HB 523

A bill to be entitled
2An act relating to motor vehicle personal injury
3protection insurance; amending s. 316.066, F.S.;
4revising criteria relating to whether a motor vehicle
5crash report must be submitted to the Department of
6Highway Safety and Motor Vehicles by an investigating
7law enforcement officer; providing a penalty; revising
8requirements relating to the content of crash reports;
9authorizing the submission of certain crash reports to
10a traffic records center; authorizing an investigating
11officer to testify at trial or provide an affidavit
12concerning the information in a crash report; amending
13s. 324.0221, F.S.; increasing certain license
14reinstatement fees; amending s. 400.991, F.S.;
15requiring that an application for licensure as a
16health care clinic include a statement regarding
17insurance fraud; amending s. 400.9925, F.S.; imposing
18a licensing fee for health care clinics authorized to
19submit claims for payment under personal injury
20protection insurance policies; directing a portion of
21the proceeds from such licensing fees to the operation
22of the Automobile Insurance Fraud Strike Force;
23creating s. 626.9898, F.S.; providing definitions;
24authorizing the Division of Insurance Fraud to
25establish a direct-support organization for the
26purpose of prosecuting, investigating, and preventing
27motor vehicle insurance fraud; providing requirements
28for the organization and the organization's contract
29with the division; providing for a board of directors;
30authorizing the organization to use the division's
31property and facilities subject to certain
32requirements; authorizing contributions from insurers;
33providing that any moneys received by the organization
34may be held in a separate depository account in the
35name of the organization; requiring the division to
36deposit certain proceeds into the Insurance Regulatory
37Trust Fund; amending s. 627.736, F.S.; revising
38criteria relating to the entities that are authorized
39to file a claim for payment under a personal injury
40protection insurance policy; prohibiting attorney fees
41from being awarded when representation is secured by
42an illegal solicitation; specifying guidelines for
43determining a reasonable attorney fee; limiting a
44court's authority to award an attorney fee multiplier;
45providing an exception; revising circumstances under
46which information relating to a motor vehicle no-fault
47case may be transmitted electronically; amending s.
48817.234, F.S.; providing for the loss of an
49occupational license and prohibition from receiving
50reimbursement for personal injury protection benefits
51for a specified time if a business entity is found
52guilty of insurance fraud; providing for the loss of a
53health care practitioner's license to practice and
54prohibition from receiving reimbursement for personal
55injury protection benefits for a specified time if the
56practitioner is found guilty of insurance fraud;
57providing civil penalties; providing an effective
60Be It Enacted by the Legislature of the State of Florida:
62     Section 1.  Subsection (1) of section 316.066, Florida
63Statutes, is amended, and paragraph (a) of subsection (3) of
64that section is reenacted, to read:
65     316.066  Written reports of crashes.-
66     (1)(a)  A Florida Traffic Crash Report, Long Form is
67required to be completed and submitted to the department within
6810 days after completing an investigation by every law
69enforcement officer who in the regular course of duty
70investigates a motor vehicle crash that:
71     1.  That resulted in death, or personal injury, or any
72indication of complaints of pain or discomfort by any of the
73parties or passengers involved in the crash;.
74     2.  That involved one or more passengers, other than the
75drivers of the vehicles, in any of the vehicles involved in the
77     3.2.  That involved a violation of s. 316.061(1) or s.
78316.193; or.
79     4.  In which a vehicle was rendered inoperative to a degree
80that required a wrecker to remove it from traffic, if such
81action is appropriate, in the officer's discretion.
82     (b)  In every crash for which a Florida Traffic Crash
83Report, Long Form is not required by this section, the law
84enforcement officer may complete a short-form crash report or
85provide a driver exchange-of-information form to be completed by
86each party involved in the crash. Short-form crash reports
87prepared by the law enforcement officer shall be maintained by
88the officer's agency.
89     (c)  The long-form and short-form reports report must
91     1.  The date, time, and location of the crash.
92     2.  A description of the vehicles involved.
93     3.  The names and addresses of the parties involved,
94including all drivers and passengers.
95     4.  The names and addresses of all passengers in all
96vehicles involved in the crash, each clearly identified as being
97a passenger, and the identification of the vehicle in which each
98was a passenger.
99     5.4.  The names and addresses of witnesses.
