is not required to pay a

14  claim or charges:

15         a.  Made by a broker or by a person making a claim on

16  behalf of a broker;.

17         b.  For any service or treatment that was not lawful at

18  the time rendered;

19         c.  To any person who knowingly submits a false or

20  misleading statement relating to the claim or charges;

21         d.  With respect to a bill or statement that does not

22  meet the applicable requirements of paragraph (e);

23         e.  For any treatment or service that is upcoded, or

24  that is unbundled when such treatment or services should be

25  bundled, in accordance with applicable billing standards. To

26  facilitate prompt payment of lawful services, an insurer may

27  change codes that it determines to have been improperly or

28  incorrectly upcoded or unbundled, and may make payment based

29  on the changed codes, without affecting the right of the

30  provider to dispute the change by the insurer, provided that

31  before doing so, the insurer must contact the health care

                                  39

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  provider and discuss the reasons for the insurer's change and

 2  the health care provider's reason for the coding, or make a

 3  reasonable good-faith effort to do so, as documented in the

 4  insurer's file; and

 5         f.  For medical services or treatment billed by a

 6  physician and not provided in a hospital unless such services

 7  are rendered by the physician or are incident to his or her

 8  professional services and are included on the physician's

 9  bill, including documentation verifying that the physician is

10  responsible for the medical services that were rendered and

11  billed.

12         2.  Charges for the professional and technical services

13  of medically necessary cephalic thermograms, peripheral

14  thermograms, spinal ultrasounds, extremity ultrasounds, video

15  fluoroscopy (including, but not limited to, cineradiography,

16  or motion X ray), range of motion testing, muscle strength

17  testing, functional capacity testing, and surface

18  electromyography shall not exceed the maximum reimbursement

19  allowance for such procedures as set forth in the applicable

20  fee schedule or other payment methodology established pursuant

21  to s. 440.13 and in effect for the date on which the services

22  were rendered. Such charges shall not be payable by the

23  insurer or insured if there is no reimbursement allowance

24  established pursuant to s. 440.13.

25         3.  Allowable amounts that may be charged to a personal

26  injury protection insurance insurer and insured for the

27  professional and technical components of medically necessary

28  nerve conduction testing services when done in conjunction

29  with a needle electromyography procedure and both are

30  performed and billed solely by a physician licensed under

31  chapter 458, chapter 459, chapter 460, or chapter 461 who is

                                  40

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  also certified by the American Board of Electrodiagnostic

 2  Medicine or by a board recognized by the American Board of

 3  Medical Specialties or the American Osteopathic Association or

 4  who holds diplomate status with the American Chiropractic

 5  Neurology Board or its predecessors shall not exceed 200

 6  percent of the allowable amount under the participating

 7  physician fee schedule of Medicare Part B for year 2001, and

 8  in effect for October 1, 2001, for the area in which the

 9  treatment was rendered, adjusted annually by an additional

10  amount equal to the medical Consumer Price Index for Florida.

11         4.  Effective for services and treatment on or after

12  October 1, 2003, allowable amounts that may be charged to a

13  personal injury protection insurance insurer and insured for

14  the technical and professional components of medically

15  necessary nerve conduction, H-reflex, neuromuscular,

16  somatosensory, and dermatonal testing, when any such testing

17  is done in conjunction with a needle electromyography

18  procedure and both are performed and billed solely by a

19  physician licensed under chapter 458, chapter 459, chapter

20  460, or chapter 461 who is also certified by the American

21  Board of Electrodiagnostic Medicine or by a board recognized

22  by the American Board of Medical Specialities or the American

23  Osteopathic Association or who holds diplomate status with the

24  American Chiropractic Neurology Board or its predecessors,

25  shall not exceed the amount allowable under paragraph (c).

26         5.4.  Allowable amounts that may be charged to a

27  personal injury protection insurance insurer and insured for

28  the professional and technical components of medically

29  necessary nerve conduction, H-reflex, neuromuscular,

30  somatosensory, and dermatonal testing that does not meet the

31  requirements of subparagraph 3. shall not exceed the

                                  41

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  applicable fee schedule or other payment methodology

 2  established pursuant to s. 440.13 and in effect on the date on

 3  which the services were rendered. Such charges shall not be

 4  payable by the insurer or insured if there is no reimbursement

 5  allowance established pursuant to s. 440.13.

 6         6.5.  Effective for services and treatment rendered on

 7  or after June 19, 2001, upon this act becoming a law and

 8  before November 1, 2001, allowable amounts that may be charged

 9  to a personal injury protection insurance insurer and insured

10  for magnetic resonance imaging services shall not exceed 200

11  percent of the allowable amount under the participating

12  physician fee schedule of Medicare Part B for year 2001, and

13  in effect on June 19, 2001, for the area in which the

14  treatment was rendered. Beginning November 1, 2001, allowable

15  amounts that may be charged to a personal injury protection

16  insurance insurer and insured for magnetic resonance imaging

17  services shall not exceed 175 percent of the allowable amount

18  under the participating physician fee schedule of Medicare

19  Part B for year 2001, and in effect on June 19, 2001, for the

20  area in which the treatment was rendered, adjusted annually by

21  an additional amount equal to the medical Consumer Price Index

22  for Florida, except that allowable amounts that may be charged

23  to a personal injury protection insurance insurer and insured

24  for magnetic resonance imaging services provided in facilities

25  accredited by the American College of Radiology or the Joint

26  Commission on Accreditation of Healthcare Organizations shall

27  not exceed 200 percent of the allowable amount under the

28  participating physician fee schedule of Medicare Part B for

29  year 2001, for the area in which the treatment was rendered,

30  adjusted annually by an additional amount equal to the medical

31  Consumer Price Index for Florida.

                                  42

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         7.  Subparagraphs 3. through 6. do This paragraph does

 2  not apply to charges for magnetic resonance imaging services

 3  and nerve conduction, H-reflex, neuromuscular, somatosensory,

 4  and dermatonal testing for inpatients and emergency services

 5  and care as defined in chapter 395 rendered by facilities

 6  licensed under chapter 395. Effective for services and

 7  treatment on or after October 1, 2003, allowable amounts that

 8  may be charged for services under subparagraph 6. may not

 9  exceed the amount allowable under paragraph (c).

10         8.  The Department of Health, in consultation with the

11  appropriate professional licensing boards, shall adopt, by

12  rule, a list of diagnostic tests deemed not be medically

13  necessary for use in the treatment of persons sustaining

14  bodily injury covered by personal injury protection benefits

15  under this section. The initial list shall be adopted by

16  January 1, 2004, and shall be revised from time to time as

17  determined by the Department of Health, in consultation with

18  the respective professional licensing boards. Inclusion of a

19  test on the list of invalid diagnostic tests shall be based on

20  lack of demonstrated medical value and a level of general

21  acceptance by the relevant provider community and shall not be

22  dependent for results entirely upon subjective patient

23  response. Notwithstanding its inclusion on a fee schedule in

24  this subsection, an insurer or insured is not required to pay

25  any charges or reimburse claims for any invalid diagnostic

26  test as determined by the Department of Health.

27         (c)  Except as provided in paragraph (b), effective for

28  services and treatment beginning on October 1, 2003, other

29  than services and treatment rendered by a hospital:

30         1.  A person or institution providing treatment,

31  accommodations, products, or services to an injured person for

                                  43

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  an injury covered by personal injury protection benefits shall

 2  not require, request, charge, bill, or accept payment for the

 3  treatment, accommodations, products, or services from the

 4  insurer or insured in excess of 200 percent of the allowable

 5  amount under the Medicare Part B participating physicians fee

 6  schedule which is in effect on July 1, 2003, for the area in

 7  which the services are rendered, without regard to whether a

 8  fee is allowable for a particular provider under federal law

 9  and regulations.

10         2.  The allowable amount for services and treatment

11  subject to the Medicare Part B participating fee schedule

12  under this subsection shall be adjusted as provided in this

13  subparagraph. Commencing in 2004, the Financial Services

14  Commission shall at least annually review any changes made to

15  the Medicare Part B participating fee schedule and shall

16  determine the extent to which such changes shall apply under

17  this subsection in order to ensure the availability of quality

18  services to insureds and to maintain the affordability of

19  insurance under this section. Any changes approved by the

20  commission shall be effective for services and treatment

21  rendered 90 days after such determination is final.

22         3.  If a charge has not been calculated under

23  subparagraph 1., the amount of the charge may not exceed the

24  applicable fee schedule or other payment established pursuant

25  to s. 440.13 in effect on the date the services were rendered.

26         4.  If a charge has not been calculated under

27  subparagraph 1., or subparagraph 3., the treatment,

28  accommodation, product, or services is presumed to be not

29  reasonable and not reimbursable by the insurer and insured

30  pursuant to this section. Upon the request of any person, the

31  Financial Services Commission, in consultation with the Agency

                                  44

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  for Health Care Administration, may determine any charge that

 2  it finds to be reasonable for reimbursement by the insurer and

 3  insured pursuant to this section for services provided after

 4  the determination becomes effective.

 5         5.  Allowable amounts that may be charged to a personal

 6  injury protection insurance insurer and insured for magnetic

 7  resonance imaging services provided in facilities accredited

 8  by the American College of Radiology, the Accreditation

 9  Association for Ambulatory Health Care, or the Joint

10  Commission on Accreditation of Healthcare Organizations may

11  not exceed 200 percent of the allowable amount under the

12  Medicare Part B participating physician fee schedule which is

13  in effect on the date the services are rendered for the area

14  in which the services are rendered.

15         6.  If treatment is rendered out of state, the

16  allowable amounts shall be for the area where the insured

17  resides in this state.

18         (d)1.(c)  With respect to any treatment or service,

19  other than medical services billed by a hospital or other

20  provider for emergency services as defined in s. 395.002 or

21  inpatient services rendered at a hospital-owned facility, the

22  statement of charges must be furnished to the insurer by the

23  provider and may not include, and the insurer is not required

24  to pay, charges for treatment or services rendered more than

25  35 days before the postmark date of the statement, except for

26  past due amounts previously billed on a timely basis under

27  this paragraph, and except that, if the provider submits to

28  the insurer a notice of initiation of treatment within 21 days

29  after its first examination or treatment of the claimant, the

30  statement may include charges for treatment or services

31  rendered up to, but not more than, 75 days before the postmark

                                  45

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  date of the statement. The injured party is not liable for,

 2  and the provider shall not bill the injured party for, charges

 3  that are unpaid because of the provider's failure to comply

 4  with this paragraph. Any agreement requiring the injured

 5  person or insured to pay for such charges is unenforceable.

