1 | A bill to be entitled |
2 | An act relating to insurance fraud; amending s. 322.21, |
3 | F.S.; requiring an additional fee for certain offenses for |
4 | purposes of reinstatement of a driver's license; amending |
5 | s. 322.26, F.S.; specifying additional circumstances for |
6 | mandatory revocation of a driver's license by the |
7 | Department of Highway Safety and Motor Vehicles; amending |
8 | s. 456.072, F.S.; specifying additional acts constituting |
9 | grounds for certain disciplinary actions against health |
10 | care professionals; amending s. 626.989, F.S.; authorizing |
11 | the Division of Insurance Fraud to adopt rules for |
12 | reporting suspected fraudulent activity; requiring the |
13 | division to develop and maintain a World Wide Web site for |
14 | certain purposes; creating s. 626.9893, F.S.; authorizing |
15 | the Division of Insurance Fraud to deposit certain |
16 | revenues from criminal or forfeiture proceedings into the |
17 | Insurance Regulatory Trust Fund; specifying accounting and |
18 | use requirements; providing for appropriation of such |
19 | revenues; providing for carrying forward moneys remaining |
20 | in the fund each year; amending s. 627.736, F.S.; |
21 | requiring insurers to provide a notice to insureds or |
22 | persons for whom certain reimbursement claims are filed; |
23 | specifying notice contents; amending s. 817.234, F.S.; |
24 | revising provisions specifying what constitutes a material |
25 | omission and insurance fraud; prohibiting organizing, |
26 | planning, or participating in a scheme to create |
27 | documentation of a nonoccurring motor vehicle crash; |
28 | providing penalties; amending s. 817.2361, F.S.; applying |
29 | a criminal penalty to activities relating to false or |
30 | fraudulent proof of motor vehicle insurance; amending s. |
31 | 817.50, F.S.; specifying nonapplication to certain law |
32 | enforcement investigative actions of provisions relating |
33 | to evidence of intent to defraud a health care provider; |
34 | amending s. 817.505, F.S.; specifying an additional |
35 | circumstance of prohibited patient brokering, to which |
36 | penalties apply; revising the definition of "health care |
37 | provider or health care facility"; amending s. 843.08, |
38 | F.S.; including officers of the Department of Financial |
39 | Services among the list of personnel for which a criminal |
40 | penalty is provided for falsely personating such |
41 | personnel; amending s. 932.7055, F.S.; providing for |
42 | deposit of certain proceeds seized by the division into |
43 | certain trust funds; repealing s. 19, ch. 2003-411, Laws |
44 | of Florida, relating to the future repeal of the Florida |
45 | Motor Vehicle No-Fault Law; providing severability; |
46 | providing appropriations for certain purposes; providing |
47 | effective dates. |
48 |
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49 | Be It Enacted by the Legislature of the State of Florida: |
50 |
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51 | Section 1. Subsection (8) of section 322.21, Florida |
52 | Statutes, is amended to read: |
53 | 322.21 License fees; procedure for handling and collecting |
54 | fees.-- |
55 | (8) Any person who applies for reinstatement following the |
56 | suspension or revocation of the person's driver's license shall |
57 | pay a service fee of $35 following a suspension, and $60 |
58 | following a revocation, which is in addition to the fee for a |
59 | license. Any person who applies for reinstatement of a |
60 | commercial driver's license following the disqualification of |
61 | the person's privilege to operate a commercial motor vehicle |
62 | shall pay a service fee of $60, which is in addition to the fee |
63 | for a license. The department shall collect all of these fees at |
64 | the time of reinstatement. The department shall issue proper |
65 | receipts for such fees and shall promptly transmit all funds |
66 | received by it as follows: |
67 | (a) Of the $35 fee received from a licensee for |
68 | reinstatement following a suspension, the department shall |
69 | deposit $15 in the General Revenue Fund and $20 in the Highway |
70 | Safety Operating Trust Fund. |
71 | (b) Of the $60 fee received from a licensee for |
72 | reinstatement following a revocation or disqualification, the |
73 | department shall deposit $35 in the General Revenue Fund and $25 |
74 | in the Highway Safety Operating Trust Fund. |
75 |
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76 | If the revocation or suspension of the driver's license was for |
77 | a violation of s. 316.193, or for refusal to submit to a lawful |
78 | breath, blood, or urine test, an additional fee of $115 must be |
79 | charged. However, only one $115 fee may be collected from one |
