HB 17C

1	A bill to be entitled
2	An act relating to expenses of motor vehicle crashes;
3	creating s. 324.0221, F.S.; prohibiting an owner or
4	operator of a motor vehicle from recovering noneconomic
5	damages if proof of financial responsibility is not
6	established; providing exceptions; amending s. 400.990,
7	F.S.; providing additional legislative findings; amending
8	s. 400.9905, F.S.; redefining the term "clinic" for
9	purposes of the Health Care Clinic Act to include certain
10	additional providers; excluding certain facilities owned
11	by publicly traded corporations; defining the term
12	"specialty clinic"; including certain facilities owned by
13	publicly traded corporations excluded by the definition of
14	the term "clinic"; defining the terms "infusion therapy"
15	and "fraud"; amending s. 400.991, F.S.; requiring
16	specialty clinics to be subject to licensure requirements;
17	requiring additional persons to be subject to background
18	screening; revising certain requirements for applying for
19	licensure as a health care clinic; creating additional
20	requirements for applying for licensure as a specialty
21	clinic; providing additional grounds under which an
22	applicant may be denied licensure due to a finding of
23	guilt for committing a felony; providing grounds for the
24	denial of specialty clinic licensure; amending s.
25	400.9925, F.S.; providing the agency with rulemaking
26	authority regarding specialty clinics; amending s.
27	400.993, F.S.; including specialty clinics within
28	provisions regarding unlicensed clinics; amending s.
29	400.9935, F.S.; including specialty clinics within
30	provisions regarding clinic responsibilities; revising the
31	responsibilities of the medical director and the clinic
32	director; requiring clinic health care service providers
33	to comply with the licensure laws and rules under which
34	they are licensed; providing for a certificate of
35	exemption from licensure as a clinic to expire within a
36	specified period; providing for renewal of the certificate
37	of exemption; revising the application procedures for a
38	certificate of exemption; providing grounds for the
39	denial, withdrawal, or emergency suspension of a
40	certificate of exemption by the Agency for Health Care
41	Administration; providing criminal penalties for an
42	applicant who submits fraudulent or material and
43	misleading information to the agency; requiring a
44	specialty clinic to file an audited report with the agency
45	no less frequently than annually; requiring a specialty
46	clinic to maintain compliance with specified provisions;
47	requiring health care clinics and specialty clinics to
48	display signs containing certain information relating to
49	insurance fraud; authorizing compliance inspections by the
50	Division of Insurance Fraud; requiring clinics to allow
51	inspection access; amending s. 400.995, F.S.; granting the
52	agency authority to impose administrative penalties
53	against a specialty clinic; creating s. 400.996, F.S.;
54	creating a process whereby the agency receives, documents,
55	and processes complaints about specialty clinics;
56	requiring the agency to request that complaints regarding
57	billing fraud by a specialty clinic be made by sworn
58	affidavit; requiring the agency to refer to the Office of
59	Fiscal Integrity within the Department of Financial
60	Services any sworn affidavit asserting billing fraud by a
61	specialty clinic; requiring the department to report
62	findings regarding billing fraud by a specialty clinic to
63	the agency; requiring the department to refer an
64	investigation to prosecutorial authorities and provide
65	investigative assistance under certain circumstances;
66	providing criminal penalties for submission of an
67	affidavit asserting billing fraud by a specialty clinic
68	that is without any factual basis; allowing the department
69	to conduct unannounced reviews, investigations, analyses,
70	and audits to investigate complaints of billing fraud by a
71	specialty clinic; authorizing the department to enter upon
72	the premises of a specialty clinic and immediately secure
73	copies of certain documents; requiring a specialty clinic
74	to allow full and immediate access to the premises and
75	records of the clinic to a department officer or employee
76	under  specified provisions; providing that failure to
77	provide such access is a ground for emergency suspension
78	of the license of the specialty clinic; permitting the
79	agency to assess a fee against a specialty clinic equal to
80	the cost of conducting a review, investigation, analysis,
81	or audit performed by the agency or the department;
82	providing that all investigators designated by the Chief
83	Financial Officer to perform specified duties are law
84	enforcement officers of the state; amending s. 456.072,
85	F.S.; providing that intentionally providing false
86	information in an application for a certificate of
87	exemption from clinic licensure constitutes grounds for
88	which disciplinary action may be taken; providing
89	appropriations; authorizing positions and a salary rate;
90	reviving and reenacting ss. 627.730, 627.731, 627.732,
91	627.733, 627.734, 627.736, 627.737, 627.739, 627.7401,
92	627.7403, and 627.7405, F.S., the Florida Motor Vehicle
93	No-Fault Law, notwithstanding the repeal of such law
94	provided in s. 19, chapter 2003-411, Laws of Florida;
95	providing legislative intent concerning the application of
96	the act; requiring insurers to deliver revised notices of
97	premium and policy changes to certain policyholders;
98	requiring insurers to cancel the policy and return any
99	unearned premium if the insured fails to timely respond to
100	the notice; providing for calculating the amount of
101	unearned premium; providing that a person purchasing a
102	motor vehicle insurance policy without personal injury
103	protection coverage is exempt from the requirement for
104	such coverage and is not subject to certain liability
105	provisions for a specified period; requiring that insurers
106	provide notice of the requirement for personal injury
107	protection coverage or add an endorsement to the policy
108	providing such coverage; providing for the future repeal
109	of the Florida Motor Vehicle No-Fault Law, ss. 627.730,
110	627.731, 627.732, 627.733, 627.734, 627.736, 627.737,
111	627.739, 627.7401, 627.7403, and 627.7405, F.S.; providing
112	an effective date.
113
114	Be It Enacted by the Legislature of the State of Florida:
115
116	Section 1.  Section 324.0221, Florida Statutes, is created
117	to read:
118	324.0221  Proof of responsibility required to recover
119	noneconomic damages.--In any action to recover damages arising
120	out of the operation or use of a motor vehicle, a person may not
121	recover noneconomic damages to compensate for pain, suffering,
122	inconvenience, or other noneconomic loss or damages if the
123	person was the owner or operator of a vehicle involved in the
124	accident and cannot establish that he or she maintained proof of
125	financial responsibility at the time of the accident by one of
126	the methods specified in s. 324.031. However, this restriction
127	shall not apply to noneconomic damages recovered from a person
128	who intentionally caused, or who acted in a grossly negligent
129	manner in causing, the injury giving rise to the noneconomic
130	damages.
131	Section 2.  Section 400.990, Florida Statutes, is amended
132	to read:
133	400.990  Short title; legislative findings.--
134	(1)  This part, consisting of ss. 400.990-400.995, may be
135	cited as the "Health Care Clinic Act."
136	(2)  The Legislature finds that the regulation of health
137	care clinics must be strengthened to prevent significant cost
138	and harm to consumers. The purpose of this part is to provide
139	for the licensure, establishment, and enforcement of basic
140	standards for health care clinics and to provide administrative
141	oversight by the Agency for Health Care Administration.
142	(3)  The Legislature further finds the additional
143	regulation of specialty health care clinics is necessary to
144	prevent significant fraudulent practices in the provision of
145	infusion therapy services in this state.
146	(4)  The purpose of this part is to provide for the
147	licensure, establishment, and enforcement of basic standards for
148	health care clinics and to provide administrative oversight by
149	the Agency for Health Care Administration.
150	Section 3.  Subsection (4) of section 400.9905, Florida
151	Statutes, is amended, and subsections (8), (9), and (10) are
152	added to that section, to read:
153	400.9905  Definitions.--
154	(4)  "Clinic" means an entity at which health care services
155	are provided to individuals and which tenders charges for
156	reimbursement for such services, including a mobile clinic and a
157	portable equipment provider. For purposes of this part, the term
158	does not include and the licensure requirements of this part do
159	not apply to:
160	(a)  Entities licensed or registered by the state under
161	chapter 395; or entities licensed or registered by the state and
162	providing only health care services within the scope of services
163	authorized under their respective licenses granted under ss.
164	383.30-383.335, chapter 390, chapter 394, chapter 397, this
165	chapter except part X, chapter 429, chapter 463, chapter 465,
166	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
167	chapter 651; end-stage renal disease providers authorized under
168	42 C.F.R. part 405, subpart U; or providers certified under 42
169	C.F.R. part 485, subpart B or subpart H; or any entity that
170	provides neonatal or pediatric hospital-based health care
171	services or other health care services by licensed practitioners
172	solely within a hospital licensed under chapter 395.
173	(b)  Entities that own, directly or indirectly, entities
174	licensed or registered by the state pursuant to chapter 395; or
175	entities that own, directly or indirectly, entities licensed or
176	registered by the state and providing only health care services
177	within the scope of services authorized pursuant to their
178	respective licenses granted under ss. 383.30-383.335, chapter
179	390, chapter 394, chapter 397, this chapter except part X,
180	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
181	part I of chapter 483, chapter 484, chapter 651; end-stage renal
182	disease providers authorized under 42 C.F.R. part 405, subpart
183	U; or providers certified under 42 C.F.R. part 485, subpart B or
184	subpart H; or any entity that provides neonatal or pediatric
185	hospital-based health care services by licensed practitioners
186	solely within a hospital licensed under chapter 395.
187	(c)  Entities that are owned, directly or indirectly, by an
188	entity licensed or registered by the state pursuant to chapter
189	395; or entities that are owned, directly or indirectly, by an
190	entity licensed or registered by the state and providing only
191	health care services within the scope of services authorized
192	pursuant to their respective licenses granted under ss. 383.30-
193	383.335, chapter 390, chapter 394, chapter 397, this chapter
194	except part X, chapter 429, chapter 463, chapter 465, chapter
195	466, chapter 478, part I of chapter 483, chapter 484, or chapter
196	651; end-stage renal disease providers authorized under 42
197	C.F.R. part 405, subpart U; or providers certified under 42
198	C.F.R. part 485, subpart B or subpart H; or any entity that
199	provides neonatal or pediatric hospital-based health care
200	services by licensed practitioners solely within a hospital
201	under chapter 395.
202	(d)  Entities that are under common ownership, directly or
203	indirectly, with an entity licensed or registered by the state
204	pursuant to chapter 395; or entities that are under common
205	ownership, directly or indirectly, with an entity licensed or
206	registered by the state and providing only health care services
207	within the scope of services authorized pursuant to their
208	respective licenses granted under ss. 383.30-383.335, chapter
209	390, chapter 394, chapter 397, this chapter except part X,
210	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
211	part I of chapter 483, chapter 484, or chapter 651; end-stage
212	renal disease providers authorized under 42 C.F.R. part 405,
213	subpart U; or providers certified under 42 C.F.R. part 485,
214	subpart B or subpart H; or any entity that provides neonatal or
215	pediatric hospital-based health care services by licensed
216	practitioners solely within a hospital licensed under chapter
217	395.
218	(e)  An entity that is exempt from federal taxation under
219	26 U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan
220	under 26 U.S.C. s. 409 that has a board of trustees not less
221	than two-thirds of which are Florida-licensed health care
222	practitioners and provides only physical therapy services under
223	physician orders, any community college or university clinic,
224	and any entity owned or operated by the federal or state
225	government, including agencies, subdivisions, or municipalities
226	thereof.
227	(f)  A sole proprietorship, group practice, partnership, or
228	corporation, or other legal entity that provides health care
229	services by physicians and physician assistants licensed under
230	chapter 458, chapter 459, chapter 460, chapter 461, or chapter
231	466 physicians covered by s. 627.419, that is directly
232	supervised by one or more of such physicians or physician
233	assistants, and that is wholly owned by one or more of those
234	physicians or physician assistants or by a physician or
235	physician assistant and the spouse, parent, child, or sibling of
236	that that physician or physician assistant.
237	(g)  A sole proprietorship, group practice, partnership, or
238	corporation, or other legal entity that provides health care
239	services by licensed health care practitioners under chapter
240	457, chapter 458, chapter 459, chapter 460, chapter 461, chapter
241	462, chapter 463, chapter 466, chapter 467, chapter 480, chapter
242	484, chapter 486, chapter 490, chapter 491, or part I, part III,
243	part X, part XIII, or part XIV of chapter 468, or s. 464.012,
244	which entities are wholly owned by one or more licensed health
245	care practitioners, or the licensed health care practitioners
246	set forth in this paragraph and the spouse, parent, child, or
247	sibling of a licensed health care practitioner, so long as one
248	of the owners who is a licensed health care practitioner is
249	supervising the health care services business activities and is
250	legally responsible for the entity's compliance with all federal
251	and state laws. However, a health care services provided may not
252	exceed the scope of the licensed owner's health care
253	practitioner may not supervise services beyond the scope of the
254	practitioner's license, except that, for the purposes of this
255	part, a clinic owned by a licensee in s. 456.053(3)(b) that
256	provides only services authorized pursuant to s. 456.053(3)(b)
257	may be supervised by a licensee specified in s. 456.053(3)(b).
258	(h)  Clinical facilities affiliated with an accredited
259	medical school at which training is provided for medical
260	students, residents, or fellows.
261	(i)  Entities that provide only oncology or radiation
262	therapy services by physicians licensed under chapter 458 or
263	chapter 459 or entities that provide oncology or radiation
264	therapy services by physicians licensed under chapter 458 or
265	chapter 459 which are owned by a corporation whose shares are
266	publicly traded on a recognized stock exchange.
267	(j)  Clinical facilities affiliated with a college of
268	chiropractic accredited by the Council on Chiropractic Education
269	at which training is provided for chiropractic students.
270	(k)  Entities that provide licensed practitioners to staff
271	emergency departments or to deliver anesthesia services in
272	facilities licensed under chapter 395 and that derive at least
273	90 percent of their gross annual revenues from the provision of
274	such services. Entities claiming an exemption from licensure
275	under this paragraph must provide documentation demonstrating
276	compliance.
277	(l)  Orthotic or prosthetic Clinical facilities that are a
278	publicly traded corporation or that are wholly owned, directly
279	or indirectly, by a publicly traded corporation. As used in this
280	paragraph, a publicly traded corporation is a corporation that
281	issues securities traded on an exchange registered with the
282	United States Securities and Exchange Commission as a national
283	securities exchange.
284	(8)  "Specialty clinic" means a clinic, as defined in
285	subsection (4), and includes those entities exempt under that
286	subsection that are not licensed as home health agencies that
287	provide infusion therapy services to treat conditions caused by
288	or related to HIV or AIDS to outpatients who remain less than 24
289	hours at the facility or to patients who receive such services
290	where they reside. The term does not include:
291	(a)  Entities licensed under part II or part III;
292	(b)  Entities licensed under part IV that provide infusion
293	therapy to patients only in the home or residence of the
294	patient; or
295	(c)  Entities licensed under chapter 395.
296	(9)  "Infusion therapy" includes, but is not limited to,
297	the therapeutic infusion of substances into, or the injection of
298	substances through, the venous peripheral system, consisting of
299	activity that includes: observing, initiating, monitoring,
300	discontinuing, maintaining, regulating, adjusting, documenting,
301	planning, intervening, and evaluating. This definition embraces
302	the administration of nutrition, antibiotic therapy, and fluid
303	and electrolyte repletion.