 6         2.  If, however, the insured fails to furnish the

 7  provider with the correct name and address of the insured's

 8  personal injury protection insurer, the provider has 35 days

 9  from the date the provider obtains the correct information to

10  furnish the insurer with a statement of the charges. The

11  insurer is not required to pay for such charges unless the

12  provider includes with the statement documentary evidence that

13  was provided by the insured during the 35-day period

14  demonstrating that the provider reasonably relied on erroneous

15  information from the insured and either:

16         a.1.  A denial letter from the incorrect insurer; or

17         b.2.  Proof of mailing, which may include an affidavit

18  under penalty of perjury, reflecting timely mailing to the

19  incorrect address or insurer.

20         3.  For emergency services and care as defined in s.

21  395.002 rendered in a hospital emergency department or for

22  transport and treatment rendered by an ambulance provider

23  licensed pursuant to part III of chapter 401, the provider is

24  not required to furnish the statement of charges within the

25  time periods established by this paragraph; and the insurer

26  shall not be considered to have been furnished with notice of

27  the amount of covered loss for purposes of paragraph (4)(b)

28  until it receives a statement complying with paragraph (e), or

29  copy thereof, which specifically identifies the place of

30  service to be a hospital emergency department or an ambulance

31  

                                  46

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  in accordance with billing standards recognized by the Health

 2  Care Finance Administration.

 3         4.  Each notice of insured's rights under s. 627.7401

 4  must include the following statement in type no smaller than

 5  12 points:

 6         BILLING REQUIREMENTS.--Florida Statutes provide

 7         that with respect to any treatment or services,

 8         other than certain hospital and emergency

 9         services, the statement of charges furnished to

10         the insurer by the provider may not include,

11         and the insurer and the injured party are not

12         required to pay, charges for treatment or

13         services rendered more than 35 days before the

14         postmark date of the statement, except for past

15         due amounts previously billed on a timely

16         basis, and except that, if the provider submits

17         to the insurer a notice of initiation of

18         treatment within 21 days after its first

19         examination or treatment of the claimant, the

20         statement may include charges for treatment or

21         services rendered up to, but not more than, 75

22         days before the postmark date of the statement.

23         (d)  Every insurer shall include a provision in its

24  policy for personal injury protection benefits for binding

25  arbitration of any claims dispute involving medical benefits

26  arising between the insurer and any person providing medical

27  services or supplies if that person has agreed to accept

28  assignment of personal injury protection benefits. The

29  provision shall specify that the provisions of chapter 682

30  relating to arbitration shall apply.  The prevailing party

31  shall be entitled to attorney's fees and costs. For purposes

                                  47

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  of the award of attorney's fees and costs, the prevailing

 2  party shall be determined as follows:

 3         1.  When the amount of personal injury protection

 4  benefits determined by arbitration exceeds the sum of the

 5  amount offered by the insurer at arbitration plus 50 percent

 6  of the difference between the amount of the claim asserted by

 7  the claimant at arbitration and the amount offered by the

 8  insurer at arbitration, the claimant is the prevailing party.

 9         2.  When the amount of personal injury protection

10  benefits determined by arbitration is less than the sum of the

11  amount offered by the insurer at arbitration plus 50 percent

12  of the difference between the amount of the claim asserted by

13  the claimant at arbitration and the amount offered by the

14  insurer at arbitration, the insurer is the prevailing party.

15         3.  When neither subparagraph 1. nor subparagraph 2.

16  applies, there is no prevailing party. For purposes of this

17  paragraph, the amount of the offer or claim at arbitration is

18  the amount of the last written offer or claim made at least 30

19  days prior to the arbitration.

20         4.  In the demand for arbitration, the party requesting

21  arbitration must include a statement specifically identifying

22  the issues for arbitration for each examination or treatment

23  in dispute. The other party must subsequently issue a

24  statement specifying any other examinations or treatment and

25  any other issues that it intends to raise in the arbitration.

26  The parties may amend their statements up to 30 days prior to

27  arbitration, provided that arbitration shall be limited to

28  those identified issues and neither party may add additional

29  issues during arbitration.

30         (e)  All statements and bills for medical services

31  rendered by any physician, hospital, clinic, or other person

                                  48

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  or institution shall be submitted to the insurer on a properly

 2  completed Centers for Medicare and Medicaid Services (CMS)

 3  Health Care Finance Administration 1500 form, UB 92 forms, or

 4  any other standard form approved by the department for

 5  purposes of this paragraph. All billings for such services

 6  rendered by providers other than hospitals shall, to the

 7  extent applicable, follow the Physicians' Current Procedural

 8  Terminology (CPT) or Healthcare Correct Procedural Coding

 9  System (HCPCS), or ICD-9 in effect for the year in which

10  services are rendered and comply with the Centers for Medicare

11  and Medicaid Services (CMS) 1500 form instructions and the

12  American Medical Association Current Procedural Terminology

13  (CPT) Editorial Panel and Healthcare Correct Procedural Coding

14  System (HCPCS). All providers other than hospitals shall

15  include on the applicable claim form the professional license

16  number of the provider in the line or space provided for

17  "Signature of Physician or Supplier, Including Degrees or

18  Credentials." In determining compliance with applicable CPT

19  and HCPCS coding, guidance shall be provided by the

20  Physicians' Current Procedural Terminology (CPT) or the

21  Healthcare Correct Procedural Coding System (HCPCS) in effect

22  for the year in which services were rendered, the Office of

23  the Inspector General (OIG), Physicians Compliance Guidelines,

24  and other authoritative treatises designated by rule by the

25  Agency for Health Care Administration. No statement of medical

26  services may include charges for medical services of a person

27  or entity that performed such services without possessing the

28  valid licenses required to perform such services. For purposes

29  of paragraph (4)(b), an insurer shall not be considered to

30  have been furnished with notice of the amount of covered loss

31  or medical bills due unless the statements or bills comply

                                  49

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  with this paragraph, and unless the statements or bills are

 2  properly completed in their entirety as to all material

 3  provisions, with all relevant information being provided

 4  therein.

 5         (f)1.  Each physician, other licensed professional,

 6  clinic, or other medical institution providing medical

 7  services upon which a claim for personal injury protection

 8  benefits is based shall require an insured person, or his or

 9  her guardian, to execute a disclosure and acknowledgment form,

10  which reflects at a minimum that:

11         a.  The insured, or his or her guardian, must

12  countersign the form attesting to the fact that the services

13  set forth therein were actually rendered;

14         b.  The insured, or his or her guardian, has both the

15  right and affirmative duty to confirm that the services were

16  actually rendered;

17         c.  The insured, or his or her guardian, was not

18  solicited by any person to seek any services from the medical

19  provider; and

20         d.  That the physician, other licensed professional,

21  clinic, or other medical institution rendering services for

22  which payment is being claimed explained the services to the

23  insured or his or her guardian.

24         2.  The physician, other licensed professional, clinic,

25  or other medical institution rendering services for which

26  payment is being claimed has the affirmative duty to explain

27  the services rendered to the insured, or his or her guardian,

28  so that the insured, or his or her guardian, countersigns the

29  form with informed consent.

30         3.  Countersignature by the insured, or his or her

31  guardian, is not required for the reading of diagnostic tests

                                  50

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  or other services that are of such a nature that they are not

 2  required to be performed in the presence of the insured.

 3         4.  The licensed medical professional rendering

 4  treatment for which payment is being claimed must sign, by his

 5  or her own hand, the form complying with this paragraph.

 6         5.  The original completed disclosure and

 7  acknowledgement form shall be furnished to the insurer

 8  pursuant to paragraph (4)(b) and may not be electronically

 9  furnished.

10         6.  This disclosure and acknowledgement form is not

11  required for services billed by a hospital or billed by

12  another provider for emergency services as defined in s.

13  395.002, for inpatient services rendered at a hospital-owned

14  facility, for emergency services and care as defined in s.

15  395.002 rendered in a hospital emergency department, or for

16  transport and treatment rendered by an ambulance provider

17  licensed pursuant to part III of chapter 401.

18         7.  The Financial Services Commission shall adopt, by

19  rule, a standard disclosure and acknowledgment form that shall

20  be used to fulfill the requirements of this paragraph,

21  effective 90 days after such form is adopted and becomes

22  final. The commission shall adopt a proposed rule by October

23  1, 2003. Until the rule is final, the provider may use a form

24  of its own which otherwise complies with the requirements of

25  this paragraph.

26         (g)  Upon written notification by any person, an

27  insurer shall investigate any claim of improper billing by a

28  physician or other medical provider. The insurer shall

29  determine if the insured was properly billed for only those

30  services and treatments that the insured actually received. If

31  the insurer determines that the insured has been improperly

                                  51

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  billed, the insurer shall notify the insured, the person

 2  making the written notification and the provider of its

 3  findings and shall reduce the amount of payment to the

 4  provider by the amount determined to be improperly billed. If

 5  a reduction is made due to such written notification by any

 6  person, the insurer shall pay to the person 20 percent of the

 7  amount of the reduction, up to $500. If the provider is

 8  arrested due to the improper billing, then the insurer shall

 9  pay to the person 40 percent of the amount of the reduction,

10  up to $500.

11         (h)  An insurer may not systematically downcode with

12  the intent to deny reimbursement otherwise due. Such action

13  constitutes a material misrepresentation under s.

14  626.9541(1)(i)2.

15         (6)  DISCOVERY OF FACTS ABOUT AN INJURED PERSON;

16  DISPUTES.--

17         (a)  Every employer shall, if a request is made by an

18  insurer providing personal injury protection benefits under

19  ss. 627.730-627.7405 against whom a claim has been made,

20  furnish forthwith, in a form approved by the department, a

21  sworn statement of the earnings, since the time of the bodily

22  injury and for a reasonable period before the injury, of the

23  person upon whose injury the claim is based.

24         (b)  Every physician, hospital, clinic, or other

25  medical institution providing, before or after bodily injury

26  upon which a claim for personal injury protection insurance

27  benefits is based, any products, services, or accommodations

28  in relation to that or any other injury, or in relation to a

29  condition claimed to be connected with that or any other

30  injury, shall, if requested to do so by the insurer against

31  whom the claim has been made, furnish forthwith a written

                                  52

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  report of the history, condition, treatment, dates, and costs

 2  of such treatment of the injured person and why the items

 3  identified by the insurer were reasonable in amount and

 4  medically necessary, together with a sworn statement that the

 5  treatment or services rendered were reasonable and necessary

 6  with respect to the bodily injury sustained and identifying

 7  which portion of the expenses for such treatment or services

 8  was incurred as a result of such bodily injury, and produce

 9  forthwith, and permit the inspection and copying of, his or

10  her or its records regarding such history, condition,

11  treatment, dates, and costs of treatment; provided that this

12  shall not limit the introduction of evidence at trial. Such

13  sworn statement shall read as follows: "Under penalty of

14  perjury, I declare that I have read the foregoing, and the

15  facts alleged are true, to the best of my knowledge and

16  belief." No cause of action for violation of the

17  physician-patient privilege or invasion of the right of

18  privacy shall be permitted against any physician, hospital,

19  clinic, or other medical institution complying with the

20  provisions of this section. The person requesting such records

21  and such sworn statement shall pay all reasonable costs

22  connected therewith. If an insurer makes a written request for

23  documentation or information under this paragraph within 30

24  days after having received notice of the amount of a covered

25  loss under paragraph (4)(a), the amount or the partial amount

26  which is the subject of the insurer's inquiry shall become

27  overdue if the insurer does not pay in accordance with

28  paragraph (4)(b) or within 10 days after the insurer's receipt

29  of the requested documentation or information, whichever

30  occurs later. For purposes of this paragraph, the term

31  "receipt" includes, but is not limited to, inspection and

                                  53

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  copying pursuant to this paragraph. Any insurer that requests

 2  documentation or information pertaining to reasonableness of

 3  charges or medical necessity under this paragraph without a

 4  reasonable basis for such requests as a general business

 5  practice is engaging in an unfair trade practice under the

 6  insurance code.

