House Bill hb0885er

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  2         An act relating to Hillsborough County;

  3         amending chapter 98-499, Laws of Florida,

  4         relating to liens authorized by ordinance in

  5         favor of hospitals providing medical care,

  6         treatment, or maintenance to a patient, and in

  7         favor of the County when it pays for medical

  8         care, treatment, or maintenance of a patient;

  9         providing definitions; providing optional and

10         mandatory components, both substantive and

11         procedural, of any such implementing ordinance

12         including establishing limitations on lien

13         amounts, and providing for the treatment of

14         other claims, noneconomic damages, and

15         attorney's fees; requiring the ordinance to

16         provide identical procedural remedies to

17         hospitals and the County; providing for an

18         offset for the cost of an insurance policy

19         resulting in payment of any part of the lien

20         amount; barring a lienholder or the

21         lienholder's legal representative from

22         additional compensation from the patient and

23         others in relation to the charges covered by a

24         lien; providing penalties; providing an

25         effective date.

26

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

28

29         Section 1.  Chapter 98-499, Laws of Florida, is amended

30  to read:

31         Section 1.  As used in this act:


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  1         (1)  "Applicable lien rate" means charges arising from

  2  a covered event in effect at the time the care and treatment

  3  were delivered for the covered event, which shall in no event

  4  exceed:

  5         (a)  The amount that a lienholder has contracted to

  6  accept from all sources for the care and treatment of the

  7  patient whether the source is commercial, nongovernmental

  8  health insurance coverage through a health maintenance

  9  organization, or other nongovernmental entity that is under

10  contract with the lienholder;

11         (b)  For uninsured patients, a rate not exceeding that

12  rate which is customarily paid to a lienholder for services

13  provided to a patient, in compliance with the payment

14  provisions established by the Medicare Act; or

15         (c)  If the patient is covered by the County Indigent

16  Health Care Plan, all amounts payable by the county in

17  connection with services provided to the patient pursuant to

18  the county's indigent health care plan.

19         (2)  "Board" means the Board of County Commissioners of

20  Hillsborough County.

21         (3)  "County" means Hillsborough County.

22         (4)  "Covered event" means an illness, injury,

23  deformity, infirmity, abnormality, disease or pregnancy, which

24  results in medical care, treatment or maintenance of a person

25  and forms the basis for a cause of action, suit, claim,

26  counterclaim, demand, judgment, settlement or settlement

27  agreement pursued by the patient against a third party.

28         (5)  "Hospital" means any establishment operating in

29  the county that:

30         (a)  Offers services more intensive than those required

31  for room, board, personal services, and general nursing care,


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  1  and offers facilities and beds for use beyond 24 hours by

  2  individuals requiring diagnosis, treatment, or care for

  3  illness, injury, deformity, infirmity, abnormality, disease,

  4  or pregnancy.

  5         (b)  Regularly makes available at least clinical

  6  laboratory services, diagnostic x-ray services, and treatment

  7  facilities for surgery or obstetrical care, or other

  8  definitive medical treatment of similar extent but does not

  9  include any institution conducted by or for the adherents of

10  any well-recognized church or religious denomination that

11  depends exclusively upon prayer or spiritual means to heal,

12  care for, or treat any person.

13         (6)  "Lienholder" means a hospital or the county, that

14  has a claim of lien pursuant to this act.

15         (7)  "Medicare Act" means the law embodied at 42 U.S.C.

16  s. 426, as amended.

17         (8)  "Patient" means a person who receives medical

18  care, treatment, or maintenance from a lienholder in the

19  county in connection with a covered event or the patient's

20  legal representatives.

21         (9)  "Patient's claims" means the total of all claims

22  attributable to medical care, treatment, or maintenance not

23  provided by a lienholder and includes lost wages, noneconomic

24  damages, and future medical costs, as applicable, and

25  reasonable attorney's fees and reasonable collection costs

26  except as otherwise provided in paragraph (1)(g) of section 2.

27         (10)  "Pro rata share" means a percentage amount of the

28  recovery proceeds, which shall be derived by dividing the

29  total amounts claimed by either a lienholder, the patient, or

30  when applicable, the patient's attorney, by the total sum of

31  all claims arising out of the covered event which are payable


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  1  from the recovery proceeds including all of the patient's

  2  claims, and multiplying the resulting percentage by the total

  3  recovery proceeds. For the purpose of calculating pro rata

  4  share, if the patient is uninsured, a lienholder hospital may

  5  calculate its lien amount as an amount equal to its full

  6  billed charges for services provided in connection with a

  7  covered event. However, in no event may the hospital's pro

  8  rata share of the recovery proceeds exceed the payment amount

  9  established by the Medicare Act for all services provided.

10         (11)  "Recovery proceeds" means the total amount of all

11  settlement, settlement agreement, and/or judgment proceeds

12  along with any other remuneration for damages arising directly

13  or indirectly from a covered event, minus amounts secured by

14  statutory liens having priority over liens created by this

15  act, an offset for insurance proceeds as provided herein, and,

16  in the event litigation is filed, the patient's attorney's

17  fees as provided in paragraph (1)(g) of section 2.

