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

House Bill 0759

Florida House of Representatives - 1997 HB 759 By Representative Geller 1 A bill to be entitled 2 An act relating to home medical equipment 3 suppliers; creating part IX of chapter 400, 4 F.S.; providing for regulation of home medical 5 equipment suppliers by the Agency for Health 6 Care Administration; providing legislative 7 intent; providing definitions; providing for 8 licensure and exemptions; providing unlawful 9 acts; providing penalties; providing for 10 license applications; providing for a fee; 11 providing for provisional licenses and 12 temporary permits; providing for administrative 13 penalties; providing for injunctions, emergency 14 orders, and moratoriums; providing for 15 licensure inspections; providing minimum 16 standards; providing for agency rules; 17 providing for clinical records; providing for 18 notice of toll-free telephone number for the 19 central abuse registry; providing for 20 background screening of home medical equipment 21 supplier personnel; providing screening 22 procedures; providing for agency injunctions; 23 prohibiting referrals to home medical equipment 24 suppliers; prohibiting rebates; providing 25 penalties; providing an effective date. 26 27 Be It Enacted by the Legislature of the State of Florida: 28 29 Section 1. Part IX of chapter 400, Florida Statutes, 30 consisting of sections 400.81, 400.815, 400.82, 400.821, 31 1 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 400.822, 400.823, 400.824, 400.825, 400.83, 400.84, 400.843, 2 400.845, 400.85, 400.86, and 400.865, is created to read: 3 400.81 Legislative intent.--It is the intent of the 4 Legislature to provide for the licensure of every home medical 5 equipment supplier and to provide for the development, 6 establishment, and enforcement of basic standards that will 7 ensure quality services to persons receiving home medical 8 equipment. 9 400.815 Definitions.--As used in this chapter, the 10 term: 11 (1) "Accrediting organizations" means the Joint 12 Commission on Accreditation of Healthcare Organizations or 13 other national accreditation agencies whose standards are 14 comparable to those required by this licensure. 15 (2) "Affiliated person" means any person who directly 16 or indirectly manages, controls, or oversees the operation of 17 a corporation or other business entity that is a licensee, 18 regardless of whether such person is a partner, shareholder, 19 owner, officer, director, agent, or employee of the entity. 20 (3) "Agency" means the Agency for Health Care 21 Administration. 22 (4) "Applicant" means an individual applicant, or any 23 officer, director, agent, managing employee, general manager 24 or affiliated person, or any partner or shareholder having an 25 ownership interest equal to 5 percent or greater in the 26 corporation, partnership, or other business entity. 27 (5) "Consumer or patient" means any person who uses 28 home medical equipment in his or her home or place of 29 residence. 30 (6) "Department" means the Department of Children and 31 Family Services. 2 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (7) "General manager" means the individual who has the 2 general administrative charge of a licensed home medical 3 equipment supplier premises. 4 (8) "Home medical equipment" includes any product as 5 defined by the Federal Drug Administration's Drugs, Devices 6 and Cosmetics Act, any product reimbursed under the Medicare 7 Durable Medical Equipment benefits, or any product reimbursed 8 under the Florida Medicaid Durable Medical Equipment program. 9 Home medical equipment includes, but is not limited to, oxygen 10 products and equipment. Home medical equipment does not 11 include prosthetics or customized orthotics. 12 (9) "Home medical equipment services" means equipment 13 management and consumer instruction, including selection, 14 delivery, set-up, and maintenance of equipment, and other 15 related services for use of home medical equipment in the 16 consumer's regular or temporary place of residence. 17 (10) "Home medical equipment supplier" means any 18 person or entity that sells or rents or offers to sell or rent 19 to or for a consumer: 20 (a) Any home medical equipment and services; or 21 (b) Home medical equipment that requires any home 22 medical equipment services. 23 (11) "Home medical equipment supplier personnel" means 24 persons who are employed by or under contract with a home 25 medical equipment supplier. 26 (12) "Moratorium" means a mandated temporary cessation 27 or suspension of the sale, rental, or offering of equipment 28 after the imposition of the moratorium. Services related to 29 equipment sold prior to the moratorium must be continued 30 without interruption, unless deemed otherwise by the agency. 31 3 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (13) "Premises" means those buildings and equipment 2 that are located at the address of the licensed home medical 3 equipment supplier for the provision of home medical equipment 4 services and are in such reasonable proximity as to appear to 5 the public to be a single supplier location. 