HB 0027A, Engrossed 1 2003
1	A bill to be entitled
2	An act relating to motor vehicle insurance costs;
3	providing an act name; providing legislative findings and
4	purposes; amending s. 119.105, F.S.; prohibiting
5	disclosure of confidential police reports for purposes of
6	commercial solicitation; amending s. 316.066, F.S.;
7	requiring the filing of a sworn statement as a condition
8	to accessing a crash report stating the report will not be
9	used for commercial solicitation; providing a penalty;
10	creating part XIII of ch. 400, F.S., entitled the “Health
11	Care Clinic Act”; providing for definitions and
12	exclusions; providing for the licensure, inspection, and
13	regulation of health care clinics by the Agency for Health
14	Care Administration; requiring licensure and background
15	screening; providing for clinic inspections; providing
16	rulemaking authority; providing licensure fees; providing
17	fines and penalties for operating an unlicensed clinic;
18	providing for clinic responsibilities with respect to
19	personnel and operations; providing accreditation
20	requirements; providing for injunctive proceedings and
21	agency actions; providing administrative penalties;
22	amending s. 456.0375, F.S.; excluding certain entities
23	from clinic registration requirements; providing
24	retroactive application; amending s. 456.072, F.S.;
25	providing that making a claim with respect to personal
26	injury protection which is upcoded or which is submitted
27	for payment of services not rendered constitutes grounds
28	for disciplinary action; amending s. 627.732, F.S.;
29	providing definitions; amending s. 627.736, F.S.;
30	providing that benefits are void if fraud is committed;
31	providing for award of attorney's fees in actions to
32	recover benefits; providing that consideration shall be
33	given to certain factors regarding the reasonableness of
34	charges; specifying claims or charges that an insurer is
35	not required to pay; requiring the Department of Health,
36	in consultation with medical boards, to identify certain
37	diagnostic tests as noncompensable; specifying effective
38	dates; deleting certain provisions governing arbitration;
39	providing for compliance with billing procedures;
40	requiring certain providers to require an insured to sign
41	a disclosure form; prohibiting insurers from authorizing
42	physicians to change opinions in reports; providing
43	requirements for physicians with respect to maintaining
44	such reports; limiting the application of contingency risk
45	multipliers for awards of attorney's fees; expanding
46	provisions providing for a demand letter; authorizing the
47	Financial Services Commission to determine cost savings
48	under personal injury protection benefits under specified
49	conditions; allowing a person who elects a deductible or
50	modified coverage to claim the amount deducted from a
51	person legally responsible; amending s. 627.739, F.S.;
52	specifying application of a deductible amount; amending s.
53	817.234, F.S.; providing that it is a material omission
54	and insurance fraud for a physician or other provider to
55	waive a deductible or copayment or not collect the total
56	amount of a charge; specifying nonapplication to certain
57	physicians or providers under certain circumstances;
58	increasing the penalties for certain acts of solicitation
59	of accident victims; providing mandatory minimum
60	penalties; prohibiting certain solicitation of accident
61	victims; providing penalties; prohibiting a person from
62	participating in an intentional motor vehicle accident for
63	the purpose of making motor vehicle tort claims; providing
64	penalties, including mandatory minimum penalties; amending
65	s. 817.236, F.S.; increasing penalties for false and
66	fraudulent motor vehicle insurance application; creating
67	s. 817.2361, F.S.; prohibiting the creation or use of
68	false or fraudulent motor vehicle insurance cards;
69	providing penalties; amending s. 921.0022, F.S.; revising
70	the offense severity ranking chart of the Criminal
71	Punishment Code to reflect changes in penalties and the
72	creation of additional offenses under the act; providing
73	legislative intent with respect to the retroactive
74	application of certain provisions; repealing s. 456.0375,
75	F.S., relating to the regulation of clinics by the
76	Department of Health; requiring certain insurers to make a
77	rate filing to conform the per-policy fee to the
78	requirements of the act; specifying the application of any
79	increase in benefits approved by the Financial Services
80	Commission; providing for application of other provisions
81	of the act; requiring reports; providing an appropriation
82	and authorizing additional positions; repealing ss.
83	627.730, 627.731, 627.732, 627.733, 627.734, 627.736,
84	627.737, 627.739, 627.7401, 627.7403, and 627.7405, F.S.,
85	relating to the Florida Motor Vehicle No-Fault Law, unless
86	reenacted by the 2005 Regular Session, and specifying
87	certain effect; authorizing insurers to include in
88	policies a notice of termination prior to such repeal;
89	reenacting without amendment s. 626.7451, F.S.,
90	notwithstanding the provisions of HB 513 enacted during
91	the 2003 Regular Session of the Legislature; providing for
92	construction of the act in pari material with laws enacted
93	during the 2003 Regular Session of the Legislature;
94	providing an exception; providing effective dates.
95
96	Be It Enacted by the Legislature of the State of Florida:
97
98	Section 1. Florida Motor Vehicle Insurance Affordability
99	Reform Act; legislative findings; purpose.--
100	(1) This is the "Florida Motor Vehicle Insurance
101	Affordability Reform Act."
102	(2) The Legislature finds and declares that:
103	(a) The Florida Motor Vehicle No-Fault Law, enacted 32
104	years ago, has provided valuable benefits over the years to
105	consumers in this state. The principle underlying the
106	philosophical basis of the no-fault or personal injury
107	protection (PIP) insurance system is that of a trade-off of one
108	benefit for another, specifically providing medical and other
109	benefits in return for a limitation on the right to sue for
110	nonserious injuries.
111	(b) The PIP insurance system has provided benefits in the
112	form of medical payments, lost wages, replacement services,
113	funeral payments, and other benefits, without regard to fault,
114	to consumers injured in automobile accidents.
115	(c) However, the goals behind the adoption of the no-fault
116	law in 1971, which were to quickly and efficiently compensate
117	accident victims regardless of fault, to reduce the volume of
118	lawsuits by eliminating minor injuries from the tort system, and
119	to reduce overall motor vehicle insurance costs, have been
120	significantly compromised due to the fraud and abuse that has
121	permeated the PIP insurance market.
122	(d) Motor vehicle insurance fraud and abuse, other than in
123	the hospital setting, whether in the form of inappropriate
124	medical treatments, inflated claims, staged accidents,
125	solicitation of accident victims, falsification of records, or
126	in any other form, has increased premiums for consumers and must
127	be uncovered and vigorously prosecuted. The problems of
128	inappropriate medical treatment and inflated claims for PIP have
129	generally not occurred in the hospital setting.
130	(e) The no-fault system has been weakened in part due to
131	certain insurers not adequately or timely compensating injured
132	accident victims or health care providers. In addition, the
133	system has become increasingly litigious with attorneys
134	obtaining large fees by litigating, in certain instances, over
135	relatively small amounts that are in dispute.
136	(f) It is a matter of great public importance that, in
137	order to provide a healthy and competitive automobile insurance
138	market, consumers be able to obtain affordable coverage,
139	insurers be entitled to earn an adequate rate of return, and
140	providers of services be compensated fairly.
141	(g) It is further a matter of great public importance
142	that, in order to protect the public's health, safety, and
143	welfare, it is necessary to enact the provisions contained in
144	this act in order to prevent PIP insurance fraud and abuse and
145	to curb escalating medical, legal, and other related costs, and
146	the Legislature finds that the provisions of this act are the
147	least restrictive actions necessary to achieve this goal.
148	(h) Therefore, the purpose of this act is to restore the
149	health of the PIP insurance market in this state by addressing
150	these issues, preserving the no-fault system, and realizing cost
151	savings for all people in this state.
152	Section 2. Section 119.105, Florida Statutes, is amended
153	to read:
154	119.105 Protection of victims of crimes or
155	accidents.--Police reports are public records except as
156	otherwise made exempt or confidential by general or special law.
157	Every person is allowed to examine nonexempt or nonconfidential
158	police reports. ANo person who comes into possession of exempt
159	or confidential information contained in police reports may not
160	inspects or copies police reports for the purpose of obtaining
161	the names and addresses of the victims of crimes or accidents
162	shall use thatany information contained thereinfor any
163	commercial solicitation of the victims or relatives of the
164	victims of the reported crimes or accidents and may not
165	knowingly disclose such information to any third party for the
166	purpose of such solicitation during the period of time that
167	information remains exempt or confidential. This section does
168	notNothing herein shallprohibit the publication of such
169	information to the general public by any news media legally
170	entitled to possess that informationor the use of such
171	information for any other data collection or analysis purposes
172	by those entitled to possess that information.
173	Section 3. Paragraph (c) of subsection (3) of section
174	316.066, Florida Statutes, is amended, and paragraph (f) is
175	added to said subsection, to read:
176	316.066 Written reports of crashes.--
177	(3)
178	(c) Crash reports required by this section which reveal
179	the identity, home or employment telephone number or home or
180	employment address of, or other personal information concerning
181	the parties involved in the crash and which are received or
182	prepared by any agency that regularly receives or prepares
183	information from or concerning the parties to motor vehicle
184	crashes are confidential and exempt from s. 119.07(1) and s.
185	24(a), Art. I of the State Constitution for a period of 60 days
186	after the date the report is filed. However, such reports may be
187	made immediately available to the parties involved in the crash,
188	their legal representatives, their licensed insurance agents,
189	their insurers or insurers to which they have applied for
190	coverage, persons under contract with such insurers to provide
191	claims or underwriting information, prosecutorial authorities,
192	radio and television stations licensed by the Federal
193	Communications Commission, newspapers qualified to publish legal
194	notices under ss. 50.011 and 50.031, and free newspapers of
195	general circulation, published once a week or more often,
196	available and of interest to the public generally for the
197	dissemination of news. For the purposes of this section, the
198	following products or publications are not newspapers as
199	referred to in this section: those intended primarily for
200	members of a particular profession or occupational group; those
201	with the primary purpose of distributing advertising; and those
202	with the primary purpose of publishing names and other
203	personally identifying information concerning parties to motor
204	vehicle crashes. Any local, state, or federal agency, agent, or
205	employee that is authorized to have access to such reports by
206	any provision of law shall be granted such access in the
207	furtherance of the agency's statutory duties notwithstanding the
208	provisions of this paragraph. Any local, state, or federal
209	agency, agent, or employee receiving such crash reports shall
210	maintain the confidential and exempt status of those reports and
211	shall not disclose such crash reports to any person or entity.
212	As a condition precedent to accessing aAny person attempting to
213	access crash reportreportswithin 60 days after the date the
214	report is filed, a person must present a valid driver's license
215	or other photographic identification, proof of statuslegitimate
216	credentialsor identification that demonstrates his or her
217	qualifications to access that information and file a written
218	sworn statement with the state or local agency in possession of
219	the information stating that information from a crash report
220	made confidential by this section will not be used for any
221	commercial solicitation of accident victims, or knowingly be
222	disclosed to any third party for the purpose of such
223	solicitation, during the period of time that the information
224	remains confidential. In lieu of requiring the written sworn
225	statement, an agency may provide crash reports by electronic
226	means to third-party vendors under contract with one or more
227	insurers, but only when such contract states that information
228	from a crash report made confidential by this paragraph will not
229	be used for any commercial solicitation of accident victims by
230	the vendors, or knowingly be disclosed by the vendors to any
231	third party for the purpose of such solicitation, during the
232	period of time that the information remains confidential, and
233	only when a copy of such contract is furnished to the agency as
234	proof of the vendor's claimed status. This subsection does not
235	prevent the dissemination or publication of news to the general
236	public by any legitimate media entitled to access confidential
237	information pursuant to this section. A law enforcement officer
238	as defined in s. 943.10(1) may enforce this paragraph.This
239	exemption is subject to the Open Government Sunset Review Act of
240	1995 in accordance with s. 119.15, and shall stand repealed on
241	October 2, 2006, unless reviewed and saved from repeal through
242	reenactment by the Legislature.
243	(d) Any employee of a state or local agency in possession
244	of information made confidential by this section who knowingly
245	discloses such confidential information to a person not entitled
246	to access such information under this section is guilty of a
247	felony of the third degree, punishable as provided in s.
248	775.082, s. 775.083, or s. 775.084.
249	(e) Any person, knowing that he or she is not entitled to
250	obtain information made confidential by this section, who
251	obtains or attempts to obtain such information is guilty of a
252	felony of the third degree, punishable as provided in s.
253	775.082, s. 775.083, or s. 775.084.
254	(f) Any person who knowingly uses confidential information
255	in violation of a filed written sworn statement or contractual
256	agreement required by this section commits a felony of the third
257	degree, punishable as provided in s. 775.082, s. 775.083, or s.
258	775.084.
259	Section 4. Effective October 1, 2003, part XIII of chapter
260	400, Florida Statutes, consisting of sections 400.9901,
261	400.9902, 400.9903, 400.9904, 400.9905, 400.9906, 400.9907,
262	400.9908, 400.9909, 400.9910, and 400.9911, Florida Statutes, is
263	created to read:
264	400.9901 Popular name; legislative findings.--
265	(1) This part, consisting of ss. 400.9901-400.9911, may be
266	referred to as the "Health Care Clinic Act."
267	(2) The Legislature finds that the regulation of health
268	care clinics must be strengthened to prevent significant cost
269	and harm to consumers. The purpose of this part is to provide
270	for the licensure, establishment, and enforcement of basic
271	standards for health care clinics and to provide administrative
272	oversight by the Agency for Health Care Administration.
273	400.9902 Definitions.--
274	(1) "Agency" means the Agency for Health Care
275	Administration.
276	(2) "Applicant" means an individual owner, corporation,
277	partnership, firm, business, association, or other entity that
278	owns or controls, directly or indirectly, 5 percent or more of
279	an interest in the clinic and that applies for a clinic license.
280	(3) "Clinic" means an entity at which health care services
281	are provided to individuals and which tenders charges for
282	reimbursement for such services. For purposes of this part, the
283	term does not include and the licensure requirements of this
284	part do not apply to:
285	(a) Entities licensed or registered by the state under
286	chapter 390, chapter 394, chapter 395, chapter 397, this
287	chapter, chapter 463, chapter 465, chapter 466, chapter 478,
288	chapter 480, chapter 484, or chapter 651.
