SENATE AMENDMENT
Bill No. CS for CS for SB 1202
Amendment No. ___ Barcode 833848
CHAMBER ACTION
Senate House
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05/01/2003 11:11 AM .
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11 Senator Cowin moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 38, line 25, through
15 page 45, line 18, delete those lines
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17 and insert:
18 (5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
19 (a) Any physician, hospital, clinic, or other person
20 or institution lawfully rendering treatment to an injured
21 person for a bodily injury covered by personal injury
22 protection insurance may charge only a reasonable amount for
23 the services and supplies rendered, and the insurer providing
24 such coverage may pay for such charges directly to such person
25 or institution lawfully rendering such treatment, if the
26 insured receiving such treatment or his or her guardian has
27 countersigned the invoice, bill, or claim form approved by the
28 Department of Insurance upon which such charges are to be paid
29 for as having actually been rendered, to the best knowledge of
30 the insured or his or her guardian. In no event, however, may
31 such a charge be in excess of the amount the person or
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SENATE AMENDMENT
Bill No. CS for CS for SB 1202
Amendment No. ___ Barcode 833848
1 institution customarily charges for like services or supplies
2 in cases involving no insurance.
3 (b)1. An insurer or insured is not required to pay a
4 claim made by a broker or by a person making a claim on behalf
5 of a broker.
6 2. Charges for medically necessary cephalic
7 thermograms, peripheral thermograms, spinal ultrasounds,
8 extremity ultrasounds, video fluoroscopy, and surface
9 electromyography shall not exceed the maximum reimbursement
10 allowance for such procedures as set forth in the applicable
11 fee schedule or other payment methodology established pursuant
12 to s. 440.13.
13 3. Allowable amounts that may be charged to a personal
14 injury protection insurance insurer and insured for medically
15 necessary nerve conduction testing when done in conjunction
16 with a needle electromyography procedure and both are
17 performed and billed solely by a physician licensed under
18 chapter 458, chapter 459, chapter 460, or chapter 461 who is
19 also certified by the American Board of Electrodiagnostic
20 Medicine or by a board recognized by the American Board of
21 Medical Specialties or the American Osteopathic Association or
22 who holds diplomate status with the American Chiropractic
23 Neurology Board or its predecessors shall not exceed 200
24 percent of the allowable amount under Medicare Part B for year
25 2001, for the area in which the treatment was rendered,
26 adjusted annually by an additional amount equal to the medical
27 Consumer Price Index for Florida.
28 4. Allowable amounts that may be charged to a personal
29 injury protection insurance insurer and insured for medically
30 necessary nerve conduction testing that does not meet the
31 requirements of subparagraph 3. shall not exceed the
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SENATE AMENDMENT
Bill No. CS for CS for SB 1202
Amendment No. ___ Barcode 833848
1 applicable fee schedule or other payment methodology
2 established pursuant to s. 440.13.
3 5. Effective upon this act becoming a law and before
4 November 1, 2001, allowable amounts that may be charged to a
5 personal injury protection insurance insurer and insured for
6 magnetic resonance imaging services shall not exceed 200
7 percent of the allowable amount under Medicare Part B for year
8 2001, for the area in which the treatment was rendered.
9 Beginning November 1, 2001, allowable amounts that may be
10 charged to a personal injury protection insurance insurer and
11 insured for magnetic resonance imaging services shall not
12 exceed 175 percent of the allowable amount under Medicare Part
13 B for year 2001, for the area in which the treatment was
14 rendered, adjusted annually by an additional amount equal to
15 the medical Consumer Price Index for Florida, except that
16 allowable amounts that may be charged to a personal injury
17 protection insurance insurer and insured for magnetic
18 resonance imaging services provided in facilities accredited
19 by the American College of Radiology or the Joint Commission
20 on Accreditation of Healthcare Organizations shall not exceed
21 200 percent of the allowable amount under Medicare Part B for
22 year 2001, for the area in which the treatment was rendered,
23 adjusted annually by an additional amount equal to the medical
24 Consumer Price Index for Florida. This paragraph does not
25 apply to charges for magnetic resonance imaging services and
26 nerve conduction testing for inpatients and emergency services
27 and care as defined in chapter 395 rendered by facilities
28 licensed under chapter 395.
29 (c) The Department of Health, in consultation with the
30 appropriate professional licensing boards, shall adopt, by
31 rule, a list of diagnostic tests deemed not be medically
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SENATE AMENDMENT
Bill No. CS for CS for SB 1202
Amendment No. ___ Barcode 833848
1 necessary for use in the treatment of persons sustaining
2 bodily injury covered by personal injury protection benefits
3 under this section. The initial list shall be adopted by
4 January 1, 2004, and shall be revised from time to time as
5 determined by the Department of Health, in consultation with
6 the respective professional licensing boards. Inclusion of a
7 test on the list of invalid diagnostic tests shall be based on
8 lack of demonstrated medical value and a level of general
9 acceptance by the relevant provider community and shall not be
10 dependent for results entirely upon subjective patient
11 response. Notwithstanding its inclusion on a fee schedule in
12 this subsection, an insurer or insured is not required to pay
13 any charges or reimburse claims for any invalid diagnostic
14 test as determined by the Department of Health.
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18 And the title is amended as follows:
19 On page 2, lines 17-19, delete those lines
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21 and insert:
22 tests; deleting certain provisions
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