6 (14) "Residence" means the consumer's home or place of 7 residence and includes nursing homes, assisted living 8 facilities, transitional living facilities, adult family-care 9 homes, or other congregate residential facilities. 10 400.82 Home medical equipment suppliers to be 11 licensed; expiration of license; exemptions; unlawful acts; 12 penalties.-- 13 (1) Any person or entity that holds itself out to the 14 public as providing home medical equipment and services or 15 accepts physician orders for home medical equipment and 16 services is subject to licensure under this part. 17 (2) Any person or entity that holds itself out to the 18 public as providing home medical equipment that typically 19 requires home medical equipment services is subject to 20 licensure under this part. 21 (3) Any home medical equipment supplier must be 22 licensed by the agency to operate in this state. A standard 23 license issued to a home medical equipment supplier, unless 24 sooner suspended or revoked, expires 2 years after its 25 effective date. 26 (4) A separate license is required of all home medical 27 equipment suppliers operating on separate premises, even if 28 the suppliers are operated under the same management. 29 (5) No more than one licensed home medical equipment 30 supplier may operate from the same premises. 31 4 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (6) The following are exempt from home medical 2 equipment supplier licensure, unless they have a separate 3 company, corporation, division, or other business entity that 4 is in the business of providing home medical equipment and 5 services for sale or rent to consumers at their residences 6 pursuant to the provisions of this part: 7 (a) Suppliers operated by the Federal Government. 8 (b) Nursing homes licensed under part II. 9 (c) Home health agencies licensed under part IV. 10 (d) Hospices licensed under part VI. 11 (e) Intermediate care facilities, homes for special 12 services, and transitional living facilities licensed under 13 part VIII. 14 (f) Hospitals and ambulatory surgical centers licensed 15 under chapter 395. 16 (g) Manufacturers and wholesale distributors when not 17 selling directly to consumers. 18 (h) Licensed health care practitioners who utilize 19 home medical equipment in the course of their practice, but do 20 not sell home medical equipment to their patients. 21 (i) Pharmacies licensed under chapter 465. 22 (7)(a) It is unlawful for any person to offer or 23 advertise home medical equipment and services to the public 24 unless he or she has a valid license under this part. It is 25 unlawful for any holder of a license issued under this part to 26 advertise or indicate to the public that it holds a home 27 medical equipment supplier license other than the one it has 28 been issued. 29 (b) A person who violates paragraph (a) is subject to 30 an injunctive proceeding under s. 400.85. A violation of 31 paragraph (a) is a deceptive and unfair trade practice and 5 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 constitutes a violation of the Florida Deceptive and Unfair 2 Trade Practices Act. 3 (c) A person who violates paragraph (a) commits a 4 misdemeanor of the second degree, punishable as provided in s. 5 775.082 or s. 775.083. Any person who commits a second or 6 subsequent violation commits a misdemeanor of the first 7 degree, punishable as provided in s. 775.082 or s. 775.083. 8 Each day of continuing violation constitutes a separate 9 offense. 10 (d) A fine may be imposed against a licensee found to 11 be concurrently operating licensed and unlicensed supplier 12 premises. Any person who violates this section who previously 13 operated a licensed supplier premises or concurrently operates 14 a licensed supplier premises and an unlicensed supplier 15 premises, commits a felony of the third degree. When a 16 licensee has an interest in more than one supplier location 17 and fails to license any one of these locations, the agency 18 may revoke the license or impose a moratorium on any or all of 19 the licensed supplier locations until such time as the 20 delinquent supplier premises is licensed. If the supplier has 21 received government reimbursement for services provided by an 22 unlicensed supplier premises, the agency shall make a fraud 23 referral to the appropriate government reimbursement program. 24 (e) A supplier found to be operating without a license 25 may apply for licensure, and must cease operations until a 26 license is awarded by the agency. 27 400.821 Application for license; fee; provisional 28 license; temporary permit.-- 29 (1) Application for an initial license or for renewal 30 of an existing license must be made under oath to the agency 31 6 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 on forms furnished by it and must be accompanied by the 2 appropriate license fee as provided in subsection (10). 