House Panel Proposes Changes to Health Insurance Lawsuit Rules: Key Insights You Need
World Today News
March 22, 2025
A Florida House subcommittee has unanimously approved HB 947, a bill aimed at revising the state’s health insurance lawsuit regulations, igniting a heated debate among stakeholders about its potential impact on transparency, fairness, and healthcare costs.
Tallahassee, FL – Florida’s legal framework governing health insurance lawsuits is under scrutiny as HB 947 advances through the state legislature. The House civil Justice and Claims Subcommittee recently passed the bill with a 15-0 vote, demonstrating initial bipartisan support. However, the proposed changes have triggered mixed reactions from various stakeholders, raising critical questions about the bill’s ultimate impact on the state’s legal and healthcare landscape.
HB 947 seeks to clarify a 2023 law intended to curb lawsuit abuses in Florida. Representative omar Blanco, a Republican from Miami and the bill’s sponsor, asserts that HB 947 “promotes consistency, clarity, and trust in Florida’s legal system.” The proposed legislation centers on replacing the word “may” with “shall” in key provisions of the existing law. Supporters argue this alteration will provide plaintiffs, defendants, and courts with greater flexibility to present all relevant details in a case, ensuring a more comprehensive and fair legal process.
Conversely, opponents argue that this seemingly minor change could eliminate crucial guidance that mandates the inclusion of specific information in cases, potentially disincentivizing the filing of unreasonable claims.The core of the debate revolves around striking a balance between ensuring transparency and preventing frivolous lawsuits that can drive up healthcare costs for all Floridians. This debate mirrors similar discussions happening across the U.S., where states grapple with balancing access to justice with the need to control healthcare expenses.
Key Provisions of HB 947
If enacted, HB 947, slated to take effect on July 1, would allow for the admission of any court-approved evidence demonstrating the actual value of medical treatments or services. This provision challenges the current reliance on predefined criteria, such as the 120% and 170% reimbursement rates for Medicare and Medicaid, respectively, as benchmarks for determining the value of medical services. This shift could have notable implications for how medical costs are assessed in legal proceedings, potentially leading to more accurate and fair valuations.
The bill also aims to broaden the scope of admissible evidence in cases concerning the extent of health care coverage insurers are obligated to provide, reasonable and customary rates for medical services, and the amounts paid under letters of protection (LOPs) for past unpaid charges. Similar evidence would be admissible for future medical treatments or services. This expansion of admissible evidence is intended to provide a more complete picture of the financial aspects of healthcare, allowing juries to make more informed decisions.
Representative Mike Gottlieb, a democratic lawyer from Davie, emphasized the importance of this change, arguing that Medicare and Medicaid rates are “generally significantly lower than what is reasonable and customary” and therefore not ideal benchmarks for determining the true value of medical care. He further stated, “Anybody on the defense can bring in the Medicaid or Medicare if they believe that’s reasonable or customary, and a jury can see and hear that evidence. This is a better bill.I think we got it wrong in 2023. I think we’re fixing it now.” Gottlieb’s perspective highlights the potential for HB 947 to address perceived inequities in the current system.
Representative Vanessa Oliver, a Republican from Punta Gorda and CEO of an ambulance company, echoed this sentiment, noting that “health care rates are all over the place” and that the “government-imposed rate is the floor” in terms of cost. She argued that juries should have access to all relevant data points and testimony to make informed decisions. Oliver’s experience in the healthcare industry lends credibility to her argument that a more comprehensive approach to evaluating medical costs is needed.
Stakeholder Opposition and Concerns
Despite the bipartisan support in the subcommittee, HB 947 faces significant opposition from various organizations and companies, including the Florida Insurance Council, The Doctors Company, U.S.Chamber of Commerce, State Farm, Publix, American Property Casualty Insurance Association, Uber, Personal Insurance Federation of Florida, and Associated Industries of Florida. These groups express concerns that the bill could undermine recent progress in tort reform and lead to increased litigation and healthcare costs. Their opposition underscores the potential economic impact of HB 947 on businesses and the insurance industry.
Laurette balinsky of the Florida Justice Reform Institute argued that the bill would “undo all the good progress (Florida) made on transparency and damages as 2023,” suggesting that healthcare costs have decreased sence the enactment of HB 837. Balinsky further contended that replacing “may” with “shall” would eliminate uniformity in the evidence presented to jurors, leading to inconsistent standards. This argument highlights the potential for HB 947 to create uncertainty and unpredictability in the legal system.
Ellin Kunz, a certified medical auditor working for Associated Industries of Florida, highlighted the lack of guidance regarding the reasonable value of healthcare before juries. She stated, “There’s no definition of what is reasonable. There’s no definition of what is customary.” Kunz’s concerns raise questions about the potential for abuse and manipulation in the absence of clear guidelines.
Potential Implications and Counterarguments
The potential implications of HB 947 are far-reaching and complex. Supporters argue that the bill will lead to more accurate and fair valuations of medical services, preventing insurance companies from undervaluing legitimate claims. They also contend that it will empower juries to make informed decisions based on a complete picture of the financial aspects of healthcare. However, opponents fear that the bill will open the door to increased litigation and higher healthcare costs, ultimately burdening consumers and businesses. They argue that the lack of clear guidelines regarding the reasonable value of healthcare could lead to inconsistent and unpredictable outcomes.
A key counterargument to the concerns raised by opponents is that the bill allows for the admission of any court-approved evidence, providing a safeguard against the presentation of irrelevant or misleading information. Additionally, supporters argue that juries are capable of discerning the true value of medical services based on the evidence presented, even in the absence of strict guidelines. The debate over HB 947 reflects a broader national conversation about the role of the legal system in regulating healthcare costs and ensuring access to justice.
Next Steps and Future Outlook
Following its approval by the House Civil Justice and Claims Subcommittee, HB 947 will now move to the full House for consideration. If passed by the House, the bill will then be sent to the Senate for further review and potential amendment. The future of HB 947 remains uncertain, as it faces significant opposition from various stakeholders. Though, the bill’s initial bipartisan support suggests that it has a chance of becoming law.The outcome of this legislative process will have a significant impact on the health insurance lawsuit landscape in Florida, potentially affecting healthcare costs, access to justice, and the overall legal climate.
As the legislative process unfolds, it is crucial for stakeholders to remain engaged and informed. The debate over HB 947 highlights the complex challenges of balancing competing interests in the healthcare system. Ultimately,the goal should be to create a legal framework that is fair,obvious,and promotes access to affordable healthcare for all Floridians.
Summary of Arguments
