Senate Bill 1376

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    Florida Senate - 1999                                  SB 1376

    By Senator Gutman





    34-1058-99

  1                      A bill to be entitled

  2         An act relating to the Patient Self-Referral

  3         Act; amending s. 455.654, F.S.; defining the

  4         term "personal supervision" for purposes of

  5         regulating financial arrangements between

  6         referring health care providers and providers

  7         of health care services; redefining the term

  8         "referral" to exclude certain actions;

  9         providing an effective date.

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

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13         Section 1.  Present paragraphs (k) and (l) of

14  subsection (3) of section 455.654, Florida Statutes, 1998

15  Supplement, are redesignated paragraphs (l) and (m),

16  respectively, and amended, and new paragraph (k) is added to

17  that subsection, to read:

18         455.654  Financial arrangements between referring

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

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

21  word, phrase, or term:

22         (k)  "Personal supervision" means that the health care

23  provider is legally responsible for monitoring the quality,

24  performance, and results of any test or other designated

25  health service and is available to assist the individual who

26  is furnishing the service, even though the health care

27  provider need not be physically present while the service is

28  being furnished.

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

30  health care provider for health care services, including,

31  without limitation:

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    Florida Senate - 1999                                  SB 1376
    34-1058-99




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

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

  3  provides or supplies designated health services or any other

  4  health care item or service; or

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

  6  health care provider, which includes the provision of

  7  designated health services or other health care item or

  8  service.

  9         3.  The following orders, recommendations, or plans of

10  care shall not constitute a referral by a health care

11  provider:

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

13         b.  By a physician specializing in the provision of

14  radiation therapy services for such services.

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

16  be prepared and administered intravenously to such

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

18  equipment used in connection therewith to treat such patient

19  for cancer and the complications thereof.

20         d.  By a cardiologist for cardiac catheterization

21  services, cardiac services, or cardiac diagnostic imaging.

22         e.  By a pathologist for diagnostic clinical laboratory

23  tests and pathological examination services, if furnished by

24  or under the supervision of such pathologist pursuant to a

25  consultation requested by another physician.

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

27  or member of a group practice for designated health services

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

29  provided solely for such referring health care provider's or

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

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    Florida Senate - 1999                                  SB 1376
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  1  performed by or under the direct supervision of such referring

  2  health care provider or group practice.

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

  4  an ambulatory surgical center licensed under chapter 395.

  5         h.  By a health care provider for diagnostic clinical

  6  laboratory services where such services are directly related

  7  to renal dialysis.

  8         i.  By a urologist for lithotripsy services.

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

10  employee of or health care provider who is an independent

11  contractor with the dentist or group practice of which the

12  dentist is a member.

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

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

15  group practice.

16         l.  By a nephrologist for renal dialysis services and

17  supplies.

18         m.  By a neurologist for nerve conduction studies,

19  evoked potentials studies, and electroencephalograms (EEGs).

20         n.  By a vascular surgeon for peripheral vascular

21  laboratories using doppler and vascular ultrasound.

22         o.  By a physician specializing in physical medicine

23  and rehabilitation or occupational and environmental medicine

24  for evaluation procedures and therapeutic services.

25         p.  By a health care provider for clinical laboratory

26  services or physical therapy services when the services are

27  provided either personally by, or under the personal

28  supervision of, the health care provider or another health

29  care provider in the same group practice and when the services

30  are provided in a building in which the health care provider

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    Florida Senate - 1999                                  SB 1376
    34-1058-99




  1  or another health care provider who is a member of the same

  2  group practice furnish health care services.

  3         (m)(l)  "Rural area" means a county with a population

  4  density of no greater than 100 persons per square mile, as

  5  defined by the United States Census.

  6         Section 2.  This act shall take effect upon becoming a

  7  law.

  8

  9            *****************************************

10                          SENATE SUMMARY

11    Defines the term "personal supervision" for purposes of
      the Patient Self-Referral Act and redefines the term
12    "referral" to exclude additional orders, recommendations,
      and plans of care by a health care provider.
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