304	(10)  "Fraud" means deception or misrepresentation made by
305	a person or business entity with the intent that the deception
306	will likely result in an unauthorized benefit to himself or
307	herself or another person. The term includes any act that
308	constitutes fraud under applicable federal or state law.
309	Section 4.  Section 400.991, Florida Statutes, is amended
310	to read:
311	400.991  License requirements; background screenings;
312	prohibitions.--
313	(1)(a)  The requirements of part II of chapter 408 apply to
314	the provision of services that require licensure pursuant to
315	this part and part II of chapter 408 and to entities licensed by
316	or applying for such licensure from the agency pursuant to this
317	part. A license issued by the agency is required in order to
318	operate a clinic or specialty clinic in this state. Each clinic
319	or specialty clinic location shall be licensed separately
320	regardless of whether the clinic or specialty clinic is operated
321	under the same business name or management as another clinic.
322	(b)  Each mobile clinic or specialty clinic must obtain a
323	separate health care clinic license and must provide to the
324	agency, at least quarterly, its projected street location to
325	enable the agency to locate and inspect such clinic or specialty
326	clinic. A portable equipment provider must obtain a health care
327	clinic license for a single administrative office and is not
328	required to submit quarterly projected street locations.
329	(2)  The initial clinic license application shall be filed
330	with the agency by all clinics, as defined in s. 400.9905, on or
331	before July 1, 2004.
332	(2)(a)(3)  The license application shall contain
333	information that includes, but need not be limited to,
334	information pertaining to the name, residence and business
335	address, phone number, social security number, and license
336	number of the medical or clinic director and of the licensed
337	medical providers employed or under contract with the clinic.
338	(b)  Any person or entity that has a pecuniary interest in
339	the clinic or specialty clinic who may or may not own stock or
340	an equivalent interest in the clinic or specialty clinic, but
341	nonetheless has control over or the authority to approve,
342	directly or indirectly, clinic billing, policy, business
343	activities, or personnel decisions, including, but not limited
344	to, contracted or employed third-party billing persons or
345	entities, managers, and management companies, and persons and
346	entities, directly or indirectly, that lend or give money of any
347	denomination or any thing of value exceeding an aggregate of
348	$5,000, for clinic use, with or without an expectation of a
349	return of the money or thing of value, and regardless of profit
350	motive, are subject to background screening requirements under
351	this part.
352	(c)  The agency may adopt rules pursuant to ss. 120.536(1)
353	and 120.54 to administer this subsection.
354	(3)  An application for a specialty clinic shall contain,
355	in addition to the information required in subsection (4):
356	(a)  The correct business name of each business entity and
357	the full name of each individual holding any ownership interest
358	of 5 percent or more, or any pecuniary interest of $5,000 or
359	more, in any legal entity that owns or operates any specialty
360	clinic seeking licensure, whether such ownership or pecuniary
361	interest arose out of a contract, loan, gift, investment,
362	inheritance, or any other source. Individual possession of an
363	ownership or pecuniary interest in any subject specialty clinic
364	includes, but is not limited to, a direct or indirect interest
365	in:
366	1.  The business operation, equipment, or legend
367	pharmaceuticals used in the clinic;
368	2.  The premises in which the clinic provides its services;
369	or
370	3.  Any legal entity that owns any such interest, directly
371	or indirectly, in the business operation of the clinic; the
372	equipment used in providing infusion therapy services at the
373	clinic; the legend pharmaceuticals used at the clinic; or the
374	premises in which the clinic provides its services.
375	(b)  In the case of an incorporated business entity that
376	holds any ownership interest of 5 percent or more, or any
377	pecuniary interest of $5,000 or more, in the specialty clinic,
378	copies of the articles of incorporation and bylaws, and the
379	names and addresses of all officers and directors of the
380	corporation.
381	(c)  On a form furnished by the agency, a sworn notarized
382	statement by each business entity and individual that holds any
383	ownership interest of 5 percent or more, or any pecuniary
384	interest of $5,000 or more, in the subject specialty clinic that
385	discloses the nature and degree of each such ownership or
386	pecuniary interest and that discloses the source of funds that
387	gave rise to each such ownership or pecuniary interest.
388	(d)  On a form furnished by the agency, a sworn notarized
389	statement by each individual and business entity that holds any
390	ownership interest of 5 percent or more, or any pecuniary
391	interest of $5,000 or more, in the subject specialty clinic that
392	discloses whether he or she has been an owner or part owner,
393	individually or through any business entity, of any business
394	entity whose health care license has been revoked or suspended
395	in any jurisdiction.
396	(e)  On a form furnished by the agency, an estimate of the
397	costs for establishing the specialty clinic and the source of
398	funds for payment of those costs and for sustaining the
399	operation of the clinic until its operation produces a positive
400	cash flow.
401
402	For purposes of this subsection, the term "ownership or
403	pecuniary interest" does not include any individual whose
404	interest in a specialty clinic arises only out of his or her
405	interest in a lending company, insurance company, or banking
406	institution licensed by this state or any other state of the
407	United States; a company regularly trading on a national stock
408	exchange of the United States; or a governmental entity in the
409	United States.
410	(4)  In addition to the requirements of part II of chapter
411	408, the applicant must file with the application satisfactory
412	proof that the clinic or specialty clinic is in compliance with
413	this part and applicable rules, including:
414	(a)  A listing of services to be provided either directly
415	by the applicant or through contractual arrangements with
416	existing providers;
417	(b)  The number and discipline of each professional staff
418	member to be employed; and
419	(c)  Proof of financial ability to operate as required
420	under s. 408.810(8). As an alternative to submitting proof of
421	financial ability to operate as required under s. 408.810(8),
422	the applicant may file a surety bond of at least $500,000 which
423	guarantees that the clinic or specialty clinic will act in full
424	conformity with all legal requirements for operating a clinic or
425	specialty clinic, payable to the agency. The agency may adopt
426	rules to specify related requirements for such surety bond.
427	(5)  Each applicant for licensure shall comply with the
428	following requirements:
429	(a)  As used in this subsection, the term "applicant" means
430	an individual individuals owning or controlling, directly or
431	indirectly, 5 percent or more of an interest in a clinic or an
432	individual owning or controlling, directly or indirectly, any
433	interest in a specialty clinic; the medical or clinic director,
434	or a similarly titled person who is responsible for the day-to-
435	day operation of the licensed clinic; the financial officer or
436	similarly titled individual who is responsible for the financial
437	operation of the clinic; and licensed health care practitioners
438	at the clinic.
439	(b)  Upon receipt of a completed, signed, and dated
440	application, the agency shall require background screening of
441	the applicant, in accordance with the level 2 standards for
442	screening set forth in paragraph (d) chapter 435. Proof of
443	compliance with the level 2 background screening requirements of
444	paragraph (d) chapter 435 which has been submitted within the
445	previous 5 years in compliance with the any other health care
446	licensure requirements of this part state is acceptable in
447	fulfillment of this paragraph. Applicants who own less than 10
448	percent of a health care clinic are not required to submit
449	fingerprints under this section.
450	(c)  Each applicant must submit to the agency, with the
451	application, a description and explanation of any exclusions,
452	permanent suspensions, or terminations of an applicant from the
453	Medicare or Medicaid programs. Proof of compliance with the
454	requirements for disclosure of ownership and control interest
455	under the Medicaid or Medicare programs may be accepted in lieu
456	of this submission. The description and explanation may indicate
457	whether such exclusions, suspensions, or terminations were
458	voluntary or not voluntary on the part of the applicant. The
459	agency may deny or revoke licensure based on information
460	received under this paragraph.
461	(d)  A license may not be granted to a clinic or specialty
462	clinic if the applicant, or a person or entity identified in
463	paragraph (3)(b), has been found guilty of, regardless of
464	adjudication, or has entered a plea of nolo contendere or guilty
465	to, any offense prohibited under the level 2 standards for
466	screening set forth in chapter 435; any felony under chapter
467	400, chapter 408, chapter 409, chapter 440, chapter 624, chapter
468	626, chapter 627, chapter 812, chapter 817, chapter 831, chapter
469	837, chapter 838, chapter 895, or chapter 896; or any
470	substantially comparable offense or crime of another state or of
471	the United States, if a felony in that jurisdiction, within the
472	past 10 years. Each person required to provide background
473	screening shall disclose to the agency any arrest for any crime
474	for which any court disposition other than dismissal has been
475	made within the past 10 years. Failure to provide such
476	information shall be considered a material omission in the
477	application process, or a violation of insurance fraud under s.
478	817.234, within the past 5 years. If the applicant has been
479	convicted of an offense prohibited under the level 2 standards
480	or insurance fraud in any jurisdiction, the applicant must show
481	that his or her civil rights have been restored prior to
482	submitting an application.
483	(e)  Each applicant that performs the technical component
484	of magnetic resonance imaging, static radiographs, computed
485	tomography, or positron emission tomography, and also provides
486	the professional components of such services through an employee
487	or independent contractor, must provide to the agency, on a form
488	provided by the agency, the name and address of the clinic, the
489	serial or operating number of each magnetic resonance imaging,
490	static radiograph, computed tomography, and positron emission
491	tomography machine, the name of the manufacturer of the machine,
492	and such other information as required by the agency to identify
493	the machine. The information must be provided to the agency upon
494	renewal of the clinic's licensure and within 30 days after a
495	clinic begins using a machine for which it has not provided the
496	information to the agency.
497	(f)  The agency shall deny or revoke a specialty clinic
498	license if an applicant has been found guilty of, regardless of
499	adjudication, or entered a plea of nolo contendere or guilty to,
500	any felony involving dishonesty or making a false statement in
501	any jurisdiction within the preceding 10 years.
502	(g)  The agency shall deny a specialty clinic license
503	application when any business entity or individual possessing an
504	ownership or pecuniary interest in the specialty clinic also
505	possessed an ownership or pecuniary interest, individually or
506	through any business entity, in any health care facility whose
507	license was revoked in any jurisdiction during the pendency of
508	that interest.
509	(h)  The agency may not issue a specialty clinic license to
510	any applicant to whom the agency has sent notice that there is a
511	pending question as to whether one or more of the individuals
512	with an ownership of 5 percent or more or with a pecuniary
513	interest of $5,000 or more in the clinic has a disqualifying
514	criminal record. The agency notice shall request the applicant
515	to submit any additional information necessary to resolve the
516	pending criminal background question within 21 days after
517	receipt of the notice. The agency shall deny a specialty clinic
518	license application when the applicant has failed to resolve a
519	criminal background screening issue pertaining to an individual
520	who is required to meet criminal background screening
521	requirements of this part, and the agency raised such background
522	screening issue by notice as set forth in this part.
523	Section 5.  Subsections (1) and (2) of section 400.9925,
524	Florida Statutes, are amended to read:
525	400.9925  Rulemaking authority; license fees.--
526	(1)  The agency shall adopt rules necessary to administer
527	the clinic and specialty clinic administration, regulation, and
528	licensure program, including rules pursuant to this part and
529	part II of chapter 408, establishing the specific licensure
530	requirements, procedures, forms, and fees. It shall adopt rules
531	establishing a procedure for the biennial renewal of licenses.
532	The agency may issue initial licenses for less than the full 2-
533	year period by charging a prorated licensure fee and specifying
534	a different renewal date than would otherwise be required for
535	biennial licensure. The rules shall specify the expiration dates
536	of licenses, the process of tracking compliance with financial
537	responsibility requirements, and any other conditions of renewal
538	required by law or rule.
539	(2)  The agency shall adopt rules specifying limitations on
540	the number of licensed clinics and specialty clinics and
541	licensees for which a medical director or a clinic director may
542	assume responsibility for purposes of this part. In determining
543	the quality of supervision a medical director or a clinic or
544	specialty clinic director can provide, the agency shall consider
545	the number of clinic or specialty clinic employees, the clinic
546	or specialty clinic location, and the health care services
547	provided by the clinic or specialty clinic.
548	Section 6.  Subsection (3) of section 400.993, Florida
549	Statutes, is amended to read:
550	400.993  Unlicensed clinics; reporting.--
551	(3)  In addition to the requirements of part II of chapter
552	408, any health care provider who is aware of the operation of
553	an unlicensed clinic or specialty clinic shall report that
554	facility to the agency. Failure to report a clinic or specialty
555	clinic that the provider knows or has reasonable cause to
556	suspect is unlicensed shall be reported to the provider's
557	licensing board.
558	Section 7.  Section 400.9935, Florida Statutes, is amended
559	to read:
560	400.9935  Clinic responsibilities.--
561	(1)  Each clinic and specialty clinic shall appoint a
562	medical director or clinic director who shall agree in writing
563	to accept legal responsibility for the following activities on
564	behalf of the clinic. The medical director or the clinic
565	director shall:
566	(a)  Have signs identifying the medical director or clinic
567	director posted in a conspicuous location within the clinic
568	readily visible to all patients.
569	(b)  Ensure that all practitioners providing health care
570	services or supplies to patients maintain a current active and
571	unencumbered Florida license.
572	(c)  Review any patient referral contracts or agreements
573	executed by the clinic.
574	(d)  Ensure that all health care practitioners at the
575	clinic have active appropriate certification or licensure for
576	the level of care being provided.
577	(e)  Ensure that all health care practitioners at the
578	clinic provide health care services in accordance with the
579	requirements of subsection (5).
580	(f)(e)  Serve as the clinic records owner as defined in s.
581	456.057.
582	(g)(f)  Ensure compliance with the recordkeeping, office
583	surgery, and adverse incident reporting requirements of chapter
584	456, the respective practice acts, and rules adopted under this
585	part and part II of chapter 408.
586	(h)(g)  Conduct systematic reviews of clinic billings to
587	ensure that the billings are not fraudulent or unlawful. Upon
588	discovery of an unlawful charge, the medical director or clinic
589	director shall take immediate corrective action. If the clinic
590	performs only the technical component of magnetic resonance
591	imaging, static radiographs, computed tomography, or positron
592	emission tomography, and provides the professional
593	interpretation of such services, in a fixed facility that is
594	accredited by the Joint Commission on Accreditation of
595	Healthcare Organizations or the Accreditation Association for
596	Ambulatory Health Care, and the American College of Radiology;
597	and if, in the preceding quarter, the percentage of scans
598	performed by that clinic which was billed to all personal injury
599	protection insurance carriers was less than 15 percent, the
600	chief financial officer of the clinic may, in a written
601	acknowledgment provided to the agency, assume the responsibility
602	for the conduct of the systematic reviews of clinic billings to
603	ensure that the billings are not fraudulent or unlawful.
604	(i)(h)  Not refer a patient to the clinic if the clinic
605	performs magnetic resonance imaging, static radiographs,
606	computed tomography, or positron emission tomography. The term
607	"refer a patient" means the referral of one or more patients of
608	the medical or clinical director or a member of the medical or
609	clinical director's group practice to the clinic for magnetic
610	resonance imaging, static radiographs, computed tomography, or
611	positron emission tomography. A medical director who is found to
612	violate this paragraph commits a felony of the third degree,
613	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
614	(j)  Serve in that capacity for no more than five health
615	care clinics that have a cumulative total of no more than 200
616	employees and persons under contract with the health care clinic
617	at a given time. A medical or clinic director may not supervise
618	a health care clinic more than 200 miles away from any other
619	health care clinic supervised by the same medical or clinic
620	director. The agency may waive the limitations of this paragraph
621	upon a showing of good cause and a determination by the agency
622	that the medical director will be able to adequately perform the
623	requirements of this subsection.