289	(b) Entities that own, directly or indirectly, entities
290	licensed or registered by the state pursuant to chapter 390,
291	chapter 394, chapter 395, chapter 397, this chapter, chapter
292	463, chapter 465, chapter 466, chapter 478, chapter 480, chapter
293	484, or chapter 651.
294	(c) Entities that are owned, directly or indirectly, by an
295	entity licensed or registered by the state pursuant to chapter
296	390, chapter 394, chapter, 395, chapter 397, this chapter,
297	chapter 463, chapter 465, chapter 466, chapter 478, chapter 480,
298	chapter 484, or chapter 651.
299	(d) Entities that are under common ownership, directly or
300	indirectly, with an entity licensed or registered by the state
301	pursuant to chapter 390, chapter 394, chapter 395, chapter 397,
302	this chapter, chapter 463, chapter 465, chapter 466, chapter
303	478, chapter 480, chapter 484, or chapter 651.
304	(e) An entity that is exempt from federal taxation under
305	26 U.S.C. s. 501(c)(3) and any community college or university
306	clinic.
307	(f) A sole proprietorship, group practice, partnership, or
308	corporation that provides health care services by licensed
309	health care practitioners under chapter 457, chapter 458,
310	chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
311	chapter 466, chapter 467, chapter 484, chapter 486, chapter 490,
312	chapter 491, or part I, part III, part X, part XIII, or part XIV
313	of chapter 468, or s. 464.012, which are wholly owned by a
314	licensed health care practitioner, or the licensed health care
315	practitioner and the spouse, parent, or child of the licensed
316	health care practitioner, so long as one of the owners who is a
317	licensed health care practitioner is supervising the services
318	performed therein and is legally responsible for the entity's
319	compliance with all federal and state laws. However, a health
320	care practitioner may not supervise services beyond the scope of
321	the practitioner's license.
322	(g) Clinical facilities affiliated with an accredited
323	medical school at which training is provided for medical
324	students, residents, or fellows.
325	(4) "Medical director" means a physician who is employed
326	or under contract with a clinic and who maintains a full and
327	unencumbered physician license in accordance with chapter 458,
328	chapter 459, chapter 460, or chapter 461. However, if the clinic
329	is limited to providing health care services pursuant to chapter
330	457, chapter 484, chapter 486, chapter 490, or chapter 491 or
331	part I, part III, part X, part XIII, or part XIV of chapter 468,
332	the clinic may appoint a health care practitioner licensed under
333	that chapter to serve as a clinic director who is responsible
334	for the clinic's activities. A health care practitioner may not
335	serve as the clinic director if the services provided at the
336	clinic are beyond the scope of that practitioner's license.
337	400.9903 License requirements; background screenings;
338	prohibitions.--
339	(1) Each clinic, as defined in s. 400.9902, must be
340	licensed and shall at all times maintain a valid license with
341	the agency. Each clinic location shall be licensed separately,
342	regardless of whether the clinic is operated under the same
343	business name or management as another clinic. Mobile clinics
344	must provide to the agency, at least quarterly, their projected
345	street locations to enable the agency to locate and inspect such
346	clinics.
347	(2) The initial clinic license application shall be filed
348	with the agency by all clinics, as defined in s. 400.9902, on or
349	before March 1, 2004. A clinic license must be renewed
350	biennially.
351	(3) Applicants that submit an application on or before
352	March 1, 2004, which meets all requirements for initial
353	licensure as specified in this section shall receive a temporary
354	license until the completion of an initial inspection verifying
355	that the applicant meets all requirements in rules authorized by
356	s. 400.9906. However, a clinic engaged in magnetic resonance
357	imaging services may not receive a temporary license unless it
358	presents evidence satisfactory to the agency that such clinic is
359	making a good-faith effort and substantial progress in seeking
360	accreditation required under s. 400.9908.
361	(4) Application for an initial clinic license or for
362	renewal of an existing license shall be notarized on forms
363	furnished by the agency and must be accompanied by the
364	appropriate license fee as provided in s. 400.9906. The agency
365	shall take final action on an initial license application within
366	60 days after receipt of all required documentation.
367	(5) The application shall contain information that
368	includes, but need not be limited to, information pertaining to
369	the name, residence and business address, phone number, social
370	security number, and license number of the medical or clinic
371	director, of the licensed medical providers employed or under
372	contract with the clinic, and of each person who, directly or
373	indirectly, owns or controls 5 percent or more of an interest in
374	the clinic, or general partners in limited liability
375	partnerships.
376	(6) The applicant must file with the application
377	satisfactory proof that the clinic is in compliance with this
378	part and applicable rules, including:
379	(a) A listing of services to be provided either directly
380	by the applicant or through contractual arrangements with
381	existing providers;
382	(b) The number and discipline of each professional staff
383	member to be employed; and
384	(c) Proof of financial ability to operate. An applicant
385	must demonstrate financial ability to operate a clinic by
386	submitting a balance sheet and an income and expense statement
387	for the first year of operation which provide evidence of the
388	applicant's having sufficient assets, credit, and projected
389	revenues to cover liabilities and expenses. The applicant shall
390	have demonstrated financial ability to operate if the
391	applicant's assets, credit, and projected revenues meet or
392	exceed projected liabilities and expenses. All documents
393	required under this subsection must be prepared in accordance
394	with generally accepted accounting principles, may be in a
395	compilation form, and the financial statement must be signed by
396	a certified public accountant. As an alternative to submitting a
397	balance sheet and an income and expense statement for the first
398	year of operation, the applicant may file a surety bond of at
399	least $500,000 which guarantees that the clinic will act in full
400	conformity with all legal requirements for operating a clinic,
401	payable to the agency. The agency may adopt rules to specify
402	related requirements for such surety bond.
403	(7) Each applicant for licensure shall comply with the
404	following requirements:
405	(a) As used in this subsection, the term "applicant" means
406	individuals owning or controlling, directly or indirectly, 5
407	percent or more of an interest in a clinic; the medical or
408	clinic director, or a similarly titled person who is responsible
409	for the day-to-day operation of the licensed clinic; the
410	financial officer or similarly titled individual who is
411	responsible for the financial operation of the clinic; and
412	licensed medical providers at the clinic.
413	(b) Upon receipt of a completed, signed, and dated
414	application, the agency shall require background screening of
415	the applicant, in accordance with the level 2 standards for
416	screening set forth in chapter 435. Proof of compliance with the
417	level 2 background screening requirements of chapter 435 which
418	has been submitted within the previous 5 years in compliance
419	with any other health care licensure requirements of this state
420	is acceptable in fulfillment of this paragraph.
421	(c) Each applicant must submit to the agency, with the
422	application, a description and explanation of any exclusions,
423	permanent suspensions, or terminations of an applicant from the
424	Medicare or Medicaid programs. Proof of compliance with the
425	requirements for disclosure of ownership and control interest
426	under the Medicaid or Medicare programs may be accepted in lieu
427	of this submission. The description and explanation may indicate
428	whether such exclusions, suspensions, or terminations were
429	voluntary or not voluntary on the part of the applicant.
430	(d) A license may not be granted to a clinic if the
431	applicant has been found guilty of, regardless of adjudication,
432	or has entered a plea of nolo contendere or guilty to, any
433	offense prohibited under the level 2 standards for screening set
434	forth in chapter 435, or a violation of insurance fraud under s.
435	817.234, within the past 5 years. If the applicant has been
436	convicted of an offense prohibited under the level 2 standards
437	or insurance fraud in any jurisdiction, the applicant must show
438	that his or her civil rights have been restored prior to
439	submitting an application.
440	(e) The agency may deny or revoke licensure if the
441	applicant has falsely represented any material fact or omitted
442	any material fact from the application required by this part.
443	(8) Requested information omitted from an application for
444	licensure, license renewal, or transfer of ownership must be
445	filed with the agency within 21 days after receipt of the
446	agency's request for omitted information, or the application
447	shall be deemed incomplete and shall be withdrawn from further
448	consideration.
449	(9) The failure to file a timely renewal application shall
450	result in a late fee charged to the facility in an amount equal
451	to 50 percent of the current license fee.
452	400.9904 Clinic inspections; emergency suspension;
453	costs.--
454	(1) Any authorized officer or employee of the agency shall
455	make inspections of the clinic as part of the initial license
456	application or renewal application. The application for a clinic
457	license issued under this part or for a renewal license
458	constitutes permission for an appropriate agency inspection to
459	verify the information submitted on or in connection with the
460	application or renewal.
461	(2) An authorized officer or employee of the agency may
462	make unannounced inspections of clinics licensed pursuant to
463	this part as are necessary to determine that the clinic is in
464	compliance with this part and with applicable rules. A licensed
465	clinic shall allow full and complete access to the premises and
466	to billing records or information to any representative of the
467	agency who makes an inspection to determine compliance with this
468	part and with applicable rules.
469	(3) Failure by a clinic licensed under this part to allow
470	full and complete access to the premises and to billing records
471	or information to any representative of the agency who makes a
472	request to inspect the clinic to determine compliance with this
473	part or failure by a clinic to employ a qualified medical
474	director or clinic director constitutes a ground for emergency
475	suspension of the license by the agency pursuant to s.
476	120.60(6).
477	(4) In addition to any administrative fines imposed, the
478	agency may assess a fee equal to the cost of conducting a
479	complaint investigation.
480	400.9905 License renewal; transfer of ownership;
481	provisional license.--
482	(1) An application for license renewal must contain
483	information as required by the agency.
484	(2) Ninety days before the expiration date, an application
485	for renewal must be submitted to the agency.
486	(3) The clinic must file with the renewal application
487	satisfactory proof that it is in compliance with this part and
488	applicable rules. If there is evidence of financial instability,
489	the clinic must submit satisfactory proof of its financial
490	ability to comply with the requirements of this part.
491	(4) When transferring the ownership of a clinic, the
492	transferee must submit an application for a license at least 60
493	days before the effective date of the transfer. An application
494	for change of ownership of a clinic is required only when 45
495	percent or more of the ownership, voting shares, or controlling
496	interest of a clinic is transferred or assigned, including the
497	final transfer or assignment of multiple transfers or
498	assignments over a 2-year period that cumulatively total 45
499	percent or greater.
500	(5) The license may not be sold, leased, assigned, or
501	otherwise transferred, voluntarily or involuntarily, and is
502	valid only for the clinic owners and location for which
503	originally issued.
504	(6) A clinic against whom a revocation or suspension
505	proceeding is pending at the time of license renewal may be
506	issued a provisional license effective until final disposition
507	by the agency of such proceedings. If judicial relief is sought
508	from the final disposition, the agency that has jurisdiction may
509	issue a temporary permit for the duration of the judicial
510	proceeding.
511	400.9906 Rulemaking authority; license fees.--
512	(1) The agency shall adopt rules necessary to administer
513	the clinic administration, regulation, and licensure program,
514	including rules establishing the specific licensure
515	requirements, procedures, forms, and fees. It shall adopt rules
516	establishing a procedure for the biennial renewal of licenses.
517	The agency may issue initial licenses for less than the full 2-
518	year period by charging a prorated licensure fee and specifying
519	a different renewal date than would otherwise be required for
520	biennial licensure. The rules shall specify the expiration dates
521	of licenses, the process of tracking compliance with financial
522	responsibility requirements, and any other conditions of renewal
523	required by law or rule.
524	(2) The agency shall adopt rules specifying limitations on
525	the number of licensed clinics and licensees for which a medical
526	director or a clinic director may assume responsibility for
527	purposes of this part. In determining the quality of supervision
528	a medical director or a clinic director can provide, the agency
529	shall consider the number of clinic employees, the clinic
530	location, and the health care services provided by the clinic.
531	(3) License application and renewal fees must be
532	reasonably calculated by the agency to cover its costs in
533	carrying out its responsibilities under this part, including the
534	cost of licensure, inspection, and regulation of clinics, and
535	must be of such amount that the total fees collected do not
536	exceed the cost of administering and enforcing compliance with
537	this part. Clinic licensure fees are nonrefundable and may not
538	exceed $2,000. The agency shall adjust the license fee annually
539	by not more than the change in the Consumer Price Index based on
540	the 12 months immediately preceding the increase. All fees
541	collected under this part must be deposited in the Health Care
542	Trust Fund for the administration of this part.
543	400.9907 Unlicensed clinics; penalties; fines;
544	verification of licensure status.--
545	(1) It is unlawful to own, operate, or maintain a clinic
546	without obtaining a license under this part.
547	(2) Any person who owns, operates, or maintains an
548	unlicensed clinic commits a felony of the third degree,
549	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
550	Each day of continued operation is a separate offense.
551	(3) Any person found guilty of violating subsection (2) a
552	second or subsequent time commits a felony of the second degree,
553	punishable as provided under s. 775.082, s. 775.083, or s.
554	775.084. Each day of continued operation is a separate offense.
555	(4) Any person who owns, operates, or maintains an
556	unlicensed clinic due to a change in this part or a modification
557	in agency rules within 6 months after the effective date of such
558	change or modification and who, within 10 working days after
559	receiving notification from the agency, fails to cease operation
560	or apply for a license under this part commits a felony of the
561	third degree, punishable as provided in s. 775.082, s. 775.083,
562	or s. 775.084. Each day of continued operation is a separate
563	offense.
564	(5) Any clinic that fails to cease operation after agency
565	notification may be fined for each day of noncompliance pursuant
566	to this part.
567	(6) When a person has an interest in more than one clinic,
568	and fails to obtain a license for any one of these clinics, the
569	agency may revoke the license, impose a moratorium, or impose a
570	fine pursuant to this part on any or all of the licensed clinics
571	until such time as the unlicensed clinic is licensed or ceases
572	operation.
573	(7) Any person aware of the operation of an unlicensed
574	clinic must report that facility to the agency.
575	(8) Any health care provider who is aware of the operation
576	of an unlicensed clinic shall report that facility to the
577	agency. Failure to report a clinic that the provider knows or
578	has reasonable cause to suspect is unlicensed shall be reported
579	to the provider's licensing board.
580	(9) The agency may not issue a license to a clinic that
581	has any unpaid fines assessed under this part.
