Bill Amendment: FL S0966 | 2013 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: Health Care
Status: 2013-05-03 - Died on Calendar, companion bill(s) passed, see CS/HB 1071 (Ch. 2013-93), CS/CS/HB 1159 (Ch. 2013-153), SB 1520 (Ch. 2013-48) [S0966 Detail]
Download: Florida-2013-S0966-Health_Policy_Committee_Amendment_Delete_All_373656.html
Bill Title: Health Care
Status: 2013-05-03 - Died on Calendar, companion bill(s) passed, see CS/HB 1071 (Ch. 2013-93), CS/CS/HB 1159 (Ch. 2013-153), SB 1520 (Ch. 2013-48) [S0966 Detail]
Download: Florida-2013-S0966-Health_Policy_Committee_Amendment_Delete_All_373656.html
Florida Senate - 2013 COMMITTEE AMENDMENT Bill No. SB 966 Barcode 373656 LEGISLATIVE ACTION Senate . House Comm: RCS . 03/15/2013 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Bean) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Paragraphs (d) and (e) of subsection (12) of 6 section 112.0455, Florida Statutes, are amended to read: 7 112.0455 Drug-Free Workplace Act.— 8 (12) DRUG-TESTING STANDARDS; LABORATORIES.— 9(d) The laboratory shall submit to the Agency for Health10Care Administration a monthly report with statistical11information regarding the testing of employees and job12applicants. The reports shall include information on the methods13of analyses conducted, the drugs tested for, the number of14positive and negative results for both initial and confirmation15tests, and any other information deemed appropriate by the16Agency for Health Care Administration. No monthly report shall17identify specific employees or job applicants.18 (d)(e)Laboratories shall provide technical assistance to 19 the employer, employee, or job applicant for the purpose of 20 interpreting any positive confirmed test results which could 21 have been caused by prescription or nonprescription medication 22 taken by the employee or job applicant. 23 Section 2. Paragraph (n) of subsection (1) of section 24 154.11, Florida Statutes, is amended to read: 25 154.11 Powers of board of trustees.— 26 (1) The board of trustees of each public health trust shall 27 be deemed to exercise a public and essential governmental 28 function of both the state and the county and in furtherance 29 thereof it shall, subject to limitation by the governing body of 30 the county in which such board is located, have all of the 31 powers necessary or convenient to carry out the operation and 32 governance of designated health care facilities, including, but 33 without limiting the generality of, the foregoing: 34 (n) To appoint originally the staff of physicians to 35 practice in aanydesignated facility owned or operated by the 36 board and to approve the bylaws and rules to be adopted by the 37 medical staff of aanydesignated facility owned and operated by 38 the board, such governing regulations to be in accordance with 39 the standards of the Joint Commission, the American Osteopathic 40 Association/Healthcare Facilities Accreditation Program, or a 41 national accrediting organization that is approved by the 42 Centers for Medicare and Medicaid Services and whose standards 43 incorporate comparable licensure regulations required by the 44 stateon the Accreditation of Hospitalswhich provide, among 45 other things, for the method of appointing additional staff 46 members and for the removal of staff members. 47 Section 3. Section 385.2035, Florida Statutes, is created 48 to read: 49 385.2035 Resource for research in the prevention and 50 treatment of diabetes.—The Florida Hospital Sanford-Burnham 51 Translational Research Institute for Metabolism and Diabetes is 52 designated as a resource in this state for research in the 53 prevention and treatment of diabetes. 54 Section 4. Subsection (2) of section 394.741, Florida 55 Statutes, is amended to read: 56 394.741 Accreditation requirements for providers of 57 behavioral health care services.— 58 (2) Notwithstanding any provision of law to the contrary, 59 accreditation shall be accepted by the agency and department in 60 lieu of the agency’s and department’s facility licensure onsite 61 review requirements and shall be accepted as a substitute for 62 the department’s administrative and program monitoring 63 requirements, except as required by subsections (3) and (4), 64 for: 65 (a) AnAnyorganization from which the department purchases 66 behavioral health care services whichthatis accredited by the 67 Joint Commission, American Osteopathic Association/the 68 Healthcare Facilities Accreditation Program, a national 69 accrediting organization that is approved by the Centers for 70 Medicare and Medicaid Services and whose standards incorporate 71 comparable licensure regulations required by the state,on72Accreditation of Healthcare Organizationsorthe Council on 73 Accreditationfor Children and Family Services, or CARF 74 International for thehas thoseservices that are being 75 purchased by the departmentaccredited by CARF—the76Rehabilitation Accreditation Commission. 77 (b) AAnymental health facility licensed by the agency or 78 aanysubstance abuse component licensed by the department which 79thatis accredited by the Joint Commission, the American 80 Osteopathic Association/Healthcare Facilities Accreditation 81 Program, a national accrediting organization that is approved by 82 the Centers for Medicare and Medicaid Services and whose 83 standards incorporate comparable licensure regulations required 84 by the state, CARF Internationalon Accreditation of Healthcare85Organizations, CARF—the Rehabilitation Accreditation Commission, 86 or the Council on Accreditationof Children and Family Services. 87 (c) AAnynetwork of providers from which the department or 88 the agency purchases behavioral health care services accredited 89 by the Joint Commission, the American Osteopathic 90 Association/Healthcare Facilities Accreditation Program, a 91 national accrediting organization that is approved by the 92 Centers for Medicare and Medicaid Services and whose standards 93 incorporate comparable licensure regulations required by the 94 state, CARF Internationalon Accreditation of Healthcare95Organizations, CARF—the Rehabilitation Accreditation Commission, 96 the Council on Accreditationof Children and Family Services, or 97 the National Committee for Quality Assurance. A provider 98 organization that, whichis part of an accredited network,is 99 afforded the same rights under this part. 100 Section 5. Subsection (3) of section 395.0161, Florida 101 Statutes, is amended to read: 102 395.0161 Licensure inspection.— 103 (3) In accordance with s. 408.805, an applicant or licensee 104 shall pay a fee for each license application submitted under 105 this part, part II of chapter 408, and applicable rules. With 106 the exception of state-operated licensed facilities, each 107 facility licensed under this part shall pay to the agency, at108the time of inspection,the following fees: 109 (a) Inspection for licensure.—A fee shall be paid which is 110 not less than $8 per hospital bed, nor more than $12 per 111 hospital bed, except that the minimum fee shall be $400 per 112 facility. 113 (b) Inspection for lifesafety only.—A fee shall be paid 114 which is not less than 75 cents per hospital bed, nor more than 115 $1.50 per hospital bed, except that the minimum fee shall be $40 116 per facility. 117 Section 6. Section 395.1046, Florida Statutes, is repealed. 118 Section 7. Section 395.3038, Florida Statutes, is amended 119 to read: 120 395.3038 State-listed primary stroke centers and 121 comprehensive stroke centers; notification of hospitals.