Senate Bill sb2092e1

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  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         154.306, F.S.; providing procedures for

  4         computing the maximum amount that specified

  5         counties must pay for the treatment of an

  6         indigent resident of the county at a hospital

  7         located outside the county; providing for the

  8         exclusion of active-duty military personnel and

  9         certain institutionalized county residents from

10         state population estimates when calculating a

11         county's financial responsibility for such

12         hospital care; requiring the county of

13         residence to accept the hospital's

14         documentation of financial eligibility and

15         county residence; requiring that the

16         documentation meet specified criteria; amending

17         s. 381.0403, F.S.; transferring the community

18         hospital education program from the Board of

19         Regents to the Department of Health;

20         prescribing membership of a committee reporting

21         on graduate medical education; amending s.

22         409.908, F.S.; revising provisions relating to

23         the reimbursement of Medicaid providers to

24         conform to the transfer of the Community

25         Hospital Education Program from the Board of

26         Regents to the Department of Health; providing

27         for the certification of local matching funds;

28         providing requirements for the distribution of

29         federal funds earned as a result of local

30         matching funds; requiring an impact statement;

31         providing rulemaking authority to the


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  1         Department of Health; amending s. 409.911,

  2         F.S.; redefining the term "charity care" or

  3         "uncompensated charity care" for purposes of

  4         the disproportionate share program; amending s.

  5         409.9117, F.S.; revising eligibility criteria

  6         for payments under the primary care

  7         disproportionate share program; amending s.

  8         409.912, F.S.; extending the duration of

  9         certain demonstration projects to test Medicaid

10         direct contracting; providing legislative

11         findings and intent; amending s. 456.057,

12         395.3025, 400.1415, F.S.; prohibiting the use

13         of a patient's medical records for purposes of

14         solicitation and marketing without specific

15         written release or authorization; providing for

16         criminal penalties; creating s. 626.9651, F.S.;

17         requiring the Department of Insurance to adopt

18         rules governing the use of a consumer's

19         nonpublic personal financial and health

20         information; providing standards for the rules;

21         providing an effective date.

22

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

24

25         Section 1.  Present subsections (3) and (4) of section

26  154.306, Florida Statutes, are redesignated as subsections (4)

27  and (5), respectively, and a new subsection (3) is added to

28  that section, to read:

29         154.306  Financial responsibility for certified

30  residents who are qualified indigent patients treated at an

31  out-of-county participating hospital or regional referral


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  1  hospital.--Ultimate financial responsibility for treatment

  2  received at a participating hospital or a regional referral

  3  hospital by a qualified indigent patient who is a certified

  4  resident of a county in the State of Florida, but is not a

  5  resident of the county in which the participating hospital or

  6  regional referral hospital is located, is the obligation of

  7  the county of which the qualified indigent patient is a

  8  resident. Each county shall reimburse participating hospitals

  9  or regional referral hospitals as provided for in this part,

10  and shall provide or arrange for indigent eligibility

11  determination procedures and resident certification

12  determination procedures as provided for in rules developed to

13  implement this part.  The agency, or any county determining

14  eligibility of a qualified indigent, shall provide to the

15  county of residence, upon request, a copy of any documents,

16  forms, or other information, as determined by rule, which may

17  be used in making an eligibility determination.

18         (3)  For the purpose of computing the maximum amount

19  that a county having a population of 100,000 or less may be

20  required to pay, the agency must reduce the official state

21  population estimates by the number of inmates and patients

22  residing in the county in institutions operated by the Federal

23  Government, the Department of Corrections, the Department of

24  Health, or the Department of Children and Family Services, and

25  by the number of active-duty military personnel residing in

26  the county, all of whom shall not be considered residents of

27  the county. However, a county is entitled to receive the

28  benefit of such a reduction in estimated population figures

29  only if the county accepts as valid and true, and does not

30  require any reverification of, the documentation of financial

31  eligibility and county residency which is provided to it by


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  1  the participating hospital or regional referral hospital. The

  2  participating hospital or regional referral hospital must

  3  provide documentation that is complete and in the form

  4  required by s. 154.3105.