3 (2) The applicant must file with the application 4 satisfactory proof that the home medical equipment supplier is 5 in compliance with this part and applicable rules, including: 6 (a) A listing of equipment and services to be 7 provided, by category, indicating those offered either 8 directly by the applicant or through contractual arrangements 9 with existing suppliers. Categories include oxygen and 10 oxygen-related equipment, respiratory equipment, 11 rehabilitation environmental control equipment, diagnostic 12 equipment, rehabilitation seating, ambulation assistance 13 equipment, mobility equipment, beds and related products, and 14 orthotics. 15 (b) A listing of those with whom the applicant 16 contracts, both suppliers the applicant uses to provide 17 equipment or services to its consumers and suppliers for whom 18 the applicant provides services or equipment. 19 (c) The number and discipline of professional staff to 20 be employed, including full-time, part-time, or contract 21 status. 22 (3) An applicant for initial licensure, including 23 change of ownership, must demonstrate financial ability to 24 operate by submitting projected financial statements for the 25 first 2 years of operation. These statements shall include a 26 balance sheet and income and expense statement which provide 27 evidence of having sufficient assets, credit, and projected 28 revenues to cover liabilities and expenses. The applicant 29 shall have demonstrated financial ability to operate if the 30 assets, credit, and projected revenues meet or exceed 31 projected liabilities and expenses. All documents required 7 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 under this subsection must be prepared in accordance with 2 generally accepted accounting principles and signed by a 3 certified public accountant. 4 (4) An applicant for renewal who has demonstrated 5 financial inability to operate must demonstrate financial 6 ability to operate by submitting audited financial statements 7 for the most recent 2 years of operation which provide 8 evidence of having sufficient assets, credit, and revenues to 9 cover liabilities and expenses. The applicant shall have 10 demonstrated financial ability to operate if the assets, 11 credit, and projected revenues meet or exceed liabilities and 12 expenses. All documents required under this subsection must be 13 prepared in accordance with generally accepted accounting 14 principles and signed by a certified public accountant. 15 (5) The applicant must file with the application 16 satisfactory proof of compliance with background screening 17 requirements, as follows: 18 (a) Upon receipt of a completed, signed, and dated 19 application, the agency shall require background screening 20 using the level 2 standards for screening set forth in chapter 21 435 for the applicant. 22 (b) Such background screening shall require each 23 applicant to submit to the Department of Law Enforcement the 24 information necessary, including a full set of fingerprints, 25 to enable a criminal background investigation to be conducted 26 for a state criminal and juvenile history records check. The 27 Department of Law Enforcement shall forward the fingerprints 28 to the Federal Bureau of Investigation for a national criminal 29 history records check. Upon completion of the state and 30 national criminal history records checks, the Department of 31 Law Enforcement shall report the findings to the agency. The 8 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 actual cost of such state and national criminal history 2 records checks shall be borne by the applicant. 3 (c) Such background screening shall also require each 4 applicant to submit to the Department of Children and Family 5 Services a complete set of information necessary to conduct a 6 records check through the central abuse registry. The actual 7 costs of searching the department's central abuse registry 8 shall be borne by the applicant. 9 (d) A license shall not be granted to any applicant 10 who has been found guilty of, regardless of adjudication, or 11 who has entered a plea of nolo contendere or guilty to, any 12 offense prohibited under the level 2 standards of chapter 435. 13 A license shall not be granted to any applicant having a 14 confirmed report of abuse, neglect, or exploitation as defined 15 in s. 415.102 which has been uncontested or upheld under 16 chapter 415, or having a proposed confirmed report that 17 remains unserved and is maintained in the central abuse 18 registry and tracking system pursuant to s. 415.1065(2)(c). 19 (e) The agency shall also require every applicant, as 20 a condition of license application, to submit information 21 concerning any prior violation, fine, suspension, termination, 22 or other administrative action taken under the laws, rules, or 23 regulations of any regulatory body of this state or of any 24 other state or the Federal Government; and any prior violation 25 of the laws, rules, or regulations relating to the Medicaid or 26 Medicare programs. 