— 122 (1) The agency shall make available on its website and to 123 the department a list of the name and address of each hospital 124 that meets the criteria for a primary stroke center and the name 125 and address of each hospital that meets the criteria for a 126 comprehensive stroke center. The list of primary and 127 comprehensive stroke centers mustshallinclude only those 128 hospitals that attest in an affidavit submitted to the agency 129 that the hospital meets the named criteria, or those hospitals 130 that attest in an affidavit submitted to the agency that the 131 hospital is certified as a primary or a comprehensive stroke 132 center by the Joint Commission, the American Osteopathic 133 Association/Healthcare Facilities Accreditation Program, or a 134 national accrediting organization that is approved by the 135 Centers for Medicare and Medicaid Services and whose standards 136 incorporate comparable licensure regulations required by the 137 stateon Accreditation of Healthcare Organizations. 138 (2)(a) If a hospital no longer chooses to meet the criteria 139 for a primary or comprehensive stroke center, the hospital shall 140 notify the agency and the agency shall immediately remove the 141 hospital from the list. 142 (b)1. This subsection does not apply if the hospital is 143 unable to provide stroke treatment services for a period of time 144 not to exceed 2 months. The hospital shall immediately notify 145 all local emergency medical services providers when the 146 temporary unavailability of stroke treatment services begins and 147 when the services resume. 148 2. If stroke treatment services are unavailable for more 149 than 2 months, the agency shall remove the hospital from the 150 list of primary or comprehensive stroke centers until the 151 hospital notifies the agency that stroke treatment services have 152 been resumed. 153(3) The agency shall notify all hospitals in this state by154February 15, 2005, that the agency is compiling a list of155primary stroke centers and comprehensive stroke centers in this156state. The notice shall include an explanation of the criteria157necessary for designation as a primary stroke center and the158criteria necessary for designation as a comprehensive stroke159center. The notice shall also advise hospitals of the process by160which a hospital might be added to the list of primary or161comprehensive stroke centers.162 (3)(4)The agency shall adopt by rule criteria for a 163 primary stroke center which are substantially similar to the 164 certification standards for primary stroke centers of the Joint 165 Commission, the American Osteopathic Association/Healthcare 166 Facilities Accreditation Program, or a national accrediting 167 organization that is approved by the Centers for Medicare and 168 Medicaid Services and whose standards incorporate comparable 169 licensure regulations required by the stateon Accreditation of170Healthcare Organizations. 171 (4)(5)The agency shall adopt by rule criteria for a 172 comprehensive stroke center. However, if the Joint Commission, 173 the American Osteopathic Association/Healthcare Facilities 174 Accreditation Program, or a national accrediting organization 175 that is approved by the Centers for Medicare and Medicaid 176 Services and whose standards incorporate comparable licensure 177 regulations required by the stateon Accreditation of Healthcare178Organizationsestablishes criteria for a comprehensive stroke 179 center, the agency shall establish criteria for a comprehensive 180 stroke center which are substantially similar to those criteria 181 established by the Joint Commission, the American Osteopathic 182 Association/Healthcare Facilities Accreditation Program, or such 183 national accrediting organizationon Accreditation of Healthcare184Organizations. 185 (5)(6)This act is not a medical practice guideline and may 186 not be used to restrict the authority of a hospital to provide 187 services for which it is licensedhas received a licenseunder 188 chapter 395. The Legislature intends that all patients be 189 treated individually based on each patient’s needs and 190 circumstances. 191 Section 8. Paragraph (c) of subsection (1) of section 192 395.701, Florida Statutes, is amended to read: 193 395.701 Annual assessments on net operating revenues for 194 inpatient and outpatient services to fund public medical 195 assistance; administrative fines for failure to pay assessments 196 when due; exemption.— 197 (1) For the purposes of this section, the term: 198 (c) “Hospital” means a health care institution as defined 199 in s. 395.002(12), but does not include any hospital operated by 200 a statetheagencyor the Department of Corrections. 201 Section 9. Section 395.7015, Florida Statutes, is repealed. 202 Section 10. Section 395.7016, Florida Statutes, is amended 203 to read: 204 395.7016 Annual appropriation.—The Legislature shall 205 appropriate each fiscal year from either the General Revenue 206 Fund or the Agency for Health Care Administration Tobacco 207 Settlement Trust Fund an amount sufficient to replace the funds 208 lost due toreduction by chapter 2000-256, Laws of Florida, of209the assessment on other health care entities under s.395.7015,210andthe reduction by chapter 2000-256 in the assessment on 211 hospitals under s. 395.701, and to maintain federal approval of 212 the reduced amount of funds deposited into the Public Medical 213 Assistance Trust Fund under s. 395.701, as state match for the 214 state’s Medicaid program. 215 Section 11. Subsection (3) of section 397.403, Florida 216 Statutes, is amended to read: 217 397.403 License application.— 218 (3) The department shall accept proof of accreditation by 219 CARF International,the Commission on Accreditation of220Rehabilitation Facilities(CARF)orthe Joint Commission, the 221 American Osteopathic Association/Healthcare Facilities 222 Accreditation Program, or a national accrediting organization 223 that is approved by the Centers for Medicare and Medicaid 224 Services and whose standards incorporate comparable licensure 225 regulations required by the state; or through anotherany other226 nationally recognized certification process that is acceptable 227 to the department and meets the minimum licensure requirements 228 under this chapter, in lieu of requiring the applicant to submit 229 the information required by paragraphs (1)(a)-(c). 230 Section 12. Subsection (1) of section 400.925, Florida 231 Statutes, is amended to read: 232 400.925 Definitions.—As used in this part, the term: 233 (1) “Accrediting organizations” means the Joint Commission, 234 the American Osteopathic Association/Healthcare Facilities 235 Accreditation Program, a national accrediting organization that 236 is approved by the Centers for Medicare and Medicaid Services 237 and whose standards incorporate comparable licensure regulations 238 required by the state,on Accreditation of Healthcare239Organizationsor other national accreditingaccreditation240 agencies whose standards for accreditation are comparable to 241 those required by this part for licensure. 242 Section 13. Paragraph (g) of subsection (1) and subsection 243 (7) of section 400.9935, Florida Statutes, are amended to read: 244 400.9935 Clinic responsibilities.