House Bill 4045

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







    Florida House of Representatives - 1998                HB 4045

        By Representative Silver






  1                      A bill to be entitled

  2         An act relating to insurance fraud; amending s.

  3         627.613, F.S.; removing a limit on rewards for

  4         reductions of payments on improperly billed

  5         claims; providing construction; providing an

  6         effective date.

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

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10         Section 1.  Subsection (7) of section 627.613, Florida

11  Statutes, is amended to read:

12         627.613  Time of payment of claims.--

13         (7)  Upon written notification by an insured, an

14  insurer shall investigate any claim of improper billing by a

15  physician, hospital, or other health care provider.  The

16  insurer shall determine if the insured was properly billed for

17  only those procedures and services that the insured actually

18  received.  If the insurer determines that the insured has been

19  improperly billed, the insurer shall notify the insured and

20  the provider of its findings and shall reduce the amount of

21  payment to the provider by the amount determined to be

22  improperly billed.  If a reduction is made due to such

23  notification by the insured, the insurer shall pay to the

24  insured 20 percent of the amount of the reduction up to $500.

25  For purposes of this subsection, the term "insured" includes

26  any authorized agent of an insured.

27         Section 2.  This act shall take effect upon becoming a

28  law.

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






    Florida House of Representatives - 1998                HB 4045

    586-118-98






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  2                          HOUSE SUMMARY

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      Removes the $500 cap on rewards for reporting improperly
  4    billed medical claims which result in a reduction in
      payments.
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