18         Section 2.

19         (1)  The board of county commissioners of Hillsborough

20  County may provide by ordinance for:

21         (a)  Liens in favor of hospitals for medical care,

22  treatment, or maintenance provided to a patient, and in favor

23  of the county when the county pays for medical care, treatment

24  or maintenance of qualifying residents of the county, upon

25  causes of action, suits, claims, counterclaims, and demands in

26  connection with a covered event and accruing to a patient, and

27  upon all judgments, settlements, and settlement agreements

28  entered into by virtue thereof.

29         (b)  The attachment, perfection, priority, and

30  enforcement of any such lien and for such procedural and other

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

  2  purposes of the ordinance.

  3         (c)  Limiting the amount of a lien to the applicable

  4  lien rate.

  5         (d)  Establishing an equitable distribution plan which

  6  includes that in the event the recovery proceeds are not

  7  adequate to cover the amount actually due and owing the

  8  lienholder, as well as the patient's attorney's fees, the

  9  recovery proceeds will be equitably distributed on a pro rata

10  share basis.

11         (e)  An offset from the recovery proceeds for the costs

12  of any insurance policy which resulted in payment in whole or

13  in part of any lien amounts. These amounts shall not exceed 1

14  year's premium amount for any such policy.

15         (f)  Procedures for determining the amount of

16  noneconomic damages and future medical costs related to the

17  covered event to be used in calculating pro rata shares when

18  noneconomic damages and future medical costs are not itemized

19  in the settlement, settlement agreement, or judgment.  The

20  procedures shall provide a mechanism for resolution of

21  disputes related to this determination.

22         (g)  Providing that in the event litigation is filed to

23  recover a plaintiff's damages through settlement or judgment,

24  instead of prorating the plaintiff's attorney's fees, in

25  determining the lienholder's recovery, plaintiff's attorney's

26  fees shall be calculated at an amount not to exceed 25 percent

27  of the recovery proceeds.

28         (2)  Any ordinance enacted in accordance with this act

29  shall:

30         (a)  Include a procedure by which a patient may bring a

31  claim of alleged abuse by a lienholder in the exercise of the


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  1  lien privilege granted by this act and the manner in which the

  2  claim will be considered and resolved.

  3         (b)  Provide all operators of hospitals in Hillsborough

  4  County and in favor of Hillsborough County when it pays for

  5  medical care, treatment, or maintenance of qualifying

  6  residents of the county upon all causes of action, suits,

  7  claims, counterclaims, and demands accruing to persons to whom

  8  care, treatment, or maintenance is furnished by such hospital

  9  or is paid for by Hillsborough County on behalf of a

10  qualifying resident of the county, or accruing to the legal

11  representatives of such persons, and upon all judgments,

12  settlements, and settlement agreements entered into by virtue

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

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

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

16  settlements, and settlement agreements, and which necessitated

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

18  ordinance for the attachment, perfection, priority, and

19  enforcement of such liens and for such procedural and other

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

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

22  a beneficiary of commercial, nongovernmental health insurance

23  coverage through a health maintenance organization or other

24  nongovernmental entity that is under contract with the

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

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

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

28  delivered, and the lien shall not exceed the amount that the

29  hospital has contracted to accept from all sources for the

30  care and treatment of the patient. In the event of a claim or

31  action by the patient against a third party for which the


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  1  settlement or judgment is less than or equal to a sum of the

  2  debt actually due and owing the hospital, the settlement or

  3  judgment will be equitably distributed based on the pro rata

  4  reduction in the amount due the hospital and the patient,

  5  including a pro rata reduction in the amount of reasonable

  6  attorney's fees and costs due the patient's attorney on that

  7  portion of the settlement or judgment attributable to the

  8  hospital lien. In the event of a claim or action by the

  9  patient against a third party for which the settlement or

10  judgment exceeds the debt actually due and owing the hospital

11  but is not adequate to cover the amount actually due and owing

12  the hospital, as well as the patient's attorney's fees, then

13  the settlement or judgment will be equitably distributed based

14  on a pro rata share of the amount due the hospital and the

15  patient, including a pro rata share for the amount of

16  reasonable attorney's fees and costs due the patient's

17  attorney and the hospital's attorney. In the event litigation

18  is filed to recover a plaintiff's damages through settlement

19  or judgment, then the hospital's lien actually collected shall

20  be subject to assessment, by reduction, for plaintiff's

21  attorney's fees, which for the lien assessment shall be capped

22  at 25 percent. Any ordinance adopted by Hillsborough County

23  under this act must grant, without exception, for all

24  lienholders both to every hospital operating in the county and

25  to the County Indigent Health Care Plan the identical

26  procedural remedies.

27         Section 3.  Any lienholder or the legal representative

28  of that lienholder who enforces a lien in accordance with this

29  act and the implementing ordinance of the county is barred

30  from seeking any additional compensation in relation to the

31  covered event from the patient, any family member of the


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  1  patient, or any other individual authorized to make decisions

  2  concerning the providing or withholding of the patient's care

  3  or treatment in relation to the charges covered by the lien.

  4  Further, any lienholder or the legal representative of that

  5  lienholder who collects a lien in whole or in part pursuant to

  6  this act is prohibited from enforcing the terms of a letter of

  7  protection issued in connection with services rendered in

  8  connection with the covered event.

  9         Section 2.  This act shall take effect July 1, 2001.

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