 7         (c)  In the event of any dispute regarding an insurer's

 8  right to discovery of facts under this section about an

 9  injured person's earnings or about his or her history,

10  condition, or treatment, or the dates and costs of such

11  treatment, the insurer may petition a court of competent

12  jurisdiction to enter an order permitting such discovery.  The

13  order may be made only on motion for good cause shown and upon

14  notice to all persons having an interest, and it shall specify

15  the time, place, manner, conditions, and scope of the

16  discovery. Such court may, in order to protect against

17  annoyance, embarrassment, or oppression, as justice requires,

18  enter an order refusing discovery or specifying conditions of

19  discovery and may order payments of costs and expenses of the

20  proceeding, including reasonable fees for the appearance of

21  attorneys at the proceedings, as justice requires.

22         (d)  The injured person shall be furnished, upon

23  request, a copy of all information obtained by the insurer

24  under the provisions of this section, and shall pay a

25  reasonable charge, if required by the insurer.

26         (e)  Notice to an insurer of the existence of a claim

27  shall not be unreasonably withheld by an insured.

28         (7)  MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON;

29  REPORTS.--

30         (a)  Whenever the mental or physical condition of an

31  injured person covered by personal injury protection is

                                  54

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  material to any claim that has been or may be made for past or

 2  future personal injury protection insurance benefits, such

 3  person shall, upon the request of an insurer, submit to mental

 4  or physical examination by a physician or physicians.  The

 5  costs of any examinations requested by an insurer shall be

 6  borne entirely by the insurer. Such examination shall be

 7  conducted within the municipality where the insured is

 8  receiving treatment, or in a location reasonably accessible to

 9  the insured, which, for purposes of this paragraph, means any

10  location within the municipality in which the insured resides,

11  or any location within 10 miles by road of the insured's

12  residence, provided such location is within the county in

13  which the insured resides. If the examination is to be

14  conducted in a location reasonably accessible to the insured,

15  and if there is no qualified physician to conduct the

16  examination in a location reasonably accessible to the

17  insured, then such examination shall be conducted in an area

18  of the closest proximity to the insured's residence.  Personal

19  protection insurers are authorized to include reasonable

20  provisions in personal injury protection insurance policies

21  for mental and physical examination of those claiming personal

22  injury protection insurance benefits. An insurer may not

23  withdraw payment of a treating physician without the consent

24  of the injured person covered by the personal injury

25  protection, unless the insurer first obtains a valid report by

26  a physician licensed under the same chapter as the treating

27  physician whose treatment authorization is sought to be

28  withdrawn, stating that treatment was not reasonable, related,

29  or necessary. A valid report is one that is prepared and

30  signed by the physician examining the injured person or

31  reviewing the treatment records of the injured person and is

                                  55

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  factually supported by the examination and treatment records

 2  if reviewed and that has not been modified by anyone other

 3  than the physician. The physician preparing the report must be

 4  in active practice, unless the physician is physically

 5  disabled. Active practice means that during the 3 years

 6  immediately preceding the date of the physical examination or

 7  review of the treatment records the physician must have

 8  devoted professional time to the active clinical practice of

 9  evaluation, diagnosis, or treatment of medical conditions or

10  to the instruction of students in an accredited health

11  professional school or accredited residency program or a

12  clinical research program that is affiliated with an

13  accredited health professional school or teaching hospital or

14  accredited residency program. The physician preparing a report

15  at the request of an insurer, or on behalf of an insurer

16  through an attorney or another entity, shall maintain, for at

17  least 3 years, copies of all examination reports as medical

18  records and shall maintain, for at least 3 years, records of

19  all payments for the examinations and reports. Neither an

20  insurer nor any person acting at the direction of or on behalf

21  of an insurer may materially change an opinion in a report

22  prepared under this paragraph or direct the physician

23  preparing the report to change such opinion. The denial of a

24  payment as the result of such a changed opinion constitutes a

25  material misrepresentation under s. 626.9541(1)(i)2.; however,

26  this provision does not preclude the insurer from calling to

27  the attention of the physician errors of fact in the report

28  based upon information in the claim file.

29         (b)  If requested by the person examined, a party

30  causing an examination to be made shall deliver to him or her

31  a copy of every written report concerning the examination

                                  56

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  rendered by an examining physician, at least one of which

 2  reports must set out the examining physician's findings and

 3  conclusions in detail.  After such request and delivery, the

 4  party causing the examination to be made is entitled, upon

 5  request, to receive from the person examined every written

 6  report available to him or her or his or her representative

 7  concerning any examination, previously or thereafter made, of

 8  the same mental or physical condition.  By requesting and

 9  obtaining a report of the examination so ordered, or by taking

10  the deposition of the examiner, the person examined waives any

11  privilege he or she may have, in relation to the claim for

12  benefits, regarding the testimony of every other person who

13  has examined, or may thereafter examine, him or her in respect

14  to the same mental or physical condition. If a person

15  unreasonably refuses to submit to an examination, the personal

16  injury protection carrier is no longer liable for subsequent

17  personal injury protection benefits.

18         (8)  APPLICABILITY OF PROVISION REGULATING ATTORNEY'S

19  FEES.--With respect to any dispute under the provisions of ss.

20  627.730-627.7405 between the insured and the insurer, or

21  between an assignee of an insured's rights and the insurer,

22  the provisions of s. 627.428 shall apply, except as provided

23  in subsections subsection (11), (12), and (13).

24         (10)(a)  An insurer may negotiate and enter into

25  contracts with licensed health care providers for the benefits

26  described in this section, referred to in this section as

27  "preferred providers," which shall include health care

28  providers licensed under chapters 458, 459, 460, 461, and 463.

29  The insurer may provide an option to an insured to use a

30  preferred provider at the time of purchase of the policy for

31  personal injury protection benefits, if the requirements of

                                  57

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  this subsection are met. If the insured elects to use a

 2  provider who is not a preferred provider, whether the insured

 3  purchased a preferred provider policy or a nonpreferred

 4  provider policy, the medical benefits provided by the insurer

 5  shall be as required by this section. If the insured elects to

 6  use a provider who is a preferred provider, the insurer may

 7  pay medical benefits in excess of the benefits required by

 8  this section and may waive or lower the amount of any

 9  deductible that applies to such medical benefits. If the

10  insurer offers a preferred provider policy to a policyholder

11  or applicant, it must also offer a nonpreferred provider

12  policy. The insurer shall provide each policyholder with a

13  current roster of preferred providers in the county in which

14  the insured resides at the time of purchase of such policy,

15  and shall make such list available for public inspection

16  during regular business hours at the principal office of the

17  insurer within the state.

18         (b)  Paragraph (a) does not prohibit an insurer that

19  chooses not to offer a preferred provider policy from

20  providing the benefits described in subsection (1) pursuant to

21  a contract entered into directly or indirectly with a licensed

22  health care provider or hospital that establishes agreed

23  amounts to be charged by such health care provider or hospital

24  for services rendered to persons entitled to such benefits.

25  Such agreement shall establish the reasonable amount for such

26  services in accord with subsection (1).

27         (11)  DEMAND LETTER.--

28         (a)  As a condition precedent to filing any action for

29  an overdue claim for benefits under this section paragraph

30  (4)(b), the insurer must be provided with written notice of an

31  intent to initiate litigation; provided, however, that, except

                                  58

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  with regard to a claim or amended claim or judgment for

 2  interest only which was not paid or was incorrectly

 3  calculated, such notice is not required for an overdue claim

 4  that the insurer has denied or reduced, nor is such notice

 5  required if the insurer has been provided documentation or

 6  information at the insurer's request pursuant to subsection

 7  (6). Such notice may not be sent until the claim is overdue,

 8  including any additional time the insurer has to pay the claim

 9  pursuant to paragraph (4)(b).

10         (b)  The notice required shall state that it is a

11  "demand letter under s. 627.736(11)" and shall state with

12  specificity:

13         1.  The name of the insured upon which such benefits

14  are being sought, including a copy of the assignment giving

15  rights to the claimant if the claimant is not the insured.

16         2.  The claim number or policy number upon which such

17  claim was originally submitted to the insurer.

18         3.  To the extent applicable, the name of any medical

19  provider who rendered to an insured the treatment, services,

20  accommodations, or supplies that form the basis of such claim;

21  and an itemized statement specifying each exact amount, the

22  date of treatment, service, or accommodation, and the type of

23  benefit claimed to be due. A completed form satisfying the

24  requirements of paragraph (5)(e) or the lost-wage statement

25  previously submitted Health Care Finance Administration 1500

26  form, UB 92, or successor forms approved by the Secretary of

27  the United States Department of Health and Human Services may

28  be used as the itemized statement. To the extent that the

29  demand involves an insurer's withdrawal of payment under

30  paragraph (7)(a) for future treatment not yet rendered, the

31  claimant shall attach a copy of the insurer's notice

                                  59

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  withdrawing such payment and an itemized statement of the

 2  type, frequency, and duration of future treatment claimed to

 3  be reasonable and medically necessary.

 4         (c)  Each notice required by this subsection section

 5  must be delivered to the insurer by United States certified or

 6  registered mail, return receipt requested. Such postal costs

 7  shall be reimbursed by the insurer if so requested by the

 8  claimant provider in the notice, when the insurer pays the

 9  overdue claim. Such notice must be sent to the person and

10  address specified by the insurer for the purposes of receiving

11  notices under this subsection section, on the document denying

12  or reducing the amount asserted by the filer to be overdue.

13  Each licensed insurer, whether domestic, foreign, or alien,

14  shall may file with the office department designation of the

15  name and address of the person to whom notices pursuant to

16  this subsection section shall be sent which the office shall

17  make available on its Internet website when such document does

18  not specify the name and address to whom the notices under

19  this section are to be sent or when there is no such document.

20  The name and address on file with the office department

21  pursuant to s. 624.422 shall be deemed the authorized

22  representative to accept notice pursuant to this subsection

23  section in the event no other designation has been made.

