Florida Senate - 2015                      CS for CS for SB 1402
       
       
        
       By the Committees on Appropriations; and Banking and Insurance;
       and Senator Lee
       
       
       
       
       576-04271-15                                          20151402c2
    1                        A bill to be entitled                      
    2         An act relating to the organization of the Department
    3         of Financial Services; amending s. 20.121, F.S.;
    4         revising the divisions and functions of the
    5         department; authorizing the Chief Financial Officer to
    6         establish divisions, bureaus, or offices of the
    7         department; amending s. 110.205, F.S.; exempting
    8         certain positions within the department’s Division of
    9         Accounting and Auditing from career service
   10         requirements; amending s. 624.26, F.S.; conforming
   11         provisions to changes made by the act; amending s.
   12         624.307, F.S.; providing powers and duties of the
   13         department’s Division of Consumer Services;
   14         authorizing the division to impose certain penalties;
   15         authorizing the department to adopt rules relating to
   16         the division; providing for construction; amending s.
   17         624.502, F.S.; requiring that certain service of
   18         process fees be deposited into the Administrative
   19         Trust Fund; amending ss. 16.59, 400.9935, 409.91212,
   20         440.105, 440.1051, 440.12, 624.521, 626.016, 626.989,
   21         626.9891, 626.9892, 626.9893, 626.9894, 626.9895,
   22         626.99278, 627.351, 627.711, 627.736, 627.7401,
   23         631.156, 641.30, and 932.7055, F.S.; conforming
   24         provisions to changes made by the act; making
   25         technical changes; providing an effective date.
   26          
   27  Be It Enacted by the Legislature of the State of Florida:
   28  
   29         Section 1. Subsections (2) and (6) of section 20.121,
   30  Florida Statutes, are amended to read:
   31         20.121 Department of Financial Services.—There is created a
   32  Department of Financial Services.
   33         (2) DIVISIONS.—The Department of Financial Services shall
   34  consist of the following divisions and offices:
   35         (a) The Division of Accounting and Auditing, which shall
   36  include the following bureau and office:
   37         1. The Bureau of Unclaimed Property.
   38         2. The Office of Fiscal Integrity which shall function as a
   39  criminal justice agency for purposes of ss. 943.045-943.08 and
   40  shall have a separate budget. The office may conduct
   41  investigations within or outside this state as the bureau deems
   42  necessary to aid in the enforcement of this section. If during
   43  an investigation the office has reason to believe that any
   44  criminal law of this state has or may have been violated, the
   45  office shall refer any records tending to show such violation to
   46  state or federal law enforcement or prosecutorial agencies and
   47  shall provide investigative assistance to those agencies as
   48  required.
   49         (b) The Division of State Fire Marshal.
   50         (c) The Division of Risk Management.
   51         (d) The Division of Treasury, which shall include a Bureau
   52  of Deferred Compensation responsible for administering the
   53  Government Employees Deferred Compensation Plan established
   54  under s. 112.215 for state employees.
   55         (e) The Division of Criminal Investigations, which shall
   56  function as a criminal justice agency for purposes of ss.
   57  943.045-943.08 Insurance Fraud.
   58         (f) The Division of Rehabilitation and Liquidation.
   59         (g) The Division of Insurance Agent and Agency Services.
   60         (h) The Division of Consumer Services.
   61         1. The Division of Consumer Services shall perform the
   62  following functions concerning products or services regulated by
   63  the department or by the Office of Insurance Regulation:
   64         a. Receive inquiries and complaints from consumers.
   65         b. Prepare and disseminate such information as the
   66  department deems appropriate to inform or assist consumers.
   67         c. Provide direct assistance and advocacy for consumers who
   68  request such assistance or advocacy.
   69         d. With respect to apparent or potential violations of law
   70  or applicable rules by a person or entity licensed by the
   71  department or office, report apparent or potential violations to
   72  the office or the appropriate division of the department, which
   73  may take such further action as it deems appropriate.
   74         e. Designate an employee of the division as primary contact
   75  for consumers on issues relating to sinkholes.
   76         2. Any person licensed or issued a certificate of authority
   77  by the department or by the Office of Insurance Regulation shall
   78  respond, in writing, to the Division of Consumer Services within
   79  20 days after receipt of a written request for information from
   80  the division concerning a consumer complaint. The response must
   81  address the issues and allegations raised in the complaint. The
   82  division may impose an administrative penalty for failure to
   83  comply with this subparagraph of up to $2,500 per violation upon
   84  any entity licensed by the department or the office and $250 for
   85  the first violation, $500 for the second violation, and up to
   86  $1,000 per violation thereafter upon any individual licensed by
   87  the department or the office.
