Florida Senate - 2012 SENATOR AMENDMENT
Bill No. CS for CS for SB 1860
Senate . House
Floor: WD/2R .
03/06/2012 05:37 PM .
Senator Bennett moved the following:
1 Senate Amendment (with title amendment)
3 Delete lines 512 - 581
4 and insert:
5 (1) REQUIRED BENEFITS.—An
Every insurance policy complying
6 with the security requirements of s. 627.733 must shall provide
7 personal injury protection to the named insured, relatives
8 residing in the same household, persons operating the insured
9 motor vehicle, passengers in the such motor vehicle, and other
10 persons struck by the such motor vehicle and suffering bodily
11 injury while not an occupant of a self-propelled vehicle,
12 subject to the provisions of subsection (2) and paragraph
13 (4)(e), to a limit of $10,000 in medical and disability benefits
14 and $5,000 in death benefits resulting from for loss sustained
15 by any such person as a result of bodily injury, sickness,
16 disease, or death arising out of the ownership, maintenance, or
17 use of a motor vehicle as follows:
18 (a) Medical benefits.—Eighty percent of all reasonable
19 expenses for medically necessary medical, surgical, X-ray,
20 dental, and rehabilitative services, including prosthetic
21 devices , and medically necessary ambulance, hospital, and
22 nursing services, if the individual receives initial services
23 and care pursuant to subparagraph 1. within 14 days after the
24 motor vehicle accident. However, The medical benefits shall
25 provide reimbursement only for: such
26 1. Initial services and care that are lawfully provided,
27 supervised, ordered, or prescribed by a physician licensed under
28 chapter 458 or chapter 459, by a chiropractic physician licensed
29 under chapter 460, or by a dentist licensed under chapter 466 ,
30 or a chiropractic physician licensed under chapter 460 or that
31 are provided in a hospital or in a facility that owns, or is
32 wholly owned by, a hospital. Initial services and care may also
33 be provided by a person or entity licensed under part III of
34 chapter 401 which provides emergency transportation and
36 2. Followup services and care consistent with the
37 underlying medical diagnosis rendered pursuant to subparagraph
38 1., which may be provided, supervised, ordered, or prescribed
39 only by a physician licensed under chapter 458 or chapter 459, a
40 chiropractic physician licensed under chapter 460, a dentist
41 licensed under chapter 466, or, to the extent permitted by
42 applicable law and under the supervision of such physician,
43 osteopathic physician, chiropractic physician, or dentist, by a
44 physician assistant licensed under chapter 458 or chapter 459 or
45 an advanced registered nurse practitioner licensed under chapter
46 464. Followup services and care may also be provided by any of
47 the following persons or entities:
48 a. 1. A hospital or ambulatory surgical center licensed
49 under chapter 395.
50 2. A person or entity licensed under ss. 401.2101 - 401.45
51 that provides emergency transportation and treatment.
52 b. 3. An entity wholly owned by one or more physicians
53 licensed under chapter 458 or chapter 459, chiropractic
54 physicians licensed under chapter 460, or dentists licensed
55 under chapter 466 or by such practitioner or practitioners and
56 the spouse, parent, child, or sibling of such that practitioner
57 or those practitioners.
58 c. 4. An entity that owns or is wholly owned, directly or
59 indirectly, by a hospital or hospitals.
60 d. A physical therapist licensed under chapter 486.
61 e. 5. A health care clinic licensed under part X of chapter
62 400 which ss. 400.990 - 400.995 that is :
63 a. accredited by the Joint Commission on Accreditation of
64 Healthcare Organizations, the American Osteopathic Association,
65 the Commission on Accreditation of Rehabilitation Facilities, or
66 the Accreditation Association for Ambulatory Health Care, Inc., ;
68 b. A health care clinic that:
69 (I) Has a medical director licensed under chapter 458,
70 chapter 459, or chapter 460;
71 (II) Has been continuously licensed for more than 3 years
72 or is a publicly traded corporation that issues securities
73 traded on an exchange registered with the United States
74 Securities and Exchange Commission as a national securities
75 exchange; and
76 (III) Provides at least four of the following medical
78 (A) General medicine.
79 (B) Radiography.
80 (C) Orthopedic medicine.
81 (D) Physical medicine.
82 (E) Physical therapy.
83 (F) Physical rehabilitation.
84 (G) Prescribing or dispensing outpatient prescription
86 (H) Laboratory services.
87 3. Reimbursement for services and care provided by each
88 type of licensed medical provider authorized to render such
89 services and care is limited to the lesser of 24 treatments or
90 to services or care rendered within 12 weeks after the date of
91 the initial treatment, unless the insurer authorizes additional
92 services or care.
93 4. A physician licensed under chapter 458 or chapter 459, a
94 chiropractic physician licensed under chapter 460, or a dentist
95 licensed under chapter 466 who supervises services and care
96 pursuant to this subsection must be on the premises where the
97 services and care are being provided and the supervising
98 physician must provide his or her medical license number and the
99 times such treatment was rendered on all statements and bills
100 for such services and care. A supervising physician who submits
101 a false, misleading, or fraudulent claim for medical benefits
102 provided pursuant to this paragraph commits insurance fraud
103 pursuant to s. 817.234.
104 5. The Financial Services Commission shall adopt by rule
105 the form that must be used by an insurer and a health care
106 provider specified in sub-subparagraph 2.b., sub-subparagraph
107 2.c., or sub-subparagraph 2.e. subparagraph 3., subparagraph 4.,
108 or subparagraph 5. to document that the health care provider
109 meets the criteria of this paragraph, which rule must include a
110 requirement for a sworn statement or affidavit.
112 ================= T I T L E A M E N D M E N T ================
113 And the title is amended as follows:
114 Delete lines 45 - 47
115 and insert:
116 627.736, F.S.; revising the cap on benefits to provide
117 that death benefits are in addition to medical and
118 disability benefits; revising medical benefits;
119 distinguishing between initial and followup services
120 and specifying who may provide such services;
121 requiring physicians who supervise services and care
122 to be on the premises when supervised services are
123 provided and to include their license number on all
124 bills for services; providing that a physician who
125 submits a fraudulent statement commits insurance
126 fraud; requiring that an insurer