Bill Text: FL S0644 | 2024 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Rural Emergency Hospitals
Spectrum: Bipartisan Bill
Status: (Passed) 2024-05-29 - Chapter No. 2024-201 [S0644 Detail]
Download: Florida-2024-S0644-Introduced.html
Bill Title: Rural Emergency Hospitals
Spectrum: Bipartisan Bill
Status: (Passed) 2024-05-29 - Chapter No. 2024-201 [S0644 Detail]
Download: Florida-2024-S0644-Introduced.html
Florida Senate - 2024 SB 644 By Senator Simon 3-00959-24 2024644__ 1 A bill to be entitled 2 An act relating to rural hospitals; amending s. 3 395.002, F.S.; revising the definition of the term 4 “hospital”; amending s. 395.602, F.S.; defining the 5 term “rural emergency hospital”; revising the 6 definition of the term “rural hospital”; specifying 7 eligibility requirements for licensure of rural 8 emergency hospitals; authorizing rural emergency 9 hospitals to enter into any contracts required for 10 certain federal reimbursement; authorizing the Agency 11 for Health Care Administration to seek federal 12 approval to provide Medicaid reimbursements to 13 licensed rural emergency hospitals; amending s. 14 395.0163, F.S.; requiring facilities that are to be 15 licensed as rural emergency hospitals to submit 16 certain construction plans and specifications to the 17 agency; deleting obsolete language; creating ss. 18 627.6051, 627.6614, and 641.31078, F.S.; requiring 19 that individual health insurance policies, group 20 health insurance policies, and health maintenance 21 contracts, respectively, issued in this state on or 22 after a specified date provide coverage for services 23 performed in rural emergency hospitals under certain 24 conditions; amending ss. 409.9116 and 1009.65, F.S.; 25 conforming cross-references; providing an effective 26 date. 27 28 Be It Enacted by the Legislature of the State of Florida: 29 30 Section 1. Subsection (12) of section 395.002, Florida 31 Statutes, is amended to read: 32 395.002 Definitions.—As used in this chapter: 33 (12) “Hospital” means any establishment that: 34 (a) Offers services more intensive than those required for 35 room, board, personal services, and general nursing care, and 36 offers facilities and beds for use beyond 24 hours by 37 individuals requiring diagnosis, treatment, or care for illness, 38 injury, deformity, infirmity, abnormality, disease, or 39 pregnancy; and 40 (b) Regularly makes available at least clinical laboratory 41 services, diagnostic X-ray services, and treatment facilities 42 for surgery or obstetrical care, or other definitive medical 43 treatment of similar extent, except that a critical access 44 hospital, as defined in s. 408.07, shall not be required to make 45 available treatment facilities for surgery, obstetrical care, or 46 similar services as long as it maintains its critical access 47 hospital designation and shall be required to make such 48 facilities available only if it ceases to be designated as a 49 critical access hospital; or 50 (c) Is licensed as a rural emergency hospital under s. 51 395.602. 52 53 However,the provisions ofthis chapter doesdonot apply to any 54 institution conducted by or for the adherents of any well 55 recognized church or religious denomination that depends 56 exclusively upon prayer or spiritual means to heal, care for, or 57 treat any person. For purposes of local zoning matters, the term 58 “hospital” includes a medical office building located on the 59 same premises as a hospital facility, provided the land on which 60 the medical office building is constructed is zoned for use as a 61 hospital; provided the premises were zoned for hospital purposes 62 on January 1, 1992. 63 Section 2. Present paragraphs (b) and (c) of subsection (2) 64 of section 395.602, Florida Statutes, are redesignated as 65 paragraphs (c) and (d), respectively, a new paragraph (b) is 66 added to that subsection, subsections (4) and (5) are added to 67 that section, and present paragraph (b) of subsection (2) of 68 that section is amended, to read: 69 395.602 Rural hospitals.— 70 (2) DEFINITIONS.—As used in this part, the term: 71 (b) “Rural emergency hospital” means a hospital that meets 72 the criteria specified in 42 U.S.C. s. 1395x(kkk)(2) and is 73 certified as a rural emergency hospital by the United States 74 Secretary of Health and Human Services. 