   88         3. The department may adopt rules to administer this
   89  paragraph.
   90         4. The powers, duties, and responsibilities expressed or
   91  granted in this paragraph do not limit the powers, duties, and
   92  responsibilities of the Department of Financial Services, the
   93  Financial Services Commission, the Office of Insurance
   94  Regulation, or the Office of Financial Regulation set forth
   95  elsewhere in the Florida Statutes.
   96         (i) The Division of Workers’ Compensation.
   97         (j) The Division of Administration.
   98         (k) The Division of Legal Services.
   99         (l) The Division of Information Systems.
  100         (j)(m) The Office of Insurance Consumer Advocate.
  101         (k)(n) The Division of Funeral, Cemetery, and Consumer
  102  Services.
  103         (l)(o) The Division of Public Assistance Fraud.
  104  
  105  The Chief Financial Officer may establish any other division,
  106  bureau, or office of the department that he or she deems
  107  necessary to promote the efficient and effective operation of
  108  the department pursuant to s. 20.04.
  109         (6) STRATEGIC MARKETS RESEARCH AND ASSESSMENT UNIT.—The
  110  Strategic Markets Research and Assessment Unit is established
  111  within the Department of Financial Services. The Chief Financial
  112  Officer or his or her designee shall report on September 1,
  113  2008, and quarterly thereafter, to the Cabinet, the President of
  114  the Senate, and the Speaker of the House of Representatives on
  115  the status of the state’s financial services markets. At a
  116  minimum, the report must include a summary of issues, trends,
  117  and threats that broadly impact the condition of the financial
  118  services industries, along with the effect of such conditions on
  119  financial institutions, the securities industries, other
  120  financial entities, and the credit market. The Chief Financial
  121  Officer shall also provide findings and recommendations
  122  regarding regulatory and policy changes to the Cabinet, the
  123  President of the Senate, and the Speaker of the House of
  124  Representatives.
  125         Section 2. Paragraph (y) is added to subsection (2) of
  126  section 110.205, Florida Statutes, to read:
  127         110.205 Career service; exemptions.—
  128         (2) EXEMPT POSITIONS.—The exempt positions that are not
  129  covered by this part include the following:
  130         (y) Positions in the Division of Accounting and Auditing of
  131  the Department of Financial Services which are directly
  132  responsible for performing investigations, audits, or management
  133  studies for the purpose of making recommendations for corrective
  134  action, such as an employee disciplinary action, a civil
  135  recovery action, a criminal prosecution, or a revision of agency
  136  operational procedures.
  137         Section 3. Subsection (4) of section 624.26, Florida
  138  Statutes, is amended to read:
  139         624.26 Collaborative arrangement with the Department of
  140  Health and Human Services.—
  141         (4) The department’s Division of Consumer Services may
  142  respond to complaints by consumers relating to a requirement of
  143  PPACA as authorized under s. 20.121(2)(h), and report apparent
  144  or potential violations to the office and to the federal
  145  Department of Health and Human Services.
  146         Section 4. Subsection (10) is added to section 624.307,
  147  Florida Statutes, to read:
  148         624.307 General powers; duties.—
  149         (10)(a) The department’s Division of Consumer Services
  150  shall perform the following functions concerning products or
  151  services regulated by the department or office:
  152         1. Receive inquiries and complaints from consumers.
  153         2. Prepare and disseminate such information as the
  154  department deems appropriate to inform or assist consumers.
  155         3. Provide direct assistance and advocacy for consumers who
  156  request such assistance or advocacy.
  157         4. With respect to apparent or potential violations of law
  158  or applicable rules by a person or entity licensed by the
  159  department or office, report apparent or potential violations to
  160  the office or the appropriate division of the department, which
  161  may take such further action as it deems appropriate.
  162         5. Designate an employee of the division as primary contact
  163  for consumers on issues relating to sinkholes.
  164         (b) Any person licensed or issued a certificate of
  165  authority by the department or the office shall respond, in
  166  writing, to the division within 20 days after receipt of a
  167  written request for information from the division concerning a
  168  consumer complaint. The response must address the issues and
  169  allegations raised in the complaint. The division may impose an
  170  administrative penalty for failure to comply with this paragraph
  171  of up to $2,500 per violation upon any entity licensed by the
  172  department or the office and $250 for the first violation, $500
  173  for the second violation, and up to $1,000 per violation
  174  thereafter upon any individual licensed by the department or the
  175  office.
  176         (c) The department may adopt rules to administer this
  177  subsection.