— 245 (1) Each clinic shall appoint a medical director or clinic 246 director who shall agree in writing to accept legal 247 responsibility for the following activities on behalf of the 248 clinic. The medical director or the clinic director shall: 249 (g) Conduct systematic reviews of clinic billings to ensure 250 that the billings are not fraudulent or unlawful. Upon discovery 251 of an unlawful charge, the medical director or clinic director 252 shall take immediate corrective action. If the clinic performs 253 only the technical component of magnetic resonance imaging, 254 static radiographs, computed tomography, or positron emission 255 tomography, and provides the professional interpretation of such 256 services, in a fixed facility that is accredited by the Joint 257 Commission, the American Osteopathic Association/Healthcare 258 Facilities Accreditation Program,on Accreditation of Healthcare259Organizationsorthe Accreditation Association for Ambulatory 260 Health Care, Inc., or a national accrediting organization that 261 is approved by the Centers for Medicare and Medicaid Services 262 and whose standards incorporate comparable licensure regulations 263 required by the state; and the American College of Radiology; 264 and if, in the preceding quarter, the percentage of scans 265 performed by that clinic which was billed to all personal injury 266 protection insurance carriers was less than 15 percent, the 267 chief financial officer of the clinic may, in a written 268 acknowledgment provided to the agency, assume the responsibility 269 for the conduct of the systematic reviews of clinic billings to 270 ensure that the billings are not fraudulent or unlawful. 271 (7)(a) Each clinic engaged in magnetic resonance imaging 272 services must be accredited by the Joint Commission, the 273 American Osteopathic Association/Healthcare Facilities 274 Accreditation Program, a national accrediting organization that 275 is approved by the Centers for Medicare and Medicaid Services 276 and whose standards incorporate comparable licensure regulations 277 required by the state,on Accreditation of Healthcare278Organizations, the American College of Radiology, or the 279 Accreditation Association for Ambulatory Health Care, Inc., 280 within 1 year after licensure. A clinic that is accredited by 281 the American College of Radiology or that is within the original 282 1-year period after licensure and replaces its core magnetic 283 resonance imaging equipment shall be given 1 year after the date 284 on which the equipment is replaced to attain accreditation. 285 However, a clinic may request a single, 6-month extension if it 286 provides evidence to the agency establishing that, for good 287 cause shown, such clinic cannot be accredited within 1 year 288 after licensure, and that such accreditation will be completed 289 within the 6-month extension. After obtaining accreditation as 290 required by this subsection, each such clinic must maintain 291 accreditation as a condition of renewal of its license. A clinic 292 that files a change of ownership application must comply with 293 the original accreditation timeframe requirements of the 294 transferor. The agency shall deny a change of ownership 295 application if the clinic is not in compliance with the 296 accreditation requirements. When a clinic adds, replaces, or 297 modifies magnetic resonance imaging equipment and the 298 accreditingaccreditationagency requires new accreditation, the 299 clinic must be accredited within 1 year after the date of the 300 addition, replacement, or modification but may request a single, 301 6-month extension if the clinic provides evidence of good cause 302 to the agency. 303 (b) The agency may deny the application or revoke the 304 license of ananyentity formed for the purpose of avoiding 305 compliance with the accreditation provisions of this subsection 306 and whose principals were previously principals of an entity 307 that was unable to meet the accreditation requirements within 308 the specified timeframes. The agency may adopt rules as to the 309 accreditation of magnetic resonance imaging clinics. 310 Section 14. Subsections (1) and (2) of section 402.7306, 311 Florida Statutes, are amended to read: 312 402.7306 Administrative monitoring of child welfare 313 providers, and administrative, licensure, and programmatic 314 monitoring of mental health and substance abuse service 315 providers.—The Department of Children and Family Services, the 316 Department of Health, the Agency for Persons with Disabilities, 317 the Agency for Health Care Administration, community-based care 318 lead agencies, managing entities as defined in s. 394.9082, and 319 agencies who have contracted with monitoring agents shall 320 identify and implement changes that improve the efficiency of 321 administrative monitoring of child welfare services, and the 322 administrative, licensure, and programmatic monitoring of mental 323 health and substance abuse service providers. For the purpose of 324 this section, the term “mental health and substance abuse 325 service provider” means a provider who provides services to this 326 state’s priority population as defined in s. 394.674. To assist 327 with that goal, each such agency shall adopt the following 328 policies: 329 (1) Limit administrative monitoring to once every 3 years 330 if the child welfare provider is accredited by the Joint 331 Commission, a national accrediting organization that is approved 332 by the Centers for Medicare and Medicaid Services and whose 333 standards incorporate comparable licensure regulations required 334 by the state, CARF Internationalthe Commission on Accreditation335of Rehabilitation Facilities, or the Council on Accreditation. 336 If the accrediting body does not require documentation that the 337 state agency requires, that documentation shall be requested by 338 the state agency and may be posted by the service provider on 339 the data warehouse for the agency’s review. Notwithstanding the 340 survey or inspection of an accrediting organization specified in 341 this subsection, an agency specified in and subject to this 342 section may continue to monitor the service provider as 343 necessary with respect to: 344 (a) Ensuring that services for which the agency is paying 345 are being provided. 346 (b) Investigating complaints or suspected problems and 347 monitoring the service provider’s compliance withanyresulting 348 negotiated terms and conditions, including provisions relating 349 to consent decrees that are unique to a specific service and are 350 not statements of general applicability. 351 (c) Ensuring compliance with federal and state laws, 352 federal regulations, or state rules if such monitoring does not 353 duplicate the accrediting organization’s review pursuant to 354 accreditation standards. 355 356 Medicaid certification and precertification reviews are exempt 357 from this subsection to ensure Medicaid compliance. 