27 (f) Upon licensure renewal, each applicant must submit 28 to the agency, under penalty of perjury, an affidavit of 29 compliance with the background screening provisions of this 30 section. 31 9 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (g) Proof of compliance with the level 2 background 2 screening requirements of chapter 435 submitted within the 3 previous 5 years for any other Florida health care licensure 4 requirements shall be accepted to fulfill the Department of 5 Law Enforcement and Department of Children and Family Services 6 background check, provided that such proof of compliance is 7 accompanied, under penalty of perjury, by an affidavit of 8 compliance with these background screening provisions. 9 (6) The home medical equipment supplier must also 10 obtain and maintain professional and commercial liability 11 insurance. Proof of liability insurance, as defined in s. 12 624.605, must be submitted with the application. The agency 13 shall set the required amounts of liability insurance by rule, 14 but the required amount must not be less than $250,000 per 15 claim. In the case of contracted services, it is required that 16 the contractor have liability insurance of not less than 17 $250,000 per claim. 18 (7) A provisional license shall be issued to an 19 approved applicant for initial licensure for a period of 45 20 days, during which time a survey must be conducted 21 demonstrating substantial compliance with this section. If 22 substantial compliance is demonstrated, a standard license 23 shall be issued to expire 2 years after the effective date of 24 the provisional license. 25 (8) Ninety days before the expiration date, an 26 application for renewal must be submitted to the agency under 27 oath on forms furnished by the agency, and a license shall be 28 renewed if the applicant has met the requirements established 29 under this part and applicable rules. The home medical 30 equipment supplier must file with the application satisfactory 31 proof that it is in compliance with this part and applicable 10 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 rules. The home medical equipment supplier must submit 2 satisfactory proof of its financial ability to comply with the 3 requirements of this part. 4 (9) When a change of ownership of a home medical 5 equipment supplier occurs, the prospective owner must submit 6 an initial application for a license at least 60 days before 7 the effective date of the change of ownership. An application 8 for change of ownership of a license is required when 9 ownership, a majority of the ownership, or controlling 10 interest of a licensed home medical equipment supplier is 11 transferred or assigned and when a licensee agrees to 12 undertake or provide services to the extent that legal 13 liability for operation of the home medical equipment supplier 14 rests with the licensee. A provisional license shall be issued 15 to the new owner for a period of 45 days, during which time a 16 survey must be conducted demonstrating substantial compliance 17 with this section. If substantial compliance is demonstrated, 18 a standard license shall be issued to expire 2 years after the 19 issuance of the provisional license. 20 (10) The license fee, annual renewal fee, and change 21 of ownership fee required of a home medical equipment supplier 22 is nonrefundable. The agency shall set the fees in an amount 23 that is sufficient to cover its costs in carrying out its 24 responsibilities under this part. However, state, county, or 25 municipal governments applying for licenses under this part 26 are exempt from the payment of license fees. All fees 27 collected under this part must be deposited in the Health Care 28 Trust Fund for the administration of this part. 29 (11) When a duplicate license must be issued, a fee 30 shall be assessed, not to exceed the actual cost of 31 duplicating and mailing. 11 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (12) When applications are mailed out upon request, a 2 fee shall be assessed, not to exceed the cost of the printing, 3 preparation, and mailing. 4 (13) The license must be displayed in a conspicuous 5 place in the administrative office of the home medical 6 equipment supplier and is valid only while in the possession 7 of the person or entity to which it is issued. The license may 8 not be sold, assigned, or otherwise transferred, voluntarily 9 or involuntarily, and is valid only for the home medical 10 equipment supplier and location for which originally issued. 11 (14) A home medical equipment supplier that offers or 12 advertises to the public that it provides any service for 13 which licensure is required under this section must include in 14 such advertisement the license number issued to it by the 15 agency. 