Bill Text: FL S0966 | 2013 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Health Care
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Introduced - Dead) 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-Comm_Sub.html
Bill Title: Health Care
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Introduced - Dead) 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-Comm_Sub.html
Florida Senate - 2013 CS for SB 966
By the Committee on Health Policy; and Senator Bean
588-02389-13 2013966c1
1 A bill to be entitled
2 An act relating to health care; amending s. 112.0455,
3 F.S.; deleting a monthly reporting requirement for
4 laboratories; amending s. 154.11, F.S.; revising
5 references to certain accrediting organizations to
6 conform to changes made by the act; creating s.
7 385.2035, F.S.; designating the Florida Hospital
8 Sanford-Burnham Translational Research Institute for
9 Metabolism and Diabetes as a resource for diabetes
10 research in this state; amending s. 394.741, F.S.;
11 revising references to certain accrediting
12 organizations to conform to changes made by the act;
13 amending s. 395.0161, F.S.; deleting a requirement
14 that hospitals pay certain inspection fees at the time
15 of the inspection; repealing s. 395.1046, F.S.,
16 relating to the investigation by the Agency for Health
17 Care Administration of certain complaints against
18 hospitals; amending s. 395.3038, F.S.; deleting an
19 obsolete provision relating to stroke centers;
20 revising references to certain accrediting
21 organizations to conform; amending s. 395.701, F.S.;
22 revising the definition of the term “hospital” for
23 purposes of annual assessments on net operating
24 revenues for inpatient and outpatient services to fund
25 public medical assistance; repealing s. 395.7015,
26 F.S., relating to annual assessments on health care
27 entities; amending s. 395.7016, F.S.; revising a
28 cross-reference to conform to changes made by the act;
29 amending ss. 397.403, 400.925, 400.9935, and 402.7306,
30 F.S.; revising references to certain accrediting
31 organizations to conform to changes made by the act;
32 amending s. 408.061, F.S.; exempting hospitals
33 operated by state agencies from certain annual fiscal
34 experience reporting requirements; amending s. 408.20,
35 F.S.; exempting hospitals operated by state agencies
36 from certain assessments; amending ss. 409.966,
37 409.967, and 430.80, F.S.; revising references to
38 certain accrediting organizations to conform to
39 changes made by the act; amending s. 440.102, F.S.;
40 revising certain drug-testing standards for
41 laboratories; deleting a requirement that a laboratory
42 must comply with certain criteria to conduct an
43 initial analysis of test specimens; deleting a monthly
44 reporting requirement for laboratories; amending s.
45 440.13, F.S.; revising references to certain
46 accrediting organizations to conform to changes made
47 by the act; creating s. 456.0125, F.S.; providing
48 legislative intent; providing definitions; creating
49 the Standardized Credentials Collection and
50 Verification Program for physicians; providing
51 procedures and requirements with respect to the
52 program; authorizing the Department of Health to adopt
53 rules to develop and implement the program; amending
54 s. 499.003, F.S.; exempting prescription drugs
55 transferred either directly or through a hospital’s or
56 health care entity’s supplier for the purpose of
57 repackaging from the definition of “wholesale
58 distribution”; amending s. 499.01, F.S.; requiring a
59 permit for prescription drug repackagers located in
60 other states that repackage and distribute drugs for
61 limited purposes into this state; amending s.
62 499.01212, F.S.; requiring pedigree papers for
63 transfers pursuant to s. 499.003(54)(b)7., F.S., to
64 include specified information; amending ss. 627.645,
65 627.668, 627.669, 627.736, 641.495, and 766.1015,
66 F.S.; revising references to certain accrediting
67 organizations to conform to changes made by the act;
68 providing an effective date.
69
70 Be It Enacted by the Legislature of the State of Florida:
71
72 Section 1. Paragraphs (d) and (e) of subsection (12) of
73 section 112.0455, Florida Statutes, are amended to read:
74 112.0455 Drug-Free Workplace Act.—
75 (12) DRUG-TESTING STANDARDS; LABORATORIES.—
76 (d) The laboratory shall submit to the Agency for Health
77 Care Administration a monthly report with statistical
78 information regarding the testing of employees and job
79 applicants. The reports shall include information on the methods
80 of analyses conducted, the drugs tested for, the number of
81 positive and negative results for both initial and confirmation
82 tests, and any other information deemed appropriate by the
83 Agency for Health Care Administration. No monthly report shall
84 identify specific employees or job applicants.
85 (d)(e) Laboratories shall provide technical assistance to
86 the employer, employee, or job applicant for the purpose of
87 interpreting any positive confirmed test results which could
88 have been caused by prescription or nonprescription medication
89 taken by the employee or job applicant.
90 Section 2. Paragraph (n) of subsection (1) of section
91 154.11, Florida Statutes, is amended to read:
92 154.11 Powers of board of trustees.—
93 (1) The board of trustees of each public health trust shall
94 be deemed to exercise a public and essential governmental
95 function of both the state and the county and in furtherance
96 thereof it shall, subject to limitation by the governing body of
97 the county in which such board is located, have all of the
98 powers necessary or convenient to carry out the operation and
99 governance of designated health care facilities, including, but
100 without limiting the generality of, the foregoing:
101 (n) To appoint originally the staff of physicians to
102 practice in a any designated facility owned or operated by the
103 board and to approve the bylaws and rules to be adopted by the
104 medical staff of a any designated facility owned and operated by
105 the board, such governing regulations to be in accordance with
106 the standards of the Joint Commission, the American Osteopathic
107 Association/Healthcare Facilities Accreditation Program, or a
108 national accrediting organization that is approved by the
109 Centers for Medicare and Medicaid Services and whose standards
110 incorporate comparable licensure regulations required by the
111 state on the Accreditation of Hospitals which provide, among
112 other things, for the method of appointing additional staff
113 members and for the removal of staff members.
114 Section 3. Section 385.2035, Florida Statutes, is created
115 to read:
116 385.2035 Resource for research in the prevention and
117 treatment of diabetes.—The Florida Hospital Sanford-Burnham
118 Translational Research Institute for Metabolism and Diabetes is
119 designated as a resource in this state for research in the
120 prevention and treatment of diabetes.
121 Section 4. Subsection (2) of section 394.741, Florida
122 Statutes, is amended to read:
123 394.741 Accreditation requirements for providers of
124 behavioral health care services.—
125 (2) Notwithstanding any provision of law to the contrary,
126 accreditation shall be accepted by the agency and department in
127 lieu of the agency’s and department’s facility licensure onsite
128 review requirements and shall be accepted as a substitute for
129 the department’s administrative and program monitoring
130 requirements, except as required by subsections (3) and (4),
131 for:
132 (a) An Any organization from which the department purchases
133 behavioral health care services which that is accredited by the
134 Joint Commission, American Osteopathic Association/the
135 Healthcare Facilities Accreditation Program, a national
136 accrediting organization that is approved by the Centers for
137 Medicare and Medicaid Services and whose standards incorporate
138 comparable licensure regulations required by the state, on
139 Accreditation of Healthcare Organizations or the Council on
140 Accreditation for Children and Family Services, or CARF
141 International for the has those services that are being
142 purchased by the department accredited by CARF—the
143 Rehabilitation Accreditation Commission.
144 (b) A Any mental health facility licensed by the agency or
145 a any substance abuse component licensed by the department which
146 that is accredited by the Joint Commission, the American
147 Osteopathic Association/Healthcare Facilities Accreditation
148 Program, a national accrediting organization that is approved by
149 the Centers for Medicare and Medicaid Services and whose
150 standards incorporate comparable licensure regulations required
151 by the state, CARF International on Accreditation of Healthcare
152 Organizations, CARF—the Rehabilitation Accreditation Commission,
153 or the Council on Accreditation of Children and Family Services.
