Bill Text: FL S2504 | 2010 | Regular Session | Introduced

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Bill Title: Hospital-based Physicians [SPSC]

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2010-04-16 - Withdrawn from Health Regulation; Banking and Insurance; Health and Human Services Appropriations -SJ 00635; Withdrawn from further consideration -SJ 00635 [S2504 Detail]

Download: Florida-2010-S2504-Introduced.html

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Florida Senate - 2010                                    SB 2504 
 
By Senator Lawson 
6-01822-10                                            20102504__ 
1                        A bill to be entitled 
2         An act relating to hospital-based physicians; 
3         providing definitions; prohibiting a licensed facility 
4         from employing a hospital-based physician or group of 
5         hospital-based physicians or entering into a contract 
6         with such physicians unless those physicians are under 
7         contract with each health insurer that has contracted 
8         with the licensed facility to provide medical 
9         services; requiring the contract between a licensed 
10         facility and a hospital-based physician or group of 
11         hospital-based physicians to contain provisions that 
12         prohibit the physician or group of physicians from 
13         collecting from the enrollees or subscribers of a 
14         health insurer an amount in excess of the payment 
15         received from the health insurer other than the 
16         applicable copayment and certain other payments; 
17         prohibiting a hospital-based physician or group of 
18         hospital-based physicians from collecting from the 
19         enrollees or subscribers of a health insurer any 
20         amount in excess of the payment received from the 
21         health insurer other than the applicable copayment and 
22         certain other payments; providing for disciplinary 
23         action; providing an effective date. 
24 
25  Be It Enacted by the Legislature of the State of Florida: 
26 
27         Section 1. Hospital-based physicians.— 
28         (1) As used in this section, the term: 
29         (a) “Hospital-based physician” or “group of hospital-based 
30  physicians” means any physician or group of physicians, 
31  including, but not limited to, pathologists, emergency room 
32  physicians, anesthesiologists, and radiologists, who have 
33  entered into an arrangement, understanding, or contract with a 
34  licensed facility which: 
35         1. Allows the physician or group of physicians to provide 
36  medical services for a facility’s inpatients and outpatients 
37  without being specifically chosen by the patients; 
38         2. Precludes physicians of a similar specialty from 
39  providing medical services to the facility’s inpatients and 
40  outpatients; or 
41         3. Fosters the opportunity for the physician or group of 
42  physicians to be the providers of medical services to the 
43  facility’s inpatients and outpatients within that physician’s or 
44  group of physicians’ specialty type. 
45         (b) “Licensed facility” means a hospital, ambulatory 
46  surgical center, or mobile surgical facility licensed in 
47  accordance with chapter 395, Florida Statutes. 
48         (2) A licensed facility may not employ a hospital-based 
49  physician or group of hospital-based physicians, and may not 
50  enter into an arrangement, understanding, or contract with a 
51  hospital-based physician or group of hospital-based physicians 
52  unless the hospital-based physician or group of hospital-based 
53  physicians is under written contract, or agrees to a written 
54  contract within 90 days after the effective date of the 
55  arrangement with each health insurance company or health 
56  maintenance organization that has contracted with the licensed 
57  facility to provide medical services to its enrollees or 
58  subscribers. The hospital-based physician or group of hospital 
59  based physicians shall contract on terms that are reasonably 
60  comparable to the terms between similar health insurance 
61  companies, health maintenance organizations, and hospital-based 
62  physicians of a similar specialty in the facility’s geographic 
63  area. 
64         (3) Each arrangement, understanding, or contract between a 
65  licensed facility and a hospital-based physician or group of 
66  hospital-based physicians must contain terms that prohibit each 
67  such physician or group of physicians from collecting, or 
68  attempting to collect, from the enrollees or subscribers of a 
69  health insurance company or health maintenance organization any 
70  amount in excess of the payment received from the health 
71  insurance company or health maintenance organization other than 
72  the applicable copayment, deductible, coinsurance, or amounts 
73  for noncovered medical services. 
74         (4) A hospital-based physician or group of hospital-based 
75  physicians, in an arrangement, understanding, or contract as 
76  described in this section, may not collect, or attempt to 
77  collect, from the enrollees or subscribers of a health insurance 
78  company or health maintenance organization any amount other than 
79  the amount specified in subsection (3). 
80         (5) A violation of this section constitutes grounds for 
81  disciplinary actions specified in ss. 395.1065 and 456.072(2), 
82  Florida Statutes. 
83         Section 2. This act shall take effect July 1, 2010.