16 (15) A home medical equipment supplier against whom a 17 proceeding for revocation or suspension, or for denial of a 18 renewal application, is pending at the time of license renewal 19 may be issued a provisional license effective until final 20 disposition by the agency of such proceedings. If judicial 21 relief is sought from the final disposition, the court that 22 has jurisdiction may issue a temporary permit for the duration 23 of the judicial proceeding. 24 400.822 Administrative penalties; injunctions; 25 emergency orders; moratoriums.-- 26 (1) The agency may deny, revoke, or suspend a license, 27 or impose an administrative fine not to exceed $10,000 per 28 violation, per day, or initiate injunctive proceedings under 29 s. 400.85. 30 31 12 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (2) Any of the following actions by a home medical 2 equipment supplier or any of its employees is grounds for 3 administrative action or penalties by the agency: 4 (a) Violation of this part or of applicable rules. 5 (b) An intentional, reckless, or negligent act that 6 materially affects the health or safety of a patient. 7 (3) The agency may deny or revoke the license of any 8 applicant that: 9 (a) Made a false representation or omission of any 10 material fact in making the application, including the 11 submission of an application that conceals the controlling or 12 ownership interest of any officer, director, agent, manager, 13 employee, affiliated person, partner, or shareholder who may 14 not be eligible to participate; 15 (b) Has been previously found by any licensing, 16 certifying, or professional standards board or agency to have 17 violated the standards or conditions relating to licensure or 18 certification or the quality of services provided; or 19 (c) Has been or is currently excluded, suspended, or 20 terminated from, or has involuntarily withdrawn from 21 participation in, Florida's Medicaid program or any other 22 state's Medicaid program, or from participation in the 23 Medicare program or any other governmental or private health 24 care or health insurance program. 25 (4) The agency may issue an emergency order 26 immediately suspending or revoking a license when it 27 determines that any condition in the licensed supplier 28 presents a clear and present danger to public health and 29 safety. 30 (5) The agency may impose an immediate moratorium on 31 any licensed home medical equipment supplier when the agency 13 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 determines that any condition in the home medical equipment 2 supplier presents a threat to public health or safety. 3 400.823 Licensure inspection.-- 4 (1) The agency shall make or cause to be made such 5 inspections and investigations as it deems necessary, 6 including: 7 (a) Licensure inspections. 8 (b) Inspections directed by the federal Health Care 9 Financing Administration. 10 (c) Licensure complaint investigations, including full 11 licensure investigations with a review of all licensure 12 standards as outlined in administrative rules. Complaints 13 received by the agency from individuals, organizations, or 14 other sources are subject to review and investigation by the 15 agency. 16 (2) The agency shall accept, in lieu of its own 17 periodic inspections for licensure, the survey or inspection 18 of an accrediting organization, provided the accreditation of 19 the licensed home medical equipment supplier is not 20 provisional and provided the licensed home medical equipment 21 supplier authorizes release of, and the agency receives the 22 report of, the accrediting organization. The agency shall 23 develop, and adopt by rule, criteria for accepting survey 24 reports of accrediting organizations in lieu of conducting a 25 state licensure inspection. 26 400.824 Minimum standards.--As a requirement of 27 licensure, home medical equipment suppliers shall: 28 (1) Offer and provide home medical equipment, and 29 services as necessary, to consumers who purchase or rent 30 equipment that requires such services. 31 14 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (2) Provide at least one category of equipment 2 directly, filling orders from its own inventory. 3 (3) Respond to orders received for other equipment by 4 filling those orders from its own inventory or inventory from 5 other companies with which it has contracted to fill such 6 orders, or by fabricating or fitting items for sale from 7 supplies purchased under contract. 8 (4) Maintain trained personnel to coordinate order 9 fulfillment and schedule timely equipment and service 10 delivery. 11 (5) As necessary in relation to the sophistication of 12 the equipment and services being provided, ensure that 13 delivery personnel are appropriately trained to conduct an 14 environment and equipment compatibility assessment; 15 appropriately and safely set up the equipment; instruct 16 patients and caregivers in the safe operation and client 17 maintenance of the equipment; and recognize when additional 18 education or followup patient compliance monitoring is 19 appropriate. 20 (6) Ensure that patients are made aware of service 21 hours and emergency service procedures. 