154 (c) A Any network of providers from which the department or
155 the agency purchases behavioral health care services accredited
156 by the Joint Commission, the American Osteopathic
157 Association/Healthcare Facilities Accreditation Program, a
158 national accrediting organization that is approved by the
159 Centers for Medicare and Medicaid Services and whose standards
160 incorporate comparable licensure regulations required by the
161 state, CARF International on Accreditation of Healthcare
162 Organizations, CARF—the Rehabilitation Accreditation Commission,
163 the Council on Accreditation of Children and Family Services, or
164 the National Committee for Quality Assurance. A provider
165 organization that, which is part of an accredited network, is
166 afforded the same rights under this part.
167 Section 5. Subsection (3) of section 395.0161, Florida
168 Statutes, is amended to read:
169 395.0161 Licensure inspection.—
170 (3) In accordance with s. 408.805, an applicant or licensee
171 shall pay a fee for each license application submitted under
172 this part, part II of chapter 408, and applicable rules. With
173 the exception of state-operated licensed facilities, each
174 facility licensed under this part shall pay to the agency, at
175 the time of inspection, the following fees:
176 (a) Inspection for licensure.—A fee shall be paid which is
177 not less than $8 per hospital bed, nor more than $12 per
178 hospital bed, except that the minimum fee shall be $400 per
179 facility.
180 (b) Inspection for lifesafety only.—A fee shall be paid
181 which is not less than 75 cents per hospital bed, nor more than
182 $1.50 per hospital bed, except that the minimum fee shall be $40
183 per facility.
184 Section 6. Section 395.1046, Florida Statutes, is repealed.
185 Section 7. Section 395.3038, Florida Statutes, is amended
186 to read:
187 395.3038 State-listed primary stroke centers and
188 comprehensive stroke centers; notification of hospitals.—
189 (1) The agency shall make available on its website and to
190 the department a list of the name and address of each hospital
191 that meets the criteria for a primary stroke center and the name
192 and address of each hospital that meets the criteria for a
193 comprehensive stroke center. The list of primary and
194 comprehensive stroke centers must shall include only those
195 hospitals that attest in an affidavit submitted to the agency
196 that the hospital meets the named criteria, or those hospitals
197 that attest in an affidavit submitted to the agency that the
198 hospital is certified as a primary or a comprehensive stroke
199 center by the Joint Commission, the American Osteopathic
200 Association/Healthcare Facilities Accreditation Program, or a
201 national accrediting organization that is approved by the
202 Centers for Medicare and Medicaid Services and whose standards
203 incorporate comparable licensure regulations required by the
204 state on Accreditation of Healthcare Organizations.
205 (2)(a) If a hospital no longer chooses to meet the criteria
206 for a primary or comprehensive stroke center, the hospital shall
207 notify the agency and the agency shall immediately remove the
208 hospital from the list.
209 (b)1. This subsection does not apply if the hospital is
210 unable to provide stroke treatment services for a period of time
211 not to exceed 2 months. The hospital shall immediately notify
212 all local emergency medical services providers when the
213 temporary unavailability of stroke treatment services begins and
214 when the services resume.
215 2. If stroke treatment services are unavailable for more
216 than 2 months, the agency shall remove the hospital from the
217 list of primary or comprehensive stroke centers until the
218 hospital notifies the agency that stroke treatment services have
219 been resumed.
220 (3) The agency shall notify all hospitals in this state by
221 February 15, 2005, that the agency is compiling a list of
222 primary stroke centers and comprehensive stroke centers in this
223 state. The notice shall include an explanation of the criteria
224 necessary for designation as a primary stroke center and the
225 criteria necessary for designation as a comprehensive stroke
226 center. The notice shall also advise hospitals of the process by
227 which a hospital might be added to the list of primary or
228 comprehensive stroke centers.
229 (3)(4) The agency shall adopt by rule criteria for a
230 primary stroke center which are substantially similar to the
231 certification standards for primary stroke centers of the Joint
232 Commission, the American Osteopathic Association/Healthcare
233 Facilities Accreditation Program, or a national accrediting
234 organization that is approved by the Centers for Medicare and
235 Medicaid Services and whose standards incorporate comparable
236 licensure regulations required by the state on Accreditation of
237 Healthcare Organizations.
238 (4)(5) The agency shall adopt by rule criteria for a
239 comprehensive stroke center. However, if the Joint Commission,
240 the American Osteopathic Association/Healthcare Facilities
241 Accreditation Program, or a national accrediting organization
242 that is approved by the Centers for Medicare and Medicaid
243 Services and whose standards incorporate comparable licensure
244 regulations required by the state on Accreditation of Healthcare
245 Organizations establishes criteria for a comprehensive stroke
246 center, the agency shall establish criteria for a comprehensive
247 stroke center which are substantially similar to those criteria
248 established by the Joint Commission, the American Osteopathic
249 Association/Healthcare Facilities Accreditation Program, or such
250 national accrediting organization on Accreditation of Healthcare
251 Organizations.
252 (5)(6) This act is not a medical practice guideline and may
253 not be used to restrict the authority of a hospital to provide
254 services for which it is licensed has received a license under
255 chapter 395. The Legislature intends that all patients be
256 treated individually based on each patient’s needs and
257 circumstances.
258 Section 8. Paragraph (c) of subsection (1) of section
259 395.701, Florida Statutes, is amended to read:
260 395.701 Annual assessments on net operating revenues for
261 inpatient and outpatient services to fund public medical
262 assistance; administrative fines for failure to pay assessments
263 when due; exemption.—
264 (1) For the purposes of this section, the term:
265 (c) “Hospital” means a health care institution as defined
266 in s. 395.002(12), but does not include any hospital operated by
267 a state the agency or the Department of Corrections.
268 Section 9. Section 395.7015, Florida Statutes, is repealed.
269 Section 10. Section 395.7016, Florida Statutes, is amended
270 to read:
271 395.7016 Annual appropriation.—The Legislature shall
272 appropriate each fiscal year from either the General Revenue
273 Fund or the Agency for Health Care Administration Tobacco
274 Settlement Trust Fund an amount sufficient to replace the funds
275 lost due to reduction by chapter 2000-256, Laws of Florida, of
276 the assessment on other health care entities under s. 395.7015,
277 and the reduction by chapter 2000-256 in the assessment on
278 hospitals under s. 395.701, and to maintain federal approval of
279 the reduced amount of funds deposited into the Public Medical
280 Assistance Trust Fund under s. 395.701, as state match for the
281 state’s Medicaid program.
