HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 1 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to health care expenses; amending s. 2
95.11, F.S.; establishing a 3 -year statute of 3
limitations for an action to collect medical debt for 4
services rendered by a health care provider or 5
facility; creating s. 222.26, F.S.; providing 6
additional personal property exemptions from legal 7
process for medical debts resulting from services 8
provided in certain licensed facilities; amending s. 9
395.301, F.S.; requiring a licensed facility to post 10
on its website a consumer -friendly list of standard 11
charges for a minimum number of shoppable health care 12
services or a price estimator tool meeting certain 13
requirements; providing definitions; requiring a 14
licensed facility to provide an estimate to a patient 15
or prospective patient and the patient's health 16
insurer within specified timeframes; requiring a 17
licensed facility to establish an internal grievance 18
process for patients to dispute charges; requiring a 19
facility to make available information necessary for 20
initiating a grievance; requiring a facility to 21
respond to a patient grievance within a specified 22
timeframe; requiring a licensed facility to disclose 23
specified information relating to cost -sharing 24
obligations to certain persons; providing a penalty; 25
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 2 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
creating s. 395.3011, F.S.; defining the term 26
"extraordinary collection action"; prohibiting certain 27
collection activities by a licensed facility; amending 28
s. 624.27, F.S.; revising the definitions of "health 29
care provider"; creating s. 627.446, F.S.; defining 30
the term "health insurer"; requiring each health 31
insurer to provide an insured with an advanced 32
explanation of benefits after receiving a patient 33
estimate from a facility for scheduled services; 34
providing requirements for the advanced explanation of 35
benefits; amending s. 627.6387, F.S.; revising a 36
definition; providing that a shared savings incentive 37
constitutes a medical expense for rate development and 38
rate filing purposes; amending ss. 627.6648 and 39
641.31076, F.S.; providing that a shared savings 40
incentive offered by a health insurer or health 41
maintenance organization constitutes a medical expense 42
for rate development and rate filing purposes; 43
amending ss. 475.01, 475.611, 517.191, 768.28, and 44
787.061 F.S.; conforming provisions to changes made by 45
the act; providing applicability; providing an 46
effective date. 47
48
Be It Enacted by the Legislature of the State of Florida: 49
50
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 3 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
Section 1. Subsections (4) through (12) of section 95.11, 51
Florida Statutes, are renumbered as subsections (5) through 52
(13), respectively, paragraph (b) of subsection (2), paragraph 53
(n) of subsection (3), paragraphs (f) and (g) of present 54
subsection (5), and present subsection (10) are amended, and a 55
new subsection (4) is added to that section, to read: 56
95.11 Limitations other than for the recovery of real 57
property.—Actions other than for recovery of real property shall 58
be commenced as follows: 59
(2) WITHIN FIVE YEARS. — 60
(b) A legal or equitable action on a contract, obligation, 61
or liability founded on a written instrument, except for an 62
action to enforce a claim against a payment bond, w hich shall be 63
governed by the applicable provisions of paragraph (6)(e) 64
paragraph (5)(e), s. 255.05(10), s. 337.18(1), or s. 65
713.23(1)(e), and except for an action for a deficiency judgment 66
governed by paragraph (6)(h) paragraph (5)(h). 67
(3) WITHIN FOUR YEARS.— 68
(n) An action for assault, battery, false arrest, 69
malicious prosecution, malicious interference, false 70
imprisonment, or any other intentional tort, except as provided 71
in subsections (5), (6), and (8) subsections (4), (5), and (7) . 72
(4) WITHIN THREE YEARS.—An action to collect medical debt 73
for services rendered by a facility licensed under chapter 395, 74
provided that the period of limitations shall run from the date 75
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 4 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
on which the facility refers the medical debt to a third party 76
for collection. 77
(6)(5) WITHIN ONE YEAR.— 78
(f) Except for actions described in subsection (9) (8), a 79
petition for extraordinary writ, other than a petition 80
challenging a criminal conviction, filed by or on behalf of a 81
prisoner as defined in s. 57.085. 82
(g) Except for action s described in subsection (9) (8), an 83
action brought by or on behalf of a prisoner, as defined in s. 84
57.085, relating to the conditions of the prisoner's 85
confinement. 86
(11)(10) FOR INTENTIONAL TORTS RESULTING IN DEATH FROM 87
ACTS DESCRIBED IN S. 782.04 OR S . 782.07.—Notwithstanding 88
paragraph (5)(e) paragraph (4)(e), an action for wrongful death 89
seeking damages authorized under s. 768.21 brought against a 90