582	400.9908 Clinic responsibilities.--
583	(1) Each clinic shall appoint a medical director or clinic
584	director who shall agree in writing to accept legal
585	responsibility for the following activities on behalf of the
586	clinic. The medical director or the clinic director shall:
587	(a) Have signs identifying the medical director or clinic
588	director posted in a conspicuous location within the clinic
589	readily visible to all patients.
590	(b) Ensure that all practitioners providing health care
591	services or supplies to patients maintain a current active and
592	unencumbered Florida license.
593	(c) Review any patient referral contracts or agreements
594	executed by the clinic.
595	(d) Ensure that all health care practitioners at the
596	clinic have active appropriate certification or licensure for
597	the level of care being provided.
598	(e) Serve as the clinic records owner as defined in s.
599	456.057.
600	(f) Ensure compliance with the recordkeeping, office
601	surgery, and adverse incident reporting requirements of chapter
602	456, the respective practice acts, and rules adopted under this
603	part.
604	(g) Conduct systematic reviews of clinic billings to
605	ensure that the billings are not fraudulent or unlawful. Upon
606	discovery of an unlawful charge, the medical director or clinic
607	director shall take immediate corrective action.
608	(2) Any business that becomes a clinic after commencing
609	operations must, within 5 days after becoming a clinic, file a
610	license application under this part and shall be subject to all
611	provisions of this part applicable to a clinic.
612	(3) Any contract to serve as a medical director or a
613	clinic director entered into or renewed by a physician or a
614	licensed health care practitioner in violation of this part is
615	void as contrary to public policy. This subsection shall apply
616	to contracts entered into or renewed on or after March 1, 2004.
617	(4) All charges or reimbursement claims made by or on
618	behalf of a clinic that is required to be licensed under this
619	part, but that is not so licensed, or that is otherwise
620	operating in violation of this part, are unlawful charges, and
621	therefore are noncompensable and unenforceable.
622	(5) Any person establishing, operating, or managing an
623	unlicensed clinic otherwise required to be licensed under this
624	part, or any person who knowingly files a false or misleading
625	license application or license renewal application, or false or
626	misleading information related to such application or department
627	rule, commits a felony of the third degree, punishable as
628	provided in s. 775.082, s. 775.083, or s. 775.084.
629	(6) Any licensed health care provider who violates this
630	part is subject to discipline in accordance with this chapter
631	and his or her respective practice act.
632	(7) The agency may fine, or suspend or revoke the license
633	of, any clinic licensed under this part for operating in
634	violation of the requirements of this part or the rules adopted
635	by the agency.
636	(8) The agency shall investigate allegations of
637	noncompliance with this part and the rules adopted under this
638	part.
639	(9) Any person or entity providing health care services
640	which is not a clinic, as defined under s. 400.9902, may
641	voluntarily apply for a certificate of exemption from licensure
642	under its exempt status with the agency on a form that sets
643	forth its name or names and addresses, a statement of the
644	reasons why it cannot be defined as a clinic, and other
645	information deemed necessary by the agency.
646	(10) The clinic shall display its license in a conspicuous
647	location within the clinic readily visible to all patients.
648	(11)(a) Each clinic engaged in magnetic resonance imaging
649	services must be accredited by the Joint Commission on
650	Accreditation of Healthcare Organizations, the American College
651	of Radiology, or the Accreditation Association for Ambulatory
652	Health Care, within 1 year after licensure. However, a clinic
653	may request a single, 6-month extension if it provides evidence
654	to the agency establishing that, for good cause shown, such
655	clinic can not be accredited within 1 year after licensure, and
656	that such accreditation will be completed within the 6-month
657	extension. After obtaining accreditation as required by this
658	subsection, each such clinic must maintain accreditation as a
659	condition of renewal of its license.
660	(b) The agency may disallow the application of any entity
661	formed for the purpose of avoiding compliance with the
662	accreditation provisions of this subsection and whose principals
663	were previously principals of an entity that was unable to meet
664	the accreditation requirements within the specified timeframes.
665	The agency may adopt rules as to the accreditation of magnetic
666	resonance imaging clinics.
667	(12) The agency shall give full faith and credit
668	pertaining to any past variance and waiver granted to a magnetic
669	resonance imaging clinic from Rule 64-2002, Florida
670	Administrative Code, by the Department of Health, until
671	September 2004. After that date, such clinic must request a
672	variance and waiver from the agency under s. 120.542.
673	400.9909 Injunctions.--
674	(1) The agency may institute injunctive proceedings in a
675	court of competent jurisdiction in order to:
676	(a) Enforce the provisions of this part or any minimum
677	standard, rule, or order issued or entered into pursuant to this
678	part if the attempt by the agency to correct a violation through
679	administrative fines has failed; if the violation materially
680	affects the health, safety, or welfare of clinic patients; or if
681	the violation involves any operation of an unlicensed clinic.
682	(b) Terminate the operation of a clinic if a violation of
683	any provision of this part, or any rule adopted pursuant to this
684	part, materially affects the health, safety, or welfare of
685	clinic patients.
686	(2) Such injunctive relief may be temporary or permanent.
687	(3) If action is necessary to protect clinic patients from
688	life-threatening situations, the court may allow a temporary
689	injunction without bond upon proper proof being made. If it
690	appears by competent evidence or a sworn, substantiated
691	affidavit that a temporary injunction should issue, the court,
692	pending the determination on final hearing, shall enjoin
693	operation of the clinic.
694	400.9910 Agency actions.--Administrative proceedings
695	challenging agency licensure enforcement action shall be
696	reviewed on the basis of the facts and conditions that resulted
697	in the agency action.
698	400.9911 Agency administrative penalties.--
699	(1) The agency may impose administrative penalties against
700	clinics of up to $5,000 per violation for violations of the
701	requirements of this part. In determining if a penalty is to be
702	imposed and in fixing the amount of the fine, the agency shall
703	consider the following factors:
704	(a) The gravity of the violation, including the
705	probability that death or serious physical or emotional harm to
706	a patient will result or has resulted, the severity of the
707	action or potential harm, and the extent to which the provisions
708	of the applicable laws or rules were violated.
709	(b) Actions taken by the owner, medical director, or
710	clinic director to correct violations.
711	(c) Any previous violations.
712	(d) The financial benefit to the clinic of committing or
713	continuing the violation.
714	(2) Each day of continuing violation after the date fixed
715	for termination of the violation, as ordered by the agency,
716	constitutes an additional, separate, and distinct violation.
717	(3) Any action taken to correct a violation shall be
718	documented in writing by the owner, medical director, or clinic
719	director of the clinic and verified through followup visits by
720	agency personnel. The agency may impose a fine and, in the case
721	of an owner-operated clinic, revoke or deny a clinic's license
722	when a clinic medical director or clinic director fraudulently
723	misrepresents actions taken to correct a violation.
724	(4) For fines that are upheld following administrative or
725	judicial review, the violator shall pay the fine, plus interest
726	at the rate as specified in s. 55.03, for each day beyond the
727	date set by the agency for payment of the fine.
728	(5) Any unlicensed clinic that continues to operate after
729	agency notification is subject to a $1,000 fine per day.
730	(6) Any licensed clinic whose owner, medical director, or
731	clinic director concurrently operates an unlicensed clinic shall
732	be subject to an administrative fine of $5,000 per day.
733	(7) Any clinic whose owner fails to apply for a change-of-
734	ownership license in accordance with s. 400.9905 and operates
735	the clinic under the new ownership is subject to a fine of
736	$5,000.
737	(8) The agency, as an alternative to or in conjunction
738	with an administrative action against a clinic for violations of
739	this part and adopted rules, shall make a reasonable attempt to
740	discuss each violation and recommended corrective action with
741	the owner, medical director, or clinic director of the clinic,
742	prior to written notification. The agency, instead of fixing a
743	period within which the clinic shall enter into compliance with
744	standards, may request a plan of corrective action from the
745	clinic which demonstrates a good-faith effort to remedy each
746	violation by a specific date, subject to the approval of the
747	agency.
748	(9) Administrative fines paid by any clinic under this
749	section shall be deposited into the Health Care Trust Fund.
750	Section 5. Paragraph (b) of subsection (1) of section
751	456.0375, Florida Statutes, is amended to read:
752	456.0375 Registration of certain clinics; requirements;
753	discipline; exemptions.--
754	(1)
755	(b) For purposes of this section, the term "clinic" does
756	not include and the registration requirements herein do not
757	apply to:
758	1. Entities licensed or registered by the state pursuant
759	to chapter 390, chapter 394, chapter 395, chapter 397, chapter
760	400, chapter 463, chapter 465, chapter 466, chapter 478, chapter
761	480, or chapter 484, or chapter 651.
762	2. Entities that own, directly or indirectly, entities
763	licensed or registered by the state pursuant to chapter 390,
764	chapter 394, chapter 395, chapter 397, chapter 400, chapter 463,
765	chapter 465, chapter 466, chapter 478, chapter 480, chapter 484,
766	or chapter 651.
767	3. Entities that are owned, directly or indirectly, by an
768	entity licensed or registered by the state pursuant to chapter
769	390, chapter 394, chapter 395, chapter 397, chapter 400, chapter
770	463, chapter 465, chapter 466, chapter 478, chapter 480, chapter
771	484, or chapter 651.
772	4. Entities that are under common ownership, directly or
773	indirectly, with an entity licensed or registered by the state
774	pursuant to chapter 390, chapter 394, chapter 395, chapter 397,
775	chapter 400, chapter 463, chapter 465, chapter 466, chapter 478,
776	chapter 480, chapter 484, or chapter 651.
777	5.2.Entities exempt from federal taxation under 26 U.S.C.
778	s. 501(c)(3) and community college and university clinics.
779	6.3.Sole proprietorships, group practices, partnerships,
780	or corporations that provide health care services by licensed
781	health care practitioners pursuant to chapters 457, 458, 459,
782	460, 461, 462, 463, 466, 467, 484, 486, 490, 491, or part I,
783	part III, part X, part XIII, or part XIV of chapter 468, or s.
784	464.012, which are wholly owned by licensed health care
785	practitioners or the licensed health care practitioner and the
786	spouse, parent, or child of a licensed health care practitioner,
787	so long as one of the owners who is a licensed health care
788	practitioner is supervising the services performed therein and
789	is legally responsible for the entity's compliance with all
790	federal and state laws. However, no health care practitioner may
791	supervise services beyond the scope of the practitioner's
792	license.
793	7. Clinical facilities affiliated with an accredited
794	medical school at which training is provided for medical
795	students, residents, or fellows.
796	Section 6. Paragraphs (dd) and (ee) are added to
797	subsection (1) of section 456.072, Florida Statutes, to read:
798	456.072 Grounds for discipline; penalties; enforcement.--
799	(1) The following acts shall constitute grounds for which
800	the disciplinary actions specified in subsection (2) may be
801	taken:
802	(dd) With respect to making a personal injury protection
803	claim as required by s. 627.736, intentionally submitting a
804	claim statement, or bill that has been "upcoded" as defined in
805	s. 627.732.
806	(ee) With respect to making a personal injury protection
807	claim as required by s. 627.736, intentionally submitting a
808	claim, statement, or bill for payment of services that were not
809	rendered.
810	Section 7. Subsection (1) of section 627.732, Florida
811	Statutes, is amended, and subsections (8) through (16) are added
812	to said section, to read:
813	627.732 Definitions.--As used in ss. 627.730-627.7405, the
814	term:
815	(1) "Broker" means any person not possessing a license
816	under chapter 395, chapter 400, chapter 458, chapter 459,
817	chapter 460, chapter 461, or chapter 641 who charges or receives
818	compensation for any use of medical equipment and is not the
819	100-percent owner or the 100-percent lessee of such equipment.
820	For purposes of this section, such owner or lessee may be an
821	individual, a corporation, a partnership, or any other entity
822	and any of its 100-percent-owned affiliates and subsidiaries.
823	For purposes of this subsection, the term "lessee" means a long-
824	term lessee under a capital or operating lease, but does not
825	include a part-time lessee. The term "broker" does not include a
826	hospital or physician management company whose medical equipment
827	is ancillary to the practices managed, a debt collection agency,
828	or an entity that has contracted with the insurer to obtain a
829	discounted rate for such services; nor does the term include a
830	management company that has contracted to provide general
831	management services for a licensed physician or health care
832	facility and whose compensation is not materially affected by
833	the usage or frequency of usage of medical equipment or an
834	entity that is 100-percent owned by one or more hospitals or
835	physicians. The term "broker" does not include a person or
836	entity that certifies, upon request of an insurer, that:
837	(a) It is a clinic registered under s. 456.0375 or
838	licensed under ss. 400.9901-400.9911;
839	(b) It is a 100-percent owner of medical equipment; and
840	(c) The owner's only part-time lease of medical equipment
841	for personal injury protection patients is on a temporary basis
842	not to exceed 30 days in a 12-month period, and such lease is
843	solely for the purposes of necessary repair or maintenance of
844	the 100-percent-owned medical equipment or pending the arrival
845	and installation of the newly purchased or a replacement for the
846	100-percent-owned medical equipment, or for patients for whom,
847	because of physical size or claustrophobia, it is determined by
848	the medical director or clinical director to be medically
849	necessary that the test be performed in medical equipment that
850	is open-style. The leased medical equipment cannot be used by
851	patients who are not patients of the registered clinic for
852	medical treatment of services. Any person or entity making a
853	false certification under this subsection commits insurance
854	fraud as defined in s. 817.234. However, the 30-day period
855	provided in this paragraph may be extended for an additional 60
856	days as applicable to magnetic resonance imaging equipment if
857	the owner certifies that the extension otherwise complies with
858	this paragraph.
859	(8) "Certify" means to swear or attest to being true or
860	represented in writing.
861	(9) "Immediate personal supervision," as it relates to the
862	performance of medical services by nonphysicians not in a
863	hospital, means that an individual licensed to perform the
864	medical service or provide the medical supplies must be present
865	within the confines of the physical structure where the medical
866	services are performed or where the medical supplies are
867	provided such that the licensed individual can respond
868	immediately to any emergencies if needed.
869	(10) "Incident," with respect to services considered as
870	incident to a physician's professional service, for a physician
871	licensed under chapter 458, chapter 459, chapter 460, or chapter
872	461, if not furnished in a hospital, means such services must be
873	an integral, even if incidental, part of a covered physician's
874	service.