282 Section 11. Subsection (3) of section 397.403, Florida
283 Statutes, is amended to read:
284 397.403 License application.—
285 (3) The department shall accept proof of accreditation by
286 CARF International, the Commission on Accreditation of
287 Rehabilitation Facilities(CARF) or the Joint Commission, the
288 American Osteopathic Association/Healthcare Facilities
289 Accreditation Program, or a national accrediting organization
290 that is approved by the Centers for Medicare and Medicaid
291 Services and whose standards incorporate comparable licensure
292 regulations required by the state; or through another any other
293 nationally recognized certification process that is acceptable
294 to the department and meets the minimum licensure requirements
295 under this chapter, in lieu of requiring the applicant to submit
296 the information required by paragraphs (1)(a)-(c).
297 Section 12. Subsection (1) of section 400.925, Florida
298 Statutes, is amended to read:
299 400.925 Definitions.—As used in this part, the term:
300 (1) “Accrediting organizations” means the Joint Commission,
301 the American Osteopathic Association/Healthcare Facilities
302 Accreditation Program, a national accrediting organization that
303 is approved by the Centers for Medicare and Medicaid Services
304 and whose standards incorporate comparable licensure regulations
305 required by the state, on Accreditation of Healthcare
306 Organizations or other national accrediting accreditation
307 agencies whose standards for accreditation are comparable to
308 those required by this part for licensure.
309 Section 13. Paragraph (g) of subsection (1) and subsection
310 (7) of section 400.9935, Florida Statutes, are amended to read:
311 400.9935 Clinic responsibilities.—
312 (1) Each clinic shall appoint a medical director or clinic
313 director who shall agree in writing to accept legal
314 responsibility for the following activities on behalf of the
315 clinic. The medical director or the clinic director shall:
316 (g) Conduct systematic reviews of clinic billings to ensure
317 that the billings are not fraudulent or unlawful. Upon discovery
318 of an unlawful charge, the medical director or clinic director
319 shall take immediate corrective action. If the clinic performs
320 only the technical component of magnetic resonance imaging,
321 static radiographs, computed tomography, or positron emission
322 tomography, and provides the professional interpretation of such
323 services, in a fixed facility that is accredited by the Joint
324 Commission, the American Osteopathic Association/Healthcare
325 Facilities Accreditation Program, on Accreditation of Healthcare
326 Organizations or the Accreditation Association for Ambulatory
327 Health Care, Inc., or a national accrediting organization that
328 is approved by the Centers for Medicare and Medicaid Services
329 and whose standards incorporate comparable licensure regulations
330 required by the state; and the American College of Radiology;
331 and if, in the preceding quarter, the percentage of scans
332 performed by that clinic which was billed to all personal injury
333 protection insurance carriers was less than 15 percent, the
334 chief financial officer of the clinic may, in a written
335 acknowledgment provided to the agency, assume the responsibility
336 for the conduct of the systematic reviews of clinic billings to
337 ensure that the billings are not fraudulent or unlawful.
338 (7)(a) Each clinic engaged in magnetic resonance imaging
339 services must be accredited by the Joint Commission, the
340 American Osteopathic Association/Healthcare Facilities
341 Accreditation Program, a national accrediting organization that
342 is approved by the Centers for Medicare and Medicaid Services
343 and whose standards incorporate comparable licensure regulations
344 required by the state on Accreditation of Healthcare
345 Organizations, the American College of Radiology, or the
346 Accreditation Association for Ambulatory Health Care, Inc.,
347 within 1 year after licensure. A clinic that is accredited by
348 the American College of Radiology or that is within the original
349 1-year period after licensure and replaces its core magnetic
350 resonance imaging equipment shall be given 1 year after the date
351 on which the equipment is replaced to attain accreditation.
352 However, a clinic may request a single, 6-month extension if it
353 provides evidence to the agency establishing that, for good
354 cause shown, such clinic cannot be accredited within 1 year
355 after licensure, and that such accreditation will be completed
356 within the 6-month extension. After obtaining accreditation as
357 required by this subsection, each such clinic must maintain
358 accreditation as a condition of renewal of its license. A clinic
359 that files a change of ownership application must comply with
360 the original accreditation timeframe requirements of the
361 transferor. The agency shall deny a change of ownership
362 application if the clinic is not in compliance with the
363 accreditation requirements. When a clinic adds, replaces, or
364 modifies magnetic resonance imaging equipment and the
365 accrediting accreditation agency requires new accreditation, the
366 clinic must be accredited within 1 year after the date of the
367 addition, replacement, or modification but may request a single,
368 6-month extension if the clinic provides evidence of good cause
369 to the agency.
370 (b) The agency may deny the application or revoke the
371 license of an any entity formed for the purpose of avoiding
372 compliance with the accreditation provisions of this subsection
373 and whose principals were previously principals of an entity
374 that was unable to meet the accreditation requirements within
375 the specified timeframes. The agency may adopt rules as to the
376 accreditation of magnetic resonance imaging clinics.
377 Section 14. Subsections (1) and (2) of section 402.7306,
378 Florida Statutes, are amended to read:
379 402.7306 Administrative monitoring of child welfare
380 providers, and administrative, licensure, and programmatic
381 monitoring of mental health and substance abuse service
382 providers.—The Department of Children and Family Services, the
383 Department of Health, the Agency for Persons with Disabilities,
384 the Agency for Health Care Administration, community-based care
385 lead agencies, managing entities as defined in s. 394.9082, and
386 agencies who have contracted with monitoring agents shall
387 identify and implement changes that improve the efficiency of
388 administrative monitoring of child welfare services, and the
389 administrative, licensure, and programmatic monitoring of mental
390 health and substance abuse service providers. For the purpose of
391 this section, the term “mental health and substance abuse
392 service provider” means a provider who provides services to this
393 state’s priority population as defined in s. 394.674. To assist
394 with that goal, each such agency shall adopt the following
395 policies:
396 (1) Limit administrative monitoring to once every 3 years
397 if the child welfare provider is accredited by the Joint
398 Commission, a national accrediting organization that is approved
399 by the Centers for Medicare and Medicaid Services and whose
400 standards incorporate comparable licensure regulations required
401 by the state, CARF International the Commission on Accreditation
402 of Rehabilitation Facilities, or the Council on Accreditation.
403 If the accrediting body does not require documentation that the
404 state agency requires, that documentation shall be requested by
405 the state agency and may be posted by the service provider on
406 the data warehouse for the agency’s review. Notwithstanding the
407 survey or inspection of an accrediting organization specified in
408 this subsection, an agency specified in and subject to this
409 section may continue to monitor the service provider as
410 necessary with respect to:
411 (a) Ensuring that services for which the agency is paying
412 are being provided.
