The Florida Senate

Violation of this part, part II of chapter 408, or of applicable rules.

An intentional, reckless, or negligent act that materially affects the health or safety of a patient.

Knowingly providing home health services in an unlicensed assisted living facility or unlicensed adult family-care home, unless the home health agency or employee reports the unlicensed facility or home to the agency within 72 hours after providing the services.

Preparing or maintaining fraudulent patient records, such as, but not limited to, charting ahead, recording vital signs or symptoms that were not personally obtained or observed by the home health agency’s staff at the time indicated, borrowing patients or patient records from other home health agencies to pass a survey or inspection, or falsifying signatures.

Failing to provide at least one service directly to a patient for a period of 60 days.

Documents of training for home health aides or certified nursing assistants; or

Health statements for staff providing direct care to patients.

Require payback of all funds;

Revoke the license; or

Issue a moratorium in accordance with s. 408.814.

Gives remuneration for staffing services to:

unless the home health agency has activated its comprehensive emergency management plan in accordance with s. 400.492. This paragraph does not apply to a Medicare-certified home health agency that provides fair market value remuneration for staffing services to a non-Medicare-certified home health agency that is part of a continuing care facility licensed under chapter 651 for providing services to its own residents if each resident receiving home health services pursuant to this arrangement attests in writing that he or she made a decision without influence from staff of the facility to select, from a list of Medicare-certified home health agencies provided by the facility, that Medicare-certified home health agency to provide the services.

Provides services to residents in an assisted living facility for which the home health agency does not receive fair market value remuneration.

Provides staffing to an assisted living facility for which the home health agency does not receive fair market value remuneration.

Fails to provide the agency, upon request, with copies of all contracts with assisted living facilities which were executed within 5 years before the request.

Gives remuneration to a case manager, discharge planner, facility-based staff member, or third-party vendor who is involved in the discharge planning process of a facility licensed under chapter 395, chapter 429, or this chapter from whom the home health agency receives referrals.

Fails to submit to the agency, within 15 days after the end of each calendar quarter, a written report that includes the following data based on data as it existed on the last day of the quarter:

Gives cash, or its equivalent, to a Medicare or Medicaid beneficiary.

Has more than one medical director contract in effect at one time or more than one medical director contract and one contract with a physician-specialist whose services are mandated for the home health agency in order to qualify to participate in a federal or state health care program at one time.

Gives remuneration to a physician without a medical director contract being in effect. The contract must:

The hourly rate specified in the contract may not be increased during the term of the contract. The home health agency may not execute a subsequent contract with that physician which has an increased hourly rate and covers any portion of the term that was in the original contract.

Gives remuneration to:

if the home health agency has received a patient referral in the preceding 12 months from that physician or physician’s office staff.

Fails to provide to the agency, upon request, copies of all contracts with a medical director which were executed within 5 years before the request.

Demonstrates a pattern of billing the Medicaid program for services to Medicaid recipients which are medically unnecessary as determined by a final order. A pattern may be demonstrated by a showing of at least two such medically unnecessary services within one Medicaid program integrity audit period.

In addition to the requirements of s. 408.813, any person, partnership, or corporation that violates s. 408.812 or s. 408.813 and that previously operated a licensed home health agency or concurrently operates both a licensed home health agency and an unlicensed home health agency commits a felony of the third degree punishable as provided in s. 775.082, s. 775.083, or s. 775.084.

If any home health agency is found to be operating without a license and that home health agency has received any government reimbursement for services, the agency shall make a fraud referral to the appropriate government reimbursement program.