875	(11) "Knowingly" means that a person, with respect to
876	information, has actual knowledge of the information; acts in
877	deliberate ignorance of the truth or falsity of the information;
878	or acts in reckless disregard of the information, and proof of
879	specific intent to defraud is not required.
880	(12) "Lawful" or "lawfully" means in substantial
881	compliance with all relevant applicable criminal, civil, and
882	administrative requirements of state and federal law related to
883	the provision of medical services or treatment.
884	(13) "Hospital" means a facility that, at the time
885	services or treatment were rendered, was licensed under chapter
886	395.
887	(14) "Properly completed" means providing truthful,
888	substantially complete, and substantially accurate responses as
889	to all material elements to each applicable request for
890	information or statement by a means that may lawfully be
891	provided and that complies with this section, or as agreed by
892	the parties.
893	(15) "Upcoding" means an action that submits a billing
894	code that would result in payment greater in amount than would
895	be paid using a billing code that accurately describes the
896	services performed. The term does not include an otherwise
897	lawful bill by a magnetic resonance imaging facility, which
898	globally combines both technical and professional components for
899	services listed in that definition, if the amount of the global
900	bill is not more than the components if billed separately;
901	however, payment of such a bill constitutes payment in full for
902	all components of such service.
903	(16) "Unbundling" means an action that submits a billing
904	code that is properly billed under one billing code, but that
905	has been separated into two or more billing codes, and would
906	result in payment greater in amount than would be paid using one
907	billing code.
908	Section 8. Subsections (4), (5), (6), (7), (8), (10), and
909	(12) of section 627.736, Florida Statutes, are amended, present
910	subsection (13) is renumbered as subsection (14), and a new
911	subsection (13) is added to said section, to read:
912	627.736 Required personal injury protection benefits;
913	exclusions; priority; claims.--
914	(4) BENEFITS; WHEN DUE.--Benefits due from an insurer
915	under ss. 627.730-627.7405 shall be primary, except that
916	benefits received under any workers' compensation law shall be
917	credited against the benefits provided by subsection (1) and
918	shall be due and payable as loss accrues, upon receipt of
919	reasonable proof of such loss and the amount of expenses and
920	loss incurred which are covered by the policy issued under ss.
921	627.730-627.7405. When the Agency for Health Care Administration
922	provides, pays, or becomes liable for medical assistance under
923	the Medicaid program related to injury, sickness, disease, or
924	death arising out of the ownership, maintenance, or use of a
925	motor vehicle, benefits under ss. 627.730-627.7405 shall be
926	subject to the provisions of the Medicaid program.
927	(a) An insurer may require written notice to be given as
928	soon as practicable after an accident involving a motor vehicle
929	with respect to which the policy affords the security required
930	by ss. 627.730-627.7405.
931	(b) Personal injury protection insurance benefits paid
932	pursuant to this section shall be overdue if not paid within 30
933	days after the insurer is furnished written notice of the fact
934	of a covered loss and of the amount of same. If such written
935	notice is not furnished to the insurer as to the entire claim,
936	any partial amount supported by written notice is overdue if not
937	paid within 30 days after such written notice is furnished to
938	the insurer. Any part or all of the remainder of the claim that
939	is subsequently supported by written notice is overdue if not
940	paid within 30 days after such written notice is furnished to
941	the insurer. When an insurer pays only a portion of a claim or
942	rejects a claim, the insurer shall provide at the time of the
943	partial payment or rejection an itemized specification of each
944	item that the insurer had reduced, omitted, or declined to pay
945	and any information that the insurer desires the claimant to
946	consider related to the medical necessity of the denied
947	treatment or to explain the reasonableness of the reduced
948	charge, provided that this shall not limit the introduction of
949	evidence at trial; and the insurer shall include the name and
950	address of the person to whom the claimant should respond and a
951	claim number to be referenced in future correspondence.
952	However, notwithstanding the fact that written notice has been
953	furnished to the insurer, any payment shall not be deemed
954	overdue when the insurer has reasonable proof to establish that
955	the insurer is not responsible for the payment. For the purpose
956	of calculating the extent to which any benefits are overdue,
957	payment shall be treated as being made on the date a draft or
958	other valid instrument which is equivalent to payment was placed
959	in the United States mail in a properly addressed, postpaid
960	envelope or, if not so posted, on the date of delivery. This
961	paragraph does not preclude or limit the ability of the insurer
962	to assert that the claim was unrelated, was not medically
963	necessary, or was unreasonable or that the amount of the charge
964	was in excess of that permitted under, or in violation of,
965	subsection (5). Such assertion by the insurer may be made at any
966	time, including after payment of the claim or after the 30-day
967	time period for payment set forth in this paragraph.
968	(c) All overdue payments shall bear simple interest at the
969	rate established by the Comptrollerunder s. 55.03 or the rate
970	established in the insurance contract, whichever is greater, for
971	the year in which the payment became overdue, calculated from
972	the date the insurer was furnished with written notice of the
973	amount of covered loss. Interest shall be due at the time
974	payment of the overdue claim is made.
975	(d) The insurer of the owner of a motor vehicle shall pay
976	personal injury protection benefits for:
977	1. Accidental bodily injury sustained in this state by the
978	owner while occupying a motor vehicle, or while not an occupant
979	of a self-propelled vehicle if the injury is caused by physical
980	contact with a motor vehicle.
981	2. Accidental bodily injury sustained outside this state,
982	but within the United States of America or its territories or
983	possessions or Canada, by the owner while occupying the owner's
984	motor vehicle.
985	3. Accidental bodily injury sustained by a relative of the
986	owner residing in the same household, under the circumstances
987	described in subparagraph 1. or subparagraph 2., provided the
988	relative at the time of the accident is domiciled in the owner's
989	household and is not himself or herself the owner of a motor
990	vehicle with respect to which security is required under ss.
991	627.730-627.7405.
992	4. Accidental bodily injury sustained in this state by any
993	other person while occupying the owner's motor vehicle or, if a
994	resident of this state, while not an occupant of a self-
995	propelled vehicle, if the injury is caused by physical contact
996	with such motor vehicle, provided the injured person is not
997	himself or herself:
998	a. The owner of a motor vehicle with respect to which
999	security is required under ss. 627.730-627.7405; or
1000	b. Entitled to personal injury benefits from the insurer
1001	of the owner or owners of such a motor vehicle.
1002	(e) If two or more insurers are liable to pay personal
1003	injury protection benefits for the same injury to any one
1004	person, the maximum payable shall be as specified in subsection
1005	(1), and any insurer paying the benefits shall be entitled to
1006	recover from each of the other insurers an equitable pro rata
1007	share of the benefits paid and expenses incurred in processing
1008	the claim.
1009	(f) It is a violation of the insurance code for an insurer
1010	to fail to timely provide benefits as required by this section
1011	with such frequency as to constitute a general business
1012	practice.
1013	(g) Benefits shall not be due or payable to or on the
1014	behalf of an insured person if that person has committed, by a
1015	material act or omission, any insurance fraud relating to
1016	personal injury protection coverage under his or her policy, if
1017	the fraud is admitted to in a sworn statement by the insured or
1018	if it is established in a court of competent jurisdiction. Any
1019	insurance fraud shall void all coverage arising from the claim
1020	related to such fraud under the personal injury protection
1021	coverage of the insured person who committed the fraud,
1022	irrespective of whether a portion of the insured person's claim
1023	may be legitimate, and any benefits paid prior to the discovery
1024	of the insured person's insurance fraud shall be recoverable by
1025	the insurer from the person who committed insurance fraud in
1026	their entirety. The prevailing party is entitled to its costs
1027	and attorney's fees in any action in which it prevails in an
1028	insurer's action to enforce its right of recovery under this
1029	paragraph.
1030	(5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
1031	(a) Any physician, hospital, clinic, or other person or
1032	institution lawfully rendering treatment to an injured person
1033	for a bodily injury covered by personal injury protection
1034	insurance may charge the insurer and injured partyonly a
1035	reasonable amount pursuant to this sectionfor the services and
1036	supplies rendered, and the insurer providing such coverage may
1037	pay for such charges directly to such person or institution
1038	lawfully rendering such treatment, if the insured receiving such
1039	treatment or his or her guardian has countersigned the properly
1040	completedinvoice, bill, or claim form approved by the
1041	Department of Insurance upon which such charges are to be paid
1042	for as having actually been rendered, to the best knowledge of
1043	the insured or his or her guardian. In no event, however, may
1044	such a charge be in excess of the amount the person or
1045	institution customarily charges for like services or supplies in
1046	cases involving no insurance. With respect to a determination of
1047	whether a charge for a particular service, treatment, or
1048	otherwise is reasonable, consideration may be given to evidence
1049	of usual and customary charges and payments accepted by the
1050	provider involved in the dispute, and reimbursement levels in
1051	the community and various federal and state medical fee
1052	schedules applicable to automobile and other insurance
1053	coverages, and other information relevant to the reasonableness
1054	of the reimbursement for the service, treatment, or supply.
1055	(b)1. An insurer or insured is not required to pay a claim
1056	or charges:
1057	a.Made by a broker or by a person making a claim on
1058	behalf of a broker;
1059	b. For any service or treatment that was not lawful at the
1060	time rendered;
1061	c. To any person who knowingly submits a false or
1062	misleading statement relating to the claim or charges;
1063	d. With respect to a bill or statement that does not
1064	substantially meet the applicable requirements of paragraph (d);
1065	e. For any treatment or service that is upcoded, or that
1066	is unbundled when such treatment or services should be bundled,
1067	in accordance with paragraph (d). To facilitate prompt payment
1068	of lawful services, an insurer may change codes that it
1069	determines to have been improperly or incorrectly upcoded or
1070	unbundled, and may make payment based on the changed codes,
1071	without affecting the right of the provider to dispute the
1072	change by the insurer, provided that before doing so, the
1073	insurer must contact the health care provider and discuss the
1074	reasons for the insurer's change and the health care provider's
1075	reason for the coding, or make a reasonable good-faith effort to
1076	do so, as documented in the insurer's file; and
1077	f. For medical services or treatment billed by a physician
1078	and not provided in a hospital unless such services are rendered
1079	by the physician or are incident to his or her professional
1080	services and are included on the physician's bill, including
1081	documentation verifying that the physician is responsible for
1082	the medical services that were rendered and billed.
1083	2. Charges for medically necessary cephalic thermograms,
1084	peripheral thermograms, spinal ultrasounds, extremity
1085	ultrasounds, video fluoroscopy, and surface electromyography
1086	shall not exceed the maximum reimbursement allowance for such
1087	procedures as set forth in the applicable fee schedule or other
1088	payment methodology established pursuant to s. 440.13.
1089	3. Allowable amounts that may be charged to a personal
1090	injury protection insurance insurer and insured for medically
1091	necessary nerve conduction testing when done in conjunction with
1092	a needle electromyography procedure and both are performed and
1093	billed solely by a physician licensed under chapter 458, chapter
1094	459, chapter 460, or chapter 461 who is also certified by the
1095	American Board of Electrodiagnostic Medicine or by a board
1096	recognized by the American Board of Medical Specialties or the
1097	American Osteopathic Association or who holds diplomate status
1098	with the American Chiropractic Neurology Board or its
1099	predecessors shall not exceed 200 percent of the allowable
1100	amount under the participating physician fee schedule of
1101	Medicare Part B for year 2001, for the area in which the
1102	treatment was rendered, adjusted annually on August 1 to reflect
1103	the prior calendar year's changes in the annual Medical Care
1104	Item of the Consumer Price Index for All Urban Consumers in the
1105	South Region as determined by the Bureau of Labor Statistics of
1106	the United States Department of Laborby an additional amount
1107	equal to the medical Consumer Price Index for Florida.
1108	4. Allowable amounts that may be charged to a personal
1109	injury protection insurance insurer and insured for medically
1110	necessary nerve conduction testing that does not meet the
1111	requirements of subparagraph 3. shall not exceed the applicable
1112	fee schedule or other payment methodology established pursuant
1113	to s. 440.13.
1114	5. Effective upon this act becoming a law and before
1115	November 1, 2001, allowable amounts that may be charged to a
1116	personal injury protection insurance insurer and insured for
1117	magnetic resonance imaging services shall not exceed 200 percent
1118	of the allowable amount under Medicare Part B for year 2001, for
1119	the area in which the treatment was rendered. Beginning November
1120	1, 2001, allowable amounts that may be charged to a personal
1121	injury protection insurance insurer and insured for magnetic
1122	resonance imaging services shall not exceed 175 percent of the
1123	allowable amount under the participating physician fee schedule
1124	ofMedicare Part B for year 2001, for the area in which the
1125	treatment was rendered, adjusted annually on August 1 to reflect
1126	the prior calendar year’s changes in the annual Medical Care
1127	Item of the Consumer Price Index for All Urban Consumers in the
1128	South Region as determined by the Bureau of Labor Statistics of
1129	the United States Department of Laborby an additional amount
1130	equal to the medical Consumer Price Index for Florida, except
1131	that allowable amounts that may be charged to a personal injury
1132	protection insurance insurer and insured for magnetic resonance
1133	imaging services provided in facilities accredited by the
1134	American College of Radiology or the Joint Commission on
1135	Accreditation of Healthcare Organizations shall not exceed 200
1136	percent of the allowable amount under the participating
1137	physician fee schedule ofMedicare Part B for year 2001, for the
1138	area in which the treatment was rendered, adjusted annually on
1139	August 1to reflect the prior calendar year’s changes in the
1140	annual Medical Care Item of the Consumer Price Index for All
1141	Urban Consumers in the South Region as determined by the Bureau
1142	of Labor Statistics of the United States Department of Labor by
1143	an additional amount equal to the medical Consumer Price Index
1144	for Florida. This paragraph does not apply to charges for
1145	magnetic resonance imaging services and nerve conduction testing
1146	for inpatients and emergency services and care as defined in
1147	chapter 395 rendered by facilities licensed under chapter 395.