413 (b) Investigating complaints or suspected problems and
414 monitoring the service provider’s compliance with any resulting
415 negotiated terms and conditions, including provisions relating
416 to consent decrees that are unique to a specific service and are
417 not statements of general applicability.
418 (c) Ensuring compliance with federal and state laws,
419 federal regulations, or state rules if such monitoring does not
420 duplicate the accrediting organization’s review pursuant to
421 accreditation standards.
422
423 Medicaid certification and precertification reviews are exempt
424 from this subsection to ensure Medicaid compliance.
425 (2) Limit administrative, licensure, and programmatic
426 monitoring to once every 3 years if the mental health or
427 substance abuse service provider is accredited by the Joint
428 Commission, the American Osteopathic Association/Healthcare
429 Facilities Accreditation Program, a national accrediting
430 organization that is approved by the Centers for Medicare and
431 Medicaid Services and whose standards incorporate comparable
432 licensure regulations required by the state, CARF International
433 the Commission on Accreditation of Rehabilitation Facilities, or
434 the Council on Accreditation. If the services being monitored
435 are not the services for which the provider is accredited, the
436 limitations of this subsection do not apply. If the accrediting
437 body does not require documentation that the state agency
438 requires, that documentation, except documentation relating to
439 licensure applications and fees, must be requested by the state
440 agency and may be posted by the service provider on the data
441 warehouse for the agency’s review. Notwithstanding the survey or
442 inspection of an accrediting organization specified in this
443 subsection, an agency specified in and subject to this section
444 may continue to monitor the service provider as necessary with
445 respect to:
446 (a) Ensuring that services for which the agency is paying
447 are being provided.
448 (b) Investigating complaints, identifying problems that
449 would affect the safety or viability of the service provider,
450 and monitoring the service provider’s compliance with any
451 resulting negotiated terms and conditions, including provisions
452 relating to consent decrees that are unique to a specific
453 service and are not statements of general applicability.
454 (c) Ensuring compliance with federal and state laws,
455 federal regulations, or state rules if such monitoring does not
456 duplicate the accrediting organization’s review pursuant to
457 accreditation standards.
458
459 Federal certification and precertification reviews are exempt
460 from this subsection to ensure Medicaid compliance.
461 Section 15. Subsection (4) of section 408.061, Florida
462 Statutes, is amended to read:
463 408.061 Data collection; uniform systems of financial
464 reporting; information relating to physician charges;
465 confidential information; immunity.—
466 (4) Within 120 days after the end of its fiscal year, each
467 health care facility, excluding continuing care facilities,
468 hospitals operated by state agencies, and nursing homes as
469 defined in s. 408.07(14) and (37), shall file with the agency,
470 on forms adopted by the agency and based on the uniform system
471 of financial reporting, its actual financial experience for that
472 fiscal year, including expenditures, revenues, and statistical
473 measures. Such data may be based on internal financial reports
474 which are certified to be complete and accurate by the provider.
475 However, hospitals’ actual financial experience shall be their
476 audited actual experience. Every nursing home shall submit to
477 the agency, in a format designated by the agency, a statistical
478 profile of the nursing home residents. The agency, in
479 conjunction with the Department of Elderly Affairs and the
480 Department of Health, shall review these statistical profiles
481 and develop recommendations for the types of residents who might
482 more appropriately be placed in their homes or other
483 noninstitutional settings.
484 Section 16. Subsection (4) of section 408.20, Florida
485 Statutes, is amended to read:
486 408.20 Assessments; Health Care Trust Fund.—
487 (4) Hospitals operated by state agencies the Department of
488 Children and Family Services, the Department of Health, or the
489 Department of Corrections are exempt from the assessments
490 required under this section.
491 Section 17. Paragraph (a) of subsection (3) of section
492 409.966, Florida Statutes, is amended to read:
493 409.966 Eligible plans; selection.—
494 (3) QUALITY SELECTION CRITERIA.—
495 (a) The invitation to negotiate must specify the criteria
496 and the relative weight of the criteria that will be used for
497 determining the acceptability of the reply and guiding the
498 selection of the organizations with which the agency negotiates.
499 In addition to criteria established by the agency, the agency
500 shall consider the following factors in the selection of
501 eligible plans:
502 1. Accreditation by the National Committee for Quality
503 Assurance, the Joint Commission, the American Osteopathic
504 Association/Healthcare Facilities Accreditation Program, a
505 national accrediting organization that is approved by the
506 Centers for Medicare and Medicaid Services and whose standards
507 incorporate comparable licensure regulations required by the
508 state, or another nationally recognized accrediting body.
509 2. Experience serving similar populations, including the
510 organization’s record in achieving specific quality standards
511 with similar populations.
512 3. Availability and accessibility of primary care and
513 specialty physicians in the provider network.
514 4. Establishment of community partnerships with providers
515 that create opportunities for reinvestment in community-based
516 services.
517 5. Organization commitment to quality improvement and
518 documentation of achievements in specific quality improvement
519 projects, including active involvement by organization
520 leadership.
521 6. Provision of additional benefits, particularly dental
522 care and disease management, and other initiatives that improve
523 health outcomes.
524 7. Evidence that an eligible plan has written agreements or
525 signed contracts or has made substantial progress in
526 establishing relationships with providers before the plan
527 submitting a response.
528 8. Comments submitted in writing by an any enrolled
529 Medicaid provider relating to a specifically identified plan
530 participating in the procurement in the same region as the
531 submitting provider.
532 9. Documentation of policies and procedures for preventing
533 fraud and abuse.
534 10. The business relationship an eligible plan has with
535 another any other eligible plan that responds to the invitation
536 to negotiate.
537 Section 18. Paragraph (e) of subsection (2) of section
538 409.967, Florida Statutes, is amended to read:
539 409.967 Managed care plan accountability.—
540 (2) The agency shall establish such contract requirements
541 as are necessary for the operation of the statewide managed care
542 program. In addition to any other provisions the agency may deem
543 necessary, the contract must require:
544 (e) Continuous improvement.—The agency shall establish
545 specific performance standards and expected milestones or
546 timelines for improving performance over the term of the
547 contract.
548 1. Each managed care plan shall establish an internal
549 health care quality improvement system, including enrollee
550 satisfaction and disenrollment surveys. The quality improvement
551 system must include incentives and disincentives for network
552 providers.
553 2. Each plan must collect and report the Health Plan
554 Employer Data and Information Set (HEDIS) measures, as specified
555 by the agency. These measures must be published on the plan’s
556 website in a manner that allows recipients to reliably compare
557 the performance of plans. The agency shall use the HEDIS
558 measures as a tool to monitor plan performance.