358 (2) Limit administrative, licensure, and programmatic 359 monitoring to once every 3 years if the mental health or 360 substance abuse service provider is accredited by the Joint 361 Commission, the American Osteopathic Association/Healthcare 362 Facilities Accreditation Program, a national accrediting 363 organization that is approved by the Centers for Medicare and 364 Medicaid Services and whose standards incorporate comparable 365 licensure regulations required by the state, CARF International 366the Commission on Accreditation of Rehabilitation Facilities, or 367 the Council on Accreditation. If the services being monitored 368 are not the services for which the provider is accredited, the 369 limitations of this subsection do not apply. If the accrediting 370 body does not require documentation that the state agency 371 requires, that documentation, except documentation relating to 372 licensure applications and fees, must be requested by the state 373 agency and may be posted by the service provider on the data 374 warehouse for the agency’s review. Notwithstanding the survey or 375 inspection of an accrediting organization specified in this 376 subsection, an agency specified in and subject to this section 377 may continue to monitor the service provider as necessary with 378 respect to: 379 (a) Ensuring that services for which the agency is paying 380 are being provided. 381 (b) Investigating complaints, identifying problems that 382 would affect the safety or viability of the service provider, 383 and monitoring the service provider’s compliance withany384 resulting negotiated terms and conditions, including provisions 385 relating to consent decrees that are unique to a specific 386 service and are not statements of general applicability. 387 (c) Ensuring compliance with federal and state laws, 388 federal regulations, or state rules if such monitoring does not 389 duplicate the accrediting organization’s review pursuant to 390 accreditation standards. 391 392 Federal certification and precertification reviews are exempt 393 from this subsection to ensure Medicaid compliance. 394 Section 15. Subsection (4) of section 408.061, Florida 395 Statutes, is amended to read: 396 408.061 Data collection; uniform systems of financial 397 reporting; information relating to physician charges; 398 confidential information; immunity.— 399 (4) Within 120 days after the end of its fiscal year, each 400 health care facility, excluding continuing care facilities, 401 hospitals operated by state agencies, and nursing homes as 402 defined in s. 408.07(14) and (37), shall file with the agency, 403 on forms adopted by the agency and based on the uniform system 404 of financial reporting, its actual financial experience for that 405 fiscal year, including expenditures, revenues, and statistical 406 measures. Such data may be based on internal financial reports 407 which are certified to be complete and accurate by the provider. 408 However, hospitals’ actual financial experience shall be their 409 audited actual experience. Every nursing home shall submit to 410 the agency, in a format designated by the agency, a statistical 411 profile of the nursing home residents. The agency, in 412 conjunction with the Department of Elderly Affairs and the 413 Department of Health, shall review these statistical profiles 414 and develop recommendations for the types of residents who might 415 more appropriately be placed in their homes or other 416 noninstitutional settings. 417 Section 16. Subsection (4) of section 408.20, Florida 418 Statutes, is amended to read: 419 408.20 Assessments; Health Care Trust Fund.— 420 (4) Hospitals operated by state agenciesthe Department of421Children and Family Services, the Department of Health, or the422Department of Correctionsare exempt from the assessments 423 required under this section. 424 Section 17. Paragraph (a) of subsection (3) of section 425 409.966, Florida Statutes, is amended to read: 426 409.966 Eligible plans; selection.— 427 (3) QUALITY SELECTION CRITERIA.— 428 (a) The invitation to negotiate must specify the criteria 429 and the relative weight of the criteria that will be used for 430 determining the acceptability of the reply and guiding the 431 selection of the organizations with which the agency negotiates. 432 In addition to criteria established by the agency, the agency 433 shall consider the following factors in the selection of 434 eligible plans: 435 1. Accreditation by the National Committee for Quality 436 Assurance, the Joint Commission, the American Osteopathic 437 Association/Healthcare Facilities Accreditation Program, a 438 national accrediting organization that is approved by the 439 Centers for Medicare and Medicaid Services and whose standards 440 incorporate comparable licensure regulations required by the 441 state, or another nationally recognized accrediting body. 442 2. Experience serving similar populations, including the 443 organization’s record in achieving specific quality standards 444 with similar populations. 445 3. Availability and accessibility of primary care and 446 specialty physicians in the provider network. 447 4. Establishment of community partnerships with providers 448 that create opportunities for reinvestment in community-based 449 services. 450 5. Organization commitment to quality improvement and 451 documentation of achievements in specific quality improvement 452 projects, including active involvement by organization 453 leadership. 454 6. Provision of additional benefits, particularly dental 455 care and disease management, and other initiatives that improve 456 health outcomes. 457 7. Evidence that an eligible plan has written agreements or 458 signed contracts or has made substantial progress in 459 establishing relationships with providers before the plan 460 submitting a response. 461 8. Comments submitted in writing by ananyenrolled 462 Medicaid provider relating to a specifically identified plan 463 participating in the procurement in the same region as the 464 submitting provider. 465 9. Documentation of policies and procedures for preventing 466 fraud and abuse. 467 10. The business relationship an eligible plan has with 468 anotherany othereligible plan that responds to the invitation 469 to negotiate. 470 Section 18. Paragraph (e) of subsection (2) of section 471 409.967, Florida Statutes, is amended to read: 472 409.967 Managed care plan accountability.— 473 (2) The agency shall establish such contract requirements 474 as are necessary for the operation of the statewide managed care 475 program. In addition to any other provisions the agency may deem 476 necessary, the contract must require: 477 (e) Continuous improvement.—The agency shall establish 478 specific performance standards and expected milestones or 479 timelines for improving performance over the term of the 480 contract. 481 1. Each managed care plan shall establish an internal 482 health care quality improvement system, including enrollee 483 satisfaction and disenrollment surveys. The quality improvement 484 system must include incentives and disincentives for network 485 providers. 486 2. Each plan must collect and report the Health Plan 487 Employer Data and Information Set (HEDIS) measures, as specified 488 by the agency. These measures must be published on the plan’s 489 website in a manner that allows recipients to reliably compare 490 the performance of plans. The agency shall use the HEDIS 491 measures as a tool to monitor plan performance. 492 3. Each managed care plan must be accredited by the 493 National Committee for Quality Assurance, the Joint Commission, 494 a national accrediting organization that is approved by the 495 Centers for Medicare and Medicaid Services and whose standards 496 incorporate comparable licensure regulations required by the 497 state, or another nationally recognized accrediting body, or 498 have initiated the accreditation process, within 1 year after 499 the contract is executed. The agency shall suspend automatic 500 assignment under ss. 409.977 and 409.984 for aanyplan not 501 accredited within 18 months after executing the contract, the502agency shall suspend automatic assignment under s.409.977and503409.984. 