FL S1790

Requires Department of Health to establish statewide fee schedules effective July 1, 2020, for hospital and ambulatory surgical center services based on 200 percent of Medicare rates (150 percent for medications).

Creates standards of care requiring licensed medical professionals to document clinical rationale for diagnostic tests, maintain treatment plans updated every 6-8 weeks, and demonstrate patient interaction at minimum every 2 weeks or every fourth visit.

Establishes disciplinary grounds for violations of new fee schedule and standards of care provisions, with enforcement by Department of Health and professional licensing boards.

Amends personal injury protection insurance to extend initial care window from 14 to 30 days, require treatment plan submission within 30 days for no-fault claims exceeding three patient interactions, and limit reimbursement for services without proper treatment plan documentation.

Allows insurers to deny payment for services that are upcoded, unbundled improperly, lack treatment plans, involve excessive treatment without updated plans, or fail to meet reasonableness and necessity standards.