natural person for an intentional tort resulting in death from 91
acts described in s. 782.04 or s. 782.07 m ay be commenced at any 92
time. This subsection shall not be construed to require an 93
arrest, the filing of formal criminal charges, or a conviction 94
for a violation of s. 782.04 or s. 782.07 as a condition for 95
filing a civil action. 96
Section 2. Section 222. 26, Florida Statutes, is created to 97
read: 98
222.26 Additional exemptions from legal process concerning 99
medical debt.—If a debt is owed for medical services provided by 100
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 5 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
a facility licensed under chapter 395, the following property is 101
exempt from attachment, garnishment, or other legal process in 102
an action on such debt: 103
(1) A debtor's interest, not to exceed $10,000 in value, 104
in a single motor vehicle as defined in s. 320.01(1). 105
(2) A debtor's interest in personal property, not to 106
exceed $10,000 in value, if the debtor does not claim or receive 107
the benefits of a homestead exemption under s. 4, Art. X of the 108
State Constitution. 109
Section 3. Paragraphs (b), (c), and (d) of subsection (1) 110
of section 395.301, Florida Statutes, are redesignated as 111
paragraphs (c), (d), and (e), respectively, subsection (6) is 112
renumbered as subsection (8), present paragraph (b) of 113
subsection (1) is amended, a new paragraph (b) is added to 114
subsection (1), and new subsections (6) and (7) are added to 115
that section, to read: 116
395.301 Price transparency; itemized patient statement or 117
bill; patient admission status notification. — 118
(1) A facility licensed under this chapter shall provide 119
timely and accurate financial information and quality of service 120
measures to patients and prospec tive patients of the facility, 121
or to patients' survivors or legal guardians, as appropriate. 122
Such information shall be provided in accordance with this 123
section and rules adopted by the agency pursuant to this chapter 124
and s. 408.05. Licensed facilities oper ating exclusively as 125
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 6 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
state facilities are exempt from this subsection. 126
(b) Each licensed facility shall post on its website a 127
consumer-friendly list of standard charges for at least 300 128
shoppable health care services, or an Internet -based price 129
estimator tool meeting federal standards. If a facility provides 130
fewer than 300 distinct shoppable health care services, it shall 131
make available on its website the standard charges for each 132
service it provides. As used in this paragraph, the term: 133
1. "Shoppable health care service" means a service that 134
can be scheduled by a healthcare consumer in advance. The term 135
includes, but is not limited to, the services described in s. 136
627.6387(2)(e) and any services defined in regulations or 137
guidance issued by the United St ates Department of Health and 138
Human Services. 139
2. "Standard charge" has the same meaning as that term is 140
defined in regulations or guidance issued by the United States 141
Department of Health and Human Services for purposes of hospital 142
price transparency. 143
(c)(b)1. Upon request, and Before providing any 144
nonemergency medical services, each licensed facility shall 145
provide in writing or by electronic means a good faith estimate 146
of reasonably anticipated charges by the facility for the 147
treatment of a the patient's or prospective patient's specific 148
condition. Such estimate must be provided to the patient or 149
prospective patient upon scheduling a medical service. The 150
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 7 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
facility must provide the estimate to the patient or prospective 151
patient within 7 business days afte r the receipt of the request 152
and is not required to adjust the estimate for any potential 153
insurance coverage. The facility must provide the estimate to 154
the patient's health insurer, as defined in s. 627.446(1), and 155
the patient at least 3 business days befo re a service is to be 156
provided, but no later than 1 business day after the service is 157
scheduled or, in the case of a service scheduled at least 10 158
business days in advance, no later than 3 business days after 159
the service is scheduled. The estimate may be b ased on the 160
descriptive service bundles developed by the agency under s. 161
408.05(3)(c) unless the patient or prospective patient requests 162
a more personalized and specific estimate that accounts for the 163
specific condition and characteristics of the patient o r 164
prospective patient. The facility shall inform the patient or 165
prospective patient that he or she may contact his or her health 166
insurer or health maintenance organization for additional 167
information concerning cost -sharing responsibilities. 168
2. In the estimate, the facility shall provide to the 169
patient or prospective patient information on the facility's 170