504 4. By the end of the fourth year of the first contract 505 term, the agency shall issue a request for information to 506 determine whether cost savings could be achieved by contracting 507 for plan oversight and monitoring, including analysis of 508 encounter data, assessment of performance measures, and 509 compliance with other contractual requirements. 510 Section 19. Paragraph (b) of subsection (3) of section 511 430.80, Florida Statutes, is amended to read: 512 430.80 Implementation of a teaching nursing home pilot 513 project.— 514 (3) To be designated as a teaching nursing home, a nursing 515 home licensee must, at a minimum: 516 (b) Participate in a nationally recognized accrediting 517accreditationprogram and hold a valid accreditation, such as 518 the accreditation awarded by the Joint Commissionon519Accreditation of Healthcare Organizations, a national 520 accrediting organization that is approved by the Centers for 521 Medicare and Medicaid Services and whose standards incorporate 522 comparable licensure regulations required by the state, or, at 523 the time of initial designation, possess a Gold Seal Award as 524 conferred by the state on its licensed nursing home; 525 Section 20. Paragraphs (b) and (d) of subsection (9) of 526 section 440.102, Florida Statutes, are amended to read: 527 440.102 Drug-free workplace program requirements.—The 528 following provisions apply to a drug-free workplace program 529 implemented pursuant to law or to rules adopted by the Agency 530 for Health Care Administration: 531 (9) DRUG-TESTING STANDARDS FOR LABORATORIES.— 532 (b) A laboratory may analyzeinitial orconfirmation test 533 specimens only if: 534 1. The laboratory obtains a license under part II of 535 chapter 408 and s. 112.0455(17). Each applicant for licensure 536 and each licensee must comply with all requirements of this 537 section, part II of chapter 408, and applicable rules. 538 2. The laboratory has written procedures to ensure the 539 chain of custody. 540 3. The laboratory follows proper quality control 541 procedures, including, but not limited to: 542 a. The use of internal quality controls, including the use 543 of samples of known concentrations which are used to check the 544 performance and calibration of testing equipment, and periodic 545 use of blind samples for overall accuracy. 546 b. An internal review and certification process for drug 547 test results, conducted by a person qualified to perform that 548 function in the testing laboratory. 549 c. Security measures implemented by the testing laboratory 550 to preclude adulteration of specimens and drug test results. 551 d. Other necessary and proper actions taken to ensure 552 reliable and accurate drug test results. 553(d) The laboratory shall submit to the Agency for Health554Care Administration a monthly report with statistical555information regarding the testing of employees and job556applicants. The report must include information on the methods557of analysis conducted, the drugs tested for, the number of558positive and negative results for both initial tests and559confirmation tests, and any other information deemed appropriate560by the Agency for Health Care Administration. A monthly report561must not identify specific employees or job applicants.562 Section 21. Paragraph (a) of subsection (2) of section 563 440.13, Florida Statutes, is amended to read: 564 440.13 Medical services and supplies; penalty for 565 violations; limitations.— 566 (2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.— 567 (a) Subject to the limitations specified elsewhere in this 568 chapter, the employer shall furnish to the employee such 569 medically necessary remedial treatment, care, and attendance for 570 such period as the nature of the injury or the process of 571 recovery may require, which is in accordance with established 572 practice parameters and protocols of treatment as provided for 573 in this chapter, including medicines, medical supplies, durable 574 medical equipment, orthoses, prostheses, and other medically 575 necessary apparatus. Remedial treatment, care, and attendance, 576 including work-hardening programs or pain-management programs 577 accredited by CARF International, theCommission on578Accreditation of Rehabilitation FacilitiesorJoint Commission, 579 the American Osteopathic Association/Healthcare Facilities 580 Accreditation Program, or a national accrediting organization 581 that is approved by the Centers for Medicare and Medicaid 582 Services and whose standards incorporate comparable licensure 583 regulations required by the state,on the Accreditation of584Health Organizationsor pain-management programs affiliated with 585 medical schools, shall be consideredascovered treatment only 586 when such care is given based on a referral by a physician as 587 defined in this chapter. Medically necessary treatment, care, 588 and attendance does not include chiropractic services in excess 589 of 24 treatments or rendered 12 weeks beyond the date of the 590 initial chiropractic treatment, whichever comes first, unless 591 the carrier authorizes additional treatment or the employee is 592 catastrophically injured. 593 594 Failure of the carrier to timely comply with this subsection 595 shall be a violation of this chapter and the carrier shall be 596 subject to penalties as provided for in s. 440.525. 597 Section 22. Section 456.0125, Florida Statutes, is created 598 to read: 599 456.0125 Standardized Credentials Collection and 600 Verification Program for physicians.— 601 (1) It is the intent of the Legislature to establish the 602 Standardized Credentials Collection and Verification Program to 603 designate an entity to act as a repository for the core 604 credentials data of physicians and to ensure that this 605 information is collected only once unless a correction, update, 606 or modification is required. The Legislature further intends 607 that the credentials collection and verification entity, the 608 department, health care entities, and physicians work 609 cooperatively to ensure the integrity and accuracy of the 610 program. A physician, an insurance company operating in 611 accordance with chapter 624 which offers health insurance 612 coverage under part VI of chapter 627, a health maintenance 613 organization as defined in s. 641.19, or an entity licensed 614 under chapter 395 must participate in the program. 615 (2) As used in this section, the term: 616 (a) “Accredited” or “certified” means approved by a 617 national accrediting organization as defined in this subsection, 618 another nationally recognized and accepted organization 619 authorized by the department to assess and certify a credentials 620 collection and verification program, or another entity or 621 organization that verifies the credentials of a physician. 622 (b) “Core credentials data” means data that are verified by 623 a primary source as defined in this subsection and that include 624 professional education, professional training, licensure, 625 current Drug Enforcement Administration certification, specialty 626 board certification, Educational Commission for Foreign Medical 627 Graduates certification, and final disciplinary action reported 628 pursuant to s. 456.039(1)(a)8. 629 (c) “Credential” or “credentialing” means the process by 630 which the qualifications of a licensed physician or an applicant 631 for licensure as a physician are assessed and verified. 