1148	6. The Department of Health, in consultation with the
1149	appropriate professional licensing boards, shall adopt, by rule,
1150	a list of diagnostic tests deemed not to be medically necessary
1151	for use in the treatment of persons sustaining bodily injury
1152	covered by personal injury protection benefits under this
1153	section. The initial list shall be adopted by January 1, 2004,
1154	and shall be revised from time to time as determined by the
1155	Department of Health, in consultation with the respective
1156	professional licensing boards. Inclusion of a test on the list
1157	of invalid diagnostic tests shall be based on lack of
1158	demonstrated medical value and a level of general acceptance by
1159	the relevant provider community and shall not be dependent for
1160	results entirely upon subjective patient response.
1161	Notwithstanding its inclusion on a fee schedule in this
1162	subsection, an insurer or insured is not required to pay any
1163	charges or reimburse claims for any invalid diagnostic test as
1164	determined by the Department of Health.
1165	(c)1.With respect to any treatment or service, other than
1166	medical services billed by a hospital or other provider for
1167	emergency services as defined in s. 395.002 or inpatient
1168	services rendered at a hospital-owned facility, the statement of
1169	charges must be furnished to the insurer by the provider and may
1170	not include, and the insurer is not required to pay, charges for
1171	treatment or services rendered more than 35 days before the
1172	postmark date of the statement, except for past due amounts
1173	previously billed on a timely basis under this paragraph, and
1174	except that, if the provider submits to the insurer a notice of
1175	initiation of treatment within 21 days after its first
1176	examination or treatment of the claimant, the statement may
1177	include charges for treatment or services rendered up to, but
1178	not more than, 75 days before the postmark date of the
1179	statement. The injured party is not liable for, and the provider
1180	shall not bill the injured party for, charges that are unpaid
1181	because of the provider's failure to comply with this paragraph.
1182	Any agreement requiring the injured person or insured to pay for
1183	such charges is unenforceable.
1184	2.If, however, the insured fails to furnish the provider
1185	with the correct name and address of the insured's personal
1186	injury protection insurer, the provider has 35 days from the
1187	date the provider obtains the correct information to furnish the
1188	insurer with a statement of the charges. The insurer is not
1189	required to pay for such charges unless the provider includes
1190	with the statement documentary evidence that was provided by the
1191	insured during the 35-day period demonstrating that the provider
1192	reasonably relied on erroneous information from the insured and
1193	either:
1194	a.1.A denial letter from the incorrect insurer; or
1195	b.2.Proof of mailing, which may include an affidavit
1196	under penalty of perjury, reflecting timely mailing to the
1197	incorrect address or insurer.
1198	3.For emergency services and care as defined in s.
1199	395.002 rendered in a hospital emergency department or for
1200	transport and treatment rendered by an ambulance provider
1201	licensed pursuant to part III of chapter 401, the provider is
1202	not required to furnish the statement of charges within the time
1203	periods established by this paragraph; and the insurer shall not
1204	be considered to have been furnished with notice of the amount
1205	of covered loss for purposes of paragraph (4)(b) until it
1206	receives a statement complying with paragraph (d)(e), or copy
1207	thereof, which specifically identifies the place of service to
1208	be a hospital emergency department or an ambulance in accordance
1209	with billing standards recognized by the Health Care Finance
1210	Administration.
1211	4.Each notice of insured's rights under s. 627.7401 must
1212	include the following statement in type no smaller than 12
1213	points:
1214	BILLING REQUIREMENTS.--Florida Statutes provide that with
1215	respect to any treatment or services, other than certain
1216	hospital and emergency services, the statement of charges
1217	furnished to the insurer by the provider may not include, and
1218	the insurer and the injured party are not required to pay,
1219	charges for treatment or services rendered more than 35 days
1220	before the postmark date of the statement, except for past
1221	due amounts previously billed on a timely basis, and except
1222	that, if the provider submits to the insurer a notice of
1223	initiation of treatment within 21 days after its first
1224	examination or treatment of the claimant, the statement may
1225	include charges for treatment or services rendered up to, but
1226	not more than, 75 days before the postmark date of the
1227	statement.
1228	(d) Every insurer shall include a provision in its policy
1229	for personal injury protection benefits for binding arbitration
1230	of any claims dispute involving medical benefits arising between
1231	the insurer and any person providing medical services or
1232	supplies if that person has agreed to accept assignment of
1233	personal injury protection benefits. The provision shall specify
1234	that the provisions of chapter 682 relating to arbitration shall
1235	apply. The prevailing party shall be entitled to attorney's
1236	fees and costs. For purposes of the award of attorney's fees and
1237	costs, the prevailing party shall be determined as follows:
1238	1. When the amount of personal injury protection benefits
1239	determined by arbitration exceeds the sum of the amount offered
1240	by the insurer at arbitration plus 50 percent of the difference
1241	between the amount of the claim asserted by the claimant at
1242	arbitration and the amount offered by the insurer at
1243	arbitration, the claimant is the prevailing party.
1244	2. When the amount of personal injury protection benefits
1245	determined by arbitration is less than the sum of the amount
1246	offered by the insurer at arbitration plus 50 percent of the
1247	difference between the amount of the claim asserted by the
1248	claimant at arbitration and the amount offered by the insurer at
1249	arbitration, the insurer is the prevailing party.
1250	3. When neither subparagraph 1. nor subparagraph 2.
1251	applies, there is no prevailing party. For purposes of this
1252	paragraph, the amount of the offer or claim at arbitration is
1253	the amount of the last written offer or claim made at least 30
1254	days prior to the arbitration.
1255	4. In the demand for arbitration, the party requesting
1256	arbitration must include a statement specifically identifying
1257	the issues for arbitration for each examination or treatment in
1258	dispute. The other party must subsequently issue a statement
1259	specifying any other examinations or treatment and any other
1260	issues that it intends to raise in the arbitration. The parties
1261	may amend their statements up to 30 days prior to arbitration,
1262	provided that arbitration shall be limited to those identified
1263	issues and neither party may add additional issues during
1264	arbitration.
1265	(d)(e)All statements and bills for medical services
1266	rendered by any physician, hospital, clinic, or other person or
1267	institution shall be submitted to the insurer on a properly
1268	completed Centers for Medicare and Medicaid Services (CMS)
1269	Health Care Finance Administration1500 form, UB 92 forms, or
1270	any other standard form approved by the department for purposes
1271	of this paragraph. All billings for such services rendered by
1272	providersshall, to the extent applicable, follow the
1273	Physicians' Current Procedural Terminology (CPT) or Healthcare
1274	Correct Procedural Coding System (HCPCS), or ICD-9 in effect for
1275	the year in which services are rendered and comply with the
1276	Centers for Medicare and Medicaid Services (CMS) 1500 form
1277	instructions and the American Medical Association Current
1278	Procedural Terminology (CPT) Editorial Panel and Healthcare
1279	Correct Procedural Coding System (HCPCS). All providers other
1280	than hospitals shall include on the applicable claim form the
1281	professional license number of the provider in the line or space
1282	provided for "Signature of Physician or Supplier, Including
1283	Degrees or Credentials." In determining compliance with
1284	applicable CPT and HCPCS coding, guidance shall be provided by
1285	the Physicians' Current Procedural Terminology (CPT) or the
1286	Healthcare Correct Procedural Coding System (HCPCS) in effect
1287	for the year in which services were rendered, the Office of the
1288	Inspector General (OIG), Physicians Compliance Guidelines, and
1289	other authoritative treatises designated by rule by the Agency
1290	for Health Care Administration.No statement of medical services
1291	may include charges for medical services of a person or entity
1292	that performed such services without possessing the valid
1293	licenses required to perform such services. For purposes of
1294	paragraph (4)(b), an insurer shall not be considered to have
1295	been furnished with notice of the amount of covered loss or
1296	medical bills due unless the statements or bills comply with
1297	this paragraph, and unless the statements or bills are properly
1298	completed in their entirety as to all material provisions, with
1299	all relevant information being provided therein.
1300	(e)1. At the initial treatment or service provided, each
1301	physician, other licensed professional, clinic, or other medical
1302	institution providing medical services upon which a claim for
1303	personal injury protection benefits is based shall require an
1304	insured person, or his or her guardian, to execute a disclosure
1305	and acknowledgment form, which reflects at a minimum that:
1306	a. The insured, or his or her guardian, must countersign
1307	the form attesting to the fact that the services set forth
1308	therein were actually rendered;
1309	b. The insured, or his or her guardian, has both the right
1310	and affirmative duty to confirm that the services were actually
1311	rendered;
1312	c. The insured, or his or her guardian, was not solicited
1313	by any person to seek any services from the medical provider;
1314	d. That the physician, other licensed professional,
1315	clinic, or other medical institution rendering services for
1316	which payment is being claimed explained the services to the
1317	insured or his or her guardian; and
1318	e. If the insured notifies the insurer in writing of a
1319	billing error, the insured may be entitled to a certain
1320	percentage of a reduction in the amounts paid by the insured's
1321	motor vehicle insurer.
1322	2. The physician, other licensed professional, clinic, or
1323	other medical institution rendering services for which payment
1324	is being claimed has the affirmative duty to explain the
1325	services rendered to the insured, or his or her guardian, so
1326	that the insured, or his or her guardian, countersigns the form
1327	with informed consent.
1328	3. Countersignature by the insured, or his or her
1329	guardian, is not required for the reading of diagnostic tests or
1330	other services that are of such a nature that they are not
1331	required to be performed in the presence of the insured.
1332	4. The licensed medical professional rendering treatment
1333	for which payment is being claimed must sign, by his or her own
1334	hand, the form complying with this paragraph.
1335	5. The original completed disclosure and acknowledgement
1336	form shall be furnished to the insurer pursuant to paragraph
1337	(4)(b) and may not be electronically furnished.
1338	6. This disclosure and acknowledgement form is not
1339	required for services billed by a provider for emergency
1340	services as defined in s. 395.002, for emergency services and
1341	care as defined in s. 395.002 rendered in a hospital emergency
1342	department, or for transport and treatment rendered by an
1343	ambulance provider licensed pursuant to part III of chapter 401.
1344	7. The Financial Services Commission shall adopt, by rule,
1345	a standard disclosure and acknowledgment form that shall be used
1346	to fulfill the requirements of this paragraph, effective 90 days
1347	after such form is adopted and becomes final. The commission
1348	shall adopt a proposed rule by October 1, 2003. Until the rule
1349	is final, the provider may use a form of its own which otherwise
1350	complies with the requirements of this paragraph.
1351	8. As used in this paragraph, "countersigned" means a
1352	second or verifying signature, as on a previously signed
1353	document, and is not satisfied by the statement "signature on
1354	file" or any similar statement.
1355	9. The requirements of this paragraph apply only with
1356	respect to the initial treatment or service of the insured by a
1357	provider. For subsequent treatments or service, the provider
1358	must maintain a patient log signed by the patient, in
1359	chronological order by date of service, that is consistent with
1360	the services being rendered to the patient as claimed. The
1361	requirements of this subparagraph for maintaining a patient log
1362	signed by the patient may be met by a hospital that maintains
1363	medical records, as required by s. 395.3025 and applicable rules
1364	and makes such records available to the insurer upon request.
1365	(f) Upon written notification by any person, an insurer
1366	shall investigate any claim of improper billing by a physician
1367	or other medical provider. The insurer shall determine if the
1368	insured was properly billed for only those services and
1369	treatments that the insured actually received. If the insurer
1370	determines that the insured has been improperly billed, the
1371	insurer shall notify the insured, the person making the written
1372	notification and the provider of its findings and shall reduce
1373	the amount of payment to the provider by the amount determined
1374	to be improperly billed. If a reduction is made due to such
1375	written notification by any person, the insurer shall pay to the
1376	person 20 percent of the amount of the reduction, up to $500. If
1377	the provider is arrested due to the improper billing, then the
1378	insurer shall pay to the person 40 percent of the amount of the
1379	reduction, up to $500.
1380	(h) An insurer may not systematically downcode with the
1381	intent to deny reimbursement otherwise due. Such action
1382	constitutes a material misrepresentation under s.
1383	626.9541(1)(i)2.
1384	(6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON;
1385	DISPUTES.--
1386	(a) Every employer shall, if a request is made by an
1387	insurer providing personal injury protection benefits under ss.
1388	627.730-627.7405 against whom a claim has been made, furnish
1389	forthwith, in a form approved by the department, a sworn
1390	statement of the earnings, since the time of the bodily injury
1391	and for a reasonable period before the injury, of the person
1392	upon whose injury the claim is based.
1393	(b) Every physician, hospital, clinic, or other medical
1394	institution providing, before or after bodily injury upon which
1395	a claim for personal injury protection insurance benefits is
1396	based, any products, services, or accommodations in relation to
1397	that or any other injury, or in relation to a condition claimed
1398	to be connected with that or any other injury, shall, if
1399	requested to do so by the insurer against whom the claim has
1400	been made, furnish forthwith a written report of the history,
1401	condition, treatment, dates, and costs of such treatment of the
1402	injured person and why the items identified by the insurer were
1403	reasonable in amount and medically necessary, together with a
1404	sworn statement that the treatment or services rendered were
1405	reasonable and necessary with respect to the bodily injury
1406	sustained and identifying which portion of the expenses for such
1407	treatment or services was incurred as a result of such bodily
1408	injury, and produce forthwith, and permit the inspection and
1409	copying of, his or her or its records regarding such history,
1410	condition, treatment, dates, and costs of treatment; provided
1411	that this shall not limit the introduction of evidence at trial.
1412	Such sworn statement shall read as follows: "Under penalty of
1413	perjury, I declare that I have read the foregoing, and the facts
1414	alleged are true, to the best of my knowledge and belief." No
1415	cause of action for violation of the physician-patient privilege
1416	or invasion of the right of privacy shall be permitted against
1417	any physician, hospital, clinic, or other medical institution
1418	complying with the provisions of this section. The person
1419	requesting such records and such sworn statement shall pay all
1420	reasonable costs connected therewith. If an insurer makes a
1421	written request for documentation or information under this
1422	paragraph within 30 days after having received notice of the
1423	amount of a covered loss under paragraph (4)(a), the amount or
1424	the partial amount which is the subject of the insurer's inquiry
1425	shall become overdue if the insurer does not pay in accordance
1426	with paragraph(4)(b) or within 10 days after the insurer's
1427	receipt of the requested documentation or information, whichever
1428	occurs later. For purposes of this paragraph, the term "receipt"
1429	includes, but is not limited to, inspection and copying pursuant
1430	to this paragraph. Any insurer that requests documentation or
1431	information pertaining to reasonableness of charges or medical
1432	necessity under this paragraph without a reasonable basis for
1433	such requests as a general business practice is engaging in an
1434	unfair trade practice under the insurance code.
