Senate Bill 0276e1

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







    CS for SB 276                            First Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to home medical equipment

  3         providers; creating part X of chapter 400,

  4         F.S.; providing for regulation of home medical

  5         equipment providers 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 fees;

11         providing for background screening; providing

12         for provisional licenses and temporary permits;

13         providing for administrative penalties;

14         providing for injunctions, emergency orders,

15         and moratoriums; providing for licensure

16         inspections and investigations; providing

17         minimum standards; providing for agency rules;

18         providing for patient records; providing for

19         notice of toll-free telephone number for the

20         central abuse registry; providing for

21         background screening of home medical equipment

22         provider licensees and personnel; providing

23         penalties; providing screening procedures;

24         providing for agency injunctions; prohibiting

25         patient referrals and rebates; providing for

26         application of the act to existing providers;

27         providing an appropriation; providing an

28         effective date.

29

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

31


                                  1

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






    CS for SB 276                            First Engrossed (ntc)



  1         Section 1.  Part X of chapter 400, Florida Statutes,

  2  consisting of sections 400.92, 400.925, 400.93, 400.931,

  3  400.932, 400.933, 400.934, 400.935, 400.94, 400.95, 400.953,

  4  400.955, 400.96, and 400.965, is created to read:

  5         400.92  Legislative intent.--It is the intent of the

  6  Legislature to provide for the licensure of home medical

  7  equipment providers and to provide for the development,

  8  establishment, and enforcement of basic standards that will

  9  ensure quality home medical equipment, products, and services.

10         400.925  Definitions.--As used in this part, the term:

11         (1)  "Accrediting organizations" means the Joint

12  Commission on Accreditation of Healthcare Organizations or

13  other national accreditation agencies whose standards for

14  accreditation are comparable to those required by this part

15  for licensure.

16         (2)  "Affiliated person" means any person who directly

17  or indirectly manages, controls, or oversees the operation of

18  a corporation or other business entity that is a licensee,

19  regardless of whether such person is a partner, shareholder,

20  owner, officer, director, agent, or employee of the entity.

21         (3)  "Agency" means the Agency for Health Care

22  Administration.

23         (4)  "Applicant" means an individual applicant in the

24  case of a sole proprietorship, or any officer, director,

25  agent, managing employee, general manager, or affiliated

26  person, or any partner or shareholder having an ownership

27  interest equal to 5 percent or greater in the corporation,

28  partnership, or other business entity.

29         (5)  "Consumer" or "patient" means any person who uses

30  home medical equipment in his or her place of residence.

31


                                  2

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






    CS for SB 276                            First Engrossed (ntc)



  1         (6)  "Department" means the Department of Children and

  2  Family Services.

  3         (7)  "General manager" means the individual who has the

  4  general administrative charge of the premises of a licensed

  5  home medical equipment provider.

  6         (8)  "Home medical equipment" includes any product as

  7  defined by the Federal Drug Administration's Drugs, Devices

  8  and Cosmetics Act, any products reimbursed under the Medicare

  9  Part B Durable Medical Equipment benefits, or any products

10  reimbursed under the Florida Medicaid durable medical

11  equipment program. Home medical equipment includes, but is not

12  limited to, oxygen and related respiratory equipment. Home

13  medical equipment includes customized wheelchairs and related

14  seating and positioning, but does not include prosthetics or

15  orthotics or any splints, braces, or aids custom fabricated by

16  a licensed health care practitioner.

17         (9)  "Home medical equipment provider" means any person

18  or entity that sells or rents or offers to sell or rent to or

19  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         (10)  "Home medical equipment provider personnel" means

24  persons who are employed by or under contract with a home

25  medical equipment provider.

26         (11)  "Home medical equipment services" means equipment

27  management and consumer instruction, including selection,

28  delivery, setup, and maintenance of equipment, and other

29  related services for the use of home medical equipment in the

30  consumer's regular or temporary place of residence.

31


                                  3

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






    CS for SB 276                            First Engrossed (ntc)



  1         (12)  "Licensee" means the person or entity to whom a

  2  license to operate as a home medical equipment provider is

  3  issued by the agency.

  4         (13)  "Moratorium" means a mandated temporary cessation

  5  or suspension of the sale, rental, or offering of equipment

  6  after the imposition of the moratorium. Services related to

  7  equipment sold or rented prior to the moratorium must be

  8  continued without interruption, unless deemed otherwise by the

  9  agency.

10         (14)  "Person" means any individual, firm, partnership,

11  corporation, or association.

