Florida Senate - 2016               CS for CS for CS for SB 1036
       
       
        
       By the Committees on Rules; Commerce and Tourism; and Banking
       and Insurance; and Senator Brandes
       
       595-04428-16                                          20161036c3
    1                        A bill to be entitled                      
    2         An act relating to automobile insurance; amending s.
    3         627.311, F.S.; authorizing the Florida Automobile
    4         Joint Underwriting Association and a joint
    5         underwriting plan approved by the Office of Insurance
    6         Regulation to cancel personal lines or commercial
    7         policies within a specified time for nonpayment of
    8         premium due to certain reasons; prohibiting an insured
    9         from cancelling a policy or binder within a specified
   10         time except under certain conditions; amending s.
   11         627.7283, F.S.; authorizing an insured who cancels a
   12         policy to apply the unearned portion of any premium
   13         paid to unpaid balances of other policies with the
   14         same insurer or insurer group; amending s. 627.7295,
   15         F.S.; updating applicability language to include a
   16         reference to recurring credit card or debit card
   17         payments; authorizing an additional form of payment
   18         for certain motor vehicle insurance contract premiums;
   19         authorizing an insurer to impose a specified
   20         insufficient funds fee under certain circumstances;
   21         amending s. 627.736, F.S.; requiring that a certain
   22         standard form be approved by the office and adopted by
   23         the Financial Services Commission, rather than
   24         approved by the office or adopted by the commission;
   25         revising standards for compliance for specified
   26         billings for medical services; adding a specified
   27         entity to a list of entities that are not required to
   28         be licensed as a clinic to receive reimbursement under
   29         the Florida Motor Vehicle No-Fault Law; providing an
   30         effective date.
   31          
   32  Be It Enacted by the Legislature of the State of Florida:
   33  
   34         Section 1. Paragraph (m) is added to subsection (3) of
   35  section 627.311, Florida Statutes, to read:
   36         627.311 Joint underwriters and joint reinsurers; public
   37  records and public meetings exemptions.—
   38         (3) The office may, after consultation with insurers
   39  licensed to write automobile insurance in this state, approve a
   40  joint underwriting plan for purposes of equitable apportionment
   41  or sharing among insurers of automobile liability insurance and
   42  other motor vehicle insurance, as an alternate to the plan
   43  required in s. 627.351(1). All insurers authorized to write
   44  automobile insurance in this state shall subscribe to the plan
   45  and participate therein. The plan shall be subject to continuous
   46  review by the office which may at any time disapprove the entire
   47  plan or any part thereof if it determines that conditions have
   48  changed since prior approval and that in view of the purposes of
   49  the plan changes are warranted. Any disapproval by the office
   50  shall be subject to the provisions of chapter 120. The Florida
   51  Automobile Joint Underwriting Association is created under the
   52  plan. The plan and the association:
   53         (m) May cancel personal lines or commercial policies issued
   54  by the plan within the first 60 days after the effective date of
   55  the policy or binder for nonpayment of premium if the check
   56  issued for payment of the premium is dishonored for any reason
   57  or if any other form of payment is rejected or deemed invalid.
   58  An insured may not cancel a policy or binder within the first 90
   59  days after its effective date, or within a lesser period as
   60  required by the plan, except:
   61         1. Upon total destruction of the insured motor vehicle;
   62         2. Upon transfer of ownership of the insured motor vehicle;
   63  or
   64         3. After purchase of another policy or binder covering the
   65  motor vehicle that was covered under the policy being canceled.
   66         Section 2. Section 627.7283, Florida Statutes, is amended
   67  to read:
   68         627.7283 Cancellation; return of unearned premium.—
   69         (1) If the insured cancels a policy of motor vehicle
   70  insurance, the insurer must mail or electronically transfer the
   71  unearned portion of any premium paid within 30 days after the
   72  effective date of the policy cancellation or receipt of notice
   73  or request for cancellation, whichever is later. This
   74  requirement applies to a cancellation initiated by an insured
   75  for any reason. However, the insured may apply the unearned
   76  portion of any premium paid to unpaid balances of other policies
   77  with the same insurer or insurer group.
   78         (2) If an insurer cancels a policy of motor vehicle
   79  insurance, the insurer must mail or electronically transfer the
   80  unearned premium portion of any premium within 15 days after the
   81  effective date of the policy cancellation. However, the insured
   82  may apply the unearned portion of any premium paid to unpaid
   83  balances of other policies with the same insurer or insurer
   84  group.