financial assistance policy, including the application process, 171
payment plans, and discounts and the facility's charity care 172
policy and collection procedu res. 173
3. The estimate shall clearly identify any facility fees 174
and, if applicable, include a statement notifying the patient or 175
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 8 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
prospective patient that a facility fee is included in the 176
estimate, the purpose of the fee, and that the patient may pay 177
less for the procedure or service at another facility or in 178
another health care setting. 179
4. Upon request, The facility shall notify the patient or 180
prospective patient of any revision to the estimate. 181
5. In the estimate, the facility must notify the patient 182
or prospective patient that services may be provided in the 183
health care facility by the facility as well as by other health 184
care providers that may separately bill the patient, if 185
applicable. 186
6. The facility shall take action to educate the public 187
that such estimates are available upon request. 188
6.7. Failure to timely provide the estimate pursuant to 189
this paragraph shall result in a daily fine of $1,000 until the 190
estimate is provided to the patient or prospective patient and 191
the health insurer. The total fine per patient estimate may not 192
exceed $10,000. 193
194
The provision of an estimate does not preclude the actual 195
charges from exceeding the estimate. 196
(6) Each facility shall establish an internal process for 197
reviewing and responding to grievances from patients. Such 198
process must allow a patient to dispute charges that appear on 199
the patient's itemized statement or bill. The facility shall 200
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 9 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
prominently post on its website and indicate in bold print on 201
each itemized statement or bill the instructions for initiating 202
a grievance and the direct contact information required to 203
initiate the grievance process. The facility must provide an 204
initial response to a patient grievance within 7 business days 205
after the patient formally files a grievance disputing all or a 206
portion of an itemized statement or bill. 207
(7) Each licensed facility shall disclose to a patient, a 208
prospective patient, or a patient's legal guardian whether a 209
cost-sharing obligation for a particular covered health care 210
service or item exceeds th e charge that applies to an individual 211
who pays cash or the cash equivalent for the same health care 212
service or item in the absence of health insurance coverage. 213
Failure to provide a disclosure in compliance with this 214
subsection may result in a fine not to exceed $500 per incident. 215
Section 4. Section 395.3011, Florida Statutes, is created 216
to read: 217
395.3011 Billing and collection activities. — 218
(1) As used in this section, the term "extraordinary 219
collection action" means any of the following actions ta ken by a 220
licensed facility against an individual in relation to obtaining 221
payment of a bill for care covered under the facility's 222
financial assistance policy: 223
(a) Selling the individual's debt to another party. 224
(b) Reporting adverse information about t he individual to 225
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 10 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
consumer credit reporting agencies or credit bureaus. 226
(c) Deferring, denying, or requiring a payment before 227
providing medically necessary care because of the individual's 228
nonpayment of one or more bills for previously provided care 229
covered under the facility's financial assistance policy. 230
(d) Actions that require a legal or judicial process, 231
including, but not limited to: 232
1. Placing a lien on the individual's property; 233
2. Foreclosing on the individual's real property; 234
3. Attaching or seizing the individual's bank account or 235
any other personal property; 236
4. Commencing a civil action against the individual; 237
5. Causing the individual's arrest; or 238
6. Garnishing the individual's wages. 239
(2) A facility may not engage in an extraord inary 240
collection action against an individual to obtain payment for 241
services: 242
(a) Before the facility has made reasonable efforts to 243
determine whether the individual is eligible for assistance 244
under its financial assistance policy for the care provided a nd, 245
if eligible, before a decision is made by the facility on the 246
patient's application for such financial assistance. 247
(b) Before the facility has provided the individual with 248
an itemized statement or bill. 249
(c) During an ongoing grievance process as de scribed in s. 250
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 11 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
395.301(6) or an ongoing appeal of a claim adjudication. 251
(d) Before billing any applicable insurer and allowing the 252
insurer to adjudicate a claim. 253