12         (15)  "Premises" means those buildings and equipment

13  which are located at the address of the licensed home medical

14  equipment provider for the provision of home medical equipment

15  services, which are in such reasonable proximity as to appear

16  to the public to be a single provider location, and which

17  comply with zoning ordinances.

18         (16)  "Residence" means the consumer's home or place of

19  residence, which may include nursing homes, assisted living

20  facilities, transitional living facilities, adult family-care

21  homes, or other congregate residential facilities.

22         400.93  Home medical equipment providers to be

23  licensed; expiration of license; exemptions; unlawful acts;

24  penalties.--

25         (1)  Any person or entity that holds itself out to the

26  public as providing home medical equipment and services or

27  accepts physician orders for home medical equipment and

28  services is subject to licensure under this part.

29         (2)  Any person or entity that holds itself out to the

30  public as providing home medical equipment that typically

31


                                  4

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






    CS for SB 276                            First Engrossed (ntc)



  1  requires home medical services is subject to licensure under

  2  this part.

  3         (3)  A home medical equipment provider must be licensed

  4  by the agency to operate in this state or to provide home

  5  medical equipment and services to consumers in this state. A

  6  standard license issued to a home medical equipment provider,

  7  unless sooner suspended or revoked, expires 2 years after its

  8  effective date.

  9         (4)  A separate license is required of all home medical

10  equipment providers operating on separate premises, even if

11  the providers are operated under the same management.

12         (5)  The following are exempt from home medical

13  equipment provider licensure, unless they have a separate

14  company, corporation, or division that is in the business of

15  providing home medical equipment and services for sale or rent

16  to consumers at their regular or temporary place of residence

17  pursuant to the provisions of this part:

18         (a)  Providers operated by the Federal Government.

19         (b)  Nursing homes licensed under part II.

20         (c)  Assisted living facilities licensed under part

21  III, when serving their residents.

22         (d)  Home health agencies licensed under part IV.

23         (e)  Hospices licensed under part VI.

24         (f)  Intermediate care facilities, homes for special

25  services, and transitional living facilities licensed under

26  part VIII.

27         (g)  Hospitals and ambulatory surgical centers licensed

28  under chapter 395.

29         (h)  Manufacturers and wholesale distributors when not

30  selling directly to consumers.

31


                                  5

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






    CS for SB 276                            First Engrossed (ntc)



  1         (i)  Licensed health care practitioners who utilize

  2  home medical equipment in the course of their practice, but do

  3  not sell or rent home medical equipment to their patients.

  4         (j)  Pharmacies licensed under chapter 465.

  5         (6)(a)  It is unlawful for any person to offer or

  6  advertise home medical equipment and services to the public

  7  unless he or she has a valid license under this part or is

  8  exempted from licensure under subsection (5). It is unlawful

  9  for any holder of a license issued under this part to

10  advertise or indicate to the public that it holds a home

11  medical equipment provider license other than the one it has

12  been issued.

13         (b)  A person who violates paragraph (a) is subject to

14  an injunctive proceeding under s. 400.96. A violation of

15  paragraph (a) is a deceptive and unfair trade practice and

16  constitutes a violation of the Florida Deceptive and Unfair

17  Trade Practices Act.

18         (c)  A person who violates paragraph (a) commits a

19  misdemeanor of the second degree, punishable as provided in s.

20  775.082 or s. 775.083. A person who commits a second or

21  subsequent violation commits a misdemeanor of the first

22  degree, punishable as provided in s. 775.082 or s. 775.083.

23  Each day of continuing violation constitutes a separate

24  offense.

25         (d)  The following penalties shall be imposed for

26  operating an unlicensed home medical equipment provider:

27         1.  Any person or entity who operates an unlicensed

28  provider commits a felony of the third degree.

29         2.  For any person or entity who has received

30  government reimbursement for services provided by an

31


                                  6

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






    CS for SB 276                            First Engrossed (ntc)



  1  unlicensed provider, the agency shall make a fraud referral to

  2  the appropriate government reimbursement program.

  3         3.  For any licensee found to be concurrently operating

  4  licensed and unlicensed provider premises, the agency may

  5  impose a fine or moratorium, or revoke existing licenses of

  6  any or all of the licensee's licensed provider locations until

  7  such time as the unlicensed provider premises is licensed.

  8         (e)  A provider found to be operating without a license

  9  may apply for licensure, and must cease operations until a

10  license is awarded by the agency.

