Senate Bill 2578c1

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    Florida Senate - 1999                           CS for SB 2578

    By the Committee on Judiciary and Senators Grant, Sebesta, Lee
    and Hargrett




    308-1981-99

  1                      A bill to be entitled

  2         An act relating to Hillsborough County;

  3         amending s. 1 of chapter 98-499, Laws of

  4         Florida; requiring that a hospital in

  5         Hillsborough County bill the insurer or other

  6         payor of third-party benefits prior to

  7         recording a lien; providing exceptions;

  8         providing for distribution of a patient's

  9         recovery from a third party; requiring that the

10         board of county commissioners of Hillsborough

11         County revise any ordinance adopted under

12         chapter 98-499, Laws of Florida, to incorporate

13         amendments made to the chapter 98-499, Laws of

14         Florida; repealing chapter 98-499, Laws of

15         Florida, unless the board of county

16         commissioners enacts an ordinance authorizing

17         liens to enforce payment for the medical care

18         of residents of Hillsborough County; providing

19         an effective date and an expiration date.

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

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23         Section 1.  Section 1 of chapter 98-499, Laws of

24  Florida, is amended to read:

25         Section 1.  The board of county commissioners of

26  Hillsborough County may provide by ordinance for liens in

27  favor of all operators of hospitals in Hillsborough County and

28  in favor of Hillsborough County when it pays for medical care,

29  treatment, or maintenance of qualifying residents of the

30  county upon all causes of action, suits, claims,

31  counterclaims, and demands accruing to persons to whom care,

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    Florida Senate - 1999                           CS for SB 2578
    308-1981-99




  1  treatment, or maintenance is furnished by such hospital or is

  2  paid for by Hillsborough County on behalf of a qualifying

  3  resident of the county, or accruing to the legal

  4  representatives of such persons, and upon all judgments,

  5  settlements, and settlement agreements entered into by virtue

  6  thereof on account of illness, injury, deformity, infirmity,

  7  abnormality, disease, or pregnancy giving rise to such causes

  8  of action, suits, claims, counterclaims, demands, judgments,

  9  settlements, and settlement agreements, and which necessitated

10  such care, treatment, or maintenance; and may provide by

11  ordinance for the attachment, perfection, priority, and

12  enforcement of such liens and for such procedural and other

13  matters as may be necessary or appropriate to carry out the

14  purposes of the ordinance. If the patient is covered by or is

15  a beneficiary of commercial, nongovernmental health insurance

16  coverage through a health maintenance organization or other

17  nongovernmental entity that is under contract with the

18  hospital to provide care to the patient at the time care and

19  treatment are delivered, then the lien shall be limited to the

20  covered charges in effect at the time care and treatment were

21  delivered, and the lien may shall not exceed the amount that

22  the hospital has contracted to accept from all sources for the

23  care and treatment of the patient. The hospital may not record

24  a lien unless the insurer or other payor of third-party

25  benefits, including the Medicaid or Medicare programs and the

26  County Indigent Health Care Plan, has been billed for the

27  covered charges, unless state or federal law or rules or

28  contract require the hospital to seek reimbursement from a

29  third party prior to billing the insurer, health plan, or

30  program. The hospital must accept the contract amount in

31  payment for the covered services, including the contract

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    Florida Senate - 1999                           CS for SB 2578
    308-1981-99




  1  amount provided under the Medicaid or Medicare programs,

  2  unless the patient received level I trauma center services, or

  3  the County Indigent Health Care Plan. The lien shall be for an

  4  amount that the court may determine to be the hospital's pro

  5  rata share for the debt owed the hospital for medical care,

  6  treatment, or maintenance furnished by such hospital, less its

  7  pro rata share of court costs expended by the plaintiff in the

  8  prosecution of the suit, including reasonable attorney's fees

  9  for the plaintiff's attorney. In determining the hospital's

10  pro rata share of those costs and attorney's fees, the

11  hospital shall have deducted from its recovery a percentage

12  amount equal to the percentage of the judgment or settlement

13  which is for costs and attorney's fees. Subject to this

14  deduction, the hospital shall recover from the judgment or

15  settlement, after costs and attorney's fees incurred by the

16  patient or patient's representative in that suit have been

17  deducted, 100 percent of the debt owed the hospital, except

18  that, if the patient or the patient's representative

19  demonstrates to the court that he or she did not recover full

20  value of damages sustained, the hospital shall recover from

21  the judgment or settlement, after costs and attorney's fees

22  incurred by the patient or patient's representative in that

23  suit have been deducted, a percentage of the debt owed the

24  hospital equal to the percentage that the patient's net

25  recovery is of the full value of the patient's damages. In the

26  event of a claim or action by the patient against a third

27  party for which the settlement or judgment is less than or

28  equal to a sum of the debt actually due and owing the

29  hospital, the settlement or judgment will be equitably

30  distributed based on the pro rata reduction in the amount due

31  the hospital and the patient, including a pro rata reduction

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    Florida Senate - 1999                           CS for SB 2578
    308-1981-99




  1  in the amount of reasonable attorney's fees and costs due the

  2  patient's attorney on that portion of the settlement or

  3  judgment attributable to the hospital lien. In the event of a

  4  claim or action by the patient against a third party for which

  5  the settlement or judgment exceeds the debt actually due and

  6  owing the hospital but is not adequate to cover the amount

  7  actually due and owing the hospital, as well as the patient's

  8  attorney's fees, then the settlement or judgment will be

  9  equitably distributed based on a pro rata share of the amount

10  due the hospital and the patient, including a pro rata share

11  for the amount of reasonable attorney's fees and costs due the

12  patient's attorney and the hospital's attorney. In the event

13  litigation is filed to recover a plaintiff's damages through

14  settlement or judgment, then the hospital's lien actually

15  collected shall be subject to assessment, by reduction, for

16  plaintiff's attorney's fees, which for the lien assessment

17  shall be capped at 25 percent. Any ordinance adopted by

18  Hillsborough County under this act must grant, without

19  exception, both to every hospital operating in the county and

20  to the County Indigent Health Care Plan the identical

21  remedies.

22         Section 2.  The board of county commissioners of

23  Hillsborough County shall revise any ordinance adopted

24  pursuant to chapter 98-499, Laws of Florida, to incorporate

25  the amendments made by this act to chapter 98-499, Laws of

26  Florida.

27         Section 3.  Chapter 98-499, Laws of Florida, and this

28  act are repealed on October 1, 1999, unless the board of

29  county commissioners of Hillsborough County enacts an

30  ordinance before that date in accordance with the statutory

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    Florida Senate - 1999                           CS for SB 2578
    308-1981-99




  1  provisions of Section 1 of chapter 98-499, Laws of Florida as

  2  amended by this act.

  3         Section 4.  This act shall take effect upon becoming a

  4  law.

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  6          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  7                             SB 2578

  8

  9  The committee substitute permits the hospital lien ordinance
    adopted by the county commission of Hillsborough County to
10  allow collection from third parties prior to filing a claim
    with an insurer or payor of third-party benefits when required
11  by state or federal law or rules or a contract.

12  The committee substitute requires the ordinance to provide
    that any lien entitles the hospital to a pro-rata share of any
13  settlement or judgment obtained by the patient. The hospital
    will pay a pro rata share of attorney fees and costs and then
14  receive as payment on the debt a pro rata share of the
    proceeds.
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    Finally, the bill provides that chapter 98-499, L.O.F., and
16  the provisions of this act are to be repealed on October 1,
    1999 instead of July 1, 1999 unless the board of county
17  commissioners of Hillsborough County enact an ordinance before
    that date to implement the provisions of the chapter law.
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