24         (d)  If, within 15 7 business days after receipt of

25  notice by the insurer, the overdue claim specified in the

26  notice is paid by the insurer together with applicable

27  interest and a penalty of 10 percent of the overdue amount

28  paid by the insurer, subject to a maximum penalty of $250, no

29  action for nonpayment or late payment may be brought against

30  the insurer. If the demand involves an insurer's withdrawal of

31  payment under paragraph (7)(a) for future treatment not yet

                                  60

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  rendered, no action may be brought against the insurer if,

 2  within 15 days after its receipt of the notice, the insurer

 3  mails to the person filing the notice a written statement of

 4  the insurer's agreement to pay for such treatment in

 5  accordance with the notice and to pay a penalty of 10 percent,

 6  subject to a maximum penalty of $250, when it pays for such

 7  future treatment in accordance with the requirements of this

 8  section. To the extent the insurer determines not to pay any

 9  the overdue amount demanded, the penalty shall not be payable

10  in any subsequent action for nonpayment or late payment. For

11  purposes of this subsection, payment or the insurer's

12  agreement shall be treated as being made on the date a draft

13  or other valid instrument that is equivalent to payment, or

14  the insurer's written statement of agreement, is placed in the

15  United States mail in a properly addressed, postpaid envelope,

16  or if not so posted, on the date of delivery. The insurer

17  shall not be obligated to pay any attorney's fees if the

18  insurer pays the claim or mails its agreement to pay for

19  future treatment within the time prescribed by this

20  subsection.

21         (e)  The applicable statute of limitation for an action

22  under this section shall be tolled for a period of 15 business

23  days by the mailing of the notice required by this subsection.

24         (f)  Any insurer making a general business practice of

25  not paying valid claims until receipt of the notice required

26  by this subsection section is engaging in an unfair trade

27  practice under the insurance code.

28         (12)  MEDICAL PEER REVIEW.--

29         (a)  Applicability.--This subsection applies to all

30  medical benefits payable under paragraph (1)(a); however, this

31  subsection is limited to disputes of whether a service,

                                  61

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  treatment, or otherwise is medically necessary, reasonable in

 2  the amount charged, correctly coded, and related to the injury

 3  covered by the policy under s. 627.736. The applicability of

 4  this subsection shall be broadly construed to favor inclusion

 5  of disputes. The parties voluntarily may include other issues

 6  related to the items and issues in dispute.

 7         (b)  Definitions.--As used in this subsection, the

 8  term:

 9         1.  "Agency" means the Agency for Health Care

10  Administration.

11         2.  "Claimant" means the insured injured person or the

12  medical provider involved in a dispute under this subsection.

13         3.  "Initiating party" means the party filing a notice.

14         4.  "Notice means the notice initiating peer review.

15         5.  "Peer reviewer" means the health care practitioner

16  defined in s. 456.001(4) or other person who is employed by

17  or, under contract with, a peer review organization, to whom a

18  particular medical dispute has been referred by the peer

19  review organization, and who from other work derives less than

20  25 percent of his or her income from insurers of any kind. For

21  issues of medical necessity, the health care organization must

22  use a health care practitioner who is licensed under the same

23  chapter as the health care practitioner involved in this

24  dispute. A health care practitioner must have an active

25  patient practice of at least 8 hours per week.

26         6.  "Peer review organization" means one or more

27  qualified entities selected by and contracted with the agency

28  that employs or contracts with peer reviewers.

29         7.  "Respondent" means the party upon whom a notice is

30  filed.

31  

                                  62

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (c)  Program implementation.--The agency shall

 2  establish a program by October 1, 2003, to provide assistance

 3  to medical providers, insurers, and insured injured persons

 4  for the expedited resolution of disputed medical claims for

 5  personal injury protection benefits under this section. The

 6  agency shall contract with one or more peer review

 7  organizations for the performance of peer review of medical

 8  issues. Contracted peer review organizations shall be fully

 9  accredited by URAC, also known as the American Accreditation

10  HealthCare Commission, Inc., or another comparable nationally

11  recognized organization if approved by the agency, shall

12  maintain an office in this state, be subject to the

13  jurisdiction of this state, and shall be responsible for

14  properly credentialing and educating peer reviewers and

15  ensuring compliance with the provisions of this subsection.

16  The agency shall take reasonable measures to ensure that the

17  peer review organization and peer reviewers are not biased

18  toward the insurer or claimant, that the reports required in

19  paragraph (g) are timely, and that the insurer and claimant

20  timely submit the documentation required in paragraph (f).

21         (d)  Immunity.--Peer review organizations and peer

22  reviewers are immune from liability in the execution of their

23  peer review functions to the extent provided in s. 766.101.

24         (e)  Notice initiating review.--If the insurer does not

25  pay the amount demanded within 15 days after its receipt of

26  the demand letter referenced under subsection (11), peer

27  review may be initiated under this subsection by the delivery

28  of a notice under this paragraph. To facilitate faster

29  resolution of claims, a claimant may simultaneously and

30  together deliver the demand letter and a notice under this

31  section to the insurer and the peer review organization, in

                                  63

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  which case the insurer shall have 10 additional days to

 2  provide the explanation and supporting documentation provided

 3  for in paragraph (f) and to make the written offer provided

 4  for in paragraph (i).  The initiating party shall deliver a

 5  notice to the peer review organization which shall state that

 6  it is a "notice initiating peer review under section

 7  627.736(12), Florida Statutes," and shall also provide the

 8  same information required under subsection (11) as to any item

 9  or issue still in dispute. To facilitate cost-efficient

10  resolution of disputes, the petitioner shall aggregate in its

11  notice all matters that are in dispute and subject to this

12  subsection. The initiating party, if the claimant, shall

13  deliver a copy of the notice to the person and address for

14  demand letters under paragraph (11)(c) and, if the insurer,

15  shall deliver a copy of the notice to the person or entity

16  that filed the demand letter under subsection (11). Each

17  notice must be delivered by United States certified or

18  registered mail, return receipt requested. Notice shall be

19  treated as being delivered on the date notice is placed in the

20  United States mail in a properly addressed, postpaid envelope,

21  or if not so posted, on the date of delivery.

22         (f)  Supporting documentation.--As to matters in

23  dispute, the initiating party shall submit to the peer review

24  organization and the respondent an explanation of its position

25  and supporting documentation within 10 days after it gives its

26  notice, and the respondent shall submit to the peer review

27  organization and the initiating party an explanation of its

28  position and supporting documentation within 10 days after its

29  receipt of the notice. The peer review organization may

30  require the parties to submit additional documentation.

31  

                                  64

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (g)  Review process.--The peer reviewer shall issue a

 2  written report within 10 days after its receipt of all written

 3  documentation. The report must include a statement of the

 4  issues posed and, as applicable, an itemized statement of the

 5  items determined to be medically necessary, reasonable, and

 6  related to the injury, and the type, frequency, and duration

 7  of future treatment determined to be reasonable and medically

 8  necessary. Issues shall be decided in a summary manner by the

 9  peer reviewer from the records and pleadings submitted by the

10  claimant and insurer. The peer review process is dependent

11  upon the initiating party and respondent each explaining in

12  writing the nature of the dispute and upon providing

13  sufficient documentation for resolution of the issue or claim.

14  The peer reviewer may consider any documents submitted by

15  either party subject only to the requirements of this

16  subsection. The peer reviewer shall not examine the claimant

17  or insurer. The peer reviewer may, in its discretion, schedule

18  a telephone conference with the insurer and claimant to

19  facilitate the dispute resolution in a cost-effective,

20  efficient manner. The provisions of chapter 90 governing the

21  rules of evidence shall not apply to proceedings before the

22  peer reviewer. Applying the standards of care, applicable

23  practice parameters, including those related to utilization,

24  and relevant provisions of this section, the peer reviewer

25  shall make a recommendation, pursuant to its contract with the

26  peer review organization, of the medical merits of the

27  dispute.

28         (h)  Dispute costs.--The agency shall approve a review

29  cost fee schedule and a late payment fee schedule for use by

30  the peer review organization. The rules adopted by the agency

31  shall reflect procedures that minimize the costs of a review

                                  65

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  and specify the circumstances under which review costs are not

 2  incurred, including when the insurer pays the amount demanded

 3  so as to resolve a dispute without submission of supporting

 4  documentation to the review organization or a party declines

 5  to participate in the peer review. The initiating party and

 6  respondent shall each pay 50 percent of all review costs.

 7  However, if the amount recommended by the peer reviewer is

 8  greater than the amount offered in writing to the claimant by

 9  the insurer within 15 days after the initiation of the review,

10  the insurer shall pay all of the review costs up to the first

11  $500, and the remainder shall be divided equally between the

12  insurer and the claimant. Neither party nor the review

13  organization shall reveal the amount of the insurer's offer to

14  the peer reviewer.

15         (i)  Payment by insurer.--As to any item in dispute, if

16  the insurer pays the item recommended by the peer review

17  organization within 10 business days after its receipt of the

18  written recommendation of the peer reviewer, or if at any time

19  prior to or during the pendency of a dispute under this

20  subsection the insurer pays the item demanded by the claimant,

21  together with applicable interest under paragraph (4)(c), a

22  penalty of 10 percent of the overdue amount paid by the

23  insurer, subject to a maximum penalty of $250, then as to the

24  disputed items so paid the insurer is not liable in any action

25  for attorney's fees otherwise required by provisions of the

26  insurance code or for damages under s. 624.155. If the dispute

27  involves an insurer's withdrawal of payment under paragraph

28  (7)(a) for future treatment not yet rendered, the insurer is

29  not liable in any action for attorney's fees otherwise

30  required by the insurance code or for damages under s. 624.155

31  if, within 10 business days after its receipt of the written

                                  66

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  recommendation of the peer reviewer, or at any time prior to

 2  or during the pendency of a dispute under this subsection, the

 3  insurer mails to the claimant a written statement of its

 4  agreement to pay for such treatment in accordance with the

 5  claimant's demand or peer reviewer's recommendation and to pay

 6  a penalty of 10 percent, subject to a maximum penalty of $250,

 7  when it pays for such future treatment in accordance with this

 8  section. For purposes of this subsection, payment or the

 9  insurer's agreement shall be treated as being made on the date

10  a draft or other valid instrument that is equivalent to

11  payment, or the insurer's written statement of agreement, is

12  placed in the United States mail in a properly addressed,

13  postpaid envelope, or if not so posted, on the date of

14  delivery.

15         (j)  Access to court.--Peer review under this

16  subsection is a condition precedent to the filing of any

17  action based on a dispute subject to this subsection. A party

18  may not file an action related to a disputed amount subject to

19  this section while a dispute is pending under this subsection.