624	(2)  Any contract to serve as a medical director or a
625	clinic director entered into or renewed by a physician or a
626	licensed health care practitioner in violation of this part is
627	void as contrary to public policy. This subsection shall apply
628	to contracts entered into or renewed on or after March 1, 2004.
629	(3)  All charges or reimbursement claims made by or on
630	behalf of a clinic or specialty clinic that is required to be
631	licensed under this part, but that is not so licensed, or that
632	is otherwise operating in violation of this part, are unlawful
633	charges, and therefore are noncompensable and unenforceable.
634	(4)  In addition to the requirements of s. 408.812, any
635	person establishing, operating, or managing an unlicensed clinic
636	or specialty clinic otherwise required to be licensed under this
637	part or part II of chapter 408, or any person who knowingly
638	files a false or misleading license application or license
639	renewal application, or false or misleading information related
640	to such application or department rule, commits a felony of the
641	third degree, punishable as provided in s. 775.082, s. 775.083,
642	or s. 775.084.
643	(5)  Each licensed person providing health care services to
644	an individual must comply with the licensure laws and rules
645	under which he or she is licensed to provide the services or as
646	otherwise provided by law.
647	(6)(5)  Any licensed health care provider who violates this
648	part is subject to discipline in accordance with this chapter
649	and his or her respective practice act.
650	(7)(6)  Any person or entity providing health care services
651	which is not a clinic  or specialty clinic, as defined under s.
652	400.9905, may voluntarily apply for a certificate of exemption
653	from licensure under its exempt status. Other than certificates
654	of exemption granted pursuant to an exemption under s.
655	400.9905(4)(f), certificates of exemption shall expire in 2
656	years and may be renewed with the agency on a form that sets
657	forth its name or names and addresses, a statement of the
658	reasons why it cannot be defined as a clinic, and other
659	information deemed necessary by the agency. An exemption is not
660	transferable. The agency may charge an applicant for a
661	certificate of exemption in an amount equal to $100 or the
662	actual cost of processing the certificate, whichever is less.
663	(a)  The agency shall provide a form that requires the
664	name, address, a statement of the reasons why the applicant is
665	exempt from licensure as a health care clinic or specialty
666	clinic, and any other information deemed necessary by the
667	agency. The signature on an application for a certificate of
668	exemption must be notarized and signed by persons having
669	knowledge of the truth of its contents. An exemption is not
670	transferable and is valid only for the reasons, location,
671	persons, and entity set forth on the application form. A person
672	or entity claiming an exemption under this part or issued a
673	current certificate of exemption must be exempt from the
674	licensing provisions of this part at all times, or such claim or
675	certificate shall be invalid from the date that such person or
676	entity is not exempt.
677	(b)  The agency shall charge an applicant a fee of $100 for
678	a certificate of exemption to cover the cost of processing the
679	certificate or the actual cost of processing the certificate,
680	whichever is less.
681	(c)  An application for the renewal of a certificate of
682	exemption must be submitted to the agency prior to the
683	expiration of the certificate of exemption. The agency may
684	investigate any applicant, person, or entity claiming an
685	exemption for purposes of determining compliance when a
686	certificate of exemption is sought. Authorized personnel of the
687	agency shall have access to the premises of any
688	certificateholder, applicant, or specialty clinic, other than a
689	person or entity who is exempt pursuant to s. 400.9905(4)(f),
690	for the sole purpose of determining compliance with an exemption
691	under this part. The agency shall have access to all billings
692	and records indicated in s. 400.9915(2) or in agency rules. The
693	agency may deny or withdraw a certificate of exemption when a
694	person or entity does not qualify under this part.
695	(d)  A certificate of exemption is considered withdrawn
696	when the agency determines that an exempt status cannot be
697	confirmed. The provisions applicable to the unlicensed operation
698	of a health care clinic or specialty clinic apply to any health
699	care provider that self-determines or claims an exemption or
700	that is issued a certificate of exemption if, in fact, such
701	clinic does not meet the exemption claimed.
702	(e)  Any person or entity that submits an application for a
703	certificate of exemption that contains fraudulent or material
704	and misleading information commits a felony of the third degree,
705	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
706	(f)  A response to a request in writing for additional
707	information or clarification must be filed with the agency no
708	later than 21 days after receipt of the request or the
709	application shall be denied.
710	(g)  The agency shall grant or deny an application for a
711	certificate of exemption in accordance with s. 120.60(1).
712	(h)  A person or entity that qualifies as a health care
713	clinic or specialty clinic and has been denied a certificate of
714	exemption must file an initial application and pay the fee. A
715	certificate of exemption is valid only when issued and current.
716	(i)  The agency shall issue an emergency order of
717	suspension of a certificate of exemption when the agency finds
718	that the applicant has provided false or misleading material
719	information or omitted any material fact from the application
720	for a certificate of exemption which is permitted or required by
721	this part or has submitted false or misleading information to
722	the agency when self-determining an exempt status and materially
723	misleading the agency as to such status.
724	(8)(7)(a)  Each clinic engaged in magnetic resonance
725	imaging services must be accredited by the Joint Commission on
726	Accreditation of Healthcare Organizations, the American College
727	of Radiology, or the Accreditation Association for Ambulatory
728	Health Care, within 1 year after licensure. However, a clinic
729	may request a single, 6-month extension if it provides evidence
730	to the agency establishing that, for good cause shown, such
731	clinic can not be accredited within 1 year after licensure, and
732	that such accreditation will be completed within the 6-month
733	extension. After obtaining accreditation as required by this
734	subsection, each such clinic must maintain accreditation as a
735	condition of renewal of its license.
736	(b)  The agency may deny the application or revoke the
737	license of any entity formed for the purpose of avoiding
738	compliance with the accreditation provisions of this subsection
739	and whose principals were previously principals of an entity
740	that was unable to meet the accreditation requirements within
741	the specified timeframes. The agency may adopt rules as to the
742	accreditation of magnetic resonance imaging clinics.
743	(9)(8)  The agency shall give full faith and credit
744	pertaining to any past variance and waiver granted to a magnetic
745	resonance imaging clinic from rule 64-2002, Florida
746	Administrative Code, by the Department of Health, until
747	September 2004. After that date, such clinic must request a
748	variance and waiver from the agency under s. 120.542.
749	(10)(9)  In addition to the requirements of part II of
750	chapter 408, the clinic shall display a sign in a conspicuous
751	location within the clinic readily visible to all patients
752	indicating that, pursuant to s. 626.9892, the Department of
753	Financial Services may pay rewards of up to $25,000 to persons
754	providing information leading to the arrest and conviction of
755	persons committing crimes investigated by the Division of
756	Insurance Fraud arising from violations of s. 440.105, s.
757	624.15, s. 626.9541, s. 626.989, or s. 817.234. An authorized
758	employee of the Division of Insurance Fraud may make unannounced
759	inspections of a clinic licensed under this part as necessary to
760	determine whether the clinic is in compliance with this
761	subsection. A licensed clinic shall allow full and complete
762	access to the premises to such authorized employee of the
763	division who makes an inspection to determine compliance with
764	this subsection.
765	(11)  Every licensed specialty clinic shall file with the
766	agency, upon forms to be furnished by the agency, no less
767	frequently than annually, including concurrently with the filing
768	of any change of ownership application, an audited report
769	showing the following information:
770	(a)  The number of patients served by the specialty clinic
771	during the previous 12-month period, which report may exclude
772	any partial month for the month when the report was prepared.
773	(b)  Total specialty clinic operating expenses.
774	(c)  Gross patient charges by payor category, including
775	Medicare, Medicaid, county indigent programs, any other
776	governmental programs, private insurance, self-paying patients,
777	nonpaying patients, and other payees.
778	(d)  The cost of operation of the specialty clinic during
779	the previous 12-month period, excluding any partial month during
780	which time the report was prepared.
781	(e)  Unless the specialty clinic can demonstrate that the
782	clinic already has furnished the required information regarding
783	a particular subject individual, the full name of any individual
784	who became an owner or became possessed of any pecuniary
785	interest in the subject clinic since the last report to the
786	agency, along with the disclosure of the information required by
787	s. 400.991(5) as to such individual.
788	(f)  A current statement of the source of funds for payment
789	of the costs of establishing the specialty clinic and for
790	sustaining the operation of the specialty clinic until its
791	operation produces a positive cash flow.
792	(12)  Every licensee of a specialty clinic has a continuing
793	obligation to comply with this part and to report to the agency
794	a change of circumstance related to the clinic's continuing
795	compliance with this part. Such a change of circumstance
796	includes, but is not limited to, any change in the ownership of
797	the specialty clinic, the addition of any individual or business
798	entity possessing a pecuniary interest in the specialty clinic,
799	the employment of any individual as a member of the specialty
800	clinic's staff who would be required to undergo a criminal
801	background screening if such individual had been an employee at
802	the time of the initial licensure, and any change in the medical
803	or clinic director. The specialty clinic shall furnish the
804	information required about such an individual under this
805	subsection and s. 400.991 within 30 days of the occurrence of
806	the change of circumstance.
807	(13)(a)  The clinic or specialty clinic shall display a
808	sign in a conspicuous location within the clinic readily visible
809	to all patients indicating that, pursuant to s. 626.9892, the
810	Department of Financial Services may pay rewards of up to
811	$25,000 to persons providing information leading to the arrest
812	and conviction of persons committing crimes investigated by the
813	Division of Insurance Fraud arising from violations of s.
814	440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234.
815	(b)  An authorized employee of the Division of Insurance
816	Fraud may make an unannounced inspection of a clinic or
817	specialty clinic licensed under this part when necessary to
818	determine whether the clinic is in compliance with this
819	subsection, and the clinic shall allow the division's authorized
820	employee full and complete access to the clinic's premises for
821	that purpose.
822	Section 8.  Section 400.995, Florida Statutes, is amended
823	to read:
824	400.995  Agency administrative penalties.--
825	(1)  In addition to the requirements of part II of chapter
826	408, the agency may deny the application for a license renewal,
827	revoke and suspend the license, and impose administrative fines
828	of up to $5,000 per violation for violations of the requirements
829	of this part or rules of the agency. In determining if a penalty
830	is to be imposed and in fixing the amount of the fine, the
831	agency shall consider the following factors:
832	(a)  The gravity of the violation, including the
833	probability that death or serious physical or emotional harm to
834	a patient will result or has resulted, the severity of the
835	action or potential harm, and the extent to which the provisions
836	of the applicable laws or rules were violated.
837	(b)  Actions taken by the owner, medical director, or
838	clinic director to correct violations.
839	(c)  Any previous violations.
840	(d)  The financial benefit to the clinic or specialty
841	clinic of committing or continuing the violation.
842	(2)  Each day of continuing violation after the date fixed
843	for termination of the violation, as ordered by the agency,
844	constitutes an additional, separate, and distinct violation.
845	(3)  Any action taken to correct a violation shall be
846	documented in writing by the owner, medical director, or clinic
847	director of the clinic or specialty clinic and verified through
848	followup visits by agency personnel. The agency may impose a
849	fine and, in the case of an owner-operated clinic or specialty
850	clinic, revoke or deny a clinic's license when a clinic medical
851	director or clinic director knowingly misrepresents actions
852	taken to correct a violation.
853	(4)  Any licensed clinic or specialty clinic whose owner,
854	medical director, or clinic director concurrently operates an
855	unlicensed clinic shall be subject to an administrative fine of
856	$5,000 per day.
857	(5)  Any clinic or specialty clinic whose owner fails to
858	apply for a change-of-ownership license in accordance with part
859	II of chapter 408 s. 400.992 and operates the clinic or
860	specialty clinic under the new ownership is subject to a fine of
861	$5,000.
862	(6)  The agency, as an alternative to or in conjunction
863	with an administrative action against a clinic or specialty
864	clinic for violations of this part and adopted rules, shall make
865	a reasonable attempt to discuss each violation and recommended
866	corrective action with the owner, medical director, or clinic
867	director of the clinic or specialty clinic, prior to written
868	notification. The agency, instead of fixing a period within
869	which the clinic or specialty clinic shall enter into compliance
870	with standards, may request a plan of corrective action from the
871	clinic or specialty clinic which demonstrates a good faith
872	effort to remedy each violation by a specific date, subject to
873	the approval of the agency.
874	Section 9.  Section 400.996, Florida Statutes, is created
875	to read:
876	400.996  Specialty clinics; complaints; audits;
877	referrals.--
878	(1)  The agency shall receive, document, and process
879	complaints about specialty clinics. Upon receipt of any
880	complaint that asserts the existence of facts evidencing
881	possible billing fraud by a specialty clinic or by any employee
882	of a specialty clinic, the agency shall request the complainant
883	to make such assertions by sworn affidavit.
884	(2)  Upon receipt of any sworn affidavit that asserts the
885	existence of facts evidencing possible billing fraud by a
886	specialty clinic or any of its employees, the agency shall refer
887	the complaint to the Office of Fiscal Integrity within the
888	Department of Financial Services.
889	(3)  The Department of Financial Services shall report
890	findings to the agency for any appropriate licensure action.
891	Such report shall include a statement of facts as determined by
892	the Department of Financial Services to exist, specifically with
893	regard to the possible violations of licensure requirements. If,
894	during an investigation, the department has reason to believe
895	that any criminal law of this state has or may have been
896	violated, the department shall refer such investigation to
897	appropriate prosecutorial agencies and shall provide
898	investigative assistance to those agencies as required.
899	(4)  The investigating authority and the agency shall
900	cooperate with each other with respect to preparing a record and
901	sharing information from which the agency may determine if any
902	action for sanctions under this part by the agency is warranted.
903	(5)  Any person submitting a sworn complaint that initiates
904	a complaint investigation pursuant to this section, which sworn
905	complaint is determined to be totally without any factual basis
906	to support the assertions made in the complaint that facts
907	existed evidencing possible fraudulent practices by a specialty
908	clinic or any of its employees, commits a misdemeanor of the
909	first degree, punishable as provided in s. 775.082 or s.
910	775.083.
911	(6)  The Office of Fiscal Integrity within the Department
912	of Financial Services shall conduct unannounced reviews,
913	investigations, analyses, and audits to investigate complaints
914	and, as necessary, to determine whether specialty clinic
915	billings are fraudulent or unlawful. The Department of Financial
916	Services is expressly authorized to enter upon the premises of
917	the clinic during regular business hours and demand and
918	immediately secure copies of billing and other records of the
919	clinic that will enable the Department of Financial Services to
920	investigate complaints or determine whether specialty clinic
921	billings are fraudulent or unlawful.
922	(7)  A licensed specialty clinic shall allow full,
923	complete, and immediate access to the premises and to billing
924	records or information to any such officer or employee who
925	conducts a review, investigation, analysis, or audit to
926	determine compliance with this part and with applicable rules.
927	Failure to allow full, complete, and immediate access to the
928	premises and to billing records or information to any
929	representative of the agency or Department of Financial Services
930	who attempts to conduct a review, investigation, analysis, or
931	audit to determine compliance with this part constitutes a
932	ground for emergency suspension of the license by the agency
933	pursuant to s. 120.60(6).