11         400.931  Application for license; fee; provisional

12  license; temporary permit.--

13         (1)  Application for an initial license or for renewal

14  of an existing license must be made under oath to the agency

15  on forms furnished by it and must be accompanied by the

16  appropriate license fee as provided in subsection (12).

17         (2)  The applicant must file with the application

18  satisfactory proof that the home medical equipment provider is

19  in compliance with this part and applicable rules, including:

20         (a)  A report, by category, of the equipment to be

21  provided, indicating those offered either directly by the

22  applicant or through contractual arrangements with existing

23  providers. Categories of equipment include:

24         1.  Respiratory modalities.

25         2.  Ambulation aids.

26         3.  Mobility aids.

27         4.  Sickroom setup.

28         5.  Disposables.

29         (b)  A report, by category, of the services to be

30  provided, indicating those offered either directly by the

31


                                  7

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






    CS for SB 276                            First Engrossed (ntc)



  1  applicant or through contractual arrangements with existing

  2  providers. Categories of services include:

  3         1.  Intake.

  4         2.  Equipment selection.

  5         3.  Delivery.

  6         4.  Setup and installation.

  7         5.  Patient training.

  8         6.  Ongoing service and maintenance.

  9         7.  Retrieval.

10         (c)  A listing of those with whom the applicant

11  contracts, both the providers the applicant uses to provide

12  equipment or services to its consumers and the providers for

13  whom the applicant provides services or equipment.

14         (3)  The applicant for initial licensure must

15  demonstrate financial ability to operate, which may be

16  accomplished by the submission of a $50,000 surety bond to the

17  agency.

18         (4)  An applicant for renewal who has demonstrated

19  financial inability to operate must demonstrate financial

20  ability to operate.

21         (5)  Each applicant for licensure must comply with the

22  following requirements:

23         (a)  Upon receipt of a completed, signed, and dated

24  application, the agency shall require background screening of

25  the applicant, in accordance with the level 2 standards for

26  screening set forth in chapter 435. As used in this

27  subsection, the term "applicant" means the general manager and

28  the financial officer or similarly titled individual who is

29  responsible for the financial operation of the licensed

30  facility.

31


                                  8

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






    CS for SB 276                            First Engrossed (ntc)



  1         (b)  The agency may require background screening for a

  2  member of the board of directors of the licensee or an officer

  3  or an individual owning 5 percent or more of the licensee if

  4  the agency has probable cause to believe that such individual

  5  has been convicted of an offense prohibited under the level 2

  6  standards for screening set forth in chapter 435.

  7         (c)  Proof of compliance with the level 2 background

  8  screening requirements of chapter 435 which has been submitted

  9  within the previous 5 years in compliance with any other

10  health care licensure requirements of this state is acceptable

11  in fulfillment of paragraph (a).

12         (d)  Each applicant must submit to the agency, with its

13  application, a description and explanation of any exclusions,

14  permanent suspensions, or terminations of the applicant from

15  the Medicare or Medicaid programs. Proof of compliance with

16  disclosure of ownership and control interest requirements of

17  the Medicaid or Medicare programs shall be accepted in lieu of

18  this submission.

19         (e)  Each applicant must submit to the agency a

20  description and explanation of any conviction of an offense

21  prohibited under the level 2 standards of chapter 435 by a

22  member of the board of directors of the applicant, its

23  officers, or any individual owning 5 percent or more of the

24  applicant. This requirement does not apply to a director of a

25  not-for-profit corporation or organization if the director

26  serves solely in a voluntary capacity for the corporation or

27  organization, does not regularly take part in the day-to-day

28  operational decisions of the corporation or organization,

29  receives no remuneration for his or her services on the

30  corporation's or organization's board of directors, and has no

31  financial interest and has no family members with a financial


                                  9

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






    CS for SB 276                            First Engrossed (ntc)



  1  interest in the corporation or organization, provided that the

  2  director and the not-for-profit corporation or organization

  3  include in the application a statement affirming that the

  4  director's relationship to the corporation satisfies the

  5  requirements of this provision.

  6         (f)  A license may not be granted to any potential

  7  licensee if any applicant, administrator, or financial officer

  8  has been found guilty of, regardless of adjudication, or has

  9  entered a plea of nolo contendere or guilty to, any offense

10  prohibited under the level 2 standards for screening set forth

11  in chapter 435, unless an exemption from disqualification has

12  been granted by the agency as set forth in chapter 435.