559 3. Each managed care plan must be accredited by the
560 National Committee for Quality Assurance, the Joint Commission,
561 a national accrediting organization that is approved by the
562 Centers for Medicare and Medicaid Services and whose standards
563 incorporate comparable licensure regulations required by the
564 state, or another nationally recognized accrediting body, or
565 have initiated the accreditation process, within 1 year after
566 the contract is executed. The agency shall suspend automatic
567 assignment under ss. 409.977 and 409.984 for a any plan not
568 accredited within 18 months after executing the contract, the
569 agency shall suspend automatic assignment under s. 409.977 and
570 409.984.
571 4. By the end of the fourth year of the first contract
572 term, the agency shall issue a request for information to
573 determine whether cost savings could be achieved by contracting
574 for plan oversight and monitoring, including analysis of
575 encounter data, assessment of performance measures, and
576 compliance with other contractual requirements.
577 Section 19. Paragraph (b) of subsection (3) of section
578 430.80, Florida Statutes, is amended to read:
579 430.80 Implementation of a teaching nursing home pilot
580 project.—
581 (3) To be designated as a teaching nursing home, a nursing
582 home licensee must, at a minimum:
583 (b) Participate in a nationally recognized accrediting
584 accreditation program and hold a valid accreditation, such as
585 the accreditation awarded by the Joint Commission on
586 Accreditation of Healthcare Organizations, a national
587 accrediting organization that is approved by the Centers for
588 Medicare and Medicaid Services and whose standards incorporate
589 comparable licensure regulations required by the state, or, at
590 the time of initial designation, possess a Gold Seal Award as
591 conferred by the state on its licensed nursing home;
592 Section 20. Paragraphs (b) and (d) of subsection (9) of
593 section 440.102, Florida Statutes, are amended to read:
594 440.102 Drug-free workplace program requirements.—The
595 following provisions apply to a drug-free workplace program
596 implemented pursuant to law or to rules adopted by the Agency
597 for Health Care Administration:
598 (9) DRUG-TESTING STANDARDS FOR LABORATORIES.—
599 (b) A laboratory may analyze initial or confirmation test
600 specimens only if:
601 1. The laboratory obtains a license under part II of
602 chapter 408 and s. 112.0455(17). Each applicant for licensure
603 and each licensee must comply with all requirements of this
604 section, part II of chapter 408, and applicable rules.
605 2. The laboratory has written procedures to ensure the
606 chain of custody.
607 3. The laboratory follows proper quality control
608 procedures, including, but not limited to:
609 a. The use of internal quality controls, including the use
610 of samples of known concentrations which are used to check the
611 performance and calibration of testing equipment, and periodic
612 use of blind samples for overall accuracy.
613 b. An internal review and certification process for drug
614 test results, conducted by a person qualified to perform that
615 function in the testing laboratory.
616 c. Security measures implemented by the testing laboratory
617 to preclude adulteration of specimens and drug test results.
618 d. Other necessary and proper actions taken to ensure
619 reliable and accurate drug test results.
620 (d) The laboratory shall submit to the Agency for Health
621 Care Administration a monthly report with statistical
622 information regarding the testing of employees and job
623 applicants. The report must include information on the methods
624 of analysis conducted, the drugs tested for, the number of
625 positive and negative results for both initial tests and
626 confirmation tests, and any other information deemed appropriate
627 by the Agency for Health Care Administration. A monthly report
628 must not identify specific employees or job applicants.
629 Section 21. Paragraph (a) of subsection (2) of section
630 440.13, Florida Statutes, is amended to read:
631 440.13 Medical services and supplies; penalty for
632 violations; limitations.—
633 (2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.—
634 (a) Subject to the limitations specified elsewhere in this
635 chapter, the employer shall furnish to the employee such
636 medically necessary remedial treatment, care, and attendance for
637 such period as the nature of the injury or the process of
638 recovery may require, which is in accordance with established
639 practice parameters and protocols of treatment as provided for
640 in this chapter, including medicines, medical supplies, durable
641 medical equipment, orthoses, prostheses, and other medically
642 necessary apparatus. Remedial treatment, care, and attendance,
643 including work-hardening programs or pain-management programs
644 accredited by CARF International, the Commission on
645 Accreditation of Rehabilitation Facilities or Joint Commission,
646 the American Osteopathic Association/Healthcare Facilities
647 Accreditation Program, or a national accrediting organization
648 that is approved by the Centers for Medicare and Medicaid
649 Services and whose standards incorporate comparable licensure
650 regulations required by the state, on the Accreditation of
651 Health Organizations or pain-management programs affiliated with
652 medical schools, shall be considered as covered treatment only
653 when such care is given based on a referral by a physician as
654 defined in this chapter. Medically necessary treatment, care,
655 and attendance does not include chiropractic services in excess
656 of 24 treatments or rendered 12 weeks beyond the date of the
657 initial chiropractic treatment, whichever comes first, unless
658 the carrier authorizes additional treatment or the employee is
659 catastrophically injured.
660
661 Failure of the carrier to timely comply with this subsection
662 shall be a violation of this chapter and the carrier shall be
663 subject to penalties as provided for in s. 440.525.
664 Section 22. Section 456.0125, Florida Statutes, is created
665 to read:
666 456.0125 Standardized Credentials Collection and
667 Verification Program for physicians.—
668 (1) It is the intent of the Legislature to establish the
669 Standardized Credentials Collection and Verification Program to
670 designate an entity to act as a repository for the core
671 credentials data of physicians and to ensure that this
672 information is collected only once unless a correction, update,
673 or modification is required. The Legislature further intends
674 that the credentials collection and verification entity, the
675 department, health care entities, and physicians work
676 cooperatively to ensure the integrity and accuracy of the
677 program. A physician, an insurance company operating in
678 accordance with chapter 624 which offers health insurance
679 coverage under part VI of chapter 627, a health maintenance
680 organization as defined in s. 641.19, or an entity licensed
681 under chapter 395 must participate in the program.
682 (2) As used in this section, the term:
683 (a) “Accredited” or “certified” means approved by a
684 national accrediting organization as defined in this subsection,
685 another nationally recognized and accepted organization
686 authorized by the department to assess and certify a credentials
687 collection and verification program, or another entity or
688 organization that verifies the credentials of a physician.
689 (b) “Core credentials data” means data that are verified by
690 a primary source as defined in this subsection and that include
691 professional education, professional training, licensure,
692 current Drug Enforcement Administration certification, specialty
693 board certification, Educational Commission for Foreign Medical
694 Graduates certification, and final disciplinary action reported
695 pursuant to s. 456.039(1)(a)8.
696 (c) “Credential” or “credentialing” means the process by
697 which the qualifications of a licensed physician or an applicant
698 for licensure as a physician are assessed and verified.
699 (d) “Credentials collection and verification entity” or
700 “CCVE” means an organization controlled by a statewide
701 association of physicians of all specialties licensed pursuant
702 to chapter 458 or chapter 459 which has been in existence since
703 July 1, 2003, and was selected by the department to collect and
704 store credentialing data, documents, and information.
705 (e) “Drug Enforcement Administration certification” means
706 certification issued by the Drug Enforcement Administration for
707 purposes of administration or prescription of controlled
708 substances. Submission of such certification under this section
709 must include evidence that the certification is current and must
710 also include all current addresses to which the certification is
711 issued.