80 | person convicted of violations arising out of the same incident. |
81 | The department shall collect the $115 fee and deposit the fee |
82 | into the Highway Safety Operating Trust Fund at the time of |
83 | reinstatement of the person's driver's license, but the fee may |
84 | not be collected if the suspension or revocation is overturned. |
85 | If the revocation or suspension of the driver's license was for |
86 | a conviction for violation of s. 817.234(8)(b) or (c) or (9) or |
87 | s. 817.505(1)(b)2. or (c), an additional fee of $180 must be |
88 | charged for each offense. The department shall collect and |
89 | deposit the additional $180 fee into the Highway Safety |
90 | Operating Trust Fund at the time of reinstatement of the |
91 | person's driver's license. |
92 | Section 2. Subsection (9) is added to section 322.26, |
93 | Florida Statutes, to read: |
94 | 322.26 Mandatory revocation of license by department.--The |
95 | department shall forthwith revoke the license or driving |
96 | privilege of any person upon receiving a record of such person's |
97 | conviction of any of the following offenses: |
98 | (9) Conviction in any court having jurisdiction over |
99 | offenses committed under s. 817.234(8)(b) or (c) or (9) or s. |
100 | 817.505(1)(b)2. or (c). |
101 | Section 3. Paragraphs (hh) and (ii) are added to |
102 | subsection (1) of section 456.072, Florida Statutes, to read: |
103 | 456.072 Grounds for discipline; penalties; enforcement.-- |
104 | (1) The following acts shall constitute grounds for which |
105 | the disciplinary actions specified in subsection (2) may be |
106 | taken: |
107 | (hh) Paying or receiving any commission, bonus, kickback, |
108 | or rebate or engaging in any split-fee arrangement, in any form |
109 | whatsoever, with a physician, organization, agency, or person, |
110 | directly or indirectly, for patients referred to providers of |
111 | health care goods and services, including, but not limited to, |
112 | hospitals, nursing homes, clinical laboratories, ambulatory |
113 | surgical centers, or pharmacies. The provisions of this |
114 | paragraph shall not be construed to prevent a health care |
115 | provider from receiving a fee for professional consultation |
116 | services. |
117 | (ii) Submitting a claim for payment of diagnostic or |
118 | treatment services of a person injured in an automobile crash |
119 | when the licensee knows the automobile crash was staged or did |
120 | not occur. |
121 | Section 4. Subsection (6) of section 626.989, Florida |
122 | Statutes, is amended, and subsection (10) is added to that |
123 | section, to read: |
124 | 626.989 Investigation by department or Division of |
125 | Insurance Fraud; compliance; immunity; confidential information; |
126 | reports to division; division investigator's power of arrest.-- |
127 | (6) Any person, other than an insurer, agent, or other |
128 | person licensed under the code, or an employee thereof, having |
129 | knowledge or who believes that a fraudulent insurance act or any |
130 | other act or practice which, upon conviction, constitutes a |
131 | felony or a misdemeanor under the code, or under s. 817.234, is |
132 | being or has been committed may send to the Division of |
133 | Insurance Fraud a report or information pertinent to such |
134 | knowledge or belief and such additional information relative |
135 | thereto as the department may request. Any professional |
136 | practitioner licensed or regulated by the Department of Business |
137 | and Professional Regulation, except as otherwise provided by |
138 | law, any medical review committee as defined in s. 766.101, any |
139 | private medical review committee, and any insurer, agent, or |
140 | other person licensed under the code, or an employee thereof, |
141 | having knowledge or who believes that a fraudulent insurance act |
142 | or any other act or practice which, upon conviction, constitutes |
143 | a felony or a misdemeanor under the code, or under s. 817.234, |
144 | is being or has been committed shall send to the Division of |
145 | Insurance Fraud a report or information pertinent to such |
146 | knowledge or belief and such additional information relative |
147 | thereto as the department may require. The Division of Insurance |
148 | Fraud shall review such information or reports and select such |
149 | information or reports as, in its judgment, may require further |
150 | investigation. It shall then cause an independent examination of |
151 | the facts surrounding such information or report to be made to |
152 | determine the extent, if any, to which a fraudulent insurance |
153 | act or any other act or practice which, upon conviction, |