22 (7) At the time of the initial delivery, set up an 23 appropriate followup home medical equipment service schedule 24 as needed for such times as, but not limited to, periodic 25 maintenance, supply delivery, and other related activities. 26 (8) Arrange for emergency service after normal 27 business hours; provide refresher and review training for 28 appropriate personnel; establish a system for resolution of 29 complaints and service problems; and provide for timely 30 replacement or delivery of disposable or consumable equipment 31 supplies. 15 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (9) Honor all warranties express and implied under 2 applicable state law. 3 (10) Answer any questions or complaints a consumer has 4 about an item or use of an item that the consumer purchases or 5 rents. 6 (11) Maintain and repair directly, or through a 7 service contract with another company, items rented to 8 consumers. 9 (12) Accept returns of substandard or unsuitable items 10 from consumers. For purposes of this subsection, 11 "substandard" means less than full quality for the particular 12 item and "unsuitable" means inappropriate for the consumer at 13 the time it was fitted or sold. 14 (13) Disclose consumer information to each consumer 15 who rents or purchases items, including all applicable 16 warranty information. This information consists of the 17 supplier standards to which it must conform. 18 (14) Maintain patient payment and service records in 19 accordance with the requirements of this part. 20 (15)(a) Designate appropriate staff as intake 21 coordinators, and ensure that order intake personnel are 22 appropriately trained in the types of equipment and products, 23 commonly occurring medical conditions, service procedures, 24 third-party billing, and insurance requirements and coverage. 25 (b) Train intake coordinators in a basic understanding 26 of the following areas: dealing with patient and caregiver 27 needs; and other, nonhome medical equipment provider services 28 as they relate to home medical equipment services and home 29 care patient crisis management. 30 (16) Establish procedures for maintaining a record of 31 the employment history, including background screening as 16 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 required by s. 400.843, of all home medical equipment supplier 2 personnel. A home medical equipment supplier must require its 3 personnel to submit an employment history to the home medical 4 equipment supplier and must verify the employment history, 5 unless through diligent efforts such verification is not 6 possible. There is no monetary liability on the part of, and 7 no cause of action for damages arising against a former 8 employer, a prospective employee, or a prospective independent 9 contractor with a licensed home medical equipment supplier who 10 reasonably and in good faith communicates his or her honest 11 opinions about the former employee's job performance. This 12 subsection does not affect the official immunity of an officer 13 or employee of a public corporation. 14 (17) Upon request by the consumer or as otherwise 15 required by state or federal laws, rules, and regulations, 16 assist consumers with meeting the necessary filing 17 requirements to obtain third-party payment to which a consumer 18 may be entitled. 19 (18) Maintain safe premises. 20 (19) Comply with all other state and federal laws. 21 400.825 Rules establishing minimum standards.--The 22 agency shall adopt, publish, and enforce rules to implement 23 this part, which must provide reasonable and fair minimum 24 standards relating to: 25 (1) The qualifications and minimum training 26 requirements of all home medical equipment supplier personnel. 27 (2) License application and renewal. 28 (3) License and inspection fees. 29 (4) Financial ability to operate. 30 (5) The administration of the home medical equipment 31 supplier. 17 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 (6) Procedures for maintaining patient records. 2 (7) Ensuring that the home medical equipment and 3 services provided by a home medical equipment supplier are in 4 accordance with the plan of treatment established for each 5 patient, when provided as a part of a plan of treatment. 6 (8) Standards for contractual arrangements for the 7 provision of home medical equipment and services by providers 8 not employed by the home medical equipment supplier providing 9 for the consumer's needs. 10 (9) Physical location and zoning requirements. 11 (10) Customized orthotics. 12 (11) Home medical equipment requiring home medical 13 equipment services. 14 400.83 Clinical records.