934	(8)  In addition to any administrative fines imposed, the
935	agency may assess a fee equal to the cost of conducting any
936	review, investigation, analysis, or audit performed by the
937	agency or the department.
938	(9)  All investigators designated by the Chief Financial
939	Officer to perform duties under this part and who are certified
940	under s. 943.1395 are law enforcement officers of the state.
941	Such investigators have the authority to conduct criminal
942	investigations, bear arms, make arrests, and apply for, serve,
943	and execute search warrants, arrest warrants, capias, and other
944	process throughout the state pertaining to fraud investigations
945	under this section.
946	Section 10.  Paragraph (ii) is added to subsection (1) of
947	section 456.072, Florida Statutes, to read:
948	456.072  Grounds for discipline; penalties; enforcement.--
949	(1)  The following acts shall constitute grounds for which
950	the disciplinary actions specified in subsection (2) may be
951	taken:
952	(ii)  Intentionally providing false information on an
953	application for a certificate of exemption from clinic licensure
954	under part X of chapter 400.
955	Section 11.  For the 2007-2008 fiscal year, the sums of
956	$510,276 in recurring funds and $111,455 in nonrecurring funds
957	are appropriated from the Insurance Regulatory Trust Fund of the
958	Department of Financial Services to the Division of Insurance
959	Fraud within the department for the purpose of providing a new
960	fraud unit within the division consisting of six sworn law
961	enforcement officers, one nonsworn investigator, one crime
962	analyst, and one clerical position. A total of nine full-time
963	equivalent positions and associated salary rate of 381,500 are
964	authorized. This appropriation is for the purposes provided in
965	s. 626.989, Florida Statutes.
966	Section 12.  Notwithstanding the repeal of the Florida
967	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
968	section 627.730, Florida Statutes, is revived and reenacted to
969	read:
970	627.730  Florida Motor Vehicle No-Fault Law.--Sections
971	627.730-627.7405 may be cited and known as the "Florida Motor
972	Vehicle No-Fault Law."
973	Section 13.  Notwithstanding the repeal of the Florida
974	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
975	section 627.731, Florida Statutes, is revived and reenacted to
976	read:
977	627.731  Purpose.--The purpose of ss. 627.730-627.7405 is
978	to provide for medical, surgical, funeral, and disability
979	insurance benefits without regard to fault, and to require motor
980	vehicle insurance securing such benefits, for motor vehicles
981	required to be registered in this state and, with respect to
982	motor vehicle accidents, a limitation on the right to claim
983	damages for pain, suffering, mental anguish, and inconvenience.
984	Section 14.  Notwithstanding the repeal of the Florida
985	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
986	section 627.732, Florida Statutes, is revived and reenacted to
987	read:
988	627.732  Definitions.--As used in ss. 627.730-627.7405, the
989	term:
990	(1)  "Broker" means any person not possessing a license
991	under chapter 395, chapter 400, chapter 429, chapter 458,
992	chapter 459, chapter 460, chapter 461, or chapter 641 who
993	charges or receives compensation for any use of medical
994	equipment and is not the 100-percent owner or the 100-percent
995	lessee of such equipment. For purposes of this section, such
996	owner or lessee may be an individual, a corporation, a
997	partnership, or any other entity and any of its 100-percent-
998	owned affiliates and subsidiaries. For purposes of this
999	subsection, the term "lessee" means a long-term lessee under a
1000	capital or operating lease, but does not include a part-time
1001	lessee. The term "broker" does not include a hospital or
1002	physician management company whose medical equipment is
1003	ancillary to the practices managed, a debt collection agency, or
1004	an entity that has contracted with the insurer to obtain a
1005	discounted rate for such services; nor does the term include a
1006	management company that has contracted to provide general
1007	management services for a licensed physician or health care
1008	facility and whose compensation is not materially affected by
1009	the usage or frequency of usage of medical equipment or an
1010	entity that is 100-percent owned by one or more hospitals or
1011	physicians. The term "broker" does not include a person or
1012	entity that certifies, upon request of an insurer, that:
1013	(a)  It is a clinic licensed under ss. 400.990-400.995;
1014	(b)  It is a 100-percent owner of medical equipment; and
1015	(c)  The owner's only part-time lease of medical equipment
1016	for personal injury protection patients is on a temporary basis
1017	not to exceed 30 days in a 12-month period, and such lease is
1018	solely for the purposes of necessary repair or maintenance of
1019	the 100-percent-owned medical equipment or pending the arrival
1020	and installation of the newly purchased or a replacement for the
1021	100-percent-owned medical equipment, or for patients for whom,
1022	because of physical size or claustrophobia, it is determined by
1023	the medical director or clinical director to be medically
1024	necessary that the test be performed in medical equipment that
1025	is open-style. The leased medical equipment cannot be used by
1026	patients who are not patients of the registered clinic for
1027	medical treatment of services. Any person or entity making a
1028	false certification under this subsection commits insurance
1029	fraud as defined in s. 817.234. However, the 30-day period
1030	provided in this paragraph may be extended for an additional 60
1031	days as applicable to magnetic resonance imaging equipment if
1032	the owner certifies that the extension otherwise complies with
1033	this paragraph.
1034	(2)  "Medically necessary" refers to a medical service or
1035	supply that a prudent physician would provide for the purpose of
1036	preventing, diagnosing, or treating an illness, injury, disease,
1037	or symptom in a manner that is:
1038	(a)  In accordance with generally accepted standards of
1039	medical practice;
1040	(b)  Clinically appropriate in terms of type, frequency,
1041	extent, site, and duration; and
1042	(c)  Not primarily for the convenience of the patient,
1043	physician, or other health care provider.
1044	(3)  "Motor vehicle" means any self-propelled vehicle with
1045	four or more wheels which is of a type both designed and
1046	required to be licensed for use on the highways of this state
1047	and any trailer or semitrailer designed for use with such
1048	vehicle and includes:
1049	(a)  A "private passenger motor vehicle," which is any
1050	motor vehicle which is a sedan, station wagon, or jeep-type
1051	vehicle and, if not used primarily for occupational,
1052	professional, or business purposes, a motor vehicle of the
1053	pickup, panel, van, camper, or motor home type.
1054	(b)  A "commercial motor vehicle," which is any motor
1055	vehicle which is not a private passenger motor vehicle.
1056
1057	The term "motor vehicle" does not include a mobile home or any
1058	motor vehicle which is used in mass transit, other than public
1059	school transportation, and designed to transport more than five
1060	passengers exclusive of the operator of the motor vehicle and
1061	which is owned by a municipality, a transit authority, or a
1062	political subdivision of the state.
1063	(4)  "Named insured" means a person, usually the owner of a
1064	vehicle, identified in a policy by name as the insured under the
1065	policy.
1066	(5)  "Owner" means a person who holds the legal title to a
1067	motor vehicle; or, in the event a motor vehicle is the subject
1068	of a security agreement or lease with an option to purchase with
1069	the debtor or lessee having the right to possession, then the
1070	debtor or lessee shall be deemed the owner for the purposes of
1071	ss. 627.730-627.7405.
1072	(6)  "Relative residing in the same household" means a
1073	relative of any degree by blood or by marriage who usually makes
1074	her or his home in the same family unit, whether or not
1075	temporarily living elsewhere.
1076	(7)  "Certify" means to swear or attest to being true or
1077	represented in writing.
1078	(8)  "Immediate personal supervision," as it relates to the
1079	performance of medical services by nonphysicians not in a
1080	hospital, means that an individual licensed to perform the
1081	medical service or provide the medical supplies must be present
1082	within the confines of the physical structure where the medical
1083	services are performed or where the medical supplies are
1084	provided such that the licensed individual can respond
1085	immediately to any emergencies if needed.
1086	(9)  "Incident," with respect to services considered as
1087	incident to a physician's professional service, for a physician
1088	licensed under chapter 458, chapter 459, chapter 460, or chapter
1089	461, if not furnished in a hospital, means such services must be
1090	an integral, even if incidental, part of a covered physician's
1091	service.
1092	(10)  "Knowingly" means that a person, with respect to
1093	information, has actual knowledge of the information; acts in
1094	deliberate ignorance of the truth or falsity of the information;
1095	or acts in reckless disregard of the information, and proof of
1096	specific intent to defraud is not required.
1097	(11)  "Lawful" or "lawfully" means in substantial
1098	compliance with all relevant applicable criminal, civil, and
1099	administrative requirements of state and federal law related to
1100	the provision of medical services or treatment.
1101	(12)  "Hospital" means a facility that, at the time
1102	services or treatment were rendered, was licensed under chapter
1103	395.
1104	(13)  "Properly completed" means providing truthful,
1105	substantially complete, and substantially accurate responses as
1106	to all material elements to each applicable request for
1107	information or statement by a means that may lawfully be
1108	provided and that complies with this section, or as agreed by
1109	the parties.
1110	(14)  "Upcoding" means an action that submits a billing
1111	code that would result in payment greater in amount than would
1112	be paid using a billing code that accurately describes the
1113	services performed. The term does not include an otherwise
1114	lawful bill by a magnetic resonance imaging facility, which
1115	globally combines both technical and professional components, if
1116	the amount of the global bill is not more than the components if
1117	billed separately; however, payment of such a bill constitutes
1118	payment in full for all components of such service.
1119	(15)  "Unbundling" means an action that submits a billing
1120	code that is properly billed under one billing code, but that
1121	has been separated into two or more billing codes, and would
1122	result in payment greater in amount than would be paid using one
1123	billing code.
1124	Section 15.  Notwithstanding the repeal of the Florida
1125	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
1126	section 627.733, Florida Statutes, is revived and reenacted to
1127	read:
1128	627.733  Required security.--
1129	(1)(a)  Every owner or registrant of a motor vehicle, other
1130	than a motor vehicle used as a school bus as defined in s.
1131	1006.25 or limousine, required to be registered and licensed in
1132	this state shall maintain security as required by subsection (3)
1133	in effect continuously throughout the registration or licensing
1134	period.
1135	(b)  Every owner or registrant of a motor vehicle used as a
1136	taxicab shall not be governed by paragraph (1)(a) but shall
1137	maintain security as required under s. 324.032(1), and s.
1138	627.737 shall not apply to any motor vehicle used as a taxicab.
1139	(2)  Every nonresident owner or registrant of a motor
1140	vehicle which, whether operated or not, has been physically
1141	present within this state for more than 90 days during the
1142	preceding 365 days shall thereafter maintain security as defined
1143	by subsection (3) in effect continuously throughout the period
1144	such motor vehicle remains within this state.
1145	(3)  Such security shall be provided:
1146	(a)  By an insurance policy delivered or issued for
1147	delivery in this state by an authorized or eligible motor
1148	vehicle liability insurer which provides the benefits and
1149	exemptions contained in ss. 627.730-627.7405. Any policy of
1150	insurance represented or sold as providing the security required
1151	hereunder shall be deemed to provide insurance for the payment
1152	of the required benefits; or
1153	(b)  By any other method authorized by s. 324.031(2), (3),
1154	or (4) and approved by the Department of Highway Safety and
1155	Motor Vehicles as affording security equivalent to that afforded
1156	by a policy of insurance or by self-insuring as authorized by s.
1157	768.28(16). The person filing such security shall have all of
1158	the obligations and rights of an insurer under ss. 627.730-
1159	627.7405.
1160	(4)  An owner of a motor vehicle with respect to which
1161	security is required by this section who fails to have such
1162	security in effect at the time of an accident shall have no
1163	immunity from tort liability, but shall be personally liable for
1164	the payment of benefits under s. 627.736. With respect to such
1165	benefits, such an owner shall have all of the rights and
1166	obligations of an insurer under ss. 627.730-627.7405.
1167	(5)  In addition to other persons who are not required to
1168	provide required security as required under this section and s.
1169	324.022, the owner or registrant of a motor vehicle is exempt
1170	from such requirements if she or he is a member of the United
1171	States Armed Forces and is called to or on active duty outside
1172	the United States in an emergency situation. The exemption
1173	provided by this subsection applies only as long as the member
1174	of the armed forces is on such active duty outside the United
1175	States and applies only while the vehicle covered by the
1176	security required by this section and s. 324.022 is not operated
1177	by any person. Upon receipt of a written request by the insured
1178	to whom the exemption provided in this subsection applies, the
1179	insurer shall cancel the coverages and return any unearned
1180	premium or suspend the security required by this section and s.
1181	324.022. Notwithstanding subsection (6), the Department of
1182	Highway Safety and Motor Vehicles may not suspend the
1183	registration or operator's license of any owner or registrant of
1184	a motor vehicle during the time she or he qualifies for an
1185	exemption under this subsection. Any owner or registrant of a
1186	motor vehicle who qualifies for an exemption under this
1187	subsection shall immediately notify the department prior to and
1188	at the end of the expiration of the exemption.
1189	(6)  The Department of Highway Safety and Motor Vehicles
1190	shall suspend, after due notice and an opportunity to be heard,
1191	the registration and driver's license of any owner or registrant
1192	of a motor vehicle with respect to which security is required
1193	under this section and s. 324.022:
1194	(a)  Upon its records showing that the owner or registrant
1195	of such motor vehicle did not have in full force and effect when
1196	required security complying with the terms of this section; or
1197	(b)  Upon notification by the insurer to the Department of
1198	Highway Safety and Motor Vehicles, in a form approved by the
1199	department, of cancellation or termination of the required
1200	security.
1201	(7)  Any operator or owner whose driver's license or
1202	registration has been suspended pursuant to this section or s.
1203	316.646 may effect its reinstatement upon compliance with the
1204	requirements of this section and upon payment to the Department
1205	of Highway Safety and Motor Vehicles of a nonrefundable
1206	reinstatement fee of $150 for the first reinstatement. Such
1207	reinstatement fee shall be $250 for the second reinstatement and
1208	$500 for each subsequent reinstatement during the 3 years
1209	following the first reinstatement. Any person reinstating her or
1210	his insurance under this subsection must also secure
1211	noncancelable coverage as described in ss. 324.021(8), 324.023,
1212	and 627.7275(2) and present to the appropriate person proof that
1213	the coverage is in force on a form promulgated by the Department
1214	of Highway Safety and Motor Vehicles, such proof to be
1215	maintained for 2 years. If the person does not have a second
1216	reinstatement within 3 years after her or his initial
1217	reinstatement, the reinstatement fee shall be $150 for the first
1218	reinstatement after that 3-year period. In the event that a
1219	person's license and registration are suspended pursuant to this
1220	section or s. 316.646, only one reinstatement fee shall be paid
1221	to reinstate the license and the registration. All fees shall be
1222	collected by the Department of Highway Safety and Motor Vehicles
1223	at the time of reinstatement. The Department of Highway Safety
1224	and Motor Vehicles shall issue proper receipts for such fees and
1225	shall promptly deposit those fees in the Highway Safety
1226	Operating Trust Fund. One-third of the fee collected under this
1227	subsection shall be distributed from the Highway Safety
1228	Operating Trust Fund to the local government entity or state
1229	agency which employed the law enforcement officer who seizes a
1230	license plate pursuant to s. 324.201. Such funds may be used by
1231	the local government entity or state agency for any authorized
1232	purpose.
