Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1860
       
       
       
       
       
       
                                Barcode 811080                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: WD            .                                
                  02/29/2012           .                                
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       The Committee on Budget (Richter) recommended the following:
       
    1         Senate Substitute for Amendment (344314) (with title
    2  amendment)
    3  
    4         Delete lines 296 - 1482
    5  and insert:
    6  Notwithstanding this subsection, an entity shall be deemed a
    7  clinic and must be licensed under this part in order to receive
    8  reimbursement under the Florida Motor Vehicle No-Fault Law,
    9  unless exempted under s. 627.736(5)(h), or under the Florida
   10  Motor Vehicle No-Fault Medical Care Coverage Law, unless
   11  exempted under s. 627.7485(1)(a)3.
   12         Section 3. Subsection (6) is added to section 400.991,
   13  Florida Statutes, to read:
   14         400.991 License requirements; background screenings;
   15  prohibitions.—
   16         (6) All agency forms for licensure application or exemption
   17  from licensure under this part must contain the following
   18  statement:
   19  
   20         INSURANCE FRAUD NOTICE.—A person who knowingly submits
   21         a false, misleading, or fraudulent application or
   22         other document when applying for licensure as a health
   23         care clinic, seeking an exemption from licensure as a
   24         health care clinic, or demonstrating compliance with
   25         part X of chapter 400, Florida Statutes, with the
   26         intent to use the license, exemption from licensure,
   27         or demonstration of compliance to provide services or
   28         seek reimbursement under the Florida Motor Vehicle No
   29         Fault Law or the Florida Motor Vehicle No-Fault
   30         Medical Care Coverage Law, commits a fraudulent
   31         insurance act, as defined in s. 626.989, Florida
   32         Statutes. A person who presents a claim for personal
   33         injury protection or medical care coverage benefits
   34         knowing that the payee knowingly submitted such health
   35         care clinic application or document, commits insurance
   36         fraud, as defined in s. 817.234, Florida Statutes.
   37  
   38         Section 4. Subsection (1) of section 626.989, Florida
   39  Statutes, is amended to read:
   40         626.989 Investigation by department or Division of
   41  Insurance Fraud; compliance; immunity; confidential information;
   42  reports to division; division investigator’s power of arrest.—
   43         (1) For the purposes of this section:,
   44         (a) A person commits a “fraudulent insurance act” if the
   45  person:
   46         1. Knowingly and with intent to defraud presents, causes to
   47  be presented, or prepares with knowledge or belief that it will
   48  be presented, to or by an insurer, self-insurer, self-insurance
   49  fund, servicing corporation, purported insurer, broker, or any
   50  agent thereof, any written statement as part of, or in support
   51  of, an application for the issuance of, or the rating of, any
   52  insurance policy, or a claim for payment or other benefit
   53  pursuant to any insurance policy, which the person knows to
   54  contain materially false information concerning any fact
   55  material thereto or if the person conceals, for the purpose of
   56  misleading another, information concerning any fact material
   57  thereto.
   58         2. Knowingly submits:
   59         a. A false, misleading, or fraudulent application or other
   60  document when applying for licensure as a health care clinic,
   61  seeking an exemption from licensure as a health care clinic, or
   62  demonstrating compliance with part X of chapter 400 with an
   63  intent to use the license, exemption from licensure, or
   64  demonstration of compliance to provide services or seek
   65  reimbursement under the Florida Motor Vehicle No-Fault Law or
   66  the Florida Motor Vehicle No-Fault Medical Care Coverage Law.
   67         b. A claim for payment or other benefit pursuant to an
   68  insurance policy under the Florida Motor Vehicle No-Fault Law or
   69  the Florida Motor Vehicle No-Fault Medical Care Coverage Law if
   70  the person knows that the payee knowingly submitted a false,
   71  misleading, or fraudulent application or other document when
   72  applying for licensure as a health care clinic, seeking an
   73  exemption from licensure as a health care clinic, or
   74  demonstrating compliance with part X of chapter 400. For the
   75  purposes of this section,
   76         (b) The term “insurer” also includes a any health
   77  maintenance organization, and the term “insurance policy” also
   78  includes a health maintenance organization subscriber contract.
   79         Section 5. Section 626.9895, Florida Statutes, is created
   80  to read:
   81         626.9895Motor vehicle insurance fraud direct-support
   82  organization.—
   83         (1) DEFINITIONS.—As used in this section, the term:
   84         (a) “Division” means the Division of Insurance Fraud of the
   85  Department of Financial Services.
   86         (b) “Motor vehicle insurance fraud” means any act defined
   87  as a “fraudulent insurance act” under s. 626.989, which relates
   88  to the coverage of motor vehicle insurance as described in part
   89  XI of chapter 627.
   90         (c) “Organization” means the direct-support organization
   91  established under this section.
   92         (2) ORGANIZATION ESTABLISHED.—The division may establish a
   93  direct-support organization, to be known as the “Automobile
   94  Insurance Fraud Strike Force,” whose sole purpose is to support
   95  the prosecution, investigation, and prevention of motor vehicle
   96  insurance fraud. The organization shall:
   97         (a) Be a not-for-profit corporation incorporated under
   98  chapter 617 and approved by the Department of State.
   99         (b) Be organized and operated to conduct programs and
  100  activities; raise funds; request and receive grants, gifts, and
  101  bequests of money; acquire, receive, hold, invest, and
  102  administer, in its own name, securities, funds, objects of
  103  value, or other property, real or personal; and make grants and
  104  expenditures to or for the direct or indirect benefit of the
  105  division, state attorneys’ offices, the statewide prosecutor,
  106  the Agency for Health Care Administration, and the Department of
  107  Health to the extent that such grants and expenditures are used
  108  exclusively to advance the prosecution, investigation, or
  109  prevention of motor vehicle insurance fraud. Grants and
  110  expenditures may include the cost of salaries or benefits of
  111  motor vehicle insurance fraud investigators, prosecutors, or
  112  support personnel if such grants and expenditures do not
  113  interfere with prosecutorial independence or otherwise create
  114  conflicts of interest which threaten the success of
  115  prosecutions.
  116         (c) Be determined by the division to operate in a manner
  117  that promotes the goals of laws relating to motor vehicle
  118  insurance fraud, that is in the best interest of the state, and
  119  that is in accordance with the adopted goals and mission of the
  120  division.
  121         (d) Use all of its grants and expenditures solely for the
  122  purpose of preventing and decreasing motor vehicle insurance
  123  fraud, and not for the purpose of lobbying as defined in s.
  124  11.045.
  125         (e) Be subject to an annual financial audit in accordance
  126  with s. 215.981.
  127         (3) CONTRACT.—The organization shall operate under written
  128  contract with the division. The contract must provide for:
  129         (a) Approval of the articles of incorporation and bylaws of
  130  the organization by the division.
  131         (b) Submission of an annual budget for approval of the
  132  division. The budget must require the organization to minimize
  133  costs to the division and its members at all times by using
  134  existing personnel and property and allowing for telephonic
  135  meetings, if appropriate.
  136         (c) Certification by the division that the organization is
  137  complying with the terms of the contract and in a manner
  138  consistent with the goals and purposes of the department and in
  139  the best interest of the state. Such certification must be made
  140  annually and reported in the official minutes of a meeting of
  141  the organization.
  142         (d) Allocation of funds to address motor vehicle insurance
  143  fraud.
  144         (e) Reversion of moneys and property held in trust by the
  145  organization for motor vehicle insurance fraud prosecution,
  146  investigation, and prevention to the division if the
  147  organization is no longer approved to operate for the department
  148  or if the organization ceases to exist, or to the state if the
  149  division ceases to exist.
  150         (f) Specific criteria to be used by the organization’s
  151  board of directors to evaluate the effectiveness of funding used
  152  to combat motor vehicle insurance fraud.
  153         (g) The fiscal year of the organization, which begins July
  154  1 of each year and ends June 30 of the following year.
  155         (h) Disclosure of the material provisions of the contract,
  156  and distinguishing between the department and the organization
  157  to donors of gifts, contributions, or bequests, including
  158  providing such disclosure on all promotional and fundraising
  159  publications.
  160         (4) BOARD OF DIRECTORS.—
  161         (a) The board of directors of the organization shall
  162  consist of the following eleven members:
  163         1. The Chief Financial Officer, or designee, who shall
  164  serve as chair.
  165         2. Two state attorneys, one of whom shall be appointed by
  166  the Chief Financial Officer and one of whom shall be appointed
  167  by the Attorney General.
  168         3. Two representatives of motor vehicle insurers appointed
  169  by the Chief Financial Officer.
  170         4. Two representatives of local law enforcement agencies,
  171  one of whom shall be appointed by the Chief Financial Officer
  172  and one of whom shall be appointed by the Attorney General.
  173         5. Two representatives of the types of health care
  174  providers who regularly make claims for benefits under the
  175  Florida Motor Vehicle No-Fault Law or the Florida Motor Vehicle
  176  No-Fault Medical Care Coverage Law, one of whom shall be
  177  appointed by the President of the Senate and one of whom shall
  178  be appointed by the Speaker of the House of Representatives. The
  179  appointees may not represent the same type of health care
  180  provider.
  181         6. A private attorney who has experience in representing
  182  claimants in actions for benefits under the Florida Motor
  183  Vehicle No-Fault Law, who shall be appointed by the President of
  184  the Senate.
  185         7. A private attorney who has experience in representing
  186  insurers in actions for benefits under the Florida Motor Vehicle
  187  No-Fault Law, who shall be appointed by the Speaker of the House
  188  of Representatives.
  189         (b) The officer who appointed a member of the board may
  190  remove that member for cause. The term of office of an appointed
  191  member expires at the same time as the term of the officer who
  192  appointed him or her or at such earlier time as the person
  193  ceases to be qualified.
  194         (5) USE OF PROPERTY.—The department may authorize, without
  195  charge, appropriate use of fixed property and facilities of the
  196  division by the organization, subject to this subsection.
  197         (a) The department may prescribe any condition with which
  198  the organization must comply in order to use the division’s
  199  property or facilities.
  200         (b) The department may not authorize the use of the
  201  division’s property or facilities if the organization does not
  202  provide equal membership and employment opportunities to all
  203  persons regardless of race, religion, sex, age, or national
  204  origin.
  205         (c) The department shall adopt rules prescribing the
  206  procedures by which the organization is governed and any
  207  conditions with which the organization must comply to use the
  208  division’s property or facilities.
  209         (6) CONTRIBUTIONS FROM INSURERS.—Contributions from an
  210  insurer to the organization shall be allowed as an appropriate
  211  business expense of the insurer for all regulatory purposes.
  212         (7) DEPOSITORY ACCOUNT.—Any moneys received by the
  213  organization may be held in a separate depository account in the
  214  name of the organization and subject to the contract with the
  215  division.
  216         (8) DIVISION’S RECEIPT OF PROCEEDS.—Proceeds received by
  217  the division from the organization shall be deposited into the
  218  Insurance Regulatory Trust Fund.
  219         Section 6. Section 627.732, Florida Statutes, is reordered
  220  and amended to read:
  221         627.732 Definitions.—As used in ss. 627.730-627.7405, the
  222  term:
  223         (1) “Broker” means any person not possessing a license
  224  under chapter 395, chapter 400, chapter 429, chapter 458,
  225  chapter 459, chapter 460, chapter 461, or chapter 641 who
  226  charges or receives compensation for any use of medical
  227  equipment and is not the 100-percent owner or the 100-percent
  228  lessee of such equipment. For purposes of this section, such
  229  owner or lessee may be an individual, a corporation, a
  230  partnership, or any other entity and any of its 100-percent
  231  owned affiliates and subsidiaries. For purposes of this
  232  subsection, the term “lessee” means a long-term lessee under a
  233  capital or operating lease, but does not include a part-time
  234  lessee. The term “broker” does not include a hospital or
  235  physician management company whose medical equipment is
  236  ancillary to the practices managed, a debt collection agency, or
  237  an entity that has contracted with the insurer to obtain a
  238  discounted rate for such services; nor does the term include a
  239  management company that has contracted to provide general
  240  management services for a licensed physician or health care
  241  facility and whose compensation is not materially affected by
  242  the usage or frequency of usage of medical equipment or an
  243  entity that is 100-percent owned by one or more hospitals or
  244  physicians. The term “broker” does not include a person or
  245  entity that certifies, upon request of an insurer, that:
  246         (a) It is a clinic licensed under ss. 400.990-400.995;
  247         (b) It is a 100-percent owner of medical equipment; and
  248         (c) The owner’s only part-time lease of medical equipment
  249  for personal injury protection patients is on a temporary basis
  250  not to exceed 30 days in a 12-month period, and such lease is
  251  solely for the purposes of necessary repair or maintenance of
  252  the 100-percent-owned medical equipment or pending the arrival
  253  and installation of the newly purchased or a replacement for the
  254  100-percent-owned medical equipment, or for patients for whom,
  255  because of physical size or claustrophobia, it is determined by
  256  the medical director or clinical director to be medically
  257  necessary that the test be performed in medical equipment that
  258  is open-style. The leased medical equipment cannot be used by
  259  patients who are not patients of the registered clinic for
  260  medical treatment of services. Any person or entity making a
  261  false certification under this subsection commits insurance
  262  fraud as defined in s. 817.234. However, the 30-day period
  263  provided in this paragraph may be extended for an additional 60
  264  days as applicable to magnetic resonance imaging equipment if
  265  the owner certifies that the extension otherwise complies with
  266  this paragraph.
  267         (9)(2) “Medically necessary” refers to a medical service or
  268  supply that a prudent physician would provide for the purpose of
  269  preventing, diagnosing, or treating an illness, injury, disease,
  270  or symptom in a manner that is:
  271         (a) In accordance with generally accepted standards of
  272  medical practice;
  273         (b) Clinically appropriate in terms of type, frequency,
  274  extent, site, and duration; and
  275         (c) Not primarily for the convenience of the patient,
  276  physician, or other health care provider.
  277         (10)(3) “Motor vehicle” means any self-propelled vehicle
  278  with four or more wheels which is of a type both designed and
  279  required to be licensed for use on the highways of this state
  280  and any trailer or semitrailer designed for use with such
  281  vehicle and includes:
  282         (a) A “private passenger motor vehicle,” which is any motor
  283  vehicle which is a sedan, station wagon, or jeep-type vehicle
  284  and, if not used primarily for occupational, professional, or
  285  business purposes, a motor vehicle of the pickup, panel, van,
  286  camper, or motor home type.
  287         (b) A “commercial motor vehicle,” which is any motor
  288  vehicle which is not a private passenger motor vehicle.
  289  
  290  The term “motor vehicle” does not include a mobile home or any
  291  motor vehicle which is used in mass transit, other than public
  292  school transportation, and designed to transport more than five
  293  passengers exclusive of the operator of the motor vehicle and
  294  which is owned by a municipality, a transit authority, or a
  295  political subdivision of the state.
  296         (11)(4) “Named insured” means a person, usually the owner
  297  of a vehicle, identified in a policy by name as the insured
  298  under the policy.
  299         (12)(5) “Owner” means a person who holds the legal title to
  300  a motor vehicle; or, in the event a motor vehicle is the subject
  301  of a security agreement or lease with an option to purchase with
  302  the debtor or lessee having the right to possession, then the
  303  debtor or lessee shall be deemed the owner for the purposes of
  304  ss. 627.730-627.7405.
  305         (14)(6) “Relative residing in the same household” means a
  306  relative of any degree by blood or by marriage who usually makes
  307  her or his home in the same family unit, whether or not
  308  temporarily living elsewhere.
  309         (2)(7) “Certify” means to swear or attest to being true or
  310  represented in writing.
  311         (3) “Entity wholly owned” means a proprietorship, group
  312  practice, partnership, or corporation that provides health care
  313  services rendered by licensed health care practitioners and in
  314  which licensed health care practitioners are the business owners
  315  of all aspects of the business entity, including, but not
  316  limited to, being reflected as the business owners on the title
  317  or lease of the physical facility, filing taxes as the business
  318  owners, being account holders on the entity’s bank account,
  319  being listed as the principals on all incorporation documents
  320  required by this state, and having ultimate authority over all
  321  personnel and compensation decisions relating to the entity.
  322  However, this definition does not apply to an entity that is
  323  wholly owned, directly or indirectly, by a hospital licensed
  324  under chapter 395.
  325         (5)(8) “Immediate personal supervision,” as it relates to
  326  the performance of medical services by nonphysicians not in a
  327  hospital, means that an individual licensed to perform the
  328  medical service or provide the medical supplies must be present
  329  within the confines of the physical structure where the medical
  330  services are performed or where the medical supplies are
  331  provided such that the licensed individual can respond
  332  immediately to any emergencies if needed.
  333         (6)(9) “Incident,” with respect to services considered as
  334  incident to a physician’s professional service, for a physician
  335  licensed under chapter 458, chapter 459, chapter 460, or chapter
  336  461, if not furnished in a hospital, means such services must be
  337  an integral, even if incidental, part of a covered physician’s
  338  service.
  339         (7)(10) “Knowingly” means that a person, with respect to
  340  information, has actual knowledge of the information; acts in
  341  deliberate ignorance of the truth or falsity of the information;
  342  or acts in reckless disregard of the information, and proof of
  343  specific intent to defraud is not required.
  344         (8)(11) “Lawful” or “lawfully” means in substantial
  345  compliance with all relevant applicable criminal, civil, and
  346  administrative requirements of state and federal law related to
  347  the provision of medical services or treatment.
  348         (4)(12) “Hospital” means a facility that, at the time
  349  services or treatment were rendered, was licensed under chapter
  350  395.
  351         (13) “Properly completed” means providing truthful,
  352  substantially complete, and substantially accurate responses as
  353  to all material elements to each applicable request for
  354  information or statement by a means that may lawfully be
  355  provided and that complies with this section, or as agreed by
  356  the parties.
  357         (16)(14) “Upcoding” means an action that submits a billing
  358  code that would result in payment greater in amount than would
  359  be paid using a billing code that accurately describes the
  360  services performed. The term does not include an otherwise
  361  lawful bill by a magnetic resonance imaging facility, which
  362  globally combines both technical and professional components, if
  363  the amount of the global bill is not more than the components if
  364  billed separately; however, payment of such a bill constitutes
  365  payment in full for all components of such service.
  366         (15) “Unbundling” means an action that submits a billing
  367  code that is properly billed under one billing code, but that
  368  has been separated into two or more billing codes, and would
  369  result in payment greater in amount than would be paid using one
  370  billing code.
  371         Section 7. Subsection (6) is added to section 627.733,
  372  Florida Statutes, to read:
  373         627.733 Required security.—
  374         (6) The owner or registrant of a motor vehicle otherwise
  375  subject to this section is not required to maintain the security
  376  described herein if the owner or registrant maintains the
  377  security required under s. 627.7483.
  378         Section 8. Subsections (1), (4), (5), (8), (9), (10), (11),
  379  and (16) of section 627.736, Florida Statutes, are amended to
  380  read:
  381         627.736 Required personal injury protection benefits;
  382  exclusions; priority; claims.—
  383         (1) REQUIRED BENEFITS.—An Every insurance policy providing
  384  personal injury protection must complying with the security
  385  requirements of s. 627.733 shall provide personal injury
  386  protection benefits to the named insured, relatives residing in
  387  the same household, persons operating the insured motor vehicle,
  388  passengers in the such motor vehicle, and other persons struck
  389  by the such motor vehicle and suffering bodily injury while not
  390  an occupant of a self-propelled vehicle, subject to the
  391  provisions of subsection (2) and paragraph (4)(e), up to a limit
  392  of $10,000 in medical and disability benefits and $5,000 in
  393  death benefits resulting from for loss sustained by any such
  394  person as a result of bodily injury, sickness, disease, or death
  395  to such persons arising out of the ownership, maintenance, or
  396  use of a motor vehicle as follows:
  397         (a) Medical benefits.—Eighty percent of all reasonable
  398  expenses for medically necessary medical, surgical, X-ray,
  399  dental, and rehabilitative services, including prosthetic
  400  devices, and medically necessary ambulance, hospital, and
  401  nursing services. Medical benefits do not include massage as
  402  defined in s. 480.033 or acupuncture as defined in s. 457.102,
  403  regardless of the person, entity, or licensee providing massage
  404  or acupuncture, and a licensed massage therapist or licensed
  405  acupuncturist may not be reimbursed for medical benefits under
  406  this section. However, The medical benefits shall provide
  407  reimbursement only for such services and care that are lawfully
  408  provided, supervised, ordered, or prescribed by a physician
  409  licensed under chapter 458 or chapter 459, a dentist licensed
  410  under chapter 466, or a chiropractic physician licensed under
  411  chapter 460 or that are provided by any of the following persons
  412  or entities:
  413         1. A hospital or ambulatory surgical center licensed under
  414  chapter 395.
  415         2. A person or entity licensed under part III of chapter
  416  401 which ss. 401.2101-401.45 that provides emergency
  417  transportation and treatment.
  418         3. An entity wholly owned by one or more physicians
  419  licensed under chapter 458 or chapter 459, chiropractic
  420  physicians licensed under chapter 460, or dentists licensed
  421  under chapter 466 or by such practitioner or practitioners and
  422  the spouse, parent, child, or sibling of such that practitioner
  423  or those practitioners.
  424         4. An entity wholly owned, directly or indirectly, by a
  425  hospital or hospitals.
  426         5. A health care clinic licensed under part X of chapter
  427  400 which ss. 400.990-400.995 that is:
  428         a. A health care clinic accredited by the Joint Commission
  429  on Accreditation of Healthcare Organizations, the American
  430  Osteopathic Association, the Commission on Accreditation of
  431  Rehabilitation Facilities, or the Accreditation Association for
  432  Ambulatory Health Care, Inc.; or
  433         b. A health care clinic that:
  434         (I) Has a medical director licensed under chapter 458,
  435  chapter 459, or chapter 460;
  436         (II) Has been continuously licensed for more than 3 years
  437  or is a publicly traded corporation that issues securities
  438  traded on an exchange registered with the United States
  439  Securities and Exchange Commission as a national securities
  440  exchange; and
  441         (III) Provides at least four of the following medical
  442  specialties:
  443         (A) General medicine.
  444         (B) Radiography.
  445         (C) Orthopedic medicine.
  446         (D) Physical medicine.
  447         (E) Physical therapy.
  448         (F) Physical rehabilitation.
  449         (G) Prescribing or dispensing outpatient prescription
  450  medication.
  451         (H) Laboratory services.
  452  
  453  The Financial Services Commission shall adopt by rule the form
  454  that must be used by an insurer and a health care provider
  455  specified in subparagraph 3., subparagraph 4., or subparagraph
  456  5. to document that the health care provider meets the criteria
  457  of this paragraph, which rule must include a requirement for a
  458  sworn statement or affidavit.
  459         (b) Disability benefits.—Sixty percent of any loss of gross
  460  income and loss of earning capacity per individual from
  461  inability to work proximately caused by the injury sustained by
  462  the injured person, plus all expenses reasonably incurred in
  463  obtaining from others ordinary and necessary services in lieu of
  464  those that, but for the injury, the injured person would have
  465  performed without income for the benefit of his or her
  466  household. All disability benefits payable under this provision
  467  must shall be paid at least not less than every 2 weeks.
  468         (c) Death benefits.—Death benefits equal to the lesser of
  469  $5,000 or the remainder of unused personal injury protection
  470  benefits per individual. Death benefits are in addition to the
  471  medical and disability benefits provided under the insurance
  472  policy. The insurer may pay death such benefits to the executor
  473  or administrator of the deceased, to any of the deceased’s
  474  relatives by blood, or legal adoption, or connection by
  475  marriage, or to any person appearing to the insurer to be
  476  equitably entitled to such benefits thereto.
  477  
  478  Only insurers writing motor vehicle liability insurance in this
  479  state may provide the required benefits of this section, and no
  480  such insurer shall require the purchase of any other motor
  481  vehicle coverage other than the purchase of property damage
  482  liability coverage as required by s. 627.7275 as a condition for
  483  providing such required benefits. Insurers may not require that
  484  property damage liability insurance in an amount greater than
  485  $10,000 be purchased in conjunction with personal injury
  486  protection. Such insurers shall make benefits and required
  487  property damage liability insurance coverage available through
  488  normal marketing channels. Any insurer writing motor vehicle
  489  liability insurance in this state who fails to comply with such
  490  availability requirement as a general business practice shall be
  491  deemed to have violated part IX of chapter 626, and such
  492  violation shall constitute an unfair method of competition or an
  493  unfair or deceptive act or practice involving the business of
  494  insurance; and any such insurer committing such violation shall
  495  be subject to the penalties afforded in such part, as well as
  496  those which may be afforded elsewhere in the insurance code.
  497         (4) PAYMENT OF BENEFITS; WHEN DUE.—Except for medical care
  498  coverage under ss. 627.748-627.7491, personal injury protection
  499  benefits due from an insurer under ss. 627.730-627.7405 are
  500  shall be primary, except that benefits received under any
  501  workers’ compensation law must shall be credited against the
  502  benefits provided by subsection (1) and are shall be due and
  503  payable as loss accrues, upon receipt of reasonable proof of
  504  such loss and the amount of expenses and loss incurred which are
  505  covered by the policy issued under ss. 627.730-627.7405. If When
  506  the Agency for Health Care Administration provides, pays, or
  507  becomes liable for medical assistance under the Medicaid program
  508  related to injury, sickness, disease, or death arising out of
  509  the ownership, maintenance, or use of a motor vehicle, the
  510  benefits under ss. 627.730-627.7405 are shall be subject to the
  511  provisions of the Medicaid program. However, within 30 days
  512  after receiving notice that the Medicaid program paid such
  513  benefits, the insurer shall repay the full amount of the
  514  benefits to the Medicaid program.
  515         (a) An insurer may require written notice to be given as
  516  soon as practicable after an accident involving a motor vehicle
  517  with respect to which the policy affords the security required
  518  by ss. 627.730-627.7405.
  519         (b) Personal injury protection insurance Benefits paid
  520  pursuant to this section are shall be overdue if not paid within
  521  30 days after the insurer is furnished written notice of the
  522  fact of a covered loss and of the amount of same. However:
  523         1. If such written notice of the entire claim is not
  524  furnished to the insurer as to the entire claim, any partial
  525  amount supported by written notice is overdue if not paid within
  526  30 days after such written notice is furnished to the insurer.
  527  Any part or all of the remainder of the claim that is
  528  subsequently supported by written notice is overdue if not paid
  529  within 30 days after such written notice is furnished to the
  530  insurer.
  531         2. If When an insurer pays only a portion of a claim or
  532  rejects a claim, the insurer shall provide at the time of the
  533  partial payment or rejection an itemized specification of each
  534  item that the insurer had reduced, omitted, or declined to pay
  535  and any information that the insurer desires the claimant to
  536  consider related to the medical necessity of the denied
  537  treatment or to explain the reasonableness of the reduced charge
  538  if, provided that this does shall not limit the introduction of
  539  evidence at trial.; and The insurer must also shall include the
  540  name and address of the person to whom the claimant should
  541  respond and a claim number to be referenced in future
  542  correspondence.
  543         3. If an insurer pays only a portion of a claim or rejects
  544  a claim due to an alleged error in the claim, the insurer shall
  545  provide at the time of the partial payment or rejection an
  546  itemized specification or explanation of benefits of the
  547  specified error. Upon receiving the specification or
  548  explanation, the person making the claim has, at the person’s
  549  option and without waiving any other legal remedy for payment,
  550  15 days to submit a revised claim. The revised claim shall be
  551  considered a timely submission of written notice of a claim.
  552         4.However, Notwithstanding the fact that written notice
  553  has been furnished to the insurer, any payment is shall not be
  554  deemed overdue if when the insurer has reasonable proof to
  555  establish that the insurer is not responsible for the payment.
  556         5. For the purpose of calculating the extent to which any
  557  benefits are overdue, payment shall be treated as being made on
  558  the date a draft or other valid instrument that which is
  559  equivalent to payment was placed in the United States mail in a
  560  properly addressed, postpaid envelope or, if not so posted, on
  561  the date of delivery.
  562         6. This paragraph does not preclude or limit the ability of
  563  the insurer to assert that the claim was unrelated, was not
  564  medically necessary, or was unreasonable or that the amount of
  565  the charge was in excess of that permitted under, or in
  566  violation of, subsection (5). Such assertion by the insurer may
  567  be made at any time, including after payment of the claim or
  568  after the 30-day time period for payment set forth in this
  569  paragraph.
  570         (c) Upon receiving notice of an accident that is
  571  potentially covered by personal injury protection benefits, the
  572  insurer must reserve $5,000 of coverage of personal injury
  573  protection benefits for payment to physicians licensed under
  574  chapter 458 or chapter 459 or dentists licensed under chapter
  575  466 who provide emergency services and care, as defined in s.
  576  395.002(9), or who provide hospital inpatient care.
  577  
  578  The amount required to be held in reserve may be used only to
  579  pay claims from such physicians or dentists until 30 days after
  580  the date the insurer receives notice of the accident. After the
  581  30-day period, any amount of the reserve for which the insurer
  582  has not received notice of such claims a claim from a physician
  583  or dentist who provided emergency services and care or who
  584  provided hospital inpatient care may then be used by the insurer
  585  to pay other claims. The time periods specified in paragraph (b)
  586  for required payment of personal injury protection benefits are
  587  shall be tolled for the period of time that an insurer is
  588  required by this paragraph to hold payment of a claim that is
  589  not from a physician or dentist who provided emergency services
  590  and care or who provided hospital inpatient care to the extent
  591  that the amount personal injury protection benefits not held in
  592  reserve is are insufficient to pay the claim. This paragraph
  593  does not require an insurer to establish a claim reserve for
  594  insurance accounting purposes.