--The home medical equipment 15 supplier must maintain for each patient a clinical record that 16 includes the products the home medical equipment supplier has 17 provided. Such records must contain any physician's orders, 18 pertinent past and current medical, nursing, social, and other 19 therapeutic information, the plan of treatment, and other such 20 information as is necessary for the safe and adequate care of 21 the patient. When home medical equipment supplier services are 22 terminated, the record must show the date and reason for 23 termination. Such records are considered patient records under 24 s. 455.241, and must be maintained by the home medical 25 equipment supplier for 5 years following termination of 26 services. If a patient transfers to another home medical 27 equipment supplier, a copy of his or her record must be 28 provided to the other home medical equipment supplier upon 29 request. 30 400.84 Notice of toll-free telephone number for 31 central abuse registry.--On or before the first day home 18 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 medical equipment is delivered to patient's home, any home 2 medical equipment supplier licensed under this part must 3 inform the consumer and his or her immediate family, if 4 appropriate, of the right to report abusive, neglectful, or 5 exploitative practices. The statewide toll-free telephone 6 number for the central abuse registry must be provided to 7 consumers in a manner that is clearly legible and must include 8 the words: "To report abuse, neglect, or exploitation, please 9 call toll-free (phone number)." Home medical equipment 10 suppliers shall establish appropriate policies and procedures 11 for providing such notice to consumers. 12 400.843 Background screening of home medical equipment 13 supplier personnel.--The agency shall require employment 14 screening as provided in chapter 435, using the level 1 15 standards for screening set forth in that chapter, for home 16 medical equipment supplier personnel. 17 (1) The agency may grant exemptions from 18 disqualification from employment under this section as 19 provided in s. 435.07. 20 (2) The general manager of each home medical equipment 21 supplier must sign an affidavit annually, under penalty of 22 perjury, stating that all home medical equipment supplier 23 personnel hired on or after October 1, 1997, who enter the 24 home of a patient in the capacity of their employment have 25 been screened and that its remaining personnel have worked for 26 the home medical equipment supplier continuously since before 27 October 1, 1997. 28 (3) Proof of compliance with the screening 29 requirements of s. 39.076, s. 110.1127, s. 393.0655, s. 30 394.457, s. 397.451, s. 402.305, s. 402.313, s. 409.175, or s. 31 464.008 or this part shall be accepted in lieu of the 19 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 requirements of this section if the person has been 2 continuously employed in the same type of occupation for which 3 he or she is seeking employment without a breach in service 4 that exceeds 180 days, the proof of compliance is not more 5 than 2 years old, and the person has been screened through the 6 central abuse registry and tracking system of the department 7 and by the Department of Law Enforcement. An employer or 8 contractor shall directly provide proof of compliance to 9 another employer or contractor, and a potential employer or 10 contractor may not accept any proof of compliance directly 11 from the person requiring screening. Proof of compliance with 12 the screening requirements of this section shall be provided 13 upon request to the person screened by the home medical 14 equipment supplier. 15 (4) There is no monetary liability on the part of, and 16 no cause of action for damages arises against, a licensed home 17 medical equipment supplier, that, upon notice of a confirmed 18 report of adult abuse, neglect, or exploitation under chapter 19 415, terminates the employee against whom the report was 20 issued, whether or not the employee has filed for an exemption 21 with the agency, and whether or not the time for filing has 22 expired. 23 (5) The costs of processing the statewide 24 correspondence criminal records checks and the search of the 25 department's central abuse registry must be borne by the home 26 medical equipment supplier or by the person being screened, at 27 the discretion of the home medical equipment supplier. 28 (6) Neither the agency nor the home medical equipment 29 supplier may use the criminal records, juvenile records, or 30 central abuse registry information of a person for any purpose 31 other than determining whether that person meets minimum 20 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 standards of good moral character for home medical equipment 2 supplier personnel. 3 (7)(a) It is a misdemeanor of the first degree, 4 punishable under s. 775.082 or s. 775.083, for any person 5 willfully, knowingly, or intentionally to: 6 1. Fail, by false statement, misrepresentation, 7 impersonation, or other fraudulent means, to disclose in any 8 application for voluntary or paid employment a material fact 9 used in making a determination as to such person's 10 qualifications to be an employee under this section; 11 2. Operate or attempt to operate an entity licensed 12 under this part with persons who do not meet the minimum 13 standards for good moral character as contained in this 14 section; or 15 3. Use information from the criminal records or 16 central abuse registry obtained under this section for any 17 purpose other than screening that person for employment as 18 specified in this section, or release such information to any 19 other person for any purpose other than screening for 20 employment under this section. 