632 (d) “Credentials collection and verification entity” or 633 “CCVE” means an organization controlled by a statewide 634 association of physicians of all specialties licensed pursuant 635 to chapter 458 or chapter 459 which has been in existence since 636 July 1, 2003, and was selected by the department to collect and 637 store credentialing data, documents, and information. 638 (e) “Drug Enforcement Administration certification” means 639 certification issued by the Drug Enforcement Administration for 640 purposes of administration or prescription of controlled 641 substances. Submission of such certification under this section 642 must include evidence that the certification is current and must 643 also include all current addresses to which the certification is 644 issued. 645 (f) “Health care entity” means: 646 1. A health care facility licensed pursuant to chapter 395; 647 2. An entity licensed by the Department of Insurance as a 648 prepaid health care plan, a health maintenance organization, or 649 an insurer that provides coverage for health care services 650 through a network of health care providers or similar 651 organizations licensed under chapter 627, chapter 636, chapter 652 641, or chapter 651; or 653 3. An accredited medical school in the state. 654 (g) “National accrediting organization” means an 655 organization that awards accreditation or certification to 656 hospitals, managed care organizations, CCVEs, or other health 657 care entities, including, but not limited to, the Joint 658 Commission, the American Osteopathic Association/Healthcare 659 Facilities Accreditation Program, URAC, and the National 660 Committee for Quality Assurance (NCQA). 661 (h) “Physician” means a person licensed or, for 662 credentialing purposes only, a person applying for licensure 663 pursuant to chapter 458 or chapter 459. 664 (i) “Primary source verification” means verification of 665 professional qualifications based on evidence obtained directly 666 from the issuing source of the applicable qualification, any 667 other source deemed as a primary source for verification by the 668 department, or an accrediting organization as defined in this 669 subsection approved by the department. 670 (j) “Professional training” means an internship, residency, 671 or fellowship related to the profession for which the physician 672 is licensed or seeking licensure. 673 (k) “Specialty board certification” means certification in 674 a specialty issued by a specialty board that is recognized by a 675 board as defined in s. 456.001 and that regulates the profession 676 for which the physician is licensed or seeking licensure. 677 (3) The Standardized Credentials Collection and 678 Verification Program is established and shall be administered by 679 the department, as follows: 680 (a) Each physician shall report all core credentials data 681 to the CCVE and notify the CCVE within 45 days after any 682 corrections, updates, or modifications are made to the core 683 credentials data. Failure to report and update information as 684 required under this paragraph constitutes a ground for 685 disciplinary action under the respective licensing chapter and 686 s. 456.072(1)(k). If a licensee or person applying for initial 687 licensure fails to report and update information as required 688 under this paragraph, the department or board, as appropriate, 689 may: 690 1. For a person applying for initial licensure, refuse to 691 issue a license. 692 2. For a licensee, issue a citation pursuant to s. 456.077 693 and assess a fine, as determined by rule by the board or the 694 department. 695 (b) The department: 696 1. By January 1, 2014, shall contract with one CCVE to 697 collect and store credentialing data, documents, and 698 information. The CCVE must be fully accredited or certified by a 699 national accrediting organization. If a CCVE fails to maintain 700 full accreditation or certification or to provide data 701 authorized by a physician, the department may terminate the 702 contract with the CCVE. 703 2. Shall require the CCVE to maintain liability insurance 704 sufficient to meet the certification or accreditation 705 requirements established under this section. 706 3. May designate by rule additional elements of the core 707 credentials data required under this section. 708 (c) The CCVE shall: 709 1. Maintain a complete current file of applicable core 710 credentials data on each physician. 711 2. If authorized by the physician, release the core 712 credentials data and any corrections, updates, and modifications 713 to the data that are otherwise confidential or exempt from the 714 provisions of s. 119.07(1) and s. 24(a), Art. I of the State 715 Constitution to a health care entity. 716 3. Develop standardized forms on which a physician may 717 initially report and authorize the release of core credentials 718 data and subsequently report corrections, updates, and 719 modifications to that data. 720 (d) A health care entity: 721 1. Shall use the CCVE to obtain core credentials data, 722 including corrections, updates, and modifications, on any 723 physician being considered for or renewing membership in, 724 privileges with, or participation in any plan or program with 725 the health care entity. 726 2. May not request core credentials data from the 727 physician. 728 (4) This section does not restrict the authority of a 729 health care entity to credential, approve, or deny an 730 application for hospital staff membership, clinical privileges, 731 or participation in a managed care network. 732 (5) A health care entity may rely upon any data that has 733 been verified by the CCVE to meet the primary source 734 verification requirements of a national accrediting 735 organization. 736 (6) The department shall adopt rules necessary to develop 737 and implement the program established under this section. 738 Section 23. Subsection (1) of section 627.645, Florida 739 Statutes, is amended to read: 740 627.645 Denial of health insurance claims restricted.— 741 (1) ANoclaim for payment under a health insurance policy 742 or self-insured program of health benefits for treatment, care, 743 or services in a licensed hospital thatwhichis accredited by 744 the Joint Commission, the American Osteopathic 745 Association/Healthcare Facilities Accreditation Program, a 746 national accrediting organization that is approved by the 747 Centers for Medicare and Medicaid Services and whose standards 748 incorporate comparable licensure regulations required by the 749 state,on the Accreditation of Hospitals, the American 750 Osteopathic Association, or CARF International may notthe751Commission on the Accreditation of Rehabilitative Facilities752shallbe denied because such hospital lacks major surgical 753 facilities and is primarily of a rehabilitative nature, if such 754 rehabilitation is specifically for treatment of physical 755 disability. 756 Section 24. Paragraph (c) of subsection (2) of section 757 627.668, Florida Statutes, is amended to read: 758 627.668 Optional coverage for mental and nervous disorders 759 required; exception.