  595         (d) All overdue payments shall bear simple interest at the
  596  rate established under s. 55.03 or the rate established in the
  597  insurance contract, whichever is greater, for the quarter year
  598  in which the payment became overdue, calculated from the date
  599  the insurer was furnished with written notice of the amount of
  600  covered loss. Interest is shall be due at the time payment of
  601  the overdue claim is made.
  602         (e) The insurer of the owner of a motor vehicle shall pay
  603  personal injury protection benefits for:
  604         1. Accidental bodily injury sustained in this state by the
  605  owner while occupying a motor vehicle, or while not an occupant
  606  of a self-propelled vehicle if the injury is caused by physical
  607  contact with a motor vehicle.
  608         2. Accidental bodily injury sustained outside this state,
  609  but within the United States of America or its territories or
  610  possessions or Canada, by the owner while occupying the owner’s
  611  motor vehicle.
  612         3. Accidental bodily injury sustained by a relative of the
  613  owner residing in the same household, under the circumstances
  614  described in subparagraph 1. or subparagraph 2., if provided the
  615  relative at the time of the accident is domiciled in the owner’s
  616  household and is not himself or herself the owner of a motor
  617  vehicle with respect to which security is required under ss.
  618  627.730-627.7405.
  619         4. Accidental bodily injury sustained in this state by any
  620  other person while occupying the owner’s motor vehicle or, if a
  621  resident of this state, while not an occupant of a self
  622  propelled vehicle, if the injury is caused by physical contact
  623  with such motor vehicle, if provided the injured person is not
  624  himself or herself:
  625         a. The owner of a motor vehicle for with respect to which
  626  personal injury protection benefits have been obtained pursuant
  627  to security is required under ss. 627.730-627.7405; or
  628         b. Entitled to personal injury benefits from the insurer of
  629  the owner or owners of such a motor vehicle.
  630         (f) If two or more insurers are liable for paying to pay
  631  personal injury protection benefits for the same injury to any
  632  one person, the maximum payable is shall be as specified in
  633  subsection (1), and the any insurer paying the benefits is shall
  634  be entitled to recover from each of the other insurers an
  635  equitable pro rata share of the benefits paid and expenses
  636  incurred in processing the claim.
  637         (g) It is a violation of the insurance code for an insurer
  638  to fail to timely provide benefits as required by this section
  639  with such frequency as to constitute a general business
  640  practice.
  641         (h) Benefits are shall not be due or payable to or on the
  642  behalf of an insured person if that person has committed, by a
  643  material act or omission, any insurance fraud relating to
  644  personal injury protection coverage under his or her policy, if
  645  the fraud is admitted to in a sworn statement by the insured or
  646  if it is established in a court of competent jurisdiction. Any
  647  insurance fraud voids shall void all coverage arising from the
  648  claim related to such fraud under the personal injury protection
  649  coverage of the insured person who committed the fraud,
  650  irrespective of whether a portion of the insured person’s claim
  651  may be legitimate, and any benefits paid before prior to the
  652  discovery of the insured person’s insurance fraud is shall be
  653  recoverable by the insurer in its entirety from the person who
  654  committed insurance fraud in their entirety. The prevailing
  655  party is entitled to its costs and attorney attorney’s fees in
  656  any action in which it prevails in an insurer’s action to
  657  enforce its right of recovery under this paragraph.
  658         (i)An insurer shall create and maintain for each insured a
  659  log of personal injury protection benefits paid by the insurer
  660  on behalf of the insured. The insurer shall provide to the
  661  insured a copy of the log within 30 days after receiving a
  662  request for the log from the insured.
  663         (j) In a dispute between the insured and the insurer, or
  664  between an assignee of the insured’s rights and the insurer, the
  665  insurer must notify the insured or the assignee that the policy
  666  limits under this section have been reached within 15 days after
  667  the limits have been reached.
  668         (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
  669         (a)1.A Any physician, hospital, clinic, or other person or
  670  institution lawfully rendering treatment to an injured person
  671  for a bodily injury covered by personal injury protection
  672  insurance may charge the insurer and injured party only a
  673  reasonable amount pursuant to this section for the services and
  674  supplies rendered, and the insurer providing such coverage may
  675  pay for such charges directly to such person or institution
  676  lawfully rendering such treatment, if the insured receiving such
  677  treatment or his or her guardian has countersigned the properly
  678  completed invoice, bill, or claim form approved by the office
  679  upon which such charges are to be paid for as having actually
  680  been rendered, to the best knowledge of the insured or his or
  681  her guardian. In no event, However, may such a charge may not
  682  exceed be in excess of the amount the person or institution
  683  customarily charges for like services or supplies. In
  684  determining With respect to a determination of whether a charge
  685  for a particular service, treatment, or supply otherwise is
  686  reasonable, consideration may be given to evidence of usual and
  687  customary charges and payments accepted by the provider involved
  688  in the dispute, and reimbursement levels in the community and
  689  various federal and state medical fee schedules applicable to
  690  motor vehicle automobile and other insurance coverages, and
  691  other information relevant to the reasonableness of the
  692  reimbursement for the service, treatment, or supply.
  693         1.2. The insurer may limit reimbursement to 80 percent of
  694  the following schedule of maximum charges:
  695         a. For emergency transport and treatment by providers
  696  licensed under chapter 401, 200 percent of Medicare.
  697         b. For emergency services and care provided by a hospital
  698  licensed under chapter 395, 75 percent of the hospital’s usual
  699  and customary charges.
  700         c. For emergency services and care as defined by s.
  701  395.002(9) provided in a facility licensed under chapter 395
  702  rendered by a physician or dentist, and related hospital
  703  inpatient services rendered by a physician or dentist, the usual
  704  and customary charges in the community.
  705         d. For hospital inpatient services, other than emergency
  706  services and care, 200 percent of the Medicare Part A
  707  prospective payment applicable to the specific hospital
  708  providing the inpatient services.
  709         e. For hospital outpatient services, other than emergency
  710  services and care, 200 percent of the Medicare Part A Ambulatory
  711  Payment Classification for the specific hospital providing the
  712  outpatient services.
  713         f. For all other medical services, supplies, and care, 200
  714  percent of the allowable amount under:
  715         (I) The participating physicians fee schedule of Medicare
  716  Part B, except as provided in sub-sub-subparagraphs (II) and
  717  (III).
  718         (II) Medicare Part B, in the case of services, supplies,
  719  and care provided by ambulatory surgical centers and clinical
  720  laboratories.
  721         (III) The Durable Medical Equipment Prosthetics/Orthotics
  722  and Supplies fee schedule of Medicare Part B, in the case of
  723  durable medical equipment.
  724  
  725  However, if such services, supplies, or care is not reimbursable
  726  under Medicare Part B, as provided in this sub-subparagraph, the
  727  insurer may limit reimbursement to 80 percent of the maximum
  728  reimbursable allowance under workers’ compensation, as
  729  determined under s. 440.13 and rules adopted thereunder which
  730  are in effect at the time such services, supplies, or care is
  731  provided. Services, supplies, or care that is not reimbursable
  732  under Medicare or workers’ compensation is not required to be
  733  reimbursed by the insurer.
  734         2.3. For purposes of subparagraph 1. 2., the applicable fee
  735  schedule or payment limitation under Medicare is the fee
  736  schedule or payment limitation in effect on March 1 of the year
  737  in which at the time the services, supplies, or care is was
  738  rendered and for the area in which such services, supplies, or
  739  care is were rendered, and applies until March 1 of the
  740  following year, notwithstanding any subsequent change made to
  741  the fee schedule or payment limitation, except that it may not
  742  be less than the allowable amount under the applicable
  743  participating physicians schedule of Medicare Part B for 2007
  744  for medical services, supplies, and care subject to Medicare
  745  Part B.
  746         3.4. Subparagraph 1. 2. does not allow the insurer to apply
  747  any limitation on the number of treatments or other utilization
  748  limits that apply under Medicare or workers’ compensation. An
  749  insurer that applies the allowable payment limitations of
  750  subparagraph 1. 2. must reimburse a provider who lawfully
  751  provided care or treatment under the scope of his or her
  752  license, regardless of whether such provider is would be
  753  entitled to reimbursement under Medicare due to restrictions or
  754  limitations on the types or discipline of health care providers
  755  who may be reimbursed for particular procedures or procedure
  756  codes. However, subparagraph 1. does not prohibit an insurer
  757  from using the Medicare coding policies and payment
  758  methodologies of the federal Centers for Medicare and Medicaid
  759  Services, including applicable modifiers, to determine the
  760  appropriate amount of reimbursement for medical services,
  761  supplies, or care if the coding policy or payment methodology
  762  does not constitute a utilization limit.
  763         4.5. If an insurer limits payment as authorized by
  764  subparagraph 1. 2., the person providing such services,
  765  supplies, or care may not bill or attempt to collect from the
  766  insured any amount in excess of such limits, except for amounts
  767  that are not covered by the insured’s personal injury protection
  768  coverage due to the coinsurance amount or maximum policy limits.
  769         5. Effective January 1, 2013, an insurer may limit payment
  770  as authorized by this paragraph only if the insurance policy
  771  includes a notice at the time of issuance or renewal that the
  772  insurer may limit payment pursuant to the schedule of charges
  773  specified in this paragraph. A policy form approved by the
  774  office satisfies this requirement. If a provider submits a
  775  charge for an amount less than the amount allowed under
  776  subparagraph 1., the insurer may pay the amount of the charge
  777  submitted.
  778         (b)1. An insurer or insured is not required to pay a claim
  779  or charges:
  780         a. Made by a broker or by a person making a claim on behalf
  781  of a broker;
  782         b. For any service or treatment that was not lawful at the
  783  time rendered;
  784         c. To any person who knowingly submits a false or
  785  misleading statement relating to the claim or charges;
  786         d. With respect to a bill or statement that does not
  787  substantially meet the applicable requirements of paragraph (d);
  788         e. For any treatment or service that is upcoded, or that is
  789  unbundled when such treatment or services should be bundled, in
  790  accordance with paragraph (d). To facilitate prompt payment of
  791  lawful services, an insurer may change codes that it determines
  792  to have been improperly or incorrectly upcoded or unbundled, and
  793  may make payment based on the changed codes, without affecting
  794  the right of the provider to dispute the change by the insurer,
  795  if, provided that before doing so, the insurer contacts must
  796  contact the health care provider and discusses discuss the
  797  reasons for the insurer’s change and the health care provider’s
  798  reason for the coding, or makes make a reasonable good faith
  799  effort to do so, as documented in the insurer’s file; and
  800         f. For medical services or treatment billed by a physician
  801  and not provided in a hospital unless such services are rendered
  802  by the physician or are incident to his or her professional
  803  services and are included on the physician’s bill, including
  804  documentation verifying that the physician is responsible for
  805  the medical services that were rendered and billed.
  806         2. The Department of Health, in consultation with the
  807  appropriate professional licensing boards, shall adopt, by rule,
  808  a list of diagnostic tests deemed not to be medically necessary
  809  for use in the treatment of persons sustaining bodily injury
  810  covered by personal injury protection benefits under this
  811  section. The initial list shall be adopted by January 1, 2004,
  812  and shall be revised from time to time as determined by the
  813  Department of Health, in consultation with the respective
  814  professional licensing boards. Inclusion of a test on the list
  815  of invalid diagnostic tests shall be based on lack of
  816  demonstrated medical value and a level of general acceptance by
  817  the relevant provider community and may shall not be dependent
  818  for results entirely upon subjective patient response.
  819  Notwithstanding its inclusion on a fee schedule in this
  820  subsection, an insurer or insured is not required to pay any
  821  charges or reimburse claims for an any invalid diagnostic test
  822  as determined by the Department of Health.
  823         (c)1. With respect to any treatment or service, other than
  824  medical services billed by a hospital or other provider for
  825  emergency services and care as defined in s. 395.002 or
  826  inpatient services rendered at a hospital-owned facility, the
  827  statement of charges must be furnished to the insurer by the
  828  provider and may not include, and the insurer is not required to
  829  pay, charges for treatment or services rendered more than 35
  830  days before the postmark date or electronic transmission date of
  831  the statement, except for past due amounts previously billed on
  832  a timely basis under this paragraph, and except that, if the
  833  provider submits to the insurer a notice of initiation of
  834  treatment within 21 days after its first examination or
  835  treatment of the claimant, the statement may include charges for
  836  treatment or services rendered up to, but not more than, 75 days
  837  before the postmark date of the statement. The injured party is
  838  not liable for, and the provider may shall not bill the injured
  839  party for, charges that are unpaid because of the provider’s
  840  failure to comply with this paragraph. Any agreement requiring
  841  the injured person or insured to pay for such charges is
  842  unenforceable.
  843         1.2. If, however, the insured fails to furnish the provider
  844  with the correct name and address of the insured’s personal
  845  injury protection insurer, the provider has 35 days from the
  846  date the provider obtains the correct information to furnish the
  847  insurer with a statement of the charges. The insurer is not
  848  required to pay for such charges unless the provider includes
  849  with the statement documentary evidence that was provided by the
  850  insured during the 35-day period demonstrating that the provider
  851  reasonably relied on erroneous information from the insured and
  852  either:
  853         a. A denial letter from the incorrect insurer; or
  854         b. Proof of mailing, which may include an affidavit under
  855  penalty of perjury, reflecting timely mailing to the incorrect
  856  address or insurer.
  857         2.3. For emergency services and care as defined in s.
  858  395.002 rendered in a hospital emergency department or for
  859  transport and treatment rendered by an ambulance provider
  860  licensed pursuant to part III of chapter 401, the provider is
  861  not required to furnish the statement of charges within the time
  862  periods established by this paragraph,; and the insurer is shall
  863  not be considered to have been furnished with notice of the
  864  amount of covered loss for purposes of paragraph (4)(b) until it
  865  receives a statement complying with paragraph (d), or copy
  866  thereof, which specifically identifies the place of service to
  867  be a hospital emergency department or an ambulance in accordance
  868  with billing standards recognized by the federal Centers for
  869  Medicare and Medicaid Services Health Care Finance
  870  Administration.
  871         3.4. Each notice of the insured’s rights under s. 627.7401
  872  must include the following statement in at least 12-point type
  873  in type no smaller than 12 points:
  874  
  875         BILLING REQUIREMENTS.—Florida law provides Statutes
  876         provide that with respect to any treatment or
  877         services, other than certain hospital and emergency
  878         services, the statement of charges furnished to the
  879         insurer by the provider may not include, and the
  880         insurer and the injured party are not required to pay,
  881         charges for treatment or services rendered more than
  882         35 days before the postmark date of the statement,
  883         except for past due amounts previously billed on a
  884         timely basis, and except that, if the provider submits
  885         to the insurer a notice of initiation of treatment
  886         within 21 days after its first examination or
  887         treatment of the claimant, the statement may include
  888         charges for treatment or services rendered up to, but
  889         not more than, 75 days before the postmark date of the
  890         statement.
  891  
  892         (d) All statements and bills for medical services rendered
  893  by a any physician, hospital, clinic, or other person or
  894  institution shall be submitted to the insurer on a properly
  895  completed Centers for Medicare and Medicaid Services (CMS) 1500
  896  form, UB 92 forms, or any other standard form approved by the
  897  office or adopted by the commission for purposes of this
  898  paragraph. All billings for such services rendered by providers
  899  must shall, to the extent applicable, follow the Physicians’
  900  Current Procedural Terminology (CPT) or Healthcare Correct
  901  Procedural Coding System (HCPCS), or ICD-9 in effect for the
  902  year in which services are rendered and comply with the Centers
  903  for Medicare and Medicaid Services (CMS) 1500 form instructions,
  904  and the American Medical Association Current Procedural
  905  Terminology (CPT) Editorial Panel, and the Healthcare Correct
  906  Procedural Coding System (HCPCS). All providers, other than
  907  hospitals, must shall include on the applicable claim form the
  908  professional license number of the provider in the line or space
  909  provided for “Signature of Physician or Supplier, Including
  910  Degrees or Credentials.” In determining compliance with
  911  applicable CPT and HCPCS coding, guidance shall be provided by
  912  the Physicians’ Current Procedural Terminology (CPT) or the
  913  Healthcare Correct Procedural Coding System (HCPCS) in effect
  914  for the year in which services were rendered, the Office of the
  915  Inspector General (OIG), Physicians Compliance Guidelines, and
  916  other authoritative treatises designated by rule by the Agency
  917  for Health Care Administration. A No statement of medical
  918  services may not include charges for medical services of a
  919  person or entity that performed such services without possessing
  920  the valid licenses required to perform such services. For
  921  purposes of paragraph (4)(b), an insurer is shall not be
  922  considered to have been furnished with notice of the amount of
  923  covered loss or medical bills due unless the statements or bills
  924  comply with this paragraph, and unless the statements or bills
  925  are properly completed in their entirety as to all material
  926  provisions, with all relevant information being provided
  927  therein.
  928         (e)1. At the initial treatment or service provided, each
  929  physician, other licensed professional, clinic, or other medical
  930  institution providing medical services upon which a claim for
  931  personal injury protection benefits is based shall require an
  932  insured person, or his or her guardian, to execute a disclosure
  933  and acknowledgment form, which reflects at a minimum that:
  934         a. The insured, or his or her guardian, must countersign
  935  the form attesting to the fact that the services set forth
  936  therein were actually rendered;
  937         b. The insured, or his or her guardian, has both the right
  938  and affirmative duty to confirm that the services were actually
  939  rendered;
  940         c. The insured, or his or her guardian, was not solicited
  941  by any person to seek any services from the medical provider;
  942         d. The physician, other licensed professional, clinic, or
  943  other medical institution rendering services for which payment
  944  is being claimed explained the services to the insured or his or
  945  her guardian; and
  946         e. If the insured notifies the insurer in writing of a
  947  billing error, the insured may be entitled to a certain
  948  percentage of a reduction in the amounts paid by the insured’s
  949  motor vehicle insurer.
  950         2. The physician, other licensed professional, clinic, or
  951  other medical institution rendering services for which payment
  952  is being claimed has the affirmative duty to explain the
  953  services rendered to the insured, or his or her guardian, so
  954  that the insured, or his or her guardian, countersigns the form
  955  with informed consent.
  956         3. Countersignature by the insured, or his or her guardian,
  957  is not required for the reading of diagnostic tests or other
  958  services that are of such a nature that they are not required to
  959  be performed in the presence of the insured.
  960         4. The licensed medical professional rendering treatment
  961  for which payment is being claimed must sign, by his or her own
  962  hand, the form complying with this paragraph.
  963         5. The original completed disclosure and acknowledgment
  964  form shall be furnished to the insurer pursuant to paragraph
  965  (4)(b) and may not be electronically furnished.
  966         6. The This disclosure and acknowledgment form is not
  967  required for services billed by a provider for emergency
  968  services as defined in s. 395.002, for emergency services and
  969  care as defined in s. 395.002 rendered in a hospital emergency
  970  department, or for transport and treatment rendered by an
  971  ambulance provider licensed pursuant to part III of chapter 401.
  972         7. The Financial Services Commission shall adopt, by rule,
  973  a standard disclosure and acknowledgment form to that shall be
  974  used to fulfill the requirements of this paragraph, effective 90
  975  days after such form is adopted and becomes final. The
  976  commission shall adopt a proposed rule by October 1, 2003. Until
  977  the rule is final, the provider may use a form of its own which
  978  otherwise complies with the requirements of this paragraph.
  979         8. As used in this paragraph, the term “countersign” or
  980  “countersignature” “countersigned” means a second or verifying
  981  signature, as on a previously signed document, and is not
  982  satisfied by the statement “signature on file” or any similar
  983  statement.
  984         9. The requirements of this paragraph apply only with
  985  respect to the initial treatment or service of the insured by a
  986  provider. For subsequent treatments or service, the provider
  987  must maintain a patient log signed by the patient, in
  988  chronological order by date of service, which that is consistent
  989  with the services being rendered to the patient as claimed. The
  990  requirement to maintain requirements of this subparagraph for
  991  maintaining a patient log signed by the patient may be met by a
  992  hospital that maintains medical records as required by s.
  993  395.3025 and applicable rules and makes such records available
  994  to the insurer upon request.
  995         (f) Upon written notification by any person, an insurer
  996  shall investigate any claim of improper billing by a physician
  997  or other medical provider. The insurer shall determine if the
  998  insured was properly billed for only those services and
  999  treatments that the insured actually received. If the insurer
 1000  determines that the insured has been improperly billed, the
 1001  insurer shall notify the insured, the person making the written
 1002  notification, and the provider of its findings and shall reduce
 1003  the amount of payment to the provider by the amount determined
 1004  to be improperly billed. If a reduction is made due to a such
 1005  written notification by any person, the insurer shall pay to the
 1006  person 20 percent of the amount of the reduction, up to $500. If
 1007  the provider is arrested due to the improper billing, then the
 1008  insurer shall pay to the person 40 percent of the amount of the
 1009  reduction, up to $500.
 1010         (g) An insurer may not systematically downcode with the
 1011  intent to deny reimbursement otherwise due. Such action
 1012  constitutes a material misrepresentation under s.
 1013  626.9541(1)(i)2.
 1014         (h) As provided in s. 400.9905, an entity excluded from the
 1015  definition of a clinic shall be deemed a clinic and must be
 1016  licensed under part X of chapter 400 in order to receive
 1017  reimbursement under ss. 627.730-627.7405. However, this
 1018  licensing requirement does not apply to:
 1019         1. An entity wholly owned by a physician licensed under
 1020  chapter 458 or chapter 459, or by the physician and the spouse,
 1021  parent, child, or sibling of the physician;
 1022         2. An entity wholly owned by a dentist licensed under
 1023  chapter 466, or by the dentist and the spouse, parent, child, or
 1024  sibling of the dentist;
 1025         3. An entity wholly owned by a chiropractic physician
 1026  licensed under chapter 460, or by the chiropractic physician and
 1027  the spouse, parent, child, or sibling of the chiropractic
 1028  physician if such entity has filed for a licensing exemption
 1029  with the Agency for Health Care Administration;
 1030         4. A hospital or ambulatory surgical center licensed under
 1031  chapter 395; or
 1032         5. An entity wholly owned, directly or indirectly, by a
 1033  hospital or hospitals licensed under chapter 395.
 1034         (8) APPLICABILITY OF PROVISION REGULATING ATTORNEY
 1035  ATTORNEY’S FEES.—With respect to any dispute under the
 1036  provisions of ss. 627.730-627.7405 between the insured and the
 1037  insurer, or between an assignee of an insured’s rights and the
 1038  insurer, the provisions of ss. s. 627.428 and 768.79 shall
 1039  apply, except as provided in subsections (10) and (15).
 1040         (9) PREFERRED PROVIDERS.—An insurer may negotiate and
 1041  contract enter into contracts with preferred licensed health
 1042  care providers for the benefits described in this section,
 1043  including referred to in this section as “preferred providers,”
 1044  which shall include health care providers licensed under chapter
 1045  chapters 458, chapter 459, chapter 460, chapter 461, or chapter
 1046  and 463. The insurer may provide an option to an insured to use
 1047  a preferred provider at the time of purchasing purchase of the
 1048  policy for personal injury protection benefits, if the
 1049  requirements of this subsection are met. If the insured elects
 1050  to use a provider who is not a preferred provider, whether the
 1051  insured purchased a preferred provider policy or a nonpreferred
 1052  provider policy, the medical benefits provided by the insurer
 1053  shall be as required by this section. If the insured elects to
 1054  use a provider who is a preferred provider, the insurer may pay
 1055  medical benefits in excess of the benefits required by this
 1056  section and may waive or lower the amount of any deductible that
 1057  applies to such medical benefits. If the insurer offers a
 1058  preferred provider policy to a policyholder or applicant, it
 1059  must also offer a nonpreferred provider policy. The insurer
 1060  shall provide each insured policyholder with a current roster of
 1061  preferred providers in the county in which the insured resides
 1062  at the time of purchase of such policy, and shall make such list
 1063  available for public inspection during regular business hours at
 1064  the insurer’s principal office of the insurer within the state.
 1065         (10) DEMAND LETTER.—
 1066         (a) As a condition precedent to filing any action for
 1067  benefits under this section, the insurer must be provided with
 1068  written notice of an intent to initiate litigation must be
 1069  provided to the insurer. Such notice may not be sent until the
 1070  claim is overdue, including any additional time the insurer has
 1071  to pay the claim pursuant to paragraph (4)(b).
 1072         (b) The notice must required shall state that it is a
 1073  “demand letter under s. 627.736(10)” and shall state with
 1074  specificity:
 1075         1. The name of the insured upon which such benefits are
 1076  being sought, including a copy of the assignment giving rights
 1077  to the claimant if the claimant is not the insured.
 1078         2. The claim number or policy number upon which such claim
 1079  was originally submitted to the insurer.
 1080         3. To the extent applicable, the name of any medical
 1081  provider who rendered to an insured the treatment, services,
 1082  accommodations, or supplies that form the basis of such claim;
 1083  and an itemized statement specifying each exact amount, the date
 1084  of treatment, service, or accommodation, and the type of benefit
 1085  claimed to be due. A completed form satisfying the requirements
 1086  of paragraph (5)(d) or the lost-wage statement previously
 1087  submitted may be used as the itemized statement. To the extent
 1088  that the demand involves an insurer’s withdrawal of payment
 1089  under paragraph (7)(a) for future treatment not yet rendered,
 1090  the claimant shall attach a copy of the insurer’s notice
 1091  withdrawing such payment and an itemized statement of the type,
 1092  frequency, and duration of future treatment claimed to be
 1093  reasonable and medically necessary.
 1094         (c) Each notice required by this subsection must be
 1095  delivered to the insurer by United States certified or
 1096  registered mail, return receipt requested. Such postal costs
 1097  shall be reimbursed by the insurer if so requested by the
 1098  claimant in the notice, when the insurer pays the claim. Such
 1099  notice must be sent to the person and address specified by the
 1100  insurer for the purposes of receiving notices under this
 1101  subsection. Each licensed insurer, whether domestic, foreign, or
 1102  alien, shall file with the office designation of the name and
 1103  address of the person to whom notices must pursuant to this
 1104  subsection shall be sent which the office shall make available
 1105  on its Internet website. The name and address on file with the
 1106  office pursuant to s. 624.422 are shall be deemed the authorized
 1107  representative to accept notice pursuant to this subsection if
 1108  in the event no other designation has been made.
 1109         (d) If, within 30 days after receipt of notice by the
 1110  insurer, the overdue claim specified in the notice is paid by
 1111  the insurer together with applicable interest and a penalty of
 1112  10 percent of the overdue amount paid by the insurer, subject to
 1113  a maximum penalty of $250, no action may be brought against the
 1114  insurer. If the demand involves an insurer’s withdrawal of
 1115  payment under paragraph (7)(a) for future treatment not yet
 1116  rendered, no action may be brought against the insurer if,
 1117  within 30 days after its receipt of the notice, the insurer
 1118  mails to the person filing the notice a written statement of the
 1119  insurer’s agreement to pay for such treatment in accordance with
 1120  the notice and to pay a penalty of 10 percent, subject to a
 1121  maximum penalty of $250, when it pays for such future treatment
 1122  in accordance with the requirements of this section. To the
 1123  extent the insurer determines not to pay any amount demanded,
 1124  the penalty is shall not be payable in any subsequent action.
 1125  For purposes of this subsection, payment or the insurer’s
 1126  agreement shall be treated as being made on the date a draft or
 1127  other valid instrument that is equivalent to payment, or the
 1128  insurer’s written statement of agreement, is placed in the
 1129  United States mail in a properly addressed, postpaid envelope,
 1130  or if not so posted, on the date of delivery. The insurer is not
 1131  obligated to pay any attorney attorney’s fees if the insurer
 1132  pays the claim or mails its agreement to pay for future
 1133  treatment within the time prescribed by this subsection.
 1134         (e) The applicable statute of limitation for an action
 1135  under this section shall be tolled for a period of 30 business
 1136  days by the mailing of the notice required by this subsection.
 1137         (f) Any insurer making a general business practice of not
 1138  paying valid claims until receipt of the notice required by this
 1139  subsection is engaging in an unfair trade practice under the
 1140  insurance code.
 1141         (11) FAILURE TO PAY VALID CLAIMS; UNFAIR OR DECEPTIVE
 1142  PRACTICE.—
 1143         (a) If an insurer fails to pay valid claims for personal
 1144  injury protection with such frequency so as to indicate a
 1145  general business practice, the insurer is engaging in a
 1146  prohibited unfair or deceptive practice that is subject to the
 1147  penalties provided in s. 626.9521 and the office has the powers
 1148  and duties specified under in ss. 626.9561-626.9601 with respect
 1149  thereto.
 1150         (b) Notwithstanding s. 501.212, the Department of Legal
 1151  Affairs may investigate and initiate actions for a violation of
 1152  this subsection, including, but not limited to, the powers and
 1153  duties specified in part II of chapter 501.
