Florida Senate - 2012                                    SB 1328
       
       
       
       By Senator Hays
       
       
       
       
       20-00827A-12                                          20121328__
    1                        A bill to be entitled                      
    2         An act relating to damages for medical or health care
    3         services; creating s. 768.755, F.S.; limiting recovery
    4         of damages for medical or health care services to
    5         amounts actually paid if no balance to the provider is
    6         outstanding; limiting recovery of such damages to
    7         amounts customarily accepted by providers in the same
    8         geographic area if a balance to the provider is
    9         outstanding; requiring medical or health care services
   10         to be medically necessary in order to be recoverable;
   11         specifying that certain evidence shall be considered
   12         in determining the amounts customarily accepted;
   13         providing for reduction of awards under specified
   14         provisions; providing applicability; providing an
   15         effective date.
   16  
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Section 768.755, Florida Statutes, is created to
   20  read:
   21         768.755 Damages recoverable for medical or health care
   22  services.—In any action to which this part applies, damages for
   23  medical or health care services provided or to be provided to a
   24  claimant are recoverable only as provided in this section.
   25         (1) With respect to any medical or health care services
   26  provided to the claimant for which an outstanding balance is not
   27  due to the provider, the actual amounts remitted to the provider
   28  are the only amounts recoverable. In such circumstances, any
   29  difference between the amounts originally billed by the provider
   30  and the actual amounts remitted to the provider are not
   31  recoverable or admissible into evidence.
   32         (2) With respect to any medical or health care services
   33  provided to the claimant for which an outstanding balance is
   34  claimed to be due to the provider, and to claims asserted for
   35  medical or health care services to be provided to the claimant
   36  in the future, the maximum amounts recoverable are the amounts
   37  customarily accepted in payment for such services by other
   38  providers in the same geographic area. This limitation also
   39  applies to any lien asserted for such services in the action,
   40  except for those liens described in subsection (4). In
   41  determining the amounts customarily accepted, payment rates to
   42  providers in the same geographic area for identical or
   43  substantially similar medical or health care service on a cash
   44  basis, under Medicaid and Medicare, and by payors regulated
   45  under the Florida Insurance Code shall be considered.
   46         (3) Damages for medical or health care services provided or
   47  to be provided to a claimant may be awarded only for those
   48  services determined, by a preponderance of the evidence, to be
   49  medically necessary. If it is determined that any of the
   50  claimant’s medical or health care services provided or to be
   51  provided were or are not medically necessary, the claimant may
   52  not recover damages for such services or recover from the
   53  nonprovider defendant for any damages arising out of or related
   54  to such services.
   55         (4) Notwithstanding any other provision in this section to
   56  the contrary, if Medicaid, Medicare, or a payor regulated under
   57  the Florida Insurance Code has covered or is an insurer covering
   58  the claimant’s medical or health care services and has given
   59  notice of assertion of a lien in the action, the amount of the
   60  lien shall be the only amount recoverable and admissible into
   61  evidence with respect to the covered services.
   62         (5) After damages in compliance with this section are
   63  awarded to a claimant, the court shall apply s. 768.76 and
   64  reduce the amount of such award, as appropriate.
   65         (6) This section applies only to actions for personal
   66  injury or wrongful death of the claimant and has no other
   67  application or effect regarding compensation paid to providers
   68  for medical or health care services.
   69         Section 2. This act shall take effect upon becoming a law,
   70  and shall apply to all causes of action arising on or after that
   71  date.