  178         (d) The powers, duties, and responsibilities expressed or
  179  granted in this subsection do not limit the powers, duties, and
  180  responsibilities of the Department of Financial Services, the
  181  Financial Services Commission, the Office of Insurance
  182  Regulation, or the Office of Financial Regulation as otherwise
  183  provided by law.
  184         Section 5. Section 624.502, Florida Statutes, as amended by
  185  chapter 2014-53, Laws of Florida, is amended to read:
  186         624.502 Service of process fee.—In all instances as
  187  provided in any section of the insurance code and s. 48.151(3)
  188  in which service of process is authorized to be made upon the
  189  Chief Financial Officer or the director of the office, the
  190  plaintiff shall pay to the department or office a fee of $15 for
  191  such service of process, which fee shall be deposited into the
  192  Administrative Insurance Regulatory Trust Fund.
  193         Section 6. Section 16.59, Florida Statutes, is amended to
  194  read:
  195         16.59 Medicaid fraud control.—The Medicaid Fraud Control
  196  Unit is created in the Department of Legal Affairs to
  197  investigate all violations of s. 409.920 and any criminal
  198  violations discovered during the course of those investigations.
  199  The Medicaid Fraud Control Unit may refer any criminal violation
  200  so uncovered to the appropriate prosecuting authority. The
  201  offices of the Medicaid Fraud Control Unit, the Agency for
  202  Health Care Administration Medicaid program integrity program,
  203  and the Divisions of Criminal Investigations Insurance Fraud and
  204  Public Assistance Fraud within the Department of Financial
  205  Services shall, to the extent possible, be collocated; however,
  206  positions dedicated to Medicaid managed care fraud within the
  207  Medicaid Fraud Control Unit shall be collocated with the
  208  Division of Criminal Investigations Insurance Fraud. The Agency
  209  for Health Care Administration, the Department of Legal Affairs,
  210  and the Divisions of Criminal Investigations Insurance Fraud and
  211  Public Assistance Fraud within the Department of Financial
  212  Services shall conduct joint training and other joint activities
  213  designed to increase communication and coordination in
  214  recovering overpayments.
  215         Section 7. Subsection (9) of section 400.9935, Florida
  216  Statutes, is amended to read:
  217         400.9935 Clinic responsibilities.—
  218         (9) In addition to the requirements of part II of chapter
  219  408, the clinic shall display a sign in a conspicuous location
  220  within the clinic readily visible to all patients indicating
  221  that, pursuant to s. 626.9892, the Department of Financial
  222  Services may pay rewards of up to $25,000 to persons providing
  223  information leading to the arrest and conviction of persons
  224  committing crimes investigated by the Division of Criminal
  225  Investigations Insurance Fraud arising from violations of s.
  226  440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234. An
  227  authorized employee of the Division of Criminal Investigations
  228  Insurance Fraud may make unannounced inspections of a clinic
  229  licensed under this part as necessary to determine whether the
  230  clinic is in compliance with this subsection. A licensed clinic
  231  shall allow full and complete access to the premises to such
  232  authorized employee of the division who makes an inspection to
  233  determine compliance with this subsection.
  234         Section 8. Subsection (6) of section 409.91212, Florida
  235  Statutes, is amended to read:
  236         409.91212 Medicaid managed care fraud.—
  237         (6) Each managed care plan shall report all suspected or
  238  confirmed instances of provider or recipient fraud or abuse
  239  within 15 calendar days after detection to the Office of
  240  Medicaid Program Integrity within the agency. At a minimum the
  241  report must contain the name of the provider or recipient, the
  242  Medicaid billing number or tax identification number, and a
  243  description of the fraudulent or abusive act. The Office of
  244  Medicaid Program Integrity in the agency shall forward the
  245  report of suspected overpayment, abuse, or fraud to the
  246  appropriate investigative unit, including, but not limited to,
  247  the Bureau of Medicaid program integrity, the Medicaid fraud
  248  control unit, the Division of Public Assistance Fraud, the
  249  Division of Criminal Investigations Insurance Fraud, or the
  250  Department of Law Enforcement.
  251         (a) Failure to timely report shall result in an
  252  administrative fine of $1,000 per calendar day after the 15th
  253  day of detection.
  254         (b) Failure to timely report may result in additional
  255  administrative, civil, or criminal penalties.
