Florida Senate - 2013 SB 594 By Senator Bean 4-00277A-13 2013594__ 1 A bill to be entitled 2 An act relating to nursing homes and related health 3 care facilities; amending s. 400.9905, F.S.; 4 clarifying provisions to exempt certain clinics that 5 receive reimbursement under the Florida Motor Vehicle 6 No-Fault Law from licensure requirements in this state 7 if they hold specific federal certification; extending 8 the exemption to clinics that are owned by certain 9 entities; providing an effective date. 10 11 Be It Enacted by the Legislature of the State of Florida: 12 13 Section 1. Subsection (4) of section 400.9905, Florida 14 Statutes, is amended to read: 15 400.9905 Definitions.— 16 (4) “Clinic” means an entity in whichwherehealth care 17 services are provided to individuals and which tenders charges 18 for reimbursement for such services, including a mobile clinic 19 and a portable equipment provider. As used in this part, the 20 term does not include and the licensure requirements of this 21 part do not apply to: 22 (a) Entities licensed or registered by the state under 23 chapter 395; entities licensed or registered by the state and 24 providing only health care services within the scope of services 25 authorized under their respective licenses under ss. 383.30 26 383.335, chapter 390, chapter 394, chapter 397, this chapter 27 except part X, chapter 429, chapter 463, chapter 465, chapter 28 466, chapter 478, part I of chapter 483, chapter 484, or chapter 29 651; end-stage renal disease providers authorized under 42 30 C.F.R. part 405, subpart U; providers certified under 42 C.F.R. 31 part 485, subpart B or subpart H; or any entity that provides 32 neonatal or pediatric hospital-based health care services or 33 other health care services by licensed practitioners solely 34 within a hospital licensed under chapter 395. 35 (b) Entities that own, directly or indirectly, entities 36 licensed or registered by the state pursuant to chapter 395; 37 entities that own, directly or indirectly, entities licensed or 38 registered by the state and providing only health care services 39 within the scope of services authorized pursuant to their 40 respective licenses under ss. 383.30-383.335, chapter 390, 41 chapter 394, chapter 397, this chapter except part X, chapter 42 429, chapter 463, chapter 465, chapter 466, chapter 478, part I 43 of chapter 483, chapter 484, or chapter 651; end-stage renal 44 disease providers authorized under 42 C.F.R. part 405, subpart 45 U; providers certified under 42 C.F.R. part 485, subpart B or 46 subpart H; or any entity that provides neonatal or pediatric 47 hospital-based health care services by licensed practitioners 48 solely within a hospital licensed under chapter 395. 49 (c) Entities that are owned, directly or indirectly, by an 50 entity licensed or registered by the state pursuant to chapter 51 395; entities that are owned, directly or indirectly, by an 52 entity licensed or registered by the state and providing only 53 health care services within the scope of services authorized 54 pursuant to their respective licenses under ss. 383.30-383.335, 55 chapter 390, chapter 394, chapter 397, this chapter except part 56 X, chapter 429, chapter 463, chapter 465, chapter 466, chapter 57 478, part I of chapter 483, chapter 484, or chapter 651; end 58 stage renal disease providers authorized under 42 C.F.R. part 59 405, subpart U; providers certified under 42 C.F.R. part 485, 60 subpart B or subpart H; or any entity that provides neonatal or 61 pediatric hospital-based health care services by licensed 62 practitioners solely within a hospital under chapter 395. 63 (d) Entities that are under common ownership, directly or 64 indirectly, with an entity licensed or registered by the state 65 pursuant to chapter 395; entities that are under common 66 ownership, directly or indirectly, with an entity licensed or 67 registered by the state and providing only health care services 68 within the scope of services authorized pursuant to their 69 respective licenses under ss. 383.30-383.335, chapter 390, 70 chapter 394, chapter 397, this chapter except part X, chapter 71 429, chapter 463, chapter 465, chapter 466, chapter 478, part I 72 of chapter 483, chapter 484, or chapter 651; end-stage renal 73 disease providers authorized under 42 C.F.R. part 405, subpart 74 U; providers certified under 42 C.F.R. part 485, subpart B or 75 subpart H; or any entity that provides neonatal or pediatric 76 hospital-based health care services by licensed practitioners 77 solely within a hospital licensed under chapter 395. 78 (e) An entity that is exempt from federal taxation under 26 79 U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan 80 under 26 U.S.C. s. 409 that has a board of trustees at least 81 two-thirds of which are Florida-licensed health care 82 practitioners and provides only physical therapy services under 83 physician orders, any community college or university clinic, 84 and any entity owned or operated by the federal or state 85 government, including agencies, subdivisions, or municipalities 86 thereof. 87 (f) A sole proprietorship, group practice, partnership, or 88 corporation that provides health care services by physicians 89 covered by s. 627.419, that is directly supervised by one or 90 more of such physicians, and that is wholly owned by one or more 91 of those physicians or by a physician and the spouse, parent, 92 child, or sibling of that physician. 