712 (f) “Health care entity” means:
713 1. A health care facility licensed pursuant to chapter 395;
714 2. An entity licensed by the Department of Insurance as a
715 prepaid health care plan, a health maintenance organization, or
716 an insurer that provides coverage for health care services
717 through a network of health care providers or similar
718 organizations licensed under chapter 627, chapter 636, chapter
719 641, or chapter 651; or
720 3. An accredited medical school in the state.
721 (g) “National accrediting organization” means an
722 organization that awards accreditation or certification to
723 hospitals, managed care organizations, CCVEs, or other health
724 care entities, including, but not limited to, the Joint
725 Commission, the American Osteopathic Association/Healthcare
726 Facilities Accreditation Program, URAC, and the National
727 Committee for Quality Assurance (NCQA).
728 (h) “Physician” means a person licensed or, for
729 credentialing purposes only, a person applying for licensure
730 pursuant to chapter 458 or chapter 459.
731 (i) “Primary source verification” means verification of
732 professional qualifications based on evidence obtained directly
733 from the issuing source of the applicable qualification, any
734 other source deemed as a primary source for verification by the
735 department, or an accrediting organization as defined in this
736 subsection approved by the department.
737 (j) “Professional training” means an internship, residency,
738 or fellowship related to the profession for which the physician
739 is licensed or seeking licensure.
740 (k) “Specialty board certification” means certification in
741 a specialty issued by a specialty board that is recognized by a
742 board as defined in s. 456.001 and that regulates the profession
743 for which the physician is licensed or seeking licensure.
744 (3) The Standardized Credentials Collection and
745 Verification Program is established and shall be administered by
746 the department, as follows:
747 (a) Each physician shall report all core credentials data
748 to the CCVE and notify the CCVE within 45 days after any
749 corrections, updates, or modifications are made to the core
750 credentials data. Failure to report and update information as
751 required under this paragraph constitutes a ground for
752 disciplinary action under the respective licensing chapter and
753 s. 456.072(1)(k). If a licensee or person applying for initial
754 licensure fails to report and update information as required
755 under this paragraph, the department or board, as appropriate,
756 may:
757 1. For a person applying for initial licensure, refuse to
758 issue a license.
759 2. For a licensee, issue a citation pursuant to s. 456.077
760 and assess a fine, as determined by rule by the board or the
761 department.
762 (b) The department:
763 1. By January 1, 2014, shall contract with one CCVE to
764 collect and store credentialing data, documents, and
765 information. The CCVE must be fully accredited or certified by a
766 national accrediting organization. If a CCVE fails to maintain
767 full accreditation or certification or to provide data
768 authorized by a physician, the department may terminate the
769 contract with the CCVE.
770 2. Shall require the CCVE to maintain liability insurance
771 sufficient to meet the certification or accreditation
772 requirements established under this section.
773 3. May designate by rule additional elements of the core
774 credentials data required under this section.
775 (c) The CCVE shall:
776 1. Maintain a complete current file of applicable core
777 credentials data on each physician.
778 2. If authorized by the physician, release the core
779 credentials data and any corrections, updates, and modifications
780 to the data that are otherwise confidential or exempt from the
781 provisions of s. 119.07(1) and s. 24(a), Art. I of the State
782 Constitution to a health care entity.
783 3. Develop standardized forms on which a physician may
784 initially report and authorize the release of core credentials
785 data and subsequently report corrections, updates, and
786 modifications to that data.
787 (d) A health care entity:
788 1. Shall use the CCVE to obtain core credentials data,
789 including corrections, updates, and modifications, on any
790 physician being considered for or renewing membership in,
791 privileges with, or participation in any plan or program with
792 the health care entity.
793 2. May not request core credentials data from the
794 physician.
795 (4) This section does not restrict the authority of a
796 health care entity to credential, approve, or deny an
797 application for hospital staff membership, clinical privileges,
798 or participation in a managed care network.
799 (5) A health care entity may rely upon any data that has
800 been verified by the CCVE to meet the primary source
801 verification requirements of a national accrediting
802 organization.
803 (6) The department shall adopt rules necessary to develop
804 and implement the program established under this section.
805 Section 23. Paragraph (b) of subsection (54) of section
806 499.003, Florida Statutes, is amended to read:
807 499.003 Definitions of terms used in this part.—As used in
808 this part, the term:
809 (54) “Wholesale distribution” means distribution of
810 prescription drugs to persons other than a consumer or patient,
811 but does not include:
812 (b) Any of the following activities, which is not a
813 violation of s. 499.005(21) if such activity is conducted in
814 accordance with rules established by the department:
815 1. The sale, purchase, or trade of a prescription drug
816 among federal, state, or local government health care entities
817 that are under common control and are authorized to purchase
818 such prescription drug.
819 2. The sale, purchase, or trade of a prescription drug or
820 an offer to sell, purchase, or trade a prescription drug for
821 emergency medical reasons. For purposes of this subparagraph,
822 the term “emergency medical reasons” includes transfers of
823 prescription drugs by a retail pharmacy to another retail
824 pharmacy to alleviate a temporary shortage.
825 3. The transfer of a prescription drug acquired by a
826 medical director on behalf of a licensed emergency medical
827 services provider to that emergency medical services provider
828 and its transport vehicles for use in accordance with the
829 provider’s license under chapter 401.
830 4. The revocation of a sale or the return of a prescription
831 drug to the person’s prescription drug wholesale supplier.
832 5. The donation of a prescription drug by a health care
833 entity to a charitable organization that has been granted an
834 exemption under s. 501(c)(3) of the Internal Revenue Code of
835 1986, as amended, and that is authorized to possess prescription
836 drugs.
837 6. The transfer of a prescription drug by a person
838 authorized to purchase or receive prescription drugs to a person
839 licensed or permitted to handle reverse distributions or
840 destruction under the laws of the jurisdiction in which the
841 person handling the reverse distribution or destruction receives
842 the drug.
843 7. The transfer of a prescription drug by a hospital or
844 other health care entity, either directly or through the
845 hospital’s or health care entity’s supplier, to a person
846 licensed under this part to repackage prescription drugs for the
847 purpose of repackaging the prescription drug for use by that
848 hospital, or other health care entity and other health care
849 entities that are under common control, if ownership of the
850 prescription drugs remains with the hospital or other health
851 care entity at all times. In addition to the recordkeeping
852 requirements of s. 499.0121(6) and the requirements for
853 repackagers in s. 499.01212(2), the hospital or health care
854 entity that transfers prescription drugs pursuant to this
855 subparagraph must reconcile all drugs transferred and returned
856 and resolve any discrepancies in a timely manner.
857 Section 24. Paragraph (b) of subsection (2) of section
858 499.01, Florida Statutes, is amended to read
859 499.01 Permits.—
860 (2) The following permits are established:
861 (b) Prescription drug repackager permit.—A prescription
862 drug repackager permit is required for any person that
863 repackages a prescription drug in this state or any person
864 located in another state that repackages and distributes
865 prescription drugs in or into this state that are received in a
866 transfer pursuant to s. 499.003(54)(b)7.
