Florida House reviews HB 947 addressing healthcare coverage claims and reimbursements

On February 24, 2025, the Florida State Legislature introduced House Bill 947, a significant piece of legislation aimed at reforming the way medical expenses are documented and reimbursed in personal injury claims. The bill seeks to address the complexities surrounding medical billing and insurance coverage, particularly for claimants who have varying types of health care coverage.

The primary purpose of House Bill 947 is to establish clearer guidelines for the evidence required to substantiate medical expenses in personal injury cases. Key provisions include stipulations for claimants with health care coverage other than Medicare or Medicaid, requiring them to provide evidence of the amounts their insurance would cover for medical services. Additionally, the bill mandates that if a claimant does not submit charges to their insurance, they must present evidence of what their insurance would have paid had they done so.

For those without health care coverage or who are covered by Medicare or Medicaid, the bill proposes that claimants provide evidence based on 120 percent of the Medicare reimbursement rate for the medical services incurred. This provision aims to standardize the reimbursement process and ensure that claimants receive fair compensation for their medical expenses.

Debate surrounding House Bill 947 has highlighted concerns from various stakeholders. Proponents argue that the bill will streamline the claims process and reduce disputes over medical expenses, ultimately benefiting both claimants and insurers. However, opponents have raised concerns about the potential for reduced compensation for claimants, particularly those relying on Medicare or Medicaid, who may find the reimbursement rates insufficient to cover their actual medical costs.

The economic implications of this bill could be substantial, as it may affect how insurance companies handle claims and reimbursements, potentially leading to lower overall costs for insurers. Socially, the bill could impact vulnerable populations who rely on government health programs, raising questions about access to adequate medical care and compensation.

As House Bill 947 progresses through the legislative process, its outcomes will be closely monitored by legal experts and advocacy groups. The bill's potential to reshape the landscape of personal injury claims in Florida could set a precedent for similar legislation in other states, making it a significant development in the realm of health care and insurance law.