154 | constitutes a felony or a misdemeanor under the code, or under |
155 | s. 817.234, is being committed. The Division of Insurance Fraud |
156 | shall report any alleged violations of law which its |
157 | investigations disclose to the appropriate licensing agency and |
158 | state attorney or other prosecuting agency having jurisdiction |
159 | with respect to any such violation, as provided in s. 624.310. |
160 | If prosecution by the state attorney or other prosecuting agency |
161 | having jurisdiction with respect to such violation is not begun |
162 | within 60 days of the division's report, the state attorney or |
163 | other prosecuting agency having jurisdiction with respect to |
164 | such violation shall inform the division of the reasons for the |
165 | lack of prosecution. The division may adopt rules that set forth |
166 | requirements for the manner in which suspected fraudulent |
167 | activity shall be reported to the division through the use of a |
168 | standard referral form. |
169 | (10) The Division of Insurance Fraud may develop and |
170 | maintain a World Wide Web site page for the purpose of posting |
171 | the identities and photographs of persons convicted of violating |
172 | s. 817.234(9). |
173 | Section 5. Section 626.9893, Florida Statutes, is created |
174 | to read: |
175 | 626.9893 Disposition of revenues; criminal or forfeiture |
176 | proceedings.-- |
177 | (1) The Division of Insurance Fraud of the Department of |
178 | Financial Services may deposit revenues received as a result of |
179 | criminal proceedings or forfeiture proceedings, other than |
180 | revenues deposited into the Department of Financial Services' |
181 | Federal Equitable Sharing Trust Fund under s. 17.43, into the |
182 | Insurance Regulatory Trust Fund. Moneys deposited pursuant to |
183 | this subsection shall be separately accounted for and shall be |
184 | used solely for the division to carry out its duties and |
185 | responsibilities. |
186 | (2) Moneys deposited into the Insurance Regulatory Trust |
187 | Fund pursuant to subsection (1) shall be appropriated by the |
188 | Legislature, pursuant to the provisions of chapter 216, for the |
189 | sole purpose of enabling the division to carry out its duties |
190 | and responsibilities. |
191 | (3) Notwithstanding the provisions of s. 216.301 and |
192 | pursuant to s. 216.351, any balance of moneys deposited into the |
193 | Insurance Regulatory Trust Fund pursuant to subsection (1) |
194 | remaining at the end of any fiscal year shall remain in the |
195 | trust fund at the end of that year and shall be available for |
196 | carrying out the duties and responsibilities of the Division of |
197 | Insurance Fraud. |
198 | Section 6. Subsection (14) is added to section 627.736, |
199 | Florida Statutes, to read: |
200 | 627.736 Required personal injury protection benefits; |
201 | exclusions; priority; claims.-- |
202 | (14) FRAUD ADVISORY NOTICE.--Upon receiving notice of a |
203 | claim under this section, an insurer shall provide to the |
204 | insured or to a person for whom a claim for reimbursement for |
205 | diagnosis or treatment of injuries has been filed, a notice that |
206 | shall advise that: |
207 | (a) Pursuant to s. 626.9892, the Department of Financial |
208 | Services may pay rewards of up to $25,000 to persons providing |
209 | information leading to the arrest and conviction of persons |
210 | committing crimes investigated by the Division of Insurance |
211 | Fraud arising from violations of s. 440.105, s. 624.15, s. |
212 | 626.9541, s. 626.989, or s. 817.234. |
213 | (b) Solicitation of a person injured in an automobile |
214 | crash to be treated or represented by a particular health care |
215 | provider or attorney could be a violation of s. 817.234, s. |
216 | 817.505, or the rules regulating The Florida Bar and should |
217 | immediately be reported to the department if illegal or |
218 | unethical conduct is suspected. |
219 | Section 7. Paragraph (a) of subsection (7) and subsection |
220 | (9) of section 817.234, Florida Statutes, are amended to read: |
221 | 817.234 False and fraudulent insurance claims.-- |
222 | (7)(a) It shall constitute a material omission and |
223 | insurance fraud, punishable as provided in subsection (11), for |
224 | any service physician or other provider, other than a hospital, |
225 | to engage in a general business practice of billing amounts as |
226 | its usual and customary charge, if such provider has agreed with |
227 | the insured patient or intends to waive deductibles or |
228 | copayments, or does not for any other reason intend to collect |
229 | the total amount of such charge. With respect to a determination |
230 | as to whether a service physician or other provider has engaged |