75 (c)(b)“Rural hospital” means an acute care hospital 76 licensed under this chapter, having 100 or fewer licensed beds 77 and an emergency room, which is: 78 1. The sole provider within a county with a population 79 density of up to 100 persons per square mile; 80 2. An acute care hospital, in a county with a population 81 density of up to 100 persons per square mile, which is at least 82 30 minutes of travel time, on normally traveled roads under 83 normal traffic conditions, from any other acute care hospital 84 within the same county; 85 3. A hospital supported by a tax district or subdistrict 86 whose boundaries encompass a population of up to 100 persons per 87 square mile; 88 4. A hospital classified as a sole community hospital under 89 42 C.F.R. s. 412.92, regardless of the number of licensed beds; 90 5. A hospital with a service area that has a population of 91 up to 100 persons per square mile. As used in this subparagraph, 92 the term “service area” means the fewest number of zip codes 93 that account for 75 percent of the hospital’s discharges for the 94 most recent 5-year period, based on information available from 95 the hospital inpatient discharge database in the Florida Center 96 for Health Information and Transparency at the agency;or97 6. A hospital designated as a critical access hospital, as 98 defined in s. 408.07; or 99 7. A hospital designated as a rural emergency hospital. 100 101 Population densities used in this paragraph must be based upon 102 the most recently completed United States census. A hospital 103 that received funds under s. 409.9116 for a quarter beginning no 104 later than July 1, 2002, is deemed to have been and continues 105shall continueto be a rural hospital from that date through 106 June 30, 2021, if the hospital continues to have up to 100 107 licensed beds and an emergency room. An acute care hospital that 108 has not previously been designated as a rural hospital and that 109 meets the criteria of this paragraph shall be granted such 110 designation upon application, including supporting 111 documentation, to the agency. A hospital that was licensed as a 112 rural hospital during the 2010-2011 or 2011-2012 fiscal year 113 continuesshall continueto be a rural hospital from the date of 114 designation through June 30, 2025, if the hospital continues to 115 have up to 100 licensed beds and an emergency room. 116 (4) A facility is eligible for licensure as a rural 117 emergency hospital if it meets all of the criteria specified in 118 42 U.S.C. s. 1395x(kkk)(2) and is certified as a rural emergency 119 hospital by the United States Secretary of Health and Human 120 Services. 121 (5) Licensed rural emergency hospitals may enter into any 122 contracts necessary to be eligible for federal reimbursement as 123 a rural emergency hospital. 124 Section 3. The Agency for Health Care Administration may 125 seek federal approval to provide Medicaid reimbursements to 126 licensed rural emergency hospitals. 127 Section 4. Paragraph (b) of subsection (1) of section 128 395.0163, Florida Statutes, is amended to read: 129 395.0163 Construction inspections; plan submission and 130 approval; fees.— 131 (1) 132 (b) All outpatient facilities that provide surgical 133 treatments requiring general anesthesia or IV conscious 134 sedation, that provide cardiac catheterization services, or that 135 are to be licensed as rural emergency hospitals or ambulatory 136 surgical centers shall submit plans and specifications to the 137 agency for review under this section. All other outpatient 138 facilities must be reviewed under this section, except that 139 those that are physically detached from, and have no utility 140 connections with, the hospital and that do not block emergency 141 egress from or create a fire hazard to the hospital are exempt 142 from review under this section.This paragraph applies to143applications for which review is pending on or after July 1,1441998.145 Section 5. Section 627.6051, Florida Statutes, is created 146 to read: 147 627.6051 Coverage for rural emergency hospital services.—To 148 the extent not preempted by federal or state law, any individual 149 health insurance policy issued or renewed in this state on or 150 after July 1, 2024, must provide coverage for any service 151 performed in a rural emergency hospital licensed under s. 152 395.602 if such service performed in a general hospital would be 153 covered by the policy. 154 Section 6. Section 627.6614, Florida Statutes, is created 155 to read: 156 627.6614 Coverage for rural emergency hospital services.—To 157 the extent not preempted by federal or state law, any group 158 health insurance policy issued or renewed in this state on or 159 after July 1, 2024, must provide coverage for any service 160 performed in a rural emergency hospital licensed under s. 161 395.602 if such service performed in a general hospital would be 162 covered by the policy. 163 Section 7. Section 641.31078, Florida Statutes, is created 164 to read: 165 641.31078 Coverage for rural emergency hospital services. 166 To the extent not preempted by federal or state law, any health 167 maintenance contract issued or renewed in this state on or after 168 July 1, 2024, must provide coverage for any service performed in 169 a rural emergency hospital licensed under s. 395.602 if such 170 service performed in a general hospital would be covered by the 171 contract. 