Bill Summary – FastDemocracy

       Florida Senate - 2024                                    SB 1502
       
       
        
       By Senator Collins
       
       
       
       
       
       14-01460-24                                           20241502__
                      A bill to be entitled                      
       An act relating to health care expenses; amending s.
       95.11, F.S.; establishing a 3-year statute of
       limitations for an action to collect medical debt for
       services rendered by a health care provider or
       facility; creating s. 222.26, F.S.; providing
       additional personal property exemptions from legal
       process for medical debts resulting from services
       provided in certain licensed facilities; amending s.
       395.301, F.S.; requiring a licensed facility to post
       on its website a consumer-friendly list of standard
       charges for a minimum number of shoppable health care
       services; defining terms; requiring a licensed
       facility to provide an estimate to a patient or
       prospective patient and the patient’s health insurer
       within specified timeframes; requiring a licensed
       facility to establish an internal grievance process
       for patients to dispute charges; requiring a facility
       to make available information necessary for initiating
       a grievance; requiring a facility to respond to a
       patient grievance within a specified timeframe;
       creating s. 395.3011, F.S.; prohibiting certain
       collection activities by a licensed facility; creating
       s. 627.446, F.S.; defining the term “health insurer”;
       requiring each health insurer to provide an insured
       with an advanced explanation of benefits after
       receiving a patient estimate from a facility for
       scheduled services; providing requirements for the
       advanced explanation of benefits; amending ss.
       627.6387, 627.6648, and 641.31076, F.S.; providing
       that a shared savings incentive offered by a health
       insurer or health maintenance organization constitutes
       a medical expense for rate development and rate filing
       purposes; amending ss. 475.01, 475.611, 517.191,
       768.28, and 787.061, F.S.; conforming cross
       references; providing an effective date.
        
Be It Enacted by the Legislature of the State of Florida:

       Section 1. Present subsections (4) through (12) of section
95.11, Florida Statutes, are redesignated as subsections (5)
through (13), respectively, a new subsection (4) is added to
that section, and paragraph (b) of subsection (2), paragraph (n)
of subsection (3), paragraphs (f) and (g) of present subsection
(5), and present subsection (10) of that section are amended, to
read:
       95.11 Limitations other than for the recovery of real
property.—Actions other than for recovery of real property shall
be commenced as follows:
       (2) WITHIN FIVE YEARS.—
       (b) A legal or equitable action on a contract, obligation,
or liability founded on a written instrument, except for an
action to enforce a claim against a payment bond, which shall be
governed by the applicable provisions of paragraph (6)(e)
(5)(e), s. 255.05(10), s. 337.18(1), or s. 713.23(1)(e), and
except for an action for a deficiency judgment governed by
paragraph (6)(h) (5)(h).
       (3) WITHIN FOUR YEARS.—
       (n) An action for assault, battery, false arrest, malicious
prosecution, malicious interference, false imprisonment, or any
other intentional tort, except as provided in subsections (4),
(5), (6), and (8) (7).
       (4) WITHIN THREE YEARS.—An action to collect medical debt
for services rendered by a facility licensed under chapter 395,
provided that the period of limitations shall run from the date
on which the facility refers the medical debt to a third party
for collection.
       (6)(5) WITHIN ONE YEAR.—
       (f) Except for actions described in subsection (9) (8), a
petition for extraordinary writ, other than a petition
challenging a criminal conviction, filed by or on behalf of a
prisoner as defined in s. 57.085.
       (g) Except for actions described in subsection (9) (8), an
action brought by or on behalf of a prisoner, as defined in s.
57.085, relating to the conditions of the prisoner’s
confinement.
       (11)(10) FOR INTENTIONAL TORTS RESULTING IN DEATH FROM ACTS
DESCRIBED IN S. 782.04 OR S. 782.07.—Notwithstanding paragraph
(5)(e) (4)(e), an action for wrongful death seeking damages
authorized under s. 768.21 brought against a natural person for
an intentional tort resulting in death from acts described in s.
782.04 or s. 782.07 may be commenced at any time. This
subsection shall not be construed to require an arrest, the
filing of formal criminal charges, or a conviction for a
violation of s. 782.04 or s. 782.07 as a condition for filing a
civil action.
       Section 2. Section 222.26, Florida Statutes, is created to
read:
       222.26 Additional exemptions from legal process concerning
medical debt.—If a debt is owed for medical services provided by
a facility licensed under chapter 395, the following property is
exempt from attachment, garnishment, or other legal process in
an action on such debt:
       (1) A debtor’s interest, not to exceed $10,000 in value, in
a single motor vehicle as defined in s. 320.01(1).
       (2) A debtor’s interest in personal property, not to exceed
$10,000 in value, if the debtor does not claim or receive the
benefits of a homestead exemption under s. 4, Art. X of the
State Constitution.
       Section 3. Present paragraphs (b), (c), and (d) of
subsection (1) of section 395.301, Florida Statutes, are
redesignated as paragraphs (c), (d), and (e), respectively,
present subsection (6) is redesignated as subsection (7), a new
paragraph (b) is added to subsection (1), a new subsection (6)
is added to that section, and present paragraph (b) of
subsection (1) is amended, to read:
       395.301 Price transparency; itemized patient statement or
bill; patient admission status notification.—
       (1) A facility licensed under this chapter shall provide
timely and accurate financial information and quality of service
measures to patients and prospective patients of the facility,
or to patients’ survivors or legal guardians, as appropriate.
Such information shall be provided in accordance with this
section and rules adopted by the agency pursuant to this chapter
and s. 408.05. Licensed facilities operating exclusively as
state facilities are exempt from this subsection.
       (b) Each licensed facility shall post on its website a
consumer-friendly list of standard charges for at least 300
shoppable health care services. If a facility provides fewer
than 300 distinct shoppable health care services, it shall make
available on its website the standard charges for each service
it provides. As used in this paragraph, the term:
       1. “Shoppable health care service” means a service that can
be scheduled by a healthcare consumer in advance. The term
includes, but is not limited to, the services described in s.
627.6387(2)(e) and any services defined in regulations or
guidance issued by the United States Department of Health and
Human Services.
       2. “Standard charge” has the same meaning as that term is
defined in regulations or guidance issued by the United States
Department of Health and Human Services for purposes of hospital
price transparency.
       (c)1.(b)1. Upon request, and Before providing any
nonemergency medical services, each licensed facility shall
provide in writing or by electronic means a good faith estimate
of reasonably anticipated charges by the facility for the
treatment of a the patient’s or prospective patient’s specific
condition. Such estimate must be provided to the patient or
prospective patient upon scheduling a medical service. The
facility must provide the estimate to the patient or prospective
patient within 7 business days after the receipt of the request
and is not required to adjust the estimate for any potential
insurance coverage. The facility must provide the estimate to
the patient’s health insurer, as defined in s. 627.446(1), and
the patient at least 3 business days before a service is to be
furnished, but no later than 1 business day after the service is
scheduled or, in the case of a service scheduled at least 10
business days in advance, no later than 3 business days after
the service is scheduled. The estimate may be based on the
descriptive service bundles developed by the agency under s.
408.05(3)(c) unless the patient or prospective patient requests
a more personalized and specific estimate that accounts for the
specific condition and characteristics of the patient or
prospective patient. The facility shall inform the patient or
prospective patient that he or she may contact his or her health
insurer or health maintenance organization for additional
information concerning cost-sharing responsibilities.
       2. In the estimate, the facility shall provide to the
patient or prospective patient information on the facility’s
financial assistance policy, including the application process,
payment plans, and discounts and the facility’s charity care
policy and collection procedures.
       3. The estimate shall clearly identify any facility fees
and, if applicable, include a statement notifying the patient or
prospective patient that a facility fee is included in the
estimate, the purpose of the fee, and that the patient may pay
less for the procedure or service at another facility or in
another health care setting.
       4. Upon request, The facility shall notify the patient or
prospective patient of any revision to the estimate.
       5. In the estimate, the facility must notify the patient or
prospective patient that services may be provided in the health
care facility by the facility as well as by other health care
providers that may separately bill the patient, if applicable.
       6. The facility shall take action to educate the public
that such estimates are available upon request.
       7. Failure to timely provide the estimate pursuant to this
paragraph shall result in a daily fine of $1,000 until the
estimate is provided to the patient or prospective patient and
the health insurer. The total fine per patient estimate may not
exceed $10,000.