— 760 (2) Under group policies or contracts, inpatient hospital 761 benefits, partial hospitalization benefits, and outpatient 762 benefits consisting of durational limits, dollar amounts, 763 deductibles, and coinsurance factors shall not be less favorable 764 than for physical illness generally, except that: 765 (c) Partial hospitalization benefits shall be provided 766 under the direction of a licensed physician. For purposes of 767 this part, the term “partial hospitalization services” is 768 defined as those services offered by a program that is 769 accredited by the Joint Commission, the American Osteopathic 770 Association/Healthcare Facilities Accreditation Program, or a 771 national accrediting organization approved by the Centers for 772 Medicare and Medicaid Services and whose standards incorporate 773 comparable licensure regulations required by the state;on774Accreditation of Hospitals (JCAH)or that is in compliance with 775 equivalent standards. Alcohol rehabilitation programs accredited 776 by the Joint Commissionon Accreditation of Hospitalsor 777 approved by the state and licensed drug abuse rehabilitation 778 programs shall also be qualified providers under this section. 779 In a givenanybenefit year, if partial hospitalization services 780 or a combination of inpatient and partial hospitalization are 781 usedutilized, the total benefits paid for all such services may 782shallnot exceed the cost of 30 days afterofinpatient 783 hospitalization for psychiatric services, including physician 784 fees, which prevail in the community in which the partial 785 hospitalization services are rendered. If partial 786 hospitalization services benefits are provided beyond the limits 787 set forth in this paragraph, the durational limits, dollar 788 amounts, and coinsurance factors thereof need not be the same as 789 those applicable to physical illness generally. 790 Section 25. Subsection (3) of section 627.669, Florida 791 Statutes, is amended to read: 792 627.669 Optional coverage required for substance abuse 793 impaired persons; exception.— 794 (3) The benefits provided under this section areshall be795 applicable only if treatment is provided by, or under the 796 supervision of, or is prescribed by, a licensed physician or 797 licensed psychologist and if services are provided in a program 798 that is accredited by the Joint Commission, the American 799 Osteopathic Association/Healthcare Facilities Accreditation 800 Program, or a national accrediting organization that is approved 801 by the Centers for Medicare and Medicaid Services and whose 802 standards incorporate comparable licensure regulations required 803 by the stateon Accreditation of Hospitalsor that is approved 804 by the state. 805 Section 26. Paragraph (a) of subsection (1) of section 806 627.736, Florida Statutes, is amended to read: 807 627.736 Required personal injury protection benefits; 808 exclusions; priority; claims.— 809 (1) REQUIRED BENEFITS.—An insurance policy complying with 810 the security requirements of s. 627.733 must provide personal 811 injury protection to the named insured, relatives residing in 812 the same household, persons operating the insured motor vehicle, 813 passengers in the motor vehicle, and other persons struck by the 814 motor vehicle and suffering bodily injury while not an occupant 815 of a self-propelled vehicle, subject to subsection (2) and 816 paragraph (4)(e), to a limit of $10,000 in medical and 817 disability benefits and $5,000 in death benefits resulting from 818 bodily injury, sickness, disease, or death arising out of the 819 ownership, maintenance, or use of a motor vehicle as follows: 820 (a) Medical benefits.—Eighty percent of all reasonable 821 expenses for medically necessary medical, surgical, X-ray, 822 dental, and rehabilitative services, including prosthetic 823 devices and medically necessary ambulance, hospital, and nursing 824 services if the individual receives initial services and care 825 pursuant to subparagraph 1. within 14 days after the motor 826 vehicle accident. The medical benefits provide reimbursement 827 only for: 828 1. Initial services and care that are lawfully provided, 829 supervised, ordered, or prescribed by a physician licensed under 830 chapter 458 or chapter 459, a dentist licensed under chapter 831 466, or a chiropractic physician licensed under chapter 460 or 832 that are provided in a hospital or in a facility that owns, or 833 is wholly owned by, a hospital. Initial services and care may 834 also be provided by a person or entity licensed under part III 835 of chapter 401 which provides emergency transportation and 836 treatment. 837 2. Upon referral by a provider described in subparagraph 838 1., followup services and care consistent with the underlying 839 medical diagnosis rendered pursuant to subparagraph 1. which may 840 be provided, supervised, ordered, or prescribed only by a 841 physician licensed under chapter 458 or chapter 459, a 842 chiropractic physician licensed under chapter 460, a dentist 843 licensed under chapter 466, or, to the extent permitted by 844 applicable law and under the supervision of such physician, 845 osteopathic physician, chiropractic physician, or dentist, by a 846 physician assistant licensed under chapter 458 or chapter 459 or 847 an advanced registered nurse practitioner licensed under chapter 848 464. Followup services and care may also be provided byany of849 the following persons or entities: 850 a. A hospital or ambulatory surgical center licensed under 851 chapter 395. 852 b. An entity wholly owned by one or more physicians 853 licensed under chapter 458 or chapter 459, chiropractic 854 physicians licensed under chapter 460, or dentists licensed 855 under chapter 466 or by such practitioners and the spouse, 856 parent, child, or sibling of such practitioners. 857 c. An entity that owns or is wholly owned, directly or 858 indirectly, by a hospital or hospitals. 859 d. A physical therapist licensed under chapter 486, based 860 upon a referral by a provider described in this subparagraph. 861 e. A health care clinic licensed under part X of chapter 862 400 which is accredited by the Joint Commission, the American 863 Osteopathic Association/Healthcare Facilities Accreditation 864 Program, a national accrediting organization that is approved by 865 the Centers for Medicare and Medicaid Services and whose 866 standards incorporate comparable licensure regulations required 867 by the state,on Accreditation of Healthcare Organizations, the868American Osteopathic Association,CARF Internationalthe869Commission on Accreditation of Rehabilitation Facilities, or the 870 Accreditation Association for Ambulatory Health Care, Inc., or 871 (I) Has a medical director licensed under chapter 458, 872 chapter 459, or chapter 460; 873 (II) Has been continuously licensed for more than 3 years 874 or is a publicly traded corporation that issues securities 875 traded on an exchange registered with the United States 876 Securities and Exchange Commission as a national securities 877 exchange; and 878 (III) Provides at least four of the following medical 879 specialties: 880 (A) General medicine. 881 (B) Radiography. 882 (C) Orthopedic medicine. 883 (D) Physical medicine. 884 (E) Physical therapy. 885 (F) Physical rehabilitation. 886 (G) Prescribing or dispensing outpatient prescription 887 medication. 888 (H) Laboratory services. 889 3. Reimbursement for services and care provided in 890 subparagraph 1. or subparagraph 2. up to $10,000 if a physician 891 licensed under chapter 458 or chapter 459, a dentist licensed 892 under chapter 466, a physician assistant licensed under chapter 893 458 or chapter 459, or an advanced registered nurse practitioner 894 licensed under chapter 464 has determined that the injured 895 person had an emergency medical condition. 