Florida Senate - 2012 COMMITTEE AMENDMENT
Bill No. CS for SB 1860
Barcode 310400
LEGISLATIVE ACTION
Senate . House
Comm: WD .
02/29/2012 .
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The Committee on Budget (Altman) recommended the following:
1 Senate Amendment to Amendment (811080)
2
3 Delete lines 1500 - 1611
4 and insert:
5 hospital; and
6 (II) In a facility wholly owned by a physician licensed
7 under chapter 458, chapter 459, or chapter 460, or by the
8 physician and the spouse, parents, children, or siblings of such
9 physician, which facility is selected by the injured person.
10 c. Services and care rendered when an insured is admitted
11 to a hospital within 7 days after the motor vehicle accident,
12 for a condition related to the motor vehicle accident.
13 d. If the insured receives emergency transport and
14 treatment or emergency services and care pursuant to sub
15 subparagraph a. or sub-subparagraph b., or services and care
16 pursuant to sub-subparagraph c., prescribed followup services
17 and care directly related to the medical diagnosis arising from
18 the motor vehicle accident if:
19 (I) The medical diagnosis and determination of the
20 emergency medical condition was rendered in a hospital by a
21 physician licensed under chapter 458, an osteopathic physician
22 licensed under chapter 459, a dentist licensed under chapter
23 466, or, to the extent permitted by applicable law and under the
24 supervision of such physician, osteopathic physician, or
25 dentist, by a physician assistant licensed under chapter 458 or
26 chapter 459 or an advanced registered nurse practitioner
27 licensed under chapter 464, or the insured received services and
28 care while admitted to a hospital; and
29 (II) The prescribed followup services and care are rendered
30 by a physician licensed under chapter 458, an osteopathic
31 physician licensed under chapter 459, a chiropractic physician
32 licensed under chapter 460, or a dentist licensed under chapter
33 466 as selected by the injured person, a physician assistant
34 licensed under chapter 458 or chapter 459, or an advanced
35 registered nurse practitioner licensed under chapter 464.
36 e. If the insured receives services and care pursuant to
37 sub-subparagraph a., sub-subparagraph b., sub-subparagraph c.,
38 or sub-subparagraph d., all medically necessary medical,
39 surgical, dental, nursing, or diagnostic ancillary services,
40 hospital or ambulatory surgical center services, durable medical
41 equipment, prosthetics, or orthotics and supplies.
42 2. Up to a limit of $2,000, 80 percent of all reasonable
43 expenses as follows:
44 a. Services and care rendered within 7 days after the motor
45 vehicle accident by a physician licensed under chapter 458, an
46 osteopathic physician licensed under chapter 459, a chiropractic
47 physician licensed under chapter 460, or a dentist licensed
48 under chapter 466, a physician assistant licensed under chapter
49 458 or 459, or an advanced registered nurse practitioner
50 licensed under chapter 464, who is selected by the injured
51 person.
52 b. If the insured receives services and care pursuant to
53 sub-subparagraph a., prescribed followup services and care
54 directly related to the medical diagnosis arising from the motor
55 vehicle accident. The medical benefits provide reimbursement
56 only for followup services and care provided, supervised,
57 ordered, or prescribed by a physician licensed under chapter
58 458, an osteopathic physician licensed under chapter 459, a
59 dentist licensed under chapter 466 or, to the extent permitted
60 by applicable law and under the supervision of such physician,
61 osteopathic physician, or dentist, by a physician assistant
62 licensed under chapter 458 or chapter 459 or an advanced
63 registered nurse practitioner licensed under chapter 464. Such
64 followup services and care may be rendered by a physician
65 licensed under chapter 458, an osteopathic physician licensed
66 under chapter 459, a chiropractic physician licensed under
67 chapter 460, a dentist licensed under chapter 466, or, to the
68 extent permitted by applicable law and under the supervision of
69 such physician, osteopathic physician, or dentist, by a
70 physician assistant licensed under chapter 458 or chapter 459 or
71 an advanced registered nurse practitioner licensed under chapter
72 464, who is selected by the injured person.
73 c. All medically necessary medical, surgical, dental,
74 nursing, or diagnostic ancillary services, hospital or
75 ambulatory surgical center services, durable medical equipment,
76 prosthetics, orthotics, and supplies.
77 d. Payment of benefits under sub-subparagraph a.,
78 subparagraph b., or sub-subparagraph c. occurs only if an
79 insured has been determined in a hospital to not have an
80 emergency medical condition or did not present at a hospital but
81 received treatment from a provider identified in sub
82 subparagraph a. within 7 days after the motor vehicle accident.
83 3. Prescribed followup services and care under sub
84 subparagraph 1.d. and reimbursable medical benefits under
85 subparagraph 2. must be provided in a clinic licensed under part
86 X of chapter 400 or an entity excluded from the definition of a
87 clinic. However, as provided in s. 400.9905, an entity excluded
88 from the definition of a clinic shall be deemed a clinic and
89 must be licensed under part X of chapter 400 in order to receive
90 reimbursement for prescribed followup services and care under
91 sub-subparagraph 1.d. unless the entity is:
92 a. An entity wholly owned by a physician licensed under
93 chapter 458 or chapter 459, or by the physician and the spouse,
94 parent, child, or sibling of the physician;
95 b. An entity wholly owned by a dentist licensed under
96 chapter 466, or by the dentist and the spouse, parent, child, or
97 sibling of the dentist;
98 c. An entity wholly owned by a chiropractic physician
99 licensed under chapter 460, or by the chiropractic physician and
100 the spouse, parent, child, or sibling of the chiropractic
101 physician if such entity has filed for a licensing exemption
102 with the Agency for Health Care Administration; or
103 d. A hospital or ambulatory surgical center licensed under
104 chapter 395.
105 4. Medical benefits do not include massage as defined in s.
106 480.033 or acupuncture as defined in s. 457.102, regardless of
107 the person, entity, or licensee providing massage or
108 acupuncture.
109 5. For purposes of ss. 627.748-627.7491, a medical
110 diagnosis that an emergency medical condition exists is presumed
111 to be correct unless rebutted by clear and convincing evidence
112 to the contrary.