The provision of an estimate does not preclude the actual
charges from exceeding the estimate.
       (6) Each facility shall establish an internal process for
reviewing and responding to grievances from patients. Such
process must allow patients to dispute charges that appear on
the patient’s itemized statement or bill. The facility shall
prominently post on its website and indicate in bold print on
each itemized statement or bill the instructions for initiating
a grievance and the direct contact information required to
initiate the grievance process. The facility must provide an
initial response to a patient grievance within 7 business days
after the patient formally files a grievance disputing all or a
portion of an itemized statement or bill.
       Section 4. Section 395.3011, Florida Statutes, is created
to read:
       395.3011 Billing and collection activities.—
       (1) As used in this section, the term “extraordinary
collection action” means any of the following actions taken by a
licensed facility against an individual in relation to obtaining
payment of a bill for care covered under the facility’s
financial assistance policy:
       (a) Selling the individual’s debt to another party.
       (b) Reporting adverse information about the individual to
consumer credit reporting agencies or credit bureaus.
       (c) Deferring, denying, or requiring a payment before
providing medically necessary care because of the individual’s
nonpayment of one or more bills for previously provided care
covered under the facility’s financial assistance policy.
       (d) Actions that require a legal or judicial process,
including, but not limited to:
       1. Placing a lien on the individual’s property;
       2. Foreclosing on the individual’s real property;
       3. Attaching or seizing the individual’s bank account or
any other personal property;
       4. Commencing a civil action against the individual;
       5. Causing the individual’s arrest; or
       6. Garnishing the individual’s wages.
       (2) A facility may not engage in an extraordinary
collection action against an individual to obtain payment for
services:
       (a) Before the facility has made reasonable efforts to
determine whether the individual is eligible for assistance
under its financial assistance policy for the care provided and,
if eligible, before a decision is made by the facility on the
patient’s application for such financial assistance.
       (b) Before the facility has provided the individual with an
itemized statement or bill.
       (c) During an ongoing grievance process as described in s.
395.301(6) or an ongoing appeal of a claim adjudication.
       (d) Before billing any applicable insurer and allowing the
insurer to adjudicate a claim.
       (e) For 30 days after notifying the patient in writing, by
certified mail, or by other traceable delivery method, that a
collection action will commence absent additional action by the
patient.
       (f) While the individual:
       1. Negotiates in good faith the final amount of a bill for
services rendered; or
       2. Complies with all terms of a payment plan with the
facility.
       Section 5. Section 627.446, Florida Statutes, is created to
read:
       627.446 Advanced explanation of benefits.—
       (1) As used in this section, the term “health insurer”
means a health insurer issuing individual or group coverage or a
health maintenance organization issuing coverage through an
individual or a group contract.
       (2) Each health insurer shall prepare an advanced
explanation of benefits upon receiving a patient estimate from a
facility pursuant to s. 395.301(1). The health insurer must
provide the advanced explanation of benefits to the insured no
later than 1 business day after receiving the patient estimate
from the facility or, in the case of a service scheduled at
least 10 business days in advance, no later than 3 business days
after receiving such estimate.
       (3) At a minimum, the advanced explanation of benefits must
include detailed coverage and cost-sharing information pursuant
to the No Surprises Act, Title I of Division BB, Pub. L. No.
116-260.
       Section 6. Paragraph (a) of subsection (4) of section
627.6387, Florida Statutes, is amended to read:
       627.6387 Shared savings incentive program.—
       (4)(a) A shared savings incentive offered by a health
insurer in accordance with this section:
       1. Is not an administrative expense for rate development or
rate filing purposes and shall be counted as a medical expense
for such purposes.
       2. Does not constitute an unfair method of competition or
an unfair or deceptive act or practice under s. 626.9541 and is
presumed to be appropriate unless credible data clearly
demonstrates otherwise.
       Section 7. Paragraph (a) of subsection (4) of section
627.6648, Florida Statutes, is amended to read:
       627.6648 Shared savings incentive program.—
       (4)(a) A shared savings incentive offered by a health
insurer in accordance with this section:
       1. Is not an administrative expense for rate development or
rate filing purposes and shall be counted as a medical expense
for such purposes.
       2. Does not constitute an unfair method of competition or
an unfair or deceptive act or practice under s. 626.9541 and is
presumed to be appropriate unless credible data clearly
demonstrates otherwise.
       Section 8. Paragraph (a) of subsection (4) of section
641.31076, Florida Statutes, is amended to read:
       641.31076 Shared savings incentive program.—
       (4) A shared savings incentive offered by a health
maintenance organization in accordance with this section:
       (a) Is not an administrative expense for rate development
or rate filing purposes and