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.