 1154         (16) SECURE ELECTRONIC DATA TRANSFER.—If all parties
 1155  mutually and expressly agree, A notice, documentation,
 1156  transmission, or communication of any kind required or
 1157  authorized under ss. 627.730-627.7405 may be transmitted
 1158  electronically if it is transmitted by secure electronic data
 1159  transfer that is consistent with state and federal privacy and
 1160  security laws.
 1161         Section 9. Section 627.748, Florida Statutes, is created to
 1162  read:
 1163         627.748 Short title.—Sections 627.748-627.7491 may be cited
 1164  as the “Florida Motor Vehicle No-Fault Medical Care Coverage
 1165  Law.”
 1166         Section 10. Section 627.7481, Florida Statutes, is created
 1167  to read:
 1168         627.7481Legislative findings; purpose.—
 1169         (1) LEGISLATIVE FINDINGS.—
 1170         (a) The Florida Motor Vehicle No-Fault Law, ss. 627.730
 1171  627.7405, was intended to deliver medically necessary and
 1172  appropriate medical care promptly, without regard to fault, and
 1173  without undue litigation or other associated costs. This intent
 1174  has been frustrated at significant cost and harm to consumers by
 1175  fraud, inappropriate medical treatments, overutilization of
 1176  medical services, inflated charges, and other abusive practices.
 1177         (b) Personal injury protection fraud has become pervasive.
 1178  Widespread fraud has been documented by a Statewide Grand Jury,
 1179  “Report on Insurance Fraud Related to Personal Injury
 1180  Protection” by the Fifteenth Statewide Grand Jury,” 2000; the
 1181  Insurance Consumer Advocate, “Report on Florida Motor Vehicle
 1182  No-Fault Insurance,” dated December 2011; and the Office of
 1183  Insurance Regulation, “Report on Review of the 2011 Personal
 1184  Injury Protection Data Call,” dated April 11, 2011.
 1185         (c) Personal injury protection premiums have risen to
 1186  unacceptable levels as a result of fraud and abuse,
 1187  significantly impairing the ability of insureds to maintain
 1188  coverage mandated by law. The rise in such premiums is directly
 1189  related to large increases in carrier losses. From 2008 to 2010,
 1190  personal injury protection benefits paid by insurers increased
 1191  from $1.43 billion to $2.37 billion.
 1192         (d) Significant reforms must be enacted to curtail the
 1193  level of fraudulent activity, inappropriate medical treatments,
 1194  overutilization of medical services, inflated charges, and other
 1195  abusive practices within no-fault motor vehicle insurance to
 1196  preserve the affordability and availability of coverage within
 1197  this state.
 1198         (e) Ensuring the availability and affordability of no-fault
 1199  motor vehicle insurance by requiring medical care coverage is an
 1200  overwhelming public necessity and provides a commensurate
 1201  benefit. Moreover, deterrence and prevention of fraud and abuse
 1202  is a matter of great public interest and importance to the
 1203  public’s health, safety, and welfare.
 1204         (2) PURPOSE.—The purpose of the Florida Motor Vehicle No
 1205  Fault Medical Care Coverage Law is to provide for emergency
 1206  services and care, medical services and care provided in a
 1207  hospital, prescribed followup care, funeral costs, and
 1208  disability insurance benefits without regard to fault; to
 1209  require motor vehicle insurance that secures such benefits for
 1210  motor vehicles required to be registered in this state; and,
 1211  with respect to motor vehicle accidents, to provide a limitation
 1212  on the right to claim damages for pain, suffering, mental
 1213  anguish, and inconvenience.
 1214         Section 11. Section 627.74811, Florida Statutes, is created
 1215  to read:
 1216         627.74811Effect of law on medical care coverage policies.
 1217  The provisions, schedules, and procedures authorized in ss.
 1218  627.748-627.7491 must be implemented by insurers offering
 1219  policies pursuant to the Florida Motor Vehicle No-Fault Medical
 1220  Care Coverage Law. The Legislature intends that these
 1221  provisions, schedules, and procedures have full force and effect
 1222  regardless of their express inclusion in an insurance policy
 1223  form and govern over any general provisions in the insurance
 1224  policy form. An insurer is not required to amend its policy form
 1225  or to expressly notify providers, claimants, or insureds of the
 1226  applicable fee schedules in order to implement and apply such
 1227  provisions, schedules, or procedures.
 1228         Section 12. Section 627.7482, Florida Statutes, is created
 1229  to read:
 1230         627.7482 Definitions.—As used in ss. 627.748-627.7491, the
 1231  term:
 1232         (1) “Broker” means any person not licensed under chapter
 1233  395, chapter 400, chapter 429, chapter 458, chapter 459, chapter
 1234  460, chapter 461, or chapter 641 who charges or receives
 1235  compensation for the use of medical equipment and is not the 100
 1236  percent owner or the 100 percent lessee of such equipment. For
 1237  purposes of this subsection, such owner or lessee may be an
 1238  individual, a corporation, a partnership, or any other entity
 1239  and any of its 100 percent owned affiliates and subsidiaries.
 1240         (a) The term “broker” does not include:
 1241         1. A hospital or physician management company whose medical
 1242  equipment is ancillary to the practices managed; a debt
 1243  collection agency; an entity that has contracted with the
 1244  insurer to obtain a discounted rate; a management company that
 1245  has contracted to provide general management services for a
 1246  licensed physician or health care facility and whose
 1247  compensation is not materially affected by the usage or
 1248  frequency of usage of medical equipment; or an entity that is
 1249  100 percent owned by one or more hospitals or physicians.
 1250         2. A person or entity that certifies, upon the request of
 1251  an insurer, that:
 1252         a. It is a clinic licensed under part X of chapter 400;
 1253         b. It is a 100 percent owner of medical equipment; and
 1254         c. The owner’s only part-time lease of medical equipment
 1255  for medical care coverage patients is on a temporary basis not
 1256  to exceed 30 days in a 12-month period and is necessitated by:
 1257         (I)The repair or maintenance of existing 100 percent-owned
 1258  medical equipment;
 1259         (II) The pending arrival and installation of newly
 1260  purchased medical equipment or the replacement 100-percent-owned
 1261  medical equipment; or
 1262         (III) A determination by the medical director or clinical
 1263  director that open-style medical equipment is medically
 1264  necessary for the performance of tests or procedures for
 1265  patients due to the patients’ physical sizes or claustrophobia.
 1266  The leased medical equipment may not be used, for medical
 1267  treatment or services, for a patient who is not a patient of the
 1268  registered clinic for medical treatment of services.
 1269  
 1270  However, the 30-day lease period provided in this sub
 1271  subparagraph may be extended for an additional 60 days as
 1272  applicable to magnetic resonance imaging equipment if the owner
 1273  certifies that the extension otherwise complies with this
 1274  paragraph.
 1275         (b) As used in this subsection, the term “lessee” means a
 1276  long-term lessee under a capital or operating lease but does not
 1277  include a part-time lessee.
 1278         (c) Any person or entity making a false certification under
 1279  this subsection commits insurance fraud as defined in s.
 1280  817.234.
 1281         (2) “Certify” means to swear or attest to a fact being true
 1282  or accurately represented in a writing.
 1283         (3) “Emergency medical condition” means:
 1284         (a) A medical condition manifesting itself by acute
 1285  symptoms of sufficient severity, which may include severe pain,
 1286  such that the absence of immediate medical attention could
 1287  reasonably be expected to result in any of the following:
 1288         1. Serious jeopardy to the health of a patient, including a
 1289  pregnant woman or fetus.
 1290         2. Serious impairment to bodily functions.
 1291         3. Serious dysfunction of any bodily organ or part.
 1292         (b) With respect to a pregnant woman:
 1293         1. That there is inadequate time for a safe transfer to
 1294  another hospital before delivery;
 1295         2. That a transfer may pose a threat to the health and
 1296  safety of the woman or fetus; or
 1297         3. That there is evidence of the onset and persistence of
 1298  uterine contractions or rupture of the membranes.
 1299         (4) “Emergency services and care” means medical screening,
 1300  examination and evaluation by a physician or, to the extent
 1301  permitted by applicable law, by other appropriate personnel
 1302  under the supervision of a physician, to determine if an
 1303  emergency medical condition exists and, if it does, the care,
 1304  treatment, or surgery by a physician necessary to relieve or
 1305  eliminate the emergency medical condition, within the service
 1306  capability of the facility.
 1307         (5) “Entity wholly owned” means a proprietorship, group
 1308  practice, partnership, or corporation that provides health care
 1309  services rendered by licensed health care practitioners and in
 1310  which licensed health care practitioners are the business owners
 1311  of all aspects of the business entity, including, but not
 1312  limited to, being reflected as the business owners on the title
 1313  or lease of the physical facility, filing taxes as the business
 1314  owners, being account holders on the entity’s bank account,
 1315  being listed as the principals on all incorporation documents
 1316  required by this state, and having ultimate authority over all
 1317  personnel and compensation decisions relating to the entity.
 1318  However, this definition does not apply to an entity that is
 1319  wholly owned, directly or indirectly, by a hospital licensed
 1320  under chapter 395.
 1321         (6) “Hospital” means a facility that, at the time services
 1322  or treatment was rendered, was licensed under chapter 395.
 1323         (7) “Knowingly” means having actual knowledge of
 1324  information and acting in deliberate ignorance of the truth or
 1325  falsity of the information or in reckless disregard of the
 1326  information. Proof of specific intent to defraud is not
 1327  required.
 1328         (8) “Lawful” or “lawfully” means in substantial compliance
 1329  with all relevant applicable criminal, civil, and administrative
 1330  requirements of state and federal law related to the provision
 1331  of medical services or treatment.
 1332         (9) “Medically necessary” refers to a medical service or
 1333  supply that a prudent physician would provide for the purpose of
 1334  preventing, diagnosing, or treating an illness, injury, disease,
 1335  or symptom in a manner that is:
 1336         (a) In accordance with generally accepted standards of
 1337  medical practice;
 1338         (b) Clinically appropriate in terms of type, frequency,
 1339  extent, site, and duration; and
 1340         (c) Not primarily for the convenience of the patient,
 1341  physician, or other health care provider.
 1342         (10) “Motor vehicle” means any self-propelled vehicle that
 1343  has four or more wheels and is of a type both designed and
 1344  required to be licensed for use on the highways of this state
 1345  and any trailer or semitrailer designed for use with such
 1346  vehicle. The term includes:
 1347         (a) A “private passenger motor vehicle,” which is any motor
 1348  vehicle that is a sedan, station wagon, or jeep-type vehicle
 1349  and, if not used primarily for occupational, professional, or
 1350  business purposes, a motor vehicle of the pickup truck, panel
 1351  truck, van, camper, or motor home type.
 1352         (b) A “commercial motor vehicle,” which is a motor vehicle
 1353  that is not a private passenger motor vehicle.
 1354  
 1355  The term does not include a mobile home or a motor vehicle that
 1356  is used in mass transit, other than public school
 1357  transportation; is designed to transport more than five
 1358  passengers exclusive of the operator of the motor vehicle; and
 1359  is owned by a municipality, a transit authority, or a political
 1360  subdivision of the state.
 1361         (11) “Named insured” means a person, usually the owner of a
 1362  motor vehicle, identified in a policy by name as the insured
 1363  under the policy.
 1364         (12) “Owner,” with respect to a motor vehicle, means a
 1365  person who holds legal title to the motor vehicle or, if the
 1366  motor vehicle is the subject of a security agreement or lease
 1367  with an option to purchase and the debtor or lessee has the
 1368  right to possession, the debtor or lessee of the motor vehicle.
 1369         (13) “Physician” means an allopathic physician licensed
 1370  under chapter 458 or an osteopathic physician licensed under
 1371  chapter 459.
 1372         (14) “Properly completed” means providing truthful,
 1373  substantially complete, and substantially accurate responses as
 1374  to all material elements to each applicable request for
 1375  information or statement by a means that may lawfully be
 1376  provided and that complies with this section, or as otherwise
 1377  agreed to by the parties.
 1378         (15) “Relative residing in the insured’s household” means a
 1379  relative of any degree by blood, marriage, or adoption who
 1380  usually makes her or his home in the same family unit regardless
 1381  of whether she or he is temporarily living elsewhere.
 1382         (16) “Unbundling” means separating treatment or services
 1383  that would be properly billed under one billing code into two or
 1384  more billing codes, resulting in a payment amount greater than
 1385  would be paid using one billing code.
 1386         (17) “Upcoding” means using a billing code to describe
 1387  treatment or services in a manner that would result in a payment
 1388  amount greater than would be paid using a billing code that
 1389  accurately describes such treatment or services. The term does
 1390  not include an otherwise lawful bill by a magnetic resonance
 1391  imaging facility, which globally combines both technical and
 1392  professional components, if the amount of the global bill is not
 1393  more than the components if billed separately; however, payment
 1394  of such a bill constitutes payment in full for all components of
 1395  such service.
 1396         Section 13. Section 627.7483, Florida Statutes, is created
 1397  to read:
 1398         627.7483 Required security.—
 1399         (1)An owner or registrant of a motor vehicle, other than a
 1400  motor vehicle used as a school bus as defined in s. 1006.25, a
 1401  limousine, or a taxicab, which must be registered and licensed
 1402  in this state shall continuously maintain security as described
 1403  in subsection (3) throughout the licensing or registration
 1404  period. An owner or registrant of a motor vehicle used as a
 1405  taxicab shall maintain security as required under s. 324.032(1)
 1406  and is exempt from s. 627.7486.
 1407         (2) A nonresident owner or registrant of a motor vehicle,
 1408  whether operated or not operated, which has been physically
 1409  present within this state for more than 90 days during the
 1410  preceding 365 days must thereafter continuously maintain
 1411  security as described in subsection (3) while such motor vehicle
 1412  is physically present within this state.
 1413         (3) Security required by this section shall be provided:
 1414         (a) By an insurance policy delivered or issued for delivery
 1415  in this state by an authorized or eligible motor vehicle
 1416  liability insurer which provides the benefits and exemptions
 1417  contained in ss. 627.748-627.7491. Any policy of insurance
 1418  represented or sold as providing the security required under
 1419  this section shall be deemed to provide insurance for the
 1420  payment of the required benefits; or
 1421         (b) By any other method authorized by s. 324.031(2), (3),
 1422  or (4) and approved by the Department of Highway Safety and
 1423  Motor Vehicles as affording security equivalent to that afforded
 1424  by a policy of insurance or by self-insuring as authorized by s.
 1425  768.28(16). The person filing such security has all of the
 1426  obligations and rights of an insurer under ss. 627.748-627.7491.
 1427         (4) An owner of a motor vehicle for which security is
 1428  required by this section who fails to have such security in
 1429  effect at the time of an accident is not immune from tort
 1430  liability and is personally liable for the payment of benefits
 1431  under s. 627.7485. With respect to such benefits, the owner has
 1432  all of the rights and obligations of an insurer under ss.
 1433  627.748-627.7491.
 1434         (5) In addition to persons who are not required to provide
 1435  security under this section or s. 324.022, the owner or
 1436  registrant of a motor vehicle who is a member of the United
 1437  States Armed Forces and who is called to or on active duty
 1438  outside the United States in an emergency situation is exempt
 1439  from such requirements. The exemption applies only while the
 1440  owner or registrant is on such active duty and while the motor
 1441  vehicle otherwise required to be covered by the security under
 1442  this section or s. 324.022 is not operated by any person. Upon
 1443  receipt of a written request from the insured to whom this
 1444  exemption applies, the insurer shall cancel the coverages and
 1445  return any unearned premium or suspend the security required by
 1446  this section and s. 324.022. Notwithstanding s. 324.0221(2), the
 1447  Department of Highway Safety and Motor Vehicles may not suspend
 1448  the registration or operator’s license of the owner or
 1449  registrant of a motor vehicle during the time she or he
 1450  qualifies for this exemption. The owner or registrant of the
 1451  motor vehicle qualifying for the exemption must immediately
 1452  notify the department before and at the end of the expiration of
 1453  the exemption.
 1454         Section 14. Section 627.7484, Florida Statutes, is created
 1455  to read:
 1456         627.7484 Proof of security; security requirements;
 1457  penalties.—
 1458         (1) The provisions of chapter 324 which pertain to the
 1459  method of giving and maintaining proof of financial
 1460  responsibility and which govern and define a motor vehicle
 1461  liability policy apply to filing and maintaining proof of
 1462  security required by ss. 627.748-627.7491.
 1463         (2) Any person who:
 1464         (a) Gives information required in a report or otherwise as
 1465  provided in ss. 627.748-627.7491, knowing or having reason to
 1466  believe that such information is false;
 1467         (b) Forges or, without authority, signs any evidence of
 1468  proof of security; or
 1469         (c) Files, or offers for filing, any such evidence of
 1470  proof, knowing or having reason to believe that it is forged or
 1471  signed without authority
 1472  
 1473  commits a misdemeanor of the first degree, punishable as
 1474  provided in s. 775.082 or s. 775.083.
 1475         Section 15. Section 627.7485, Florida Statutes, is created
 1476  to read:
 1477         627.7485 Required medical care coverage benefits.—
 1478         (1) REQUIRED BENEFITS.—An insurance policy complying with
 1479  the security requirements of s. 627.7483 must provide medical
 1480  care coverage to the named insured, relatives residing in the
 1481  insured’s household, persons operating the insured motor
 1482  vehicle, passengers in the motor vehicle, and other persons
 1483  struck by such motor vehicle and suffering bodily injury while
 1484  not an occupant of a self-propelled vehicle, subject to
 1485  subsection (2) and paragraph (4)(d), up to a limit of $10,000 in
 1486  medical and disability benefits and $5,000 in death benefits
 1487  resulting from bodily injury, sickness, disease, or death to
 1488  such persons arising out of the ownership, maintenance, or use
 1489  of the motor vehicle as follows:
 1490         (a) Medical benefits.
 1491         1. Up to a limit of $10,000, 80 percent of all reasonable
 1492  expenses for:
 1493         a. Emergency transport and treatment rendered by an
 1494  ambulance provider licensed under part III of chapter 401 within
 1495  24 hours after the motor vehicle accident.
 1496         b.Emergency services and care provided within 7 days after
 1497  the motor vehicle accident if such services and care are
 1498  provided:
 1499         (I)In a hospital or in a facility wholly owned by a
 1500  hospital;
 1501         (II)In a facility wholly owned by a physician licensed
 1502  under chapter 458 or chapter 459, or by the physician and the
 1503  spouse, parents, children, or siblings of such physician.
 1504         c. Services and care rendered when an insured is admitted
 1505  to a hospital within 7 days after the motor vehicle accident,
 1506  for a condition related to the motor vehicle accident.
 1507         d. If the insured receives emergency transport and
 1508  treatment or emergency services and care pursuant to sub-sub
 1509  subparagraph a. or sub-subparagraph b., or services and care
 1510  pursuant to sub-subparagraph c., prescribed followup services
 1511  and care directly related to the medical diagnosis arising from
 1512  the motor vehicle accident if:
 1513         (I) The medical diagnosis and determination of the
 1514  emergency medical condition was rendered in a hospital by a
 1515  physician licensed under chapter 458, an osteopathic physician
 1516  licensed under chapter 459, a dentist licensed under chapter
 1517  466, or, to the extent permitted by applicable law and under the
 1518  supervision of such physician, osteopathic physician, or
 1519  dentist, by a physician assistant licensed under chapter 458 or
 1520  chapter 459 or an advanced registered nurse practitioner
 1521  licensed under chapter 464, or the insured received services and
 1522  care while admitted to a hospital; and
 1523         (II) The prescribed followup services and care are rendered
 1524  by a physician licensed under chapter 458, an osteopathic
 1525  physician licensed under chapter 459, a chiropractic physician
 1526  licensed under chapter 460, a dentist licensed under chapter
 1527  466, a physician assistant licensed under chapter 458 or chapter
 1528  459, or an advanced registered nurse practitioner licensed under
 1529  chapter 464.
 1530         e. If the insured receives services and care pursuant to
 1531  sub-subparagraph a., sub-subparagraph b., sub-subparagraph c. or
 1532  sub-subparagraph d., all medically necessary medical, surgical,
 1533  dental, nursing, or diagnostic ancillary services, hospital or
 1534  ambulatory surgical center services, durable medical equipment,
 1535  prosthetics, or orthotics and supplies.
 1536         2. Up to a limit of $2,000, 80 percent of all reasonable
 1537  expenses as follows:
 1538         a. Services and care rendered within 7 days after the motor
 1539  vehicle accident by a physician licensed under chapter 458, an
 1540  osteopathic physician licensed under chapter 459, a dentist
 1541  licensed under chapter 466, a physician assistant licensed under
 1542  chapter 458 or 459, or an advanced registered nurse practitioner
 1543  licensed under chapter 464.
 1544         b. If the insured receives services and care pursuant to
 1545  sub-subparagraph a., prescribed followup services and care
 1546  directly related to the medical diagnosis arising from the motor
 1547  vehicle accident. The medical benefits provide reimbursement
 1548  only for followup services and care provided, supervised,
 1549  ordered, or prescribed by a physician licensed under chapter
 1550  458, an osteopathic physician licensed under chapter 459, a
 1551  dentist licensed under chapter 466 or, to the extent permitted
 1552  by applicable law and under the supervision of such physician,
 1553  osteopathic physician, or dentist, by a physician assistant
 1554  licensed under chapter 458 or chapter 459 or an advanced
 1555  registered nurse practitioner licensed under chapter 46. Such
 1556  followup services and care may be rendered by a physician
 1557  licensed under chapter 458, an osteopathic physician licensed
 1558  under chapter 459, a chiropractic physician licensed under
 1559  chapter 460, a dentist licensed under chapter 466, or, to the
 1560  extent permitted by applicable law and under the supervision of
 1561  such physician, osteopathic physician, or dentist, by a
 1562  physician assistant licensed under chapter 458 or chapter 459 or
 1563  an advanced registered nurse practitioner licensed under chapter
 1564  464.
 1565         c. All medically necessary medical, surgical, dental,
 1566  nursing, or diagnostic ancillary services, hospital or
 1567  ambulatory surgical center services, durable medical equipment,
 1568  prosthetics, orthotics and supplies.
 1569         d. Payment of benefits under sub-subparagraph a., sub
 1570  subparagraph b., or sub-subparagraph c. occur only if an insured
 1571  has been determined in a hospital to not have an emergency
 1572  medical condition or did not present at a hospital but received
 1573  treatment from a provider identified in sub-subparagraph a.
 1574  within 7 days after the motor vehicle accident.
 1575         3. Prescribed followup services and care under sub
 1576  subparagraph 1.d., and reimbursable medical benefits under
 1577  subparagraph 2. must be provided in a clinic licensed under part
 1578  X of chapter 400 or an entity excluded from the definition of a
 1579  clinic. However, as provided in s. 400.9905, an entity excluded
 1580  from the definition of a clinic shall be deemed a clinic and
 1581  must be licensed under part X of chapter 400 in order to receive
 1582  reimbursement for prescribed followup services and care under
 1583  sub-subparagraph 1.d. unless the entity is:
 1584         a.An entity wholly owned by a physician licensed under
 1585  chapter 458 or chapter 459, or by the physician and the spouse,
 1586  parent, child, or sibling of the physician;
 1587         b. An entity wholly owned by a dentist licensed under
 1588  chapter 466, or by the dentist and the spouse, parent, child, or
 1589  sibling of the dentist;
 1590         c. An entity wholly owned by a chiropractic physician
 1591  licensed under chapter 460, or by the chiropractic physician and
 1592  the spouse, parent, child, or sibling of the chiropractic
 1593  physician if such entity has filed for a licensing exemption
 1594  with the Agency for Health Care Administration;
 1595         d. A hospital or ambulatory surgical center licensed under
 1596  chapter 395; or
 1597         e. An entity wholly owned, directly or indirectly, by a
 1598  hospital licensed under chapter 395.
 1599         4. Reimbursement for services provided by a chiropractic
 1600  physician is limited to the lesser of 24 treatments or to
 1601  services rendered within 12 weeks after the date of the initial
 1602  chiropractic treatment, whichever comes first, unless the
 1603  insurer authorizes additional chiropractic services.
 1604         5. Medical benefits do not include massage as defined in s.
 1605  480.033 or acupuncture as defined in s. 457.102, regardless of
 1606  the person, entity, or licensee providing massage or
 1607  acupuncture.
 1608         6. For purposes of ss. 627.748-627.7491, a medical
 1609  diagnosis that an emergency medical condition exists is presumed
 1610  to be correct unless rebutted by clear and convincing evidence
 1611  to the contrary.
 1612         (b) Disability benefits.—Sixty percent of any loss of gross
 1613  income and loss of earning capacity per individual from
 1614  inability to work proximately caused by the injury sustained by
 1615  the injured person, plus all expenses reasonably incurred in
 1616  obtaining from others ordinary and necessary services in lieu of
 1617  those that, but for the injury, the injured person would have
 1618  performed without income for the benefit of her or his
 1619  household. All disability benefits payable under this paragraph
 1620  must be paid at least every 2 weeks.
 1621         (c) Death benefits.—Up to a limit of $5,000. Death benefits
 1622  are in addition to medical benefits and disability benefits
 1623  provided under the insurance policy. The insurer may pay death
 1624  benefits to the executor or administrator of the deceased, to
 1625  any of the deceased’s relatives by blood, legal adoption, or
 1626  marriage, or to any person who appears to the insurer to be
 1627  equitably entitled to such benefits.
 1628  
 1629  Only insurers writing motor vehicle liability insurance in this
 1630  state may provide the benefits required by this section, and
 1631  such insurer may not require the purchase of any other motor
 1632  vehicle coverage other than the purchase of property damage
 1633  liability coverage as required by s. 627.7275 as a condition for
 1634  providing such benefits. Insurers may not require that property
 1635  damage liability insurance in an amount greater than $10,000 be
 1636  purchased in conjunction with medical care coverage insurance.
 1637  Such insurers shall make benefits and required property damage
 1638  liability insurance coverage available through normal marketing
 1639  channels. An insurer writing motor vehicle liability insurance
 1640  in this state who fails to comply with such availability
 1641  requirement as a general business practice, as determined by the
 1642  office, violates part IX of chapter 626, and such violation
 1643  constitutes an unfair method of competition or an unfair or
 1644  deceptive act or practice involving the business of insurance.
 1645  An insurer committing such violation is subject to the penalties
 1646  provided under that part, as well as those provided elsewhere in
 1647  the insurance code.
 1648         (2) AUTHORIZED EXCLUSIONS.—An insurer may exclude benefits:
 1649         (a) For injury sustained by the named insured and relatives
 1650  residing in the insured’s household while occupying another
 1651  motor vehicle owned by the named insured and not insured under
 1652  the policy or for injury sustained by any person operating the
 1653  insured motor vehicle without the express or implied consent of
 1654  the insured.
 1655         (b) To any injured person if such person’s conduct
 1656  contributed to her or his injury under the following
 1657  circumstance:
 1658         1. Causing injury to herself or himself intentionally; or
 1659         2. Being injured while committing a felony.
 1660  
 1661  If an insured is charged with conduct as set forth in
 1662  subparagraph 2., the 30-day payment provision of paragraph
 1663  (4)(b) shall be held in abeyance, and the insurer shall withhold
 1664  payment of any benefits pending the outcome of the case at the
 1665  trial level. If the charge is nolle prossed or dismissed or the
 1666  insured is acquitted, the 30-day payment provision shall run
 1667  from the date the insurer is notified of such action.
 1668         (3) INSURED’S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN TORT
 1669  CLAIMS.—An insurer may not have a lien on any recovery in tort
 1670  by judgment, settlement, or otherwise for medcial care coverage
 1671  benefits, whether suit has been filed or settlement has been
 1672  reached without suit. An injured party who is entitled to bring
 1673  suit under ss. 627.748-627.7491, or her or his legal
 1674  representative, may not recover any damages for which benefits
 1675  are paid or payable. The plaintiff may prove all of her or his
 1676  special damages notwithstanding this limitation, but if special
 1677  damages are introduced in evidence, the trier of facts, whether
 1678  judge or jury, may not award damages for medical care coverage
 1679  benefits paid or payable. In all cases in which a jury is
 1680  required to fix damages, the court shall instruct the jury that
 1681  the plaintiff may not recover such special damages for medical
 1682  care coverage benefits paid or payable.
 1683         (4) PAYMENT OF BENEFITS.—Benefits due from an insurer under
 1684  ss. 627.748-627.7491 are primary, except that benefits received
 1685  under any workers’ compensation law must be credited against the
 1686  benefits provided under subsection (1) and are due and payable
 1687  as loss accrues upon receipt of reasonable proof of such loss
 1688  and the amount of expenses and loss incurred that are covered by
 1689  the policy issued under ss. 627.748-627.7491. If the Agency for
 1690  Health Care Administration provides, pays, or becomes liable for
 1691  medical assistance under the Medicaid program related to injury,
 1692  sickness, disease, or death arising out of the ownership,
 1693  maintenance, or use of a motor vehicle, the benefits under ss.
 1694  627.748-627.7491 are subject to the provisions of the Medicaid
 1695  program. However, within 30 days after receiving notice that the
 1696  Medicaid program paid such benefits, the insurer must repay the
 1697  full amount of the benefits to the Medicaid program.
 1698         (a) An insurer may require written notice to be given as
 1699  soon as practicable after an accident involving a motor vehicle
 1700  for which the policy provides the security required by ss.
 1701  627.748-627.7491.
 1702         (b) Medical care coverage insurance benefits paid pursuant
 1703  to this section are overdue if not paid within 30 days after
 1704  written notice of the fact and amount of a covered loss is
 1705  furnished to the insurer.
