Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. SB 1036
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  01/27/2016           .                                

       The Committee on Banking and Insurance (Richter) recommended the
    1         Senate Amendment (with directory and title amendments)
    3         Delete lines 154 - 217
    4  and insert:
    5         (9)(a) In addition to the methods provided in s.
    6  627.4035(1), the premiums for motor vehicle insurance contracts
    7  issued in this state or covering risk located in this state may
    8  be paid in cash in the form of a draft or drafts.
    9         (b) If a payment of premium under this subsection by debit
   10  card, credit card, or automatic electronic funds transfer is
   11  returned or declined or cannot be processed due to insufficient
   12  funds, the insurer may impose an insufficient funds fee of up to
   13  $15 per occurrence pursuant to the policy terms.
   14         Section 1. Paragraphs (d) and (h) of subsection (5) of
   15  section 627.736, Florida Statutes, are amended to read:
   16         627.736 Required personal injury protection benefits;
   17  exclusions; priority; claims.—
   19         (d) All statements and bills for medical services rendered
   20  by a physician, hospital, clinic, or other person or institution
   21  shall be submitted to the insurer on a properly completed
   22  Centers for Medicare and Medicaid Services (CMS) 1500 form, UB
   23  92 forms, or any other standard form approved by the office and
   24  or adopted by the commission for purposes of this paragraph. All
   25  billings for such services rendered by providers must, to the
   26  extent applicable, comply with the CMS 1500 form instructions,
   27  the American Medical Association CPT Editorial Panel, and the
   28  Healthcare Common Procedure Coding System (HCPCS); and must
   29  follow the Physicians’ Current Procedural Terminology (CPT), the
   30  HCPCS in effect for the year in which services are rendered, and
   31  the International Classification of Diseases (ICD) adopted by
   32  the United States Department of Health and Human Services for
   33  the service year in which the services, supplies, or care is
   34  rendered as described in subparagraph (a)2. follow the
   35  Physicians’ Current Procedural Terminology (CPT) or Healthcare
   36  Correct Procedural Coding System (HCPCS), or ICD-9 in effect for
   37  the year in which services are rendered and comply with the CMS
   38  1500 form instructions, the American Medical Association CPT
   39  Editorial Panel, and the HCPCS. All providers, other than
   40  hospitals, must include on the applicable claim form the
   41  professional license number of the provider in the line or space
   42  provided for “Signature of Physician or Supplier, Including
   43  Degrees or Credentials.” In determining compliance with
   44  applicable CPT and HCPCS coding, guidance shall be provided by
   45  the Physicians’ Current Procedural Terminology (CPT) or the
   46  Healthcare Correct Procedural Coding System (HCPCS) in effect
   47  for the year in which services were rendered, the Office of the
   48  Inspector General, Physicians Compliance Guidelines, and other
   49  authoritative treatises designated by rule by the Agency for
   50  Health Care Administration. A statement of medical services may
   51  not include charges for medical services of a person or entity
   52  that performed such services without possessing the valid
   53  licenses required to perform such services. For purposes of
   54  paragraph (4)(b), an insurer is not considered to have been
   55  furnished with notice of the amount of covered loss or medical
   56  bills due unless the statements or bills comply with this
   57  paragraph and are properly completed in their entirety as to all
   58  material provisions, with all relevant information being
   59  provided therein.
   60         (h) As provided in s. 400.9905, an entity excluded from the
   61  definition of a clinic shall be deemed a clinic and must be
   62  licensed under part X of chapter 400 in order to receive
   63  reimbursement under ss. 627.730-627.7405. However, this
   64  licensing requirement does not apply to:
   65         1. An entity wholly owned by a physician licensed under
   66  chapter 458 or chapter 459, or by the physician and the spouse,
   67  parent, child, or sibling of the physician;
   68         2. An entity wholly owned by a dentist licensed under
   69  chapter 466, or by the dentist and the spouse, parent, child, or
   70  sibling of the dentist;
   71         3. An entity wholly owned by a chiropractic physician
   72  licensed under chapter 460, or by the chiropractic physician and
   73  the spouse, parent, child, or sibling of the chiropractic
   74  physician;
   75         4. A hospital or ambulatory surgical center licensed under
   76  chapter 395;
   77         5. An entity that wholly owns or is wholly owned, directly
   78  or indirectly, by a hospital or hospitals licensed under chapter
   79  395;
   80         6. An entity that is a clinical facility affiliated with an
   81  accredited medical school at which training is provided for
   82  medical students, residents, or fellows; or
   83         7. An entity that is certified under 42 C.F.R. part 485,
   84  subpart H; or
   85         8.An entity that is owned by a publicly traded
   86  corporation, either directly or indirectly through its
   87  subsidiaries, that has $250 million or more in total annual
   88  sales of health care services provided by licensed health care
   89  practitioners, if one or more of the persons responsible for the
   90  operations of the entity are health care practitioners who are
   91  licensed in this state and are responsible for supervising the
   92  business activities of the entity and the entity’s compliance
   93  with state law for purposes of this section.
   96  ====== D I R E C T O R Y  C L A U S E  A M E N D M E N T ======
   97  And the directory clause is amended as follows:
   98         Delete line 115
   99  and insert:
  100  Statutes, is amended, and a new subsection (9) is added to that
  101  section, to read:
  103  ================= T I T L E  A M E N D M E N T ================
  104  And the title is amended as follows:
  105         Delete lines 17 - 26
  106  and insert:
  107         payments; authorizing an additional form of payment
  108         for certain motor vehicle insurance contract premiums;
  109         authorizing an insurer to impose a specified
  110         insufficient funds fee under certain circumstances;
  111         amending s. 627.736, F.S.; requiring that a certain
  112         standard form be approved by the office and adopted by
  113         the Financial Services Commission, rather than
  114         approved by the office or adopted by the commission;
  115         revising standards for compliance for specified
  116         billings for medical services; adding a specified
  117         entity to a list of entities that are not required to
  118         be licensed as a clinic to receive reimbursement under
  119         the Florida Motor Vehicle No-Fault Law;