13         (g)  The agency may deny or revoke licensure to any

14  potential licensee if any applicant:

15         1.  Has falsely represented a material fact in the

16  application required by paragraphs (d) and (e), or has omitted

17  any material fact from the application required by paragraphs

18  (d) and (e); or

19         2.  Has had prior Medicaid or Medicare action taken

20  against the applicant as set forth in paragraph (d).

21         (h)  Upon licensure renewal, each applicant must submit

22  to the agency, under penalty of perjury, an affidavit of

23  compliance with the background screening provisions of this

24  section.

25         (6)  The home medical equipment provider must also

26  obtain and maintain professional and commercial liability

27  insurance. Proof of liability insurance, as defined in s.

28  624.605, must be submitted with the application. The agency

29  shall set the required amounts of liability insurance by rule,

30  but the required amount must not be less than $250,000 per

31  claim. In the case of contracted services, it is required that


                                  10

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






    CS for SB 276                            First Engrossed (ntc)



  1  the contractor have liability insurance not less than $250,000

  2  per claim.

  3         (7)  A provisional license shall be issued to an

  4  approved applicant for initial licensure for a period of 90

  5  days, during which time a survey must be conducted

  6  demonstrating substantial compliance with this section. A

  7  provisional license shall also be issued pending the results

  8  of an applicant's Federal Bureau of Investigation report of

  9  background screening confirming that all standards have been

10  met. If substantial compliance is demonstrated, a standard

11  license shall be issued to expire 2 years after the effective

12  date of the provisional license.

13         (8)  Ninety days before the expiration date, an

14  application for license renewal must be submitted to the

15  agency under oath on forms furnished by the agency, and a

16  license shall be renewed if the applicant has met the

17  requirements established under this part and applicable rules.

18  The home medical equipment provider must file with the

19  application satisfactory proof that it is in compliance with

20  this part and applicable rules. The home medical equipment

21  provider must submit satisfactory proof of its financial

22  ability to comply with the requirements of this part.

23         (9)  When a change of ownership of a home medical

24  equipment provider occurs, the prospective owner must submit

25  an initial application for a license at least 15 days before

26  the effective date of the change of ownership. An application

27  for change of ownership of a license is required when

28  ownership, a majority of the ownership, or controlling

29  interest of a licensed home medical equipment provider is

30  transferred or assigned and when a licensee agrees to

31  undertake or provide services to the extent that legal


                                  11

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






    CS for SB 276                            First Engrossed (ntc)



  1  liability for operation of the home medical equipment provider

  2  rests with the licensee. A provisional license shall be issued

  3  to the new owner for a period of 90 days, during which time

  4  all required documentation must be submitted and a survey must

  5  be conducted demonstrating substantial compliance with this

  6  section. If substantial compliance is demonstrated, a standard

  7  license shall be issued to expire 2 years after the issuance

  8  of the provisional license.

  9         (10)  When a change of the general manager of a home

10  medical equipment provider occurs, the licensee must notify

11  the agency of the change within 45 days thereof and must

12  provide evidence of compliance with the background screening

13  requirements in subsection (5); except that a general manager

14  who has met the standards for the abuse registry background

15  check and the Department of Law Enforcement background check,

16  but for whom background screening results from the Federal

17  Bureau of Investigation have not yet been received, may be

18  employed pending receipt of the Federal Bureau of

19  Investigation background screening report. An individual may

20  not continue to serve as general manager if the Federal Bureau

21  of Investigation background screening report indicates any

22  violation of background screening standards.

23         (11)  All licensure fees required of a home medical

24  equipment provider are nonrefundable. The agency shall set the

25  fees in an amount that is sufficient to cover its costs in

26  carrying out its responsibilities under this part. However,

27  state, county, or municipal governments applying for licenses

28  under this part are exempt from the payment of license fees.

29  All fees collected under this part must be deposited in the

30  Health Care Trust Fund for the administration of this part.

31


                                  12

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






    CS for SB 276                            First Engrossed (ntc)



  1         (12)  An applicant for initial licensure, renewal, or

  2  change of ownership shall pay a license processing fee not to

  3  exceed $300, to be paid by all applicants, and an inspection

  4  fee not to exceed $400, to be paid by all applicants except

  5  those not subject to licensure inspection by the agency as

  6  described in s. 400.933(2).

  7         (13)  When a change is reported which requires issuance

  8  of a license, a fee must be assessed. The fee must be based on

  9  the actual cost of processing and issuing the license.