20  The respondent may decline to participate as to the entirety

21  or any item in dispute. To the extent that the insurer

22  declines to participate or declines to pay the items

23  recommended, the insurer remains potentially liable for

24  reasonable attorney's fees otherwise required by the insurance

25  code and for damages under s. 624.155. To the extent that the

26  claimant declines to participate or declines to accept payment

27  from the insurer tendered in accordance with paragraph (i),

28  the insurer is not liable for attorney's fees otherwise

29  required by the insurance code or for damages under s.

30  624.155. The decision of the peer reviewer is not binding on

31  any party and the parties retain access to courts in

                                  67

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  accordance with this subsection. A party may seek judicial

 2  review of the recommendation of the peer reviewer to determine

 3  whether the recommendation was reasonable. A recommendation is

 4  reasonable unless it was procured by corruption, fraud, or

 5  other undue means; there was evident partiality by the peer

 6  reviewer or misconduct prejudicing the rights of any party; or

 7  the peer reviewer exceeded the authority and power granted by

 8  this subsection. If the court declares the peer review

 9  recommendation to be not reasonable, the peer review

10  recommendation shall be vacated, the peer review organization

11  shall provide a different peer reviewer to review the dispute

12  and issued a recommendation, and the peer review process shall

13  proceed as if no action had been filed.

14         (k)  Evidence in litigation.--The notice of dispute and

15  all documents submitted by the health care practitioner and

16  the insurer, together with the notice of resolution and the

17  resolution of any appeal, may be introduced into evidence in

18  any civil action if such documents are admissible pursuant to

19  the Florida Evidence Code.

20         (l)  Rules.--The agency shall adopt rules to administer

21  this subsection.

22         (13)  ALTERNATIVE DISPUTE RESOLUTION.--

23         (a)  This subsection applies to disputes and claims

24  that are not subject to peer review under subsection (12). For

25  purposes of this subsection, the term "mediation" means the

26  alternative dispute resolution provided for in this

27  subsection, and the term "mediator" means the person

28  attempting to resolve the dispute or claim under this

29  subsection. As to any such dispute or claim to which this

30  subsection applies, if the insurer does not pay the amount

31  demanded within 15 days after its receipt of the demand letter

                                  68

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  referenced under subsection (1), either party may request

 2  mediation of the claim; except that to facilitate faster

 3  resolution of claims, a claimant may simultaneously and

 4  together deliver both the demand letter and a request under

 5  this subsection to the insurer and the department. As to any

 6  item that is subject both to peer review under subsection (12)

 7  and to this subsection because there is an issue to which

 8  subsection (12) does not apply, a party may not request

 9  mediation until the peer review process is concluded, absent

10  consent of the other party. The insurer may file a request for

11  mediation only on or before the 15th day after receipt of the

12  demand letter. Mediation is optional and either party may

13  decline to participate.

14         (b)  A request for mediation shall be filed with the

15  department on a form approved by the department. The request

16  for mediation must state the reason for the request for

17  mediation and must include and state all the issues in dispute

18  at the time of the request which are to be mediated. The

19  filing of a request for mediation tolls the applicable time

20  requirements for filing suit for a period of 60 days following

21  the conclusion of the mediation process or the time prescribed

22  in s. 95.11, whichever is later.

23         (c)  The mediation shall be conducted as an informal

24  process in which formal rules of evidence and procedure need

25  not be observed. The party to the mediation is not required to

26  attend the mediation if each representative of the party

27  participating in a mediation has the authority to make a

28  binding decision. All parties must mediate in good faith.

29         (d)  The department shall randomly select mediators.

30  Each party may once reject the mediator selected, either

31  

                                  69

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  originally or after the opposing side has exercised its option

 2  to reject a mediator.

 3         (e)  If the insurer requests mediation, the costs of

 4  mediation shall be paid by the insurer. Otherwise, the costs

 5  shall be paid equally by both parties, except as provided in

 6  paragraph (p).

 7         (f)  Only one mediation may be requested for all issues

 8  that are, or with due diligence of the requesting party could

 9  have been, addressed with such mediation, unless all parties

10  agree to further mediation.

11         (g)  Upon receipt of a request for mediation, the

12  department shall refer the request to a mediator. The mediator

13  shall notify the applicant and all interested parties, as

14  identified by the applicant, and any other parties the

15  mediator believes may have an interest in the mediation, of

16  the date, time, and place of the mediation conference. The

17  conference may be held by telephone, if feasible. The

18  mediation conference shall be held within 45 days after the

19  request for mediation.

20         (h)  The department shall approve mediators to conduct

21  mediations pursuant to this section. All mediators must file

22  an application under oath for approval as a mediator.

23         (i)  To qualify for approval as a mediator, a person

24  must meet the following qualifications:

25         1.  Possess a masters or doctorate degree in

26  psychology, counseling, business, accounting, or economics; be

27  a member of The Florida Bar; be licensed as a certified public

28  accountant; or demonstrate that the applicant for approval has

29  been actively engaged as a qualified mediator for at least 4

30  years prior to July 1, 1990.

31  

                                  70

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         2.  Within 4 years immediately preceding the date the

 2  application for approval is filed with the department, have

 3  completed a minimum of a 40-hour training program approved by

 4  the department and successfully passed a final examination

 5  included in the training program and approved by the

 6  department. The training program shall include and address all

 7  of the following:

 8         a.  Mediation theory.

 9         b.  Mediation process and techniques.

10         c.  Standards of conduct for mediators.

11         d.  Conflict management and intervention skills.

12         e.  Insurance nomenclature.

13         f.  The provisions of this section and additional

14  training if required as to any person not trained concerning

15  applicable principles of law.

16         (j)  The Financial Services Commission must adopt rules

17  of procedure for claims mediation, taking into consideration a

18  system that is consistent with this section and that:

19         1.  Is fair.

20         2.  Promotes settlement.

21         3.  Avoids delay.

22         4.  Is nonadversarial.

23         5.  Used a framework for modern mediating technique.

24         6.  Controls costs and expenses of mediation.

25         7.  Provides that, as to persons not represented by an

26  attorney, consumer affairs specialists of the department shall

27  be available for consultation to the extent that they may

28  lawfully do so, and that the mediator shall diligently inquire

29  and ascertain all facts necessary to formulate a fair and

30  informed recommendation pursuant to paragraph (m).

31  

                                  71

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (k)  Disclosures and information divulged in the

 2  mediation process are not admissible in any subsequent action

 3  or proceeding relating to the claim or to the cause of action

 4  giving rise to the claim, except as provided in paragraph (m).

 5         (l)  A person demanding mediation under this section

 6  may not demand or request mediation after a suit is filed

 7  relating to the same issues already mediated.

 8         (m)  For matters that are not resolved by the parties

 9  at the conclusion of the mediation, the mediator shall prepare

10  a report recommending whether any amount is due and, if so,

11  the amount deemed to be owed on an itemized basis. Such report

12  shall be sent to all parties in attendance at the mediation

13  and to the department. This recommendation is not binding on

14  any party and the parties retain access to courts. The

15  mediator's written recommendation is admissible in any

16  subsequent action or proceeding relating to the claim or to

17  the cause of action giving rise to the claim only for purposes

18  of determining the award of attorney's fees.

19         (n)  If the insurer declines to participate in

20  mediation or declines to pay the amount recommended in a

21  mediator's report, the insurer remains potentially liable for

22  reasonable attorney's fees pursuant to law. In such cases,

23  contingency risk multipliers apply only if the court

24  determines and states explicitly the particular legal or

25  factual issue involved and provides reasons supporting its

26  determination. The contingency risk multiplier shall be 2.5 if

27  the court determines that the issue is of such great public

28  importance that the public interest requires the determination

29  of that issue.

30         (o)  If the claimant declines to mediate or declines to

31  settle the matter in accordance with the recommendation of the

                                  72

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  mediator pursuant to this section, the insurer is not liable

 2  for attorney's fees otherwise required by provisions of the

 3  insurance code or for damages under s. 624.155.

 4         (p)  The insurer is not liable for attorney's fees

 5  otherwise required by provisions of the insurance code or for

 6  damages under s. 624.155 if the insurer tenders payment of the

 7  amount demanded in the demand letter at any time prior to the

 8  insurer's receipt of the mediator's written recommendation, or

 9  tenders the amount recommended within 10 days after the

10  insurer's receipt of the mediator's written recommendation,

11  together with the mediator's fee if any has accrued,

12  applicable interest, and a penalty of 10 percent of the

13  overdue amount paid by the insurer, subject to a maximum

14  penalty of $250. If the dispute involves an insurer's

15  withdrawal of payment under paragraph (7)(a) for future

16  treatment not yet rendered, the insurer is not liable in any

17  action for attorney's fees otherwise required by the insurance

18  code or for damages under s. 624.155 if within 10 business

19  days after its receipt of the written recommendation of the

20  peer reviewer, or at any time prior to or during the pendency

21  of a dispute under this subsection, the insurer tenders the

22  mediator's fee if any has accrued, and mails to the claimant a

23  written statement of its agreement to pay for such treatment

24  in accordance with the claimant's demand or mediator's

25  recommendation and to pay a penalty of 10 percent, subject to

26  a maximum penalty of $250, when it pays for such future

27  treatment in accordance with this section. However, if the

28  mediator recommends an amount that is in excess of the amount

29  that the insurer has paid, the insurer is liable for

30  reasonable attorney's fees of the claimant of up to $1,000, as

31  determined by the mediator. For purposes of this subsection,

                                  73

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  payment or the insurer's agreement shall be treated as being

 2  made on the date a draft or other valid instrument that is

 3  equivalent to payment or tender of payment, or the insurer's

 4  written statement of agreement, is placed in the United States

 5  mail in a properly addressed, postpaid envelope, or if not so

 6  posted, on the date of delivery.

 7         (q)  An action may not be brought against an insurer

 8  without attaching a copy of the notice required by this

 9  subsection and a copy of the proof of delivery of the notice

10  required by this section.

11         (r)  A party may seek judicial review of the

12  recommendation of the mediator to determine whether the

13  recommendation was reasonable. A recommendation is reasonable

14  unless it was procured by corruption, fraud, or other undue

15  means; there was evident partiality by the peer reviewer or

16  misconduct prejudicing the rights of any party; or the

17  mediator exceeded the authority and power granted by this

18  subsection. If the court declares the recommendation to be not

19  reasonable, the mediation recommendation shall be vacated, the

20  department shall provide a different mediator to review the

21  dispute and issue a recommendation, and the mediation process

22  shall proceed as if no action had been filed.