   85         (3) If the unearned premium is not mailed, or
   86  electronically transferred, or applied to the unpaid balance of
   87  other policies within the applicable period, the insurer must
   88  pay to the insured 8 percent interest on the amount due. If the
   89  unearned premium is not mailed or electronically transferred
   90  within 45 days after the applicable period, the insured may
   91  bring an action against the insurer pursuant to s. 624.155.
   92         (4) If the insured cancels, the insurer may retain up to 10
   93  percent of the unearned premium and must refund at least 90
   94  percent of the unearned premium. If the insurer cancels, the
   95  insurer must refund 100 percent of the unearned premium.
   96  Cancellation is without prejudice to any claim originating prior
   97  to the effective date of the cancellation. For purposes of this
   98  section, unearned premiums must be computed on a pro rata basis.
   99         (5) The insurer must refund 100 percent of the unearned
  100  premium if the insured is a servicemember, as defined in s.
  101  250.01, who cancels because he or she is called to active duty
  102  or transferred by the United States Armed Forces to a location
  103  where the insurance is not required. The insurer may require a
  104  servicemember to submit either a copy of the official military
  105  orders or a written verification signed by the servicemember’s
  106  commanding officer to support the refund authorized under this
  107  subsection. If the insurer cancels, the insurer must refund 100
  108  percent of the unearned premium. Cancellation is without
  109  prejudice to any claim originating prior to the effective date
  110  of the cancellation. For purposes of this section, unearned
  111  premiums must be computed on a pro rata basis.
  112         Section 3. Subsection (7) of section 627.7295, Florida
  113  Statutes, is amended, and subsection (9) is added to that
  114  section, to read:
  115         627.7295 Motor vehicle insurance contracts.—
  116         (7) A policy of private passenger motor vehicle insurance
  117  or a binder for such a policy may be initially issued in this
  118  state only if, before the effective date of such binder or
  119  policy, the insurer or agent has collected from the insured an
  120  amount equal to 2 months’ premium. An insurer, agent, or premium
  121  finance company may not, directly or indirectly, take any action
  122  resulting in the insured having paid from the insured’s own
  123  funds an amount less than the 2 months’ premium required by this
  124  subsection. This subsection applies without regard to whether
  125  the premium is financed by a premium finance company or is paid
  126  pursuant to a periodic payment plan of an insurer or an
  127  insurance agent. This subsection does not apply if an insured or
  128  member of the insured’s family is renewing or replacing a policy
  129  or a binder for such policy written by the same insurer or a
  130  member of the same insurer group. This subsection does not apply
  131  to an insurer that issues private passenger motor vehicle
  132  coverage primarily to active duty or former military personnel
  133  or their dependents. This subsection does not apply if all
  134  policy payments are paid pursuant to a payroll deduction plan,
  135  or an automatic electronic funds transfer payment plan from the
  136  policyholder, or a recurring credit card or debit card agreement
  137  with the insurer. This subsection and subsection (4) do not
  138  apply if all policy payments to an insurer are paid pursuant to
  139  an automatic electronic funds transfer payment plan from an
  140  agent, a managing general agent, or a premium finance company
  141  and if the policy includes, at a minimum, personal injury
  142  protection pursuant to ss. 627.730-627.7405; motor vehicle
  143  property damage liability pursuant to s. 627.7275; and bodily
  144  injury liability in at least the amount of $10,000 because of
  145  bodily injury to, or death of, one person in any one accident
  146  and in the amount of $20,000 because of bodily injury to, or
  147  death of, two or more persons in any one accident. This
  148  subsection and subsection (4) do not apply if an insured has had
  149  a policy in effect for at least 6 months, the insured’s agent is
  150  terminated by the insurer that issued the policy, and the
  151  insured obtains coverage on the policy’s renewal date with a new
  152  company through the terminated agent.
  153         (9)(a) In addition to the methods provided in s.
  154  627.4035(1), the premiums for motor vehicle insurance contracts
  155  issued in this state or covering risk located in this state may
  156  be paid in cash in the form of a draft or drafts.
  157         (b) If, due to insufficient funds, a payment of premium
  158  under this subsection by debit card, credit card, electronic
  159  funds transfer, or electronic check is returned or declined or
  160  cannot be processed, the insurer may impose an insufficient
  161  funds fee of up to $15 per occurrence pursuant to the policy
  162  terms.