 1706         1. If written notice of the entire claim is not furnished
 1707  to the insurer, any partial amount supported by the written
 1708  notice is overdue if not paid within 30 days after the written
 1709  notice is furnished. Any part or all of the remainder of the
 1710  claim that is subsequently supported by written notice is
 1711  overdue if not paid within 30 days after subsequent written
 1712  notice is furnished to the insurer.
 1713         2. This paragraph does not preclude or limit the ability of
 1714  the insurer to assert that the claim or a portion of the claim
 1715  was unrelated, was not medically necessary, or was unreasonable,
 1716  or that the amount of the charge was in excess of that permitted
 1717  under, or in violation of, subsection (5). Such assertion may be
 1718  made at any time, including after payment of the claim or after
 1719  the 30-day period for payment set forth in this paragraph.
 1720         3. If an insurer pays only a portion of a claim or rejects
 1721  a claim, the insurer shall provide at the time of the partial
 1722  payment or rejection an itemized specification of each item that
 1723  the insurer has reduced, omitted, or declined to pay and any
 1724  information that the insurer desires the claimant to consider
 1725  related to the medical necessity of the denied treatment or to
 1726  explain the reasonableness of the reduced charge if this
 1727  information does not limit the introduction of evidence at
 1728  trial. The insurer must also include the name and address of the
 1729  person to whom the claimant should respond and a claim number to
 1730  be referenced in future correspondence.
 1731         4. If an insurer pays only a portion of a claim or rejects
 1732  a claim due to an alleged error in the claim, the insurer shall
 1733  provide at the time of the partial payment or rejection an
 1734  itemized specification or explanation of benefits of the
 1735  specified error. Upon receiving the specification or
 1736  explanation, the person making the claim has, at the person’s
 1737  option and without waiving any other legal remedy for payment,
 1738  15 days to submit a revised claim. The revised claim shall be
 1739  considered a timely submission of written notice of a claim.
 1740         5. Notwithstanding that written notice has been furnished
 1741  to the insurer, payment is not overdue if the insurer has
 1742  reasonable proof that the insurer is not responsible for the
 1743  payment.
 1744         6. For the purpose of calculating the extent to which
 1745  benefits are overdue, payment is considered made on the date a
 1746  draft or other valid instrument that is equivalent to payment
 1747  was placed in the United States mail in a properly addressed,
 1748  postpaid envelope or, if not so posted, on the date of delivery.
 1749         7. All overdue payments bear simple interest at the rate
 1750  established under s. 55.03 or the rate established in the
 1751  insurance contract, whichever is greater, for the quarter in
 1752  which the payment became overdue, calculated from the date the
 1753  insurer was furnished with written notice of the amount of the
 1754  covered loss. Interest is due at the time payment of the overdue
 1755  claim is made.
 1756         (c) Upon receiving notice of an accident that is
 1757  potentially covered by benefits under this section, the insurer
 1758  must reserve $5,000 of such coverage for payment to physicians
 1759  licensed under chapter 458 or chapter 459 or dentists licensed
 1760  under chapter 466 who provide medical care coverage pursuant to
 1761  sub-subparagraph (1)(a)1.b., sub-subparagraph (1)(a)1.c., or
 1762  (1)(a)1.d. The reserved amount may be used only to pay claims
 1763  for such providers until 30 days after the date the insurer
 1764  receives notice of the accident. After the 30-day period, any
 1765  amount of the reserve for which the insurer has not received
 1766  notice of a claim for medical care coverage benefits may be used
 1767  to pay other claims. The time periods specified in paragraph (b)
 1768  for the payment of benefits shall be tolled for the period of
 1769  time that the insurer is required by this paragraph to hold
 1770  payment of such other claims to the extent that the amount not
 1771  held in reserve is insufficient to pay such other claims. This
 1772  paragraph does not require an insurer to establish a claim
 1773  reserve for insurance accounting purposes.
 1774         (d) The insurer of the owner of a motor vehicle shall pay
 1775  medical care coverage benefits for accidental bodily injury
 1776  requiring medical treatment:
 1777         1. Sustained in this state by the owner while occupying a
 1778  motor vehicle, or while not an occupant of a self-propelled
 1779  vehicle if the injury is caused by physical contact with a motor
 1780  vehicle.
 1781         2. Sustained outside this state, but within the United
 1782  States or its territories or possessions or Canada, by the owner
 1783  while occupying the owner’s motor vehicle.
 1784         3. Sustained by a relative of the owner residing in the
 1785  owner’s household, under the circumstances described in
 1786  subparagraph 1. or subparagraph 2. if the relative at the time
 1787  of the accident is domiciled in the owner’s household and is not
 1788  the owner of a motor vehicle with respect to which security is
 1789  required under ss. 627.748-627.7491.
 1790         4. Sustained in this state by any other person while
 1791  occupying the owner’s motor vehicle or, if a resident of this
 1792  state, while not an occupant of a self-propelled vehicle, if the
 1793  injury is caused by physical contact with such motor vehicle if
 1794  the injured person is not:
 1795         a. The owner of a motor vehicle for which security is
 1796  required under ss. 627.748-627.7491; or
 1797         b. Entitled to benefits from the insurer of the owner of
 1798  such motor vehicle.
 1799         (e) If two or more insurers are liable for paying medical
 1800  care coverage benefits for the same injury to any one person,
 1801  the maximum amount payable shall be as specified in subsection
 1802  (1), and an insurer paying the benefits is entitled to recover
 1803  from each of the other insurers an equitable pro rata share of
 1804  the benefits paid and expenses incurred in processing the claim.
 1805         (f) In a dispute between the insured and the insurer, or
 1806  between an assignee of the insured’s rights and the insurer, the
 1807  insurer must notify the insured or the assignee that the policy
 1808  limits under this section have been reached within 15 days after
 1809  the limits have been reached.
 1810         (g)An insurer shall create and maintain for each insured a
 1811  log of medical care coverage benefits paid by the insurer on
 1812  behalf of the insured. The insurer shall provide to the insured
 1813  a copy of the log within 30 days after receiving a request for
 1814  the log from the insured.
 1815         (h) Benefits are not due or payable to or on behalf of an
 1816  insured, claimant, medical provider, or attorney if the insured,
 1817  claimant, medical provider, or attorney has:
 1818         1. Knowingly submitted a false material statement,
 1819  document, record, or bill;
 1820         2. Knowingly submitted false material information; or
 1821         3. Otherwise committed or attempted to commit a fraudulent
 1822  insurance act as defined in s. 626.989.
 1823  
 1824  A claimant who violates this paragraph is not entitled to any
 1825  medical care coverage benefits or payment for any bills and
 1826  services, regardless of whether a portion of the claim may be
 1827  legitimate. However, a medical provider who does not violate
 1828  this paragraph may not be denied benefits solely due to
 1829  violation by another claimant.
 1830         (i) If an insurer has a reasonable belief that a fraudulent
 1831  insurance act, as defined in s. 626.989 or s. 817.134, has been
 1832  committed, the insurer shall notify the claimant in writing
 1833  within 30 days of submission of the claim that the claim is
 1834  being investigated for suspected fraud. The insurer then has an
 1835  additional 60 days, beginning at the end of the initial 30-day
 1836  period, to conduct its fraud investigation. Notwithstanding
 1837  subsection (8), no later than the 90th day after the submission
 1838  of the claim, the insurer must deny the claim or pay the claim
 1839  with simple interest as provided in subparagraph (b)7. All
 1840  claims denied for suspected fraudulent insurance acts shall be
 1841  reported to the Division of Insurance Fraud.
 1842  
 1843  Subject to s. 626.989(4), persons or entities that in good faith
 1844  report suspected fraud to the Division of Insurance Fraud or
 1845  share information in the furtherance of a fraud investigation
 1846  are not subject to any civil or criminal liability relating to
 1847  the reporting or release of such information.
 1848         (j) It is a violation of the insurance code for an insurer
 1849  to fail to timely provide benefits as required by this section
 1850  with such frequency as to constitute a general business
 1851  practice, as determined by the office.
 1852         (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
 1853         (a) A physician, hospital, clinic, or other person or
 1854  institution lawfully rendering treatment to an injured person
 1855  for a bodily injury covered by medical care coverage insurance
 1856  may charge the insurer and injured party only a reasonable
 1857  amount pursuant to this section for the services, treatment,
 1858  supplies, and care rendered, and the insurer providing such
 1859  coverage may pay such charges directly to such person or
 1860  institution lawfully rendering such treatment if the insured
 1861  receiving such treatment, or her or his guardian, has
 1862  countersigned the properly completed invoice, bill, or claim
 1863  form approved by the office attesting that such treatment has
 1864  actually been rendered to the best knowledge of the insured or
 1865  her or his guardian. However, such charge may not exceed the
 1866  amount that the person or institution customarily charges for
 1867  like services, treatment, supplies, or care. When determining
 1868  whether a charge for a particular service, treatment, supply, or
 1869  care is reasonable, consideration may be given to evidence of
 1870  usual and customary charges and payments accepted by the
 1871  provider involved in the dispute, reimbursement levels in the
 1872  community and various federal and state medical fee schedules
 1873  applicable to motor vehicle and other insurance coverages, and
 1874  other information relevant to the reasonableness of the charges
 1875  for the service, treatment, supply, or care.
 1876         1. If a health care provider or entity bills an insurer an
 1877  amount less than that indicated in the following schedule of
 1878  maximum charges and the insurer pays the amount billed, the
 1879  payment shall be considered reasonable. A payment made by an
 1880  insurer that limits reimbursement to 80 percent of the following
 1881  schedule of maximum charges is considered reasonable:
 1882         a. For emergency transport and treatment by providers
 1883  licensed under chapter 401, 200 percent of Medicare charges.
 1884         b. For emergency services and care provided by a hospital,
 1885  75 percent of the hospital’s usual and customary charges.
 1886         c. For emergency services and care provided in a hospital
 1887  and rendered by a physician or dentist, and related hospital
 1888  inpatient services rendered by a physician or dentist, the usual
 1889  and customary charges in the community.
 1890         d. For hospital inpatient services, other than emergency
 1891  services and care, 200 percent of the Medicare Part A
 1892  prospective payment applicable to the specific hospital
 1893  providing the inpatient services.
 1894         e. For hospital outpatient services, other than emergency
 1895  services and care, 200 percent of the Medicare Part A Ambulatory
 1896  Payment Classification for the specific hospital providing the
 1897  outpatient services.
 1898         f.For all other medical services, treatment, supplies, and
 1899  care, 200 percent of the allowable amount under:
 1900         (I)The participating physicians fee schedule of Medicare
 1901  Part B.
 1902         (II)For medical services, treatment, supplies, and care
 1903  provided by clinical laboratories, Medicare Part B.
 1904         (III)For durable medical equipment, the Durable Medical
 1905  Equipment Prosthetics/Orthortics & Supplies (DMEPOS) fee
 1906  schedule of Medicare Part B.
 1907  
 1908  However, if such services, treatment, supplies, or care is not
 1909  reimbursable under Medicare Part B as provided in this sub
 1910  subparagraph, the insurer may limit reimbursement to 80 percent
 1911  of the maximum reimbursable allowance under workers’
 1912  compensation, as determined under s. 440.13 and rules adopted
 1913  thereunder which are in effect at the time such services,
 1914  treatment, supplies, or care is provided. Services, treatment,
 1915  supplies, or care that is not reimbursable under Medicare or
 1916  workers’ compensation is not required to be reimbursed by the
 1917  insurer.
 1918         2. For purposes of subparagraph 1., the applicable fee
 1919  schedule or payment limitation under Medicare is the fee
 1920  schedule or payment limitation that was in effect on March 1 of
 1921  the year and for the area in which the services, treatment,
 1922  supplies, or care was rendered, and applies until March 1 of the
 1923  following year, notwithstanding subsequent changes made to such
 1924  fee schedule or payment limitation, except that it may not be
 1925  less than the allowable amount under the participating
 1926  physicians schedule of Medicare Part B for 2007 for medical
 1927  services, treatment, supplies, and care subject to Medicare Part
 1928  B.
 1929         3. Subparagraph 1. does not allow the insurer to apply any
 1930  limitation on the number of treatments or other utilization
 1931  limits that apply under Medicare or workers’ compensation. An
 1932  insurer that applies the allowable payment limitations of
 1933  subparagraph 1. must reimburse a provider who lawfully provided
 1934  care or treatment under the scope of her or his license
 1935  regardless of whether such provider is entitled to reimbursement
 1936  under Medicare due to restrictions or limitations on the types
 1937  or discipline of health care providers who may be reimbursed for
 1938  particular procedures or procedure codes. However, subparagraph
 1939  1. does not prohibit an insurer from using the Medicare coding
 1940  policies and payment methodologies of the Centers for Medicare
 1941  and Medicaid Services, including applicable modifiers, to
 1942  determine the appropriate amount of reimbursement.
 1943         4. If an insurer limits payment as authorized by
 1944  subparagraph 1., the person providing such services, treatment,
 1945  supplies, or care may not bill or attempt to collect from the
 1946  insured any amount in excess of such limits, except for amounts
 1947  that are not covered by the insured’s medical care coverage
 1948  insurance due to the coinsurance amount or maximum policy
 1949  limits.
 1950         (b) An insurer or insured is not required to pay a claim or
 1951  charges:
 1952         1. Made by a broker or by a person making a claim on behalf
 1953  of a broker;
 1954         2. For any service or treatment that was not lawful at the
 1955  time rendered;
 1956         3. To any person who knowingly submits a false material
 1957  statement relating to the claim or charges;
 1958         4. With respect to a bill or statement that does not
 1959  substantially meet the applicable requirements of paragraph (d);
 1960         5. For any treatment or service that is upcoded, or that is
 1961  unbundled when such treatment or services should be bundled, in
 1962  accordance with paragraph (e). To facilitate prompt payment of
 1963  lawful services, an insurer may change billing codes that it
 1964  determines have been improperly or incorrectly upcoded or
 1965  unbundled and may make payment based on the changed billing
 1966  codes without affecting the right of the provider to dispute the
 1967  change by the insurer. However, before doing that, the insurer
 1968  must contact the health care provider and discuss the reasons
 1969  for the insurer’s change and the health care provider’s reason
 1970  for the coding or make a reasonable good faith effort to do so
 1971  as documented in the insurer’s file; or
 1972         6. For medical services or treatment billed by a physician
 1973  and not provided in a hospital unless such services are rendered
 1974  by the physician or are incident to her or his professional
 1975  services and included on the physician’s bill, including
 1976  documentation verifying that the physician is responsible for
 1977  the medical services that were rendered and billed.
 1978         (c) The Department of Health, in consultation with the
 1979  appropriate professional licensing boards, shall adopt by rule a
 1980  list of diagnostic tests deemed not to be medically necessary
 1981  for use in the treatment of persons sustaining bodily injury
 1982  covered by medical care coverage benefits under this section.
 1983  The list shall be revised from time to time as determined by the
 1984  Department of Health in consultation with the respective
 1985  professional licensing boards. Inclusion of a test on the list
 1986  shall be based on lack of demonstrated medical value and a level
 1987  of general acceptance by the relevant provider community and may
 1988  not be dependent entirely upon subjective patient response.
 1989  Notwithstanding its inclusion on a fee schedule in this
 1990  subsection, an insurer or insured is not required to pay any
 1991  charges or reimburse claims for any diagnostic test deemed not
 1992  medically necessary by the Department of Health.
 1993         (d) With respect to any treatment or service, other than
 1994  medical services billed by a hospital or other provider for
 1995  emergency services and care or inpatient services rendered at a
 1996  hospital-owned facility, the statement of charges must be
 1997  furnished to the insurer by the provider and may not include,
 1998  and the insurer is not required to pay, charges for treatment or
 1999  services rendered more than 35 days before the postmark date or
 2000  electronic transmission date of the statement, except for past
 2001  due amounts previously billed on a timely basis under this
 2002  paragraph. However, if the provider submits to the insurer a
 2003  notice of initiation of treatment within 21 days after its first
 2004  examination or treatment of the claimant, the statement may
 2005  include charges for treatment or services rendered up to, but
 2006  not more than, 75 days before the postmark date of the
 2007  statement. The injured party is not liable for, and the provider
 2008  may not bill the injured party for, charges that are unpaid
 2009  because of the provider’s failure to comply with this paragraph.
 2010  Any agreement requiring the injured person or insured to pay for
 2011  such charges is unenforceable.
 2012         1. If the insured fails to furnish the provider with the
 2013  correct name and address of the insured’s medical care coverage
 2014  insurer, the provider has 35 days after the date the provider
 2015  obtains the correct information to furnish the insurer with a
 2016  statement of the charges. The insurer is not required to pay for
 2017  such charges unless the provider includes with the statement
 2018  documentary evidence that was provided by the insured during the
 2019  35-day period which demonstrates that the provider reasonably
 2020  relied on erroneous information from the insured and:
 2021         a. A denial letter from the incorrect insurer; or
 2022         b. Proof of mailing, which may include an affidavit under
 2023  penalty of perjury reflecting timely mailing to the incorrect
 2024  address or insurer.
 2025         2. For emergency services and care rendered in a hospital
 2026  emergency department or for transport and treatment rendered by
 2027  an ambulance provider licensed pursuant to part III of chapter
 2028  401, the provider is not required to furnish the statement of
 2029  charges within the time period established by this paragraph,
 2030  and the insurer is not considered to have been furnished with
 2031  notice of the amount of the covered loss for purposes of
 2032  paragraph (4)(b) until it receives a statement complying with
 2033  paragraph (e), or a copy thereof, which specifically identifies
 2034  the place of service as a hospital emergency department or an
 2035  ambulance in accordance with billing standards recognized by the
 2036  federal Centers for Medicare and Medicaid Services.
 2037         3. Each notice of the insured’s rights under s. 627.7488
 2038  must include the following statement in at least 12-point type:
 2039  
 2040         BILLING REQUIREMENTS.—Florida law provides that with
 2041         respect to any treatment or services, other than
 2042         certain hospital and emergency services, the statement
 2043         of charges furnished to the insurer by the provider
 2044         may not include, and the insurer and the injured party
 2045         are not required to pay, charges for treatment or
 2046         services rendered more than 35 days before the
 2047         postmark date of the statement, except for past due
 2048         amounts previously billed on a timely basis, and
 2049         except that, if the provider submits to the insurer a
 2050         notice of initiation of treatment within 21 days after
 2051         its first examination or treatment of the claimant,
 2052         the statement may include charges for treatment or
 2053         services rendered up to, but not more than, 75 days
 2054         before the postmark date of the statement.
 2055  
 2056         (e) All statements and bills for medical services rendered
 2057  by a physician, hospital, clinic, or other person or institution
 2058  shall be submitted to the insurer on a properly completed
 2059  Centers for Medicare and Medicaid Services (CMS) 1500 form, UB
 2060  92 form, or any other standard form approved by the office or
 2061  adopted by the commission for purposes of this paragraph. All
 2062  billings for such services rendered by providers must, to the
 2063  extent applicable, follow the Physicians’ Current Procedural
 2064  Terminology (CPT) or Healthcare Correct Procedural Coding System
 2065  (HCPCS), or ICD-9 in effect for the year in which services are
 2066  rendered and comply with the CMS 1500 form instructions, the
 2067  American Medical Association CPT Editorial Panel and the HCPCS.
 2068  All providers, other than hospitals, must include on the
 2069  applicable claim form the professional license number of the
 2070  provider in the line or space provided for “Signature of
 2071  Physician or Supplier, Including Degrees or Credentials.” In
 2072  determining compliance with applicable CPT and HCPCS coding,
 2073  guidance shall be provided by the CPT or HCPCS in effect for the
 2074  year in which services were rendered, the Office of the
 2075  Inspector General, Physicians Compliance Guidelines, and other
 2076  authoritative treatises designated by rule by the Agency for
 2077  Health Care Administration. A statement of medical services may
 2078  not include charges for the medical services of a person or
 2079  entity that performed such services without possessing the valid
 2080  licenses required to perform such services. For purposes of
 2081  paragraph (4)(b), an insurer is not considered to have been
 2082  furnished with notice of the amount of the covered loss or
 2083  medical bills due unless the statements or bills comply with
 2084  this paragraph and are properly completed in their entirety as
 2085  to all material provisions, with all relevant information being
 2086  provided therein.
 2087         (f)1. At the time the initial treatment or service is
 2088  provided, each physician, licensed professional, clinic, or
 2089  medical institution providing medical services upon which a
 2090  claim for benefits is based shall require an insured person or
 2091  her or his guardian to execute a disclosure and acknowledgment
 2092  form that reflects at a minimum that:
 2093         a. The insured or her or his guardian must countersign the
 2094  form attesting to the fact that the services set forth in the
 2095  form were actually rendered.
 2096         b. The insured or her or his guardian has both the right
 2097  and the affirmative duty to confirm that the services were
 2098  actually rendered.
 2099         c. The insured or her or his guardian was not solicited by
 2100  any person to seek any services from the medical provider.
 2101         d. The physician, other licensed professional, clinic, or
 2102  other medical institution rendering services for which payment
 2103  is being claimed explained the services to the insured or her or
 2104  his guardian.
 2105         e. If the insured notifies the insurer in writing of a
 2106  billing error, the insured may be entitled to a certain
 2107  percentage of any reduction in the amounts paid by the insured’s
 2108  motor vehicle insurer.
 2109         2. The physician, other licensed professional, clinic, or
 2110  other medical institution rendering services for which payment
 2111  is being claimed has the affirmative duty to explain the
 2112  services rendered to the insured or her or his guardian so that
 2113  the insured or her or his guardian countersigns the form with
 2114  informed consent.
 2115         3. Countersignature by the insured or her or his guardian
 2116  is not required for the reading of diagnostic tests or other
 2117  services that are not required to be performed in the presence
 2118  of the insured.
 2119         4. The licensed medical professional rendering treatment
 2120  for which payment is being claimed must, by her or his own hand,
 2121  sign the form complying with this paragraph.
 2122         5. The completed original disclosure and acknowledgment
 2123  form shall be furnished to the insurer pursuant to paragraph
 2124  (4)(b) and may not be electronically furnished.
 2125         6. The disclosure and acknowledgment form is not required
 2126  for services billed by a provider for emergency services and
 2127  care rendered in a hospital emergency department or for
 2128  transport and treatment rendered by an ambulance provider
 2129  licensed pursuant to part III of chapter 401.
 2130         7. The Financial Services Commission shall adopt a standard
 2131  disclosure and acknowledgment form by rule to fulfill the
 2132  requirements of this paragraph.
 2133         8. As used in this paragraph, the term “countersign” or
 2134  “countersignature” means bearing a second or verifying
 2135  signature, as on a previously signed document, and is not
 2136  satisfied by the statement “signature on file” or similar
 2137  statement.
 2138         9. This paragraph applies only with respect to the initial
 2139  treatment or service of the insured by a provider. For
 2140  subsequent treatments or service, the provider must maintain a
 2141  patient log signed by the patient, in chronological order by
 2142  date of service, which is consistent with the services being
 2143  rendered to the patient as claimed. The requirement to maintain
 2144  a patient log signed by the patient may be met by a hospital
 2145  that maintains medical records as required by s. 395.3025 and
 2146  applicable rules and makes such records available to the insurer
 2147  upon request.
 2148         (g) Upon written notification by any person, an insurer
 2149  shall investigate any claim of improper billing by a physician
 2150  or other medical provider. The insurer shall determine whether
 2151  the insured was properly billed for only those services and
 2152  treatments that the insured actually received. If the insurer
 2153  determines that the insured has been improperly billed, the
 2154  insurer shall notify the insured, the person making the written
 2155  notification, and the provider of its findings and reduce the
 2156  amount of payment to the provider by the amount determined to be
 2157  improperly billed. If a reduction is made due to a written
 2158  notification by any person, the insurer shall pay to that person
 2159  20 percent of the amount of the reduction, up to $500. If the
 2160  provider is arrested due to the improper billing, the insurer
 2161  shall pay to that person 40 percent of the amount of the
 2162  reduction, up to $500.
 2163         (h) An insurer may not systematically downcode with the
 2164  intent to deny reimbursement otherwise due. Such action
 2165  constitutes a material misrepresentation under s.
 2166  626.9541(1)(i)2.
 2167         (6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON; DISPUTES.—
 2168         (a) In all circumstances, an insured seeking benefits under
 2169  ss. 627.748-627.7491, including omnibus insureds, must comply
 2170  with the terms of the policy, which includes, but is not limited
 2171  to, submitting to an examination under oath. The scope of
 2172  questioning during the examination under oath is limited to
 2173  relevant information or information that could reasonably be
 2174  expected to lead to relevant information. Compliance with this
 2175  paragraph is a condition precedent to the insured’s recovering
 2176  benefits. An insurer that, as a general business practice, as
 2177  determined by the office, requests examinations under oath
 2178  without a reasonable basis is subject to s. 626.9541.
 2179         (b) If a request is made by an insurer against whom a claim
 2180  for medical benefits has been made, an employer must furnish a
 2181  sworn statement, in a form approved by the office, of the
 2182  earnings of the person upon whose injury the claim is based
 2183  since the time of the bodily injury and for a reasonable period
 2184  before the injury.
 2185         (c) If an insured seeking to recover benefits pursuant to
 2186  ss. 627.748-627.7491 assigns the contractual right to such
 2187  benefits or payment of such benefits to any person or entity,
 2188  the assignee must comply with the terms of the policy. In all
 2189  circumstances, the assignee is obligated to cooperate under the
 2190  policy, except that an assignee may not be required to submit to
 2191  an examination under oath.
 2192         (d) All claimants must produce and allow for the inspection
 2193  of all documents requested by the insurer which are relevant to
 2194  the services rendered and reasonably obtainable by the claimant.
 2195         (e) Each physician, hospital, clinic, or other medical
 2196  institution providing, before or after bodily injury upon which
 2197  a claim for medical care coverage is based, any products,
 2198  services, or accommodations relating to that or any other
 2199  injury, or to a condition claimed to be connected with that or
 2200  any other injury, shall, if requested by the insurer against
 2201  whom the claim has been made, permit the insurer or the
 2202  insurer’s representative to conduct, within 10 days after the
 2203  insurer’s request, an onsite physical review and examination of
 2204  the treatment location, treatment apparatuses, diagnostic
 2205  devices, and any other medical equipment used for the services
 2206  rendered, and shall furnish a written report of the history,
 2207  condition, treatment, dates, and costs of such treatment of the
 2208  injured person and why the items identified by the insurer were
 2209  reasonable in amount and medically necessary.
 2210         1. The report shall be furnished with a sworn statement
 2211  that the treatment or services rendered were reasonable and
 2212  necessary with respect to the bodily injury sustained and must
 2213  identify which portion of the expenses for the treatment or
 2214  services was incurred as a result of the bodily injury. The
 2215  sworn statement must read as follows: “Under penalty of perjury,
 2216  I declare that I have read the foregoing, and the facts alleged
 2217  are true to the best of my knowledge and belief.”
 2218         2. The physician, hospital, clinic, or other medical
 2219  institution shall also permit the inspection and copying of any
 2220  records regarding such history, condition, treatment, dates, and
 2221  costs of treatment; however, this does not limit the
 2222  introduction of evidence at trial.
 2223         3. The person requesting such records and sworn statement
 2224  shall pay all reasonable costs connected therewith.
 2225         4. If an insurer makes a written request for documentation
 2226  or information within 30 days after having received notice of
 2227  the amount of a covered loss under paragraph (4)(b), the amount
 2228  or the partial amount that is the subject of the insurer’s
 2229  inquiry is overdue if the insurer does not pay in accordance
 2230  with paragraph (4)(b) or within 10 days after the insurer’s
 2231  receipt of the requested documentation or information, whichever
 2232  occurs later. As used in this subparagraph, the term “receipt”
 2233  includes, but is not limited to, inspection and copying pursuant
 2234  to this paragraph.
 2235         5. An insurer that requests documentation or information
 2236  pertaining to the reasonableness of charges or medical necessity
 2237  without a reasonable basis for such requests as a general
 2238  business practice, as determined by the office, is engaging in
 2239  an unfair trade practice under the insurance code.
 2240         6. Section 626.989(4)(d) applies to the sharing of
 2241  information related to reviews and examinations conducted
 2242  pursuant to this section.
 2243         7. A cause of action for violation of the physician-patient
 2244  privilege or invasion of the right of privacy is prohibited
 2245  against any person or entity complying with this paragraph.
 2246         (f) If there is a dispute regarding an insurer’s right to
 2247  discovery of facts under this section, the insurer may petition
 2248  the court to enter an order permitting such discovery. The order
 2249  may be made only on motion for good cause shown and upon notice
 2250  to all persons having an interest, and must specify the time,
 2251  place, manner, conditions, and scope of the discovery. The court
 2252  may, in order to protect against annoyance, embarrassment, or
 2253  oppression, as justice requires, enter an order refusing
 2254  discovery or specifying conditions of discovery and may order
 2255  payments of costs and expenses of the proceeding, including
 2256  reasonable fees for the appearance of attorneys at the
 2257  proceedings, as justice requires.
 2258         (g) Upon request, the injured person shall be furnished a
 2259  copy of all information obtained by the insurer under this
 2260  section and shall pay a reasonable charge if required by the
 2261  insurer.
 2262         (h) Notice to an insurer of the existence of a claim may
 2263  not be unreasonably withheld by an insured.