23         (14)(12)  CIVIL ACTION FOR INSURANCE FRAUD.--

24         (a)  An insurer shall have a cause of action against

25  any person convicted of, or who, regardless of adjudication of

26  guilt, pleads guilty or nolo contendere to insurance fraud

27  under s. 817.234, patient brokering under s. 817.505, or

28  kickbacks under s. 456.054, associated with a claim for

29  personal injury protection benefits in accordance with this

30  section.  An insurer prevailing in an action brought under

31  this subsection may recover compensatory, consequential, and

                                  74

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  punitive damages subject to the requirements and limitations

 2  of part II of chapter 768, and attorney's fees and costs

 3  incurred in litigating a cause of action against any person

 4  convicted of, or who, regardless of adjudication of guilt,

 5  pleads guilty or nolo contendere to insurance fraud under s.

 6  817.234, patient brokering under s. 817.505, or kickbacks

 7  under s. 456.054, associated with a claim for personal injury

 8  protection benefits in accordance with this section.

 9         (b)  Notwithstanding its payment, an insurer and

10  insured shall not be precluded from maintaining a civil cause

11  of action against any person or business entity to recover

12  payments for services later determined to have been unlawfully

13  rendered or otherwise in violation of any provision of this

14  section.

15         (15)  If the Financial Services Commission determines

16  that the cost savings under personal injury protection

17  insurance benefits paid by insurers have been realized due to

18  the provisions of this act, prior legislative reforms, or

19  other factors, the commission may increase the minimum $10,000

20  benefit coverage requirement. In establishing the amount of

21  such increase, the commission must determine that the

22  additional premium for such coverage is approximately equal to

23  the premium cost savings that have been realized for the

24  personal injury protection coverage with limits of $10,000.

25         Section 10.  Subsection (2) of section 627.739, Florida

26  Statutes, is amended to read:

27         627.739  Personal injury protection; optional

28  limitations; deductibles.--

29         (2)  Insurers shall offer to each applicant and to each

30  policyholder, upon the renewal of an existing policy,

31  deductibles, in amounts of $250, $500, $1,000, and $2,000. The

                                  75

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  deductible amount must be applied to 100 percent of the

 2  expenses and losses described in s. 627.736. After the

 3  deductible is met, each insured is eligible to receive up to

 4  $10,000 in total benefits described in s. 627.736(1)., such

 5  amount to be deducted from the benefits otherwise due each

 6  person subject to the deduction. However, this subsection

 7  shall not be applied to reduce the amount of any benefits

 8  received in accordance with s. 627.736(1)(c).

 9         Section 11.  Subsection (9) is added to section 768.79,

10  Florida Statutes, to read:

11         768.79  Offer of judgment and demand for judgment.--

12         (9)  This section is applicable to any civil action

13  filed which applies to s. 627.736, in any court in this state.

14  A filing in compliance with this section does not constitute

15  an admission of coverage, and an insurer may not be estopped

16  from denying coverage, denying liability, or defending against

17  any claim on its merits.

18         Section 12.  Subsections (7), (8), and (9) of section

19  817.234, Florida Statutes, are amended to read:

20         817.234  False and fraudulent insurance claims.--

21         (7)(a)  It shall constitute a material omission and

22  insurance fraud for any physician or other provider, other

23  than a hospital, to engage in a general business practice of

24  billing amounts as its usual and customary charge, if such

25  provider has agreed with the patient or intends to waive

26  deductibles or copayments, or does not for any other reason

27  intend to collect the total amount of such charge.

28         (b)  The provisions of this section shall also apply as

29  to any insurer or adjusting firm or its agents or

30  representatives who, with intent, injure, defraud, or deceive

31  any claimant with regard to any claim.  The claimant shall

                                  76

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  have the right to recover the damages provided in this

 2  section.

 3         (c)  An insurer, or any person acting at the direction

 4  of or on behalf of an insurer, may not change an opinion in a

 5  mental or physical report prepared under s. 627.736(7) or

 6  direct the physician preparing the report to change such

 7  opinion; however, this provision does not preclude the insurer

 8  from calling to the attention of the physician errors of fact

 9  in the report based upon information in the claim file. Any

10  person who violates this paragraph commits a felony of the

11  third degree, punishable as provided in s. 775.082, s.

12  775.083, or s. 775.084.

13         (8)(a)  A It is unlawful for any person may not, in his

14  or her individual capacity or in his or her capacity as a

15  public or private employee, or for any firm, corporation,

16  partnership, or association, to solicit or cause to be

17  solicited any business from a person involved in a motor

18  vehicle accident with the intent of defrauding any other

19  person, by any means of communication other than advertising

20  directed to the public for the purpose of making motor vehicle

21  tort claims or claims for personal injury protection benefits

22  required by s. 627.736.  Charges for any services rendered by

23  a health care provider or attorney who violates this

24  subsection in regard to the person for whom such services were

25  rendered are noncompensable and unenforceable as a matter of

26  law. Any person who violates the provisions of this paragraph

27  subsection commits a felony of the second third degree,

28  punishable as provided in s. 775.082, s. 775.083, or s.

29  775.084. A person who is convicted of a violation of this

30  subsection shall be sentenced to a minimum term of

31  imprisonment of 2 years.

                                  77

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         (b)  A person may not solicit or cause to be solicited

 2  any business from a person involved in a motor vehicle

 3  accident by any means of communication other than advertising

 4  directed to the public for the purpose of making motor vehicle

 5  tort claims or claims for personal injury protection benefits

 6  required by s. 627.736, within 60 days after the occurrence of

 7  the motor vehicle accident. Any person who violates this

 8  paragraph commits a felony of the third degree, punishable as

 9  provided in s. 775.082, s. 775.083, or s. 775.084.

10         (c)  A lawyer, health care practitioner as defined in

11  s. 456.001, or owner or medical director of a clinic required

12  to be licensed pursuant to s. 400.903 may not, at any time

13  after 60 days have elapsed from the occurrence of a motor

14  vehicle accident, solicit or cause to be solicited any

15  business from a person involved in a motor vehicle accident by

16  means of in-person or telephone contact at the person's

17  residence, for the purpose of making motor vehicle tort claims

18  or claims for personal injury protection benefits required by

19  s. 627.736. Any person who violates this paragraph commits a

20  felony of the third degree, punishable as provided in s.

21  775.082, s. 775.083, or s. 775.084.

22         (d)  Charges for any services rendered by any person

23  who violates this subsection in regard to the person for whom

24  such services were rendered are noncompensable and

25  unenforceable as a matter of law.

26         (9)  A person may not organize, plan, or knowingly

27  participate in an intentional motor vehicle crash for the

28  purpose of making motor vehicle tort claims or claims for

29  personal injury protection benefits as required by s. 627.736.

30  It is unlawful for any attorney to solicit any business

31  relating to the representation of a person involved in a motor

                                  78

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  vehicle accident for the purpose of filing a motor vehicle

 2  tort claim or a claim for personal injury protection benefits

 3  required by s. 627.736.  The solicitation by advertising of

 4  any business by an attorney relating to the representation of

 5  a person injured in a specific motor vehicle accident is

 6  prohibited by this section. Any person attorney who violates

 7  the provisions of this paragraph subsection commits a felony

 8  of the second third degree, punishable as provided in s.

 9  775.082, s. 775.083, or s. 775.084. A person who is convicted

10  of a violation of this subsection shall be sentenced to a

11  minimum term of imprisonment of 2 years. Whenever any circuit

12  or special grievance committee acting under the jurisdiction

13  of the Supreme Court finds probable cause to believe that an

14  attorney is guilty of a violation of this section, such

15  committee shall forward to the appropriate state attorney a

16  copy of the finding of probable cause and the report being

17  filed in the matter. This section shall not be interpreted to

18  prohibit advertising by attorneys which does not entail a

19  solicitation as described in this subsection and which is

20  permitted by the rules regulating The Florida Bar as

21  promulgated by the Florida Supreme Court.

22         Section 13.  Section 817.236, Florida Statutes, is

23  amended to read:

24         817.236  False and fraudulent motor vehicle insurance

25  application.--Any person who, with intent to injure, defraud,

26  or deceive any motor vehicle insurer, including any

27  statutorily created underwriting association or pool of motor

28  vehicle insurers, presents or causes to be presented any

29  written application, or written statement in support thereof,

30  for motor vehicle insurance knowing that the application or

31  statement contains any false, incomplete, or misleading

                                  79

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  information concerning any fact or matter material to the

 2  application commits a felony misdemeanor of the third first

 3  degree, punishable as provided in s. 775.082, or s. 775.083,

 4  or s. 775.084.

 5         Section 14.  Section 817.2361, Florida Statutes, is

 6  created to read:

 7         817.2361  False or fraudulent motor vehicle insurance

 8  card.--Any person who, with intent to deceive any other

 9  person, creates, markets, or presents a false or fraudulent

10  motor vehicle insurance card commits a felony of the third

11  degree, punishable as provided in s. 775.082, s. 775.083, or

12  s. 775.084.

13         Section 15.  Effective October 1, 2003, paragraphs (c)

14  and (g) of subsection (3) of section 921.0022, Florida

15  Statutes, are amended to read:

16         921.0022  Criminal Punishment Code; offense severity

17  ranking chart.--

18         (3)  OFFENSE SEVERITY RANKING CHART

19  

20  Florida           Felony

21  Statute           Degree             Description

22  

23    

24                              (c)  LEVEL 3

25  119.10(3)          3rd      Unlawful use of confidential

26                              information from police reports.

27  316.066(3)(d)-(f)  3rd      Unlawfully obtaining or using

28                              confidential crash reports.

29  316.193(2)(b)      3rd      Felony DUI, 3rd conviction.

30  

31  

                                  80

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  316.1935(2)        3rd      Fleeing or attempting to elude

 2                              law enforcement officer in marked

 3                              patrol vehicle with siren and

 4                              lights activated.

 5  319.30(4)          3rd      Possession by junkyard of motor

 6                              vehicle with identification

 7                              number plate removed.

 8  319.33(1)(a)       3rd      Alter or forge any certificate of

 9                              title to a motor vehicle or

10                              mobile home.

11  319.33(1)(c)       3rd      Procure or pass title on stolen

12                              vehicle.

13  319.33(4)          3rd      With intent to defraud, possess,

14                              sell, etc., a blank, forged, or

15                              unlawfully obtained title or

16                              registration.

17  327.35(2)(b)       3rd      Felony BUI.

18  328.05(2)          3rd      Possess, sell, or counterfeit

19                              fictitious, stolen, or fraudulent

20                              titles or bills of sale of

21                              vessels.

22  328.07(4)          3rd      Manufacture, exchange, or possess

23                              vessel with counterfeit or wrong

24                              ID number.

25  376.302(5)         3rd      Fraud related to reimbursement

26                              for cleanup expenses under the

27                              Inland Protection Trust Fund.

28  400.903(3)         3rd      Operating a clinic without a

29                              license or filing false license

30                              application or other required

31                              information.

                                  81

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  501.001(2)(b)      2nd      Tampers with a consumer product

 2                              or the container using materially

 3                              false/misleading information.

 4  697.08             3rd      Equity skimming.

 5  790.15(3)          3rd      Person directs another to

 6                              discharge firearm from a vehicle.