1233	Section 16.  Notwithstanding the repeal of the Florida
1234	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
1235	section 627.734, Florida Statutes, is revived and reenacted to
1236	read:
1237	627.734  Proof of security; security requirements;
1238	penalties.--
1239	(1)  The provisions of chapter 324 which pertain to the
1240	method of giving and maintaining proof of financial
1241	responsibility and which govern and define a motor vehicle
1242	liability policy shall apply to filing and maintaining proof of
1243	security required by ss. 627.730-627.7405.
1244	(2)  Any person who:
1245	(a)  Gives information required in a report or otherwise as
1246	provided for in ss. 627.730-627.7405, knowing or having reason
1247	to believe that such information is false;
1248	(b)  Forges or, without authority, signs any evidence of
1249	proof of security; or
1250	(c)  Files, or offers for filing, any such evidence of
1251	proof, knowing or having reason to believe that it is forged or
1252	signed without authority,
1253
1254	is guilty of a misdemeanor of the first degree, punishable as
1255	provided in s. 775.082 or s. 775.083.
1256	Section 17.  Notwithstanding the repeal of the Florida
1257	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
1258	section 627.736, Florida Statutes, is revived and reenacted to
1259	read:
1260	627.736  Required personal injury protection benefits;
1261	exclusions; priority; claims.--
1262	(1)  REQUIRED BENEFITS.--Every insurance policy complying
1263	with the security requirements of s. 627.733 shall provide
1264	personal injury protection to the named insured, relatives
1265	residing in the same household, persons operating the insured
1266	motor vehicle, passengers in such motor vehicle, and other
1267	persons struck by such motor vehicle and suffering bodily injury
1268	while not an occupant of a self-propelled vehicle, subject to
1269	the provisions of subsection (2) and paragraph (4)(d), to a
1270	limit of $10,000 for loss sustained by any such person as a
1271	result of bodily injury, sickness, disease, or death arising out
1272	of the ownership, maintenance, or use of a motor vehicle as
1273	follows:
1274	(a)  Medical benefits.--Eighty percent of all reasonable
1275	expenses for medically necessary medical, surgical, X-ray,
1276	dental, and rehabilitative services, including prosthetic
1277	devices, and medically necessary ambulance, hospital, and
1278	nursing services. Such benefits shall also include necessary
1279	remedial treatment and services recognized and permitted under
1280	the laws of the state for an injured person who relies upon
1281	spiritual means through prayer alone for healing, in accordance
1282	with his or her religious beliefs; however, this sentence does
1283	not affect the determination of what other services or
1284	procedures are medically necessary.
1285	(b)  Disability benefits.--Sixty percent of any loss of
1286	gross income and loss of earning capacity per individual from
1287	inability to work proximately caused by the injury sustained by
1288	the injured person, plus all expenses reasonably incurred in
1289	obtaining from others ordinary and necessary services in lieu of
1290	those that, but for the injury, the injured person would have
1291	performed without income for the benefit of his or her
1292	household. All disability benefits payable under this provision
1293	shall be paid not less than every 2 weeks.
1294	(c)  Death benefits.--Death benefits of $5,000 per
1295	individual. The insurer may pay such benefits to the executor or
1296	administrator of the deceased, to any of the deceased's
1297	relatives by blood or legal adoption or connection by marriage,
1298	or to any person appearing to the insurer to be equitably
1299	entitled thereto.
1300
1301	Only insurers writing motor vehicle liability insurance in this
1302	state may provide the required benefits of this section, and no
1303	such insurer shall require the purchase of any other motor
1304	vehicle coverage other than the purchase of property damage
1305	liability coverage as required by s. 627.7275 as a condition for
1306	providing such required benefits. Insurers may not require that
1307	property damage liability insurance in an amount greater than
1308	$10,000 be purchased in conjunction with personal injury
1309	protection. Such insurers shall make benefits and required
1310	property damage liability insurance coverage available through
1311	normal marketing channels. Any insurer writing motor vehicle
1312	liability insurance in this state who fails to comply with such
1313	availability requirement as a general business practice shall be
1314	deemed to have violated part IX of chapter 626, and such
1315	violation shall constitute an unfair method of competition or an
1316	unfair or deceptive act or practice involving the business of
1317	insurance; and any such insurer committing such violation shall
1318	be subject to the penalties afforded in such part, as well as
1319	those which may be afforded elsewhere in the insurance code.
1320	(2)  AUTHORIZED EXCLUSIONS.--Any insurer may exclude
1321	benefits:
1322	(a)  For injury sustained by the named insured and
1323	relatives residing in the same household while occupying another
1324	motor vehicle owned by the named insured and not insured under
1325	the policy or for injury sustained by any person operating the
1326	insured motor vehicle without the express or implied consent of
1327	the insured.
1328	(b)  To any injured person, if such person's conduct
1329	contributed to his or her injury under any of the following
1330	circumstances:
1331	1.  Causing injury to himself or herself intentionally; or
1332	2.  Being injured while committing a felony.
1333
1334	Whenever an insured is charged with conduct as set forth in
1335	subparagraph 2., the 30-day payment provision of paragraph
1336	(4)(b) shall be held in abeyance, and the insurer shall withhold
1337	payment of any personal injury protection benefits pending the
1338	outcome of the case at the trial level. If the charge is nolle
1339	prossed or dismissed or the insured is acquitted, the 30-day
1340	payment provision shall run from the date the insurer is
1341	notified of such action.
1342	(3)  INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN
1343	TORT CLAIMS.--No insurer shall have a lien on any recovery in
1344	tort by judgment, settlement, or otherwise for personal injury
1345	protection benefits, whether suit has been filed or settlement
1346	has been reached without suit. An injured party who is entitled
1347	to bring suit under the provisions of ss. 627.730-627.7405, or
1348	his or her legal representative, shall have no right to recover
1349	any damages for which personal injury protection benefits are
1350	paid or payable. The plaintiff may prove all of his or her
1351	special damages notwithstanding this limitation, but if special
1352	damages are introduced in evidence, the trier of facts, whether
1353	judge or jury, shall not award damages for personal injury
1354	protection benefits paid or payable. In all cases in which a
1355	jury is required to fix damages, the court shall instruct the
1356	jury that the plaintiff shall not recover such special damages
1357	for personal injury protection benefits paid or payable.
1358	(4)  BENEFITS; WHEN DUE.--Benefits due from an insurer
1359	under ss. 627.730-627.7405 shall be primary, except that
1360	benefits received under any workers' compensation law shall be
1361	credited against the benefits provided by subsection (1) and
1362	shall be due and payable as loss accrues, upon receipt of
1363	reasonable proof of such loss and the amount of expenses and
1364	loss incurred which are covered by the policy issued under ss.
1365	627.730-627.7405. When the Agency for Health Care Administration
1366	provides, pays, or becomes liable for medical assistance under
1367	the Medicaid program related to injury, sickness, disease, or
1368	death arising out of the ownership, maintenance, or use of a
1369	motor vehicle, benefits under ss. 627.730-627.7405 shall be
1370	subject to the provisions of the Medicaid program.
1371	(a)  An insurer may require written notice to be given as
1372	soon as practicable after an accident involving a motor vehicle
1373	with respect to which the policy affords the security required
1374	by ss. 627.730-627.7405.
1375	(b)  Personal injury protection insurance benefits paid
1376	pursuant to this section shall be overdue if not paid within 30
1377	days after the insurer is furnished written notice of the fact
1378	of a covered loss and of the amount of same. If such written
1379	notice is not furnished to the insurer as to the entire claim,
1380	any partial amount supported by written notice is overdue if not
1381	paid within 30 days after such written notice is furnished to
1382	the insurer. Any part or all of the remainder of the claim that
1383	is subsequently supported by written notice is overdue if not
1384	paid within 30 days after such written notice is furnished to
1385	the insurer. When an insurer pays only a portion of a claim or
1386	rejects a claim, the insurer shall provide at the time of the
1387	partial payment or rejection an itemized specification of each
1388	item that the insurer had reduced, omitted, or declined to pay
1389	and any information that the insurer desires the claimant to
1390	consider related to the medical necessity of the denied
1391	treatment or to explain the reasonableness of the reduced
1392	charge, provided that this shall not limit the introduction of
1393	evidence at trial; and the insurer shall include the name and
1394	address of the person to whom the claimant should respond and a
1395	claim number to be referenced in future correspondence. However,
1396	notwithstanding the fact that written notice has been furnished
1397	to the insurer, any payment shall not be deemed overdue when the
1398	insurer has reasonable proof to establish that the insurer is
1399	not responsible for the payment. For the purpose of calculating
1400	the extent to which any benefits are overdue, payment shall be
1401	treated as being made on the date a draft or other valid
1402	instrument which is equivalent to payment was placed in the
1403	United States mail in a properly addressed, postpaid envelope
1404	or, if not so posted, on the date of delivery. This paragraph
1405	does not preclude or limit the ability of the insurer to assert
1406	that the claim was unrelated, was not medically necessary, or
1407	was unreasonable or that the amount of the charge was in excess
1408	of that permitted under, or in violation of, subsection (5).
1409	Such assertion by the insurer may be made at any time, including
1410	after payment of the claim or after the 30-day time period for
1411	payment set forth in this paragraph.
1412	(c)  All overdue payments shall bear simple interest at the
1413	rate established under s. 55.03 or the rate established in the
1414	insurance contract, whichever is greater, for the year in which
1415	the payment became overdue, calculated from the date the insurer
1416	was furnished with written notice of the amount of covered loss.
1417	Interest shall be due at the time payment of the overdue claim
1418	is made.
1419	(d)  The insurer of the owner of a motor vehicle shall pay
1420	personal injury protection benefits for:
1421	1.  Accidental bodily injury sustained in this state by the
1422	owner while occupying a motor vehicle, or while not an occupant
1423	of a self-propelled vehicle if the injury is caused by physical
1424	contact with a motor vehicle.
1425	2.  Accidental bodily injury sustained outside this state,
1426	but within the United States of America or its territories or
1427	possessions or Canada, by the owner while occupying the owner's
1428	motor vehicle.
1429	3.  Accidental bodily injury sustained by a relative of the
1430	owner residing in the same household, under the circumstances
1431	described in subparagraph 1. or subparagraph 2., provided the
1432	relative at the time of the accident is domiciled in the owner's
1433	household and is not himself or herself the owner of a motor
1434	vehicle with respect to which security is required under ss.
1435	627.730-627.7405.
1436	4.  Accidental bodily injury sustained in this state by any
1437	other person while occupying the owner's motor vehicle or, if a
1438	resident of this state, while not an occupant of a self-
1439	propelled vehicle, if the injury is caused by physical contact
1440	with such motor vehicle, provided the injured person is not
1441	himself or herself:
1442	a.  The owner of a motor vehicle with respect to which
1443	security is required under ss. 627.730-627.7405; or
1444	b.  Entitled to personal injury benefits from the insurer
1445	of the owner or owners of such a motor vehicle.
1446	(e)  If two or more insurers are liable to pay personal
1447	injury protection benefits for the same injury to any one
1448	person, the maximum payable shall be as specified in subsection
1449	(1), and any insurer paying the benefits shall be entitled to
1450	recover from each of the other insurers an equitable pro rata
1451	share of the benefits paid and expenses incurred in processing
1452	the claim.
1453	(f)  It is a violation of the insurance code for an insurer
1454	to fail to timely provide benefits as required by this section
1455	with such frequency as to constitute a general business
1456	practice.
1457	(g)  Benefits shall not be due or payable to or on the
1458	behalf of an insured person if that person has committed, by a
1459	material act or omission, any insurance fraud relating to
1460	personal injury protection coverage under his or her policy, if
1461	the fraud is admitted to in a sworn statement by the insured or
1462	if it is established in a court of competent jurisdiction. Any
1463	insurance fraud shall void all coverage arising from the claim
1464	related to such fraud under the personal injury protection
1465	coverage of the insured person who committed the fraud,
1466	irrespective of whether a portion of the insured person's claim
1467	may be legitimate, and any benefits paid prior to the discovery
1468	of the insured person's insurance fraud shall be recoverable by
1469	the insurer from the person who committed insurance fraud in
1470	their entirety. The prevailing party is entitled to its costs
1471	and attorney's fees in any action in which it prevails in an
1472	insurer's action to enforce its right of recovery under this
1473	paragraph.
1474	(5)  CHARGES FOR TREATMENT OF INJURED PERSONS.--
1475	(a)  Any physician, hospital, clinic, or other person or
1476	institution lawfully rendering treatment to an injured person
1477	for a bodily injury covered by personal injury protection
1478	insurance may charge the insurer and injured party only a
1479	reasonable amount pursuant to this section for the services and
1480	supplies rendered, and the insurer providing such coverage may
1481	pay for such charges directly to such person or institution
1482	lawfully rendering such treatment, if the insured receiving such
1483	treatment or his or her guardian has countersigned the properly
1484	completed invoice, bill, or claim form approved by the office
1485	upon which such charges are to be paid for as having actually
1486	been rendered, to the best knowledge of the insured or his or
1487	her guardian. In no event, however, may such a charge be in
1488	excess of the amount the person or institution customarily
1489	charges for like services or supplies. With respect to a
1490	determination of whether a charge for a particular service,
1491	treatment, or otherwise is reasonable, consideration may be
1492	given to evidence of usual and customary charges and payments
1493	accepted by the provider involved in the dispute, and
1494	reimbursement levels in the community and various federal and
1495	state medical fee schedules applicable to automobile and other
1496	insurance coverages, and other information relevant to the
1497	reasonableness of the reimbursement for the service, treatment,
1498	or supply.
1499	(b)1.  An insurer or insured is not required to pay a claim
1500	or charges:
1501	a.  Made by a broker or by a person making a claim on
1502	behalf of a broker;
1503	b.  For any service or treatment that was not lawful at the
1504	time rendered;
1505	c.  To any person who knowingly submits a false or
1506	misleading statement relating to the claim or charges;
1507	d.  With respect to a bill or statement that does not
1508	substantially meet the applicable requirements of paragraph (d);
1509	e.  For any treatment or service that is upcoded, or that
1510	is unbundled when such treatment or services should be bundled,
1511	in accordance with paragraph (d). To facilitate prompt payment
1512	of lawful services, an insurer may change codes that it
1513	determines to have been improperly or incorrectly upcoded or
1514	unbundled, and may make payment based on the changed codes,
1515	without affecting the right of the provider to dispute the
1516	change by the insurer, provided that before doing so, the
1517	insurer must contact the health care provider and discuss the
1518	reasons for the insurer's change and the health care provider's
1519	reason for the coding, or make a reasonable good faith effort to
1520	do so, as documented in the insurer's file; and
1521	f.  For medical services or treatment billed by a physician
1522	and not provided in a hospital unless such services are rendered
1523	by the physician or are incident to his or her professional
1524	services and are included on the physician's bill, including
1525	documentation verifying that the physician is responsible for
1526	the medical services that were rendered and billed.
1527	2.  Charges for medically necessary cephalic thermograms,
1528	peripheral thermograms, spinal ultrasounds, extremity
1529	ultrasounds, video fluoroscopy, and surface electromyography
1530	shall not exceed the maximum reimbursement allowance for such
1531	procedures as set forth in the applicable fee schedule or other
1532	payment methodology established pursuant to s. 440.13.