867 1. A person that operates an establishment permitted as a
868 prescription drug repackager may engage in wholesale
869 distribution of prescription drugs repackaged at that
870 establishment and must comply with all the provisions of this
871 part and the rules adopted under this part that apply to a
872 wholesale distributor.
873 2. A prescription drug repackager must comply with all
874 appropriate state and federal good manufacturing practices.
875 Section 25. Paragraph (a) of subsection (2) of section
876 499.01212, Florida Statutes, is amended to read:
877 499.01212 Pedigree paper.—
878 (2) FORMAT.—A pedigree paper must contain the following
879 information:
880 (a) For the wholesale distribution of a prescription drug
881 within the normal distribution chain or pursuant to a transfer
882 described in s. 499.003(54)(b)7.:
883 1. The following statement: “This wholesale distributor
884 purchased the specific unit of the prescription drug directly
885 from the manufacturer.”
886 2. The manufacturer’s national drug code identifier and the
887 name and address of the wholesale distributor and the purchaser
888 of the prescription drug.
889 3. The name of the prescription drug as it appears on the
890 label.
891 4. The quantity, dosage form, and strength of the
892 prescription drug.
893
894 The wholesale distributor must also maintain and make available
895 to the department, upon request, the point of origin of the
896 prescription drugs, including intracompany transfers, the date
897 of the shipment from the manufacturer to the wholesale
898 distributor, the lot numbers of such drugs, and the invoice
899 numbers from the manufacturer. When a repackager further
900 distributes prescription drugs to a hospital or other health
901 care entity pursuant to s. 499.003(54)(b)7., the pedigree paper
902 must contain the statement from the wholesale distributor in
903 this subsection, along with the lot numbers of the prescription
904 drugs, the name and address of the repackager and his or her
905 signature, the date of receipt, and the name and address of the
906 person authorized by law to purchase prescription drugs for the
907 purpose of administering or dispensing the drug, as defined in
908 s. 465.003.
909 Section 26. Subsection (1) of section 627.645, Florida
910 Statutes, is amended to read:
911 627.645 Denial of health insurance claims restricted.—
912 (1) A No claim for payment under a health insurance policy
913 or self-insured program of health benefits for treatment, care,
914 or services in a licensed hospital that which is accredited by
915 the Joint Commission, the American Osteopathic
916 Association/Healthcare Facilities Accreditation Program, a
917 national accrediting organization that is approved by the
918 Centers for Medicare and Medicaid Services and whose standards
919 incorporate comparable licensure regulations required by the
920 state on the Accreditation of Hospitals, the American
921 Osteopathic Association, or CARF International may not the
922 Commission on the Accreditation of Rehabilitative Facilities
923 shall be denied because such hospital lacks major surgical
924 facilities and is primarily of a rehabilitative nature, if such
925 rehabilitation is specifically for treatment of physical
926 disability.
927 Section 27. Paragraph (c) of subsection (2) of section
928 627.668, Florida Statutes, is amended to read:
929 627.668 Optional coverage for mental and nervous disorders
930 required; exception.—
931 (2) Under group policies or contracts, inpatient hospital
932 benefits, partial hospitalization benefits, and outpatient
933 benefits consisting of durational limits, dollar amounts,
934 deductibles, and coinsurance factors shall not be less favorable
935 than for physical illness generally, except that:
936 (c) Partial hospitalization benefits shall be provided
937 under the direction of a licensed physician. For purposes of
938 this part, the term “partial hospitalization services” is
939 defined as those services offered by a program that is
940 accredited by the Joint Commission, the American Osteopathic
941 Association/Healthcare Facilities Accreditation Program, or a
942 national accrediting organization approved by the Centers for
943 Medicare and Medicaid Services and whose standards incorporate
944 comparable licensure regulations required by the state; on
945 Accreditation of Hospitals (JCAH) or that is in compliance with
946 equivalent standards. Alcohol rehabilitation programs accredited
947 by the Joint Commission on Accreditation of Hospitals or
948 approved by the state and licensed drug abuse rehabilitation
949 programs shall also be qualified providers under this section.
950 In a given any benefit year, if partial hospitalization services
951 or a combination of inpatient and partial hospitalization are
952 used utilized, the total benefits paid for all such services may
953 shall not exceed the cost of 30 days after of inpatient
954 hospitalization for psychiatric services, including physician
955 fees, which prevail in the community in which the partial
956 hospitalization services are rendered. If partial
957 hospitalization services benefits are provided beyond the limits
958 set forth in this paragraph, the durational limits, dollar
959 amounts, and coinsurance factors thereof need not be the same as
960 those applicable to physical illness generally.
961 Section 28. Subsection (3) of section 627.669, Florida
962 Statutes, is amended to read:
963 627.669 Optional coverage required for substance abuse
964 impaired persons; exception.—
965 (3) The benefits provided under this section are shall be
966 applicable only if treatment is provided by, or under the
967 supervision of, or is prescribed by, a licensed physician or
968 licensed psychologist and if services are provided in a program
969 that is accredited by the Joint Commission, the American
970 Osteopathic Association/Healthcare Facilities Accreditation
971 Program, or a national accrediting organization that is approved
972 by the Centers for Medicare and Medicaid Services and whose
973 standards incorporate comparable licensure regulations required
974 by the state on Accreditation of Hospitals or that is approved
975 by the state.
976 Section 29. Paragraph (a) of subsection (1) of section
977 627.736, Florida Statutes, is amended to read:
978 627.736 Required personal injury protection benefits;
979 exclusions; priority; claims.—
980 (1) REQUIRED BENEFITS.—An insurance policy complying with
981 the security requirements of s. 627.733 must provide personal
982 injury protection to the named insured, relatives residing in
983 the same household, persons operating the insured motor vehicle,
984 passengers in the motor vehicle, and other persons struck by the
985 motor vehicle and suffering bodily injury while not an occupant
986 of a self-propelled vehicle, subject to subsection (2) and
987 paragraph (4)(e), to a limit of $10,000 in medical and
988 disability benefits and $5,000 in death benefits resulting from
989 bodily injury, sickness, disease, or death arising out of the
990 ownership, maintenance, or use of a motor vehicle as follows:
991 (a) Medical benefits.—Eighty percent of all reasonable
992 expenses for medically necessary medical, surgical, X-ray,
993 dental, and rehabilitative services, including prosthetic
994 devices and medically necessary ambulance, hospital, and nursing
995 services if the individual receives initial services and care
996 pursuant to subparagraph 1. within 14 days after the motor
997 vehicle accident. The medical benefits provide reimbursement
998 only for:
999 1. Initial services and care that are lawfully provided,
1000 supervised, ordered, or prescribed by a physician licensed under
1001 chapter 458 or chapter 459, a dentist licensed under chapter
1002 466, or a chiropractic physician licensed under chapter 460 or
1003 that are provided in a hospital or in a facility that owns, or
1004 is wholly owned by, a hospital. Initial services and care may
1005 also be provided by a person or entity licensed under part III
1006 of chapter 401 which provides emergency transportation and
1007 treatment.