21 (b) It is a felony of the third degree, punishable 22 under s. 775.082, s. 775.083, or s. 775.084, for any person 23 willfully, knowingly, or intentionally to use information from 24 the juvenile records of a person obtained under this section 25 for any purpose other than screening for employment under this 26 section. 27 400.845 Procedures for screening of home medical 28 equipment supplier personnel.--A person employed by home 29 medical equipment suppliers shall, within 5 working days after 30 starting to work, submit to the home medical equipment 31 supplier or registrant a complete set of information necessary 21 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 to conduct a screening under this section. The person must 2 sign an affidavit stating whether the person meets the minimum 3 standards for good moral character under this section. The 4 home medical equipment supplier shall submit the information 5 to the Department of Law Enforcement and to the department's 6 central abuse registry and tracking system for processing. If 7 disposition information is missing on a criminal record, it is 8 the responsibility of the person being screened to obtain and 9 supply the missing information within 30 days. Failure to 10 supply the missing information or to show reasonable efforts 11 to obtain such information will result in automatic 12 disqualification for employment. 13 (1) Home medical equipment supplier personnel hired on 14 or after October 1, 1997, must be placed on probationary 15 status pending a determination of compliance with minimum 16 standards for good moral character. 17 (2) The home medical equipment supplier must 18 automatically terminate the employment of any of its personnel 19 found to be in noncompliance with the minimum standards for 20 good moral character under this section unless such person has 21 obtained an exemption under s. 400.843(1). 22 (3) The general manager of each home medical equipment 23 supplier must sign an affidavit annually, under penalty of 24 perjury, stating that all personnel hired on or after October 25 1, 1997, have been screened and that its remaining personnel 26 have worked for the home medical equipment supplier 27 continuously since before October 1, 1997. 28 400.85 Injunction proceedings.--The agency may 29 institute injunction proceedings in a court of competent 30 jurisdiction when violation of this part or of applicable 31 22 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 rules constitutes an emergency affecting the immediate health 2 and safety of a patient or consumer. 3 400.86 Prohibited referrals to home medical equipment 4 suppliers.-- 5 (1) A physician licensed under chapter 458 or chapter 6 459 must comply with s. 455.236. 7 (2) A hospital or an ambulatory surgical center that 8 has a financial interest in a home medical equipment supplier 9 is prohibited from requiring any physician on its staff to 10 refer a patient to the home medical equipment supplier. 11 (3)(a) A violation of this section is punishable by an 12 administrative fine not to exceed $15,000. The proceeds of 13 such fines must be deposited into the Health Care Trust Fund. 14 (b) A physician who violates this section is subject 15 to disciplinary action by the appropriate board under s. 16 458.331(2) or s. 459.015(2). A hospital or ambulatory surgical 17 center that violates this section is subject to the rules 18 adopted by the agency under s. 395.0185(2). 19 400.65 Rebates prohibited; penalties.-- 20 (1) It is unlawful for any person to pay or receive 21 any commission, bonus, kickback, or rebate or engage in any 22 split-fee arrangement, in any form whatsoever, with any 23 physician, surgeon, organization, or person, either directly 24 or indirectly, for patients referred to a licensed supplier. 25 (2) The agency shall adopt rules which assess 26 administrative penalties for acts prohibited in subsection 27 (1). In the case of an entity licensed by the agency, such 28 penalties may include any disciplinary action available to the 29 agency under the appropriate licensing laws. In the case of an 30 entity not licensed by the agency, such penalties may include 31 a fine not to exceed $50,000. 23 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 759 139-234-97 1 Section 2. This act shall take effect October 1, 1997. 2 3 ***************************************** 4 HOUSE SUMMARY 5 Provides for licensure and regulation of home medical 6 equipment suppliers by the Agency for Health Care Administration. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 24