172 Section 8. Subsection (6) of section 409.9116, Florida 173 Statutes, is amended to read: 174 409.9116 Disproportionate share/financial assistance 175 program for rural hospitals.—In addition to the payments made 176 under s. 409.911, the Agency for Health Care Administration 177 shall administer a federally matched disproportionate share 178 program and a state-funded financial assistance program for 179 statutory rural hospitals. The agency shall make 180 disproportionate share payments to statutory rural hospitals 181 that qualify for such payments and financial assistance payments 182 to statutory rural hospitals that do not qualify for 183 disproportionate share payments. The disproportionate share 184 program payments shall be limited by and conform with federal 185 requirements. Funds shall be distributed quarterly in each 186 fiscal year for which an appropriation is made. Notwithstanding 187 the provisions of s. 409.915, counties are exempt from 188 contributing toward the cost of this special reimbursement for 189 hospitals serving a disproportionate share of low-income 190 patients. 191 (6) This section applies only to hospitals that were 192 defined as statutory rural hospitals, or their successor-in 193 interest hospital, prior to January 1, 2001. Any additional 194 hospital that is defined as a statutory rural hospital, or its 195 successor-in-interest hospital, on or after January 1, 2001, is 196 not eligible for programs under this section unless additional 197 funds are appropriated each fiscal year specifically to the 198 rural hospital disproportionate share and financial assistance 199 programs in an amount necessary to prevent any hospital, or its 200 successor-in-interest hospital, eligible for the programs prior 201 to January 1, 2001, from incurring a reduction in payments 202 because of the eligibility of an additional hospital to 203 participate in the programs. A hospital, or its successor-in 204 interest hospital, which received funds pursuant to this section 205 before January 1, 2001, and which qualifies under s. 206 395.602(2)(c)s. 395.602(2)(b), shall be included in the 207 programs under this section and is not required to seek 208 additional appropriations under this subsection. 209 Section 9. Paragraph (a) of subsection (1) of section 210 1009.65, Florida Statutes, is amended to read: 211 1009.65 Medical Education Reimbursement and Loan Repayment 212 Program.— 213 (1) To encourage qualified medical professionals to 214 practice in underserved locations where there are shortages of 215 such personnel, there is established the Medical Education 216 Reimbursement and Loan Repayment Program. The function of the 217 program is to make payments that offset loans and educational 218 expenses incurred by students for studies leading to a medical 219 or nursing degree, medical or nursing licensure, or advanced 220 practice registered nurse licensure or physician assistant 221 licensure. The following licensed or certified health care 222 professionals are eligible to participate in this program: 223 (a) Medical doctors with primary care specialties, doctors 224 of osteopathic medicine with primary care specialties, physician 225 assistants, licensed practical nurses and registered nurses, and 226 advanced practice registered nurses with primary care 227 specialties such as certified nurse midwives. Primary care 228 medical specialties for physicians include obstetrics, 229 gynecology, general and family practice, internal medicine, 230 pediatrics, and other specialties which may be identified by the 231 Department of Health. From the funds available, the Department 232 of Health shall make payments as follows: 233 1. Up to $4,000 per year for licensed practical nurses and 234 registered nurses, up to $10,000 per year for advanced practice 235 registered nurses and physician assistants, and up to $20,000 236 per year for physicians. Penalties for noncompliance shall be 237 the same as those in the National Health Services Corps Loan 238 Repayment Program. Educational expenses include costs for 239 tuition, matriculation, registration, books, laboratory and 240 other fees, other educational costs, and reasonable living 241 expenses as determined by the Department of Health. 242 2. All payments are contingent on continued proof of 243 primary care practice in an area defined in s. 395.602(2)(c)s.244395.602(2)(b), or an underserved area designated by the 245 Department of Health, provided the practitioner accepts Medicaid 246 reimbursement if eligible for such reimbursement. Correctional 247 facilities, state hospitals, and other state institutions that 248 employ medical personnel shall be designated by the Department 249 of Health as underserved locations. Locations with high 250 incidences of infant mortality, high morbidity, or low Medicaid 251 participation by health care professionals may be designated as 252 underserved. 253 Section 10. This act shall take effect July 1, 2024.