10         (14)  When a duplicate license is issued, a fee must be

11  assessed, not to exceed the actual cost of duplicating and

12  mailing.

13         (15)  When applications are mailed out upon request, a

14  fee must be assessed, not to exceed the cost of the printing,

15  preparation, and mailing.

16         (16)  The license must be displayed in a conspicuous

17  place in the administrative office of the home medical

18  equipment provider and is valid only while in the possession

19  of the person or entity to which it is issued. The license may

20  not be sold, assigned, or otherwise transferred, voluntarily

21  or involuntarily, and is valid only for the home medical

22  equipment provider and location for which originally issued.

23         (17)  A home medical equipment provider against whom a

24  proceeding for revocation or suspension, or for denial of a

25  renewal application, is pending at the time of license renewal

26  may be issued a provisional license effective until final

27  disposition by the agency of such proceedings. If judicial

28  relief is sought from the final disposition, the court that

29  has jurisdiction may issue a temporary permit for the duration

30  of the judicial proceeding.

31


                                  13

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






    CS for SB 276                            First Engrossed (ntc)



  1         400.932  Administrative penalties; injunctions;

  2  emergency orders; moratoriums.--

  3         (1)  The agency may deny, revoke, or suspend a license,

  4  or impose an administrative fine not to exceed $5,000 per

  5  violation, per day, or initiate injunctive proceedings under

  6  s. 400.96.

  7         (2)  Any of the following actions by a home medical

  8  equipment provider or any of its employees is grounds for

  9  administrative action or penalties by the agency:

10         (a)  Violation of this part or of applicable rules.

11         (b)  An intentional, reckless, or negligent act that

12  materially affects the health or safety of a patient.

13         (3)  The agency may deny or revoke the license of any

14  applicant that:

15         (a)  Made a false representation or omission of any

16  material fact in making the application, including the

17  submission of an application that conceals the controlling or

18  ownership interest or any officer, director, agent, managing

19  employee, affiliated person, partner, or shareholder who may

20  not be eligible to participate;

21         (b)  Has been previously found by any professional

22  licensing, certifying, or standards board or agency to have

23  violated the standards or conditions relating to licensure or

24  certification or the quality of services provided.

25  "Professional licensing, certifying, or standards board or

26  agency" shall include, but is not limited to, practitioners,

27  health care facilities, programs, or services, or residential

28  care, treatment programs, or other human services; or

29         (c)  Has been or is currently excluded, suspended, or

30  terminated from, or has involuntarily withdrawn from,

31  participation in Florida's Medicaid program or any other


                                  14

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






    CS for SB 276                            First Engrossed (ntc)



  1  state's Medicaid program, or participation in the Medicare

  2  program or any other governmental or private health care or

  3  health insurance program.

  4         (4)  The agency may issue an emergency order

  5  immediately suspending or revoking a license when it

  6  determines that any condition within the responsibility of the

  7  home medical equipment provider presents a clear and present

  8  danger to public health and safety.

  9         (5)  The agency may impose an immediate moratorium on

10  any licensed home medical equipment provider when the agency

11  determines that any condition within the responsibility of the

12  home medical equipment provider presents a threat to public

13  health or safety.

14         400.933  Licensure inspections and investigations.--

15         (1)  The agency shall make or cause to be made such

16  inspections and investigations as it considers necessary,

17  including:

18         (a)  Licensure inspections.

19         (b)  Inspections directed by the federal Health Care

20  Financing Administration.

21         (c)  Licensure complaint investigations, including full

22  licensure investigations with a review of all licensure

23  standards as outlined in the administrative rules. Complaints

24  received by the agency from individuals, organizations, or

25  other sources are subject to review and investigation by the

26  agency.

27         (2)  The agency shall accept, in lieu of its own

28  periodic inspections for licensure, submission of the

29  following:

30         (a)  The survey or inspection of an accrediting

31  organization, provided the accreditation of the licensed home


                                  15

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






    CS for SB 276                            First Engrossed (ntc)



  1  medical equipment provider is not provisional and provided the

  2  licensed home medical equipment provider authorizes release

  3  of, and the agency receives the report of, the accrediting

  4  organization; or

  5         (b)  A copy of a valid medical oxygen retail

  6  establishment permit issued by the Department of Health,

  7  pursuant to chapter 499.

  8         400.934  Minimum standards.--As a requirement of

  9  licensure, home medical equipment providers shall:

10         (1)  Offer and provide home medical equipment and

11  services, as necessary, to consumers who purchase or rent

12  equipment that requires such services.

