Senate Bill sb1346
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Florida Senate - 2005 SB 1346
By Senator Saunders
37-1060-05
1 A bill to be entitled
2 An act relating to health care risk management;
3 amending s. 395.10974, F.S.; revising the fee
4 requirements for applicants for licensure to
5 practice health care risk management; amending
6 s. 395.0197, F.S.; requiring that a licensed
7 health care facility use the services of a
8 licensed risk manager rather than hire a
9 licensed risk manager; providing that a risk
10 manager may not be responsible for more than
11 four internal risk management programs in
12 separate hospitals, unless the hospitals are
13 under one corporate ownership or the risk
14 management programs are in rural hospitals;
15 amending s. 456.072, F.S.; providing that
16 invasive action taken in preparation of the
17 patient constitutes grounds for which specified
18 disciplinary actions may be taken; provides
19 that noninvasive preparatory procedures do not
20 constitute grounds for which specified
21 disciplinary actions may be taken; providing an
22 exception for disciplinary action when leaving
23 a foreign body in a patient if leaving the
24 foreign body is medically indicated and
25 documented in the patient record; amending s.
26 395.3025, F.S.; clarifying circumstances under
27 which confidential patient records may be
28 disclosed by health care facility personnel and
29 other licensed health care facilities for the
30 purpose of treating a patient; authorizing the
31 disclosure of confidential patient records by
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Florida Senate - 2005 SB 1346
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1 facility personnel for the purposes of
2 treatment, payment, and its own health care
3 operations; authorizing the disclosure of
4 confidential patient records to health care
5 oversight agencies and researchers of facility
6 personnel for research purposes; defining the
7 term "marketing" for purposes of patient
8 treatment records that are confidential and
9 exempt from the public-records law; providing
10 an effective date.
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12 Be It Enacted by the Legislature of the State of Florida:
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14 Section 1. Subsection (3) of section 395.10974,
15 Florida Statutes, is amended to read:
16 395.10974 Health care risk managers; qualifications,
17 licensure, fees.--
18 (3) The agency shall issue a license to practice
19 health care risk management to any applicant who qualifies
20 under this section. The amount of the fees shall be
21 established by rule, as follows: and submits an application
22 fee of not more than $75, a fingerprinting fee of not more
23 than $75, and a license fee of not more than $100. The agency
24 shall by rule establish fees and procedures for the issuance
25 and cancellation of licenses.
26 Section 2. Subsection (2) of section 395.0197, Florida
27 Statutes, is amended to read:
28 395.0197 Internal risk management program.--
29 (2) The internal risk management program is the
30 responsibility of the governing board of the health care
31 facility. Each licensed facility shall use the services of
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1 hire a risk manager, licensed under s. 395.10974, who is
2 responsible for implementation and oversight of such
3 facility's internal risk management program as required by
4 this section. A risk manager must not be made responsible for
5 more than four internal risk management programs in separate
6 hospitals licensed facilities, unless the hospitals facilities
7 are under one corporate ownership or the risk management
8 programs are in rural hospitals.
9 Section 3. Paragraphs (aa) and (bb) of subsection (1)
10 of section 456.072, Florida Statutes, are amended to read:
11 456.072 Grounds for discipline; penalties;
12 enforcement.--
13 (1) The following acts shall constitute grounds for
14 which the disciplinary actions specified in subsection (2) may
15 be taken:
16 (aa) Performing or attempting to perform health care
17 services on the wrong patient, a wrong-site procedure, a wrong
18 procedure, or an unauthorized procedure or a procedure that is
19 medically unnecessary or otherwise unrelated to the patient's
20 diagnosis or medical condition. For the purposes of this
21 paragraph, performing or attempting to perform health care
22 services includes invasive action taken in furtherance of the
23 preparation of the patient, but does not include those
24 preparations that are noninvasive.
25 (bb) Leaving a foreign body in a patient, such as a
26 sponge, clamp, forceps, surgical needle, or other
27 paraphernalia commonly used in surgical, examination, or other
28 diagnostic procedures, unless leaving the foreign body is
29 medically indicated and documented in the patient record. For
30 the purposes of this paragraph, it shall be legally presumed
31 that retention of a foreign body is not in the best interest
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1 of the patient and is not within the standard of care of the
2 profession, unless medically indicated and documented in the
3 patient record regardless of the intent of the professional.
4 Section 4. Subsections (4) and (7) of section
5 395.3025, Florida Statutes, are amended to read:
6 395.3025 Patient and personnel records; copies;
7 examination.--
8 (4) Patient records are confidential and must not be
9 disclosed without the consent of the person to whom they
10 pertain, but appropriate disclosure may be made without such
11 consent to:
12 (a) Licensed Facility personnel and all other licensed
13 health care facilities and practitioners if such disclosure
14 pertains to the facility's treatment of the patient or the
15 treatment by another health care provider of the patient
16 attending physicians for use in connection with the treatment
17 of the patient.
