Florida Senate - 2024                                    SB 1502
       
       
        
       By Senator Collins
       
       
       
       
       
       14-01460-24                                           20241502__
    1                        A bill to be entitled                      
    2         An act relating to health care expenses; amending s.
    3         95.11, F.S.; establishing a 3-year statute of
    4         limitations for an action to collect medical debt for
    5         services rendered by a health care provider or
    6         facility; creating s. 222.26, F.S.; providing
    7         additional personal property exemptions from legal
    8         process for medical debts resulting from services
    9         provided in certain licensed facilities; amending s.
   10         395.301, F.S.; requiring a licensed facility to post
   11         on its website a consumer-friendly list of standard
   12         charges for a minimum number of shoppable health care
   13         services; defining terms; requiring a licensed
   14         facility to provide an estimate to a patient or
   15         prospective patient and the patient’s health insurer
   16         within specified timeframes; requiring a licensed
   17         facility to establish an internal grievance process
   18         for patients to dispute charges; requiring a facility
   19         to make available information necessary for initiating
   20         a grievance; requiring a facility to respond to a
   21         patient grievance within a specified timeframe;
   22         creating s. 395.3011, F.S.; prohibiting certain
   23         collection activities by a licensed facility; creating
   24         s. 627.446, F.S.; defining the term “health insurer”;
   25         requiring each health insurer to provide an insured
   26         with an advanced explanation of benefits after
   27         receiving a patient estimate from a facility for
   28         scheduled services; providing requirements for the
   29         advanced explanation of benefits; amending ss.
   30         627.6387, 627.6648, and 641.31076, F.S.; providing
   31         that a shared savings incentive offered by a health
   32         insurer or health maintenance organization constitutes
   33         a medical expense for rate development and rate filing
   34         purposes; amending ss. 475.01, 475.611, 517.191,
   35         768.28, and 787.061, F.S.; conforming cross
   36         references; providing an effective date.
   37          
   38  Be It Enacted by the Legislature of the State of Florida:
   39  
   40         Section 1. Present subsections (4) through (12) of section
   41  95.11, Florida Statutes, are redesignated as subsections (5)
   42  through (13), respectively, a new subsection (4) is added to
   43  that section, and paragraph (b) of subsection (2), paragraph (n)
   44  of subsection (3), paragraphs (f) and (g) of present subsection
   45  (5), and present subsection (10) of that section are amended, to
   46  read:
   47         95.11 Limitations other than for the recovery of real
   48  property.—Actions other than for recovery of real property shall
   49  be commenced as follows:
   50         (2) WITHIN FIVE YEARS.—
   51         (b) A legal or equitable action on a contract, obligation,
   52  or liability founded on a written instrument, except for an
   53  action to enforce a claim against a payment bond, which shall be
   54  governed by the applicable provisions of paragraph (6)(e)
   55  (5)(e), s. 255.05(10), s. 337.18(1), or s. 713.23(1)(e), and
   56  except for an action for a deficiency judgment governed by
   57  paragraph (6)(h) (5)(h).
   58         (3) WITHIN FOUR YEARS.—
   59         (n) An action for assault, battery, false arrest, malicious
   60  prosecution, malicious interference, false imprisonment, or any
   61  other intentional tort, except as provided in subsections (4),
   62  (5), (6), and (8) (7).
   63         (4)WITHIN THREE YEARS.—An action to collect medical debt
   64  for services rendered by a facility licensed under chapter 395,
   65  provided that the period of limitations shall run from the date
   66  on which the facility refers the medical debt to a third party
   67  for collection.
   68         (6)(5) WITHIN ONE YEAR.—
   69         (f) Except for actions described in subsection (9) (8), a
   70  petition for extraordinary writ, other than a petition
   71  challenging a criminal conviction, filed by or on behalf of a
   72  prisoner as defined in s. 57.085.
   73         (g) Except for actions described in subsection (9) (8), an
   74  action brought by or on behalf of a prisoner, as defined in s.
   75  57.085, relating to the conditions of the prisoner’s
   76  confinement.