1533	3.  Allowable amounts that may be charged to a personal
1534	injury protection insurance insurer and insured for medically
1535	necessary nerve conduction testing when done in conjunction with
1536	a needle electromyography procedure and both are performed and
1537	billed solely by a physician licensed under chapter 458, chapter
1538	459, chapter 460, or chapter 461 who is also certified by the
1539	American Board of Electrodiagnostic Medicine or by a board
1540	recognized by the American Board of Medical Specialties or the
1541	American Osteopathic Association or who holds diplomate status
1542	with the American Chiropractic Neurology Board or its
1543	predecessors shall not exceed 200 percent of the allowable
1544	amount under the participating physician fee schedule of
1545	Medicare Part B for year 2001, for the area in which the
1546	treatment was rendered, adjusted annually on August 1 to reflect
1547	the prior calendar year's changes in the annual Medical Care
1548	Item of the Consumer Price Index for All Urban Consumers in the
1549	South Region as determined by the Bureau of Labor Statistics of
1550	the United States Department of Labor.
1551	4.  Allowable amounts that may be charged to a personal
1552	injury protection insurance insurer and insured for medically
1553	necessary nerve conduction testing that does not meet the
1554	requirements of subparagraph 3. shall not exceed the applicable
1555	fee schedule or other payment methodology established pursuant
1556	to s. 440.13.
1557	5.  Allowable amounts that may be charged to a personal
1558	injury protection insurance insurer and insured for magnetic
1559	resonance imaging services shall not exceed 175 percent of the
1560	allowable amount under the participating physician fee schedule
1561	of Medicare Part B for year 2001, for the area in which the
1562	treatment was rendered, adjusted annually on August 1 to reflect
1563	the prior calendar year's changes in the annual Medical Care
1564	Item of the Consumer Price Index for All Urban Consumers in the
1565	South Region as determined by the Bureau of Labor Statistics of
1566	the United States Department of Labor for the 12-month period
1567	ending June 30 of that year, except that allowable amounts that
1568	may be charged to a personal injury protection insurance insurer
1569	and insured for magnetic resonance imaging services provided in
1570	facilities accredited by the Accreditation Association for
1571	Ambulatory Health Care, the American College of Radiology, or
1572	the Joint Commission on Accreditation of Healthcare
1573	Organizations shall not exceed 200 percent of the allowable
1574	amount under the participating physician fee schedule of
1575	Medicare Part B for year 2001, for the area in which the
1576	treatment was rendered, adjusted annually on August 1 to reflect
1577	the prior calendar year's changes in the annual Medical Care
1578	Item of the Consumer Price Index for All Urban Consumers in the
1579	South Region as determined by the Bureau of Labor Statistics of
1580	the United States Department of Labor for the 12-month period
1581	ending June 30 of that year. This paragraph does not apply to
1582	charges for magnetic resonance imaging services and nerve
1583	conduction testing for inpatients and emergency services and
1584	care as defined in chapter 395 rendered by facilities licensed
1585	under chapter 395.
1586	6.  The Department of Health, in consultation with the
1587	appropriate professional licensing boards, shall adopt, by rule,
1588	a list of diagnostic tests deemed not to be medically necessary
1589	for use in the treatment of persons sustaining bodily injury
1590	covered by personal injury protection benefits under this
1591	section. The initial list shall be adopted by January 1, 2004,
1592	and shall be revised from time to time as determined by the
1593	Department of Health, in consultation with the respective
1594	professional licensing boards. Inclusion of a test on the list
1595	of invalid diagnostic tests shall be based on lack of
1596	demonstrated medical value and a level of general acceptance by
1597	the relevant provider community and shall not be dependent for
1598	results entirely upon subjective patient response.
1599	Notwithstanding its inclusion on a fee schedule in this
1600	subsection, an insurer or insured is not required to pay any
1601	charges or reimburse claims for any invalid diagnostic test as
1602	determined by the Department of Health.
1603	(c)1.  With respect to any treatment or service, other than
1604	medical services billed by a hospital or other provider for
1605	emergency services as defined in s. 395.002 or inpatient
1606	services rendered at a hospital-owned facility, the statement of
1607	charges must be furnished to the insurer by the provider and may
1608	not include, and the insurer is not required to pay, charges for
1609	treatment or services rendered more than 35 days before the
1610	postmark date of the statement, except for past due amounts
1611	previously billed on a timely basis under this paragraph, and
1612	except that, if the provider submits to the insurer a notice of
1613	initiation of treatment within 21 days after its first
1614	examination or treatment of the claimant, the statement may
1615	include charges for treatment or services rendered up to, but
1616	not more than, 75 days before the postmark date of the
1617	statement. The injured party is not liable for, and the provider
1618	shall not bill the injured party for, charges that are unpaid
1619	because of the provider's failure to comply with this paragraph.
1620	Any agreement requiring the injured person or insured to pay for
1621	such charges is unenforceable.
1622	2.  If, however, the insured fails to furnish the provider
1623	with the correct name and address of the insured's personal
1624	injury protection insurer, the provider has 35 days from the
1625	date the provider obtains the correct information to furnish the
1626	insurer with a statement of the charges. The insurer is not
1627	required to pay for such charges unless the provider includes
1628	with the statement documentary evidence that was provided by the
1629	insured during the 35-day period demonstrating that the provider
1630	reasonably relied on erroneous information from the insured and
1631	either:
1632	a.  A denial letter from the incorrect insurer; or
1633	b.  Proof of mailing, which may include an affidavit under
1634	penalty of perjury, reflecting timely mailing to the incorrect
1635	address or insurer.
1636	3.  For emergency services and care as defined in s.
1637	395.002 rendered in a hospital emergency department or for
1638	transport and treatment rendered by an ambulance provider
1639	licensed pursuant to part III of chapter 401, the provider is
1640	not required to furnish the statement of charges within the time
1641	periods established by this paragraph; and the insurer shall not
1642	be considered to have been furnished with notice of the amount
1643	of covered loss for purposes of paragraph (4)(b) until it
1644	receives a statement complying with paragraph (d), or copy
1645	thereof, which specifically identifies the place of service to
1646	be a hospital emergency department or an ambulance in accordance
1647	with billing standards recognized by the Health Care Finance
1648	Administration.
1649	4.  Each notice of insured's rights under s. 627.7401 must
1650	include the following statement in type no smaller than 12
1651	points:
1652
1653	BILLING REQUIREMENTS.--Florida Statutes provide that with
1654	respect to any treatment or services, other than certain
1655	hospital and emergency services, the statement of charges
1656	furnished to the insurer by the provider may not include, and
1657	the insurer and the injured party are not required to pay,
1658	charges for treatment or services rendered more than 35 days
1659	before the postmark date of the statement, except for past due
1660	amounts previously billed on a timely basis, and except that, if
1661	the provider submits to the insurer a notice of initiation of
1662	treatment within 21 days after its first examination or
1663	treatment of the claimant, the statement may include charges for
1664	treatment or services rendered up to, but not more than, 75 days
1665	before the postmark date of the statement.
1666	(d)  All statements and bills for medical services rendered
1667	by any physician, hospital, clinic, or other person or
1668	institution shall be submitted to the insurer on a properly
1669	completed Centers for Medicare and Medicaid Services (CMS) 1500
1670	form, UB 92 forms, or any other standard form approved by the
1671	office or adopted by the commission for purposes of this
1672	paragraph. All billings for such services rendered by providers
1673	shall, to the extent applicable, follow the Physicians' Current
1674	Procedural Terminology (CPT) or Healthcare Correct Procedural
1675	Coding System (HCPCS), or ICD-9 in effect for the year in which
1676	services are rendered and comply with the Centers for Medicare
1677	and Medicaid Services (CMS) 1500 form instructions and the
1678	American Medical Association Current Procedural Terminology
1679	(CPT) Editorial Panel and Healthcare Correct Procedural Coding
1680	System (HCPCS). All providers other than hospitals shall include
1681	on the applicable claim form the professional license number of
1682	the provider in the line or space provided for "Signature of
1683	Physician or Supplier, Including Degrees or Credentials." In
1684	determining compliance with applicable CPT and HCPCS coding,
1685	guidance shall be provided by the Physicians' Current Procedural
1686	Terminology (CPT) or the Healthcare Correct Procedural Coding
1687	System (HCPCS) in effect for the year in which services were
1688	rendered, the Office of the Inspector General (OIG), Physicians
1689	Compliance Guidelines, and other authoritative treatises
1690	designated by rule by the Agency for Health Care Administration.
1691	No statement of medical services may include charges for medical
1692	services of a person or entity that performed such services
1693	without possessing the valid licenses required to perform such
1694	services. For purposes of paragraph (4)(b), an insurer shall not
1695	be considered to have been furnished with notice of the amount
1696	of covered loss or medical bills due unless the statements or
1697	bills comply with this paragraph, and unless the statements or
1698	bills are properly completed in their entirety as to all
1699	material provisions, with all relevant information being
1700	provided therein.
1701	(e)1.  At the initial treatment or service provided, each
1702	physician, other licensed professional, clinic, or other medical
1703	institution providing medical services upon which a claim for
1704	personal injury protection benefits is based shall require an
1705	insured person, or his or her guardian, to execute a disclosure
1706	and acknowledgment form, which reflects at a minimum that:
1707	a.  The insured, or his or her guardian, must countersign
1708	the form attesting to the fact that the services set forth
1709	therein were actually rendered;
1710	b.  The insured, or his or her guardian, has both the right
1711	and affirmative duty to confirm that the services were actually
1712	rendered;
1713	c.  The insured, or his or her guardian, was not solicited
1714	by any person to seek any services from the medical provider;
1715	d.  That the physician, other licensed professional,
1716	clinic, or other medical institution rendering services for
1717	which payment is being claimed explained the services to the
1718	insured or his or her guardian; and
1719	e.  If the insured notifies the insurer in writing of a
1720	billing error, the insured may be entitled to a certain
1721	percentage of a reduction in the amounts paid by the insured's
1722	motor vehicle insurer.
1723	2.  The physician, other licensed professional, clinic, or
1724	other medical institution rendering services for which payment
1725	is being claimed has the affirmative duty to explain the
1726	services rendered to the insured, or his or her guardian, so
1727	that the insured, or his or her guardian, countersigns the form
1728	with informed consent.
1729	3.  Countersignature by the insured, or his or her
1730	guardian, is not required for the reading of diagnostic tests or
1731	other services that are of such a nature that they are not
1732	required to be performed in the presence of the insured.
1733	4.  The licensed medical professional rendering treatment
1734	for which payment is being claimed must sign, by his or her own
1735	hand, the form complying with this paragraph.
1736	5.  The original completed disclosure and acknowledgment
1737	form shall be furnished to the insurer pursuant to paragraph
1738	(4)(b) and may not be electronically furnished.
1739	6.  This disclosure and acknowledgment form is not required
1740	for services billed by a provider for emergency services as
1741	defined in s. 395.002, for emergency services and care as
1742	defined in s. 395.002 rendered in a hospital emergency
1743	department, or for transport and treatment rendered by an
1744	ambulance provider licensed pursuant to part III of chapter 401.
1745	7.  The Financial Services Commission shall adopt, by rule,
1746	a standard disclosure and acknowledgment form that shall be used
1747	to fulfill the requirements of this paragraph, effective 90 days
1748	after such form is adopted and becomes final. The commission
1749	shall adopt a proposed rule by October 1, 2003. Until the rule
1750	is final, the provider may use a form of its own which otherwise
1751	complies with the requirements of this paragraph.
1752	8.  As used in this paragraph, "countersigned" means a
1753	second or verifying signature, as on a previously signed
1754	document, and is not satisfied by the statement "signature on
1755	file" or any similar statement.
1756	9.  The requirements of this paragraph apply only with
1757	respect to the initial treatment or service of the insured by a
1758	provider. For subsequent treatments or service, the provider
1759	must maintain a patient log signed by the patient, in
1760	chronological order by date of service, that is consistent with
1761	the services being rendered to the patient as claimed. The
1762	requirements of this subparagraph for maintaining a patient log
1763	signed by the patient may be met by a hospital that maintains
1764	medical records as required by s. 395.3025 and applicable rules
1765	and makes such records available to the insurer upon request.
1766	(f)  Upon written notification by any person, an insurer
1767	shall investigate any claim of improper billing by a physician
1768	or other medical provider. The insurer shall determine if the
1769	insured was properly billed for only those services and
1770	treatments that the insured actually received. If the insurer
1771	determines that the insured has been improperly billed, the
1772	insurer shall notify the insured, the person making the written
1773	notification and the provider of its findings and shall reduce
1774	the amount of payment to the provider by the amount determined
1775	to be improperly billed. If a reduction is made due to such
1776	written notification by any person, the insurer shall pay to the
1777	person 20 percent of the amount of the reduction, up to $500. If
1778	the provider is arrested due to the improper billing, then the
1779	insurer shall pay to the person 40 percent of the amount of the
1780	reduction, up to $500.
1781	(g)  An insurer may not systematically downcode with the
1782	intent to deny reimbursement otherwise due. Such action
1783	constitutes a material misrepresentation under s.
1784	626.9541(1)(i)2.
1785	(6)  DISCOVERY OF FACTS ABOUT AN INJURED PERSON;
1786	DISPUTES.--
1787	(a)  Every employer shall, if a request is made by an
1788	insurer providing personal injury protection benefits under ss.
1789	627.730-627.7405 against whom a claim has been made, furnish
1790	forthwith, in a form approved by the office, a sworn statement
1791	of the earnings, since the time of the bodily injury and for a
1792	reasonable period before the injury, of the person upon whose
1793	injury the claim is based.
1794	(b)  Every physician, hospital, clinic, or other medical
1795	institution providing, before or after bodily injury upon which
1796	a claim for personal injury protection insurance benefits is
1797	based, any products, services, or accommodations in relation to
1798	that or any other injury, or in relation to a condition claimed
1799	to be connected with that or any other injury, shall, if
1800	requested to do so by the insurer against whom the claim has
1801	been made, furnish forthwith a written report of the history,
1802	condition, treatment, dates, and costs of such treatment of the
1803	injured person and why the items identified by the insurer were
1804	reasonable in amount and medically necessary, together with a
1805	sworn statement that the treatment or services rendered were
1806	reasonable and necessary with respect to the bodily injury
1807	sustained and identifying which portion of the expenses for such
1808	treatment or services was incurred as a result of such bodily
1809	injury, and produce forthwith, and permit the inspection and
1810	copying of, his or her or its records regarding such history,
1811	condition, treatment, dates, and costs of treatment; provided
1812	that this shall not limit the introduction of evidence at trial.
