House Bill 4807

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    Florida House of Representatives - 1998                HB 4807

        By Representative Ogles






  1                      A bill to be entitled

  2         An act relating to health care providers;

  3         amending s. 455.654, F.S.; revising definitions

  4         of "investment interest" and "referral" with

  5         respect to financial arrangements between

  6         referring health care providers and providers

  7         of health care services; repealing s. 455.661,

  8         F.S., relating to licensure of designated

  9         health care services; providing an effective

10         date.

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

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14         Section 1.  Paragraphs (i) and (k) of subsection (3) of

15  section 455.654, Florida Statutes, are amended to read:

16         455.654  Financial arrangements between referring

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

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

19  word, phrase, or term:

20         (i)  "Investment interest" means an equity or debt

21  security issued by an entity, including, without limitation,

22  shares of stock in a corporation, units or other interests in

23  a partnership, bonds, debentures, notes, or other equity

24  interests or debt instruments.  Except for purposes of s.

25  455.661, The following investment interests shall be excepted

26  from this definition:

27         1.  An investment interest in an entity that is the

28  sole provider of designated health services in a rural area;

29         2.  An investment interest in notes, bonds, debentures,

30  or other debt instruments issued by an entity which provides

31  designated health services, as an integral part of a plan by

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    Florida House of Representatives - 1998                HB 4807

    520-185-98






  1  such entity to acquire such investor's equity investment

  2  interest in the entity, provided that the interest rate is

  3  consistent with fair market value, and that the maturity date

  4  of the notes, bonds, debentures, or other debt instruments

  5  issued by the entity to the investor is not later than October

  6  1, 1996.

  7         3.  An investment interest in real property resulting

  8  in a landlord-tenant relationship between the health care

  9  provider and the entity in which the equity interest is held,

10  unless the rent is determined, in whole or in part, by the

11  business volume or profitability of the tenant or exceeds fair

12  market value; or

13         4.  An investment interest in an entity which owns or

14  leases and operates a hospital licensed under chapter 395 or a

15  nursing home facility licensed under chapter 400.

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.

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    Florida House of Representatives - 1998                HB 4807

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  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 solely for such referring health care provider's or

18  group practice's own patients, and that are provided or

19  performed by or under the direct supervision of such referring

20  health care provider or group practice.

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

22  an ambulatory surgical center licensed under chapter 395.

23         h.  By a health care provider for diagnostic clinical

24  laboratory services where such services are directly related

25  to renal dialysis, provided that the entity does not have a

26  direct or indirect financial interest in the clinical

27  laboratory or the dialysis clinic.

28         i.  By a urologist for lithotripsy services.

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

30  employee of or health care provider who is an independent

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    Florida House of Representatives - 1998                HB 4807

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  1  contractor with the dentist or group practice of which the

  2  dentist is a member.

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

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

  5  group practice.

  6         l.  By a nephrologist for renal dialysis services and

  7  supplies.

  8         Section 2.  Section 455.661, Florida Statutes, is

  9  repealed.

10         Section 3.  This act shall take effect October 1 of the

11  year in which enacted.

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13            *****************************************

14                          HOUSE SUMMARY

15
      With respect to the "Patient Self-Referral Act of 1992,"
16    restricts an exemption from the definition of "referral,"
      for health care providers referring patients for
17    diagnostic clinical laboratory services related to renal
      dialysis, to those entities with no financial interest in
18    the clinical laboratory or dialysis clinic. Repeals a
      requirement for licensure by the Agency for Health Care
19    Administration of business entities providing designated
      health care services, and conforms definitions to said
20    repeal.

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