100     6.5.  The name, badge number, and law enforcement agency of
101the officer investigating the crash.
102     7.6.  The names of the insurance companies for the
103respective parties involved in the crash.
104     (d)  The phone numbers of the parties involved in the crash
105may not be included in any crash report except in the case of a
106criminal traffic offense.
107     (e)(c)  Each party to the crash must provide the law
108enforcement officer with proof of insurance, which must be
109included documented in the crash report. If a law enforcement
110officer submits a report on the crash, proof of insurance must
111be provided to the officer by each party involved in the crash.
112Any party who fails to provide the required information commits
113a noncriminal traffic infraction, punishable as a nonmoving
114violation as provided in chapter 318, unless the officer
115determines that due to injuries or other special circumstances
116such insurance information cannot be provided immediately. If
117the person provides the law enforcement agency, within 24 hours
118after the crash, proof of insurance that was valid at the time
119of the crash, the law enforcement agency may void the citation.
120     (f)(d)  The driver of a vehicle that was in any manner
121involved in a crash resulting in damage to any vehicle or other
122property in an amount of $500 or more, which crash was not
123investigated by a law enforcement agency, shall, within 10 days
124after the crash, submit a written report of the crash to the
125department or traffic records center. The entity receiving the
126report may require witnesses of the crash to render reports and
127may require any driver of a vehicle involved in a crash of which
128a written report must be made to file supplemental written
129reports if the original report is deemed insufficient by the
130receiving entity.
131     (g)  The investigating law enforcement officer may testify
132at trial or provide a signed affidavit to confirm or supplement
133the information included on the long-form or short-form report.
134     (e)  Short-form crash reports prepared by law enforcement
135shall be maintained by the law enforcement officer's agency.
136     (3)(a)  Any driver failing to file the written report
137required under subsection (1) commits a noncriminal traffic
138infraction, punishable as a nonmoving violation as provided in
139chapter 318.
140     Section 2.  Subsection (3) of section 324.0221, Florida
141Statutes, is amended to read:
142     324.0221  Reports by insurers to the department; suspension
143of driver driver's license and vehicle registrations;
145     (3)  An operator or owner whose driver driver's license or
146registration has been suspended under this section or s. 316.646
147may effect its reinstatement upon compliance with the
148requirements of this section and upon payment to the department
149of a nonrefundable reinstatement fee of $250 $150 for the first
150reinstatement. The reinstatement fee is $350 $250 for the second
151reinstatement and $750 $500 for each subsequent reinstatement
152during the 3 years following the first reinstatement. A person
153reinstating her or his insurance under this subsection must also
154secure noncancelable coverage as described in ss. 324.021(8),
155324.023, and 627.7275(2) and present to the appropriate person
156proof that the coverage is in force on a form adopted by the
157department, and such proof shall be maintained for 2 years. If
158the person does not have a second reinstatement within 3 years
159after her or his initial reinstatement, the reinstatement fee is
160$250 $150 for the first reinstatement after that 3-year period.
161If a person's license and registration are suspended under this
162section or s. 316.646, only one reinstatement fee must be paid
163to reinstate the license and the registration. All fees shall be
164collected by the department at the time of reinstatement. The
165department shall issue proper receipts for such fees and shall
166promptly deposit those fees in the Highway Safety Operating
167Trust Fund. One-third of the fees collected under this
168subsection shall be distributed from the Highway Safety
169Operating Trust Fund to the local governmental entity or state
170agency that employed the law enforcement officer seizing the
171license plate pursuant to s. 324.201. The funds may be used by
172the local governmental entity or state agency for any authorized
174     Section 3.  Subsection (6) is added to section 400.991,
175Florida Statutes, to read:
176     400.991  License requirements; background screenings;
178     (6)  All forms that constitute part of the application for
179licensure or exemption from licensure under this part must
180contain the following statement:
182Submitting a false, misleading, or fraudulent application or
183other document when applying for licensure as a health care
184clinic, when seeking an exemption from licensure as a health
185care clinic, or when demonstrating compliance with part X of
186chapter 400, Florida Statutes, is a fraudulent insurance act, as
187described in ss. 626.989 and 817.234, Florida Statutes, and as
188such is a basis for investigation by the Division of Insurance
189Fraud and grounds for discipline by the appropriate licensing
190board of the Department of Health.