1813	Such sworn statement shall read as follows: "Under penalty of
1814	perjury, I declare that I have read the foregoing, and the facts
1815	alleged are true, to the best of my knowledge and belief." No
1816	cause of action for violation of the physician-patient privilege
1817	or invasion of the right of privacy shall be permitted against
1818	any physician, hospital, clinic, or other medical institution
1819	complying with the provisions of this section. The person
1820	requesting such records and such sworn statement shall pay all
1821	reasonable costs connected therewith. If an insurer makes a
1822	written request for documentation or information under this
1823	paragraph within 30 days after having received notice of the
1824	amount of a covered loss under paragraph (4)(a), the amount or
1825	the partial amount which is the subject of the insurer's inquiry
1826	shall become overdue if the insurer does not pay in accordance
1827	with paragraph (4)(b) or within 10 days after the insurer's
1828	receipt of the requested documentation or information, whichever
1829	occurs later. For purposes of this paragraph, the term "receipt"
1830	includes, but is not limited to, inspection and copying pursuant
1831	to this paragraph. Any insurer that requests documentation or
1832	information pertaining to reasonableness of charges or medical
1833	necessity under this paragraph without a reasonable basis for
1834	such requests as a general business practice is engaging in an
1835	unfair trade practice under the insurance code.
1836	(c)  In the event of any dispute regarding an insurer's
1837	right to discovery of facts under this section, the insurer may
1838	petition a court of competent jurisdiction to enter an order
1839	permitting such discovery. The order may be made only on motion
1840	for good cause shown and upon notice to all persons having an
1841	interest, and it shall specify the time, place, manner,
1842	conditions, and scope of the discovery. Such court may, in order
1843	to protect against annoyance, embarrassment, or oppression, as
1844	justice requires, enter an order refusing discovery or
1845	specifying conditions of discovery and may order payments of
1846	costs and expenses of the proceeding, including reasonable fees
1847	for the appearance of attorneys at the proceedings, as justice
1848	requires.
1849	(d)  The injured person shall be furnished, upon request, a
1850	copy of all information obtained by the insurer under the
1851	provisions of this section, and shall pay a reasonable charge,
1852	if required by the insurer.
1853	(e)  Notice to an insurer of the existence of a claim shall
1854	not be unreasonably withheld by an insured.
1855	(7)  MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON;
1856	REPORTS.--
1857	(a)  Whenever the mental or physical condition of an
1858	injured person covered by personal injury protection is material
1859	to any claim that has been or may be made for past or future
1860	personal injury protection insurance benefits, such person
1861	shall, upon the request of an insurer, submit to mental or
1862	physical examination by a physician or physicians. The costs of
1863	any examinations requested by an insurer shall be borne entirely
1864	by the insurer. Such examination shall be conducted within the
1865	municipality where the insured is receiving treatment, or in a
1866	location reasonably accessible to the insured, which, for
1867	purposes of this paragraph, means any location within the
1868	municipality in which the insured resides, or any location
1869	within 10 miles by road of the insured's residence, provided
1870	such location is within the county in which the insured resides.
1871	If the examination is to be conducted in a location reasonably
1872	accessible to the insured, and if there is no qualified
1873	physician to conduct the examination in a location reasonably
1874	accessible to the insured, then such examination shall be
1875	conducted in an area of the closest proximity to the insured's
1876	residence. Personal protection insurers are authorized to
1877	include reasonable provisions in personal injury protection
1878	insurance policies for mental and physical examination of those
1879	claiming personal injury protection insurance benefits. An
1880	insurer may not withdraw payment of a treating physician without
1881	the consent of the injured person covered by the personal injury
1882	protection, unless the insurer first obtains a valid report by a
1883	Florida physician licensed under the same chapter as the
1884	treating physician whose treatment authorization is sought to be
1885	withdrawn, stating that treatment was not reasonable, related,
1886	or necessary. A valid report is one that is prepared and signed
1887	by the physician examining the injured person or reviewing the
1888	treatment records of the injured person and is factually
1889	supported by the examination and treatment records if reviewed
1890	and that has not been modified by anyone other than the
1891	physician. The physician preparing the report must be in active
1892	practice, unless the physician is physically disabled. Active
1893	practice means that during the 3 years immediately preceding the
1894	date of the physical examination or review of the treatment
1895	records the physician must have devoted professional time to the
1896	active clinical practice of evaluation, diagnosis, or treatment
1897	of medical conditions or to the instruction of students in an
1898	accredited health professional school or accredited residency
1899	program or a clinical research program that is affiliated with
1900	an accredited health professional school or teaching hospital or
1901	accredited residency program. The physician preparing a report
1902	at the request of an insurer and physicians rendering expert
1903	opinions on behalf of persons claiming medical benefits for
1904	personal injury protection, or on behalf of an insured through
1905	an attorney or another entity, shall maintain, for at least 3
1906	years, copies of all examination reports as medical records and
1907	shall maintain, for at least 3 years, records of all payments
1908	for the examinations and reports. Neither an insurer nor any
1909	person acting at the direction of or on behalf of an insurer may
1910	materially change an opinion in a report prepared under this
1911	paragraph or direct the physician preparing the report to change
1912	such opinion. The denial of a payment as the result of such a
1913	changed opinion constitutes a material misrepresentation under
1914	s. 626.9541(1)(i)2.; however, this provision does not preclude
1915	the insurer from calling to the attention of the physician
1916	errors of fact in the report based upon information in the claim
1917	file.
1918	(b)  If requested by the person examined, a party causing
1919	an examination to be made shall deliver to him or her a copy of
1920	every written report concerning the examination rendered by an
1921	examining physician, at least one of which reports must set out
1922	the examining physician's findings and conclusions in detail.
1923	After such request and delivery, the party causing the
1924	examination to be made is entitled, upon request, to receive
1925	from the person examined every written report available to him
1926	or her or his or her representative concerning any examination,
1927	previously or thereafter made, of the same mental or physical
1928	condition. By requesting and obtaining a report of the
1929	examination so ordered, or by taking the deposition of the
1930	examiner, the person examined waives any privilege he or she may
1931	have, in relation to the claim for benefits, regarding the
1932	testimony of every other person who has examined, or may
1933	thereafter examine, him or her in respect to the same mental or
1934	physical condition. If a person unreasonably refuses to submit
1935	to an examination, the personal injury protection carrier is no
1936	longer liable for subsequent personal injury protection
1937	benefits.
1938	(8)  APPLICABILITY OF PROVISION REGULATING ATTORNEY'S
1939	FEES.--With respect to any dispute under the provisions of ss.
1940	627.730-627.7405 between the insured and the insurer, or between
1941	an assignee of an insured's rights and the insurer, the
1942	provisions of s. 627.428 shall apply, except as provided in
1943	subsection (11).
1944	(9)(a)  Each insurer which has issued a policy providing
1945	personal injury protection benefits shall report the renewal,
1946	cancellation, or nonrenewal thereof to the Department of Highway
1947	Safety and Motor Vehicles within 45 days from the effective date
1948	of the renewal, cancellation, or nonrenewal. Upon the issuance
1949	of a policy providing personal injury protection benefits to a
1950	named insured not previously insured by the insurer thereof
1951	during that calendar year, the insurer shall report the issuance
1952	of the new policy to the Department of Highway Safety and Motor
1953	Vehicles within 30 days. The report shall be in such form and
1954	format and contain such information as may be required by the
1955	Department of Highway Safety and Motor Vehicles which shall
1956	include a format compatible with the data processing
1957	capabilities of said department, and the Department of Highway
1958	Safety and Motor Vehicles is authorized to adopt rules necessary
1959	with respect thereto. Failure by an insurer to file proper
1960	reports with the Department of Highway Safety and Motor Vehicles
1961	as required by this subsection or rules adopted with respect to
1962	the requirements of this subsection constitutes a violation of
1963	the Florida Insurance Code. Reports of cancellations and policy
1964	renewals and reports of the issuance of new policies received by
1965	the Department of Highway Safety and Motor Vehicles are
1966	confidential and exempt from the provisions of s. 119.07(1).
1967	These records are to be used for enforcement and regulatory
1968	purposes only, including the generation by the department of
1969	data regarding compliance by owners of motor vehicles with
1970	financial responsibility coverage requirements. In addition, the
1971	Department of Highway Safety and Motor Vehicles shall release,
1972	upon a written request by a person involved in a motor vehicle
1973	accident, by the person's attorney, or by a representative of
1974	the person's motor vehicle insurer, the name of the insurance
1975	company and the policy number for the policy covering the
1976	vehicle named by the requesting party. The written request must
1977	include a copy of the appropriate accident form as provided in
1978	s. 316.065, s. 316.066, or s. 316.068.
1979	(b)  Every insurer with respect to each insurance policy
1980	providing personal injury protection benefits shall notify the
1981	named insured or in the case of a commercial fleet policy, the
1982	first named insured in writing that any cancellation or
1983	nonrenewal of the policy will be reported by the insurer to the
1984	Department of Highway Safety and Motor Vehicles. The notice
1985	shall also inform the named insured that failure to maintain
1986	personal injury protection and property damage liability
1987	insurance on a motor vehicle when required by law may result in
1988	the loss of registration and driving privileges in this state,
1989	and the notice shall inform the named insured of the amount of
1990	the reinstatement fees required by s. 627.733(7). This notice is
1991	for informational purposes only, and no civil liability shall
1992	attach to an insurer due to failure to provide this notice.
1993	(10)  An insurer may negotiate and enter into contracts
1994	with licensed health care providers for the benefits described
1995	in this section, referred to in this section as "preferred
1996	providers," which shall include health care providers licensed
1997	under chapters 458, 459, 460, 461, and 463. The insurer may
1998	provide an option to an insured to use a preferred provider at
1999	the time of purchase of the policy for personal injury
2000	protection benefits, if the requirements of this subsection are
2001	met. If the insured elects to use a provider who is not a
2002	preferred provider, whether the insured purchased a preferred
2003	provider policy or a nonpreferred provider policy, the medical
2004	benefits provided by the insurer shall be as required by this
2005	section. If the insured elects to use a provider who is a
2006	preferred provider, the insurer may pay medical benefits in
2007	excess of the benefits required by this section and may waive or
2008	lower the amount of any deductible that applies to such medical
2009	benefits. If the insurer offers a preferred provider policy to a
2010	policyholder or applicant, it must also offer a nonpreferred
2011	provider policy. The insurer shall provide each policyholder
2012	with a current roster of preferred providers in the county in
2013	which the insured resides at the time of purchase of such
2014	policy, and shall make such list available for public inspection
2015	during regular business hours at the principal office of the
2016	insurer within the state.
2017	(11)  DEMAND LETTER.--
2018	(a)  As a condition precedent to filing any action for
2019	benefits under this section, the insurer must be provided with
2020	written notice of an intent to initiate litigation. Such notice
2021	may not be sent until the claim is overdue, including any
2022	additional time the insurer has to pay the claim pursuant to
2023	paragraph (4)(b).
2024	(b)  The notice required shall state that it is a "demand
2025	letter under s. 627.736(11)" and shall state with specificity:
2026	1.  The name of the insured upon which such benefits are
2027	being sought, including a copy of the assignment giving rights
2028	to the claimant if the claimant is not the insured.
2029	2.  The claim number or policy number upon which such claim
2030	was originally submitted to the insurer.
2031	3.  To the extent applicable, the name of any medical
2032	provider who rendered to an insured the treatment, services,
2033	accommodations, or supplies that form the basis of such claim;
2034	and an itemized statement specifying each exact amount, the date
2035	of treatment, service, or accommodation, and the type of benefit
2036	claimed to be due. A completed form satisfying the requirements
2037	of paragraph (5)(d) or the lost-wage statement previously
2038	submitted may be used as the itemized statement. To the extent
2039	that the demand involves an insurer's withdrawal of payment
2040	under paragraph (7)(a) for future treatment not yet rendered,
2041	the claimant shall attach a copy of the insurer's notice
2042	withdrawing such payment and an itemized statement of the type,
2043	frequency, and duration of future treatment claimed to be
2044	reasonable and medically necessary.
2045	(c)  Each notice required by this subsection must be
2046	delivered to the insurer by United States certified or
2047	registered mail, return receipt requested. Such postal costs
2048	shall be reimbursed by the insurer if so requested by the
2049	claimant in the notice, when the insurer pays the claim. Such
2050	notice must be sent to the person and address specified by the
2051	insurer for the purposes of receiving notices under this
2052	subsection. Each licensed insurer, whether domestic, foreign, or
2053	alien, shall file with the office designation of the name and
2054	address of the person to whom notices pursuant to this
2055	subsection shall be sent which the office shall make available
2056	on its Internet website. The name and address on file with the
2057	office pursuant to s. 624.422 shall be deemed the authorized
2058	representative to accept notice pursuant to this subsection in
2059	the event no other designation has been made.
2060	(d)  If, within 15 days after receipt of notice by the
2061	insurer, the overdue claim specified in the notice is paid by
2062	the insurer together with applicable interest and a penalty of
2063	10 percent of the overdue amount paid by the insurer, subject to
2064	a maximum penalty of $250, no action may be brought against the
2065	insurer. If the demand involves an insurer's withdrawal of
2066	payment under paragraph (7)(a) for future treatment not yet
2067	rendered, no action may be brought against the insurer if,
2068	within 15 days after its receipt of the notice, the insurer
2069	mails to the person filing the notice a written statement of the
2070	insurer's agreement to pay for such treatment in accordance with
2071	the notice and to pay a penalty of 10 percent, subject to a
2072	maximum penalty of $250, when it pays for such future treatment
2073	in accordance with the requirements of this section. To the
2074	extent the insurer determines not to pay any amount demanded,
2075	the penalty shall not be payable in any subsequent action. For
2076	purposes of this subsection, payment or the insurer's agreement
2077	shall be treated as being made on the date a draft or other
2078	valid instrument that is equivalent to payment, or the insurer's
2079	written statement of agreement, is placed in the United States
2080	mail in a properly addressed, postpaid envelope, or if not so
2081	posted, on the date of delivery. The insurer shall not be
2082	obligated to pay any attorney's fees if the insurer pays the
2083	claim or mails its agreement to pay for future treatment within
2084	the time prescribed by this subsection.
2085	(e)  The applicable statute of limitation for an action
2086	under this section shall be tolled for a period of 15 business
2087	days by the mailing of the notice required by this subsection.
2088	(f)  Any insurer making a general business practice of not
2089	paying valid claims until receipt of the notice required by this
2090	subsection is engaging in an unfair trade practice under the
2091	insurance code.
2092	(12)  CIVIL ACTION FOR INSURANCE FRAUD.--An insurer shall
2093	have a cause of action against any person convicted of, or who,
2094	regardless of adjudication of guilt, pleads guilty or nolo
2095	contendere to insurance fraud under s. 817.234, patient
2096	brokering under s. 817.505, or kickbacks under s. 456.054,
2097	associated with a claim for personal injury protection benefits
2098	in accordance with this section. An insurer prevailing in an
2099	action brought under this subsection may recover compensatory,
2100	consequential, and punitive damages subject to the requirements
2101	and limitations of part II of chapter 768, and attorney's fees
2102	and costs incurred in litigating a cause of action against any
2103	person convicted of, or who, regardless of adjudication of
2104	guilt, pleads guilty or nolo contendere to insurance fraud under
2105	s. 817.234, patient brokering under s. 817.505, or kickbacks
2106	under s. 456.054, associated with a claim for personal injury
2107	protection benefits in accordance with this section.