13         (2)  Provide at least one category of equipment

14  directly, filling orders from its own inventory.

15         (3)  Respond to orders received for other equipment by

16  filling those orders from its own inventory or inventory from

17  other companies with which it has contracted to fill such

18  orders; or customizing or fitting items for sale from supplies

19  purchased under contract.

20         (4)  Maintain trained personnel to coordinate order

21  fulfillment and schedule timely equipment and service

22  delivery.

23         (5)  As necessary in relation to the sophistication of

24  the equipment and services being provided, ensure that

25  delivery personnel are appropriately trained to conduct an

26  environment and equipment compatibility assessment;

27  appropriately and safely set up the equipment; instruct

28  patients and caregivers in the safe operation and client

29  maintenance of the equipment; and recognize when additional

30  education or followup patient compliance monitoring is

31  appropriate.


                                  16

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






    CS for SB 276                            First Engrossed (ntc)



  1         (6)  Ensure that patients are made aware of service

  2  hours and emergency service procedures.

  3         (7)  At the time of the initial delivery, set up an

  4  appropriate followup home medical equipment service schedule

  5  as needed for such times as, but not limited to, periodic

  6  maintenance, supply delivery, and other related activities.

  7         (8)  Arrange for emergency service after normal

  8  business hours; provide refresher and review training for

  9  appropriate personnel; establish a system for resolution of

10  complaints and service problems; and provide for timely

11  replacement or delivery of disposable or consumable equipment

12  supplies.

13         (9)  Honor all warranties expressed and implied under

14  applicable state law.

15         (10)  Answer any questions or complaints a consumer has

16  about an item or the use of an item that the consumer

17  purchases or rents.

18         (11)  Maintain and repair directly, or through a

19  service contract with another company, items rented to

20  consumers.

21         (12)  Accept returns of substandard or unsuitable items

22  from consumers. As used in this subsection, the term

23  "substandard" means less than full quality for the particular

24  item and the term "unsuitable" means inappropriate for the

25  consumer at the time it was fitted or sold.

26         (13)  Disclose consumer information to each consumer

27  who rents or purchases items, including all applicable

28  warranty information. This information consists of the

29  provider standards to which the item must conform.

30         (14)  Maintain patient payment and service records in

31  accordance with the requirements of this part.


                                  17

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






    CS for SB 276                            First Engrossed (ntc)



  1         (15)(a)  Designate appropriate staff as intake

  2  coordinators, and ensure that order intake personnel are

  3  appropriately trained in the types of equipment and products,

  4  commonly occurring medical conditions, service procedures,

  5  third-party billing, and insurance requirements and coverage.

  6         (b)  Train intake coordinators in a basic understanding

  7  of the following areas:  dealing with patient and caregiver

  8  needs; other, nonhome medical equipment provider services as

  9  they relate to home medical equipment services and home care

10  patient crisis management.

11         (16)  Establish procedures for maintaining a record of

12  the employment history, including background screening as

13  required by s. 400.953, of all home medical equipment provider

14  personnel. A home medical equipment provider must require its

15  personnel to submit an employment history to the home medical

16  equipment provider and must verify the employment history for

17  at least the previous 5 years, unless through diligent efforts

18  such verification is not possible. There is no monetary

19  liability on the part of, and no cause of action for damages

20  arising against a former employer, a prospective employee, or

21  a prospective independent contractor with a licensed home

22  medical equipment provider, who reasonably and in good faith

23  communicates his or her honest opinions about a former

24  employee's job performance. This subsection does not affect

25  the official immunity of an officer or employee of a public

26  corporation.

27         (17)  Upon request by the consumer or as otherwise

28  required by state law and rules, or federal law and

29  regulations, assist consumers with meeting the necessary

30  filing requirements to obtain third-party payment to which a

31  consumer may be entitled.


                                  18

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






    CS for SB 276                            First Engrossed (ntc)



  1         (18)  Maintain safe premises.

  2         (19)  Comply with all other state and federal laws.

  3         400.935  Rules establishing minimum standards.--The

  4  agency shall adopt, publish, and enforce rules to implement

  5  this part, which must provide reasonable and fair minimum

  6  standards relating to:

  7         (1)  The qualifications and minimum training

  8  requirements of all home medical equipment provider personnel.

  9         (2)  License application and renewal.

10         (3)  License and inspection fees.

11         (4)  Financial ability to operate.

12         (5)  The administration of the home medical equipment

13  provider.