  5         Section 2.  Subsections (3), (4), (5), (6), (7), and

  6  (9) of section 381.0403, Florida Statutes, are amended, and

  7  subsection (10) is added to that section, to read:

  8         381.0403  The Community Hospital Education Act.--

  9         (3)  PROGRAM FOR COMMUNITY HOSPITAL EDUCATION; STATE

10  AND LOCAL PLANNING.--

11         (a)  There is established under the Department of

12  Health Board of Regents a program for statewide graduate

13  medical education.  It is intended that continuing graduate

14  medical education programs for interns and residents be

15  established on a statewide basis. The program shall provide

16  financial support for primary care specialty interns and

17  residents based on policies recommended and approved by the

18  Community Hospital Education Council, herein established, and

19  the Department of Health Board of Regents. Only those programs

20  with at least three residents or interns in each year of the

21  training program are qualified to apply for financial support.

22  Programs with fewer than three residents or interns per

23  training year are qualified to apply for financial support,

24  but only if the appropriate accrediting entity for the

25  particular specialty has approved the program for fewer

26  positions. Programs added after fiscal year 1997-1998 shall

27  have 5 years to attain the requisite number of residents or

28  interns. When feasible and to the extent allowed through the

29  General Appropriations Act, state funds shall be used to

30  generate federal matching funds under Medicaid, or other

31  federal programs, and the resulting combined state and federal


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  1  funds shall be allocated to participating hospitals for the

  2  support of graduate medical education. The department may

  3  spend up to $75,000 of the state appropriation, for

  4  administrative costs associated with the production of the

  5  annual report as specified in subsection (9), and for

  6  administration of the program council.

  7         (b)  For the purposes of this section, primary care

  8  specialties include emergency medicine, family practice,

  9  internal medicine, pediatrics, psychiatry,

10  obstetrics/gynecology, and combined pediatrics and internal

11  medicine, and other primary care specialties as may be

12  included by the council and Department of Health Board of

13  Regents.

14         (c)  Medical institutions throughout the state may

15  apply to the Community Hospital Education Council for

16  grants-in-aid for financial support of their approved

17  programs.  Recommendations for funding of approved programs

18  shall be forwarded to the Department of Health Board of

19  Regents.

20         (d)  The program shall provide a plan for community

21  clinical teaching and training with the cooperation of the

22  medical profession, hospitals, and clinics.  The plan shall

23  also include formal teaching opportunities for intern and

24  resident training.  In addition, the plan shall establish an

25  off-campus medical faculty with university faculty review to

26  be located throughout the state in local communities.

27         (4)  PROGRAM FOR GRADUATE MEDICAL EDUCATION

28  INNOVATIONS.--

29         (a)  There is established under the Department of

30  Health Board of Regents a program for fostering graduate

31  medical education innovations. Funds appropriated annually by


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  1  the Legislature for this purpose shall be distributed to

  2  participating hospitals or consortia of participating

  3  hospitals and Florida medical schools or to a Florida medical

  4  school for the direct costs of providing graduate medical

  5  education in community-based clinical settings on a

  6  competitive grant or formula basis to achieve state health

  7  care workforce policy objectives, including, but not limited

  8  to:

  9         1.  Increasing the number of residents in primary care

10  and other high demand specialties or fellowships;

11         2.  Enhancing retention of primary care physicians in

12  Florida practice;

13         3.  Promoting practice in medically underserved areas

14  of the state;

15         4.  Encouraging racial and ethnic diversity within the

16  state's physician workforce; and

17         5.  Encouraging increased production of geriatricians.

18         (b)  Participating hospitals or consortia of

19  participating hospitals and Florida medical schools or a

20  Florida medical school providing graduate medical education in

21  community-based clinical settings may apply to the Community

22  Hospital Education Council for funding under this innovations

23  program, except when such innovations directly compete with

24  services or programs provided by participating hospitals or

25  consortia of participating hospitals, or by both hospitals and

26  consortia. Innovations program funding shall provide funding

27  based on policies recommended and approved by the Community

28  Hospital Education Council and the Department of Health Board

29  of Regents.