2108	(13)  MINIMUM BENEFIT COVERAGE.--If the Financial Services
2109	Commission determines that the cost savings under personal
2110	injury protection insurance benefits paid by insurers have been
2111	realized due to the provisions of this act, prior legislative
2112	reforms, or other factors, the commission may increase the
2113	minimum $10,000 benefit coverage requirement. In establishing
2114	the amount of such increase, the commission must determine that
2115	the additional premium for such coverage is approximately equal
2116	to the premium cost savings that have been realized for the
2117	personal injury protection coverage with limits of $10,000.
2118	(14)  FRAUD ADVISORY NOTICE.--Upon receiving notice of a
2119	claim under this section, an insurer shall provide a notice to
2120	the insured or to a person for whom a claim for reimbursement
2121	for diagnosis or treatment of injuries has been filed, advising
2122	that:
2123	(a)  Pursuant to s. 626.9892, the Department of Financial
2124	Services may pay rewards of up to $25,000 to persons providing
2125	information leading to the arrest and conviction of persons
2126	committing crimes investigated by the Division of Insurance
2127	Fraud arising from violations of s. 440.105, s. 624.15, s.
2128	626.9541, s. 626.989, or s. 817.234.
2129	(b)  Solicitation of a person injured in a motor vehicle
2130	crash for purposes of filing personal injury protection or tort
2131	claims could be a violation of s. 817.234, s. 817.505, or the
2132	rules regulating The Florida Bar and should be immediately
2133	reported to the Division of Insurance Fraud if such conduct has
2134	taken place.
2135	Section 18.  Notwithstanding the repeal of the Florida
2136	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
2137	section 627.737, Florida Statutes, is revived and reenacted to
2138	read:
2139	627.737  Tort exemption; limitation on right to damages;
2140	punitive damages.--
2141	(1)  Every owner, registrant, operator, or occupant of a
2142	motor vehicle with respect to which security has been provided
2143	as required by ss. 627.730-627.7405, and every person or
2144	organization legally responsible for her or his acts or
2145	omissions, is hereby exempted from tort liability for damages
2146	because of bodily injury, sickness, or disease arising out of
2147	the ownership, operation, maintenance, or use of such motor
2148	vehicle in this state to the extent that the benefits described
2149	in s. 627.736(1) are payable for such injury, or would be
2150	payable but for any exclusion authorized by ss. 627.730-
2151	627.7405, under any insurance policy or other method of security
2152	complying with the requirements of s. 627.733, or by an owner
2153	personally liable under s. 627.733 for the payment of such
2154	benefits, unless a person is entitled to maintain an action for
2155	pain, suffering, mental anguish, and inconvenience for such
2156	injury under the provisions of subsection (2).
2157	(2)  In any action of tort brought against the owner,
2158	registrant, operator, or occupant of a motor vehicle with
2159	respect to which security has been provided as required by ss.
2160	627.730-627.7405, or against any person or organization legally
2161	responsible for her or his acts or omissions, a plaintiff may
2162	recover damages in tort for pain, suffering, mental anguish, and
2163	inconvenience because of bodily injury, sickness, or disease
2164	arising out of the ownership, maintenance, operation, or use of
2165	such motor vehicle only in the event that the injury or disease
2166	consists in whole or in part of:
2167	(a)  Significant and permanent loss of an important bodily
2168	function.
2169	(b)  Permanent injury within a reasonable degree of medical
2170	probability, other than scarring or disfigurement.
2171	(c)  Significant and permanent scarring or disfigurement.
2172	(d)  Death.
2173	(3)  When a defendant, in a proceeding brought pursuant to
2174	ss. 627.730-627.7405, questions whether the plaintiff has met
2175	the requirements of subsection (2), then the defendant may file
2176	an appropriate motion with the court, and the court shall, on a
2177	one-time basis only, 30 days before the date set for the trial
2178	or the pretrial hearing, whichever is first, by examining the
2179	pleadings and the evidence before it, ascertain whether the
2180	plaintiff will be able to submit some evidence that the
2181	plaintiff will meet the requirements of subsection (2). If the
2182	court finds that the plaintiff will not be able to submit such
2183	evidence, then the court shall dismiss the plaintiff's claim
2184	without prejudice.
2185	(4)  In any action brought against an automobile liability
2186	insurer for damages in excess of its policy limits, no claim for
2187	punitive damages shall be allowed.
2188	Section 19.  Notwithstanding the repeal of the Florida
2189	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
2190	section 627.739, Florida Statutes, is revived and reenacted to
2191	read:
2192	627.739  Personal injury protection; optional limitations;
2193	deductibles.--
2194	(1)  The named insured may elect a deductible or modified
2195	coverage or combination thereof to apply to the named insured
2196	alone or to the named insured and dependent relatives residing
2197	in the same household, but may not elect a deductible or
2198	modified coverage to apply to any other person covered under the
2199	policy.
2200	(2)  Insurers shall offer to each applicant and to each
2201	policyholder, upon the renewal of an existing policy,
2202	deductibles, in amounts of $250, $500, and $1,000. The
2203	deductible amount must be applied to 100 percent of the expenses
2204	and losses described in s. 627.736. After the deductible is met,
2205	each insured is eligible to receive up to $10,000 in total
2206	benefits described in s. 627.736(1). However, this subsection
2207	shall not be applied to reduce the amount of any benefits
2208	received in accordance with s. 627.736(1)(c).
2209	(3)  Insurers shall offer coverage wherein, at the election
2210	of the named insured, the benefits for loss of gross income and
2211	loss of earning capacity described in s. 627.736(1)(b) shall be
2212	excluded.
2213	(4)  The named insured shall not be prevented from electing
2214	a deductible under subsection (2) and modified coverage under
2215	subsection (3). Each election made by the named insured under
2216	this section shall result in an appropriate reduction of premium
2217	associated with that election.
2218	(5)  All such offers shall be made in clear and unambiguous
2219	language at the time the initial application is taken and prior
2220	to each annual renewal and shall indicate that a premium
2221	reduction will result from each election. At the option of the
2222	insurer, the requirements of the preceding sentence are met by
2223	using forms of notice approved by the office, or by providing
2224	the following notice in 10-point type in the insurer's
2225	application for initial issuance of a policy of motor vehicle
2226	insurance and the insurer's annual notice of renewal premium:
2227
2228	For personal injury protection insurance, the named insured may
2229	elect a deductible and to exclude coverage for loss of gross
2230	income and loss of earning capacity ("lost wages"). These
2231	elections apply to the named insured alone, or to the named
2232	insured and all dependent resident relatives. A premium
2233	reduction will result from these elections. The named insured is
2234	hereby advised not to elect the lost wage exclusion if the named
2235	insured or dependent resident relatives are employed, since lost
2236	wages will not be payable in the event of an accident.
2237	Section 20.  Notwithstanding the repeal of the Florida
2238	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
2239	section 627.7401, Florida Statutes, is revived and reenacted to
2240	read:
2241	627.7401  Notification of insured's rights.--
2242	(1)  The commission, by rule, shall adopt a form for the
2243	notification of insureds of their right to receive personal
2244	injury protection benefits under the Florida Motor Vehicle No-
2245	Fault Law. Such notice shall include:
2246	(a)  A description of the benefits provided by personal
2247	injury protection, including, but not limited to, the specific
2248	types of services for which medical benefits are paid,
2249	disability benefits, death benefits, significant exclusions from
2250	and limitations on personal injury protection benefits, when
2251	payments are due, how benefits are coordinated with other
2252	insurance benefits that the insured may have, penalties and
2253	interest that may be imposed on insurers for failure to make
2254	timely payments of benefits, and rights of parties regarding
2255	disputes as to benefits.
2256	(b)  An advisory informing insureds that:
2257	1.  Pursuant to s. 626.9892, the Department of Financial
2258	Services may pay rewards of up to $25,000 to persons providing
2259	information leading to the arrest and conviction of persons
2260	committing crimes investigated by the Division of Insurance
2261	Fraud arising from violations of s. 440.105, s. 624.15, s.
2262	626.9541, s. 626.989, or s. 817.234.
2263	2.  Pursuant to s. 627.736(5)(e)1., if the insured notifies
2264	the insurer of a billing error, the insured may be entitled to a
2265	certain percentage of a reduction in the amount paid by the
2266	insured's motor vehicle insurer.
2267	(c)  A notice that solicitation of a person injured in a
2268	motor vehicle crash for purposes of filing personal injury
2269	protection or tort claims could be a violation of s. 817.234, s
2270	817.505, or the rules regulating The Florida Bar and should be
2271	immediately reported to the Division of Insurance Fraud if such
2272	conduct has taken place.
2273	(2)  Each insurer issuing a policy in this state providing
2274	personal injury protection benefits must mail or deliver the
2275	notice as specified in subsection (1) to an insured within 21
2276	days after receiving from the insured notice of an automobile
2277	accident or claim involving personal injury to an insured who is
2278	covered under the policy. The office may allow an insurer
2279	additional time to provide the notice specified in subsection
2280	(1) not to exceed 30 days, upon a showing by the insurer that an
2281	emergency justifies an extension of time.
2282	(3)  The notice required by this section does not alter or
2283	modify the terms of the insurance contract or other requirements
2284	of this act.
2285	Section 21.  Notwithstanding the repeal of the Florida
2286	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
2287	section 627.7403, Florida Statutes, is revived and reenacted to
2288	read:
2289	627.7403  Mandatory joinder of derivative claim.--In any
2290	action brought pursuant to the provisions of s. 627.737 claiming
2291	personal injuries, all claims arising out of the plaintiff's
2292	injuries, including all derivative claims, shall be brought
2293	together, unless good cause is shown why such claims should be
2294	brought separately.
2295	Section 22.  Notwithstanding the repeal of the Florida
2296	Motor Vehicle No-Fault Law, which occurred on October 1, 2007,
2297	section 627.7405, Florida Statutes, is revived and reenacted to
2298	read:
2299	627.7405  Insurers' right of reimbursement.--
2300	Notwithstanding any other provisions of ss. 627.730-627.7405,
2301	any insurer providing personal injury protection benefits on a
2302	private passenger motor vehicle shall have, to the extent of any
2303	personal injury protection benefits paid to any person as a
2304	benefit arising out of such private passenger motor vehicle
2305	insurance, a right of reimbursement against the owner or the
2306	insurer of the owner of a commercial motor vehicle, if the
2307	benefits paid result from such person having been an occupant of
2308	the commercial motor vehicle or having been struck by the
2309	commercial motor vehicle while not an occupant of any self-
2310	propelled vehicle.
2311	Section 23.  This act revives and reenacts the Florida
2312	Motor Vehicle No-Fault Law, which expired by operation of law on
2313	October 1, 2007. This act is intended to be remedial and
2314	curative in nature. Therefore, the Florida Motor Vehicle No-
2315	Fault Law shall continue to be codified as ss. 627.730-627.7405,
2316	Florida Statutes, notwithstanding the repeal of those sections
2317	contained in s. 19, chapter 2003-411, Laws of Florida.
2318	Section 24.  (1)  The Legislature intends that the
2319	provisions of this act reviving and reenacting the Florida Motor
2320	Vehicle No-Fault Law apply to policies issued on or after the
2321	effective date of this act.
2322	(2)  Each insurer that issued coverage for a motor vehicle
2323	that is subject to the Florida Motor Vehicle No-Fault Law shall,
2324	within 30 days after the effective date of this act, mail or
2325	deliver a revised notice of the premium and policy changes to
2326	each policyholder whose policy has an effective date on or after
2327	the effective date of this act and who was previously issued a
2328	motor vehicle insurance policy or sent a renewal notice based on
2329	the assumption that the Florida Motor Vehicle No-Fault Law would
2330	be repealed on October 1, 2007. For a renewal policy, the
2331	coverage must provide the same limits of personal injury
2332	protection coverage, the same deductible from personal injury
2333	protection coverage, and the same limits of medical payments
2334	coverage as provided in the prior policy, unless the
2335	policyholder elects different limits that are available. The
2336	effective date of the revised policy or renewal shall be the
2337	same as the effective date specified in the prior notice. The
2338	revised notice of premium and coverage changes are exempt from
2339	the requirements of ss. 627.7277, 627.728, and 627.7282, Florida
2340	Statutes. The policyholder has a period of 30 days, or a longer
2341	period if specified by the insurer, following receipt of the
2342	revised notice within which to pay any additional amount of
2343	premium due and thereby maintain the policy in force as
2344	specified in this section. Alternatively, the policyholder may
2345	cancel the policy within this time period and obtain a refund of
2346	the unearned premium. If the policyholder fails to timely
2347	respond to the notice, the insurer must cancel the policy and
2348	return any unearned premium to the insured. The date on which
2349	the policy will be canceled shall be stated in the notice and
2350	may not be less than 35 days after the date of the notice. The
2351	amount of unearned premium due to the policyholder shall be
2352	calculated on a pro rata basis. The failure of an insurer to
2353	timely mail or deliver a revised notice as required by this
2354	subsection does not affect the other requirements of this
2355	section.
2356	(3)  The Legislature recognizes that some persons have been
2357	issued a motor vehicle insurance policy effective on or after
2358	October 1, 2007, and before the effective date of this act,
2359	which does not include personal injury protection, based upon
2360	the expected repeal of the Florida Motor Vehicle No-Fault Law on
2361	October 1, 2007, pursuant to s. 19, chapter 2003-411, Laws of
2362	Florida. Any such person:
2363	(a)  May continue to own and operate a motor vehicle in
2364	this state without being subject to any sanction for failing to
2365	maintain personal injury protection coverage if that person
2366	continues to meet statutory requirements relating to property
2367	damage liability coverage and obtains personal injury protection
2368	coverage that takes effect no later than December 1, 2007.
2369	(b)  Is not subject to the provisions of s. 627.737,
2370	Florida Statutes, relating to the exemption from tort liability
2371	with respect to injuries sustained by the person in a motor
2372	vehicle crash occurring while the policy without personal injury
2373	protection coverage is in effect but not later than November 30,
2374	2007. This paragraph also applies during such period to any
2375	person who would have been covered under a personal injury
2376	protection policy if such a policy had been maintained on such
2377	motor vehicle.
2378	(4)  Each insurer shall, by October 31, 2007, provide
2379	written notification to each insured referred to in subsection
2380	(3) informing the insured that he or she must obtain personal
2381	injury protection coverage that takes effect no later than
2382	December 1, 2007. Such notice must include the premium for such
2383	coverage and the premium credit, if any, which will be provided
2384	for other coverage, such as bodily injury liability coverage or
2385	uninsured motorist coverage. Alternatively, the insurer may add
2386	an endorsement to the policy to provide personal injury
2387	protection coverage as required by law, effective no later than
2388	December 1, 2007, without requiring any additional payment from
2389	the insured and shall provide written notification to the
2390	insured of such endorsement by October 31, 2007.
2391	Section 25.  Effective January 1, 2009, sections 627.730,
2392	627.731, 627.732, 627.733, 627.734, 627.736, 627.737, 627.739,
2393	627.7401, 627.7403, and 627.7405, Florida Statutes, constituting
2394	the Florida Motor Vehicle No-Fault Law, are repealed, unless
2395	reviewed and reenacted by the Legislature before that date.
2396	Section 26.  This act shall take effect upon becoming a
2397	law.

CODING: Words stricken are deletions; words underlined are additions.