93 (g) A sole proprietorship, group practice, partnership, or 94 corporation that provides health care services by licensed 95 health care practitioners under chapter 457, chapter 458, 96 chapter 459, chapter 460, chapter 461, chapter 462, chapter 463, 97 chapter 466, chapter 467, chapter 480, chapter 484, chapter 486, 98 chapter 490, chapter 491, or part I, part III, part X, part 99 XIII, or part XIV of chapter 468, or s. 464.012, and that is 100 wholly owned by one or more licensed health care practitioners, 101 or the licensed health care practitioners set forth in this 102 paragraph and the spouse, parent, child, or sibling of a 103 licensed health care practitioner if one of the owners who is a 104 licensed health care practitioner is supervising the business 105 activities and is legally responsible for the entity’s 106 compliance with all federal and state laws. However, a health 107 care practitioner may not supervise services beyond the scope of 108 the practitioner’s license, except that, for the purposes of 109 this part, a clinic owned by a licensee in s. 456.053(3)(b) 110 which provides only services authorized pursuant to s. 111 456.053(3)(b) may be supervised by a licensee specified in s. 112 456.053(3)(b). 113 (h) Clinical facilities affiliated with an accredited 114 medical school at which training is provided for medical 115 students, residents, or fellows. 116 (i) Entities that provide only oncology or radiation 117 therapy services by physicians licensed under chapter 458 or 118 chapter 459 or entities that provide oncology or radiation 119 therapy services by physicians licensed under chapter 458 or 120 chapter 459 which are owned by a corporation whose shares are 121 publicly traded on a recognized stock exchange. 122 (j) Clinical facilities affiliated with a college of 123 chiropractic accredited by the Council on Chiropractic Education 124 at which training is provided for chiropractic students. 125 (k) Entities that provide licensed practitioners to staff 126 emergency departments or to deliver anesthesia services in 127 facilities licensed under chapter 395 and that derive at least 128 90 percent of their gross annual revenues from the provision of 129 such services. Entities claiming an exemption from licensure 130 under this paragraph must provide documentation demonstrating 131 compliance. 132 (l) Orthotic or prosthetic clinical facilities that are a 133 publicly traded corporation or that are wholly owned, directly 134 or indirectly, by a publicly traded corporation. As used in this 135 paragraph, a publicly traded corporation is a corporation that 136 issues securities traded on an exchange registered with the 137 United States Securities and Exchange Commission as a national 138 securities exchange. 139 (m) Entities that are owned by a corporation that has $250 140 million or more in total annual sales of health care services 141 provided by licensed health care practitioners where one or more 142 of the owners is a health care practitioner who is licensed in 143 this state and who is responsible for supervising the business 144 activities of the entity and is legally responsible for the 145 entity’s compliance with state law for purposes of this part. 146 (n) Entities that employ 50 or more licensed health care 147 practitioners licensed under chapter 458 or chapter 459 where 148 the billing for medical services is under a single tax 149 identification number. The application for exemption under this 150 subsection shall contain information that includes: the name, 151 residence, and business address and phone number of the entity 152 that owns the practice; a complete list of the names and contact 153 information of all the officers and directors of the 154 corporation; the name, residence address, business address, and 155 medical license number of each licensed Florida health care 156 practitioner employed by the entity; the corporate tax 157 identification number of the entity seeking an exemption; a 158 listing of health care services to be provided by the entity at 159 the health care clinics owned or operated by the entity and a 160 certified statement prepared by an independent certified public 161 accountant which states that the entity and the health care 162 clinics owned or operated by the entity have not received 163 payment for health care services under personal injury 164 protection insurance coverage for the preceding year. If the 165 agency determines that an entity which is exempt under this 166 subsection has received payments for medical services under 167 personal injury protection insurance coverage, the agency may 168 deny or revoke the exemption from licensure under this 169 subsection. 170 171 Notwithstanding this subsection, an entity shall be deemed a 172 clinic and must be licensed under this part in order to receive 173 reimbursement under the Florida Motor Vehicle No-Fault Law, ss. 174 627.730-627.7405, unless exempted under s. 627.736(5)(h) or 175 under this subsection as a provider certified under 42 C.F.R. 176 part 485, subpart H, before June 30, 2014. However, if a single 177 legal entity owns clinics certified under 42 C.F.R. part 485, 178 subpart H, which are exempted under this provision, the 179 exemption extends after June 30, 2014, to other clinics 180 certified under 42 C.F.R. part 485, subpart H, which are owned 181 by that entity. 182 Section 2. This act shall take effect July 1, 2013.