231 | in such general business practice, consideration shall be given |
232 | to evidence of whether the service physician or other provider |
233 | made a good faith attempt to collect such deductible or |
234 | copayment. This paragraph does not apply to service physicians |
235 | or other providers who waive deductibles or copayments or reduce |
236 | their bills as part of a bodily injury settlement or verdict. |
237 | (9) A person may not organize, plan, or knowingly |
238 | participate in an intentional motor vehicle crash or a scheme to |
239 | create documentation of a motor vehicle crash that did not occur |
240 | for the purpose of making motor vehicle tort claims or claims |
241 | for personal injury protection benefits as required by s. |
242 | 627.736. Any person who violates this subsection commits a |
243 | felony of the second degree, punishable as provided in s. |
244 | 775.082, s. 775.083, or s. 775.084. A person who is convicted of |
245 | a violation of this subsection shall be sentenced to a minimum |
246 | term of imprisonment of 2 years. |
247 | Section 8. Section 817.2361, Florida Statutes, is amended |
248 | to read: |
249 | 817.2361 False or fraudulent proof of motor vehicle |
250 | insurance card.--Any person who, with intent to deceive any |
251 | other person, creates, markets, or presents a false or |
252 | fraudulent proof of motor vehicle insurance card commits a |
253 | felony of the third degree, punishable as provided in s. |
254 | 775.082, s. 775.083, or s. 775.084. |
255 | Section 9. Subsection (2) of section 817.50, Florida |
256 | Statutes, is amended to read: |
257 | 817.50 Fraudulently obtaining goods, services, etc., from |
258 | a health care provider.-- |
259 | (2) If any person gives to any health care provider in |
260 | this state a false or fictitious name or a false or fictitious |
261 | address or assigns to any health care provider the proceeds of |
262 | any health maintenance contract or insurance contract, then |
263 | knowing that such contract is no longer in force, is invalid, or |
264 | is void for any reason, such action shall be prima facie |
265 | evidence of the intent of such person to defraud the health care |
266 | provider. However, this subsection does not apply to |
267 | investigative actions taken by law enforcement officers for law |
268 | enforcement purposes in the course of their official duties. |
269 | Section 10. Paragraph (b) of subsection (1) and paragraph |
270 | (a) of subsection (2) of section 817.505, Florida Statutes, are |
271 | amended to read: |
272 | 817.505 Patient brokering prohibited; exceptions; |
273 | penalties.-- |
274 | (1) It is unlawful for any person, including any health |
275 | care provider or health care facility, to: |
276 | (b) Solicit or receive any commission, bonus, rebate, |
277 | kickback, or bribe, directly or indirectly, in cash or in kind, |
278 | or engage in any split-fee arrangement, in any form whatsoever, |
279 | in return for: |
280 | 1. Referring patients or patronage to a health care |
281 | provider or health care facility; or |
282 | 2. Signing a disclosure and acknowledgment form or a |
283 | patient log required by s. 627.736(5) when such medical |
284 | treatment is intentionally not provided; or |
285 | (2) For the purposes of this section, the term: |
286 | (a) "Health care provider or health care facility" means |
287 | any person or entity licensed, certified, or registered, or |
288 | required to be licensed, certified, or registered, under part I, |
289 | part II, part III, or part IV of chapter 395, part XIII of |
290 | chapter 400, chapter 457, chapter 458, chapter 459, chapter 460, |
291 | chapter 461, chapter 462, chapter 463, chapter 464, chapter 465, |
292 | chapter 466, chapter 467, part I, part II, part III, part IV, |
293 | part X, part XIII, or part XIV of chapter 468, chapter 480, |
294 | chapter 484, chapter 486, chapter 490, or chapter 491, or |
295 | lawfully exempt from such licensure, certification, or |
296 | registration with the Agency for Health Care Administration; any |
297 | person or entity that has contracted with the Agency for Health |
298 | Care Administration to provide goods or services to Medicaid |
299 | recipients as provided under s. 409.907; a county health |
300 | department established under part I of chapter 154; any |
301 | community service provider contracting with the Department of |
302 | Children and Family Services to furnish alcohol, drug abuse, or |
303 | mental health services under part IV of chapter 394; any |
304 | substance abuse service provider licensed under chapter 397; or |
305 | any federally supported primary care program such as a migrant |
306 | or community health center authorized under ss. 329 and 330 of |