 7  796.05(1)          3rd      Live on earnings of a prostitute.

 8  806.10(1)          3rd      Maliciously injure, destroy, or

 9                              interfere with vehicles or

10                              equipment used in firefighting.

11  806.10(2)          3rd      Interferes with or assaults

12                              firefighter in performance of

13                              duty.

14  810.09(2)(c)       3rd      Trespass on property other than

15                              structure or conveyance armed

16                              with firearm or dangerous weapon.

17  812.014(2)(c)2.    3rd      Grand theft; $5,000 or more but

18                              less than $10,000.

19  812.0145(2)(c)     3rd      Theft from person 65 years of age

20                              or older; $300 or more but less

21                              than $10,000.

22  815.04(4)(b)       2nd      Computer offense devised to

23                              defraud or obtain property.

24  817.034(4)(a)3.    3rd      Engages in scheme to defraud

25                              (Florida Communications Fraud

26                              Act), property valued at less

27                              than $20,000.

28  817.233            3rd      Burning to defraud insurer.

29  

30  

31  

                                  82

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  817.234(8)

 2  (b)-(c)&(9)        3rd      Unlawful solicitation of persons

 3                              involved in motor vehicle

 4                              accidents.

 5  817.234(11)(a)     3rd      Insurance fraud; property value

 6                              less than $20,000.

 7  817.236            3rd      Filing a false motor vehicle

 8                              insurance application.

 9  817.2361           3rd      Creating, marketing, or

10                              presenting a false or fraudulent

11                              motor vehicle insurance card.

12  817.505(4)         3rd      Patient brokering.

13  828.12(2)          3rd      Tortures any animal with intent

14                              to inflict intense pain, serious

15                              physical injury, or death.

16  831.28(2)(a)       3rd      Counterfeiting a payment

17                              instrument with intent to defraud

18                              or possessing a counterfeit

19                              payment instrument.

20  831.29             2nd      Possession of instruments for

21                              counterfeiting drivers' licenses

22                              or identification cards.

23  838.021(3)(b)      3rd      Threatens unlawful harm to public

24                              servant.

25  843.19             3rd      Injure, disable, or kill police

26                              dog or horse.

27  870.01(2)          3rd      Riot; inciting or encouraging.

28  

29  

30  

31  

                                  83

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  893.13(1)(a)2.     3rd      Sell, manufacture, or deliver

 2                              cannabis (or other s.

 3                              893.03(1)(c), (2)(c)1., (2)(c)2.,

 4                              (2)(c)3., (2)(c)5., (2)(c)6.,

 5                              (2)(c)7., (2)(c)8., (2)(c)9.,

 6                              (3), or (4) drugs).

 7  893.13(1)(d)2.     2nd      Sell, manufacture, or deliver s.

 8                              893.03(1)(c), (2)(c)1., (2)(c)2.,

 9                              (2)(c)3., (2)(c)5., (2)(c)6.,

10                              (2)(c)7., (2)(c)8., (2)(c)9.,

11                              (3), or (4) drugs within 200 feet

12                              of university or public park.

13  893.13(1)(f)2.     2nd      Sell, manufacture, or deliver s.

14                              893.03(1)(c), (2)(c)1., (2)(c)2.,

15                              (2)(c)3., (2)(c)5., (2)(c)6.,

16                              (2)(c)7., (2)(c)8., (2)(c)9.,

17                              (3), or (4) drugs within 200 feet

18                              of public housing facility.

19  893.13(6)(a)       3rd      Possession of any controlled

20                              substance other than felony

21                              possession of cannabis.

22  893.13(7)(a)8.     3rd      Withhold information from

23                              practitioner regarding previous

24                              receipt of or prescription for a

25                              controlled substance.

26  893.13(7)(a)9.     3rd      Obtain or attempt to obtain

27                              controlled substance by fraud,

28                              forgery, misrepresentation, etc.

29  893.13(7)(a)10.    3rd      Affix false or forged label to

30                              package of controlled substance.

31  

                                  84

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  893.13(7)(a)11.    3rd      Furnish false or fraudulent

 2                              material information on any

 3                              document or record required by

 4                              chapter 893.

 5  893.13(8)(a)1.     3rd      Knowingly assist a patient, other

 6                              person, or owner of an animal in

 7                              obtaining a controlled substance

 8                              through deceptive, untrue, or

 9                              fraudulent representations in or

10                              related to the practitioner's

11                              practice.

12  893.13(8)(a)2.     3rd      Employ a trick or scheme in the

13                              practitioner's practice to assist

14                              a patient, other person, or owner

15                              of an animal in obtaining a

16                              controlled substance.

17  893.13(8)(a)3.     3rd      Knowingly write a prescription

18                              for a controlled substance for a

19                              fictitious person.

20  893.13(8)(a)4.     3rd      Write a prescription for a

21                              controlled substance for a

22                              patient, other person, or an

23                              animal if the sole purpose of

24                              writing the prescription is a

25                              monetary benefit for the

26                              practitioner.

27  918.13(1)(a)       3rd      Alter, destroy, or conceal

28                              investigation evidence.

29  944.47

30   (1)(a)1.-2.       3rd      Introduce contraband to

31                              correctional facility.

                                  85

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  944.47(1)(c)       2nd      Possess contraband while upon the

 2                              grounds of a correctional

 3                              institution.

 4  985.3141           3rd      Escapes from a juvenile facility

 5                              (secure detention or residential

 6                              commitment facility).

 7                              (g)  LEVEL 7

 8  316.193(3)(c)2.    3rd      DUI resulting in serious bodily

 9                              injury.

10  327.35(3)(c)2.     3rd      Vessel BUI resulting in serious

11                              bodily injury.

12  402.319(2)         2nd      Misrepresentation and negligence

13                              or intentional act resulting in

14                              great bodily harm, permanent

15                              disfiguration, permanent

16                              disability, or death.

17  409.920(2)         3rd      Medicaid provider fraud.

18  456.065(2)         3rd      Practicing a health care

19                              profession without a license.

20  456.065(2)         2nd      Practicing a health care

21                              profession without a license

22                              which results in serious bodily

23                              injury.

24  458.327(1)         3rd      Practicing medicine without a

25                              license.

26  459.013(1)         3rd      Practicing osteopathic medicine

27                              without a license.

28  460.411(1)         3rd      Practicing chiropractic medicine

29                              without a license.

30  461.012(1)         3rd      Practicing podiatric medicine

31                              without a license.

                                  86

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  462.17             3rd      Practicing naturopathy without a

 2                              license.

 3  463.015(1)         3rd      Practicing optometry without a

 4                              license.

 5  464.016(1)         3rd      Practicing nursing without a

 6                              license.

 7  465.015(2)         3rd      Practicing pharmacy without a

 8                              license.

 9  466.026(1)         3rd      Practicing dentistry or dental

10                              hygiene without a license.

11  467.201            3rd      Practicing midwifery without a

12                              license.

13  468.366            3rd      Delivering respiratory care

14                              services without a license.

15  483.828(1)         3rd      Practicing as clinical laboratory

16                              personnel without a license.

17  483.901(9)         3rd      Practicing medical physics

18                              without a license.

19  484.013(1)(c)      3rd      Preparing or dispensing optical

20                              devices without a prescription.

21  484.053            3rd      Dispensing hearing aids without a

22                              license.

23  494.0018(2)        1st      Conviction of any violation of

24                              ss. 494.001-494.0077 in which the

25                              total money and property

26                              unlawfully obtained exceeded

27                              $50,000 and there were five or

28                              more victims.

29  

30  

31  

                                  87

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  560.123(8)(b)1.    3rd      Failure to report currency or

 2                              payment instruments exceeding

 3                              $300 but less than $20,000 by

 4                              money transmitter.

 5  560.125(5)(a)      3rd      Money transmitter business by

 6                              unauthorized person, currency or

 7                              payment instruments exceeding

 8                              $300 but less than $20,000.

 9  655.50(10)(b)1.    3rd      Failure to report financial

10                              transactions exceeding $300 but

11                              less than $20,000 by financial

12                              institution.

13  782.051(3)         2nd      Attempted felony murder of a

14                              person by a person other than the

15                              perpetrator or the perpetrator of

16                              an attempted felony.

17  782.07(1)          2nd      Killing of a human being by the

18                              act, procurement, or culpable

19                              negligence of another

20                              (manslaughter).

21  782.071            2nd      Killing of human being or viable

22                              fetus by the operation of a motor

23                              vehicle in a reckless manner

24                              (vehicular homicide).

25  782.072            2nd      Killing of a human being by the

26                              operation of a vessel in a

27                              reckless manner (vessel

28                              homicide).

29  784.045(1)(a)1.    2nd      Aggravated battery; intentionally

30                              causing great bodily harm or

31                              disfigurement.

                                  88

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  784.045(1)(a)2.    2nd      Aggravated battery; using deadly

 2                              weapon.

 3  784.045(1)(b)      2nd      Aggravated battery; perpetrator

 4                              aware victim pregnant.

 5  784.048(4)         3rd      Aggravated stalking; violation of

 6                              injunction or court order.

 7  784.07(2)(d)       1st      Aggravated battery on law

 8                              enforcement officer.

 9  784.074(1)(a)      1st      Aggravated battery on sexually

10                              violent predators facility staff.

11  784.08(2)(a)       1st      Aggravated battery on a person 65

12                              years of age or older.

13  784.081(1)         1st      Aggravated battery on specified

14                              official or employee.

15  784.082(1)         1st      Aggravated battery by detained

16                              person on visitor or other

17                              detainee.

18  784.083(1)         1st      Aggravated battery on code

19                              inspector.

20  790.07(4)          1st      Specified weapons violation

21                              subsequent to previous conviction

22                              of s. 790.07(1) or (2).

23  790.16(1)          1st      Discharge of a machine gun under

24                              specified circumstances.

25  790.165(2)         2nd      Manufacture, sell, possess, or

26                              deliver hoax bomb.

27  790.165(3)         2nd      Possessing, displaying, or

28                              threatening to use any hoax bomb

29                              while committing or attempting to

30                              commit a felony.

31  

                                  89

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  790.166(3)         2nd      Possessing, selling, using, or

 2                              attempting to use a hoax weapon

 3                              of mass destruction.

 4  790.166(4)         2nd      Possessing, displaying, or

 5                              threatening to use a hoax weapon

 6                              of mass destruction while

 7                              committing or attempting to

 8                              commit a felony.

 9  796.03             2nd      Procuring any person under 16

10                              years for prostitution.

11  800.04(5)(c)1.     2nd      Lewd or lascivious molestation;

12                              victim less than 12 years of age;

13                              offender less than 18 years.

14  800.04(5)(c)2.     2nd      Lewd or lascivious molestation;

15                              victim 12 years of age or older

16                              but less than 16 years; offender

17                              18 years or older.