1008 2. Upon referral by a provider described in subparagraph
1009 1., followup services and care consistent with the underlying
1010 medical diagnosis rendered pursuant to subparagraph 1. which may
1011 be provided, supervised, ordered, or prescribed only by a
1012 physician licensed under chapter 458 or chapter 459, a
1013 chiropractic physician licensed under chapter 460, a dentist
1014 licensed under chapter 466, or, to the extent permitted by
1015 applicable law and under the supervision of such physician,
1016 osteopathic physician, chiropractic physician, or dentist, by a
1017 physician assistant licensed under chapter 458 or chapter 459 or
1018 an advanced registered nurse practitioner licensed under chapter
1019 464. Followup services and care may also be provided by any of
1020 the following persons or entities:
1021 a. A hospital or ambulatory surgical center licensed under
1022 chapter 395.
1023 b. An entity wholly owned by one or more physicians
1024 licensed under chapter 458 or chapter 459, chiropractic
1025 physicians licensed under chapter 460, or dentists licensed
1026 under chapter 466 or by such practitioners and the spouse,
1027 parent, child, or sibling of such practitioners.
1028 c. An entity that owns or is wholly owned, directly or
1029 indirectly, by a hospital or hospitals.
1030 d. A physical therapist licensed under chapter 486, based
1031 upon a referral by a provider described in this subparagraph.
1032 e. A health care clinic licensed under part X of chapter
1033 400 which is accredited by the Joint Commission, the American
1034 Osteopathic Association/Healthcare Facilities Accreditation
1035 Program, a national accrediting organization that is approved by
1036 the Centers for Medicare and Medicaid Services and whose
1037 standards incorporate comparable licensure regulations required
1038 by the state, CARF International on Accreditation of Healthcare
1039 Organizations, the American Osteopathic Association, the
1040 Commission on Accreditation of Rehabilitation Facilities, or the
1041 Accreditation Association for Ambulatory Health Care, Inc., or
1042 (I) Has a medical director licensed under chapter 458,
1043 chapter 459, or chapter 460;
1044 (II) Has been continuously licensed for more than 3 years
1045 or is a publicly traded corporation that issues securities
1046 traded on an exchange registered with the United States
1047 Securities and Exchange Commission as a national securities
1048 exchange; and
1049 (III) Provides at least four of the following medical
1050 specialties:
1051 (A) General medicine.
1052 (B) Radiography.
1053 (C) Orthopedic medicine.
1054 (D) Physical medicine.
1055 (E) Physical therapy.
1056 (F) Physical rehabilitation.
1057 (G) Prescribing or dispensing outpatient prescription
1058 medication.
1059 (H) Laboratory services.
1060 3. Reimbursement for services and care provided in
1061 subparagraph 1. or subparagraph 2. up to $10,000 if a physician
1062 licensed under chapter 458 or chapter 459, a dentist licensed
1063 under chapter 466, a physician assistant licensed under chapter
1064 458 or chapter 459, or an advanced registered nurse practitioner
1065 licensed under chapter 464 has determined that the injured
1066 person had an emergency medical condition.
1067 4. Reimbursement for services and care provided in
1068 subparagraph 1. or subparagraph 2. is limited to $2,500 if a any
1069 provider listed in subparagraph 1. or subparagraph 2. determines
1070 that the injured person did not have an emergency medical
1071 condition.
1072 5. Medical benefits do not include massage as defined in s.
1073 480.033 or acupuncture as defined in s. 457.102, regardless of
1074 the person, entity, or licensee providing massage or
1075 acupuncture, and a licensed massage therapist or licensed
1076 acupuncturist may not be reimbursed for medical benefits under
1077 this section.
1078 6. The Financial Services Commission shall adopt by rule
1079 the form that must be used by an insurer and a health care
1080 provider specified in sub-subparagraph 2.b., sub-subparagraph
1081 2.c., or sub-subparagraph 2.e. to document that the health care
1082 provider meets the criteria of this paragraph. Such, which rule
1083 must include a requirement for a sworn statement or affidavit.
1084
1085 Only insurers writing motor vehicle liability insurance in this
1086 state may provide the required benefits of this section, and
1087 such insurer may not require the purchase of any other motor
1088 vehicle coverage other than the purchase of property damage
1089 liability coverage as required by s. 627.7275 as a condition for
1090 providing such benefits. Insurers may not require that property
1091 damage liability insurance in an amount greater than $10,000 be
1092 purchased in conjunction with personal injury protection. Such
1093 insurers shall make benefits and required property damage
1094 liability insurance coverage available through normal marketing
1095 channels. An insurer writing motor vehicle liability insurance
1096 in this state who fails to comply with such availability
1097 requirement as a general business practice violates part IX of
1098 chapter 626, and such violation constitutes an unfair method of
1099 competition or an unfair or deceptive act or practice involving
1100 the business of insurance. An insurer committing such violation
1101 is subject to the penalties provided under that part, as well as
1102 those provided elsewhere in the insurance code.
1103 Section 30. Subsection (12) of section 641.495, Florida
1104 Statutes, is amended to read:
1105 641.495 Requirements for issuance and maintenance of
1106 certificate.—
1107 (12) The provisions of part I of chapter 395 do not apply
1108 to a health maintenance organization that, on or before January
1109 1, 1991, provides not more than 10 outpatient holding beds for
1110 short-term and hospice-type patients in an ambulatory care
1111 facility for its members, provided that such health maintenance
1112 organization maintains current accreditation by the Joint
1113 Commission on Accreditation of Health Care Organizations, a
1114 national accrediting organization that is approved by the
1115 Centers for Medicare and Medicaid Services and whose standards
1116 incorporate comparable licensure regulations required by the
1117 state, the Accreditation Association for Ambulatory Health Care,
1118 Inc., or the National Committee for Quality Assurance.
1119 Section 31. Subsection (2) of section 766.1015, Florida
1120 Statutes, is amended to read:
1121 766.1015 Civil immunity for members of or consultants to
1122 certain boards, committees, or other entities.—
1123 (2) Such committee, board, group, commission, or other
1124 entity must be established in accordance with state law, or in
1125 accordance with requirements of the Joint Commission, the
1126 American Osteopathic Association/Healthcare Facilities
1127 Accreditation Program, or a national accrediting organization
1128 that is approved by the Centers for Medicare and Medicaid
1129 Services and whose standards incorporate comparable licensure
1130 regulations required by the state on Accreditation of Healthcare
1131 Organizations, established and duly constituted by one or more
1132 public or licensed private hospitals or behavioral health
1133 agencies, or established by a governmental agency. To be
1134 protected by this section, the act, decision, omission, or
1135 utterance may not be made or done in bad faith or with malicious
1136 intent.
1137 Section 32. This act shall take effect July 1, 2013.