30         (c)  Participating hospitals or consortia of

31  participating hospitals and Florida medical schools or Florida


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  1  medical schools awarded an innovations grant shall provide the

  2  Community Hospital Education Council and Department of Health

  3  Board of Regents with an annual report on their project.

  4         (5)  FAMILY PRACTICE RESIDENCIES.--In addition to the

  5  programs established in subsection (3), the Community Hospital

  6  Education Council and the Department of Health Board of

  7  Regents shall establish an ongoing statewide program of family

  8  practice residencies.  The administration of this program

  9  shall be in the manner described in this section.

10         (6)  COUNCIL AND DIRECTOR.--

11         (a)  There is established the Community Hospital

12  Education Council, hereinafter referred to as the council,

13  which shall consist of 11 members, as follows:

14         1.  Seven members must be program directors of

15  accredited graduate medical education programs or practicing

16  physicians who have faculty appointments in accredited

17  graduate medical education programs.  Six of these members

18  must be board certified or board eligible in family practice,

19  internal medicine, pediatrics, emergency medicine,

20  obstetrics-gynecology, and psychiatry, respectively, and

21  licensed pursuant to chapter 458. No more than one of these

22  members may be appointed from any one specialty.  One member

23  must be licensed pursuant to chapter 459.

24         2.  One member must be a representative of the

25  administration of a hospital with an approved community

26  hospital medical education program;

27         3.  One member must be the dean of a medical school in

28  this state; and

29         4.  Two members must be consumer representatives.

30

31


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  1  All of the members shall be appointed by the Governor for

  2  terms of 4 years each.

  3         (b)  Council membership shall cease when a member's

  4  representative status no longer exists.  Members of similar

  5  representative status shall be appointed to replace retiring

  6  or resigning members of the council.

  7         (c)  The Secretary of the Department of Health

  8  Chancellor of the State University System shall designate an

  9  administrator to serve as staff director.  The council shall

10  elect a chair from among its membership.  Such other personnel

11  as may be necessary to carry out the program shall be employed

12  as authorized by the Department of Health Board of Regents.

13         (7)  DEPARTMENT OF HEALTH BOARD OF REGENTS;

14  STANDARDS.--

15         (a)  The Department of Health Board of Regents, with

16  recommendations from the council, shall establish standards

17  and policies for the use and expenditure of graduate medical

18  education funds appropriated pursuant to subsection (8) for a

19  program of community hospital education.  The Department of

20  Health board shall establish requirements for hospitals to be

21  qualified for participation in the program which shall

22  include, but not be limited to:

23         1.  Submission of an educational plan and a training

24  schedule.

25         2.  A determination by the council to ascertain that

26  each portion of the program of the hospital provides a high

27  degree of academic excellence and is accredited by the

28  Accreditation Council for Graduate Medical Education of the

29  American Medical Association or is accredited by the American

30  Osteopathic Association.

31


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  1         3.  Supervision of the educational program of the

  2  hospital by a physician who is not the hospital administrator.

  3         (b)  The Department of Health Board of Regents shall

  4  periodically review the educational program provided by a

  5  participating hospital to assure that the program includes a

  6  reasonable amount of both formal and practical training and

  7  that the formal sessions are presented as scheduled in the

  8  plan submitted by each hospital.

  9         (c)  In years that funds are transferred to the Agency

10  for Health Care Administration, the Department of Health Board

11  of Regents shall certify to the Agency for Health Care

12  Administration on a quarterly basis the number of primary care

13  specialty residents and interns at each of the participating

14  hospitals for which the Community Hospital Education Council

15  and the board recommends funding.