   77         (11)(10) FOR INTENTIONAL TORTS RESULTING IN DEATH FROM ACTS
   78  DESCRIBED IN S. 782.04 OR S. 782.07.—Notwithstanding paragraph
   79  (5)(e) (4)(e), an action for wrongful death seeking damages
   80  authorized under s. 768.21 brought against a natural person for
   81  an intentional tort resulting in death from acts described in s.
   82  782.04 or s. 782.07 may be commenced at any time. This
   83  subsection shall not be construed to require an arrest, the
   84  filing of formal criminal charges, or a conviction for a
   85  violation of s. 782.04 or s. 782.07 as a condition for filing a
   86  civil action.
   87         Section 2. Section 222.26, Florida Statutes, is created to
   88  read:
   89         222.26Additional exemptions from legal process concerning
   90  medical debt.—If a debt is owed for medical services provided by
   91  a facility licensed under chapter 395, the following property is
   92  exempt from attachment, garnishment, or other legal process in
   93  an action on such debt:
   94         (1)A debtor’s interest, not to exceed $10,000 in value, in
   95  a single motor vehicle as defined in s. 320.01(1).
   96         (2)A debtor’s interest in personal property, not to exceed
   97  $10,000 in value, if the debtor does not claim or receive the
   98  benefits of a homestead exemption under s. 4, Art. X of the
   99  State Constitution.
  100         Section 3. Present paragraphs (b), (c), and (d) of
  101  subsection (1) of section 395.301, Florida Statutes, are
  102  redesignated as paragraphs (c), (d), and (e), respectively,
  103  present subsection (6) is redesignated as subsection (7), a new
  104  paragraph (b) is added to subsection (1), a new subsection (6)
  105  is added to that section, and present paragraph (b) of
  106  subsection (1) is amended, to read:
  107         395.301 Price transparency; itemized patient statement or
  108  bill; patient admission status notification.—
  109         (1) A facility licensed under this chapter shall provide
  110  timely and accurate financial information and quality of service
  111  measures to patients and prospective patients of the facility,
  112  or to patients’ survivors or legal guardians, as appropriate.
  113  Such information shall be provided in accordance with this
  114  section and rules adopted by the agency pursuant to this chapter
  115  and s. 408.05. Licensed facilities operating exclusively as
  116  state facilities are exempt from this subsection.
  117         (b)Each licensed facility shall post on its website a
  118  consumer-friendly list of standard charges for at least 300
  119  shoppable health care services. If a facility provides fewer
  120  than 300 distinct shoppable health care services, it shall make
  121  available on its website the standard charges for each service
  122  it provides. As used in this paragraph, the term:
  123         1.“Shoppable health care service” means a service that can
  124  be scheduled by a healthcare consumer in advance. The term
  125  includes, but is not limited to, the services described in s.
  126  627.6387(2)(e) and any services defined in regulations or
  127  guidance issued by the United States Department of Health and
  128  Human Services.
  129         2.“Standard charge” has the same meaning as that term is
  130  defined in regulations or guidance issued by the United States
  131  Department of Health and Human Services for purposes of hospital
  132  price transparency.
  133         (c)1.(b)1.Upon request, and Before providing any
  134  nonemergency medical services, each licensed facility shall
  135  provide in writing or by electronic means a good faith estimate
  136  of reasonably anticipated charges by the facility for the
  137  treatment of a the patient’s or prospective patient’s specific
  138  condition. Such estimate must be provided to the patient or
  139  prospective patient upon scheduling a medical service. The
  140  facility must provide the estimate to the patient or prospective
  141  patient within 7 business days after the receipt of the request
  142  and is not required to adjust the estimate for any potential
  143  insurance coverage. The facility must provide the estimate to
  144  the patient’s health insurer, as defined in s. 627.446(1), and
  145  the patient at least 3 business days before a service is to be
  146  furnished, but no later than 1 business day after the service is
  147  scheduled or, in the case of a service scheduled at least 10
  148  business days in advance, no later than 3 business days after
  149  the service is scheduled. The estimate may be based on the
  150  descriptive service bundles developed by the agency under s.
