House Bill 3969

    Florida House of Representatives - 1998                HB 3969

        By the Committee on Health Care Services and
    Representative Albright





  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         455.654, F.S.; revising an exemption from the

  4         definition of "referral"; providing conditions

  5         for forfeiture of the exemption; providing an

  6         effective date.

  7

  8  Be It Enacted by the Legislature of the State of Florida:

  9

10         Section 1.  Paragraph (k) of subsection (3) of section

11  455.654, Florida Statutes, is amended to read:

12         455.654  Financial arrangements between referring

13  health care providers and providers of health care services.--

14         (3)  DEFINITIONS.--For the purpose of this section, the

15  word, phrase, or term:

16         (k)  "Referral" means any referral of a patient by a

17  health care provider for health care services, including,

18  without limitation:

19         1.  The forwarding of a patient by a health care

20  provider to another health care provider or to an entity which

21  provides or supplies designated health services or any other

22  health care item or service; or

23         2.  The request or establishment of a plan of care by a

24  health care provider, which includes the provision of

25  designated health services or other health care item or

26  service.

27         3.  Except for the purposes of s. 455.661, the

28  following orders, recommendations, or plans of care shall not

29  constitute a referral by a health care provider:

30         a.  By a radiologist for diagnostic-imaging services.

31

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1998                HB 3969

    169-416-98






  1         b.  By a physician specializing in the provision of

  2  radiation therapy services for such services.

  3         c.  By a medical oncologist for drugs and solutions to

  4  be prepared and administered intravenously to such

  5  oncologist's patient, as well as for the supplies and

  6  equipment used in connection therewith to treat such patient

  7  for cancer and the complications thereof.

  8         d.  By a cardiologist for cardiac catheterization

  9  services.

10         e.  By a pathologist for diagnostic clinical laboratory

11  tests and pathological examination services, if furnished by

12  or under the supervision of such pathologist pursuant to a

13  consultation requested by another physician.

14         f.  By a health care provider who is the sole provider

15  or member of a group practice for designated health services

16  or other health care items or services that are prescribed or

17  provided for not less than 50 percent of solely for such

18  referring health care provider's or group practice's own

19  patients, and that are provided or performed by or under the

20  direct supervision of such referring health care provider or

21  group practice. For a group practice, this exemption is

22  forfeited if the group practice accepts a referral from a

23  physician who is not a member of the group practice but who

24  has an investment interest in or is an investor in the group

25  practice.  For a sole provider, this exemption is forfeited if

26  the sole provider accepts a referral from a physician who has

27  an investment interest in or is an investor in the sole

28  provider's practice.

29         g.  By a health care provider for services provided by

30  an ambulatory surgical center licensed under chapter 395.

31

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1998                HB 3969

    169-416-98






  1         h.  By a health care provider for diagnostic clinical

  2  laboratory services where such services are directly related

  3  to renal dialysis.

  4         i.  By a urologist for lithotripsy services.

  5         j.  By a dentist for dental services performed by an

  6  employee of or health care provider who is an independent

  7  contractor with the dentist or group practice of which the

  8  dentist is a member.

  9         k.  By a physician for infusion therapy services to a

10  patient of that physician or a member of that physician's

11  group practice.

12         l.  By a nephrologist for renal dialysis services and

13  supplies.

14         Section 2.  This act shall take effect October 1 of the

15  year in which enacted.

16

17            *****************************************

18                          HOUSE SUMMARY

19
      Exempts from the definition of "referral" health care
20    items or services prescribed or provided for at least
      one-half of a provider's patients, and provided or
21    performed under the direct supervision of the provider,
      whether a sole provider or a group practice. Provides for
22    forfeiture of the exemption if referral is accepted by
      the provider from an outside physician with an investment
23    interest in the provider's practice.

24

25

26

27

28

29

30

31

                                  3