Florida House of Representatives Insurance and Banking Subcommittee to Consider Proposed Committee Substitute for HB 119 Relating to Motor Vehicle Personal Injury Protection Insurance

 

At its November 16, 2011 meeting, the Florida House of Representatives Insurance and Banking Subcommittee is scheduled to consider a draft proposed committee substitute (“PCS”) for HB 119, entitled, “Motor Vehicle Personal Injury Protection Insurance.”  A copy of the draft PCS is attached in PDF format.

A Colodny Fass representative will attend the meeting and provide a report. 

A summary of the PCS is provided below.

 

Should you have any comments or questions, please contact Colodny Fass.

 

Summary of Draft Proposed Committee Substitute for HB 119

Section 1.  Names the bill the “Comprehensive Motor Vehicle Accountability Act.”

Section 2.  Amends s. 316.066, F.S., to require that law enforcement officers complete and submit a detailed crash report in the event of a motor vehicle crash; allows the investigating law enforcement officer to testify at trial or provide an affidavit to confirm or supplement information in the crash report.

Section 3.  Amends s. 400.9905, F.S., to require, beginning January 1, 2013, licensure of any clinic that derives more than 30 percent of its gross annual income from Personal Injury Protection (“PIP”) benefits.

Section 4.  Makes the following changes to s. 627.736, F.S.:

• Limits reimbursement for chiropractors and massage therapists to 24 treatments or services rendered within 12 weeks of the date of the first chiropractic or massage therapy treatment, whichever is first.
• Specifies that medical benefits under PIP are only reimbursable when provided, supervised, ordered, or prescribed by a physician, dentist, or chiropractor.
• Specifies that PIP benefits are not due when the insured, claimant, medical provider, or attorney has submitted false or misleading statements, documents, records, bills, or information or has attempted or attempted to commit insurance fraud as defined in s. 626.989, F.S.
• Limits the charges for durable medical equipment, care, and services provided by a clinical laboratory to 200 percent of Medicare Part B.
• Limits the charges for care and services provided by an ambulatory surgical center to 80 percent of the workers’ compensation fee schedule.
• Clarifies that the applicable fee schedule is the Medicare fee schedule that was in effect on January 1 of the year that the care was rendered.
• Provides that refusal or failure to appear for two independent medical exams raises a rebuttable presumption that the refusal or failure was unreasonable.
• Limits attorney fees in the following manner:
  • For disputed amounts under $500, the attorney fees may not exceed 15 times the disputed amount up to $5,000.
  • For disputed amounts between $500 and $5,000, the attorney fees may not exceed 10 times the disputed amount up to $10,000.
  • For disputed amounts between $5,000 and $10,000, the attorney fee may not exceed five times the disputed amount up to $15,000.
  • Fees incurred in litigating or quantifying the amount of the attorney fees are not recoverable.
  • Prohibits the use of a contingency risk multiplier.
  • Limits attorney fees in a class action to $5,000 or three times the total of the disputed amount recovered, whichever is less.
• Clarifies that insurers may enter into preferred provider contracts to provide PIP benefits; allows insurers to offer a discount to insureds who select the preferred provider option.

Section 5.  Amends s. 627.7407, F.S., to provide for repeal of the Florida Motor Vehicle No-Fault Law (ss. 627.730-627.7405, F.S.) effective July 1, 2015, unless reenacted by the Legislature.

Section 6.  Requires the Florida Office of Insurance Regulation to perform a PIP data call to be published 24 months after the effective date.  Requires the data call to include the number of PIP claims filed; the number of independent medical exams requested and completed; the number of examinations under oath requested and completed; and the number of denied claims.

Section 7.  Requires PIP insurers to decrease rates through a “use and file” filing or make a full annual base rate filing within 18 months of the effective date of this act.

Section 8.  Provides a severability clause.

Section 9.  Provides an effective date of July 1, 2012.

 

 

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