14         (6)  Procedures for maintaining patient records.

15         (7)  Ensuring that the home medical equipment and

16  services provided by a home medical equipment provider are in

17  accordance with the plan of treatment established for each

18  patient, when provided as a part of a plan of treatment.

19         (8)  Contractual arrangements for the provision of home

20  medical equipment and services by providers not employed by

21  the home medical equipment provider providing for the

22  consumer's needs.

23         (9)  Physical location and zoning requirements.

24         (10)  Home medical equipment requiring home medical

25  equipment services.

26         400.94  Patient records.--

27         (1)  The home medical equipment provider must maintain,

28  for each patient, a patient record that includes the home

29  medical equipment and services the home medical equipment

30  provider has provided. Such records must contain:

31


                                  19

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






    CS for SB 276                            First Engrossed (ntc)



  1         (a)  Any physician's order or certificate of medical

  2  necessity, if the equipment was ordered by a physician.

  3         (b)  Signed and dated delivery slips verifying

  4  delivery.

  5         (c)  Notes reflecting all services and maintenance

  6  performed, and any equipment exchanges.

  7         (d)  The date on which rental equipment was retrieved.

  8         (e)  Such other information as is appropriate to

  9  specific patients in light of the particular equipment

10  provided to them.

11         (2)  Such records are considered patient records under

12  s. 455.667, and must be maintained by the home medical

13  equipment provider for 5 years following termination of

14  services. If a patient transfers to another home medical

15  equipment provider, a copy of his or her record must be

16  provided to the other home medical equipment provider, upon

17  request.

18         400.95  Notice of toll-free telephone number for

19  central abuse registry.--On or before the first day home

20  medical equipment is delivered to the patient's home, any home

21  medical equipment provider licensed under this part must

22  inform the consumer and his or her immediate family, if

23  appropriate, of the right to report abusive, neglectful, or

24  exploitative practices. The statewide toll-free telephone

25  number for the central abuse registry must be provided to

26  consumers in a manner that is clearly legible and must include

27  the words:  "To report abuse, neglect, or exploitation, please

28  call toll-free 1-800-962-2873." Home medical equipment

29  providers shall establish appropriate policies and procedures

30  for providing such notice to consumers.

31


                                  20

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






    CS for SB 276                            First Engrossed (ntc)



  1         400.953  Background screening of home medical equipment

  2  provider personnel.--The agency shall require employment

  3  screening as provided in chapter 435, using the level 1

  4  standards for screening set forth in that chapter, for home

  5  medical equipment provider personnel.

  6         (1)  The agency may grant exemptions from

  7  disqualification from employment under this section as

  8  provided in s. 435.07.

  9         (2)  The general manager of each home medical equipment

10  provider must sign an affidavit annually, under penalty of

11  perjury, stating that all home medical equipment provider

12  personnel hired on or after July 1, 1999, who enter the home

13  of a patient in the capacity of their employment have been

14  screened and that its remaining personnel have worked for the

15  home medical equipment provider continuously since before July

16  1, 1999.

17         (3)  Proof of compliance with the screening

18  requirements of s. 110.1127, s. 393.0655, s. 394.4572, s.

19  397.451, s. 402.305, s. 402.313, s. 409.175, s. 464.008, or s.

20  985.407 or this part must be accepted in lieu of the

21  requirements of this section if the person has been

22  continuously employed in the same type of occupation for which

23  he or she is seeking employment without a breach in service

24  that exceeds 180 days, the proof of compliance is not more

25  than 2 years old, and the person has been screened through the

26  central abuse registry and tracking system of the department

27  and by the Department of Law Enforcement. An employer or

28  contractor shall directly provide proof of compliance to

29  another employer or contractor, and a potential employer or

30  contractor may not accept any proof of compliance directly

31  from the person requiring screening. Proof of compliance with


                                  21

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






    CS for SB 276                            First Engrossed (ntc)



  1  the screening requirements of this section shall be provided,

  2  upon request, to the person screened by the home medical

  3  equipment provider.

  4         (4)  There is no monetary liability on the part of, and

  5  no cause of action for damages arising against, a licensed

  6  home medical equipment provider that, upon notice of a

  7  confirmed report of adult abuse, neglect, or exploitation

  8  under chapter 415, terminates the employee against whom the

  9  report was issued, whether or not the employee has filed for

10  an exemption with the agency and whether or not the time for

11  filing has expired.