(e) For 30 days after notifying the patient in writing, by 254
certified mail, or by other trac eable delivery method, that a 255
collection action will commence absent additional action by the 256
patient. 257
(f) While the individual: 258
1. Negotiates in good faith the final amount of a bill for 259
services rendered; or 260
2. Complies with all terms of a payment pl an with the 261
facility. 262
Section 5. Paragraph (b) of subsection (1) of section 263
624.27, Florida Statutes, is amended to read: 264
624.27 Direct health care agreements; exemption from 265
code.— 266
(1) As used in this section, the term: 267
(b) "Health care provider " means a health care provider 268
licensed under chapter 458, chapter 459, chapter 460, chapter 269
461, chapter 464, or chapter 466, chapter 490, or chapter 491, 270
or a health care group practice, who provides health care 271
services to patients. 272
Section 6. Section 627.446, Florida Statutes, is created 273
to read: 274
627.446 Advanced explanation of benefits. — 275
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 12 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(1) As used in this section, the term "health insurer" 276
means a health insurer issuing individual or group coverage or a 277
health maintenance organization issuin g coverage through an 278
individual or a group contract. 279
(2) Each health insurer shall prepare an advanced 280
explanation of benefits upon receiving a patient estimate from a 281
facility pursuant to s. 395.301(1). The health insurer must 282
provide the advanced expl anation of benefits to the insured no 283
later than 1 business day after receiving the patient estimate 284
from the facility or, in the case of a service scheduled at 285
least 10 business days in advance, no later than 3 business days 286
after receiving such estimate. 287
(3) At a minimum, the advanced explanation of benefits 288
must include detailed coverage and cost -sharing information 289
pursuant to the No Surprises Act, Title I of Division BB of the 290
Consolidated Appropriations Act, 2021, Pub. L. No. 116 -260. 291
Section 7. Paragraph (b) of subsection (2) and paragraph 292
(a) of subsection (4) of section 627.6387, Florida Statutes, are 293
amended to read: 294
627.6387 Shared savings incentive program. — 295
(2) As used in this section, the term: 296
(b) "Health insurer" has the same meaning as in s. 297
627.446(1) means an authorized insurer offering health insurance 298
as defined in s. 624.603. 299
(4)(a) A shared savings incentive offered by a health 300
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 13 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
insurer in accordance with this section: 301
1. Is not an administrative expense for rate deve lopment 302
or rate filing purposes and shall be counted as a medical 303
expense for such purposes . 304
2. Does not constitute an unfair method of competition or 305
an unfair or deceptive act or practice under s. 626.9541 and is 306
presumed to be appropriate unless credi ble data clearly 307
demonstrates otherwise. 308
Section 8. Paragraph (a) of subsection (4) of section 309
627.6648, Florida Statutes, is amended to read: 310
627.6648 Shared savings incentive program. — 311
(4)(a) A shared savings incentive offered by a health 312
insurer in accordance with this section: 313
1. Is not an administrative expense for rate development 314
or rate filing purposes and shall be counted as a medical 315
expense for such purposes . 316
2. Does not constitute an unfair method of competition or 317
an unfair or deceptive act or practice under s. 626.9541 and is 318
presumed to be appropriate unless credible data clearly 319
demonstrates otherwise. 320
Section 9. Paragraph (a) of subsection (4) of section 321
641.31076, Florida Statutes, is amended to read: 322
641.31076 Shared savi ngs incentive program. — 323
(4) A shared savings incentive offered by a health 324
maintenance organization in accordance with this section: 325
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 14 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(a) Is not an administrative expense for rate development 326
or rate filing purposes and shall be counted as a medical 327
expense for such purposes . 328
Section 10. Paragraphs (a) and (j) of subsection (1) of 329
section 475.01, Florida Statutes, are amended to read: 330
475.01 Definitions. — 331
(1) As used in this part: 332
(a) "Broker" means a person who, for another, and for a 333
compensation or valuable consideration directly or indirectly 334
paid or promised, expressly or impliedly, or with an intent to 335
collect or receive a compensation or valuable consideration 336
therefor, appraises, auctions, sells, exchanges, buys, rents, or 337
offers, attempts or agrees to appraise, auction, or negotiate 338
the sale, exchange, purchase, or rental of business enterprises 339
or business opportunities or any real property or any interest 340
in or concerning the same, including mineral rights or leases, 341
or who advertises or holds out to the public by any oral or 342
printed solicitation or representation that she or he is engaged 343