  151  408.05(3)(c) unless the patient or prospective patient requests
  152  a more personalized and specific estimate that accounts for the
  153  specific condition and characteristics of the patient or
  154  prospective patient. The facility shall inform the patient or
  155  prospective patient that he or she may contact his or her health
  156  insurer or health maintenance organization for additional
  157  information concerning cost-sharing responsibilities.
  158         2. In the estimate, the facility shall provide to the
  159  patient or prospective patient information on the facility’s
  160  financial assistance policy, including the application process,
  161  payment plans, and discounts and the facility’s charity care
  162  policy and collection procedures.
  163         3. The estimate shall clearly identify any facility fees
  164  and, if applicable, include a statement notifying the patient or
  165  prospective patient that a facility fee is included in the
  166  estimate, the purpose of the fee, and that the patient may pay
  167  less for the procedure or service at another facility or in
  168  another health care setting.
  169         4. Upon request, The facility shall notify the patient or
  170  prospective patient of any revision to the estimate.
  171         5. In the estimate, the facility must notify the patient or
  172  prospective patient that services may be provided in the health
  173  care facility by the facility as well as by other health care
  174  providers that may separately bill the patient, if applicable.
  175         6. The facility shall take action to educate the public
  176  that such estimates are available upon request.
  177         7. Failure to timely provide the estimate pursuant to this
  178  paragraph shall result in a daily fine of $1,000 until the
  179  estimate is provided to the patient or prospective patient and
  180  the health insurer. The total fine per patient estimate may not
  181  exceed $10,000.
  182  
  183  The provision of an estimate does not preclude the actual
  184  charges from exceeding the estimate.
  185         (6)Each facility shall establish an internal process for
  186  reviewing and responding to grievances from patients. Such
  187  process must allow patients to dispute charges that appear on
  188  the patient’s itemized statement or bill. The facility shall
  189  prominently post on its website and indicate in bold print on
  190  each itemized statement or bill the instructions for initiating
  191  a grievance and the direct contact information required to
  192  initiate the grievance process. The facility must provide an
  193  initial response to a patient grievance within 7 business days
  194  after the patient formally files a grievance disputing all or a
  195  portion of an itemized statement or bill.
  196         Section 4. Section 395.3011, Florida Statutes, is created
  197  to read:
  198         395.3011Billing and collection activities.—
  199         (1)As used in this section, the term “extraordinary
  200  collection action” means any of the following actions taken by a
  201  licensed facility against an individual in relation to obtaining
  202  payment of a bill for care covered under the facility’s
  203  financial assistance policy:
  204         (a)Selling the individual’s debt to another party.
  205         (b)Reporting adverse information about the individual to
  206  consumer credit reporting agencies or credit bureaus.
  207         (c)Deferring, denying, or requiring a payment before
  208  providing medically necessary care because of the individual’s
  209  nonpayment of one or more bills for previously provided care
  210  covered under the facility’s financial assistance policy.
  211         (d)Actions that require a legal or judicial process,
  212  including, but not limited to:
  213         1.Placing a lien on the individual’s property;
  214         2.Foreclosing on the individual’s real property;
  215         3.Attaching or seizing the individual’s bank account or
  216  any other personal property;
  217         4.Commencing a civil action against the individual;
  218         5.Causing the individual’s arrest; or
  219         6.Garnishing the individual’s wages.
  220         (2)A facility may not engage in an extraordinary
  221  collection action against an individual to obtain payment for
  222  services:
  223         (a)Before the facility has made reasonable efforts to
  224  determine whether the individual is eligible for assistance
  225  under its financial assistance policy for the care provided and,
  226  if eligible, before a decision is made by the facility on the
  227  patient’s application for such financial assistance.
  228         (b)Before the facility has provided the individual with an
  229  itemized statement or bill.
  230         (c)During an ongoing grievance process as described in s.
  231  395.301(6) or an ongoing appeal of a claim adjudication.
  232         (d)Before billing any applicable insurer and allowing the
  233  insurer to adjudicate a claim.