16         (9)  ANNUAL REPORT ON GRADUATE MEDICAL EDUCATION;

17  COMMITTEE.--The Board of Regents, the Executive Office of the

18  Governor, the Department of Health, and the Agency for Health

19  Care Administration shall collaborate to establish a committee

20  that shall produce an annual report on graduate medical

21  education. The committee shall be comprised of 11 members:

22  five members shall be deans of the medical schools or their

23  designees; the Governor shall appoint two members, one of whom

24  must be a representative of the Florida Medical Association

25  who has supervised or currently supervises residents or

26  interns and one of whom must be a representative of the

27  Florida Hospital Association; the Secretary of Health Care

28  Administration shall appoint two members, one of whom must be

29  a representative of a statutory teaching hospital and one of

30  whom must be a physician who has supervised or is currently

31  supervising residents or interns; and the Secretary of Health


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  1  shall appoint two members, one of whom must be a

  2  representative of a statutory family practice teaching

  3  hospital and one of whom must be a physician who has

  4  supervised or is currently supervising residents or interns.

  5  With the exception of the deans, members shall serve 4-year

  6  terms. In order to stagger the terms, the Governor's

  7  appointees shall serve initial terms of 4 years, the Secretary

  8  of Health's appointees shall serve initial terms of 3 years,

  9  and the Secretary of Health Care Administration's appointees

10  shall serve initial terms of 2 years. A member's term shall be

11  deemed terminated when the member's representative status no

12  longer exists. Once the committee is appointed, it shall elect

13  a chair to serve for a 1-year term. To the maximum extent

14  feasible, the committee shall have the same membership as the

15  Graduate Medical Education Study Committee, established by

16  proviso accompanying Specific Appropriation 191 of the

17  1999-2000 General Appropriations Act. The report shall be

18  provided to the Governor, the President of Senate, and the

19  Speaker of the House of Representatives by January 15

20  annually. Committee members shall serve without compensation.

21  From the funds provided pursuant to subsection (3), the

22  committee is authorized to expend a maximum of $75,000 per

23  year to provide for administrative costs and contractual

24  services. The report shall address the following:

25         (a)  The role of residents and medical faculty in the

26  provision of health care.

27         (b)  The relationship of graduate medical education to

28  the state's physician workforce.

29         (c)  The costs of training medical residents for

30  hospitals, medical schools, teaching hospitals, including all

31


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  1  hospital-medical affiliations, practice plans at all of the

  2  medical schools, and municipalities.

  3         (d)  The availability and adequacy of all sources of

  4  revenue to support graduate medical education and recommend

  5  alternative sources of funding for graduate medical education.

  6         (e)  The use of state and federal appropriated funds

  7  for graduate medical education by hospitals receiving such

  8  funds.

  9         (10)  RULEMAKING.--The department has authority to

10  adopt rules pursuant to ss. 120.536(1) and 120.54 to implement

11  the provisions of this section.

12         Section 3.  All statutory powers, duties, and functions

13  and the records, personnel, property, and unexpended balances

14  of appropriations, allocations, or other funds of the

15  Community Hospital Education Program are transferred from the

16  Board of Regents to the Department of Health by a type two

17  transfer as defined in section 20.06, Florida Statutes.

18         Section 4.  Paragraph (a) of subsection (1) of section

19  409.908, Florida Statutes, is amended to read:

20         409.908  Reimbursement of Medicaid providers.--Subject

21  to specific appropriations, the agency shall reimburse

22  Medicaid providers, in accordance with state and federal law,

23  according to methodologies set forth in the rules of the

24  agency and in policy manuals and handbooks incorporated by

25  reference therein. These methodologies may include fee

26  schedules, reimbursement methods based on cost reporting,

27  negotiated fees, competitive bidding pursuant to s. 287.057,

28  and other mechanisms the agency considers efficient and

29  effective for purchasing services or goods on behalf of

30  recipients. Payment for Medicaid compensable services made on

31  behalf of Medicaid eligible persons is subject to the


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  1  availability of moneys and any limitations or directions

  2  provided for in the General Appropriations Act or chapter 216.

  3  Further, nothing in this section shall be construed to prevent

  4  or limit the agency from adjusting fees, reimbursement rates,

  5  lengths of stay, number of visits, or number of services, or

  6  making any other adjustments necessary to comply with the

  7  availability of moneys and any limitations or directions

  8  provided for in the General Appropriations Act, provided the

  9  adjustment is consistent with legislative intent.

10         (1)  Reimbursement to hospitals licensed under part I

11  of chapter 395 must be made prospectively or on the basis of

12  negotiation.

