Florida Senate - 2012                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1860
                                Barcode 141570                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Floor: WD/2R          .                                
             03/06/2012 05:37 PM       .                                

       Senator Bennett moved the following:
    1         Senate Amendment (with title amendment)
    3         Delete lines 512 - 581
    4  and insert:
    5         (1) REQUIRED BENEFITS.—An Every insurance policy complying
    6  with the security requirements of s. 627.733 must shall provide
    7  personal injury protection to the named insured, relatives
    8  residing in the same household, persons operating the insured
    9  motor vehicle, passengers in the such motor vehicle, and other
   10  persons struck by the such motor vehicle and suffering bodily
   11  injury while not an occupant of a self-propelled vehicle,
   12  subject to the provisions of subsection (2) and paragraph
   13  (4)(e), to a limit of $10,000 in medical and disability benefits
   14  and $5,000 in death benefits resulting from for loss sustained
   15  by any such person as a result of bodily injury, sickness,
   16  disease, or death arising out of the ownership, maintenance, or
   17  use of a motor vehicle as follows:
   18         (a) Medical benefits.—Eighty percent of all reasonable
   19  expenses for medically necessary medical, surgical, X-ray,
   20  dental, and rehabilitative services, including prosthetic
   21  devices, and medically necessary ambulance, hospital, and
   22  nursing services, if the individual receives initial services
   23  and care pursuant to subparagraph 1. within 14 days after the
   24  motor vehicle accident. However, The medical benefits shall
   25  provide reimbursement only for: such
   26         1. Initial services and care that are lawfully provided,
   27  supervised, ordered, or prescribed by a physician licensed under
   28  chapter 458 or chapter 459, by a chiropractic physician licensed
   29  under chapter 460, or by a dentist licensed under chapter 466,
   30  or a chiropractic physician licensed under chapter 460 or that
   31  are provided in a hospital or in a facility that owns, or is
   32  wholly owned by, a hospital. Initial services and care may also
   33  be provided by a person or entity licensed under part III of
   34  chapter 401 which provides emergency transportation and
   35  treatment.
   36         2. Followup services and care consistent with the
   37  underlying medical diagnosis rendered pursuant to subparagraph
   38  1., which may be provided, supervised, ordered, or prescribed
   39  only by a physician licensed under chapter 458 or chapter 459, a
   40  chiropractic physician licensed under chapter 460, a dentist
   41  licensed under chapter 466, or, to the extent permitted by
   42  applicable law and under the supervision of such physician,
   43  osteopathic physician, chiropractic physician, or dentist, by a
   44  physician assistant licensed under chapter 458 or chapter 459 or
   45  an advanced registered nurse practitioner licensed under chapter
   46  464. Followup services and care may also be provided by any of
   47  the following persons or entities:
   48         a.1. A hospital or ambulatory surgical center licensed
   49  under chapter 395.
   50         2. A person or entity licensed under ss. 401.2101-401.45
   51  that provides emergency transportation and treatment.
   52         b.3. An entity wholly owned by one or more physicians
   53  licensed under chapter 458 or chapter 459, chiropractic
   54  physicians licensed under chapter 460, or dentists licensed
   55  under chapter 466 or by such practitioner or practitioners and
   56  the spouse, parent, child, or sibling of such that practitioner
   57  or those practitioners.
   58         c.4. An entity that owns or is wholly owned, directly or
   59  indirectly, by a hospital or hospitals.
   60         d. A physical therapist licensed under chapter 486.
   61         e.5. A health care clinic licensed under part X of chapter
   62  400 which ss. 400.990-400.995 that is:
   63         a. accredited by the Joint Commission on Accreditation of
   64  Healthcare Organizations, the American Osteopathic Association,
   65  the Commission on Accreditation of Rehabilitation Facilities, or
   66  the Accreditation Association for Ambulatory Health Care, Inc.,;
   67  or
   68         b. A health care clinic that:
   69         (I) Has a medical director licensed under chapter 458,
   70  chapter 459, or chapter 460;
   71         (II) Has been continuously licensed for more than 3 years
   72  or is a publicly traded corporation that issues securities
   73  traded on an exchange registered with the United States
   74  Securities and Exchange Commission as a national securities
   75  exchange; and
   76         (III) Provides at least four of the following medical
   77  specialties:
   78         (A) General medicine.
   79         (B) Radiography.
   80         (C) Orthopedic medicine.
   81         (D) Physical medicine.
   82         (E) Physical therapy.
   83         (F) Physical rehabilitation.
   84         (G) Prescribing or dispensing outpatient prescription
   85  medication.
   86         (H) Laboratory services.
   87         3. Reimbursement for services and care provided by each
   88  type of licensed medical provider authorized to render such
   89  services and care is limited to the lesser of 24 treatments or
   90  to services or care rendered within 12 weeks after the date of
   91  the initial treatment, unless the insurer authorizes additional
   92  services or care.
   93         4.A physician licensed under chapter 458 or chapter 459, a
   94  chiropractic physician licensed under chapter 460, or a dentist
   95  licensed under chapter 466 who supervises services and care
   96  pursuant to this subsection must be on the premises where the
   97  services and care are being provided and the supervising
   98  physician must provide his or her medical license number and the
   99  times such treatment was rendered on all statements and bills
  100  for such services and care. A supervising physician who submits
  101  a false, misleading, or fraudulent claim for medical benefits
  102  provided pursuant to this paragraph commits insurance fraud
  103  pursuant to s. 817.234.
  104         5. The Financial Services Commission shall adopt by rule
  105  the form that must be used by an insurer and a health care
  106  provider specified in sub-subparagraph 2.b., sub-subparagraph
  107  2.c., or sub-subparagraph 2.e. subparagraph 3., subparagraph 4.,
  108  or subparagraph 5. to document that the health care provider
  109  meets the criteria of this paragraph, which rule must include a
  110  requirement for a sworn statement or affidavit.
  112  ================= T I T L E  A M E N D M E N T ================
  113         And the title is amended as follows:
  114         Delete lines 45 - 47
  115  and insert:
  116         627.736, F.S.; revising the cap on benefits to provide
  117         that death benefits are in addition to medical and
  118         disability benefits; revising medical benefits;
  119         distinguishing between initial and followup services
  120         and specifying who may provide such services;
  121         requiring physicians who supervise services and care
  122         to be on the premises when supervised services are
  123         provided and to include their license number on all
  124         bills for services; providing that a physician who
  125         submits a fraudulent statement commits insurance
  126         fraud; requiring that an insurer