191     Section 4.  Subsection (4) is added to section 400.9925,
192Florida Statutes, to read:
193     400.9925  Rulemaking authority; license fees.-
194     (4)  The licensing fee for any health care clinic
195authorized to submit claims for payment under a personal injury
196protection insurance policy pursuant to s. 627.736(5)(a)1.c.
197shall be $2,000. Two-thirds of the proceeds from the licensing
198fee shall be used to assist in the operation of the Automobile
199Insurance Fraud Strike Force established under s. 626.9898.
200     Section 5.  Section 626.9898, Florida Statutes, is created
201to read:
202     626.9898  Motor vehicle insurance fraud direct-support
204     (1)  DEFINITIONS.-As used in this section, the term:
205     (a)  "Division" means the Division of Insurance Fraud of
206the Department of Financial Services.
207     (b)  "Motor vehicle insurance fraud" means any act defined
208as a "fraudulent insurance act" under s. 626.989 that relates to
209motor vehicle insurance coverage as described in part XI of
210chapter 627.
211     (c)  "Organization" means the direct-support organization
212established under this section.
213     (2)  ORGANIZATION ESTABLISHED.-The division may establish a
214direct-support organization, to be known as the "Automobile
215Insurance Fraud Strike Force," whose sole purpose is to support
216the prosecution, investigation, and prevention of motor vehicle
217insurance fraud. The organization shall:
218     (a)  Be a not-for-profit corporation incorporated under
219chapter 617 and approved by the Department of State.
220     (b)  Be organized and operated to conduct programs and
221activities; to raise funds; to request and receive grants,
222gifts, and bequests of money; to acquire, receive, hold, invest,
223and administer, in its own name, securities, funds, objects of
224value, or other property, real or personal; and to make grants
225and expenditures to or for the direct or indirect benefit of the
226division, state attorneys' offices, the statewide prosecutor,
227the Agency for Health Care Administration, and the Department of
228Health to the extent that such grants and expenditures are to be
229used exclusively to advance the purpose of prosecuting,
230investigating, or preventing motor vehicle insurance fraud.
231Grants and expenditures may include the cost of salaries or
232benefits of dedicated motor vehicle insurance fraud
233investigators, prosecutors, or support personnel if such grants
234and expenditures do not interfere with prosecutorial
235independence or otherwise create conflicts of interest that
236threaten the success of prosecutions. Funds received under this
237paragraph by a state attorney's office or the statewide
238prosecutor, and staff or prosecutors employed by a state
239attorney's office or the statewide prosecutor with such funds,
240shall be under the exclusive direction and control of that state
241attorney or the statewide prosecutor, as applicable.
242     (c)  Be determined by the division to operate in a manner
243that promotes the goals of laws relating to motor vehicle
244insurance fraud, that is in the best interest of the state, and
245that is in accordance with the adopted goals and mission of the
247     (d)  Use all of its grants and expenditures solely for the
248purpose of preventing and decreasing motor vehicle insurance
249fraud and not for the purpose of lobbying as defined in s.
251     (e)  Be subject to an annual financial audit in accordance
252with s. 215.981.
253     (3)  CONTRACT.-The organization shall operate under written
254contract with the division. The contract must provide for:
255     (a)  Approval of the articles of incorporation and bylaws
256of the organization by the division.
257     (b)  Submission of an annual budget for division approval.
258The budget must require the organization to minimize costs to
259the division and its members at all times by using existing
260personnel and property and allowing for telephonic meetings when
262     (c)  Certification by the division that the organization is
263complying with the terms of the contract and in a manner
264consistent with the goals and purposes of the department and in
265the best interest of the state. Such certification must be made
266annually and reported in the official minutes of a meeting of
267the organization.
268     (d)  Allocation of funds to address motor vehicle insurance
270     (e)  Reversion of moneys and property held in trust by the
271organization for motor vehicle insurance fraud prosecution,
272investigation, and prevention to the division if the
273organization is no longer approved to operate for the department
274or if the organization ceases to exist, or to the state if the
275division ceases to exist.
276     (f)  Specific criteria to be used by the organization's
277board of directors to evaluate the effectiveness of funding used
278to combat motor vehicle insurance fraud.