  163         Section 4. Paragraphs (d) and (h) of subsection (5) of
  164  section 627.736, Florida Statutes, are amended to read:
  165         627.736 Required personal injury protection benefits;
  166  exclusions; priority; claims.—
  167         (5) CHARGES FOR TREATMENT OF INJURED PERSONS.—
  168         (d) All statements and bills for medical services rendered
  169  by a physician, hospital, clinic, or other person or institution
  170  shall be submitted to the insurer on a properly completed
  171  Centers for Medicare and Medicaid Services (CMS) 1500 form, UB
  172  92 forms, or any other standard form approved by the office and
  173  or adopted by the commission for purposes of this paragraph. All
  174  billings for such services rendered by providers must, to the
  175  extent applicable, comply with the CMS 1500 form instructions,
  176  the American Medical Association CPT Editorial Panel, and the
  177  Healthcare Common Procedure Coding System (HCPCS); and must
  178  follow the Physicians’ Current Procedural Terminology (CPT), the
  179  HCPCS in effect for the year in which services are rendered, and
  180  the International Classification of Diseases (ICD) adopted by
  181  the United States Department of Health and Human Services for
  182  the service year in which the services, supplies, or care is
  183  rendered as described in subparagraph (a)2. follow the
  184  Physicians’ Current Procedural Terminology (CPT) or Healthcare
  185  Correct Procedural Coding System (HCPCS), or ICD-9 in effect for
  186  the year in which services are rendered and comply with the CMS
  187  1500 form instructions, the American Medical Association CPT
  188  Editorial Panel, and the HCPCS. All providers, other than
  189  hospitals, must include on the applicable claim form the
  190  professional license number of the provider in the line or space
  191  provided for “Signature of Physician or Supplier, Including
  192  Degrees or Credentials.” In determining compliance with
  193  applicable CPT and HCPCS coding, guidance shall be provided by
  194  the Physicians’ Current Procedural Terminology (CPT) or the
  195  Healthcare Correct Procedural Coding System (HCPCS) in effect
  196  for the year in which services were rendered, the Office of the
  197  Inspector General, Physicians Compliance Guidelines, and other
  198  authoritative treatises designated by rule by the Agency for
  199  Health Care Administration. A statement of medical services may
  200  not include charges for medical services of a person or entity
  201  that performed such services without possessing the valid
  202  licenses required to perform such services. For purposes of
  203  paragraph (4)(b), an insurer is not considered to have been
  204  furnished with notice of the amount of covered loss or medical
  205  bills due unless the statements or bills comply with this
  206  paragraph and are properly completed in their entirety as to all
  207  material provisions, with all relevant information being
  208  provided therein.
  209         (h) As provided in s. 400.9905, an entity excluded from the
  210  definition of a clinic shall be deemed a clinic and must be
  211  licensed under part X of chapter 400 in order to receive
  212  reimbursement under ss. 627.730-627.7405. However, this
  213  licensing requirement does not apply to:
  214         1. An entity wholly owned by a physician licensed under
  215  chapter 458 or chapter 459, or by the physician and the spouse,
  216  parent, child, or sibling of the physician;
  217         2. An entity wholly owned by a dentist licensed under
  218  chapter 466, or by the dentist and the spouse, parent, child, or
  219  sibling of the dentist;
  220         3. An entity wholly owned by a chiropractic physician
  221  licensed under chapter 460, or by the chiropractic physician and
  222  the spouse, parent, child, or sibling of the chiropractic
  223  physician;
  224         4. A hospital or ambulatory surgical center licensed under
  225  chapter 395;
  226         5. An entity that wholly owns or is wholly owned, directly
  227  or indirectly, by a hospital or hospitals licensed under chapter
  228  395;
  229         6. An entity that is a clinical facility affiliated with an
  230  accredited medical school at which training is provided for
  231  medical students, residents, or fellows; or
  232         7. An entity that is certified under 42 C.F.R. part 485,
  233  subpart H; or
  234         8.An entity that is owned by a publicly traded
  235  corporation, either directly or indirectly through its
  236  subsidiaries, that has $250 million or more in total annual
  237  sales of health care services provided by licensed health care
  238  practitioners, if one or more of the persons responsible for the
  239  operations of the entity are health care practitioners who are
  240  licensed in this state and are responsible for supervising the
  241  business activities of the entity and the entity’s compliance
  242  with state law for purposes of this section.
  243         Section 5. This act shall take effect July 1, 2016.