SENATE AMENDMENT
Bill No. CS for SB 1362
Amendment No. ___ Barcode 443178
CHAMBER ACTION
Senate House
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11 Senator Geller moved the following amendment to House
12 amendment (803811):
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14 Senate Amendment (with title amendment)
15 On page 5, line 15, through
16 page 8, line 4, delete those lines
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18 and insert:
19 Section 4. Paragraphs (d) and (e) of subsection (5) of
20 section 627.736, Florida Statutes, are amended to read:
21 627.736 Required personal injury protection benefits;
22 exclusions; priority; claims.--
23 (5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
24 (d) Every insurer shall include a provision in its
25 policy for personal injury protection benefits for binding
26 arbitration of any claims dispute involving medical benefits
27 arising between the insurer and any person providing medical
28 services or supplies if that person has agreed to accept
29 assignment of personal injury protection benefits. The
30 provision shall specify that the provisions of chapter 682
31 relating to arbitration shall apply. The prevailing party
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SENATE AMENDMENT
Bill No. CS for SB 1362
Amendment No. ___ Barcode 443178
1 shall be entitled to attorney's fees and costs. For purposes
2 of the award of attorney's fees and costs, the prevailing
3 party shall be determined as follows:
4 1. When the amount of personal injury protection
5 benefits determined by arbitration exceeds the sum of the
6 amount offered by the insurer at arbitration plus 50 percent
7 of the difference between the amount of the claim asserted by
8 the claimant at arbitration and the amount offered by the
9 insurer at arbitration, the claimant is the prevailing party.
10 2. When the amount of personal injury protection
11 benefits determined by arbitration is less than the sum of the
12 amount offered by the insurer at arbitration plus 50 percent
13 of the difference between the amount of the claim asserted by
14 the claimant at arbitration and the amount offered by the
15 insurer at arbitration, the insurer is the prevailing party.
16 3. When neither subparagraph 1. nor subparagraph 2.
17 applies, there is no prevailing party. For purposes of this
18 paragraph, the amount of the offer or claim at arbitration is
19 the amount of the last written offer or claim made at least 30
20 days prior to the arbitration.
21 4. In the demand for arbitration, the party requesting
22 arbitration must include a statement specifically identifying
23 the issues for arbitration for each examination or treatment
24 in dispute. The other party must subsequently issue a
25 statement specifying any other examinations or treatment and
26 any other issues that it intends to raise in the arbitration.
27 The parties may amend their statements up to 30 days prior to
28 arbitration, provided that arbitration shall be limited to
29 those identified issues and neither party may add additional
30 issues during arbitration.
31 (d)(e) All statements and bills for medical services
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SENATE AMENDMENT
Bill No. CS for SB 1362
Amendment No. ___ Barcode 443178
1 rendered by any physician, hospital, clinic, or other person
2 or institution shall be submitted to the insurer on a Health
3 Care Finance Administration 1500 form, UB 92 forms, or any
4 other standard form approved by the department for purposes of
5 this paragraph. All billings for such services shall, to the
6 extent applicable, follow the Physicians' Current Procedural
7 Terminology (CPT) in the year in which services are rendered.
8 No statement of medical services may include charges for
9 medical services of a person or entity that performed such
10 services without possessing the valid licenses required to
11 perform such services. For purposes of paragraph (4)(b), an
12 insurer shall not be considered to have been furnished with
13 notice of the amount of covered loss or medical bills due
14 unless the statements or bills comply with this paragraph.
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18 And the title is amended as follows:
19 On page 8, lines 26-28, delete those lines
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21 and insert:
22 insurance; amending s. 627.736, F.S.;
23 eliminating a requirement that an insurer
24 include provisions for binding arbitration in
25 policies for personal injury protection;
26 providing an effective date.
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