279     (g)  The fiscal year of the organization, which begins July
2801 of each year and ends June 30 of the following year.
281     (h)  Disclosure of the material provisions of the contract,
282and distinguishing between the department and the organization
283to donors of gifts, contributions, or bequests, including
284providing such disclosure on all promotional and fundraising
286     (4)  BOARD OF DIRECTORS.-The board of directors of the
287organization shall consist of the following nine members:
288     (a)  The Chief Financial Officer, or designee, who shall
289serve as chair.
290     (b)  Two state attorneys, one of whom shall be appointed by
291the Chief Financial Officer and one of whom shall be appointed
292by the Attorney General.
293     (c)  Two representatives of motor vehicle insurers
294appointed by the Chief Financial Officer.
295     (d)  Two representatives of local law enforcement agencies,
296both of whom shall be appointed by the Chief Financial Officer.
297     (e)  Two representatives of health care providers that
298routinely provide services billed under motor vehicle insurance
299policies, one of whom shall be appointed by the President of the
300Florida Medical Association and one of whom shall be appointed
301by the President of the Florida Chiropractic Society.
303The officer who appointed a member of the board may remove that
304member for cause. The term of office of an appointed member
305expires at the same time as the term of the officer who
306appointed him or her or at such earlier time as the person
307ceases to be qualified.
308     (5)  USE OF PROPERTY.-The department may authorize, without
309charge, appropriate use of fixed property and facilities of the
310division by the organization, subject to this subsection.
311     (a)  The department may prescribe any condition with which
312the organization must comply in order to use the division's
313property or facilities.
314     (b)  The department may not authorize the use of the
315division's property or facilities if the organization does not
316provide equal membership and employment opportunities to all
317persons regardless of race, religion, sex, age, or national
319     (c)  The department shall adopt rules prescribing the
320procedures by which the organization is governed and any
321condition with which the organization must comply in order to
322use the division's property or facilities.
323     (6)  CONTRIBUTIONS.-Any contributions made by an insurer to
324the organization shall be allowed as appropriate business
325expenses for all regulatory purposes.
326     (7)  DEPOSITORY.-Any moneys received by the organization
327may be held in a separate depository account in the name of the
328organization and subject to the provisions of the contract with
329the division.
330     (8)  DIVISION'S RECEIPT OF PROCEEDS.-If the division
331receives proceeds from the organization, those proceeds shall be
332deposited into the Insurance Regulatory Trust Fund.
333     Section 6.  Paragraph (a) of subsection (5) and subsections
334(8) and (16) of section 627.736, Florida Statutes, are amended
335to read:
336     627.736  Required personal injury protection benefits;
337exclusions; priority; claims.-
339     (a)1.  A claim for payment under a personal injury
340protection insurance policy may be filed only by:
341     a.  A sole proprietorship, group practice, partnership, or
342corporation that is wholly owned by one or more physicians
343licensed under chapter 458, chapter 459, chapter 460, chapter
344461, or chapter 466;
345     b.  An entity that is owned, directly or indirectly, by an
346entity licensed or registered by the state under chapter 395;
347     c.  An entity owned by a corporation the stock of which is
348publicly traded; or
349     d.  A clinic licensed under part X of chapter 400 that
350provides health care services by health care practitioners as
351defined in s. 456.001(4), the medical director of which is
352licensed under chapter 458 or chapter 459, and that holds
353accreditation by the Joint Commission on Accreditation of
354Healthcare Organizations, the Accreditation Association for
355Ambulatory Health Care, the Accreditation Commission for Health
356Care, the Commission on Accreditation of Rehabilitation
357Facilities, or the National Committee for Quality Assurance.
358     2.1.  Any physician, hospital, clinic, or other person or
359institution lawfully rendering treatment to an injured person
360for a bodily injury covered by personal injury protection
361insurance may charge the insurer and injured party only a
362reasonable amount pursuant to this section for the services and
363supplies rendered, and the insurer providing such coverage may
364pay for such charges directly to such person or institution
365lawfully rendering such treatment, if the insured receiving such
366treatment or his or her guardian has countersigned the properly
367completed invoice, bill, or claim form approved by the office
368upon which such charges are to be paid for as having actually
369been rendered, to the best knowledge of the insured or his or
370her guardian. In no event, however, may such a charge be in
371excess of the amount the person or institution customarily
372charges for like services or supplies. With respect to a
373determination of whether a charge for a particular service,
374treatment, or otherwise is reasonable, consideration may be
375given to evidence of usual and customary charges and payments
376accepted by the provider involved in the dispute, and
377reimbursement levels in the community and various federal and
378state medical fee schedules applicable to automobile and other
379insurance coverages, and other information relevant to the
380reasonableness of the reimbursement for the service, treatment,
381or supply.