  234         (e)For 30 days after notifying the patient in writing, by
  235  certified mail, or by other traceable delivery method, that a
  236  collection action will commence absent additional action by the
  237  patient.
  238         (f)While the individual:
  239         1. Negotiates in good faith the final amount of a bill for
  240  services rendered; or
  241         2. Complies with all terms of a payment plan with the
  242  facility.
  243         Section 5. Section 627.446, Florida Statutes, is created to
  244  read:
  245         627.446Advanced explanation of benefits.—
  246         (1)As used in this section, the term “health insurer”
  247  means a health insurer issuing individual or group coverage or a
  248  health maintenance organization issuing coverage through an
  249  individual or a group contract.
  250         (2)Each health insurer shall prepare an advanced
  251  explanation of benefits upon receiving a patient estimate from a
  252  facility pursuant to s. 395.301(1). The health insurer must
  253  provide the advanced explanation of benefits to the insured no
  254  later than 1 business day after receiving the patient estimate
  255  from the facility or, in the case of a service scheduled at
  256  least 10 business days in advance, no later than 3 business days
  257  after receiving such estimate.
  258         (3)At a minimum, the advanced explanation of benefits must
  259  include detailed coverage and cost-sharing information pursuant
  260  to the No Surprises Act, Title I of Division BB, Pub. L. No.
  261  116-260.
  262         Section 6. Paragraph (a) of subsection (4) of section
  263  627.6387, Florida Statutes, is amended to read:
  264         627.6387 Shared savings incentive program.—
  265         (4)(a) A shared savings incentive offered by a health
  266  insurer in accordance with this section:
  267         1. Is not an administrative expense for rate development or
  268  rate filing purposes and shall be counted as a medical expense
  269  for such purposes.
  270         2. Does not constitute an unfair method of competition or
  271  an unfair or deceptive act or practice under s. 626.9541 and is
  272  presumed to be appropriate unless credible data clearly
  273  demonstrates otherwise.
  274         Section 7. Paragraph (a) of subsection (4) of section
  275  627.6648, Florida Statutes, is amended to read:
  276         627.6648 Shared savings incentive program.—
  277         (4)(a) A shared savings incentive offered by a health
  278  insurer in accordance with this section:
  279         1. Is not an administrative expense for rate development or
  280  rate filing purposes and shall be counted as a medical expense
  281  for such purposes.
  282         2. Does not constitute an unfair method of competition or
  283  an unfair or deceptive act or practice under s. 626.9541 and is
  284  presumed to be appropriate unless credible data clearly
  285  demonstrates otherwise.
  286         Section 8. Paragraph (a) of subsection (4) of section
  287  641.31076, Florida Statutes, is amended to read:
  288         641.31076 Shared savings incentive program.—
  289         (4) A shared savings incentive offered by a health
  290  maintenance organization in accordance with this section:
  291         (a) Is not an administrative expense for rate development
  292  or rate filing purposes and shall be counted as a medical
  293  expense for such purposes.
  294         Section 9. Paragraphs (a) and (j) of subsection (1) of
  295  section 475.01, Florida Statutes, are amended to read:
  296         475.01 Definitions.—
  297         (1) As used in this part:
  298         (a) “Broker” means a person who, for another, and for a
  299  compensation or valuable consideration directly or indirectly
  300  paid or promised, expressly or impliedly, or with an intent to
  301  collect or receive a compensation or valuable consideration
  302  therefor, appraises, auctions, sells, exchanges, buys, rents, or
  303  offers, attempts or agrees to appraise, auction, or negotiate
  304  the sale, exchange, purchase, or rental of business enterprises
  305  or business opportunities or any real property or any interest
  306  in or concerning the same, including mineral rights or leases,
  307  or who advertises or holds out to the public by any oral or
  308  printed solicitation or representation that she or he is engaged
  309  in the business of appraising, auctioning, buying, selling,
  310  exchanging, leasing, or renting business enterprises or business
  311  opportunities or real property of others or interests therein,
  312  including mineral rights, or who takes any part in the procuring
  313  of sellers, purchasers, lessors, or lessees of business
  314  enterprises or business opportunities or the real property of
  315  another, or leases, or interest therein, including mineral
  316  rights, or who directs or assists in the procuring of prospects
  317  or in the negotiation or closing of any transaction which does,
  318  or is calculated to, result in a sale, exchange, or leasing
  319  thereof, and who receives, expects, or is promised any
  320  compensation or valuable consideration, directly or indirectly
  321  therefor; and all persons who advertise rental property
  322  information or lists. A broker renders a professional service
  323  and is a professional within the meaning of s. 95.11(5)(b) s.