  256         Section 9. Paragraph (a) of subsection (1) of section
  257  440.105, Florida Statutes, is amended to read:
  258         440.105 Prohibited activities; reports; penalties;
  259  limitations.—
  260         (1)(a) Any insurance carrier, any individual self-insured,
  261  any commercial or group self-insurance fund, any professional
  262  practitioner licensed or regulated by the Department of Health,
  263  except as otherwise provided by law, any medical review
  264  committee as defined in s. 766.101, any private medical review
  265  committee, and any insurer, agent, or other person licensed
  266  under the insurance code, or any employee thereof, having
  267  knowledge or who believes that a fraudulent act or any other act
  268  or practice which, upon conviction, constitutes a felony or
  269  misdemeanor under this chapter is being or has been committed
  270  shall send to the Division of Criminal Investigations Insurance
  271  Fraud, Bureau of Workers’ Compensation Fraud, a report or
  272  information pertinent to such knowledge or belief and such
  273  additional information relative thereto as the bureau may
  274  require. The bureau shall review such information or reports and
  275  select such information or reports as, in its judgment, may
  276  require further investigation. It shall then cause an
  277  independent examination of the facts surrounding such
  278  information or report to be made to determine the extent, if
  279  any, to which a fraudulent act or any other act or practice
  280  which, upon conviction, constitutes a felony or a misdemeanor
  281  under this chapter is being committed. The bureau shall report
  282  any alleged violations of law which its investigations disclose
  283  to the appropriate licensing agency and state attorney or other
  284  prosecuting agency having jurisdiction with respect to any such
  285  violations of this chapter. If prosecution by the state attorney
  286  or other prosecuting agency having jurisdiction with respect to
  287  such violation is not begun within 60 days of the bureau’s
  288  report, the state attorney or other prosecuting agency having
  289  jurisdiction with respect to such violation shall inform the
  290  bureau of the reasons for the lack of prosecution.
  291         Section 10. Subsections (1) and (2) of section 440.1051,
  292  Florida Statutes, are amended to read
  293         440.1051 Fraud reports; civil immunity; criminal
  294  penalties.—
  295         (1) The Bureau of Workers’ Compensation Insurance Fraud of
  296  the Division of Criminal Investigations Insurance Fraud of the
  297  department shall establish a toll-free telephone number to
  298  receive reports of workers’ compensation fraud committed by an
  299  employee, employer, insurance provider, physician, attorney, or
  300  other person.
  301         (2) Any person who reports workers’ compensation fraud to
  302  the Division of Criminal Investigations Insurance Fraud under
  303  subsection (1) is immune from civil liability for doing so, and
  304  the person or entity alleged to have committed the fraud may not
  305  retaliate against him or her for providing such report, unless
  306  the person making the report knows it to be false.
  307         Section 11. Paragraph (c) of subsection (1) of section
  308  440.12, Florida Statutes, is amended to read:
  309         440.12 Time for commencement and limits on weekly rate of
  310  compensation.—
  311         (1)  Compensation is not allowed for the first 7 days of
  312  the disability, except for benefits provided under s. 440.13.
  313  However, if the injury results in more than 21 days of
  314  disability, compensation is allowed from the commencement of the
  315  disability.
  316         (c) Each carrier shall keep a record of all payments made
  317  under this subsection, including the time and manner of such
  318  payments, and shall furnish these records or a report based on
  319  these records to the Division of Criminal Investigations
  320  Insurance Fraud and the Division of Workers’ Compensation, upon
  321  request.
  322         Section 12. Subsection (1) of section 624.521, Florida
  323  Statutes, is amended to read:
  324         624.521 Deposit of certain tax receipts; refund of improper
  325  payments.—
  326         (1) The department of Financial Services shall promptly
  327  deposit in the State Treasury to the credit of the Insurance
  328  Regulatory Trust Fund all “state tax” portions of agents’
  329  licenses collected under s. 624.501 necessary to fund the
  330  Division of Criminal Investigations Insurance Fraud. The balance
  331  of the tax shall be credited to the General Fund. All moneys
  332  received by the department of Financial Services or the office
  333  not in accordance with the provisions of this code or not in the
  334  exact amount as specified by the applicable provisions of this
  335  code shall be returned to the remitter. The records of the
  336  department or office shall show the date and reason for such
  337  return.