18  806.01(2)          2nd      Maliciously damage structure by

19                              fire or explosive.

20  810.02(3)(a)       2nd      Burglary of occupied dwelling;

21                              unarmed; no assault or battery.

22  810.02(3)(b)       2nd      Burglary of unoccupied dwelling;

23                              unarmed; no assault or battery.

24  810.02(3)(d)       2nd      Burglary of occupied conveyance;

25                              unarmed; no assault or battery.

26  812.014(2)(a)      1st      Property stolen, valued at

27                              $100,000 or more; cargo stolen

28                              valued at $50,000 or more;

29                              property stolen while causing

30                              other property damage; 1st degree

31                              grand theft.

                                  90

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  812.014(2)(b)3.    2nd      Property stolen, emergency

 2                              medical equipment; 2nd degree

 3                              grand theft.

 4  812.0145(2)(a)     1st      Theft from person 65 years of age

 5                              or older; $50,000 or more.

 6  812.019(2)         1st      Stolen property; initiates,

 7                              organizes, plans, etc., the theft

 8                              of property and traffics in

 9                              stolen property.

10  812.131(2)(a)      2nd      Robbery by sudden snatching.

11  812.133(2)(b)      1st      Carjacking; no firearm, deadly

12                              weapon, or other weapon.

13  817.234(8)(a)      2nd      Solicitation of motor vehicle

14                              accident victims with intent to

15                              defraud.

16  817.234(9)         2nd      Organizing, planning, or

17                              participating in an intentional

18                              motor vehicle collision.

19  817.234(11)(c)     1st      Insurance fraud; property value

20                              $100,000 or more.

21  825.102(3)(b)      2nd      Neglecting an elderly person or

22                              disabled adult causing great

23                              bodily harm, disability, or

24                              disfigurement.

25  825.103(2)(b)      2nd      Exploiting an elderly person or

26                              disabled adult and property is

27                              valued at $20,000 or more, but

28                              less than $100,000.

29  827.03(3)(b)       2nd      Neglect of a child causing great

30                              bodily harm, disability, or

31                              disfigurement.

                                  91

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  827.04(3)          3rd      Impregnation of a child under 16

 2                              years of age by person 21 years

 3                              of age or older.

 4  837.05(2)          3rd      Giving false information about

 5                              alleged capital felony to a law

 6                              enforcement officer.

 7  872.06             2nd      Abuse of a dead human body.

 8  893.13(1)(c)1.     1st      Sell, manufacture, or deliver

 9                              cocaine (or other drug prohibited

10                              under s. 893.03(1)(a), (1)(b),

11                              (1)(d), (2)(a), (2)(b), or

12                              (2)(c)4.) within 1,000 feet of a

13                              child care facility or school.

14  893.13(1)(e)1.     1st      Sell, manufacture, or deliver

15                              cocaine or other drug prohibited

16                              under s. 893.03(1)(a), (1)(b),

17                              (1)(d), (2)(a), (2)(b), or

18                              (2)(c)4., within 1,000 feet of

19                              property used for religious

20                              services or a specified business

21                              site.

22  893.13(4)(a)       1st      Deliver to minor cocaine (or

23                              other s. 893.03(1)(a), (1)(b),

24                              (1)(d), (2)(a), (2)(b), or

25                              (2)(c)4. drugs).

26  893.135(1)(a)1.    1st      Trafficking in cannabis, more

27                              than 25 lbs., less than 2,000

28                              lbs.

29  893.135

30   (1)(b)1.a.        1st      Trafficking in cocaine, more than

31                              28 grams, less than 200 grams.

                                  92

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  893.135

 2   (1)(c)1.a.        1st      Trafficking in illegal drugs,

 3                              more than 4 grams, less than 14

 4                              grams.

 5  893.135

 6   (1)(d)1.          1st      Trafficking in phencyclidine,

 7                              more than 28 grams, less than 200

 8                              grams.

 9  893.135(1)(e)1.    1st      Trafficking in methaqualone, more

10                              than 200 grams, less than 5

11                              kilograms.

12  893.135(1)(f)1.    1st      Trafficking in amphetamine, more

13                              than 14 grams, less than 28

14                              grams.

15  893.135

16   (1)(g)1.a.        1st      Trafficking in flunitrazepam, 4

17                              grams or more, less than 14

18                              grams.

19  893.135

20   (1)(h)1.a.        1st      Trafficking in

21                              gamma-hydroxybutyric acid (GHB),

22                              1 kilogram or more, less than 5

23                              kilograms.

24  893.135

25   (1)(j)1.a.        1st      Trafficking in 1,4-Butanediol, 1

26                              kilogram or more, less than 5

27                              kilograms.

28  893.135

29   (1)(k)2.a.        1st      Trafficking in Phenethylamines,

30                              10 grams or more, less than 200

31                              grams.

                                  93

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  896.101(5)(a)      3rd      Money laundering, financial

 2                              transactions exceeding $300 but

 3                              less than $20,000.

 4  896.104(4)(a)1.    3rd      Structuring transactions to evade

 5                              reporting or registration

 6                              requirements, financial

 7                              transactions exceeding $300 but

 8                              less than $20,000.

 9         Section 16.  The amendments made by this act to

10  sections 456.0375(1)(b) and 627.736(5)(b)3. and 6., Florida

11  Statutes, are intended to clarify the legislative intent of

12  those provisions as they existed at the time those provisions

13  initially took effect. Accordingly, sections 456.0375(1)(b)

14  and 627.736(5)(b)3., Florida Statutes, as amended by this act

15  shall operate retroactively to October 1, 2001; and section

16  627.736(5)(b)6., as amended by this act, shall operate

17  retroactively to June 19, 2001.

18         Section 17.  Effective March 1, 2004, section 456.0375,

19  Florida Statutes, is repealed.

20         Section 18.  (1)  On or before January 1, 2004, every

21  insurer writing with a managing general agent and having a

22  per-policy fee in its rate filing shall make a rate filing

23  under section 627.0651, Florida Statutes, to conform its

24  per-policy fee to the requirements of this act.

25         (2)  Any increase in benefits approved by the Financial

26  Services Commission under subsection (14) of section 627.736,

27  Florida Statutes, as added by this act, shall apply to new and

28  renewal policies that are effective 120 days after the order

29  issued by the commission becomes final. Subsection (2) of

30  section 627.739, Florida Statutes, as amended by this act,

31  

                                  94

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  shall apply to new and renewal policies issued on or after

 2  October 1, 2003.

 3         (3)  Subject to any specific effective dates in this

 4  act, paragraphs (4)(b), (5)(b), (5)(c), (5)(e), (5)(f),

 5  (5)(g), and (5)(h) of section 627.736, Florida Statutes, as

 6  amended by this act, shall apply to treatment and services

 7  occurring on or after October 1, 2003.

 8         (4)  Subsection (11) of section 627.736, Florida

 9  Statutes, as amended by this act, shall apply to actions filed

10  on and after the effective date of this act. Subsections (12)

11  and (13) of section 627.736, Florida Statutes, as amended by

12  this act, shall apply to new and renewal policies issued on

13  and after October 1, 2003.

14         (5)  Paragraph (7)(a) of section 627.736, Florida

15  Statutes, as amended by this act, and paragraph (7)(c) of

16  section 817.234, Florida Statutes, as amended by this act,

17  shall apply to examinations conducted on and after October 1,

18  2003.

19         Section 19.  By December 31, 2004, the Department of

20  Financial Services, the Department of Health, and the Agency

21  for Health Care Administration each shall submit a report on

22  the implementation of this act and recommendations, if any, to

23  further improve the automobile insurance market, reduce

24  automobile insurance costs, and reduce automobile insurance

25  fraud and abuse to the President of the Senate and the Speaker

26  of the House of Representatives.

27         Section 20.  There is appropriated $2.5 million from

28  the Health Care Trust Fund, and 51 full-time equivalent

29  positions are authorized, for the Agency for Health Care

30  Administration to implement the provisions of this act.

31  

                                  95

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1         Section 21.  Except as otherwise expressly provided in

 2  this act, this act shall take effect July 1, 2003.

 3  

 4  

 5  

 6  

 7  

 8  

 9  

10  

11  

12  

13  

14  

15  

16  

17  

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

                                  96

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                      Senate Bill CS/SB 1202

 3                                 

 4  The committee substitute establishes an expedited peer review
    procedure to resolve personal injury protection (PIP) disputes
 5  involving medical and other related issues between claimants,
    providers and insurers. Provides definitions; qualifications
 6  for peer reviewers; notice provisions; review procedures;
    costs; and attorney's fees. The Agency for Health Care
 7  Administration (AHCA) will administer the peer review program.

 8  Designates mediation as the alternative dispute resolution
    process and restricts its application to non-medical issues.
 9  
    Provides that third-party vendors approved by the Division of
10  Insurance Fraud within the Department of Financial Services
    may furnish crash reports solely to insurers for adjustment
11  and claims' investigation purposes. Provides that such vendors
    are subject to criminal penalties.
12  
    Provides exceptions to the definition of a "clinic" relating
13  to continuing care facilities, community college and
    university clinics, and clinical facilities affiliated with
14  medical schools.

15  Provides for a six-month extension for a magnetic resonance
    imaging (MRI) facility to become accredited by specified
16  accreditation organizations. Prohibits certain entities formed
    for the purpose of avoiding compliance with the accreditation
17  requirements from being licensed as clinics.

18  Provides for the definition of an independent diagnostic
    testing facility to include both the technical testing
19  component and professional service component and that the
    lawful billing by such a facility does not violate the
20  upcoding restriction.

21  Narrows the definition of what services are "incident" to a
    physician's services.
22  
    Reduces the amount of insurance policy fees provided to
23  specified entities for the investigation and prosecution of
    motor vehicle insurance fraud.
24  
    Specifies that certain tests and services, including MRI
25  services, are subject to 200 percent of the Medicare Part B
    Participating Physician fee schedule and that other specified
26  tests are subject to the workers' compensation fee schedule.
    Provides for the Financial Services Commission to at least
27  annually review changes to the Medicare fee schedule and adopt
    such changes for PIP, if warranted to maintain availability
28  and affordability of services.

29  Clarifies that the disclosure and acknowledgement form
    pertains to the provision of services instead of charges and
30  exempts specified emergency services.

31  Removes the authority for the Department of Health to
    promulgate utilization guidelines.
                                  97

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2003                    CS for CS for SB 1202
    309-2532-03




 1  Provides an appropriation of $2.5 million from the Health Care
    Trust Fund and 51 FTE's for the Agency for Health Care
 2  Administration to implement the provisions of the act.

 3  Provides for effective dates.

 4  

 5  

 6  

 7  

 8  

 9  

10  

11  

12  

13  

14  

15  

16  

17  

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

                                  98

CODING: Words stricken are deletions; words underlined are additions.