1435	(c) In the event of any dispute regarding an insurer's
1436	right to discovery of facts under this sectionabout an injured
1437	person's earnings or about his or her history, condition, or
1438	treatment, or the dates and costs of such treatment, the insurer
1439	may petition a court of competent jurisdiction to enter an order
1440	permitting such discovery. The order may be made only on motion
1441	for good cause shown and upon notice to all persons having an
1442	interest, and it shall specify the time, place, manner,
1443	conditions, and scope of the discovery. Such court may, in order
1444	to protect against annoyance, embarrassment, or oppression, as
1445	justice requires, enter an order refusing discovery or
1446	specifying conditions of discovery and may order payments of
1447	costs and expenses of the proceeding, including reasonable fees
1448	for the appearance of attorneys at the proceedings, as justice
1449	requires.
1450	(d) The injured person shall be furnished, upon request, a
1451	copy of all information obtained by the insurer under the
1452	provisions of this section, and shall pay a reasonable charge,
1453	if required by the insurer.
1454	(e) Notice to an insurer of the existence of a claim shall
1455	not be unreasonably withheld by an insured.
1456	(7) MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON;
1457	REPORTS.--
1458	(a) Whenever the mental or physical condition of an
1459	injured person covered by personal injury protection is material
1460	to any claim that has been or may be made for past or future
1461	personal injury protection insurance benefits, such person
1462	shall, upon the request of an insurer, submit to mental or
1463	physical examination by a physician or physicians. The costs of
1464	any examinations requested by an insurer shall be borne entirely
1465	by the insurer. Such examination shall be conducted within the
1466	municipality where the insured is receiving treatment, or in a
1467	location reasonably accessible to the insured, which, for
1468	purposes of this paragraph, means any location within the
1469	municipality in which the insured resides, or any location
1470	within 10 miles by road of the insured's residence, provided
1471	such location is within the county in which the insured resides.
1472	If the examination is to be conducted in a location reasonably
1473	accessible to the insured, and if there is no qualified
1474	physician to conduct the examination in a location reasonably
1475	accessible to the insured, then such examination shall be
1476	conducted in an area of the closest proximity to the insured's
1477	residence. Personal protection insurers are authorized to
1478	include reasonable provisions in personal injury protection
1479	insurance policies for mental and physical examination of those
1480	claiming personal injury protection insurance benefits. An
1481	insurer may not withdraw payment of a treating physician without
1482	the consent of the injured person covered by the personal injury
1483	protection, unless the insurer first obtains a valid report by a
1484	Floridaphysician licensed under the same chapter as the
1485	treating physician whose treatment authorization is sought to be
1486	withdrawn, stating that treatment was not reasonable, related,
1487	or necessary. A valid report is one that is prepared and signed
1488	by the physician examining the injured person or reviewing the
1489	treatment records of the injured person and is factually
1490	supported by the examination and treatment records if reviewed
1491	and that has not been modified by anyone other than the
1492	physician. The physician preparing the report must be in active
1493	practice, unless the physician is physically disabled. Active
1494	practice means that during the 3 years immediately preceding the
1495	date of the physical examination or review of the treatment
1496	records the physician must have devoted professional time to the
1497	active clinical practice of evaluation, diagnosis, or treatment
1498	of medical conditions or to the instruction of students in an
1499	accredited health professional school or accredited residency
1500	program or a clinical research program that is affiliated with
1501	an accredited health professional school or teaching hospital or
1502	accredited residency program. The physician preparing a report
1503	at the request of an insurer and physicians rendering expert
1504	opinions on behalf of persons claiming medical benefits for
1505	personal injury protection, or on behalf of an insured through
1506	an attorney or another entity, shall maintain, for at least 3
1507	years, copies of all examination reports as medical records and
1508	shall maintain, for at least 3 years, records of all payments
1509	for the examinations and reports. Neither an insurer nor any
1510	person acting at the direction of or on behalf of an insurer may
1511	materially change an opinion in a report prepared under this
1512	paragraph or direct the physician preparing the report to change
1513	such opinion. The denial of a payment as the result of such a
1514	changed opinion constitutes a material misrepresentation under
1515	s. 626.9541(1)(i)2.; however, this provision does not preclude
1516	the insurer from calling to the attention of the physician
1517	errors of fact in the report based upon information in the claim
1518	file.
1519	(b) If requested by the person examined, a party causing
1520	an examination to be made shall deliver to him or her a copy of
1521	every written report concerning the examination rendered by an
1522	examining physician, at least one of which reports must set out
1523	the examining physician's findings and conclusions in detail.
1524	After such request and delivery, the party causing the
1525	examination to be made is entitled, upon request, to receive
1526	from the person examined every written report available to him
1527	or her or his or her representative concerning any examination,
1528	previously or thereafter made, of the same mental or physical
1529	condition. By requesting and obtaining a report of the
1530	examination so ordered, or by taking the deposition of the
1531	examiner, the person examined waives any privilege he or she may
1532	have, in relation to the claim for benefits, regarding the
1533	testimony of every other person who has examined, or may
1534	thereafter examine, him or her in respect to the same mental or
1535	physical condition. If a person unreasonably refuses to submit
1536	to an examination, the personal injury protection carrier is no
1537	longer liable for subsequent personal injury protection
1538	benefits.
1539	(8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S
1540	FEES.--With respect to any dispute under the provisions of ss.
1541	627.730-627.7405 between the insured and the insurer, or between
1542	an assignee of an insured's rights and the insurer, the
1543	provisions of s. 627.428 shall apply, except as provided in
1544	subsection (11).
1545	(10) An insurer may negotiate and enter into contracts
1546	with licensed health care providers for the benefits described
1547	in this section, referred to in this section as "preferred
1548	providers," which shall include health care providers licensed
1549	under chapters 458, 459, 460, 461, and 463. The insurer may
1550	provide an option to an insured to use a preferred provider at
1551	the time of purchase of the policy for personal injury
1552	protection benefits, if the requirements of this subsection are
1553	met. If the insured elects to use a provider who is not a
1554	preferred provider, whether the insured purchased a preferred
1555	provider policy or a nonpreferred provider policy, the medical
1556	benefits provided by the insurer shall be as required by this
1557	section. If the insured elects to use a provider who is a
1558	preferred provider, the insurer may pay medical benefits in
1559	excess of the benefits required by this section and may waive or
1560	lower the amount of any deductible that applies to such medical
1561	benefits. If the insurer offers a preferred provider policy to a
1562	policyholder or applicant, it must also offer a nonpreferred
1563	provider policy. The insurer shall provide each policyholder
1564	with a current roster of preferred providers in the county in
1565	which the insured resides at the time of purchase of such
1566	policy, and shall make such list available for public inspection
1567	during regular business hours at the principal office of the
1568	insurer within the state.
1569	(12) CIVIL ACTION FOR INSURANCE FRAUD.--An insurer shall
1570	have a cause of action against any person convicted of, or who,
1571	regardless of adjudication of guilt, pleads guilty or nolo
1572	contendere to insurance fraud under s. 817.234, patient
1573	brokering under s. 817.505, or kickbacks under s. 456.054,
1574	associated with a claim for personal injury protection benefits
1575	in accordance with this section. An insurer prevailing in an
1576	action brought under this subsection may recover compensatory,
1577	consequential, and punitive damages subject to the requirements
1578	and limitations of part II of chapter 768, and attorney's fees
1579	and costs incurred in litigating a cause of action against any
1580	person convicted of, or who, regardless of adjudication of
1581	guilt, pleads guilty or nolo contendere to insurance fraud under
1582	s. 817.234, patient brokering under s. 817.505, or kickbacks
1583	under s. 456.054, associated with a claim for personal injury
1584	protection benefits in accordance with this section.
1585	(13) If the Financial Services Commission determines that
1586	the cost savings under personal injury protection insurance
1587	benefits paid by insurers have been realized due to the
1588	provisions of this act, prior legislative reforms, or other
1589	factors, the commission may increase the minimum $10,000 benefit
1590	coverage requirement. In establishing the amount of such
1591	increase, the commission must determine that the additional
1592	premium for such coverage is approximately equal to the premium
1593	cost savings that have been realized for the personal injury
1594	protection coverage with limits of $10,000.
1595	Section 9. Effective October 1, 2003, subsection (11) of
1596	section 627.736, Florida Statutes, is amended to read:
1597	627.736 Required personal injury protection benefits;
1598	exclusions; priority; claims.--
1599	(11) DEMAND LETTER.--
1600	(a) As a condition precedent to filing any action for an
1601	overdue claim for benefits under this sectionparagraph(4)(b),
1602	the insurer must be provided with written notice of an intent to
1603	initiate litigation; provided, however, that, except with regard
1604	to a claim or amended claim or judgment for interest only which
1605	was not paid or was incorrectly calculated, such notice is not
1606	required for an overdue claim that the insurer has denied or
1607	reduced, nor is such notice required if the insurer has been
1608	provided documentation or information at the insurer's request
1609	pursuant to subsection (6). Such notice is not required if,
1610	after conducting an investigation, an insurer has chosen to
1611	deny, reduce, or downcode a claim.Such notice may not be sent
1612	until the claim is overdue, including any additional time the
1613	insurer has to pay the claim pursuant to paragraph (4)(b).
1614	(b) The notice required shall state that it is a "demand
1615	letter under s. 627.736(11)" and shall state with specificity:
1616	1. The name of the insured upon which such benefits are
1617	being sought, including a copy of the assignment giving rights
1618	to the claimant if the claimant is not the insured.
1619	2. The claim number or policy number upon which such claim
1620	was originally submitted to the insurer.
1621	3. To the extent applicable, the name of any medical
1622	provider who rendered to an insured the treatment, services,
1623	accommodations, or supplies that form the basis of such claim;
1624	and an itemized statement specifying each exact amount, the date
1625	of treatment, service, or accommodation, and the type of benefit
1626	claimed to be due. A completed form satisfying the requirements
1627	of paragraph (5)(d) or the lost-wage statement previously
1628	submittedHealth Care Finance Administration 1500 form, UB 92,
1629	or successor forms approved by the Secretary of the United
1630	States Department of Health and Human Servicesmay be used as
1631	the itemized statement. To the extent that the demand involves
1632	an insurer's withdrawal of payment under paragraph (7)(a) for
1633	future treatment not yet rendered, the claimant shall attach a
1634	copy of the insurer's notice withdrawing such payment and an
1635	itemized statement of the type, frequency, and duration of
1636	future treatment claimed to be reasonable and medically
1637	necessary.
1638	(c) Each notice required by this subsectionsectionmust
1639	be delivered to the insurer by United States certified or
1640	registered mail, return receipt requested. Such postal costs
1641	shall be reimbursed by the insurer if so requested by the
1642	claimantprovider in the notice, when the insurer pays the
1643	overdueclaim. Such notice must be sent to the person and
1644	address specified by the insurer for the purposes of receiving
1645	notices under this subsectionsection, on the document denying
1646	or reducing the amount asserted by the filer to be overdue. Each
1647	licensed insurer, whether domestic, foreign, or alien, shallmay
1648	file with the officedepartmentdesignation of the name and
1649	address of the person to whom notices pursuant to this
1650	subsectionsection shall be sent which the office shall make
1651	available on its Internet websitewhen such document does not
1652	specify the name and address to whom the notices under this
1653	section are to be sent or when there is no such document. The
1654	name and address on file with the officedepartmentpursuant to
1655	s. 624.422 shall be deemed the authorized representative to
1656	accept notice pursuant to this subsectionsectionin the event
1657	no other designation has been made.
1658	(d) If, within 157 businessdays after receipt of notice
1659	by the insurer, the overdue claim specified in the notice is
1660	paid by the insurer together with applicable interest and a
1661	penalty of 10 percent of the overdue amount paid by the insurer,
1662	subject to a maximum penalty of $250, no action for nonpayment
1663	or late payment may be brought against the insurer. If the
1664	demand involves an insurer's withdrawal of payment under
1665	paragraph (7)(a) for future treatment not yet rendered, no
1666	action may be brought against the insurer if, within 15 days
1667	after its receipt of the notice, the insurer mails to the person
1668	filing the notice a written statement of the insurer's agreement
1669	to pay for such treatment in accordance with the notice and to
1670	pay a penalty of 10 percent, subject to a maximum penalty of
1671	$250, when it pays for such future treatment in accordance with
1672	the requirements of this section.To the extent the insurer
1673	determines not to pay anythe overdue amount demanded, the
1674	penalty shall not be payable in any subsequent action for
1675	nonpayment or late payment. For purposes of this subsection,
1676	payment or the insurer's agreementshall be treated as being
1677	made on the date a draft or other valid instrument that is
1678	equivalent to payment, or the insurer's written statement of
1679	agreement,is placed in the United States mail in a properly
1680	addressed, postpaid envelope, or if not so posted, on the date
1681	of delivery. The insurer shall not be obligated to pay any
1682	attorney's fees if the insurer pays the claim or mails its
1683	agreement to pay for future treatmentwithin the time prescribed
1684	by this subsection.
1685	(e) The applicable statute of limitation for an action
1686	under this section shall be tolled for a period of 15 business
1687	days by the mailing of the notice required by this subsection.
1688	(f) Any insurer making a general business practice of not
1689	paying valid claims until receipt of the notice required by this
1690	subsectionsectionis engaging in an unfair trade practice under
1691	the insurance code.