896 4. Reimbursement for services and care provided in 897 subparagraph 1. or subparagraph 2. is limited to $2,500 if aany898 provider listed in subparagraph 1. or subparagraph 2. determines 899 that the injured person did not have an emergency medical 900 condition. 901 5. Medical benefits do not include massage as defined in s. 902 480.033 or acupuncture as defined in s. 457.102, regardless of 903 the person, entity, or licensee providing massage or 904 acupuncture, and a licensed massage therapist or licensed 905 acupuncturist may not be reimbursed for medical benefits under 906 this section. 907 6. The Financial Services Commission shall adopt by rule 908 the form that must be used by an insurer and a health care 909 provider specified in sub-subparagraph 2.b., sub-subparagraph 910 2.c., or sub-subparagraph 2.e. to document that the health care 911 provider meets the criteria of this paragraph. Such, whichrule 912 must include a requirement for a sworn statement or affidavit. 913 914 Only insurers writing motor vehicle liability insurance in this 915 state may provide the required benefits of this section, and 916 such insurer may not require the purchase of any other motor 917 vehicle coverage other than the purchase of property damage 918 liability coverage as required by s. 627.7275 as a condition for 919 providing such benefits. Insurers may not require that property 920 damage liability insurance in an amount greater than $10,000 be 921 purchased in conjunction with personal injury protection. Such 922 insurers shall make benefits and required property damage 923 liability insurance coverage available through normal marketing 924 channels. An insurer writing motor vehicle liability insurance 925 in this state who fails to comply with such availability 926 requirement as a general business practice violates part IX of 927 chapter 626, and such violation constitutes an unfair method of 928 competition or an unfair or deceptive act or practice involving 929 the business of insurance. An insurer committing such violation 930 is subject to the penalties provided under that part, as well as 931 those provided elsewhere in the insurance code. 932 Section 27. Subsection (12) of section 641.495, Florida 933 Statutes, is amended to read: 934 641.495 Requirements for issuance and maintenance of 935 certificate.— 936 (12) The provisions of part I of chapter 395 do not apply 937 to a health maintenance organization that, on or before January 938 1, 1991, provides not more than 10 outpatient holding beds for 939 short-term and hospice-type patients in an ambulatory care 940 facility for its members, provided that such health maintenance 941 organization maintains current accreditation by the Joint 942 Commissionon Accreditation of Health Care Organizations, , a 943 national accrediting organization that is approved by the 944 Centers for Medicare and Medicaid Services and whose standards 945 incorporate comparable licensure regulations required by the 946 state, the Accreditation Association for Ambulatory Health Care, 947 Inc., or the National Committee for Quality Assurance. 948 Section 28. Subsection (2) of section 766.1015, Florida 949 Statutes, is amended to read: 950 766.1015 Civil immunity for members of or consultants to 951 certain boards, committees, or other entities.— 952 (2) Such committee, board, group, commission, or other 953 entity must be established in accordance with state law,orin 954 accordance with requirements of the Joint Commission, the 955 American Osteopathic Association/Healthcare Facilities 956 Accreditation Program, or a national accrediting organization 957 that is approved by the Centers for Medicare and Medicaid 958 Services and whose standards incorporate comparable licensure 959 regulations required by the stateon Accreditation of Healthcare960Organizations, established and duly constituted by one or more 961 public or licensed private hospitals or behavioral health 962 agencies, or established by a governmental agency. To be 963 protected by this section, the act, decision, omission, or 964 utterance may not be made or done in bad faith or with malicious 965 intent. 966 Section 29. This act shall take effect July 1, 2013. 967 968 ================= T I T L E A M E N D M E N T ================ 969 And the title is amended as follows: 970 Delete everything before the enacting clause 971 and insert: 972 A bill to be entitled 973 An act relating to health care; amending s. 112.0455, 974 F.S.; deleting a monthly reporting requirement for 975 laboratories; amending s. 154.11, F.S.; revising 976 references to certain accrediting organizations to 977 conform to changes made by the act; creating s. 978 385.2035, F.S.; designating the Florida Hospital 979 Sanford-Burnham Translational Research Institute for 980 Metabolism and Diabetes as a resource for diabetes 981 research in this state; amending s. 394.741, F.S.; 982 revising references to certain accrediting 983 organizations to conform to changes made by the act; 984 amending s. 395.0161, F.S.; deleting a requirement 985 that hospitals pay certain inspection fees at the time 986 of the inspection; repealing s. 395.1046, F.S., 987 relating to the investigation by the Agency for Health 988 Care Administration of certain complaints against 989 hospitals; amending s. 395.3038, F.S.; deleting an 990 obsolete provision relating to stroke centers; 991 revising references to certain accrediting 992 organizations to conform; amending s. 395.701, F.S.; 993 revising the definition of the term “hospital” for 994 purposes of annual assessments on net operating 995 revenues for inpatient and outpatient services to fund 996 public medical assistance; repealing s. 395.7015, 997 F.S., relating to annual assessments on health care 998 entities; amending s. 397.7016, F.S.; revising a 999 cross-reference to conform to changes made by the act; 1000 amending ss. 397.403, 400.925, 400.9935, and 402.7306, 1001 F.S.; revising references to certain accrediting 1002 organizations to conform to changes made by the act; 1003 amending s. 408.061, F.S.; exempting hospitals 1004 operated by state agencies from certain annual fiscal 1005 experience reporting requirements; amending s. 408.20, 1006 F.S.; exempting hospitals operated by state agencies 1007 from certain assessments; amending ss. 409.966, 1008 409.967, and 430.80, F.S.; revising references to 1009 certain accrediting organizations to conform to 1010 changes made by the act; amending s. 440.102, F.S.; 1011 revising certain drug-testing standards for 1012 laboratories; deleting a requirement that a laboratory 1013 must comply with certain criteria to conduct an 1014 initial analysis of test specimens; deleting a monthly 1015 reporting requirement for laboratories; amending s. 1016 440.13, F.S.; revising references to certain 1017 accrediting organizations to conform to changes made 1018 by the act; creating s. 456.0125, F.S.; providing 1019 legislative intent; providing definitions; creating 1020 the Standardized Credentials Collection and 1021 Verification Program for physicians; providing 1022 procedures and requirements with respect to the 1023 program; authorizing the Department of Health to adopt 1024 rules to develop and implement the program; amending 1025 ss. 627.645, 627.668, 627.669, 627.736, 641.495, and 1026 766.1015, F.S.; revising references to certain 1027 accrediting organizations to conform to changes made 1028 by the act; providing an effective date.