  338         Section 13. Subsection (4) of section 626.016, Florida
  339  Statutes, is amended to read:
  340         626.016 Powers and duties of department, commission, and
  341  office.—
  342         (4) Nothing in this section is intended to limit the
  343  authority of the department and the Division of Criminal
  344  Investigations Insurance Fraud, as specified in s. 626.989.
  345         Section 14. Subsections (2) and (6) of section 626.989,
  346  Florida Statutes, are amended to read:
  347         626.989 Investigation by department or Division of Criminal
  348  Investigations Insurance Fraud; compliance; immunity;
  349  confidential information; reports to division; division
  350  investigator’s power of arrest.—
  351         (2) If, by its own inquiries or as a result of complaints,
  352  the department or its Division of Criminal Investigations
  353  Insurance Fraud has reason to believe that a person has engaged
  354  in, or is engaging in, a fraudulent insurance act, an act or
  355  practice that violates s. 626.9541 or s. 817.234, or an act or
  356  practice punishable under s. 624.15, it may administer oaths and
  357  affirmations, request the attendance of witnesses or proffering
  358  of matter, and collect evidence. The department shall not compel
  359  the attendance of any person or matter in any such investigation
  360  except pursuant to subsection (4).
  361         (6) Any person, other than an insurer, agent, or other
  362  person licensed under the code, or an employee thereof, having
  363  knowledge or who believes that a fraudulent insurance act or any
  364  other act or practice which, upon conviction, constitutes a
  365  felony or a misdemeanor under the code, or under s. 817.234, is
  366  being or has been committed may send to the Division of Criminal
  367  Investigations Insurance Fraud a report or information pertinent
  368  to such knowledge or belief and such additional information
  369  relative thereto as the department may request. Any professional
  370  practitioner licensed or regulated by the Department of Business
  371  and Professional Regulation, except as otherwise provided by
  372  law, any medical review committee as defined in s. 766.101, any
  373  private medical review committee, and any insurer, agent, or
  374  other person licensed under the code, or an employee thereof,
  375  having knowledge or who believes that a fraudulent insurance act
  376  or any other act or practice which, upon conviction, constitutes
  377  a felony or a misdemeanor under the code, or under s. 817.234,
  378  is being or has been committed shall send to the Division of
  379  Criminal Investigations Insurance Fraud a report or information
  380  pertinent to such knowledge or belief and such additional
  381  information relative thereto as the department may require. The
  382  Division of Criminal Investigations Insurance Fraud shall review
  383  such information or reports and select such information or
  384  reports as, in its judgment, may require further investigation.
  385  It shall then cause an independent examination of the facts
  386  surrounding such information or report to be made to determine
  387  the extent, if any, to which a fraudulent insurance act or any
  388  other act or practice which, upon conviction, constitutes a
  389  felony or a misdemeanor under the code, or under s. 817.234, is
  390  being committed. The Division of Criminal Investigations
  391  Insurance Fraud shall report any alleged violations of law which
  392  its investigations disclose to the appropriate licensing agency
  393  and state attorney or other prosecuting agency having
  394  jurisdiction with respect to any such violation, as provided in
  395  s. 624.310. If prosecution by the state attorney or other
  396  prosecuting agency having jurisdiction with respect to such
  397  violation is not begun within 60 days of the division’s report,
  398  the state attorney or other prosecuting agency having
  399  jurisdiction with respect to such violation shall inform the
  400  division of the reasons for the lack of prosecution.
  401         Section 15. Subsections (1), (2), and (3) of section
  402  626.9891, Florida Statutes, are amended to read:
  403         626.9891 Insurer anti-fraud investigative units; reporting
  404  requirements; penalties for noncompliance.—
  405         (1) Each Every insurer admitted to do business in this
  406  state who in the previous calendar year, at any time during that
  407  year, had $10 million or more in direct premiums written shall:
  408         (a) Establish and maintain a unit or division within the
  409  company to investigate possible fraudulent claims by insureds or
  410  by persons making claims for services or repairs against
  411  policies held by insureds; or
  412         (b) Contract with others to investigate possible fraudulent
  413  claims for services or repairs against policies held by
  414  insureds.
  415  
  416  An insurer subject to this subsection shall file with the
  417  Division of Criminal Investigations Insurance Fraud of the
  418  department on or before July 1, 1996, a detailed description of
  419  the unit or division established pursuant to paragraph (a) or a
  420  copy of the contract and related documents required by paragraph
  421  (b).
  422         (2) Every insurer admitted to do business in this state,
  423  which in the previous calendar year had less than $10 million in
  424  direct premiums written, must adopt an anti-fraud plan and file
  425  it with the Division of Criminal Investigations Insurance Fraud
  426  of the department on or before July 1, 1996. An insurer may, in
  427  lieu of adopting and filing an anti-fraud plan, comply with the
  428  provisions of subsection (1).