18 (b) Licensed Facility personnel may disclose protected
19 health information for treatment and payment and for purposes
20 of the facility's health care operations as defined by 45
21 C.F.R. 160 and 164 only for administrative purposes or risk
22 management and quality assurance functions.
23 (c) Health care oversight agencies The agency, for
24 purposes of health care cost containment.
25 (d) In any civil or criminal action, unless otherwise
26 prohibited by law, upon the issuance of a subpoena from a
27 court of competent jurisdiction and proper notice by the party
28 seeking such records to the patient or his or her legal
29 representative.
30 (e) The agency upon subpoena issued pursuant to s.
31 456.071, but the records obtained thereby must be used solely
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1 for the purpose of the agency and the appropriate professional
2 board in its investigation, prosecution, and appeal of
3 disciplinary proceedings. If the agency requests copies of the
4 records, the facility shall charge no more than its actual
5 copying costs, including reasonable staff time. The records
6 must be sealed and must not be available to the public
7 pursuant to s. 119.07(1) or any other statute providing access
8 to records, nor may they be available to the public as part of
9 the record of investigation for and prosecution in
10 disciplinary proceedings made available to the public by the
11 agency or the appropriate regulatory board. However, the
12 agency must make available, upon written request by a
13 practitioner against whom probable cause has been found, any
14 such records that form the basis of the determination of
15 probable cause.
16 (f) The Department of Health or its agent, for the
17 purpose of establishing and maintaining a trauma registry and
18 for the purpose of ensuring that hospitals and trauma centers
19 are in compliance with the standards and rules established
20 under ss. 395.401, 395.4015, 395.4025, 395.404, 395.4045, and
21 395.405, and for the purpose of monitoring patient outcome at
22 hospitals and trauma centers that provide trauma care
23 services.
24 (g) The Department of Children and Family Services or
25 its agent, for the purpose of investigations of cases of
26 abuse, neglect, or exploitation of children or vulnerable
27 adults.
28 (h) The State Long-Term Care Ombudsman Council and the
29 local long-term care ombudsman councils, with respect to the
30 records of a patient who has been admitted from a nursing home
31 or long-term care facility, when the councils are conducting
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1 an investigation involving the patient as authorized under
2 part II of chapter 400, upon presentation of identification as
3 a council member by the person making the request. Disclosure
4 under this paragraph shall only be made after a competent
5 patient or the patient's representative has been advised that
6 disclosure may be made and the patient has not objected.
7 (i) A local trauma agency or a regional trauma agency
8 that performs quality assurance activities, or a panel or
9 committee assembled to assist a local trauma agency or a
10 regional trauma agency in performing quality assurance
11 activities. Patient records obtained under this paragraph are
12 confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
13 of the State Constitution.
14 (j) Organ procurement organizations, tissue banks, and
15 eye banks required to conduct death records reviews pursuant
16 to s. 395.2050.
17 (k) The Medicaid Fraud Control Unit in the Department
18 of Legal Affairs pursuant to s. 409.920.
19 (l) The Department of Financial Services, or an agent,
20 employee, or independent contractor of the department who is
21 auditing for unclaimed property pursuant to chapter 717.
22 (m) Researchers or facility personnel for research
23 purposes if the facility or researchers demonstrate compliance
24 with the requirements of 45 C.F.R. s. 164.512(12)(i).
25 (7)(a) If the content of any record of patient
26 treatment is provided under this section, the recipient, if
27 other than the patient or the patient's representative, may
28 use such information only for the purpose provided and may not
29 further disclose any information to any other person or
30 entity, unless expressly permitted by the written consent of
31 the patient. A general authorization for the release of
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1 medical information is not sufficient for this purpose. The
2 content of such patient treatment record is confidential and
3 exempt from the provisions of s. 119.07(1) and s. 24(a), Art.
4 I of the State Constitution.
5 (b) Absent a specific written release or authorization
6 permitting utilization of patient information for solicitation
7 or marketing the sale of goods or services, any use of such
8 that information for that purpose those purposes is
9 prohibited. As used in this paragraph, the term "marketing"
10 has the same meaning as set forth in 45 C.F.R. s. 164.501
11 Section 5. This act shall take effect July 1, 2005.
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14 SENATE SUMMARY
15 Establisher fees for health care risk management
licenses. Provides that a health care facility only need
16 use the services of, instead of hire, a licensed risk
manager. Requires that the licensed risk manager must not
17 be responsible for more than four risk management
programs in separate hospitals, but provides exceptions
18 to the requirement. Provides that invasive preparatory
procedures constitute grounds for specific disciplinary
19 actions while noninvasive preparatory procedures do not.
Provides that leaving a foreign body in a patient does
20 not constitute grounds for discipline if doing so is
medically indicated and documented in the patient record.
21 Provides additional situations in which confidential
patient records may be disclosed. Defines the term
22 "marketing" for purposes of a public-records exemption.
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