 2264         (7) MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON;
 2265  REPORTS.—If the mental or physical condition of an injured
 2266  person covered by medical care coverage is material to a claim
 2267  that has been or may be made for past or future benefits under
 2268  such coverage, upon the request of an insurer, such person must
 2269  submit to mental or physical examination by a physician. The
 2270  costs of such examination shall be borne entirely by the
 2271  insurer. The insurer may include reasonable provisions in
 2272  medical care coverage insurance policies for the mental and
 2273  physical examination of those claiming benefits under the
 2274  policy.
 2275         (a) The examination must be conducted within the
 2276  municipality where the insured is receiving treatment, or in a
 2277  location reasonably accessible to the insured, which means any
 2278  location within the municipality in which the insured resides,
 2279  or within 10 miles by road of the insured’s residence if such
 2280  location is within the county in which the insured resides. If
 2281  the examination is to be conducted in a location reasonably
 2282  accessible to the insured but there is no qualified physician to
 2283  conduct the examination in such location, the examination shall
 2284  be conducted in an area that is in the closest proximity to the
 2285  insured’s residence.
 2286         (b) An insurer may not withdraw payment from a treating
 2287  physician without the consent of the injured person covered by
 2288  the policy unless the insurer first obtains a valid report by a
 2289  Florida physician licensed under the same chapter as the
 2290  treating physician stating that treatment was not reasonable,
 2291  related, or necessary. A valid report is one that is prepared
 2292  and signed by the physician examining the injured person or who
 2293  reviewed the treatment records of the injured person, is
 2294  factually supported by the examination or treatment records
 2295  reviewed, and that has not been modified by anyone other than
 2296  the reviewing physician. The physician preparing the report must
 2297  be in active practice, unless he or she is physically disabled.
 2298  “Active practice” means that during the 3 years immediately
 2299  preceding the date of the physical examination or review of
 2300  treatment records, the physician devoted professional time to
 2301  the active clinical practice of evaluation, diagnosis, or
 2302  treatment of medical conditions or to the instruction of
 2303  students in an accredited health professional school, accredited
 2304  residency program, or a clinical research program that is
 2305  affiliated with an accredited health professional school,
 2306  teaching hospital, or accredited residency program. The insurer
 2307  and any person acting at the direction of or on behalf of the
 2308  insurer may not materially change an opinion in a report
 2309  prepared under this paragraph or direct the physician preparing
 2310  the report to change such opinion. The denial of a payment
 2311  resulting from a changed opinion constitutes a material
 2312  misrepresentation under s. 626.9541(1)(i)2. This provision does
 2313  not preclude the insurer from calling to the physician’s
 2314  attention any errors of fact in the report based upon
 2315  information in the claim file.
 2316         (c) If requested by the person examined, a party causing an
 2317  examination to be made must deliver a copy of every written
 2318  report concerning a examination rendered by an examining
 2319  physician to the person examined, at least one of which must set
 2320  out the examining physician’s findings and conclusions in
 2321  detail. After such request and delivery, the party causing the
 2322  examination to be made is entitled, upon request, to receive
 2323  from the person examined every written report available to him
 2324  or her or his or her representative concerning any examination,
 2325  previously or thereafter made, of the same mental or physical
 2326  condition. By requesting and obtaining a report of the
 2327  examination so ordered, or by taking the deposition of the
 2328  examiner, the person examined waives any privilege he or she may
 2329  have, relating to the claim for benefits, regarding the
 2330  testimony of every other person who has examined, or may
 2331  thereafter examine, him or her with respect to the same mental
 2332  or physical condition.
 2333         (d) The physician preparing a report at the request of an
 2334  insurer and physicians rendering expert opinions on behalf of
 2335  persons claiming medical benefits for medical care coverage, or
 2336  on behalf of an insured through an attorney or another entity,
 2337  must maintain copies of all examination reports as medical
 2338  records and all payments for the examinations and reports for at
 2339  least 3 years.
 2340         (e) If a person unreasonably refuses to submit to an
 2341  examination or fails to appear for an examination, the insurer
 2342  is no longer liable for subsequent medical care benefits.
 2343  Refusal or failure to appear for two examinations raises a
 2344  rebuttable presumption that such refusal or failure was
 2345  unreasonable.
 2346         (8) DEMAND LETTER.—
 2347         (a) As a condition precedent to filing an action for
 2348  benefits under this section, the insurer must be provided with
 2349  written notice of an intent to initiate litigation. Such notice
 2350  may not be sent until the claim is overdue, including any
 2351  additional time the insurer has to pay the claim pursuant to
 2352  subsection (4).
 2353         (b) The notice required must state that it is a “demand
 2354  letter under s. 627.7485(8), F.S.,” and state with specificity:
 2355         1. The name of the insured upon whom such benefits are
 2356  being sought, including a copy of the assignment giving rights
 2357  to the claimant if the claimant is not the insured.
 2358         2. The claim number or policy number upon which such claim
 2359  was originally submitted to the insurer.
 2360         3. To the extent applicable, the name of any medical
 2361  provider who rendered the treatment, services, accommodations,
 2362  or supplies to an insured which form the basis of such claim and
 2363  an itemized statement specifying each exact amount, the date of
 2364  treatment, service, or accommodation, and the type of benefit
 2365  claimed to be due. A completed form satisfying the requirements
 2366  of paragraph (5)(e) or the lost-wage statement previously
 2367  submitted may be used as the itemized statement. If the demand
 2368  involves an insurer’s withdrawal of payment under paragraph
 2369  (7)(b) for future treatment not yet rendered, the claimant shall
 2370  attach a copy of the insurer’s notice withdrawing such payment
 2371  and an itemized statement of the type, frequency, and duration
 2372  of future treatment claimed to be reasonable and medically
 2373  necessary.
 2374         (c) Each notice required by this subsection must be
 2375  delivered to the insurer by United States certified or
 2376  registered mail, return receipt requested. If requested by the
 2377  claimant in the notice, such postal costs shall be reimbursed by
 2378  the insurer when the insurer pays the claim. The notice must be
 2379  sent to the person and address specified by the insurer for the
 2380  purposes of receiving notices under this subsection. Each
 2381  licensed insurer, whether domestic, foreign, or alien, shall
 2382  file with the office the name and address of the person to whom
 2383  notices pursuant to this subsection are sent, which the office
 2384  shall make available on its website. The name and address on
 2385  file with the office pursuant to s. 624.422 shall be deemed the
 2386  authorized representative to accept notice pursuant to this
 2387  subsection if no other designation has been made.
 2388         (d) If the overdue claim specified in the notice is paid by
 2389  the insurer within 30 days after receipt of notice by the
 2390  insurer, plus applicable interest and a penalty of 10 percent of
 2391  the overdue amount, subject to a maximum penalty of $250, no
 2392  action may be brought against the insurer. If the demand
 2393  involves an insurer’s withdrawal of payment under paragraph
 2394  (7)(b) for future treatment not yet rendered, no action may be
 2395  brought against the insurer if, within 30 days after receipt of
 2396  the notice, the insurer mails to the person filing the notice a
 2397  written statement of the insurer’s agreement to pay for such
 2398  treatment in accordance with the notice and to pay a penalty of
 2399  10 percent, subject to a maximum penalty of $250, when it pays
 2400  for such future treatment in accordance with the requirements of
 2401  this section. To the extent the insurer determines not to pay
 2402  any amount demanded, the penalty is not payable in any
 2403  subsequent action. For purposes of this paragraph, payment or
 2404  the insurer’s agreement are considered made on the date a draft
 2405  or other valid instrument that is equivalent to payment, or the
 2406  insurer’s written statement of agreement, is placed in the
 2407  United States mail in a properly addressed, postpaid envelope,
 2408  or if not so posted, on the date of delivery. The insurer is not
 2409  obligated to pay any attorney fees if the insurer pays the claim
 2410  or mails its agreement to pay for future treatment within the
 2411  time prescribed by this paragraph.
 2412         (e) The applicable statute of limitation for an action
 2413  under this section shall be tolled for 30 business days by the
 2414  mailing of the notice required by this subsection.
 2415         (f) Any insurer making a general business practice of not
 2416  paying valid claims until receipt of the notice required by this
 2417  subsection, as determined by the office, is engaging in an
 2418  unfair trade practice under the insurance code.
 2419         (9) FAILURE TO PAY VALID CLAIMS; UNFAIR OR DECEPTIVE
 2420  PRACTICE.—
 2421         (a) If an insurer fails to pay valid claims for medical
 2422  care coverage with such frequency as to indicate a general
 2423  business practice, as determined by the office, the insurer is
 2424  engaging in a prohibited unfair or deceptive practice subject to
 2425  the penalties provided in s. 626.9521, and the office has the
 2426  powers and duties specified in ss. 626.9561-626.9601 with
 2427  respect thereto.
 2428         (b) Notwithstanding s. 501.212, the Department of Legal
 2429  Affairs may investigate and initiate actions for a violation of
 2430  this subsection, including, but not limited to, the powers and
 2431  duties specified in part II of chapter 501.
 2432         (10) CIVIL ACTION FOR INSURANCE FRAUD.—An insurer shall
 2433  have a cause of action against any person convicted of, or who,
 2434  regardless of adjudication of guilt, pleads guilty or nolo
 2435  contendere to, insurance fraud under s. 817.234, patient
 2436  brokering under s. 817.505, or kickbacks under s. 456.054,
 2437  associated with a claim for medical care coverage in accordance
 2438  with this section. An insurer prevailing in an action brought
 2439  under this subsection may recover compensatory, consequential,
 2440  and punitive damages subject to the requirements and limitations
 2441  of part II of chapter 768 and attorney fees and costs incurred
 2442  in litigating the cause of action.
 2443         (11) FRAUD ADVISORY NOTICE.—Upon receiving notice of a
 2444  claim under this section, an insurer shall provide a notice to
 2445  the insured or to a person for whom a claim for reimbursement
 2446  for diagnosis or treatment of injuries has been filed advising
 2447  that:
 2448         (a) Pursuant to s. 626.9892, the Department of Financial
 2449  Services may pay rewards of up to $25,000 to persons providing
 2450  information leading to the arrest and conviction of persons
 2451  committing crimes investigated by the Division of Insurance
 2452  Fraud arising from violations of s. 440.105, s. 624.15, s.
 2453  626.9541, s. 626.989, or s. 817.234.
 2454         (b) Solicitation of a person injured in a motor vehicle
 2455  crash for purposes of filing medical care coverage or tort
 2456  claims could be a violation of s. 817.234 or s. 817.505 or the
 2457  rules regulating The Florida Bar and, if such conduct has taken
 2458  place, should be immediately reported to the Division of
 2459  Insurance Fraud.
 2460         (12) ALL CLAIMS BROUGHT IN A SINGLE ACTION.—In any civil
 2461  action to recover medical care coverage benefits brought by a
 2462  claimant pursuant to this section against an insurer, all claims
 2463  related to the same health care provider for the same injured
 2464  person shall be brought in one action unless good cause is shown
 2465  why such claims should be brought separately. If the court
 2466  determines that a civil action is filed for a claim that should
 2467  have been brought in a prior civil action, the court may not
 2468  award attorney fees to the claimant.
 2469         (13) SECURE ELECTRONIC DATA TRANSFER.—A notice,
 2470  documentation, transmission, or communication of any kind
 2471  required or authorized under ss. 627.748-627.7491 may be
 2472  transmitted electronically if it is transmitted by secure
 2473  electronic data transfer that is consistent with state and
 2474  federal privacy and security laws.
 2475         Section 16. Section 627.7486, Florida Statutes, is created
 2476  to read:
 2477         627.7486 Tort exemption; limitation on right to damages;
 2478  punitive damages.—
 2479         (1) Every owner, registrant, operator, or occupant of a
 2480  motor vehicle for which security has been provided as required
 2481  by ss. 627.748-627.7491, and every person or organization
 2482  legally responsible for her or his acts or omissions, is exempt
 2483  from tort liability for damages because of bodily injury,
 2484  sickness, or disease arising out of the ownership, operation,
 2485  maintenance, or use of such motor vehicle in this state to the
 2486  extent that the benefits described in s. 627.7485(1) are payable
 2487  for such injury, or would be payable but for any exclusion
 2488  authorized by ss. 627.748-627.7491, under any insurance policy
 2489  or other method of security complying with s. 627.7483, or by an
 2490  owner personally liable under s. 627.7483 for the payment of
 2491  such benefits, unless the person is entitled to maintain an
 2492  action for pain, suffering, mental anguish, and inconvenience
 2493  for such injury under subsection (2).
 2494         (2) In any action of tort brought against the owner,
 2495  registrant, operator, or occupant of a motor vehicle for which
 2496  security has been provided as required by ss. 627.748-627.7491,
 2497  or against any person or organization legally responsible for
 2498  her or his acts or omissions, a plaintiff may recover damages in
 2499  tort for pain, suffering, mental anguish, and inconvenience
 2500  because of bodily injury, sickness, or disease arising out of
 2501  the ownership, maintenance, operation, or use of such motor
 2502  vehicle only if the injury or disease consists in whole or in
 2503  part of:
 2504         (a) Significant and permanent loss of an important bodily
 2505  function;
 2506         (b) Permanent injury within a reasonable degree of medical
 2507  probability, other than scarring or disfigurement;
 2508         (c) Significant and permanent scarring or disfigurement; or
 2509         (d) Death.
 2510         (3) If a defendant in a proceeding brought pursuant to ss.
 2511  627.748-627.7491 questions whether the plaintiff has met the
 2512  requirements of subsection (2), the defendant may file an
 2513  appropriate motion with the court, and the court, 30 days before
 2514  the date set for the trial or the pretrial hearing, whichever is
 2515  first, shall, on a one-time basis only, ascertain by examining
 2516  the pleadings and the evidence before it whether the plaintiff
 2517  will be able to submit some evidence that the plaintiff will
 2518  meet the requirements of subsection (2). If the court finds that
 2519  the plaintiff will not be able to submit such evidence, the
 2520  court shall dismiss the plaintiff’s claim without prejudice.
 2521         (4) A claim for punitive damages is not allowed in any
 2522  action brought against a motor vehicle liability insurer for
 2523  damages in excess of its policy limits.
 2524         Section 17. Section 627.7487, Florida Statutes, is created
 2525  to read:
 2526         627.7487 Medical care coverage; optional limitations;
 2527  deductibles.—
 2528         (1) The named insured may elect a deductible or modified
 2529  coverage or combination thereof to apply to the named insured
 2530  alone or to the named insured and dependent relatives residing
 2531  in the insured’s household but may not elect a deductible or
 2532  modified coverage to apply to any other person covered under the
 2533  policy.
 2534         (2) Upon the renewal of an existing policy, an insurer
 2535  shall offer deductibles of $250, $500, and $1,000 to each
 2536  applicant and to each policyholder. The deductible amount must
 2537  be applied to 100 percent of the expenses and losses described
 2538  in s. 627.7485. After the deductible is met, each insured may
 2539  receive up to $10,000 in total benefits as described in s.
 2540  627.7485(1). However, this subsection may not be applied to
 2541  reduce the amount of any benefits received in accordance with s.
 2542  627.7485(1)(c).
 2543         (3) An insurer shall offer coverage where, at the election
 2544  of the named insured, the benefits for loss of gross income and
 2545  loss of earning capacity described in s. 627.7485(1)(b) are
 2546  excluded.
 2547         (4) The named insured may not be prevented from electing a
 2548  deductible under subsection (2) and modified coverage under
 2549  subsection (3). Each election made by the named insured under
 2550  this section must result in an appropriate reduction of premium
 2551  associated with that election.
 2552         (5) All such offers must be made in clear and unambiguous
 2553  language at the time the initial application is taken and before
 2554  each annual renewal and indicate that a premium reduction will
 2555  result from each election. At the option of the insurer, such
 2556  requirement may be met by using forms of notice approved by the
 2557  office or by providing the following notice in 10-point type in
 2558  the insurer’s application for initial issuance of a policy of
 2559  motor vehicle insurance and the insurer’s annual notice of
 2560  renewal premium:
 2561  
 2562  For medical care coverage insurance, the named insured may elect
 2563  a deductible and may choose to exclude coverage for loss of
 2564  gross income and loss of earning capacity (“lost wages”). This
 2565  selection and choice apply to the named insured alone, or to the
 2566  named insured and all dependent resident relatives. A premium
 2567  reduction will result from these elections. The named insured is
 2568  hereby advised not to elect the lost wage exclusion if the named
 2569  insured or dependent resident relatives are employed, since lost
 2570  wages will not be payable in the event of an accident.
 2571         Section 18. Section 627.7488, Florida Statutes, is created
 2572  to read:
 2573         627.7488 Notice of insured’s rights.—
 2574         (1) The commission shall adopt by rule a form for notifying
 2575  insureds of their right to receive coverage under the Florida
 2576  Motor Vehicle No-Fault Medical Care Coverage Law. Such notice
 2577  must include:
 2578         (a) A description of the benefits provided, including, but
 2579  not limited to, the specific types of services for which medical
 2580  benefits are paid, disability benefits, death benefits,
 2581  significant exclusions from and limitations on coverage, how
 2582  benefits are coordinated with other insurance benefits that the
 2583  insured may have, when payments are due, penalties and interest
 2584  that may be imposed on insurers for failure to make timely
 2585  payments of benefits, and rights of parties regarding disputes
 2586  as to benefits.
 2587         (b) An advisory informing insureds that:
 2588         1. Pursuant to s. 626.9892, the Department of Financial
 2589  Services may pay rewards of up to $25,000 to persons providing
 2590  information leading to the arrest and conviction of persons
 2591  committing crimes investigated by the Division of Insurance
 2592  Fraud arising from violations of s. 440.105, s. 624.15, s.
 2593  626.9541, s. 626.989, or s. 817.234.
 2594         2. Pursuant to s. 627.7485(5)(f)1.e., if the insured
 2595  notifies the insurer in writing of a billing error, the insured
 2596  may be entitled to a certain percentage of a reduction in the
 2597  amounts paid by the insured’s motor vehicle insurer.
 2598         (c) A notice that solicitation of a person injured in a
 2599  motor vehicle crash for purposes of filing medical care coverage
 2600  or tort claims could be a violation of s. 817.234 or s. 817.505
 2601  or the rules regulating The Florida Bar and, if such conduct has
 2602  taken place, it should be immediately reported to the Division
 2603  of Insurance Fraud.
 2604         (2) Each insurer issuing a policy in this state providing
 2605  medical care coverage must mail or deliver the notice as
 2606  specified in subsection (1) to an insured within 21 days after
 2607  receiving from the insured notice of a motor vehicle accident or
 2608  claim involving personal injury to an insured who is covered
 2609  under the policy. The office may allow an insurer additional
 2610  time, not to exceed 30 days, to provide the notice specified in
 2611  subsection (1) upon a showing by the insurer that an emergency
 2612  justifies an extension of time.
 2613         (3) The notice required by this section does not alter or
 2614  modify the terms of the insurance contract or other requirements
 2615  of ss. 627.748-627.7491.
 2616         Section 19. Section 627.7489, Florida Statutes, is created
 2617  to read:
 2618         627.7489 Mandatory joinder of derivative claim.—In any
 2619  action brought pursuant to s. 627.7486 claiming personal
 2620  injuries, all claims arising out of the plaintiff’s injuries,
 2621  including all derivative claims, shall be brought together,
 2622  unless good cause is shown why such claims should be brought
 2623  separately.
 2624         Section 20. Section 627.749, Florida Statutes, is created
 2625  to read:
 2626         627.749 Insurers’ right of reimbursement.—Notwithstanding
 2627  any other provisions of ss. 627.748-627.7491, an insurer
 2628  providing medical care coverage on a private passenger motor
 2629  vehicle shall, to the extent of any medical care coverage paid
 2630  to any person as a benefit arising out of such private passenger
 2631  motor vehicle insurance, have a right of reimbursement against
 2632  the owner or the insurer of the owner of a commercial motor
 2633  vehicle if the benefits paid result from such person having been
 2634  an occupant of the commercial motor vehicle or having been
 2635  struck by the commercial motor vehicle while not an occupant of
 2636  any self-propelled vehicle.
 2637         Section 21. Effective December 1, 2012, section 627.7491,
 2638  Florida Statutes, is created to read:
 2639         627.7491 Application of the Florida Motor Vehicle No-Fault
 2640  Medical Care Coverage Law.—
 2641         (1) All forms and rates for policies issued or renewed on
 2642  or after January 1, 2013, must reflect ss. 627.748-627.7491 and
 2643  must be approved by the office before use.
 2644         (2) After January 1, 2013, insurers must provide notice of
 2645  the Florida Motor Vehicle No-Fault Medical Care Coverage Law to
 2646  existing policyholders at least 30 days before the policy
 2647  expiration date and to applicants for no-fault coverage upon
 2648  receipt of the application. The notice is not subject to
 2649  approval by the office and must clearly inform the policyholder
 2650  or applicant of the following:
 2651         (a) That, effective January 1, 2013, no-fault motor vehicle
 2652  insurance requirements are governed by the Florida Motor Vehicle
 2653  No-Fault Medical Care Coverage Law and must provide an
 2654  explanation of medical care coverage. With respect to the
 2655  initial renewal after January 1, 2013, current policyholders
 2656  must also be provided with an explanation of differences between
 2657  their current policies and the coverage provided under medical
 2658  care coverage policies.
 2659         (b) That failure to maintain required medical care coverage
 2660  and $10,000 in property damage liability coverage may result in
 2661  state suspension of the policyholder’s driver license and
 2662  vehicle registration.
 2663         (c) The name and telephone number of a person to contact
 2664  with any questions she or he may have.
 2665         Section 22. Subsection (1), paragraph (c) of subsection
 2666  (7), paragraphs (a), (b), and (c) of subsection (8), and
 2667  subsections (9), (10), and (13) of section 817.234, Florida
 2668  Statutes, are amended to read:
 2669         817.234 False and fraudulent insurance claims.—
 2670         (1)(a) A person commits insurance fraud punishable as
 2671  provided in subsection (11) if that person, with the intent to
 2672  injure, defraud, or deceive any insurer:
 2673         1. Presents or causes to be presented any written or oral
 2674  statement as part of, or in support of, a claim for payment or
 2675  other benefit pursuant to an insurance policy or a health
 2676  maintenance organization subscriber or provider contract,
 2677  knowing that such statement contains any false, incomplete, or
 2678  misleading information concerning any fact or thing material to
 2679  such claim;
 2680         2. Prepares or makes any written or oral statement that is
 2681  intended to be presented to any insurer in connection with, or
 2682  in support of, any claim for payment or other benefit pursuant
 2683  to an insurance policy or a health maintenance organization
 2684  subscriber or provider contract, knowing that such statement
 2685  contains any false, incomplete, or misleading information
 2686  concerning any fact or thing material to such claim; or
 2687         3.a. Knowingly presents, causes to be presented, or
 2688  prepares or makes with knowledge or belief that it will be
 2689  presented to any insurer, purported insurer, servicing
 2690  corporation, insurance broker, or insurance agent, or any
 2691  employee or agent thereof, any false, incomplete, or misleading
 2692  information or written or oral statement as part of, or in
 2693  support of, an application for the issuance of, or the rating
 2694  of, any insurance policy, or a health maintenance organization
 2695  subscriber or provider contract; or
 2696         b. Who Knowingly conceals information concerning any fact
 2697  material to such application; or.
 2698         4. Knowingly presents, causes to be presented, or, with
 2699  knowledge or belief that it will be presented to an insurer,
 2700  prepares or makes a claim for payment or other benefit under a
 2701  personal injury protection insurance policy or an emergency care
 2702  overage insurance policy and the person knows that the payee
 2703  knowingly submitted a false, misleading, or fraudulent
 2704  application or other document when applying for licensure as a
 2705  health care clinic, seeking an exemption from licensure as a
 2706  health care clinic, or demonstrating compliance with part X of
 2707  chapter 400.
 2708         (b) All claims and application forms must shall contain a
 2709  statement that is approved by the Office of Insurance Regulation
 2710  of the Financial Services Commission which clearly states in
 2711  substance the following: “Any person who knowingly and with
 2712  intent to injure, defraud, or deceive any insurer files a
 2713  statement of claim or an application containing any false,
 2714  incomplete, or misleading information is guilty of a felony of
 2715  the third degree.” This paragraph does shall not apply to
 2716  reinsurance contracts, reinsurance agreements, or reinsurance
 2717  claims transactions.
 2718         (7)
 2719         (c) An insurer, or any person acting at the direction of or
 2720  on behalf of an insurer, may not change an opinion in a mental
 2721  or physical report prepared under s. 627.736(7) or s.
 2722  627.7485(7), as applicable, s. 627.736(8) or direct the
 2723  physician preparing the report to change such opinion; however,
 2724  this provision does not preclude the insurer from calling to the
 2725  attention of the physician errors of fact in the report based
 2726  upon information in the claim file. Any person who violates this
 2727  paragraph commits a felony of the third degree, punishable as
 2728  provided in s. 775.082, s. 775.083, or s. 775.084.
 2729         (8)(a) It is unlawful for any person intending to defraud
 2730  any other person to solicit or cause to be solicited any
 2731  business from a person involved in a motor vehicle accident for
 2732  the purpose of making, adjusting, or settling motor vehicle tort
 2733  claims or claims for personal injury protection or medical care
 2734  coverage benefits required by s. 627.736 or 627.7485, as
 2735  applicable. Any person who violates the provisions of this
 2736  paragraph commits a felony of the second degree, punishable as
 2737  provided in s. 775.082, s. 775.083, or s. 775.084. A person who
 2738  is convicted of a violation of this subsection shall be
 2739  sentenced to a minimum term of imprisonment of 2 years.
 2740         (b) A person may not solicit or cause to be solicited any
 2741  business from a person involved in a motor vehicle accident by
 2742  any means of communication other than advertising directed to
 2743  the public for the purpose of making motor vehicle tort claims
 2744  or claims for personal injury protection or medical care
 2745  coverage benefits required by s. 627.736 or 627.7485, as
 2746  applicable, within 60 days after the occurrence of the motor
 2747  vehicle accident. Any person who violates this paragraph commits
 2748  a felony of the third degree, punishable as provided in s.
 2749  775.082, s. 775.083, or s. 775.084.
 2750         (c) A lawyer, health care practitioner as defined in s.
 2751  456.001, or owner or medical director of a clinic required to be
 2752  licensed pursuant to s. 400.9905 may not, at any time after 60
 2753  days have elapsed from the occurrence of a motor vehicle
 2754  accident, solicit or cause to be solicited any business from a
 2755  person involved in a motor vehicle accident by means of in
 2756  person or telephone contact at the person’s residence, for the
 2757  purpose of making motor vehicle tort claims or claims for
 2758  personal injury protection or medical care coverage benefits
 2759  required by s. 627.736 or 627.7485, as applicable. Any person
 2760  who violates this paragraph commits a felony of the third
 2761  degree, punishable as provided in s. 775.082, s. 775.083, or s.
 2762  775.084.
 2763         (9) A person may not organize, plan, or knowingly
 2764  participate in an intentional motor vehicle crash or a scheme to
 2765  create documentation of a motor vehicle crash that did not occur
 2766  for the purpose of making motor vehicle tort claims or claims
 2767  for personal injury protection or medical care coverage benefits
 2768  as required by s. 627.736 or s. 627.7485, as applicable. Any
 2769  person who violates this subsection commits a felony of the
 2770  second degree, punishable as provided in s. 775.082, s. 775.083,
 2771  or s. 775.084. A person who is convicted of a violation of this
 2772  subsection shall be sentenced to a minimum term of imprisonment
 2773  of 2 years.
 2774         (10) A licensed health care practitioner who is found
 2775  guilty of insurance fraud under this section for an act relating
 2776  to a personal injury protection or medical care coverage
 2777  insurance policy may not be licensed or continue to be licensed
 2778  for 5 years and may not receive reimbursement for benefits under
 2779  such policies for 10 years. As used in this section, the term
 2780  “insurer” means any insurer, health maintenance organization,
 2781  self-insurer, self-insurance fund, or other similar entity or
 2782  person regulated under chapter 440 or chapter 641 or by the
 2783  Office of Insurance Regulation under the Florida Insurance Code.
 2784         (13) As used in this section, the term:
 2785         (a) “Insurer” means any insurer, health maintenance
 2786  organization, self-insurer, self-insurance fund, or similar
 2787  entity or person regulated under chapter 440 or chapter 641 or
 2788  by the Office of Insurance Regulation under the Florida
 2789  Insurance Code.
 2790         (b)(a) “Property” means property as defined in s. 812.012.
 2791         (c)(b) “Value” means value as defined in s. 812.012.
 2792         Section 23. Subsection (4) of section 316.065, Florida
 2793  Statutes, is amended to read:
 2794         316.065 Crashes; reports; penalties.—
 2795         (4) Any person who knowingly repairs a motor vehicle
 2796  without having made a report as required by subsection (3) is
 2797  guilty of a misdemeanor of the first degree, punishable as
 2798  provided in s. 775.082 or s. 775.083. The owner and driver of a
 2799  vehicle involved in a crash who makes a report thereof in
 2800  accordance with subsection (1) or s. 316.066(1) is not liable
 2801  under this section.