12         (5)  The costs of processing the statewide

13  correspondence criminal records checks and the search of the

14  department's central abuse registry must be borne by the home

15  medical equipment provider or by the person being screened, at

16  the discretion of the home medical equipment provider.

17         (6)  Neither the agency nor the home medical equipment

18  provider may use the criminal records, juvenile records, or

19  central abuse registry information of a person for any purpose

20  other than determining whether that person meets minimum

21  standards of good moral character for home medical equipment

22  provider personnel.

23         (7)(a)  It is a misdemeanor of the first degree,

24  punishable as provided in s. 775.082 or s. 775.083, for any

25  person willfully, knowingly, or intentionally to:

26         1.  Fail, by false statement, misrepresentation,

27  impersonation, or other fraudulent means, to disclose in any

28  application for paid employment a material fact used in making

29  a determination as to the person's qualifications to be an

30  employee under this section;

31


                                  22

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






    CS for SB 276                            First Engrossed (ntc)



  1         2.  Operate or attempt to operate an entity licensed

  2  under this part with persons who do not meet the minimum

  3  standards for good moral character as contained in this

  4  section; or

  5         3.  Use information from the criminal records or

  6  central abuse registry obtained under this section for any

  7  purpose other than screening that person for employment as

  8  specified in this section, or release such information to any

  9  other person for any purpose other than screening for

10  employment under this section.

11         (b)  It is a felony of the third degree, punishable as

12  provided in s. 775.082, s. 775.083, or s. 775.084, for any

13  person willfully, knowingly, or intentionally to use

14  information from the juvenile records of a person obtained

15  under this section for any purpose other than screening for

16  employment under this section.

17         400.955  Procedures for screening of home medical

18  equipment provider personnel.--

19         (1)  A person employed by a home medical equipment

20  provider shall, within 5 working days after starting to work,

21  submit to the home medical equipment provider a complete set

22  of information necessary to conduct a screening under this

23  section. The person must sign an affidavit stating whether he

24  or she meets the minimum standards for good moral character

25  under this section. The home medical equipment provider shall

26  submit the information to the Department of Law Enforcement

27  and to the department's central abuse registry and tracking

28  system for processing. If disposition information is missing

29  on a criminal record, it is the responsibility of the person

30  being screened to obtain and supply the missing information

31  within 30 days. Failure to supply the missing information or


                                  23

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






    CS for SB 276                            First Engrossed (ntc)



  1  to show reasonable efforts to obtain such information will

  2  result in automatic disqualification for employment.

  3         (2)  Home medical equipment provider personnel hired on

  4  or after July 1, 1999, must be placed on probationary status

  5  pending a determination of compliance with minimum standards

  6  for good moral character.

  7         (3)  The home medical equipment provider must

  8  automatically terminate the employment of any of its personnel

  9  found to be in noncompliance with the minimum standards for

10  good moral character under this section, unless such person

11  has obtained an exemption under s. 400.953(1).

12         (4)  The general manager of each home medical equipment

13  provider must sign an affidavit annually, under penalty of

14  perjury, stating that all personnel hired on or after July 1,

15  1999, have been screened and that its remaining personnel have

16  worked for the home medical equipment provider continuously

17  since before July 1, 1999.

18         400.96  Injunction proceedings.--The agency may

19  institute injunction proceedings in a court of competent

20  jurisdiction when violation of this part or of applicable

21  rules constitutes an emergency affecting the immediate health

22  and safety of a patient or consumer.

23         400.965  Prohibited acts.--Compliance with state and

24  federal laws regarding prohibited patient referrals and

25  rebates shall be a condition of licensure.

26         Section 2.  Home medical equipment providers in

27  existence on the effective date of this act who are subject to

28  licensure under part X of chapter 400, Florida Statutes, as

29  created in this act, shall submit an application and

30  applicable fees for licensure by December 31, 1999. Those

31  existing providers that submit applications and fees prior to


                                  24

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






    CS for SB 276                            First Engrossed (ntc)



  1  December 31, 1999, shall be deemed to meet licensure

  2  requirements until the agency acts to deny or grant the

  3  initial licensure application. After December 31, 1999,

  4  applicants for licensure may not operate until they are

  5  approved and obtain a license.

  6         Section 3.  There is hereby appropriated from the

  7  Health Care Trust Fund to the Agency for Health Care

  8  Administration 13 full-time-equivalent staff positions and

  9  $701,370 to implement the provisions of this act.

10         Section 4.  This act shall take effect July 1, 1999.

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31


                                  25