  324  95.11(4)(b). Where the term “appraise” or “appraising” appears
  325  in the definition of the term “broker,” it specifically excludes
  326  those appraisal services which must be performed only by a
  327  state-licensed or state-certified appraiser, and those appraisal
  328  services which may be performed by a registered trainee
  329  appraiser as defined in part II. The term “broker” also includes
  330  any person who is a general partner, officer, or director of a
  331  partnership or corporation which acts as a broker. The term
  332  “broker” also includes any person or entity who undertakes to
  333  list or sell one or more timeshare periods per year in one or
  334  more timeshare plans on behalf of any number of persons, except
  335  as provided in ss. 475.011 and 721.20.
  336         (j) “Sales associate” means a person who performs any act
  337  specified in the definition of “broker,” but who performs such
  338  act under the direction, control, or management of another
  339  person. A sales associate renders a professional service and is
  340  a professional within the meaning of s. 95.11(5)(b) s.
  341  95.11(4)(b).
  342         Section 10. Paragraph (h) of subsection (1) of section
  343  475.611, Florida Statutes, is amended to read:
  344         475.611 Definitions.—
  345         (1) As used in this part, the term:
  346         (h) “Appraiser” means any person who is a registered
  347  trainee real estate appraiser, a licensed real estate appraiser,
  348  or a certified real estate appraiser. An appraiser renders a
  349  professional service and is a professional within the meaning of
  350  s. 95.11(5)(b) s. 95.11(4)(b).
  351         Section 11. Subsection (7) of section 517.191, Florida
  352  Statutes, is amended to read:
  353         517.191 Injunction to restrain violations; civil penalties;
  354  enforcement by Attorney General.—
  355         (7) Notwithstanding s. 95.11(5)(f) s. 95.11(4)(f), an
  356  enforcement action brought under this section based on a
  357  violation of any provision of this chapter or any rule or order
  358  issued under this chapter shall be brought within 6 years after
  359  the facts giving rise to the cause of action were discovered or
  360  should have been discovered with the exercise of due diligence,
  361  but not more than 8 years after the date such violation
  362  occurred.
  363         Section 12. Subsection (14) of section 768.28, Florida
  364  Statutes, is amended to read:
  365         768.28 Waiver of sovereign immunity in tort actions;
  366  recovery limits; civil liability for damages caused during a
  367  riot; limitation on attorney fees; statute of limitations;
  368  exclusions; indemnification; risk management programs.—
  369         (14) Every claim against the state or one of its agencies
  370  or subdivisions for damages for a negligent or wrongful act or
  371  omission pursuant to this section shall be forever barred unless
  372  the civil action is commenced by filing a complaint in the court
  373  of appropriate jurisdiction within 4 years after such claim
  374  accrues; except that an action for contribution must be
  375  commenced within the limitations provided in s. 768.31(4), and
  376  an action for damages arising from medical malpractice or
  377  wrongful death must be commenced within the limitations for such
  378  actions in s. 95.11(5) s. 95.11(4).
  379         Section 13. Subsection (4) of section 787.061, Florida
  380  Statutes, is amended to read:
  381         787.061 Civil actions by victims of human trafficking.—
  382         (4) STATUTE OF LIMITATIONS.—The statute of limitations as
  383  specified in s. 95.11(8) or (10) s. 95.11(7) or (9), as
  384  applicable, governs an action brought under this section.
  385         Section 14. This act shall take effect October 1, 2024.