in the business of appraising, auctioning, buying, selling, 344
exchanging, leasing, or renting business enterprises or business 345
opportunities or real property of others or interests therein, 346
including mineral rights, or who takes any part in the procuring 347
of sellers, purchasers, lessors, or lessees of business 348
enterprises or business opportu nities or the real property of 349
another, or leases, or interest therein, including mineral 350
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 15 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
rights, or who directs or assists in the procuring of prospects 351
or in the negotiation or closing of any transaction which does, 352
or is calculated to, result in a sale, exchange, or leasing 353
thereof, and who receives, expects, or is promised any 354
compensation or valuable consideration, directly or indirectly 355
therefor; and all persons who advertise rental property 356
information or lists. A broker renders a professional servic e 357
and is a professional within the meaning of s. 95.11(5)(b) s. 358
95.11(4)(b). Where the term "appraise" or "appraising" appears 359
in the definition of the term "broker," it specifically excludes 360
those appraisal services which must be performed only by a 361
state-licensed or state-certified appraiser, and those appraisal 362
services which may be performed by a registered trainee 363
appraiser as defined in part II. The term "broker" also includes 364
any person who is a general partner, officer, or director of a 365
partnership or corporation which acts as a broker. The term 366
"broker" also includes any person or entity who undertakes to 367
list or sell one or more timeshare periods per year in one or 368
more timeshare plans on behalf of any number of persons, except 369
as provided in ss. 4 75.011 and 721.20. 370
(j) "Sales associate" means a person who performs any act 371
specified in the definition of "broker," but who performs such 372
act under the direction, control, or management of another 373
person. A sales associate renders a professional servic e and is 374
a professional within the meaning of s. 95.11(5)(b) s. 375
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 16 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
95.11(4)(b). 376
Section 11. Paragraph (h) of subsection (1) of section 377
475.611, Florida Statutes, is amended to read: 378
475.611 Definitions. — 379
(1) As used in this part, the term: 380
(h) "Appraiser" means any person who is a registered 381
trainee real estate appraiser, a licensed real estate appraiser, 382
or a certified real estate appraiser. An appraiser renders a 383
professional service and is a professional within the meaning of 384
s. 95.11(5)(b) s. 95.11(4)(b). 385
Section 12. Subsection (7) of section 517.191, Florida 386
Statutes, is amended to read: 387
517.191 Injunction to restrain violations; civil 388
penalties; enforcement by Attorney General. — 389
(7) Notwithstanding s. 95.11(5)(f) s. 95.11(4)(f), an 390
enforcement action brought under this section based on a 391
violation of any provision of this chapter or any rule or order 392
issued under this chapter shall be brought within 6 years after 393
the facts giving rise to the cause of action were discovered or 394
should have been discovered with the exercise of due diligence, 395
but not more than 8 years after the date such violation 396
occurred. 397
Section 13. Subsection (14) of section 768.28, Florida 398
Statutes, is amended to read: 399
768.28 Waiver of sovereign immunity in tort ac tions; 400
HB 7089, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb7089-01-e1
Page 17 of 17
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
recovery limits; civil liability for damages caused during a 401
riot; limitation on attorney fees; statute of limitations; 402
exclusions; indemnification; risk management programs. — 403
(14) Every claim against the state or one of its agencies 404
or subdivisions for damages for a negligent or wrongful act or 405
omission pursuant to this section shall be forever barred unless 406
the civil action is commenced by filing a complaint in the court 407
of appropriate jurisdiction within 4 years after such claim 408
accrues; except that an action for contribution must be 409
commenced within the limitations provided in s. 768.31(4), and 410
an action for damages arising from medical malpractice or 411
wrongful death must be commenced within the limitations for such 412
actions in s. 95.11(5) s. 95.11(4). 413
Section 14. Subsection (4) of section 787.061, Florida 414
Statutes, is amended to read: 415
787.061 Civil actions by victims of human trafficking. — 416
(4) STATUTE OF LIMITATIONS. —The statute of limitations as 417
specified in s. 95.11(8) or (10) s. 95.11(7) or (9), as 418
applicable, governs an action brought under this section. 419
Section 15. The changes made by this act to ss. 395.301 420
and 627.446, Florida Statutes, do not apply to ambulatory 421
surgical centers, as defined in s. 395.002, Florida Statutes , 422
until January 1, 2026. 423
Section 16. This act shall take effect July 1, 2024. 424