1692	Section 9. Effective October 1, 2003, subsection (11) of
1693	section 627.736, Florida Statutes, is amended to read:
1694	627.736 Required personal injury protection benefits;
1695	exclusions; priority; claims.--
1696	(11) DEMAND LETTER.--
1697	(a) As a condition precedent to filing any action for an
1698	overdue claim for benefits under this sectionparagraph(4)(b),
1699	the insurer must be provided with written notice of an intent to
1700	initiate litigation; provided, however, that, except with regard
1701	to a claim or amended claim or judgment for interest only which
1702	was not paid or was incorrectly calculated, such notice is not
1703	required for an overdue claim that the insurer has denied or
1704	reduced, nor is such notice required if the insurer has been
1705	provided documentation or information at the insurer's request
1706	pursuant to subsection (6). Such notice may not be sent until
1707	the claim is overdue, including any additional time the insurer
1708	has to pay the claim pursuant to paragraph (4)(b).
1709	(b) The notice required shall state that it is a "demand
1710	letter under s. 627.736(11)" and shall state with specificity:
1711	1. The name of the insured upon which such benefits are
1712	being sought, including a copy of the assignment giving rights
1713	to the claimant if the claimant is not the insured.
1714	2. The claim number or policy number upon which such claim
1715	was originally submitted to the insurer.
1716	3. To the extent applicable, the name of any medical
1717	provider who rendered to an insured the treatment, services,
1718	accommodations, or supplies that form the basis of such claim;
1719	and an itemized statement specifying each exact amount, the date
1720	of treatment, service, or accommodation, and the type of benefit
1721	claimed to be due. A completed form satisfying the requirements
1722	of paragraph (5)(d) or the lost-wage statement previously
1723	submittedHealth Care Finance Administration 1500 form, UB 92,
1724	or successor forms approved by the Secretary of the United
1725	States Department of Health and Human Servicesmay be used as
1726	the itemized statement. To the extent that the demand involves
1727	an insurer's withdrawal of payment under paragraph (7)(a) for
1728	future treatment not yet rendered, the claimant shall attach a
1729	copy of the insurer's notice withdrawing such payment and an
1730	itemized statement of the type, frequency, and duration of
1731	future treatment claimed to be reasonable and medically
1732	necessary.
1733	(c) Each notice required by this subsectionsectionmust
1734	be delivered to the insurer by United States certified or
1735	registered mail, return receipt requested. Such postal costs
1736	shall be reimbursed by the insurer if so requested by the
1737	claimantprovider in the notice, when the insurer pays the
1738	overdueclaim. Such notice must be sent to the person and
1739	address specified by the insurer for the purposes of receiving
1740	notices under this subsectionsection, on the document denying
1741	or reducing the amount asserted by the filer to be overdue. Each
1742	licensed insurer, whether domestic, foreign, or alien, shallmay
1743	file with the officedepartmentdesignation of the name and
1744	address of the person to whom notices pursuant to this
1745	subsectionsection shall be sent which the office shall make
1746	available on its Internet websitewhen such document does not
1747	specify the name and address to whom the notices under this
1748	section are to be sent or when there is no such document. The
1749	name and address on file with the officedepartmentpursuant to
1750	s. 624.422 shall be deemed the authorized representative to
1751	accept notice pursuant to this subsectionsectionin the event
1752	no other designation has been made.
1753	(d) If, within 157 businessdays after receipt of notice
1754	by the insurer, the overdue claim specified in the notice is
1755	paid by the insurer together with applicable interest and a
1756	penalty of 10 percent of the overdue amount paid by the insurer,
1757	subject to a maximum penalty of $250, no action for nonpayment
1758	or late payment may be brought against the insurer. If the
1759	demand involves an insurer's withdrawal of payment under
1760	paragraph (7)(a) for future treatment not yet rendered, no
1761	action may be brought against the insurer if, within 15 days
1762	after its receipt of the notice, the insurer mails to the person
1763	filing the notice a written statement of the insurer's agreement
1764	to pay for such treatment in accordance with the notice and to
1765	pay a penalty of 10 percent, subject to a maximum penalty of
1766	$250, when it pays for such future treatment in accordance with
1767	the requirements of this section.To the extent the insurer
1768	determines not to pay anythe overdue amount demanded, the
1769	penalty shall not be payable in any subsequent action for
1770	nonpayment or late payment. For purposes of this subsection,
1771	payment or the insurer's agreementshall be treated as being
1772	made on the date a draft or other valid instrument that is
1773	equivalent to payment, or the insurer's written statement of
1774	agreement,is placed in the United States mail in a properly
1775	addressed, postpaid envelope, or if not so posted, on the date
1776	of delivery. The insurer shall not be obligated to pay any
1777	attorney's fees if the insurer pays the claim or mails its
1778	agreement to pay for future treatmentwithin the time prescribed
1779	by this subsection.
1780	(e) The applicable statute of limitation for an action
1781	under this section shall be tolled for a period of 15 business
1782	days by the mailing of the notice required by this subsection.
1783	(f) Any insurer making a general business practice of not
1784	paying valid claims until receipt of the notice required by this
1785	subsectionsectionis engaging in an unfair trade practice under
1786	the insurance code.
1787	Section 10. Subsections (1) and (2) of section 627.739,
1788	Florida Statutes, are amended to read:
1789	627.739 Personal injury protection; optional limitations;
1790	deductibles.--
1791	(1) The named insured may elect a deductible or modified
1792	coverage or combination thereof to apply to the named insured
1793	alone or to the named insured and dependent relatives residing
1794	in the same household, but may not elect a deductible or
1795	modified coverage to apply to any other person covered under the
1796	policy. Any person electing a deductible or modified coverage,
1797	or a combination thereof, or subject to such deductible or
1798	modified coverage as a result of the named insured's election,
1799	shall have no right to claim or to recover any amount so
1800	deducted from any owner, registrant, operator, or occupant of a
1801	vehicle or any person or organization legally responsible for
1802	any such person's acts or omissions who is made exempt from tort
1803	liability by ss. 627.730-627.7405.
1804	(2) Insurers shall offer to each applicant and to each
1805	policyholder, upon the renewal of an existing policy,
1806	deductibles, in amounts of $250, $500, and $1,000, and $2,000.
1807	The deductible amount must be applied to 100 percent of the
1808	expenses and losses described in s. 627.736. After the
1809	deductible is met, each insured is eligible to receive up to
1810	$10,000 in total benefits described in s. 627.736(1)., such
1811	amount to be deducted from the benefits otherwise due each
1812	person subject to the deduction.However, this subsection shall
1813	not be applied to reduce the amount of any benefits received in
1814	accordance with s. 627.736(1)(c).
1815	Section 11. Subsections (7), (8), and (9) of section
1816	817.234, Florida Statutes, are amended to read:
1817	817.234 False and fraudulent insurance claims.--
1818	(7)(a) It shall constitute a material omission and
1819	insurance fraud for any physician or other provider, other than
1820	a hospital, to engage in a general business practice of billing
1821	amounts as its usual and customary charge, if such provider has
1822	agreed with the patient or intends to waive deductibles or
1823	copayments, or does not for any other reason intend to collect
1824	the total amount of such charge. This paragraph does not apply
1825	to physicians or other providers who waive deductibles or
1826	copayments or reduce their bills as part of a bodily injury
1827	settlement or verdict.
1828	(b)The provisions of this section shall also apply as to
1829	any insurer or adjusting firm or its agents or representatives
1830	who, with intent, injure, defraud, or deceive any claimant with
1831	regard to any claim. The claimant shall have the right to
1832	recover the damages provided in this section.
1833	(c) An insurer, or any person acting at the direction of
1834	or on behalf of an insurer, may not change an opinion in a
1835	mental or physical report prepared under s. 627.736(7) or direct
1836	the physician preparing the report to change such opinion;
1837	however, this provision does not preclude the insurer from
1838	calling to the attention of the physician errors of fact in the
1839	report based upon information in the claim file. Any person who
1840	violates this paragraph commits a felony of the third degree,
1841	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
1842	(8)(a) It is unlawful for any person intending to defraud
1843	any other person, in his or her individual capacity or in his or
1844	her capacity as a public or private employee, or for any firm,
1845	corporation, partnership, or association,to solicit or cause to
1846	be solicited any business from a person involved in a motor
1847	vehicle accident by any means of communication other than
1848	advertising directed to the public for the purpose of making,
1849	adjusting, or settlingmotor vehicle tort claims or claims for
1850	personal injury protection benefits required by s. 627.736.
1851	Charges for any services rendered by a health care provider or
1852	attorney who violates this subsection in regard to the person
1853	for whom such services were rendered are noncompensable and
1854	unenforceable as a matter of law.Any person who violates the
1855	provisions of this paragraphsubsection commits a felony of the
1856	secondthirddegree, punishable as provided in s. 775.082, s.
1857	775.083, or s. 775.084. A person who is convicted of a violation
1858	of this subsection shall be sentenced to a minimum term of
1859	imprisonment of 2 years.
1860	(b) A person may not solicit or cause to be solicited any
1861	business from a person involved in a motor vehicle accident by
1862	any means of communication other than advertising directed to
1863	the public for the purpose of making motor vehicle tort claims
1864	or claims for personal injury protection benefits required by s.
1865	627.736, within 60 days after the occurrence of the motor
1866	vehicle accident. Any person who violates this paragraph commits
1867	a felony of the third degree, punishable as provided in s.
1868	775.082, s. 775.083, or s. 775.084.
1869	(c) A lawyer, health care practitioner as defined in s.
1870	456.001, or owner or medical director of a clinic required to be
1871	licensed pursuant to s. 400.9902 may not, at any time after 60
1872	days have elapsed from the occurrence of a motor vehicle
1873	accident, solicit or cause to be solicited any business from a
1874	person involved in a motor vehicle accident by means of in-
1875	person or telephone contact at the person's residence, for the
1876	purpose of making motor vehicle tort claims or claims for
1877	personal injury protection benefits required by s. 627.736. Any
1878	person who violates this paragraph commits a felony of the third
1879	degree, punishable as provided in s. 775.082, s. 775.083, or s.
1880	775.084.
1881	(d) Charges for any services rendered by any person who
1882	violates this subsection in regard to the person for whom such
1883	services were rendered are noncompensable and unenforceable as a
1884	matter of law.
1885	(9) A person may not organize, plan, or knowingly
1886	participate in an intentional motor vehicle crash for the
1887	purpose of making motor vehicle tort claims or claims for
1888	personal injury protection benefits as required by s. 627.736.
1889	It is unlawful for any attorney to solicit any business relating
1890	to the representation of a person involved in a motor vehicle
1891	accident for the purpose of filing a motor vehicle tort claim or
1892	a claim for personal injury protection benefits required by s.
1893	627.736. The solicitation by advertising of any business by an
1894	attorney relating to the representation of a person injured in a
1895	specific motor vehicle accident is prohibited by this section.
1896	Any personattorney who violates the provisions of this
1897	paragraphsubsection commits a felony of the secondthird
1898	degree, punishable as provided in s. 775.082, s. 775.083, or s.
1899	775.084. A person who is convicted of a violation of this
1900	subsection shall be sentenced to a minimum term of imprisonment
1901	of 2 years.Whenever any circuit or special grievance committee
1902	acting under the jurisdiction of the Supreme Court finds
1903	probable cause to believe that an attorney is guilty of a
1904	violation of this section, such committee shall forward to the
1905	appropriate state attorney a copy of the finding of probable
1906	cause and the report being filed in the matter. This section
1907	shall not be interpreted to prohibit advertising by attorneys
1908	which does not entail a solicitation as described in this
1909	subsection and which is permitted by the rules regulating The
1910	Florida Bar as promulgated by the Florida Supreme Court.
1911	Section 12. Section 817.236, Florida Statutes, is amended
1912	to read:
1913	817.236 False and fraudulent motor vehicle insurance
1914	application.--Any person who, with intent to injure, defraud, or
1915	deceive any motor vehicle insurer, including any statutorily
1916	created underwriting association or pool of motor vehicle
1917	insurers, presents or causes to be presented any written
1918	application, or written statement in support thereof, for motor
1919	vehicle insurance knowing that the application or statement
1920	contains any false, incomplete, or misleading information
1921	concerning any fact or matter material to the application
1922	commits a felonymisdemeanor of the thirdfirstdegree,
1923	punishable as provided in s. 775.082,or s. 775.083, or s.
1924	775.084.
1925	Section 13. Section 817.2361, Florida Statutes, is created
1926	to read:
1927	817.2361 False or fraudulent motor vehicle insurance
1928	card.--Any person who, with intent to deceive any other person,
1929	creates, markets, or presents a false or fraudulent motor
1930	vehicle insurance card commits a felony of the third degree,
1931	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
1932	Section 14. Effective October 1, 2003, paragraphs (c) and
1933	(g) of subsection (3) of section 921.0022, Florida Statutes, are
1934	amended to read:
1935	921.0022 Criminal Punishment Code; offense severity
1936	ranking chart.--
1937	(3) OFFENSE SEVERITY RANKING CHART
1938
1939	Florida Felony
1940	Statute Degree Description
1941	(c) LEVEL 3
1942	119.10(3) 3rd Unlawful use of confidential information from police reports.
1943	316.066(3)(d)-(f) 3rd Unlawfully obtaining or using confidential crash reports.
1944	316.193(2)(b) 3rd Felony DUI, 3rd conviction.
1945	316.1935(2) 3rd Fleeing or attempting to elude law enforcement officer in marked patrol vehicle with siren and lights activated.
1946	319.30(4) 3rd Possession by junkyard of motor vehicle with identification number plate removed.
1947	319.33(1)(a) 3rd Alter or forge any certificate of title to a motor vehicle or mobile home.
1948	319.33(1)(c) 3rd Procure or pass title on stolen vehicle.
1949	319.33(4) 3rd With intent to defraud, possess, sell, etc., a blank, forged, or unlawfully obtained title or registration.
1950	327.35(2)(b) 3rd Felony BUI.
1951	328.05(2) 3rd Possess, sell, or counterfeit fictitious, stolen, or fraudulent titles or bills of sale of vessels.
1952	328.07(4) 3rd Manufacture, exchange, or possess vessel with counterfeit or wrong ID number.
1953	376.302(5) 3rd Fraud related to reimbursement for cleanup expenses under the Inland Protection Trust Fund.
1954	400.9902 (3) 3rd Operating a clinic without a license or filing false license application or other required information.
1955	501.001(2)(b) 2nd Tampers with a consumer product or the container using materially false/misleading information.