  429         (3) Each insurer’s insurers anti-fraud plan must plans
  430  shall include all of the following:
  431         (a) A description of the insurer’s procedures for detecting
  432  and investigating possible fraudulent insurance acts.;
  433         (b) A description of the insurer’s procedures for the
  434  mandatory reporting of possible fraudulent insurance acts to the
  435  Division of Criminal Investigations Insurance Fraud of the
  436  department.;
  437         (c) A description of the insurer’s plan for anti-fraud
  438  education and training of its claims adjusters or other
  439  personnel.; and
  440         (d) A written description or chart outlining the
  441  organizational arrangement of the insurer’s anti-fraud personnel
  442  who are responsible for the investigation and reporting of
  443  possible fraudulent insurance acts.
  444         Section 16. Subsection (2) of section 626.9892, Florida
  445  Statutes, is amended to read:
  446         626.9892 Anti-Fraud Reward Program; reporting of insurance
  447  fraud.—
  448         (2) The department may pay rewards of up to $25,000 to
  449  persons providing information leading to the arrest and
  450  conviction of persons committing crimes investigated by the
  451  Division of Criminal Investigations Insurance Fraud arising from
  452  violations of s. 440.105, s. 624.15, s. 626.9541, s. 626.989, or
  453  s. 817.234.
  454         Section 17. Subsection (1) of section 626.9893, Florida
  455  Statutes, is amended to read:
  456         626.9893 Disposition of revenues; criminal or forfeiture
  457  proceedings.—
  458         (1) The Division of Criminal Investigations Insurance Fraud
  459  of the Department of Financial Services may deposit revenues
  460  received as a result of criminal proceedings or forfeiture
  461  proceedings, other than revenues deposited into the Department
  462  of Financial Services’ Federal Law Enforcement Trust Fund under
  463  s. 17.43, into the Insurance Regulatory Trust Fund. Moneys
  464  deposited pursuant to this section shall be separately accounted
  465  for and shall be used solely for the division to carry out its
  466  duties and responsibilities.
  467         Section 18. Subsection (2) of section 626.9894, Florida
  468  Statutes, is amended to read:
  469         626.9894 Gifts and grants.—
  470         (2) All rights to, interest in, and title to such donated
  471  or granted property shall immediately vest in the Division of
  472  Criminal Investigations Insurance Fraud upon donation. The
  473  division may hold such property in coownership, sell its
  474  interest in the property, liquidate its interest in the
  475  property, or dispose of its interest in the property in any
  476  other reasonable manner.
  477         Section 19. Paragraph (a) of subsection (1) of section
  478  626.9895, Florida Statutes, is amended to read:
  479         626.9895 Motor vehicle insurance fraud direct-support
  480  organization.—
  481         (1) DEFINITIONS.—As used in this section, the term:
  482         (a) “Division” means the Division of Criminal
  483  Investigations Insurance Fraud of the Department of Financial
  484  Services.
  485         Section 20. Section 626.99278, Florida Statutes, is amended
  486  to read:
  487         626.99278 Viatical provider anti-fraud plan.—Every licensed
  488  viatical settlement provider and registered life expectancy
  489  provider must adopt an anti-fraud plan and file it with the
  490  Division of Criminal Investigations Insurance Fraud of the
  491  department. Each anti-fraud plan shall include:
  492         (1) A description of the procedures for detecting and
  493  investigating possible fraudulent acts and procedures for
  494  resolving material inconsistencies between medical records and
  495  insurance applications.
  496         (2) A description of the procedures for the mandatory
  497  reporting of possible fraudulent insurance acts and prohibited
  498  practices set forth in s. 626.99275 to the Division of Criminal
  499  Investigations Insurance Fraud of the department.
  500         (3) A description of the plan for anti-fraud education and
  501  training of its underwriters or other personnel.
  502         (4) A written description or chart outlining the
  503  organizational arrangement of the anti-fraud personnel who are
  504  responsible for the investigation and reporting of possible
  505  fraudulent insurance acts and for the investigation of
  506  unresolved material inconsistencies between medical records and
  507  insurance applications.
  508         (5) For viatical settlement providers, a description of the
  509  procedures used to perform initial and continuing review of the
  510  accuracy of life expectancies used in connection with a viatical
  511  settlement contract or viatical settlement investment.
  512         Section 21. Paragraph (k) of subsection (6) of section
  513  627.351, Florida Statutes, is amended to read:
  514         627.351 Insurance risk apportionment plans.—
  515         (6) CITIZENS PROPERTY INSURANCE CORPORATION.—
  516         (k)1. The corporation shall establish and maintain a unit
  517  or division to investigate possible fraudulent claims by
  518  insureds or by persons making claims for services or repairs
  519  against policies held by insureds; or it may contract with
  520  others to investigate possible fraudulent claims for services or
  521  repairs against policies held by the corporation pursuant to s.
