Florida Senate - 2019                                      SB 80
       
       
        
       By Senator Stargel
       
       
       
       
       
       22-00375-19                                             201980__
    1                        A bill to be entitled                      
    2         An act relating to medical malpractice; creating s.
    3         766.1181, F.S.; specifying how to calculate damages in
    4         certain personal injury or wrongful death actions;
    5         prohibiting admission of specified information
    6         relating to costs of medical or health care as
    7         evidence in such actions; providing applicability;
    8         providing a directive to the Division of Law Revision;
    9         providing an effective date.
   10          
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Section 766.1181, Florida Statutes, is created
   14  to read:
   15         766.1181 Damages recoverable for cost of medical or health
   16  care services; evidence of damages; applicability.—
   17         (1) In any personal injury or wrongful death action to
   18  which this chapter applies, damages for the cost of medical or
   19  health care services provided to a claimant are calculated as
   20  follows:
   21         (a) For medical or health care services provided by a
   22  health care provider to a claimant which the claimant paid for
   23  and for which an outstanding balance is not due to the provider,
   24  the actual amount remitted to the provider is the maximum amount
   25  recoverable. Any difference between the amount originally billed
   26  by the provider and the actual amount remitted to the provider
   27  is not recoverable or admissible in evidence.
   28         (b) For medical or health care services provided by a
   29  health care provider to a claimant which a government program or
   30  private health insurance paid for and for which an outstanding
   31  balance is not due to the provider, other than a copayment or
   32  deductible owed by the claimant, the actual amount remitted to
   33  the provider by the government program or private health
   34  insurance, plus any copayment or deductible owed by the
   35  claimant, is the maximum amount recoverable. Any difference
   36  between the amount originally billed by the provider and the sum
   37  of the actual amount remitted to the provider and the copayment
   38  or deductible owed by the claimant is not recoverable or
   39  admissible in evidence.
   40         (c) For medical or health care services provided to a
   41  claimant for which an outstanding balance is claimed to be due
   42  to the health care provider and for claims asserted for medical
   43  or health care services to be provided to the claimant in the
   44  future, the maximum amounts recoverable are the amounts
   45  customarily accepted from Medicare in payment for such services
   46  by other health care providers in the same geographic area. This
   47  limitation also applies to any lien asserted for such services
   48  in the action, with the exception of liens identified in
   49  subsection (3).
   50         (2) An individual contract between a health care provider
   51  and a health insurer or health maintenance organization is not
   52  subject to discovery or disclosure in an action under this
   53  section, and such information is not admissible in evidence in
   54  an action to which this section applies.
   55         (3) Notwithstanding this section, if Medicaid, Medicare, or
   56  a payor regulated under the Florida Insurance Code has covered
   57  or is covering the cost of a claimant’s medical or health care
   58  services and has given notice of assertion of a lien or
   59  subrogation claim for past medical expenses in the action, the
   60  amount of the lien or subrogation claim, in addition to the
   61  amount of a copayment or deductible paid or payable by the
   62  claimant, is the maximum amount recoverable and admissible in
   63  evidence with respect to the covered medical or health care
   64  services.
   65         (4) This section applies only to personal injury or
   66  wrongful death actions to which this chapter applies which arise
   67  on or after the effective date of this act. This section has no
   68  other application or effect regarding compensation paid to
   69  providers of medical or health care services.
   70         Section 2. The Division of Law Revision is directed to
   71  replace the phrase “the effective date of this act” whenever it
   72  occurs in this act with the date the act becomes a law.
   73         Section 3. This act shall take effect upon becoming a law.