 2802         Section 24. Subsection (1) of section 316.646, Florida
 2803  Statutes, is amended to read:
 2804         316.646 Security required; proof of security and display
 2805  thereof; dismissal of cases.—
 2806         (1) Any person required by s. 324.022 to maintain property
 2807  damage liability security, required by s. 324.023 to maintain
 2808  liability security for bodily injury or death, or required by s.
 2809  627.733 to maintain personal injury protection security, or
 2810  required by s. 627.7483 to maintain medical care coverage
 2811  security, as applicable, on a motor vehicle must shall have in
 2812  his or her immediate possession at all times while operating
 2813  such motor vehicle proper proof of maintenance of the required
 2814  security. Such proof must shall be a uniform proof-of-insurance
 2815  card in a form prescribed by the department, a valid insurance
 2816  policy, an insurance policy binder, a certificate of insurance,
 2817  or such other proof as may be prescribed by the department.
 2818         Section 25. Paragraph (b) of subsection (2) of section
 2819  318.18, Florida Statutes, is amended to read:
 2820         318.18 Amount of penalties.—The penalties required for a
 2821  noncriminal disposition pursuant to s. 318.14 or a criminal
 2822  offense listed in s. 318.17 are as follows:
 2823         (2) Thirty dollars for all nonmoving traffic violations
 2824  and:
 2825         (b) For all violations of ss. 320.0605, 320.07(1), 322.065,
 2826  and 322.15(1). Any person who is cited for a violation of s.
 2827  320.07(1) shall be charged a delinquent fee pursuant to s.
 2828  320.07(4).
 2829         1. If a person who is cited for a violation of s. 320.0605
 2830  or s. 320.07 can show proof of having a valid registration at
 2831  the time of arrest, the clerk of the court may dismiss the case
 2832  and may assess a dismissal fee of up to $10. A person who finds
 2833  it impossible or impractical to obtain a valid registration
 2834  certificate must submit an affidavit detailing the reasons for
 2835  the impossibility or impracticality. The reasons may include,
 2836  but are not limited to, the fact that the vehicle was sold,
 2837  stolen, or destroyed; that the state in which the vehicle is
 2838  registered does not issue a certificate of registration; or that
 2839  the vehicle is owned by another person.
 2840         2. If a person who is cited for a violation of s. 322.03,
 2841  s. 322.065, or s. 322.15 can show a driver driver’s license
 2842  issued to him or her and valid at the time of arrest, the clerk
 2843  of the court may dismiss the case and may assess a dismissal fee
 2844  of up to $10.
 2845         3. If a person who is cited for a violation of s. 316.646
 2846  can show proof of security as required by s. 627.733 or s.
 2847  627.7483, as applicable, issued to the person and valid at the
 2848  time of arrest, the clerk of the court may dismiss the case and
 2849  may assess a dismissal fee of up to $10. A person who finds it
 2850  impossible or impractical to obtain proof of security must
 2851  submit an affidavit detailing the reasons for the
 2852  impracticality. The reasons may include, but are not limited to,
 2853  the fact that the vehicle has since been sold, stolen, or
 2854  destroyed; that the owner or registrant of the vehicle is not
 2855  required by s. 627.733 or s. 627.7483 to maintain personal
 2856  injury protection insurance or medical care coverage insurance,
 2857  as applicable; or that the vehicle is owned by another person.
 2858         Section 26. Paragraphs (a) and (d) of subsection (5) of
 2859  section 320.02, Florida Statutes, are amended to read:
 2860         320.02 Registration required; application for registration;
 2861  forms.—
 2862         (5)(a) Proof that personal injury protection benefits or
 2863  medical care coverage benefits, as applicable, have been
 2864  purchased if when required under s. 627.733 or s. 627.7483, as
 2865  applicable, that property damage liability coverage has been
 2866  purchased as required under s. 324.022, that bodily injury or
 2867  death coverage has been purchased if required under s. 324.023,
 2868  and that combined bodily liability insurance and property damage
 2869  liability insurance have been purchased if when required under
 2870  s. 627.7415 shall be provided in the manner prescribed by law by
 2871  the applicant at the time of application for registration of any
 2872  motor vehicle that is subject to such requirements. The issuing
 2873  agent shall refuse to issue registration if such proof of
 2874  purchase is not provided. Insurers shall furnish uniform proof
 2875  of-purchase cards in a form prescribed by the department and
 2876  shall include the name of the insured’s insurance company, the
 2877  coverage identification number, and the make, year, and vehicle
 2878  identification number of the vehicle insured. The card must
 2879  shall contain a statement notifying the applicant of the penalty
 2880  specified in s. 316.646(4). The card or insurance policy,
 2881  insurance policy binder, or certificate of insurance or a
 2882  photocopy of any of these; an affidavit containing the name of
 2883  the insured’s insurance company, the insured’s policy number,
 2884  and the make and year of the vehicle insured; or such other
 2885  proof as may be prescribed by the department shall constitute
 2886  sufficient proof of purchase. If an affidavit is provided as
 2887  proof, it must shall be in substantially the following form:
 2888  
 2889         Under penalty of perjury, I ...(Name of insured)... do
 2890  hereby certify that I have ...(Personal Injury Protection or
 2891  Medical Care Coverage, as applicable, Property Damage Liability,
 2892  and, if when required, Bodily Injury Liability)... Insurance
 2893  currently in effect with ...(Name of insurance company)... under
 2894  ...(policy number)... covering ...(make, year, and vehicle
 2895  identification number of vehicle).... ...(Signature of
 2896  Insured)...
 2897  
 2898         The Such affidavit must shall include the following
 2899  warning:
 2900  
 2901         WARNING: GIVING FALSE INFORMATION IN ORDER TO OBTAIN A
 2902  VEHICLE REGISTRATION CERTIFICATE IS A CRIMINAL OFFENSE UNDER
 2903  FLORIDA LAW. ANYONE GIVING FALSE INFORMATION ON THIS AFFIDAVIT
 2904  IS SUBJECT TO PROSECUTION.
 2905  
 2906         If When an application is made through a licensed motor
 2907  vehicle dealer as required in s. 319.23, the original or a
 2908  photostatic copy of such card, insurance policy, insurance
 2909  policy binder, or certificate of insurance or the original
 2910  affidavit from the insured shall be forwarded by the dealer to
 2911  the tax collector of the county or the Department of Highway
 2912  Safety and Motor Vehicles for processing. By executing the
 2913  aforesaid affidavit, the no licensed motor vehicle dealer will
 2914  not be liable in damages for any inadequacy, insufficiency, or
 2915  falsification of any statement contained therein. A card must
 2916  shall also indicate the existence of any bodily injury liability
 2917  insurance voluntarily purchased.
 2918         (d) The verifying of proof of personal injury protection
 2919  insurance or medical care coverage insurance, as applicable,
 2920  proof of property damage liability insurance, proof of combined
 2921  bodily liability insurance and property damage liability
 2922  insurance, or proof of financial responsibility insurance and
 2923  the issuance or failure to issue the motor vehicle registration
 2924  under the provisions of this chapter may not be construed in any
 2925  court as a warranty of the reliability or accuracy of the
 2926  evidence of such proof. Neither the department nor any tax
 2927  collector is liable in damages for any inadequacy,
 2928  insufficiency, falsification, or unauthorized modification of
 2929  any item of the proof of personal injury protection insurance or
 2930  medical care coverage insurance, as applicable, proof of
 2931  property damage liability insurance, proof of combined bodily
 2932  liability insurance and property damage liability insurance, or
 2933  proof of financial responsibility insurance before prior to,
 2934  during, or subsequent to the verification of the proof. The
 2935  issuance of a motor vehicle registration does not constitute
 2936  prima facie evidence or a presumption of insurance coverage.
 2937         Section 27. Paragraph (b) of subsection (1) of section
 2938  320.0609, Florida Statutes, is amended to read:
 2939         320.0609 Transfer and exchange of registration license
 2940  plates; transfer fee.—
 2941         (1)
 2942         (b) The transfer of a license plate from a vehicle disposed
 2943  of to a newly acquired vehicle does not constitute a new
 2944  registration. The application for transfer shall be accepted
 2945  without requiring proof of personal injury protection insurance
 2946  or medical care coverage insurance, as applicable, or liability
 2947  insurance.
 2948         Section 28. Subsection (3) of section 320.27, Florida
 2949  Statutes, is amended to read:
 2950         320.27 Motor vehicle dealers.—
 2951         (3) APPLICATION AND FEE.—The application for the license
 2952  must shall be in such form as may be prescribed by the
 2953  department and shall be subject to such rules with respect
 2954  thereto as may be so prescribed by it. Such application must
 2955  shall be verified by oath or affirmation and shall contain a
 2956  full statement of the name and birth date of the applicant
 2957  person or persons applying therefor; the name of the firm or
 2958  copartnership, with the names and places of residence of all
 2959  members thereof, if such applicant is a firm or copartnership;
 2960  the names and places of residence of the principal officers, if
 2961  the applicant is a body corporate or other artificial body; the
 2962  name of the state under whose laws the corporation is organized;
 2963  the present and former place or places of residence of the
 2964  applicant; and prior business in which the applicant has been
 2965  engaged and the location thereof. The Such application must
 2966  shall describe the exact location of the place of business and
 2967  shall state whether the place of business is owned by the
 2968  applicant and if when acquired, or, if leased, a true copy of
 2969  the lease must shall be attached to the application. The
 2970  applicant shall certify that the location provides an adequately
 2971  equipped office and is not a residence; that the location
 2972  affords sufficient unoccupied space upon and within which to
 2973  adequately to store all motor vehicles offered and displayed for
 2974  sale; and that the location is a suitable place where the
 2975  applicant can in good faith carry on such business and keep and
 2976  maintain books, records, and files necessary to conduct such
 2977  business, which will be available at all reasonable hours for to
 2978  inspection by the department or any of its inspectors or other
 2979  employees. The applicant shall certify that the business of a
 2980  motor vehicle dealer is the principal business that will which
 2981  shall be conducted at that location. The Such application must
 2982  shall contain a statement that the applicant is either
 2983  franchised by a manufacturer of motor vehicles, in which case
 2984  the name of each motor vehicle that the applicant is franchised
 2985  to sell shall be included, or an independent, (nonfranchised,)
 2986  motor vehicle dealer. The Such application must shall contain
 2987  such other relevant information as may be required by the
 2988  department, including evidence that the applicant is insured
 2989  under a garage liability insurance policy or a general liability
 2990  insurance policy coupled with a business automobile policy,
 2991  which includes shall include, at a minimum, $25,000 combined
 2992  single-limit liability coverage including bodily injury and
 2993  property damage protection and $10,000 personal injury
 2994  protection or medical care coverage, as applicable. Franchise
 2995  dealers must submit a garage liability insurance policy, and all
 2996  other dealers must submit a garage liability insurance policy or
 2997  a general liability insurance policy coupled with a business
 2998  automobile policy. The Such policy shall be for the license
 2999  period, and evidence of a new or continued policy must shall be
 3000  delivered to the department at the beginning of each license
 3001  period. Upon making initial application, the applicant shall pay
 3002  to the department a fee of $300 in addition to any other fees
 3003  now required by law; upon making a subsequent renewal
 3004  application, the applicant shall pay to the department a fee of
 3005  $75 in addition to any other fees now required by law. Upon
 3006  making an application for a change of location, the person shall
 3007  pay a fee of $50 in addition to any other fees now required by
 3008  law. The department shall, in the case of every application for
 3009  initial licensure, verify whether certain facts set forth in the
 3010  application are true. Each applicant, general partner in the
 3011  case of a partnership, or corporate officer and director in the
 3012  case of a corporate applicant, must file a set of fingerprints
 3013  with the department for the purpose of determining any prior
 3014  criminal record or any outstanding warrants. The department
 3015  shall submit the fingerprints to the Department of Law
 3016  Enforcement for state processing and forwarding to the Federal
 3017  Bureau of Investigation for federal processing. The actual cost
 3018  of state and federal processing shall be borne by the applicant
 3019  and is in addition to the fee for licensure. The department may
 3020  issue a license to an applicant pending the results of the
 3021  fingerprint investigation, which license is fully revocable if
 3022  the department subsequently determines that any facts set forth
 3023  in the application are not true or correctly represented.
 3024         Section 29. Paragraph (j) of subsection (3) of section
 3025  320.771, Florida Statutes, is amended to read:
 3026         320.771 License required of recreational vehicle dealers.—
 3027         (3) APPLICATION.—The application for such license shall be
 3028  in the form prescribed by the department and subject to such
 3029  rules as may be prescribed by it. The application shall be
 3030  verified by oath or affirmation and shall contain:
 3031         (j) A statement that the applicant is insured under a
 3032  garage liability insurance policy, which shall include, at a
 3033  minimum, includes $25,000 combined single-limit liability
 3034  coverage, including bodily injury and property damage
 3035  protection, and $10,000 personal injury protection or medical
 3036  care coverage, as applicable, if the applicant is to be licensed
 3037  as a dealer in, or intends to sell, recreational vehicles.
 3038  
 3039  The department shall, if it deems necessary, cause an
 3040  investigation to be made to ascertain if the facts set forth in
 3041  the application are true and may shall not issue a license to
 3042  the applicant until it is satisfied that the facts set forth in
 3043  the application are true.
 3044         Section 30. Subsection (1) of section 322.251, Florida
 3045  Statutes, is amended to read:
 3046         322.251 Notice of cancellation, suspension, revocation, or
 3047  disqualification of license.—
 3048         (1) All orders of cancellation, suspension, revocation, or
 3049  disqualification issued under the provisions of this chapter,
 3050  chapter 318, chapter 324, or ss. 627.732-627.734, or ss.
 3051  627.748-627.7491 must be made shall be given either by personal
 3052  delivery thereof to the licensee whose license is being
 3053  canceled, suspended, revoked, or disqualified or by deposit in
 3054  the United States mail in an envelope, first class, postage
 3055  prepaid, addressed to the licensee at his or her last known
 3056  mailing address furnished to the department. Such mailing by the
 3057  department constitutes notification, and any failure by the
 3058  person to receive the mailed order does will not affect or stay
 3059  the effective date or term of the cancellation, suspension,
 3060  revocation, or disqualification of the licensee’s driving
 3061  privilege.
 3062         Section 31. Paragraph (a) of subsection (8) of section
 3063  322.34, Florida Statutes, is amended to read:
 3064         322.34 Driving while license suspended, revoked, canceled,
 3065  or disqualified.—
 3066         (8)(a) Upon the arrest of a person for the offense of
 3067  driving while the person’s driver driver’s license or driving
 3068  privilege is suspended or revoked, the arresting officer must
 3069  shall determine:
 3070         1. Whether the person’s driver driver’s license is
 3071  suspended or revoked.
 3072         2. Whether the person’s driver driver’s license has
 3073  remained suspended or revoked since a conviction for the offense
 3074  of driving with a suspended or revoked license.
 3075         3. Whether the suspension or revocation was made under s.
 3076  316.646, or s. 627.733, or s. 627.7483, relating to failure to
 3077  maintain required security, or under s. 322.264, relating to
 3078  habitual traffic offenders.
 3079         4. Whether the driver is the registered owner or coowner of
 3080  the vehicle.
 3081         Section 32. Subsection (1) and paragraph (c) of subsection
 3082  (9) of section 324.021, Florida Statutes, are amended to read:
 3083         324.021 Definitions; minimum insurance required.—The
 3084  following words and phrases when used in this chapter shall, for
 3085  the purpose of this chapter, have the meanings respectively
 3086  ascribed to them in this section, except in those instances
 3087  where the context clearly indicates a different meaning:
 3088         (1) MOTOR VEHICLE.—Every self-propelled vehicle that which
 3089  is designed and required to be licensed for use upon a highway,
 3090  including trailers and semitrailers designed for use with such
 3091  vehicles, except traction engines, road rollers, farm tractors,
 3092  power shovels, and well drillers, and every vehicle that which
 3093  is propelled by electric power obtained from overhead wires but
 3094  not operated upon rails, but not including any bicycle or moped.
 3095  However, the term “motor vehicle” does shall not include a any
 3096  motor vehicle as defined in s. 627.732(3) or s. 627.7482, as
 3097  applicable, if when the owner of such vehicle has complied with
 3098  the requirements of ss. 627.730-627.7405 or ss. 627.748
 3099  627.7491, as applicable, inclusive, unless the provisions of s.
 3100  324.051 applies apply; and, in such case, the applicable proof
 3101  of insurance provisions of s. 320.02 apply.
 3102         (9) OWNER; OWNER/LESSOR.—
 3103         (c) Application.—
 3104         1. The limits on liability in subparagraphs (b)2. and 3. do
 3105  not apply to an owner of motor vehicles that are used for
 3106  commercial activity in the owner’s ordinary course of business,
 3107  other than a rental company that rents or leases motor vehicles.
 3108  For purposes of this paragraph, the term “rental company”
 3109  includes only an entity that is engaged in the business of
 3110  renting or leasing motor vehicles to the general public and that
 3111  rents or leases a majority of its motor vehicles to persons who
 3112  have with no direct or indirect affiliation with the rental
 3113  company. The term also includes a motor vehicle dealer that
 3114  provides temporary replacement vehicles to its customers for up
 3115  to 10 days. The term “rental company” also includes:
 3116         a. A related rental or leasing company that is a subsidiary
 3117  of the same parent company as that of the renting or leasing
 3118  company that rented or leased the vehicle.
 3119         b. The holder of a motor vehicle title or an equity
 3120  interest in a motor vehicle title if the title or equity
 3121  interest is held pursuant to or to facilitate an asset-backed
 3122  securitization of a fleet of motor vehicles used solely in the
 3123  business of renting or leasing motor vehicles to the general
 3124  public and under the dominion and control of a rental company,
 3125  as described in this subparagraph, in the operation of such
 3126  rental company’s business.
 3127         2. Furthermore, With respect to commercial motor vehicles
 3128  as defined in s. 627.732 or s. 627.7482, as applicable, the
 3129  limits on liability in subparagraphs (b)2. and 3. do not apply
 3130  if, at the time of the incident, the commercial motor vehicle is
 3131  being used in the transportation of materials found to be
 3132  hazardous for the purposes of the Hazardous Materials
 3133  Transportation Authorization Act of 1994, as amended, 49 U.S.C.
 3134  ss. 5101 et seq., and that is required pursuant to such act to
 3135  carry placards warning others of the hazardous cargo, unless at
 3136  the time of lease or rental either:
 3137         a. The lessee indicates in writing that the vehicle will
 3138  not be used to transport materials found to be hazardous for the
 3139  purposes of the Hazardous Materials Transportation Authorization
 3140  Act of 1994, as amended, 49 U.S.C. ss. 5101 et seq.; or
 3141         b. The lessee or other operator of the commercial motor
 3142  vehicle has in effect insurance with limits of at least
 3143  $5,000,000 combined property damage and bodily injury liability.
 3144         Section 33. Section 324.0221, Florida Statutes, is amended
 3145  to read:
 3146         324.0221 Reports by insurers to the department; suspension
 3147  of driver driver’s license and vehicle registrations;
 3148  reinstatement.—
 3149         (1)(a) Each insurer that has issued a policy providing
 3150  personal injury protection or medical care coverage or property
 3151  damage liability coverage shall report the renewal,
 3152  cancellation, or nonrenewal of the policy thereof to the
 3153  department within 45 days after the effective date of each
 3154  renewal, cancellation, or nonrenewal. Upon the issuance of a
 3155  policy providing personal injury protection or medical care
 3156  coverage or property damage liability coverage to a named
 3157  insured not previously insured by the insurer during that
 3158  calendar year, the insurer shall report the issuance of the new
 3159  policy to the department within 30 days. The report shall be in
 3160  the form and format and contain any information required by the
 3161  department and must be provided in a format that is compatible
 3162  with the data processing capabilities of the department. The
 3163  department may adopt rules regarding the form and documentation
 3164  required. Failure by an insurer to file proper reports with the
 3165  department as required by this subsection or rules adopted with
 3166  respect to the requirements of this subsection constitutes a
 3167  violation of the Florida Insurance Code. These records shall be
 3168  used by the department only for enforcement and regulatory
 3169  purposes, including the generation by the department of data
 3170  regarding compliance by owners of motor vehicles with the
 3171  requirements for financial responsibility coverage.
 3172         (b) With respect to an insurance policy providing personal
 3173  injury protection or medical care coverage or property damage
 3174  liability coverage, each insurer shall notify the named insured,
 3175  or the first-named insured in the case of a commercial fleet
 3176  policy, in writing that any cancellation or nonrenewal of the
 3177  policy will be reported by the insurer to the department. The
 3178  notice must also inform the named insured that failure to
 3179  maintain personal injury protection or medical care coverage and
 3180  property damage liability coverage on a motor vehicle as when
 3181  required by law may result in the loss of registration and
 3182  driving privileges in this state and inform the named insured of
 3183  the amount of the reinstatement fees required by this section.
 3184  This notice is for informational purposes only, and an insurer
 3185  is not civilly liable for failing to provide this notice.
 3186         (2) The department shall suspend, after due notice and an
 3187  opportunity to be heard, the registration and driver driver’s
 3188  license of any owner or registrant of a motor vehicle with
 3189  respect to which security is required under s. ss. 324.022 and
 3190  either s. 627.733 or s. 627.7483, as applicable, upon:
 3191         (a) The department’s records showing that the owner or
 3192  registrant of such motor vehicle did not have in full force and
 3193  effect when required security that complies with the
 3194  requirements of s. ss. 324.022 and either s. 627.733 or s.
 3195  627.7483, as applicable; or
 3196         (b) Notification by the insurer to the department, in a
 3197  form approved by the department, of cancellation or termination
 3198  of the required security.
 3199         (3) An operator or owner whose driver driver’s license or
 3200  registration has been suspended under this section or s. 316.646
 3201  may effect its reinstatement upon compliance with the
 3202  requirements of this section and upon payment to the department
 3203  of a nonrefundable reinstatement fee of $150 for the first
 3204  reinstatement. The reinstatement fee is $250 for the second
 3205  reinstatement and $500 for each subsequent reinstatement during
 3206  the 3 years following the first reinstatement. A person
 3207  reinstating her or his insurance under this subsection must also
 3208  secure noncancelable coverage as described in ss. 324.021(8),
 3209  324.023, and 627.7275(2) and present proof to the appropriate
 3210  person proof that the coverage is in force on a form adopted by
 3211  the department, and such proof shall be maintained for 2 years.
 3212  If the person does not have a second reinstatement within 3
 3213  years after her or his initial reinstatement, the reinstatement
 3214  fee is $150 for the first reinstatement after that 3-year
 3215  period. If a person’s license and registration are suspended
 3216  under this section or s. 316.646, only one reinstatement fee
 3217  must be paid to reinstate the license and the registration. All
 3218  fees shall be collected by the department at the time of
 3219  reinstatement. The department shall issue proper receipts for
 3220  such fees and shall promptly deposit those fees in the Highway
 3221  Safety Operating Trust Fund. One-third of the fees collected
 3222  under this subsection shall be distributed from the Highway
 3223  Safety Operating Trust Fund to the local governmental entity or
 3224  state agency that employed the law enforcement officer seizing
 3225  the license plate pursuant to s. 324.201. The funds may be used
 3226  by the local governmental entity or state agency for any
 3227  authorized purpose.
 3228         Section 34. Paragraph (a) of subsection (1) of section
 3229  324.032, Florida Statutes, is amended to read:
 3230         324.032 Manner of proving financial responsibility; for
 3231  hire passenger transportation vehicles.—Notwithstanding the
 3232  provisions of s. 324.031:
 3233         (1)(a) A person who is either the owner or a lessee
 3234  required to maintain insurance under s. 627.733(1)(b) or s.
 3235  627.7483(1), as applicable, and who operates one or more
 3236  taxicabs, limousines, jitneys, or any other for-hire passenger
 3237  transportation vehicles may prove financial responsibility by
 3238  furnishing satisfactory evidence of holding a motor vehicle
 3239  liability policy that has, but with minimum limits of
 3240  $125,000/250,000/50,000.
 3241  
 3242  Upon request by the department, the applicant must provide the
 3243  department at the applicant’s principal place of business in
 3244  this state access to the applicant’s underlying financial
 3245  information and financial statements that provide the basis of
 3246  the certified public accountant’s certification. The applicant
 3247  shall reimburse the requesting department for all reasonable
 3248  costs incurred by it in reviewing the supporting information.
 3249  The maximum amount of self-insurance permissible under this
 3250  subsection is $300,000 and must be stated on a per-occurrence
 3251  basis, and the applicant shall maintain adequate excess
 3252  insurance issued by an authorized or eligible insurer licensed
 3253  or approved by the Office of Insurance Regulation. All risks
 3254  self-insured shall remain with the owner or lessee providing it,
 3255  and the risks are not transferable to any other person, unless a
 3256  policy complying with subsection (1) is obtained.
 3257         Section 35. Subsection (2) of section 324.171, Florida
 3258  Statutes, is amended to read:
 3259         324.171 Self-insurer.—
 3260         (2) The self-insurance certificate must shall provide
 3261  limits of liability insurance in the amounts specified under s.
 3262  324.021(7) or s. 627.7415 and shall provide personal injury
 3263  protection or medical care coverage under s. 627.733(3)(b) or s.
 3264  627.7483(3)(b), as applicable.
 3265         Section 36. Paragraph (g) of subsection (1) of section
 3266  400.9935, Florida Statutes, is amended to read:
 3267         400.9935 Clinic responsibilities.—
 3268         (1) Each clinic shall appoint a medical director or clinic
 3269  director who shall agree in writing to accept legal
 3270  responsibility for the following activities on behalf of the
 3271  clinic. The medical director or the clinic director shall:
 3272         (g) Conduct systematic reviews of clinic billings to ensure
 3273  that the billings are not fraudulent or unlawful. Upon discovery
 3274  of an unlawful charge, the medical director or clinic director
 3275  must shall take immediate corrective action. If the clinic
 3276  performs only the technical component of magnetic resonance
 3277  imaging, static radiographs, computed tomography, or positron
 3278  emission tomography, and provides the professional
 3279  interpretation of such services, in a fixed facility that is
 3280  accredited by the Joint Commission on Accreditation of
 3281  Healthcare Organizations or the Accreditation Association for
 3282  Ambulatory Health Care, and the American College of Radiology;
 3283  and if, in the preceding quarter, the percentage of scans
 3284  performed by that clinic which was billed to all personal injury
 3285  protection insurance or medical care coverage insurance carriers
 3286  was less than 15 percent, the chief financial officer of the
 3287  clinic may, in a written acknowledgment provided to the agency,
 3288  assume the responsibility for the conduct of the systematic
 3289  reviews of clinic billings to ensure that the billings are not
 3290  fraudulent or unlawful.
 3291         Section 37. Subsection (28) of section 409.901, Florida
 3292  Statutes, is amended to read:
 3293         409.901 Definitions; ss. 409.901-409.920.—As used in ss.
 3294  409.901-409.920, except as otherwise specifically provided, the
 3295  term:
 3296         (28) “Third-party benefit” means any benefit that is or may
 3297  be available at any time through contract, court award,
 3298  judgment, settlement, agreement, or any arrangement between a
 3299  third party and any person or entity, including, without
 3300  limitation, a Medicaid recipient, a provider, another third
 3301  party, an insurer, or the agency, for any Medicaid-covered
 3302  injury, illness, goods, or services, including costs of related
 3303  medical services related thereto, for personal injury or for
 3304  death of the recipient, but specifically excluding policies of
 3305  life insurance on the recipient, unless available under terms of
 3306  the policy to pay medical expenses before prior to death. The
 3307  term includes, without limitation, collateral, as defined in
 3308  this section, health insurance, any benefit under a health
 3309  maintenance organization, a preferred provider arrangement, a
 3310  prepaid health clinic, liability insurance, uninsured motorist
 3311  insurance or personal injury protection or medical care
 3312  coverage, medical benefits under workers’ compensation, and any
 3313  obligation under law or equity to provide medical support.
 3314         Section 38. Paragraph (f) of subsection (11) of section
 3315  409.910, Florida Statutes, is amended to read:
 3316         409.910 Responsibility for payments on behalf of Medicaid
 3317  eligible persons when other parties are liable.—
 3318         (11) The agency may, as a matter of right, in order to
 3319  enforce its rights under this section, institute, intervene in,
 3320  or join any legal or administrative proceeding in its own name
 3321  in one or more of the following capacities: individually, as
 3322  subrogee of the recipient, as assignee of the recipient, or as
 3323  lienholder of the collateral.
 3324         (f) Notwithstanding any other provision in this section to
 3325  the contrary, in the event of an action in tort against a third
 3326  party in which the recipient or his or her legal representative
 3327  is a party which results in a judgment, award, or settlement
 3328  from a third party, the amount recovered shall be distributed as
 3329  follows:
 3330         1. After attorney attorney’s fees and taxable costs as
 3331  defined by the Florida Rules of Civil Procedure, one-half of the
 3332  remaining recovery shall be paid to the agency up to the total
 3333  amount of medical assistance provided by Medicaid.
 3334         2. The remaining amount of the recovery shall be paid to
 3335  the recipient.
 3336         3. For purposes of calculating the agency’s recovery of
 3337  medical assistance benefits paid, the fee for services of an
 3338  attorney retained by the recipient or his or her legal
 3339  representative shall be calculated at 25 percent of the
 3340  judgment, award, or settlement.
