Florida Senate - 2019 SB 80 By Senator Stargel 22-00375-19 201980__ 1 A bill to be entitled 2 An act relating to medical malpractice; creating s. 3 766.1181, F.S.; specifying how to calculate damages in 4 certain personal injury or wrongful death actions; 5 prohibiting admission of specified information 6 relating to costs of medical or health care as 7 evidence in such actions; providing applicability; 8 providing a directive to the Division of Law Revision; 9 providing an effective date. 10 11 Be It Enacted by the Legislature of the State of Florida: 12 13 Section 1. Section 766.1181, Florida Statutes, is created 14 to read: 15 766.1181 Damages recoverable for cost of medical or health 16 care services; evidence of damages; applicability.— 17 (1) In any personal injury or wrongful death action to 18 which this chapter applies, damages for the cost of medical or 19 health care services provided to a claimant are calculated as 20 follows: 21 (a) For medical or health care services provided by a 22 health care provider to a claimant which the claimant paid for 23 and for which an outstanding balance is not due to the provider, 24 the actual amount remitted to the provider is the maximum amount 25 recoverable. Any difference between the amount originally billed 26 by the provider and the actual amount remitted to the provider 27 is not recoverable or admissible in evidence. 28 (b) For medical or health care services provided by a 29 health care provider to a claimant which a government program or 30 private health insurance paid for and for which an outstanding 31 balance is not due to the provider, other than a copayment or 32 deductible owed by the claimant, the actual amount remitted to 33 the provider by the government program or private health 34 insurance, plus any copayment or deductible owed by the 35 claimant, is the maximum amount recoverable. Any difference 36 between the amount originally billed by the provider and the sum 37 of the actual amount remitted to the provider and the copayment 38 or deductible owed by the claimant is not recoverable or 39 admissible in evidence. 40 (c) For medical or health care services provided to a 41 claimant for which an outstanding balance is claimed to be due 42 to the health care provider and for claims asserted for medical 43 or health care services to be provided to the claimant in the 44 future, the maximum amounts recoverable are the amounts 45 customarily accepted from Medicare in payment for such services 46 by other health care providers in the same geographic area. This 47 limitation also applies to any lien asserted for such services 48 in the action, with the exception of liens identified in 49 subsection (3). 50 (2) An individual contract between a health care provider 51 and a health insurer or health maintenance organization is not 52 subject to discovery or disclosure in an action under this 53 section, and such information is not admissible in evidence in 54 an action to which this section applies. 55 (3) Notwithstanding this section, if Medicaid, Medicare, or 56 a payor regulated under the Florida Insurance Code has covered 57 or is covering the cost of a claimant’s medical or health care 58 services and has given notice of assertion of a lien or 59 subrogation claim for past medical expenses in the action, the 60 amount of the lien or subrogation claim, in addition to the 61 amount of a copayment or deductible paid or payable by the 62 claimant, is the maximum amount recoverable and admissible in 63 evidence with respect to the covered medical or health care 64 services. 65 (4) This section applies only to personal injury or 66 wrongful death actions to which this chapter applies which arise 67 on or after the effective date of this act. This section has no 68 other application or effect regarding compensation paid to 69 providers of medical or health care services. 70 Section 2. The Division of Law Revision is directed to 71 replace the phrase “the effective date of this act” whenever it 72 occurs in this act with the date the act becomes a law. 73 Section 3. This act shall take effect upon becoming a law.