382     3.2.  The insurer may limit reimbursement to 80 percent of
383the following schedule of maximum charges:
384     a.  For emergency transport and treatment by providers
385licensed under chapter 401, 200 percent of Medicare.
386     b.  For emergency services and care provided by a hospital
387licensed under chapter 395, 75 percent of the hospital's usual
388and customary charges.
389     c.  For emergency services and care as defined by s.
390395.002(9) provided in a facility licensed under chapter 395
391rendered by a physician or dentist, and related hospital
392inpatient services rendered by a physician or dentist, the usual
393and customary charges in the community.
394     d.  For hospital inpatient services, other than emergency
395services and care, 200 percent of the Medicare Part A
396prospective payment applicable to the specific hospital
397providing the inpatient services.
398     e.  For hospital outpatient services, other than emergency
399services and care, 200 percent of the Medicare Part A Ambulatory
400Payment Classification for the specific hospital providing the
401outpatient services.
402     f.  For all other medical services, supplies, and care, 200
403percent of the allowable amount under the participating
404physicians schedule of Medicare Part B. However, if such
405services, supplies, or care is not reimbursable under Medicare
406Part B, the insurer may limit reimbursement to 80 percent of the
407maximum reimbursable allowance under workers' compensation, as
408determined under s. 440.13 and rules adopted thereunder which
409are in effect at the time such services, supplies, or care is
410provided. Services, supplies, or care that is not reimbursable
411under Medicare or workers' compensation is not required to be
412reimbursed by the insurer.
413     4.3.  For purposes of subparagraph 3. 2., the applicable
414fee schedule or payment limitation under Medicare is the fee
415schedule or payment limitation in effect at the time the
416services, supplies, or care was rendered and for the area in
417which such services were rendered, except that it may not be
418less than the allowable amount under the participating
419physicians schedule of Medicare Part B for 2007 for medical
420services, supplies, and care subject to Medicare Part B.
421     5.4.  Subparagraph 3. 2. does not allow the insurer to
422apply any limitation on the number of treatments or other
423utilization limits that apply under Medicare or workers'
424compensation. An insurer that applies the allowable payment
425limitations of subparagraph 3. 2. must reimburse a provider who
426lawfully provided care or treatment under the scope of his or
427her license, regardless of whether such provider would be
428entitled to reimbursement under Medicare due to restrictions or
429limitations on the types or discipline of health care providers
430who may be reimbursed for particular procedures or procedure
432     6.5.  If an insurer limits payment as authorized by
433subparagraph 3. 2., the person providing such services,
434supplies, or care may not bill or attempt to collect from the
435insured any amount in excess of such limits, except for amounts
436that are not covered by the insured's personal injury protection
437coverage due to the coinsurance amount or maximum policy limits.
440     (a)  With respect to any dispute under the provisions of
441ss. 627.730-627.7405 between the insured and the insurer, or
442between an assignee of an insured's rights and the insurer, the
443provisions of s. 627.428 shall apply, except as provided in
444subsections (10) and (15).
445     (b)  Attorney fees may not be awarded under this subsection
446in regard to representation that was secured by an illegal
448     (c)  Guidelines for determining a reasonable attorney fee
449under this subsection include:
450     1.  The time and labor required; the novelty, complexity,
451and difficulty of the questions involved; and the skill
452requisite to perform the legal service properly.
453     2.  The likelihood that the acceptance of the particular
454employment will preclude other employment by the attorney.
455     3.  The fee, or rate of fee, customarily charged in the
456locality for legal services of a comparable or similar nature.
457     4.  The significance of, or amount involved in, the subject
458matter of the representation; the responsibility involved in the
459representation; and the results obtained.