  522  626.9891. The corporation must comply with reporting
  523  requirements of s. 626.9891. An employee of the corporation
  524  shall notify the corporation’s Office of the Inspector General
  525  and the Division of Criminal Investigations Insurance Fraud
  526  within 48 hours after having information that would lead a
  527  reasonable person to suspect that fraud may have been committed
  528  by any employee of the corporation.
  529         2. The corporation shall establish a unit or division
  530  responsible for receiving and responding to consumer complaints,
  531  which unit or division is the sole responsibility of a senior
  532  manager of the corporation.
  533         Section 22. Subsections (4) and (7) of section 627.711,
  534  Florida Statutes, are amended to read:
  535         627.711 Notice of premium discounts for hurricane loss
  536  mitigation; uniform mitigation verification inspection form.—
  537         (4) An authorized mitigation inspector that signs a uniform
  538  mitigation form, and a direct employee authorized to conduct
  539  mitigation verification inspections under subsection paragraph
  540  (3), may not commit misconduct in performing hurricane
  541  mitigation inspections or in completing a uniform mitigation
  542  form that causes financial harm to a customer or their insurer;
  543  or that jeopardizes a customer’s health and safety. Misconduct
  544  occurs when an authorized mitigation inspector signs a uniform
  545  mitigation verification form that:
  546         (a) Falsely indicates that he or she personally inspected
  547  the structures referenced by the form;
  548         (b) Falsely indicates the existence of a feature which
  549  entitles an insured to a mitigation discount which the inspector
  550  knows does not exist or did not personally inspect;
  551         (c) Contains erroneous information due to the gross
  552  negligence of the inspector; or
  553         (d) Contains a pattern of demonstrably false information
  554  regarding the existence of mitigation features that could give
  555  an insured a false evaluation of the ability of the structure to
  556  withstand major damage from a hurricane endangering the safety
  557  of the insured’s life and property.
  558         (7) An insurer, person, or other entity that obtains
  559  evidence of fraud or evidence that an authorized mitigation
  560  inspector or an employee authorized to conduct mitigation
  561  verification inspections under subsection paragraph (3) has made
  562  false statements in the completion of a mitigation inspection
  563  form shall file a report with the Division of Criminal
  564  Investigations Insurance Fraud, along with all of the evidence
  565  in its possession that supports the allegation of fraud or
  566  falsity. An insurer, person, or other entity making the report
  567  shall be immune from liability, in accordance with s.
  568  626.989(4), for any statements made in the report, during the
  569  investigation, or in connection with the report. The Division of
  570  Criminal Investigations Insurance Fraud shall issue an
  571  investigative report if it finds that probable cause exists to
  572  believe that the authorized mitigation inspector, or an employee
  573  authorized to conduct mitigation verification inspections under
  574  subsection paragraph (3), made intentionally false or fraudulent
  575  statements in the inspection form. Upon conclusion of the
  576  investigation and a finding of probable cause that a violation
  577  has occurred, the Division of Criminal Investigations Insurance
  578  Fraud shall send a copy of the investigative report to the
  579  office and a copy to the agency responsible for the professional
  580  licensure of the authorized mitigation inspector, whether or not
  581  a prosecutor takes action based upon the report.
  582         Section 23. Paragraph (i) of subsection (4) and subsection
  583  (14) of section 627.736, Florida Statutes, are amended to read:
  584         627.736 Required personal injury protection benefits;
  585  exclusions; priority; claims.—
  586         (4) PAYMENT OF BENEFITS.—Benefits due from an insurer under
  587  ss. 627.730-627.7405 are primary, except that benefits received
  588  under any workers’ compensation law must be credited against the
  589  benefits provided by subsection (1) and are due and payable as
  590  loss accrues upon receipt of reasonable proof of such loss and
  591  the amount of expenses and loss incurred which are covered by
  592  the policy issued under ss. 627.730-627.7405. If the Agency for
  593  Health Care Administration provides, pays, or becomes liable for
  594  medical assistance under the Medicaid program related to injury,
  595  sickness, disease, or death arising out of the ownership,
  596  maintenance, or use of a motor vehicle, the benefits under ss.
  597  627.730-627.7405 are subject to the Medicaid program. However,
  598  within 30 days after receiving notice that the Medicaid program
  599  paid such benefits, the insurer shall repay the full amount of
  600  the benefits to the Medicaid program.
  601         (i) If an insurer has a reasonable belief that a fraudulent
  602  insurance act, for the purposes of s. 626.989 or s. 817.234, has
  603  been committed, the insurer shall notify the claimant, in
  604  writing, within 30 days after submission of the claim that the
  605  claim is being investigated for suspected fraud. Beginning at
  606  the end of the initial 30-day period, the insurer has an
  607  additional 60 days to conduct its fraud investigation.