307 | the United States Public Health Services Act. |
308 | Section 11. Section 843.08, Florida Statutes, is amended |
309 | to read: |
310 | 843.08 Falsely personating officer, etc.--A person who |
311 | falsely assumes or pretends to be a sheriff, officer of the |
312 | Florida Highway Patrol, officer of the Fish and Wildlife |
313 | Conservation Commission, officer of the Department of |
314 | Environmental Protection, officer of the Department of |
315 | Transportation, officer of the Department of Corrections, |
316 | officer of the Department of Financial Services, correctional |
317 | probation officer, deputy sheriff, state attorney or assistant |
318 | state attorney, statewide prosecutor or assistant statewide |
319 | prosecutor, state attorney investigator, coroner, police |
320 | officer, lottery special agent or lottery investigator, beverage |
321 | enforcement agent, or watchman, or any member of the Parole |
322 | Commission and any administrative aide or supervisor employed by |
323 | the commission, or any personnel or representative of the |
324 | Department of Law Enforcement, and takes upon himself or herself |
325 | to act as such, or to require any other person to aid or assist |
326 | him or her in a matter pertaining to the duty of any such |
327 | officer, commits a felony of the third degree, punishable as |
328 | provided in s. 775.082, s. 775.083, or s. 775.084; however, a |
329 | person who falsely personates any such officer during the course |
330 | of the commission of a felony commits a felony of the second |
331 | degree, punishable as provided in s. 775.082, s. 775.083, or s. |
332 | 775.084; except that if the commission of the felony results in |
333 | the death or personal injury of another human being, the person |
334 | commits a felony of the first degree, punishable as provided in |
335 | s. 775.082, s. 775.083, or s. 775.084. |
336 | Section 12. Paragraph (n) is added to subsection (6) of |
337 | section 932.7055, Florida Statutes, to read: |
338 | 932.7055 Disposition of liens and forfeited property.-- |
339 | (6) If the seizing agency is a state agency, all remaining |
340 | proceeds shall be deposited into the General Revenue Fund. |
341 | However, if the seizing agency is: |
342 | (n) The Division of Insurance Fraud of the Department of |
343 | Financial Services, the proceeds accrued under the Florida |
344 | Contraband Forfeiture Act shall be deposited into the Insurance |
345 | Regulatory Trust Fund as provided in s. 626.9893 or into the |
346 | Department of Financial Services' Federal Equitable Sharing |
347 | Trust Fund as provided in s. 17.43, as applicable. |
348 | Section 13. Effective upon this act becoming a law, |
349 | section 19 of chapter 2003-411, Laws of Florida, is repealed. |
350 | Section 14. If any provision of this act or its |
351 | application to any person or circumstance is held invalid, the |
352 | invalidity does not affect other provisions or applications of |
353 | the act which can be given effect without the invalid provision |
354 | or application, and to this end the provisions of this act are |
355 | declared severable. |
356 | Section 15. For the 2006-2007 fiscal year: |
357 | (1) The sum of $1,670,000 in recurring funds is |
358 | appropriated from the Insurance Regulatory Trust Fund, and nine |
359 | new positions are authorized to the Division of Insurance Fraud |
360 | within the Department of Financial Services. The purposes of |
361 | this appropriation are to administer and implement the |
362 | provisions of s. 626.989, Florida Statutes, establish a new |
363 | fraud unit in the Division of Insurance Fraud of the Department |
364 | of Financial Services, and provide an approximate $10,000 salary |
365 | increase for each of the 122 existing sworn fraud law |
366 | enforcement investigators within the Division of Insurance Fraud |
367 | to achieve relative parity with investigators who have similar |
368 | responsibilities at other state law enforcement agencies. The |
369 | Legislature recognizes and finds that without such an increase, |
370 | the Division of Insurance Fraud will continue to have difficulty |
371 | recruiting, training, and retaining qualified and experienced |
372 | fraud investigators. |
373 | (2) The sum of $750,000 in recurring funds is appropriated |
374 | to the state attorneys' offices in the six judicial circuits |
375 | comprising Broward, Palm Beach, Hillsborough, Pinellas/Pasco, |
376 | Duval, and Orange Counties. The purpose of this appropriation is |
377 | to establish and fund six new prosecutors dedicated to insurance |
378 | fraud cases. |
379 | Section 16. Except as otherwise expressly provided in this |
380 | act, this act shall take effect July 1, 2006. |