460     5.  The time limitations imposed by the client or by the
461circumstances and, as between attorney and client, any
462additional or special time demands or requests of the attorney
463by the client.
464     6.  The nature and length of the professional relationship
465with the client.
466     7.  The experience, reputation, diligence, and ability of
467the attorney or attorneys performing the service and the skill,
468expertise, or efficiency reflected in the actual provision of
469such services.
470     8.  Whether the fee is fixed or contingent and, if fixed as
471to amount or rate, whether the client's ability to pay rested
472significantly on the outcome of the representation.
473     (d)  An attorney fee multiplier may only be awarded under
474this subsection if the court makes findings of fact based upon
475competent evidence in the record establishing that:
476     1.  The party requesting the multiplier would have faced
477substantial difficulties finding competent counsel to pursue the
478case in the relevant market but for the consideration of a fee
480     2.  Consideration of a fee multiplier was a necessary
481incentive to obtain competent counsel to pursue the case;
482     3.  The claim would not have been economically feasible if
483brought on a noncontingent, fixed attorney fee basis;
484     4.  The attorney was unable to mitigate the risk of
485nonpayment of attorney fees in any other way; and
486     5.  Use of a multiplier is justified based on factors such
487as the amount of risk undertaken by the attorney at the outset
488of the case, the results obtained, and the type of fee
489arrangement between the attorney and client.
490     (e)  Notwithstanding the limitations in paragraph (d), a
491fee multiplier may be awarded under this subsection in a class
492action case.
493     (16)  SECURE ELECTRONIC DATA TRANSFER.-Any If all parties
494mutually and expressly agree, a notice, documentation,
495transmission, or communication of any kind required or
496authorized under ss. 627.730-627.7405 may be transmitted
497electronically if it is transmitted by secure electronic data
498transfer that is consistent with chapter 668 and state and
499federal privacy and security laws.
500     Section 7.  Subsections (10) and (13) of section 817.234,
501Florida Statutes, are amended, and subsection (12) of that
502section is reenacted, to read:
503     817.234  False and fraudulent insurance claims.-
504     (10)(a)  Any person who owns a business entity eligible for
505reimbursement under s. 627.736(1) and who is found guilty of
506insurance fraud under this section shall lose his or her
507occupational license for such entity for 5 years and may not
508receive reimbursement for personal injury protection benefits
509for 10 years.
510     (b)  Any licensed health care practitioner found guilty of
511insurance fraud under this section shall lose his or her license
512to practice for 5 years and may not receive reimbursement for
513personal injury protection benefits for 10 years. As used in
514this section, the term "insurer" means any insurer, health
515maintenance organization, self-insurer, self-insurance fund, or
516other similar entity or person regulated under chapter 440 or
517chapter 641 or by the Office of Insurance Regulation under the
518Florida Insurance Code.
519     (12)  In addition to any criminal liability, a person
520convicted of violating any provision of this section for the
521purpose of receiving insurance proceeds from a motor vehicle
522insurance contract is subject to a civil penalty.
523     (a)  Except for a violation of subsection (9), the civil
524penalty shall be:
525     1.  A fine up to $5,000 for a first offense.
526     2.  A fine greater than $5,000, but not to exceed $10,000,
527for a second offense.
528     3.  A fine greater than $10,000, but not to exceed $15,000,
529for a third or subsequent offense.
530     (b)  The civil penalty for a violation of subsection (9)
531must be at least $15,000 but may not exceed $50,000.
532     (c)  The civil penalty shall be paid to the Insurance
533Regulatory Trust Fund within the Department of Financial
534Services and used by the department for the investigation and
535prosecution of insurance fraud.
536     (d)  This subsection does not prohibit a state attorney
537from entering into a written agreement in which the person
538charged with the violation does not admit to or deny the charges
539but consents to payment of the civil penalty.
540     (13)  As used in this section, the term:
541     (a)  "Insurer" means any insurer, health maintenance
542organization, self-insurer, self-insurance fund, or similar
543entity or person regulated under chapter 440 or chapter 641 or
544by the Office of Insurance Regulation under the Florida
545Insurance Code.
546     (b)(a)  "Property" means property as defined in s. 812.012.
547     (c)(b)  "Value" means value as defined in s. 812.012.
548     Section 8.  This act shall take effect July 1, 2012.

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