 3341         4. Notwithstanding any other provision of this section to
 3342  the contrary, the agency is shall be entitled to all medical
 3343  coverage benefits up to the total amount of medical assistance
 3344  provided by Medicaid. For purposes of this paragraph, “medical
 3345  coverage” means any benefits under health insurance, a health
 3346  maintenance organization, a preferred provider arrangement, or a
 3347  prepaid health clinic, and the portion of benefits designated
 3348  for medical payments under coverage for workers’ compensation,
 3349  medical care coverage, personal injury protection, and casualty.
 3350         Section 39. Paragraph (k) of subsection (2) of section
 3351  456.057, Florida Statutes, is amended to read:
 3352         456.057 Ownership and control of patient records; report or
 3353  copies of records to be furnished.—
 3354         (2) As used in this section, the terms “records owner,”
 3355  “health care practitioner,” and “health care practitioner’s
 3356  employer” do not include any of the following persons or
 3357  entities; furthermore, the following persons or entities may are
 3358  not authorized to acquire or own medical records, but, are
 3359  authorized under the confidentiality and disclosure requirements
 3360  of this section, may to maintain those documents that are
 3361  required by the part or chapter under which they are licensed or
 3362  regulated:
 3363         (k) Persons or entities practicing under s. 627.736(7) or
 3364  s. 627.7485(7), as applicable.
 3365         Section 40. Paragraphs (ee) and (ff) of subsection (1) of
 3366  section 456.072, Florida Statutes, are amended to read:
 3367         456.072 Grounds for discipline; penalties; enforcement.—
 3368         (1) The following acts shall constitute grounds for which
 3369  the disciplinary actions specified in subsection (2) may be
 3370  taken:
 3371         (ee) With respect to making a personal injury protection or
 3372  an medical care coverage claim as required by s. 627.736 or s.
 3373  627.7485, respectively, intentionally submitting a claim,
 3374  statement, or bill that has been “upcoded” as defined in s.
 3375  627.732 or s. 627.7482, as applicable.
 3376         (ff) With respect to making a personal injury protection or
 3377  an medical care coverage claim as required by s. 627.736 or s.
 3378  627.7485, respectively, intentionally submitting a claim,
 3379  statement, or bill for payment of services that were not
 3380  rendered.
 3381         Section 41. Paragraph (o) of subsection (1) of section
 3382  626.9541, Florida Statutes, is amended to read:
 3383         626.9541 Unfair methods of competition and unfair or
 3384  deceptive acts or practices defined.—
 3385         (1) UNFAIR METHODS OF COMPETITION AND UNFAIR OR DECEPTIVE
 3386  ACTS.—The following are defined as unfair methods of competition
 3387  and unfair or deceptive acts or practices:
 3388         (o) Illegal dealings in premiums; excess or reduced charges
 3389  for insurance.—
 3390         1. Knowingly collecting any sum as a premium or charge for
 3391  insurance, which is not then provided, or is not in due course
 3392  to be provided, subject to acceptance of the risk by the
 3393  insurer, by an insurance policy issued by an insurer as
 3394  permitted by this code.
 3395         2. Knowingly collecting as a premium or charge for
 3396  insurance any sum in excess of or less than the premium or
 3397  charge applicable to such insurance, in accordance with the
 3398  applicable classifications and rates as filed with and approved
 3399  by the office, and as specified in the policy; or, if in cases
 3400  when classifications, premiums, or rates are not required by
 3401  this code to be so filed and approved, premiums and charges
 3402  collected from a Florida resident in excess of or less than
 3403  those specified in the policy and as fixed by the insurer. This
 3404  provision may shall not be deemed to prohibit the charging and
 3405  collection, by surplus lines agents licensed under part VIII of
 3406  this chapter, of the amount of applicable state and federal
 3407  taxes, or fees as authorized by s. 626.916(4), in addition to
 3408  the premium required by the insurer or the charging and
 3409  collection, by licensed agents, of the exact amount of any
 3410  discount or other such fee charged by a credit card facility in
 3411  connection with the use of a credit card, as authorized by
 3412  subparagraph (q)3., in addition to the premium required by the
 3413  insurer. This subparagraph does shall not be construed to
 3414  prohibit collection of a premium for a universal life or a
 3415  variable or indeterminate value insurance policy made in
 3416  accordance with the terms of the contract.
 3417         3.a. Imposing or requesting an additional premium for a
 3418  policy of motor vehicle liability, medical care coverage,
 3419  personal injury protection, medical payment, or collision
 3420  insurance or any combination thereof or refusing to renew the
 3421  policy solely because the insured was involved in a motor
 3422  vehicle accident unless the insurer’s file contains information
 3423  from which the insurer in good faith determines that the insured
 3424  was substantially at fault in the accident.
 3425         a.b. An insurer which imposes and collects such a surcharge
 3426  or which refuses to renew such policy shall, in conjunction with
 3427  the notice of premium due or notice of nonrenewal, notify the
 3428  named insured that he or she is entitled to reimbursement of
 3429  such amount or renewal of the policy under the conditions listed
 3430  below and will subsequently reimburse him or her or renew the
 3431  policy, if the named insured demonstrates that the operator
 3432  involved in the accident was:
 3433         (I) Lawfully parked;
 3434         (II) Reimbursed by, or on behalf of, a person responsible
 3435  for the accident or has a judgment against such person;
 3436         (III) Struck in the rear by another vehicle headed in the
 3437  same direction and was not convicted of a moving traffic
 3438  violation in connection with the accident;
 3439         (IV) Hit by a “hit-and-run” driver, if the accident was
 3440  reported to the proper authorities within 24 hours after
 3441  discovering the accident;
 3442         (V) Not convicted of a moving traffic violation in
 3443  connection with the accident, but the operator of the other
 3444  automobile involved in such accident was convicted of a moving
 3445  traffic violation;
 3446         (VI) Finally adjudicated not to be liable by a court of
 3447  competent jurisdiction;
 3448         (VII) In receipt of a traffic citation that which was
 3449  dismissed or nolle prossed; or
 3450         (VIII) Not at fault as evidenced by a written statement
 3451  from the insured establishing facts demonstrating lack of fault
 3452  which are not rebutted by information in the insurer’s file from
 3453  which the insurer in good faith determines that the insured was
 3454  substantially at fault.
 3455         b.c. In addition to the other provisions of this
 3456  subparagraph, an insurer may not fail to renew a policy if the
 3457  insured has had only one accident in which he or she was at
 3458  fault within the current 3-year period. However, an insurer may
 3459  nonrenew a policy for reasons other than accidents in accordance
 3460  with s. 627.728. This subparagraph does not prohibit nonrenewal
 3461  of a policy under which the insured has had three or more
 3462  accidents, regardless of fault, during the most recent 3-year
 3463  period.
 3464         4. Imposing or requesting an additional premium for, or
 3465  refusing to renew, a policy for motor vehicle insurance solely
 3466  because the insured committed a noncriminal traffic infraction
 3467  as described in s. 318.14 unless the infraction is:
 3468         a. A second infraction committed within an 18-month period,
 3469  or a third or subsequent infraction committed within a 36-month
 3470  period.
 3471         b. A violation of s. 316.183, if when such violation is a
 3472  result of exceeding the lawful speed limit by more than 15 miles
 3473  per hour.
 3474         5. Upon the request of the insured, the insurer and
 3475  licensed agent shall supply to the insured the complete proof of
 3476  fault or other criteria which justifies the additional charge or
 3477  cancellation.
 3478         6. Imposing or requesting No insurer shall impose or
 3479  request an additional premium for motor vehicle insurance,
 3480  cancelling or refusing cancel or refuse to issue a policy, or
 3481  refusing refuse to renew a policy because the insured or the
 3482  applicant is a handicapped or physically disabled person if, so
 3483  long as such handicap or physical disability does not
 3484  substantially impair such person’s mechanically assisted driving
 3485  ability.
 3486         7. Cancelling No insurer may cancel or otherwise
 3487  terminating an terminate any insurance contract or coverage, or
 3488  requiring require execution of a consent to rate endorsement,
 3489  during the stated policy term for the purpose of offering to
 3490  issue, or issuing, a similar or identical contract or coverage
 3491  to the same insured with the same exposure at a higher premium
 3492  rate or continuing an existing contract or coverage with the
 3493  same exposure at an increased premium.
 3494         8. Issuing No insurer may issue a nonrenewal notice on any
 3495  insurance contract or coverage, or requiring require execution
 3496  of a consent to rate endorsement, for the purpose of offering to
 3497  issue, or issuing, a similar or identical contract or coverage
 3498  to the same insured at a higher premium rate or continuing an
 3499  existing contract or coverage at an increased premium without
 3500  meeting any applicable notice requirements.
 3501         9. No insurer shall, With respect to premiums charged for
 3502  motor vehicle insurance, unfairly discriminating discriminate
 3503  solely on the basis of age, sex, marital status, or scholastic
 3504  achievement.
 3505         10. Imposing or requesting an additional premium for motor
 3506  vehicle comprehensive or uninsured motorist coverage solely
 3507  because the insured was involved in a motor vehicle accident or
 3508  was convicted of a moving traffic violation.
 3509         11. Cancelling or issuing No insurer shall cancel or issue
 3510  a nonrenewal notice on any insurance policy or contract without
 3511  complying with any applicable cancellation or nonrenewal
 3512  provision required under the Florida Insurance Code.
 3513         12. Imposing or requesting No insurer shall impose or
 3514  request an additional premium, cancelling cancel a policy, or
 3515  issuing issue a nonrenewal notice on any insurance policy or
 3516  contract because of any traffic infraction when adjudication has
 3517  been withheld and no points have been assessed pursuant to s.
 3518  318.14(9) and (10). However, this subparagraph does not apply to
 3519  traffic infractions involving accidents in which the insurer has
 3520  incurred a loss due to the fault of the insured.
 3521         Section 42. Subsection (5) of section 626.9894, Florida
 3522  Statutes, is amended to read:
 3523         626.9894 Gifts and grants.—
 3524         (5) Notwithstanding the provisions of s. 216.301 and
 3525  pursuant to s. 216.351, any balance of moneys deposited into the
 3526  Insurance Regulatory Trust Fund pursuant to this section or s.
 3527  626.9895 remaining at the end of any fiscal year is shall be
 3528  available for carrying out the duties and responsibilities of
 3529  the division. The department may request annual appropriations
 3530  from the grants and donations received pursuant to this section
 3531  or s. 626.9895 and cash balances in the Insurance Regulatory
 3532  Trust Fund for the purpose of carrying out its duties and
 3533  responsibilities related to the division’s anti-fraud efforts,
 3534  including the funding of dedicated prosecutors and related
 3535  personnel.
 3536         Section 43. Subsection (1) of section 627.06501, Florida
 3537  Statutes, is amended to read:
 3538         627.06501 Insurance discounts for certain persons
 3539  completing driver improvement course.—
 3540         (1) Any rate, rating schedule, or rating manual for the
 3541  liability, medical care coverage, personal injury protection,
 3542  and collision coverages of a motor vehicle insurance policy
 3543  filed with the office may provide for an appropriate reduction
 3544  in premium charges as to such coverages if when the principal
 3545  operator on the covered vehicle has successfully completed a
 3546  driver improvement course approved and certified by the
 3547  Department of Highway Safety and Motor Vehicles which is
 3548  effective in reducing crash or violation rates, or both, as
 3549  determined pursuant to s. 318.1451(5). Any discount, not to
 3550  exceed 10 percent, used by an insurer is presumed to be
 3551  appropriate unless credible data demonstrates otherwise.
 3552         Section 44. Subsection (1) of section 627.0652, Florida
 3553  Statutes, is amended to read:
 3554         627.0652 Insurance discounts for certain persons completing
 3555  safety course.—
 3556         (1) Any rates, rating schedules, or rating manuals for the
 3557  liability, medical care coverage, personal injury protection,
 3558  and collision coverages of a motor vehicle insurance policy
 3559  filed with the office must shall provide for an appropriate
 3560  reduction in premium charges as to such coverages if when the
 3561  principal operator on the covered vehicle is an insured 55 years
 3562  of age or older who has successfully completed a motor vehicle
 3563  accident prevention course approved by the Department of Highway
 3564  Safety and Motor Vehicles. Any discount used by an insurer is
 3565  presumed to be appropriate unless credible data demonstrates
 3566  otherwise.
 3567         Section 45. Subsections (1) and (3) of section 627.0653,
 3568  Florida Statutes, are amended to read:
 3569         627.0653 Insurance discounts for specified motor vehicle
 3570  equipment.—
 3571         (1) Any rates, rating schedules, or rating manuals for the
 3572  liability, medical care coverage, personal injury protection,
 3573  and collision coverages of a motor vehicle insurance policy
 3574  filed with the office must shall provide a premium discount if
 3575  the insured vehicle is equipped with factory-installed, four
 3576  wheel antilock brakes.
 3577         (3) Any rates, rating schedules, or rating manuals for
 3578  medical care coverage, personal injury protection coverage, and
 3579  medical payments coverage, if offered, of a motor vehicle
 3580  insurance policy filed with the office shall provide a premium
 3581  discount if the insured vehicle is equipped with one or more air
 3582  bags that which are factory installed.
 3583         Section 46. Section 627.4132, Florida Statutes, is amended
 3584  to read:
 3585         627.4132 Stacking of coverages prohibited.—If an insured or
 3586  named insured is protected by any type of motor vehicle
 3587  insurance policy for liability, medical care coverage, personal
 3588  injury protection, or other coverage, the policy must shall
 3589  provide that the insured or named insured is protected only to
 3590  the extent of the coverage she or he has on the vehicle involved
 3591  in the accident. However, if none of the insured’s or named
 3592  insured’s vehicles is involved in the accident, coverage is
 3593  available only to the extent of coverage on any one of the
 3594  vehicles with applicable coverage. Coverage on any other
 3595  vehicles may shall not be added to or stacked upon that
 3596  coverage. This section does not apply:
 3597         (1) To uninsured motorist coverage that which is separately
 3598  governed by s. 627.727.
 3599         (2) To reduce the coverage available by reason of insurance
 3600  policies insuring different named insureds.
 3601         Section 47. Subsection (6) of section 627.6482, Florida
 3602  Statutes, is amended to read:
 3603         627.6482 Definitions.—As used in ss. 627.648-627.6498, the
 3604  term:
 3605         (6) “Health insurance” means any hospital and medical
 3606  expense incurred policy, minimum premium plan, stop-loss
 3607  coverage, health maintenance organization contract, prepaid
 3608  health clinic contract, multiple-employer welfare arrangement
 3609  contract, or fraternal benefit society health benefits contract,
 3610  whether sold as an individual or group policy or contract. The
 3611  term does not include a any policy covering medical payment
 3612  coverage or medical care coverage or personal injury protection
 3613  coverage in a motor vehicle policy, coverage issued as a
 3614  supplement to liability insurance, or workers’ compensation.
 3615         Section 48. Section 627.7263, Florida Statutes, is amended
 3616  to read:
 3617         627.7263 Rental and leasing driver driver’s insurance to be
 3618  primary; exception.—
 3619         (1) The valid and collectible liability insurance, medical
 3620  care coverage insurance, or personal injury protection insurance
 3621  providing coverage for the lessor of a motor vehicle for rent or
 3622  lease is primary unless otherwise stated in at least 10-point
 3623  type on the face of the rental or lease agreement. Such
 3624  insurance is primary for the limits of liability and personal
 3625  injury protection or medical care coverage as required by s. ss.
 3626  324.021(7) and either s. 627.736 or s. 627.7485, as applicable.
 3627         (2) If the lessee’s coverage is to be primary, the rental
 3628  or lease agreement must contain the following language, in at
 3629  least 10-point type:
 3630  
 3631         “The valid and collectible liability insurance and
 3632         personal injury protection insurance or medical care
 3633         coverage insurance, as applicable, of an any
 3634         authorized rental or leasing driver is primary for the
 3635         limits of liability and personal injury protection or
 3636         medical care coverage required by s. ss. 324.021(7)
 3637         and either s. 627.736 or s. 627.7485, Florida
 3638         Statutes, as applicable.”
 3639  
 3640         Section 49. Subsections (1) and (7) of section 627.727,
 3641  Florida Statutes, are amended to read:
 3642         627.727 Motor vehicle insurance; uninsured and underinsured
 3643  vehicle coverage; insolvent insurer protection.—
 3644         (1) A No motor vehicle liability insurance policy which
 3645  provides bodily injury liability coverage may not shall be
 3646  delivered or issued for delivery in this state with respect to
 3647  any specifically insured or identified motor vehicle registered
 3648  or principally garaged in this state unless uninsured motor
 3649  vehicle coverage is provided therein or supplemental thereto for
 3650  the protection of persons insured thereunder who are legally
 3651  entitled to recover damages from owners or operators of
 3652  uninsured motor vehicles because of bodily injury, sickness, or
 3653  disease, including death, resulting therefrom. However, the
 3654  coverage required under this section is not applicable if when,
 3655  or to the extent that, an insured named in the policy makes a
 3656  written rejection of the coverage on behalf of all insureds
 3657  under the policy. If When a motor vehicle is leased for a period
 3658  of 1 year or longer and the lessor of such vehicle, by the terms
 3659  of the lease contract, provides liability coverage on the leased
 3660  vehicle, the lessee of such vehicle shall have the sole
 3661  privilege to reject uninsured motorist coverage or to select
 3662  lower limits than the bodily injury liability limits, regardless
 3663  of whether the lessor is qualified as a self-insurer pursuant to
 3664  s. 324.171. Unless an insured, or lessee having the privilege of
 3665  rejecting uninsured motorist coverage, requests such coverage or
 3666  requests higher uninsured motorist limits in writing, the
 3667  coverage or such higher uninsured motorist limits need not be
 3668  provided in or supplemental to any other policy that which
 3669  renews, extends, changes, supersedes, or replaces an existing
 3670  policy with the same bodily injury liability limits if when an
 3671  insured or lessee had rejected the coverage. If When an insured
 3672  or lessee has initially selected limits of uninsured motorist
 3673  coverage lower than her or his bodily injury liability limits,
 3674  higher limits of uninsured motorist coverage need not be
 3675  provided in or supplemental to any other policy that which
 3676  renews, extends, changes, supersedes, or replaces an existing
 3677  policy with the same bodily injury liability limits unless an
 3678  insured requests higher uninsured motorist coverage in writing.
 3679  The rejection or selection of lower limits shall be made on a
 3680  form approved by the office. The form must shall fully advise
 3681  the applicant of the nature of the coverage and shall state that
 3682  the coverage is equal to bodily injury liability limits unless
 3683  lower limits are requested or the coverage is rejected. The
 3684  heading of the form must shall be in 12-point bold type and
 3685  shall state: “You are electing not to purchase certain valuable
 3686  coverage that which protects you and your family or you are
 3687  purchasing uninsured motorist limits less than your bodily
 3688  injury liability limits when you sign this form. Please read
 3689  carefully.” If this form is signed by a named insured, it will
 3690  be conclusively presumed that there was an informed, knowing
 3691  rejection of coverage or election of lower limits on behalf of
 3692  all insureds. The insurer shall notify the named insured at
 3693  least annually of her or his options as to the coverage required
 3694  by this section. Such notice must shall be part of, and attached
 3695  to, the notice of premium, shall provide for a means to allow
 3696  the insured to request such coverage, and shall be given in a
 3697  manner approved by the office. Receipt of this notice does not
 3698  constitute an affirmative waiver of the insured’s right to
 3699  uninsured motorist coverage if where the insured has not signed
 3700  a selection or rejection form. The coverage described under this
 3701  section shall be over and above, but may shall not duplicate,
 3702  the benefits available to an insured under any workers’
 3703  compensation law, medical care coverage or personal injury
 3704  protection benefits, disability benefits law, or similar law;
 3705  under any automobile medical expense coverage; under any motor
 3706  vehicle liability insurance coverage; or from the owner or
 3707  operator of the uninsured motor vehicle or any other person or
 3708  organization jointly or severally liable together with such
 3709  owner or operator for the accident; and such coverage must shall
 3710  cover the difference, if any, between the sum of such benefits
 3711  and the damages sustained, up to the maximum amount of such
 3712  coverage provided under this section. The amount of coverage
 3713  available under this section may shall not be reduced by a
 3714  setoff against any coverage, including liability insurance. Such
 3715  coverage may shall not inure directly or indirectly to the
 3716  benefit of any workers’ compensation or disability benefits
 3717  carrier or any person or organization qualifying as a self
 3718  insurer under any workers’ compensation or disability benefits
 3719  law or similar law.
 3720         (7) The legal liability of an uninsured motorist coverage
 3721  insurer does not include damages in tort for pain, suffering,
 3722  mental anguish, and inconvenience unless the injury or disease
 3723  is described in one or more of paragraphs (a)-(d) of s.
 3724  627.737(2) or paragraphs (a)-(d) of s. 627.7486(2).
 3725         Section 50. Subsection (1) of section 627.7275, Florida
 3726  Statutes, is amended to read:
 3727         627.7275 Motor vehicle liability.—
 3728         (1) A motor vehicle insurance policy providing personal
 3729  injury protection as set forth in s. 627.736 or medical care
 3730  coverage as set forth in s. 627.7485 may not be delivered or
 3731  issued for delivery in this state with respect to any
 3732  specifically insured or identified motor vehicle registered or
 3733  principally garaged in this state unless the policy also
 3734  provides coverage for property damage liability as required by
 3735  s. 324.022.
 3736         Section 51. Paragraph (a) of subsection (1) of section
 3737  627.728, Florida Statutes, is amended to read:
 3738         627.728 Cancellations; nonrenewals.—
 3739         (1) As used in this section, the term:
 3740         (a) “Policy” means the bodily injury and property damage
 3741  liability, medical care coverage or personal injury protection,
 3742  medical payments, comprehensive, collision, and uninsured
 3743  motorist coverage portions of a policy of motor vehicle
 3744  insurance delivered or issued for delivery in this state:
 3745         1. Insuring a natural person as named insured or one or
 3746  more related individuals resident of the same household; and
 3747         2. Insuring only a motor vehicle of the private passenger
 3748  type or station wagon type which is not used as a public or
 3749  livery conveyance for passengers or rented to others; or
 3750  insuring any other four-wheel motor vehicle having a load
 3751  capacity of 1,500 pounds or less which is not used in the
 3752  occupation, profession, or business of the insured other than
 3753  farming; other than any policy issued under an automobile
 3754  insurance assigned risk plan; insuring more than four
 3755  automobiles; or covering garage, automobile sales agency, repair
 3756  shop, service station, or public parking place operation
 3757  hazards.
 3758  
 3759  The term “policy” does not include a binder as defined in s.
 3760  627.420 unless the duration of the binder period exceeds 60
 3761  days.
 3762         Section 52. Subsection (1), paragraph (a) of subsection
 3763  (5), and subsections (6) and (7) of section 627.7295, Florida
 3764  Statutes, are amended to read:
 3765         627.7295 Motor vehicle insurance contracts.—
 3766         (1) As used in this section, the term:
 3767         (a) “Policy” means a motor vehicle insurance policy that
 3768  provides personal injury protection or medical care coverage, or
 3769  property damage liability coverage, or both.
 3770         (b) “Binder” means a binder that provides motor vehicle
 3771  personal injury protection or medical care coverage and property
 3772  damage liability coverage.
 3773         (5)(a) A licensed general lines agent may charge a per
 3774  policy fee of up to not to exceed $10 to cover the
 3775  administrative costs of the agent associated with selling the
 3776  motor vehicle insurance policy if the policy covers only
 3777  personal injury protection or medical care coverage as provided
 3778  by s. 627.736 or s. 627.7485, as applicable, and property damage
 3779  liability coverage as provided by s. 627.7275 and if no other
 3780  insurance is sold or issued in conjunction with or collateral to
 3781  the policy. The fee is not considered part of the premium.
 3782         (6) If a motor vehicle owner’s driver license, license
 3783  plate, and registration have previously been suspended pursuant
 3784  to s. 316.646, or s. 627.733, or s. 627.7483, an insurer may
 3785  cancel a new policy only as provided in s. 627.7275.
 3786         (7) A policy of private passenger motor vehicle insurance
 3787  or a binder for such a policy may be initially issued in this
 3788  state only if, before the effective date of such binder or
 3789  policy, the insurer or agent has collected from the insured an
 3790  amount equal to 2 months’ premium. An insurer, agent, or premium
 3791  finance company may not, directly or indirectly, take any action
 3792  resulting in the insured paying having paid from the insured’s
 3793  own funds an amount less than the 2 months’ premium required by
 3794  this subsection. This subsection applies without regard to
 3795  whether the premium is financed by a premium finance company or
 3796  is paid pursuant to a periodic payment plan of an insurer or an
 3797  insurance agent.
 3798         (a) This subsection does not apply:
 3799         1. If an insured or member of the insured’s family is
 3800  renewing or replacing a policy or a binder for such policy
 3801  written by the same insurer or a member of the same insurer
 3802  group. This subsection does not apply
 3803         2. To an insurer that issues private passenger motor
 3804  vehicle coverage primarily to active duty or former military
 3805  personnel or their dependents. This subsection does not apply
 3806         3. If all policy payments are paid pursuant to a payroll
 3807  deduction plan or an automatic electronic funds transfer payment
 3808  plan from the policyholder.
 3809         (b) This subsection and subsection (4) do not apply
 3810         1. If all policy payments to an insurer are paid pursuant
 3811  to an automatic electronic funds transfer payment plan from an
 3812  agent, a managing general agent, or a premium finance company
 3813  and if the policy includes, at a minimum, personal injury
 3814  protection or medical care coverage pursuant to ss. 627.730
 3815  627.7405 or ss. 627.748-627.7491, as applicable; motor vehicle
 3816  property damage liability pursuant to s. 627.7275; and bodily
 3817  injury liability in at least the amount of $10,000 because of
 3818  bodily injury to, or death of, one person in any one accident
 3819  and in the amount of $20,000 because of bodily injury to, or
 3820  death of, two or more persons in any one accident. This
 3821  subsection and subsection (4) do not apply
 3822         2. If an insured has had a policy in effect for at least 6
 3823  months, the insured’s agent is terminated by the insurer that
 3824  issued the policy, and the insured obtains coverage on the
 3825  policy’s renewal date with a new company through the terminated
 3826  agent.
 3827         Section 53. Subsections (1), (2), and (3) of section
 3828  627.737, Florida Statutes, are amended to read:
 3829         627.737 Tort exemption; limitation on right to damages;
 3830  punitive damages.—
 3831         (1) Every owner, registrant, operator, or occupant of a
 3832  motor vehicle with respect to which security has been provided
 3833  as required by ss. 627.730-627.7405 or ss. 627.748-627.7491, as
 3834  applicable, and every person or organization legally responsible
 3835  for her or his acts or omissions, is hereby exempted from tort
 3836  liability for damages because of bodily injury, sickness, or
 3837  disease arising out of the ownership, operation, maintenance, or
 3838  use of such motor vehicle in this state to the extent that the
 3839  benefits described in s. 627.736(1) or s. 627.7485(1), as
 3840  applicable, are payable for such injury, or would be payable but
 3841  for any exclusion authorized by ss. 627.730-627.7405 or ss.
 3842  627.748-627.7491, as applicable, under any insurance policy or
 3843  other method of security complying with the requirements of s.
 3844  627.733, or by an owner personally liable under s. 627.733 for
 3845  the payment of such benefits, unless a person is entitled to
 3846  maintain an action for pain, suffering, mental anguish, and
 3847  inconvenience for such injury under the provisions of subsection
 3848  (2).
 3849         (2) In any action of tort brought against the owner,
 3850  registrant, operator, or occupant of a motor vehicle with
 3851  respect to which security has been provided as required by ss.
 3852  627.730-627.7405 or ss. 627.748-627.7491, as applicable, or
 3853  against any person or organization legally responsible for her
 3854  or his acts or omissions, a plaintiff may recover damages in
 3855  tort for pain, suffering, mental anguish, and inconvenience
 3856  because of bodily injury, sickness, or disease arising out of
 3857  the ownership, maintenance, operation, or use of such motor
 3858  vehicle only if in the event that the injury or disease consists
 3859  in whole or in part of:
 3860         (a) Significant and permanent loss of an important bodily
 3861  function.
 3862         (b) Permanent injury within a reasonable degree of medical
 3863  probability, other than scarring or disfigurement.
 3864         (c) Significant and permanent scarring or disfigurement.
 3865         (d) Death.
 3866         (3) If When a defendant, in a proceeding brought pursuant
 3867  to ss. 627.730-627.7405 or ss. 627.748-627.7491, as applicable,
 3868  questions whether the plaintiff has met the requirements of
 3869  subsection (2), then the defendant may file an appropriate
 3870  motion with the court, and the court shall, on a one-time basis
 3871  only, 30 days before the date set for the trial or the pretrial
 3872  hearing, whichever is first, by examining the pleadings and the
 3873  evidence before it, ascertain whether the plaintiff will be able
 3874  to submit some evidence that the plaintiff will meet the
 3875  requirements of subsection (2). If the court finds that the
 3876  plaintiff will not be able to submit such evidence, then the
 3877  court shall dismiss the plaintiff’s claim without prejudice.
