Florida Senate - 2017                                     SB 146
       
       
        
       By Senator Passidomo
       
       28-00214-17                                            2017146__
    1                        A bill to be entitled                      
    2         An act relating to damages recoverable for the cost of
    3         medical or health care services; creating s. 768.755,
    4         F.S.; providing for the calculation of an award of
    5         damages for certain medical or health care services
    6         paid or owed by a claimant or a governmental or
    7         commercial insurance payor; providing that individual
    8         contracts between providers and licensed commercial
    9         insurers or licensed health maintenance organizations
   10         are not subject to discovery or disclosure and are not
   11         admissible into evidence in certain actions; providing
   12         that the amount of a lien or subrogation claim
   13         asserted by Medicaid, Medicare, or a payor regulated
   14         under the Florida Insurance Code for certain past
   15         medical expenses, in addition to the amount of
   16         copayments or deductibles payable by the claimant, is
   17         the maximum amount recoverable and admissible into
   18         evidence under certain circumstances; providing
   19         applicability; providing a directive to the Division
   20         of Law Revision and Information; providing an
   21         effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Section 768.755, Florida Statutes, is created to
   26  read:
   27         768.755 Damages recoverable for cost of medical or health
   28  care services; evidence of amount of damages; applicability.—
   29         (1) In any personal injury or wrongful death action to
   30  which this part applies, damages for the cost of medical or
   31  health care services provided to a claimant shall be calculated
   32  as follows:
   33         (a) For medical or health care services provided by a
   34  health care provider to the claimant which the claimant paid for
   35  and for which an outstanding balance is not due the provider,
   36  the actual amount remitted to the provider is the maximum amount
   37  recoverable. Any difference between the amount originally billed
   38  by the provider and the actual amount remitted to the provider
   39  is not recoverable or admissible into evidence.
   40         (b) For medical or health care services provided by a
   41  health care provider to the claimant which a governmental or
   42  commercial insurance payor paid for and for which an outstanding
   43  balance is not due the provider, other than a copay or
   44  deductible owed by the claimant, the sum of the actual amount
   45  remitted to the provider by the governmental or commercial
   46  insurance payor and any copay or deductible owed by the claimant
   47  is the maximum amount recoverable. Any difference between the
   48  amount originally billed by the provider and the actual amount
   49  remitted to the provider or due from the claimant for a copay or
   50  deductible is not recoverable or admissible into evidence.
   51         (c) For medical or health care services provided to the
   52  claimant for which an outstanding balance is claimed to be due
   53  the provider and for claims asserted for medical or health care
   54  services to be provided to the claimant in the future, the
   55  maximum amounts recoverable are the amounts customarily accepted
   56  from Medicaid in payment for such services by other providers in
   57  the same geographic area. This limitation also applies to any
   58  lien asserted in the action for such services, with the
   59  exception of liens identified in subsection (3).
   60         (2) Individual contracts between providers and licensed
   61  commercial insurers or licensed health maintenance organizations
   62  are not subject to discovery or disclosure in an action under
   63  this part, and such information is not admissible into evidence
   64  in an action to which this section applies.
   65         (3) Notwithstanding this section, if Medicaid, Medicare, or
   66  a payor regulated under the Florida Insurance Code has covered
   67  or is covering the cost of a claimant’s medical or health care
   68  services and has given notice of assertion of a lien or
   69  subrogation claim for past medical expenses in the action, the
   70  amount of the lien or subrogation claim, in addition to the
   71  amount of any copayment or deductible paid or payable by the
   72  claimant, is the maximum amount recoverable and admissible into
   73  evidence with respect to the covered medical or health care
   74  services.
   75         (4) This section applies only to those actions for personal
   76  injury or wrongful death to which this part applies arising on
   77  or after the effective date of this act. This section has no
   78  other application or effect regarding compensation paid to
   79  providers of medical or health care services.
   80         Section 2. The Division of Law Revision and Information is
   81  directed to replace the phrase “the effective date of this act”
   82  wherever it occurs in this act with the date the act becomes a
   83  law.
   84         Section 3. This act shall take effect upon becoming a law.