1956	697.08 3rd Equity skimming.
1957	790.15(3) 3rd Person directs another to discharge firearm from a vehicle.
1958	796.05(1) 3rd Live on earnings of a prostitute.
1959	806.10(1) 3rd Maliciously injure, destroy, or interfere with vehicles or equipment used in firefighting.
1960	806.10(2) 3rd Interferes with or assaults firefighter in performance of duty.
1961	810.09(2)(c) 3rd Trespass on property other than structure or conveyance armed with firearm or dangerous weapon.
1962	812.014(2)(c)2. 3rd Grand theft; $5,000 or more but less than $10,000.
1963	812.0145(2)(c) 3rd Theft from person 65 years of age or older; $300 or more but less than $10,000.
1964	815.04(4)(b) 2nd Computer offense devised to defraud or obtain property.
1965	817.034(4)(a)3. 3rd Engages in scheme to defraud (Florida Communications Fraud Act), property valued at less than $20,000.
1966	817.233 3rd Burning to defraud insurer.
1967	817.234(8)(b)-(c)&(9) 3rd Unlawful solicitation of persons involved in motor vehicle accidents.
1968	817.234(11)(a) 3rd Insurance fraud; property value less than $20,000.
1969	817.236 3rd Filing a false motor vehicle insurance application.
1970	817.2361 3rd Creating, marketing, or presenting a false or fraudulent motor vehicle insurance card.
1971	817.505(4) 3rd Patient brokering.
1972	828.12(2) 3rd Tortures any animal with intent to inflict intense pain, serious physical injury, or death.
1973	831.28(2)(a) 3rd Counterfeiting a payment instrument with intent to defraud or possessing a counterfeit payment instrument.
1974	831.29 2nd Possession of instruments for counterfeiting drivers' licenses or identification cards.
1975	838.021(3)(b) 3rd Threatens unlawful harm to public servant.
1976	843.19 3rd Injure, disable, or kill police dog or horse.
1977	870.01(2) 3rd Riot; inciting or encouraging.
1978	893.13(1)(a)2. 3rd Sell, manufacture, or deliver cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7.,(2)(c)8., (2)(c)9., (3), or (4) drugs).
1979	893.13(1)(d)2. 2nd Sell, manufacture, or deliver s. 893.03(1)(c),(2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8.,(2)(c)9., (3), or (4) drugs within 200 feet of university or public park.
1980	893.13(1)(f)2. 2nd Sell, manufacture, or deliver s. 893.03(1)(c),(2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8.,(2)(c)9., (3), or (4) drugs within 200 feet of public housing facility.
1981	893.13(6)(a) 3rd Possession of any controlled substance other than felony possession of cannabis.
1982	893.13(7)(a)8. 3rd Withhold information from practitioner regarding previous receipt of or prescription for a controlled substance.
1983	893.13(7)(a)9. 3rd Obtain or attempt to obtain controlled substance by fraud, forgery, misrepresentation, etc.
1984	893.13(7)(a)10. 3rd Affix false or forged label to package of controlled substance.
1985	893.13(7)(a)11. 3rd Furnish false or fraudulent material information on any document or record required by chapter 893.
1986	893.13(8)(a)1. 3rd Knowingly assist a patient, other person, or owner of an animal in obtaining a controlled substance through deceptive, untrue, or fraudulent representations in or related to the practitioner's practice.
1987	893.13(8)(a)2. 3rd Employ a trick or scheme in the practitioner's practice to assist a patient, other person, or owner of an animal in obtaining a controlled substance.
1988	893.13(8)(a)3. 3rd Knowingly write a prescription for a controlled substance for a fictitious person.
1989	893.13(8)(a)4. 3rd Write a prescription for a controlled substance for a patient, other person, or an animal if the sole purpose of writing the prescription is a monetary benefit for the practitioner.
1990	918.13(1)(a) 3rd Alter, destroy, or conceal investigation evidence.
1991	944.47(1)(a)1.-2. 3rd Introduce contraband to correctional facility.
1992	944.47(1)(c) 2nd Possess contraband while upon the grounds of a correctional institution.
1993	985.3141 3rd Escapes from a juvenile facility (secure detention or residential commitment facility).
1994	(g) LEVEL 7
1995	316.193(3)(c)2. 3rd DUI resulting in serious bodily injury.
1996	327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury.
1997	402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
1998	409.920(2) 3rd Medicaid provider fraud.
1999	456.065(2) 3rd Practicing a health care profession without a license.
2000	456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury.
2001	458.327(1) 3rd Practicing medicine without a license.
2002	459.013(1) 3rd Practicing osteopathic medicine without a license.
2003	460.411(1) 3rd Practicing chiropractic medicine without a license.
2004	461.012(1) 3rd Practicing podiatric medicine without a license.
2005	462.17 3rd Practicing naturopathy without a license.
2006	463.015(1) 3rd Practicing optometry without a license.
2007	464.016(1) 3rd Practicing nursing without a license.
2008	465.015(2) 3rd Practicing pharmacy without a license.
2009	466.026(1) 3rd Practicing dentistry or dental hygiene without a license.
2010	467.201 3rd Practicing midwifery without a license.
2011	468.366 3rd Delivering respiratory care services without a license.
2012	483.828(1) 3rd Practicing as clinical laboratory personnel without a license.
2013	483.901(9) 3rd Practicing medical physics without a license.
2014	484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription.
2015	484.053 3rd Dispensing hearing aids without a license.
2016	494.0018(2) 1st Conviction of any violation of ss. 494.001-494.0077 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
2017	560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by money transmitter.
2018	560.125(5)(a) 3rd Money transmitter business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
2019	655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
2020	782.051(3) 2nd Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
2021	782.07(1) 2nd Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
2022	782.071 2nd Killing of human being or viable fetus by the operation of a motor vehicle in a reckless manner (vehicular homicide).
2023	782.072 2nd Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
2024	784.045(1)(a)1. 2nd Aggravated battery; intentionally causing great bodily harm or disfigurement.
2025	784.045(1)(a)2. 2nd Aggravated battery; using deadly weapon.
2026	784.045(1)(b) 2nd Aggravated battery; perpetrator aware victim pregnant.
2027	784.048(4) 3rd Aggravated stalking; violation of injunction or court order.
2028	784.07(2)(d) 1st Aggravated battery on law enforcement officer.
2029	784.074(1)(a) 1st Aggravated battery on sexually violent predators facility staff.
2030	784.08(2)(a) 1st Aggravated battery on a person 65 years of age or older.
2031	784.081(1) 1st Aggravated battery on specified official or employee.
2032	784.082(1) 1st Aggravated battery by detained person on visitor or other detainee.
2033	784.083(1) 1st Aggravated battery on code inspector.
2034	790.07(4) 1st Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
2035	790.16(1) 1st Discharge of a machine gun under specified circumstances.
2036	790.165(2) 2nd Manufacture, sell, possess, or deliver hoax bomb.
2037	790.165(3) 2nd Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
2038	790.166(3) 2nd Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
2039	790.166(4) 2nd Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
2040	796.03 2nd Procuring any person under 16 years for prostitution.
2041	800.04(5)(c)1. 2nd Lewd or lascivious molestation; victim less than 12 years of age; offender less than 18 years.
2042	800.04(5)(c)2. 2nd Lewd or lascivious molestation; victim 12 years of age or older but less than 16 years; offender 18 years or older.
2043	806.01(2) 2nd Maliciously damage structure by fire or explosive.
2044	810.02(3)(a) 2nd Burglary of occupied dwelling; unarmed; no assault or battery.
2045	810.02(3)(b) 2nd Burglary of unoccupied dwelling; unarmed; no assault or battery.
2046	810.02(3)(d) 2nd Burglary of occupied conveyance; unarmed; no assault or battery.
2047	812.014(2)(a) 1st Property stolen, valued at $100,000 or more; cargo stolen valued at $50,000 or more; property stolen while causing other property damage; 1st degree grand theft.
2048	812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft.
2049	812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more.
2050	812.019(2) 1st Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
2051	812.131(2)(a) 2nd Robbery by sudden snatching.
2052	812.133(2)(b) 1st Carjacking; no firearm, deadly weapon, or other weapon.
2053	817.234(8)(a) 2nd Solicitation of motor vehicle accident victims with intent to defraud.
2054	817.234(9) 2nd Organizing, planning, or participating in an intentional motor vehicle collision.
2055	817.234(11)(c) 1st Insurance fraud; property value $100,000 or more.
2056	825.102(3)(b) 2nd Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
2057	825.103(2)(b) 2nd Exploiting an elderly person or disabled adult and property is valued at $20,000 or more, but less than $100,000.
2058	827.03(3)(b) 2nd Neglect of a child causing great bodily harm, disability, or disfigurement.
2059	827.04(3) 3rd Impregnation of a child under 16 years of age by person 21 years of age or older.
2060	837.05(2) 3rd Giving false information about alleged capital felony to a law enforcement officer.
2061	872.06 2nd Abuse of a dead human body.
2062	893.13(1)(c)1. 1st Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or(2)(c)4.) within 1,000 feet of a child care facility or school.
2063	893.13(1)(e)1. 1st Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or(2)(c)4., within 1,000 feet of property used for religious services or a specified business site.
2064	893.13(4)(a) 1st Deliver to minor cocaine (or other s. 893.03(1)(a),(1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
2065	893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
2066	893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams.
2067	893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
2068	893.135(1)(d)1. 1st Trafficking in phencyclidine, more than 28 grams, less than 200 grams.
2069	893.135(1)(e)1. 1st Trafficking in methaqualone, more than 200 grams, less than 5 kilograms.
2070	893.135(1)(f)1. 1st Trafficking in amphetamine, more than 14 grams, less than 28 grams.
2071	893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
2072	893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
2073	893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
2074	893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
2075	896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000.
2076	896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
2077	Section 15. The amendment by this act of s.
2078	456.0375(1)(b), Florida Statutes, is intended to clarify the
2079	legislative intent of this provision as it existed at the time
2080	the provision initially took effect. Accordingly, the amendment
2081	by this act of s. 456.0375(1)(b), Florida Statutes, shall
2082	operate retroactively to October 1, 2001.
2083	Section 16. Effective March 1, 2004, s. 456.0375, Florida
2084	Statutes, is repealed.
2085	Section 17. (1) Any increase in benefits approved by the
2086	Financial Services Commission under s. 627.736(12), Florida
2087	Statutes, as created by this act, shall apply to new and renewal
2088	policies that are effective 120 days after the order issued by
2089	the commission becomes final. The amendment by this act of s.
2090	627.739(2), Florida Statutes, shall apply to new and renewal
2091	policies issued on or after October 1, 2003.
2092	(2) The amendment by this act of s. 627.736(11), Florida
2093	Statutes, shall apply to actions filed on and after the
2094	effective date of this act.
2095	(3) The amendments by this act of ss. 627.736(7)(a) and
2096	817.234(7)(c), Florida Statutes, shall apply to examinations
2097	conducted on and after October 1, 2003.
2098	Section 18. By December 31, 2004, the Department of
2099	Financial Services, the Department of Health, and the Agency for
2100	Health Care Administration each shall submit a report on the
2101	implementation of this act and recommendations, if any, to
2102	further improve the automobile insurance market, reduce
2103	automobile insurance costs, and reduce automobile insurance
2104	fraud and abuse to the President of the Senate and the Speaker
2105	of the House of Representatives. The report by the Department of
2106	Financial Services shall include a study of the medical and
2107	legal costs associated with personal injury protection insurance
2108	claims.
2109	Section 19. There is appropriated $2.5 million from the
2110	Health Care Trust Fund, and 51 full-time equivalent positions
2111	are authorized, for the Agency for Health Care Administration to
2112	implement the provisions of this act.
2113	Section 20. (1) Effective October 1, 2007, ss. 627.730,
2114	627.731, 627.732, 627.733, 627.734, 627.736, 627.737, 627.739,
2115	627.7401, 627.7403, and 627.7405, Florida Statutes, constituting
2116	the Florida Motor Vehicle No-Fault Law, are repealed, unless
2117	reenacted by the Legislature during the 2006 Regular Session and
2118	such reenactment becomes law to take effect for policies issued
2119	or renewed on or after October 1, 2006.
2120	(2) Insurers are authorized to provide, in all policies
2121	issued or renewed after October 1, 2006, that such policies may
2122	terminate on or after October 1, 2007, as provided in subsection
2123	(1).
2124	Section 21. Effective upon becoming law, to be applied
2125	retroactively to the date upon which HB 513 enacted during the
2126	2003 Regular Session of the Legislature becomes law,
2127	notwithstanding the provisions of HB 513 enacted during the 2003
2128	Regular Session of the Legislature, subsection (11) of section
2129	626.7451, Florida Statutes 2002, is not amended and is reenacted
2130	to read:
2131	626.7451 Managing general agents; required contract
2132	provisions.--No person acting in the capacity of a managing
2133	general agent shall place business with an insurer unless there
2134	is in force a written contract between the parties which sets
2135	forth the responsibility for a particular function, specifies
2136	the division of responsibilities, and contains the following
2137	minimum provisions:
2138	(11) A licensed managing general agent, when placing
2139	business with an insurer under this code, may charge a per-
2140	policy fee not to exceed $25. In no instance shall the aggregate
2141	of per-policy fees for a placement of business authorized under
2142	this section, when combined with any other per-policy fee
2143	charged by the insurer, result in per-policy fees which exceed
2144	the aggregate amount of $25. The per-policy fee shall be a
2145	component of the insurer's rate filing and shall be fully
2146	earned.
2147
2148	For the purposes of this section and ss. 626.7453 and 626.7454,
2149	the term "controlling person" or "controlling" has the meaning
2150	set forth in s. 625.012(5)(b)1., and the term "controlled
2151	person" or "controlled" has the meaning set forth in s.
2152	625.012(5)(b)2.
2153	Section 22. Except as otherwise specifically provided
2154	herein, if any law amended by this act was also amended by a law
2155	enacted at the 2003 Regular Session of the Legislature, such
2156	laws shall be construed as if they had been enacted at the same
2157	session of the Legislature, and full effect shall be given to
2158	each if possible.
2159	Section 23. Except as otherwise provided, this act shall
2160	take effect July 1, 2003.