HB 1317 Summary

• Creates statewide fee schedules for hospitals and ambulatory surgical centers effective July 1, 2020, setting reimbursement rates at 200% of applicable Medicare rates for emergency services, inpatient/outpatient services, and most supplies, with medication at 150% of average wholesale price.

• Establishes standards of care requiring licensed medical professionals to document diagnostic test results and clinical rationale, maintain treatment plans not exceeding 6 weeks initially and 8 weeks for updates, and interact with patients at minimum every 2 weeks or every fourth visit.

• Adds violation of the new fee schedule and standards of care provisions as grounds for professional discipline under Florida health professions law.

• Modifies personal injury protection insurance requirements by reducing the time frame for receiving initial services from 30 to 14 days after accident, excluding massage and acupuncture from coverage, and adding restrictions on reimbursement for services without proper treatment plans or documentation.

• Authorizes insurers to deny claims for services that are upcoded, unbundled improperly, lack required treatment plans, or fail to meet documented standards of care; requires Department of Health to establish a list of medically unnecessary diagnostic tests.