  608  Notwithstanding subsection (10), no later than 90 days after the
  609  submission of the claim, the insurer must deny the claim or pay
  610  the claim with simple interest as provided in paragraph (d).
  611  Interest shall be assessed from the day the claim was submitted
  612  until the day the claim is paid. All claims denied for suspected
  613  fraudulent insurance acts shall be reported to the Division of
  614  Criminal Investigations Insurance Fraud.
  615         (14) FRAUD ADVISORY NOTICE.—Upon receiving notice of a
  616  claim under this section, an insurer shall provide a notice to
  617  the insured or to a person for whom a claim for reimbursement
  618  for diagnosis or treatment of injuries has been filed, advising
  619  that:
  620         (a) Pursuant to s. 626.9892, the Department of Financial
  621  Services may pay rewards of up to $25,000 to persons providing
  622  information leading to the arrest and conviction of persons
  623  committing crimes investigated by the Division of Criminal
  624  Investigations Insurance Fraud arising from violations of s.
  625  440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234.
  626         (b) Solicitation of a person injured in a motor vehicle
  627  crash for purposes of filing personal injury protection or tort
  628  claims could be a violation of s. 817.234, s. 817.505, or the
  629  rules regulating The Florida Bar and should be immediately
  630  reported to the Division of Criminal Investigations Insurance
  631  Fraud if such conduct has taken place.
  632         Section 24. Paragraphs (b) and (c) of subsection (1) of
  633  section 627.7401, Florida Statutes, are amended to read:
  634         627.7401 Notification of insured’s rights.—
  635         (1) The commission, by rule, shall adopt a form for the
  636  notification of insureds of their right to receive personal
  637  injury protection benefits under the Florida Motor Vehicle No
  638  Fault Law. Such notice shall include:
  639         (b) An advisory informing insureds that:
  640         1. Pursuant to s. 626.9892, the Department of Financial
  641  Services may pay rewards of up to $25,000 to persons providing
  642  information leading to the arrest and conviction of persons
  643  committing crimes investigated by the Division of Criminal
  644  Investigations Insurance Fraud arising from violations of s.
  645  440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234.
  646         2. Pursuant to s. 627.736(5)(e)1., if the insured notifies
  647  the insurer of a billing error, the insured may be entitled to a
  648  certain percentage of a reduction in the amount paid by the
  649  insured’s motor vehicle insurer.
  650         (c) A notice that solicitation of a person injured in a
  651  motor vehicle crash for purposes of filing personal injury
  652  protection or tort claims could be a violation of s. 817.234, s
  653  817.505, or the rules regulating The Florida Bar and should be
  654  immediately reported to the Division of Criminal Investigations
  655  Insurance Fraud if such conduct has taken place.
  656         Section 25. Subsection (2) of section 631.156, Florida
  657  Statutes, is amended to read:
  658         631.156 Investigation by the department; scope of
  659  authority; sharing of materials.—
  660         (2) The department may provide documents, books, and
  661  records; other investigative products, work product, and
  662  analysis; and copies of any or all of such materials to the
  663  Division of Criminal Investigations Insurance Fraud or any other
  664  appropriate government agency. The sharing of these materials
  665  shall not waive any work product or other privilege otherwise
  666  applicable under law.
  667         Section 26. Subsection (4) of section 641.30, Florida
  668  Statutes, is amended to read:
  669         641.30 Construction and relationship to other laws.—
  670         (4) The Division of Criminal Investigations Insurance Fraud
  671  of the department is vested with all powers granted to it under
  672  the Florida Insurance Code with respect to the investigation of
  673  any violation of this part.
  674         Section 27. Paragraph (l) of subsection (6) of section
  675  932.7055, Florida Statutes, is amended to read:
  676         932.7055 Disposition of liens and forfeited property.—
  677         (6) If the seizing agency is a state agency, all remaining
  678  proceeds shall be deposited into the General Revenue Fund.
  679  However, if the seizing agency is:
  680         (l) The Division of Criminal Investigations Insurance Fraud
  681  of the Department of Financial Services, the proceeds accrued
  682  pursuant to the provisions of the Florida Contraband Forfeiture
  683  Act shall be deposited into the Insurance Regulatory Trust Fund
  684  as provided in s. 626.9893 or into the Department of Financial
  685  Services’ Federal Law Enforcement Trust Fund as provided in s.
  686  17.43, as applicable.
  687         Section 28. This act shall take effect July 1, 2015.