 3878         Section 54. Section 627.8405, Florida Statutes, is amended
 3879  to read:
 3880         627.8405 Prohibited acts; financing companies.—A No premium
 3881  finance company shall, in a premium finance agreement or other
 3882  agreement, may not finance the cost of or otherwise provide for
 3883  the collection or remittance of dues, assessments, fees, or
 3884  other periodic payments of money for the cost of:
 3885         (1) A membership in an automobile club. The term
 3886  “automobile club” means a legal entity that which, in
 3887  consideration of dues, assessments, or periodic payments of
 3888  money, promises its members or subscribers to assist them in
 3889  matters relating to the ownership, operation, use, or
 3890  maintenance of a motor vehicle; however, this definition of
 3891  “automobile club” does not include persons, associations, or
 3892  corporations that which are organized and operated solely for
 3893  the purpose of conducting, sponsoring, or sanctioning motor
 3894  vehicle races, exhibitions, or contests upon racetracks, or upon
 3895  racecourses established and marked as such for the duration of
 3896  such particular events. The term words “motor vehicle” has used
 3897  herein have the same meaning as provided defined in s. 320.01
 3898  chapter 320.
 3899         (2) An accidental death and dismemberment policy sold in
 3900  combination with a personal injury protection and property
 3901  damage only policy or an emergency care and property damage only
 3902  policy, as applicable.
 3903         (3) Any product not regulated under the provisions of this
 3904  insurance code.
 3905  
 3906  This section also applies to premium financing by any insurance
 3907  agent or insurance company under part XVI. The commission shall
 3908  adopt rules to assure disclosure, at the time of sale, of
 3909  coverages financed with personal injury protection or medical
 3910  care coverage and shall prescribe the form of such disclosure.
 3911         Section 55. Subsection (1) of section 627.915, Florida
 3912  Statutes, is amended to read:
 3913         627.915 Insurer experience reporting.—
 3914         (1) Each insurer transacting private passenger automobile
 3915  insurance in this state shall report certain information
 3916  annually to the office. The information is will be due on or
 3917  before July 1 of each year. The information shall be divided
 3918  into the following categories: bodily injury liability; property
 3919  damage liability; uninsured motorist; medical care coverage or
 3920  personal injury protection benefits; medical payments;
 3921  comprehensive and collision. The information given must shall be
 3922  on direct insurance writings in the state alone and shall
 3923  represent total limits data. The information set forth in
 3924  paragraphs (a)-(f) is applicable to voluntary private passenger
 3925  and Joint Underwriting Association private passenger writings
 3926  and must shall be reported for each of the latest 3 calendar
 3927  accident years, with an evaluation date of March 31 of the
 3928  current year. The information set forth in paragraphs (g)-(j) is
 3929  applicable to voluntary private passenger writings and must
 3930  shall be reported on a calendar-accident year basis ultimately
 3931  seven times at seven different stages of development.
 3932         (a) Premiums earned for the latest 3 calendar-accident
 3933  years.
 3934         (b) Loss development factors and the historic development
 3935  of those factors.
 3936         (c) Policyholder dividends incurred.
 3937         (d) Expenses for other acquisition and general expense.
 3938         (e) Expenses for agents’ commissions and taxes, licenses,
 3939  and fees.
 3940         (f) Profit and contingency factors as used utilized in the
 3941  insurer’s automobile rate filings for the applicable years.
 3942         (g) Losses paid.
 3943         (h) Losses unpaid.
 3944         (i) Loss adjustment expenses paid.
 3945         (j) Loss adjustment expenses unpaid.
 3946         Section 56. Paragraph (d) of subsection (2) and paragraph
 3947  (d) of subsection (3) of section 628.909, Florida Statutes, are
 3948  amended to read:
 3949         628.909 Applicability of other laws.—
 3950         (2) The following provisions of the Florida Insurance Code
 3951  shall apply to captive insurers who are not industrial insured
 3952  captive insurers to the extent that such provisions are not
 3953  inconsistent with this part:
 3954         (d) Sections 627.730-627.7405 or ss. 627.748-627.7491, as
 3955  applicable, if when no-fault coverage is provided.
 3956         (3) The following provisions of the Florida Insurance Code
 3957  shall apply to industrial insured captive insurers to the extent
 3958  that such provisions are not inconsistent with this part:
 3959         (d) Sections 627.730-627.7405 or ss. 627.748-627.7491, as
 3960  applicable, if when no-fault coverage is provided.
 3961         Section 57. Subsections (2) and (6) and paragraphs (a),
 3962  (c), and (d) of subsection (7) of section 705.184, Florida
 3963  Statutes, are amended to read:
 3964         705.184 Derelict or abandoned motor vehicles on the
 3965  premises of public-use airports.—
 3966         (2) The airport director or the director’s designee shall
 3967  contact the Department of Highway Safety and Motor Vehicles to
 3968  notify that department that the airport has possession of the
 3969  abandoned or derelict motor vehicle and to determine the name
 3970  and address of the owner of the motor vehicle, the insurance
 3971  company insuring the motor vehicle, notwithstanding the
 3972  provisions of s. 627.736 or s. 627.7485, as applicable, and any
 3973  person who has filed a lien on the motor vehicle. Within 7
 3974  business days after receipt of the information, the director or
 3975  the director’s designee shall send notice by certified mail,
 3976  return receipt requested, to the owner of the motor vehicle, the
 3977  insurance company insuring the motor vehicle, notwithstanding
 3978  the provisions of s. 627.736 or s. 627.7485, as applicable, and
 3979  all persons of record claiming a lien against the motor vehicle.
 3980  The notice must shall state the fact of possession of the motor
 3981  vehicle, that charges for reasonable towing, storage, and
 3982  parking fees, if any, have accrued and the amount thereof, that
 3983  a lien as provided in subsection (6) will be claimed, that the
 3984  lien is subject to enforcement pursuant to law, that the owner
 3985  or lienholder, if any, has the right to a hearing as set forth
 3986  in subsection (4), and that any motor vehicle that which, at the
 3987  end of 30 calendar days after receipt of the notice, has not
 3988  been removed from the airport upon payment in full of all
 3989  accrued charges for reasonable towing, storage, and parking
 3990  fees, if any, may be disposed of as provided in s.
 3991  705.182(2)(a), (b), (d), or (e), including, but not limited to,
 3992  the motor vehicle being sold free of all prior liens after 35
 3993  calendar days after the time the motor vehicle is stored if any
 3994  prior liens on the motor vehicle are more than 5 years of age or
 3995  after 50 calendar days after the time the motor vehicle is
 3996  stored if any prior liens on the motor vehicle are 5 years of
 3997  age or less.
 3998         (6) The airport pursuant to this section or, if used, a
 3999  licensed independent wrecker company pursuant to s. 713.78 shall
 4000  have a lien on an abandoned or derelict motor vehicle for all
 4001  reasonable towing, storage, and accrued parking fees, if any,
 4002  except that a no storage fee may not shall be charged if the
 4003  motor vehicle is stored less than 6 hours. As a prerequisite to
 4004  perfecting a lien under this section, the airport director or
 4005  the director’s designee must serve a notice in accordance with
 4006  subsection (2) on the owner of the motor vehicle, the insurance
 4007  company insuring the motor vehicle, notwithstanding the
 4008  provisions of s. 627.736 or s. 627.7485, as applicable, and all
 4009  persons of record claiming a lien against the motor vehicle. If
 4010  attempts to notify the owner, the insurance company insuring the
 4011  motor vehicle, notwithstanding the provisions of s. 627.736, or
 4012  lienholders are not successful, the requirement of notice by
 4013  mail shall be considered met. Serving of the notice does not
 4014  dispense with recording the claim of lien.
 4015         (7)(a) For the purpose of perfecting its lien under this
 4016  section, the airport shall record a claim of lien which shall
 4017  state:
 4018         1. The name and address of the airport.
 4019         2. The name of the owner of the motor vehicle, the
 4020  insurance company insuring the motor vehicle, notwithstanding
 4021  the provisions of s. 627.736 or s. 627.7485, as applicable, and
 4022  all persons of record claiming a lien against the motor vehicle.
 4023         3. The costs incurred from reasonable towing, storage, and
 4024  parking fees, if any.
 4025         4. A description of the motor vehicle sufficient for
 4026  identification.
 4027         (c) The claim of lien shall be sufficient if it is in
 4028  substantially the following form:
 4029                            CLAIM OF LIEN                          
 4030         State of ....
 4031         County of ....
 4032         Before me, the undersigned notary public, personally
 4033  appeared ...., who was duly sworn and says that he/she is the
 4034  .... of ...., whose address is....; and that the following
 4035  described motor vehicle:
 4036         ...(Description of motor vehicle)...
 4037         owned by ...., whose address is ...., has accrued $.... in
 4038  fees for a reasonable tow, for storage, and for parking, if
 4039  applicable; that the lienor served its notice to the owner, the
 4040  insurance company insuring the motor vehicle notwithstanding the
 4041  provisions of s. 627.736 or s. 627.7485, Florida Statutes, as
 4042  applicable, and all persons of record claiming a lien against
 4043  the motor vehicle on ...., ...(year)..., by.....
 4044         ...(Signature)...
 4045         Sworn to (or affirmed) and subscribed before me this ....
 4046  day of ...., ...(year)..., by ...(name of person making
 4047  statement)....
 4048         ...(Signature of Notary Public)......(Print, Type, or Stamp
 4049  Commissioned name of Notary Public)...
 4050         Personally Known....OR Produced....as identification.
 4051  
 4052  However, the negligent inclusion or omission of any information
 4053  in this claim of lien which does not prejudice the owner does
 4054  not constitute a default that operates to defeat an otherwise
 4055  valid lien.
 4056         (d) The claim of lien shall be served on the owner of the
 4057  motor vehicle, the insurance company insuring the motor vehicle,
 4058  notwithstanding the provisions of s. 627.736 or s. 627.7485, as
 4059  applicable, if no-fault coverage is provided, and all persons of
 4060  record claiming a lien against the motor vehicle. If attempts to
 4061  notify the owner, the insurance company insuring the motor
 4062  vehicle notwithstanding the provisions of s. 627.736, or
 4063  lienholders are not successful, the requirement of notice by
 4064  mail shall be considered met. The claim of lien shall be so
 4065  served before recordation.
 4066         Section 58. Paragraphs (a), (b), and (c) of subsection (4)
 4067  of section 713.78, Florida Statutes, are amended to read:
 4068         713.78 Liens for recovering, towing, or storing vehicles
 4069  and vessels.—
 4070         (4)(a) Any person regularly engaged in the business of
 4071  recovering, towing, or storing vehicles or vessels who comes
 4072  into possession of a vehicle or vessel pursuant to subsection
 4073  (2), and who claims a lien for recovery, towing, or storage
 4074  services, must shall give notice to the registered owner, the
 4075  insurance company insuring the vehicle notwithstanding the
 4076  provisions of s. 627.736 or s. 627.7485, as applicable, and to
 4077  all persons claiming a lien thereon, as disclosed by the records
 4078  in the Department of Highway Safety and Motor Vehicles or of a
 4079  corresponding agency in any other state.
 4080         (b) If a Whenever any law enforcement agency authorizes the
 4081  removal of a vehicle or vessel or if whenever any towing
 4082  service, garage, repair shop, or automotive service, storage, or
 4083  parking place notifies the law enforcement agency of possession
 4084  of a vehicle or vessel pursuant to s. 715.07(2)(a)2., the law
 4085  enforcement agency of the jurisdiction where the vehicle or
 4086  vessel is stored shall contact the Department of Highway Safety
 4087  and Motor Vehicles, or the appropriate agency of the state of
 4088  registration, if known, within 24 hours through the medium of
 4089  electronic communications, giving the full description of the
 4090  vehicle or vessel. Upon receipt of the full description of the
 4091  vehicle or vessel, the department shall search its files to
 4092  determine the owner’s name, the insurance company insuring the
 4093  vehicle or vessel, and whether any person has filed a lien upon
 4094  the vehicle or vessel as provided in s. 319.27(2) and (3) and
 4095  notify the applicable law enforcement agency within 72 hours.
 4096  The person in charge of the towing service, garage, repair shop,
 4097  or automotive service, storage, or parking place shall obtain
 4098  such information from the applicable law enforcement agency
 4099  within 5 days after the date of storage and shall give notice
 4100  pursuant to paragraph (a). The department may release the
 4101  insurance company information to the requestor notwithstanding
 4102  the provisions of s. 627.736 or s. 627.7485, as applicable.
 4103         (c) Notice by certified mail, return receipt requested,
 4104  shall be sent within 7 business days after the date of storage
 4105  of the vehicle or vessel to the registered owner, the insurance
 4106  company insuring the vehicle notwithstanding the provisions of
 4107  s. 627.736 or s. 627.7485, as applicable, and all persons of
 4108  record claiming a lien against the vehicle or vessel. The notice
 4109  must It shall state the fact of possession of the vehicle or
 4110  vessel, that a lien as provided in subsection (2) is claimed,
 4111  that charges have accrued and the amount thereof, that the lien
 4112  is subject to enforcement pursuant to law, and that the owner or
 4113  lienholder, if any, has the right to a hearing as set forth in
 4114  subsection (5), and that any vehicle or vessel that which
 4115  remains unclaimed, or for which the charges for recovery,
 4116  towing, or storage services remain unpaid, may be sold free of
 4117  all prior liens after 35 days if the vehicle or vessel is more
 4118  than 3 years of age or after 50 days if the vehicle or vessel is
 4119  3 years of age or less.
 4120         Section 59. The Office of Insurance Regulation shall
 4121  perform a data call relating to coverage under the Florida Motor
 4122  Vehicle No-Fault Medical Care Coverage Law and publish the
 4123  results by January 1, 2015. It is the intent of the Legislature
 4124  that the office design the data call with the expectation that
 4125  the Legislature will use the data to help evaluate market
 4126  conditions relating to motor vehicle insurance and the impact on
 4127  the market of reforms made by this act. The elements of the data
 4128  call must address, but need not be limited to, the following
 4129  components of the new law:
 4130         (1) Quantity of claims.
 4131         (2) Type or nature of claimants.
 4132         (3) Amount and type of benefits paid and expenses incurred.
 4133         (4) Type and quantity of, and charges for, medical
 4134  benefits.
 4135         (5)Attorney fees related to bringing and defending actions
 4136  for benefits.
 4137         (6) Direct earned premiums for medical care coverage, pure
 4138  loss ratios, pure premiums, and other information related to
 4139  premiums and losses.
 4140         (7) Licensed drivers and accidents.
 4141         (8) Fraud and enforcement.
 4142         Section 60. Any motor vehicle policy issued or renewed on
 4143  or after January 1, 2013, is subject to and deemed to
 4144  incorporate the Florida Motor Vehicle No-Fault Medical Care
 4145  Coverage Law as created by this act and is not subject to ss.
 4146  627.730-627.7405, Florida Statutes, the Florida Motor Vehicle
 4147  No-Fault Act. The coverage provided under ss. 627.748-627.7491,
 4148  Florida Statutes, supersedes and replaces the coverage provided
 4149  by the Florida Motor Vehicle No-Fault Law for any motor vehicle
 4150  insurance policy issued on or after the effective date of the
 4151  Florida Motor Vehicle No-Fault Medical Care Coverage Law.
 4152         Section 61. Sections 627.730, 627.731, 627.732, 627.733,
 4153  627.734, 627.736, 627.737, 627.739, 627.7401, 627.7403,
 4154  627.7405, and 627.7407, Florida Statutes, do not apply to
 4155  persons subject to the s. 627.7483, Florida Statutes, and are
 4156  repealed effective January 1, 2014.
 4157         Section 62. If any provision of this act or its application
 4158  to any person or circumstance is held invalid, the invalidity
 4159  does not affect other provisions or applications of the act
 4160  which can be given effect without the invalid provision or
 4161  application, and to this end the provisions of this act are
 4162  severable.
 4163         Section 63. Except as otherwise expressly provided in this
 4164  act and except for this section, which shall take effect
 4165  December 1, 2012, this act shall take effect January 1, 2013.
 4166  
 4167  ================= T I T L E  A M E N D M E N T ================
 4168         And the title is amended as follows:
 4169         Delete lines 14 - 94
 4170  and insert:
 4171         injury protection and medical care coverage benefits;
 4172         amending s. 400.991, F.S.; requiring that an
 4173         application for licensure, or exemption from
 4174         licensure, as a health care clinic include a statement
 4175         regarding insurance fraud; amending s. 626.989, F.S.;
 4176         providing that knowingly submitting false, misleading,
 4177         or fraudulent documents relating to licensure as a
 4178         health care clinic, or submitting a claim for personal
 4179         injury protection or medical care coverage relating to
 4180         clinic licensure documents, is a fraudulent insurance
 4181         act under certain conditions; creating s. 626.9895,
 4182         F.S.; providing definitions; authorizing the Division
 4183         of Insurance Fraud of the Department of Financial
 4184         Services to establish a direct-support organization
 4185         for the purpose of prosecuting, investigating, and
 4186         preventing motor vehicle insurance fraud; providing
 4187         requirements for, and duties of, the organization;
 4188         requiring that the organization operate pursuant to a
 4189         contract with the division; providing for the
 4190         requirements of the contract; providing for a board of
 4191         directors; authorizing the organization to use the
 4192         division’s property and facilities subject to certain
 4193         requirements; requiring that the department adopt
 4194         rules relating to procedures for the organization’s
 4195         governance and relating to conditions for the use of
 4196         the division’s property or facilities; authorizing
 4197         contributions from insurers; authorizing any moneys
 4198         received by the organization to be held in a separate
 4199         depository account in the name of the organization;
 4200         requiring that the division deposit certain proceeds
 4201         into the Insurance Regulatory Trust Fund; reordering
 4202         and amending s. 627.732, F.S.; defining the term
 4203         “entitity wholly owned”; amending s. 627.733, F.S.;
 4204         providing that an owner or registrant of a motor
 4205         vehicle does not have to comply with this section if
 4206         required security is obtained under the Florida Motor
 4207         Vehicle No-Fault Medical Care Coverage Law; amending
 4208         s. 627.736, F.S.; revising the cap on benefits to
 4209         provide that death benefits are in addition to medical
 4210         and disability benefits; excluding massage and
 4211         acupuncture from medical benefits that may be
 4212         reimbursed under the motor vehicle no-fault law;
 4213         deleting provisions prohibiting the purchase of other
 4214         motor vehicle coverage; requiring that an insurer
 4215         repay any benefits covered by the Medicaid program
 4216         within a specified time; requiring that an insurer
 4217         provide a claimant an opportunity to revise claims
 4218         that contain errors; requiring that an insurer create
 4219         and maintain a log of benefits paid and provide a copy
 4220         of the log to the insured upon request; requiring that
 4221         an insurer notify parties in disputes over claims when
 4222         policy limits are reached; revising the Medicare fee
 4223         schedules that an insurer may use as a basis for
 4224         limiting reimbursement of benefits; providing that the
 4225         Medicare fee schedule in effect on a specific date
 4226         applies for purposes of limiting such reimbursement;
 4227         authorizing insurers to apply certain Medicare coding
 4228         policies and payment methodologies; requiring that an
 4229         insurer that limits payments based on the statutory
 4230         fee schedule include a notice in insurance policies at
 4231         the time of issuance or renewal; deleting obsolete
 4232         provisions; providing that certain entities exempt
 4233         from licensure as a clinic must nonetheless be
 4234         licensed to receive reimbursement for the provision of
 4235         personal injury protection benefits; providing
 4236         exceptions; eliminating a requirement that all parties
 4237         mutually and expressly agree for the use of electronic
 4238         transmission of data; creating s. 627.748, F.S.;
 4239         designating specified provisions as the Florida Motor
 4240         Vehicle No-Fault Medical Care Coverage Law; providing
 4241         a short title; creating s. 627.7481, F.S.; providing
 4242         legislative findings and purposes; creating s.
 4243         627.74811, F.S.; providing legislative intent that
 4244         provisions, schedules, or procedures are to be given
 4245         full force and effect regardless of their express
 4246         inclusion in insurer forms; creating s. 627.7482,
 4247         F.S.; providing definitions; creating s. 627.7483,
 4248         F.S.; requiring every owner or registrant of a motor
 4249         vehicle required to be registered and licensed in this
 4250         state to maintain specified security; providing
 4251         exceptions; requiring every nonresident owner or
 4252         registrant of a motor vehicle that has been physically
 4253         present within this state for a specified period to
 4254         maintain security; specifying means by which such
 4255         security is provided; providing that an owner of a
 4256         motor vehicle who fails to have such security is not
 4257         immune to certain liabilities; providing an exemption;
 4258         creating s. 627.7484, F.S.; providing requirements for
 4259         filing and maintaining proof of security; providing
 4260         penalties; creating s. 627.7485, F.S.; requiring that
 4261         insurance policies provide medical care coverage to
 4262         specified persons; providing limits of coverage;
 4263         specifying limits for medical, disability, and death
 4264         benefits; providing restrictions on insurers with
 4265         respect to provision of required benefits; prohibiting
 4266         an insurer from requiring the purchase of other motor
 4267         vehicle coverage as a condition for providing such
 4268         benefits; prohibiting an insurer from requiring the
 4269         purchase of property damage liability insurance
 4270         exceeding a specified amount in conjunction with
 4271         medical care coverage insurance; providing that
 4272         failure to comply with specified availability
 4273         requirements constitutes an unfair method of
 4274         competition or an unfair or deceptive act or practice;
 4275         providing penalties; authorizing an insurer to exclude
 4276         certain benefits; providing procedure with respect to
 4277         such exclusions; specifying when benefits are due from
 4278         an insurer; prohibiting insurers from obtaining liens
 4279         on recovery of special damages in tort claims for
 4280         medical care coverage benefits; prohibiting an insured
 4281         party from recovering any damages for which medical
 4282         care coverage benefits are paid or payable; requiring
 4283         that benefits received under any workers’ compensation
 4284         law be credited against the benefits provided under
 4285         the medical care coverage; providing that benefits
 4286         under the Florida Motor Vehicle No-Fault Medical Care
 4287         Coverage Law are subject to the Medicaid program in
 4288         specified circumstances; providing for notice to
 4289         insurers; specifying when benefits are overdue;
 4290         providing for interest on overdue payments; requiring
 4291         insurers to hold a specified amount of benefits in
 4292         reserve for a certain time for the payment of
 4293         providers; specifying injuries for which an insurer
 4294         must pay benefits; providing for a pro rata
 4295         distribution of benefits paid and expenses if there
 4296         are two or more insurers; requiring that an insurer
 4297         notify parties in disputes over claims when policy
 4298         limits are reached; requiring that an insurer create
 4299         and maintain a log of benefits paid and provide the
 4300         log to the insured upon request; providing for tolling
 4301         the time period in which benefits are required to be
 4302         paid when the insurer has reasonable belief that fraud
 4303         has been committed; requiring that the insurer notify
 4304         the claimant if the claim is being investigated for
 4305         fraud; providing immunity to persons or entities that
 4306         report suspected fraud in good faith; providing that
 4307         an insurer who fails to timely provide benefits
 4308         violates the insurance code; providing that a person
 4309         or entity lawfully rendering treatment to an injured
 4310         person for a bodily injury covered by medical care
 4311         coverage may charge only a reasonable amount for
 4312         services and care; providing that the insurer may pay
 4313         such charges directly to the person or entity lawfully
 4314         rendering such treatment; providing limits on such
 4315         charges; providing for determination of reasonableness
 4316         of charges; providing that payments made by an insurer
 4317         pursuant to the schedule of maximum charges, or for
 4318         lesser amounts billed by providers, are considered
 4319         reasonable; establishing a schedule of maximum
 4320         charges; specifying that reimbursement under a
 4321         schedule of maximum charges which is based on Medicare
 4322         is to be calculated under the applicable Medicare
 4323         schedule in effect on a specified date each year;
 4324         authorizing insurers to use all Medicare coding
 4325         policies and CMS payment methodologies in determining
 4326         reimbursement under a schedule of maximum charges
 4327         which is Medicare based; establishing limits on
 4328         specified emergency services and care; providing
 4329         conditions under which an insurer or insured is not
 4330         required to pay a claim or charges; requiring the
 4331         Department of Health to adopt by rule a list of
 4332         diagnostic tests deemed not to be medically necessary
 4333         and to periodically revise the list; providing
 4334         procedures and requirements with respect to statements
 4335         of and bills for charges for emergency services and
 4336         care; requiring that a notice of the insured’s rights
 4337         include a specified statement; requiring that a
 4338         physician, licensed professional, clinic, or medical
 4339         institution providing medical services require an
 4340         insured person to execute and countersign a disclosure
 4341         and acknowledgement form; directing the Financial
 4342         Services Commission to adopt by rule a disclosure and
 4343         acknowledgment form to be countersigned by claimants
 4344         upon receipt of medical services; providing procedures
 4345         and requirements with respect to investigation of
 4346         claims of improper billing by a physician or other
 4347         medical provider; prohibiting insurers from
 4348         systematically downcoding with intent to deny
 4349         reimbursement; requiring insureds and persons to whom
 4350         the right to payment for benefits has been assigned to
 4351         comply with all terms of the policy; providing that
 4352         compliance with policy terms is a condition precedent
 4353         to the receipt of benefits; requiring that an employer
 4354         furnish a sworn statement of an employee’s earnings
 4355         under certain circumstances; requiring that an
 4356         insured’s assignee comply with the terms of the
 4357         insurance policy; providing for insurers to inspect
 4358         the physical premises of providers seeking payment;
 4359         requiring that a provider seeking payment furnish to
 4360         the insurer a written report; requiring the insurer to
 4361         furnish to the injured person a copy of all
 4362         information; authorizing the insurer to petition the
 4363         court to enter an order permitting discovery of facts
 4364         under certain circumstances; providing for the
 4365         examination of the injured person and reports
 4366         regarding the examination; prohibiting an insurer from
 4367         withdrawing payment from a treating physician under
 4368         certain circumstances; providing requirements with
 4369         respect to a demand letter; providing procedures and
 4370         requirements with respect to payment of an overdue
 4371         claim; providing for the tolling of the time period
 4372         for an action against an insurer; providing that
 4373         failure to pay valid claims with specified frequency
 4374         constitutes an unfair or deceptive trade practice;
 4375         providing penalties; providing circumstances under
 4376         which an insurer has a cause of action; providing for
 4377         fraud advisory notice; requiring that all claims
 4378         related to the same health care provider for the same
 4379         injured person be brought in one action unless good
 4380         cause is shown; authorizing the electronic
 4381         transmission of notices and communications under
 4382         certain conditions; creating s. 627.7486, F.S.;
 4383         providing an exemption from tort liability for certain
 4384         damages in legal actions under the Florida Motor
 4385         Vehicle No-Fault Medical Care Coverage Law in certain
 4386         circumstances; providing for recovery of tort damages
 4387         in certain circumstances; providing for motions to
 4388         dismiss action on specified grounds; prohibiting a
 4389         claim for punitive damages in excess of the coverage
 4390         policy limits; creating s. 627.7487, F.S.; providing
 4391         for optional deductibles and limitations of coverage
 4392         for medical care coverage policies; requiring a
 4393         specified notice to policyholders; creating s.
 4394         627.7488, F.S.; requiring the commission to adopt by
 4395         rule a form for the notification of insureds of their
 4396         right to receive medical care coverage benefits;
 4397         specifying contents of such notice; providing
 4398         requirements for the mailing or delivery of such
 4399         notice; creating s. 627.7489, F.S.; providing for
 4400         mandatory joinder of specified claims; creating s.
 4401         627.749, F.S.; providing for an insurer’s right of
 4402         reimbursement for emergency medical care benefits paid
 4403         to a person injured by a commercial motor vehicle
 4404         under specified circumstances; creating s. 627.7491,
 4405         F.S.; providing for application of the Florida Motor
 4406         Vehicle No-Fault Medical Care Coverage Law; providing
 4407         for requirements for forms and rates for policies
 4408         issued or renewed on or after a specified date;
 4409         requiring a specified notice to existing
 4410         policyholders; amending s. 817.234, F.S.; providing
 4411         that it is insurance fraud to present a claim for
 4412         personal injury protection or medical care coverage
 4413         benefits payable to a person or entity that knowingly
 4414         submitted false, misleading, or fraudulent documents
 4415         relating to licensure as a health care clinic;
 4416         providing that a licensed health care practitioner who
 4417         is found guilty of certain insurance fraud loses his
 4418         or her license and may not receive reimbursement for
 4419         personal injury protection or medical care coverage
 4420         benefits for a specified period; defining the term
 4421         “insurer”; conforming provisions; amending ss.
 4422         316.065, 316.646, 318.18, 320.02, 320.0609, 320.27,
 4423         320.771, 322.251, 322.34, 324.021, 324.0221, 324.032,
 4424         324.171, 400.9935, 409.901, 409.910, 456.057, 456.072,
 4425         626.9541, 626.9894, 627.06501, 627.0652, 627.0653,
 4426         627.4132, 627.6482, 627.7263, 627.727, 627.7275,
 4427         627.728, 627.7295, 627.737, 627.8405, 627.915,
 4428         628.909, 705.184, 713.78, and 817.234, F.S.;
 4429         conforming provisions; requiring that the Office of
 4430         Insurance Regulation perform a data call relating to
 4431         medical care coverage and publish the results;
 4432         providing applicability; repealing ss. 627.730,
 4433         627.731, 627.732, 627.733, 627.734, 627.736, 627.737,
 4434         627.739, 627.7401, 627.7403, 627.7405, and 627.7407.
 4435         Sections 627.730, 627.731, 627.732, 627.733, 627.734,
 4436         627.736, 627.737, 627.739, 627.7401, 627.7403,
 4437         627.7405, and 627.7407, relating to the Florida Motor
 4438         Vehicle No-Fault Law; providing for severability;