13         (a)  Reimbursement for inpatient care is limited as

14  provided for in s. 409.905(5), except for:

15         1.  The raising of rate reimbursement caps, excluding

16  rural hospitals.

17         2.  Recognition of the costs of graduate medical

18  education.

19         3.  Other methodologies recognized in the General

20  Appropriations Act.

21

22  During the years funds are transferred from the Department of

23  Health Board of Regents, any reimbursement supported by such

24  funds shall be subject to certification by the Department of

25  Health Board of Regents that the hospital has complied with s.

26  381.0403. The agency is authorized to receive funds from state

27  entities, including, but not limited to, the Department of

28  Health, the Board of Regents, local governments, and other

29  local political subdivisions, for the purpose of making

30  special exception payments, including federal matching funds,

31  through the Medicaid inpatient reimbursement methodologies.


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  1  Funds received from state entities or local governments for

  2  this purpose shall be separately accounted for and shall not

  3  be commingled with other state or local funds in any manner.

  4  The agency may certify all local governmental funds used as

  5  state match under Title XIX of the Social Security Act, to the

  6  extent that the identified local health care provider that is

  7  otherwise entitled to and is contracted to receive such local

  8  funds is the benefactor under the state's Medicaid program as

  9  determined under the General Appropriations Act and pursuant

10  to an agreement between the Agency for Health Care

11  Administration and the local governmental entity. The local

12  governmental entity shall use a certification form prescribed

13  by the agency. At a minimum, the certification form shall

14  identify the amount being certified and describe the

15  relationship between the certifying local governmental entity

16  and the local health care provider. The agency shall prepare

17  an annual statement of impact which documents the specific

18  activities undertaken during the previous fiscal year pursuant

19  to this paragraph, to be submitted to the Legislature no later

20  than January 1, annually. Notwithstanding this section and s.

21  409.915, counties are exempt from contributing toward the cost

22  of the special exception reimbursement for hospitals serving a

23  disproportionate share of low-income persons and providing

24  graduate medical education.

25         (b)  Reimbursement for hospital outpatient care is

26  limited to $1,500 per state fiscal year per recipient, except

27  for:

28         1.  Such care provided to a Medicaid recipient under

29  age 21, in which case the only limitation is medical

30  necessity.

31         2.  Renal dialysis services.


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  1         3.  Other exceptions made by the agency.

  2

  3  The agency is authorized to receive funds from state entities,

  4  including, but not limited to, the Board of Regents, local

  5  governments, and other local political subdivisions, for the

  6  purpose of making payments, including federal matching funds,

  7  through the Medicaid outpatient reimbursement methodologies.

  8  Funds received from state entities and local governments for

  9  this purpose shall be separately accounted for and shall not

10  be commingled with other state or local funds in any manner.

11         (c)  Hospitals that provide services to a

12  disproportionate share of low-income Medicaid recipients, or

13  that participate in the regional perinatal intensive care

14  center program under chapter 383, or that participate in the

15  statutory teaching hospital disproportionate share program may

16  receive additional reimbursement. The total amount of payment

17  for disproportionate share hospitals shall be fixed by the

18  General Appropriations Act. The computation of these payments

19  must be made in compliance with all federal regulations and

20  the methodologies described in ss. 409.911, 409.9112, and

21  409.9113.

22         (d)  The agency is authorized to limit inflationary

23  increases for outpatient hospital services as directed by the

24  General Appropriations Act.

25         Section 5.  Paragraph (d) of subsection (1) of section

26  409.911, Florida Statutes, is amended to read:

27         409.911  Disproportionate share program.--Subject to

28  specific allocations established within the General

29  Appropriations Act and any limitations established pursuant to

30  chapter 216, the agency shall distribute, pursuant to this

31  section, moneys to hospitals providing a disproportionate


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  1  share of Medicaid or charity care services by making quarterly

  2  Medicaid payments as required. Notwithstanding the provisions

  3  of s. 409.915, counties are exempt from contributing toward

  4  the cost of this special reimbursement for hospitals serving a

  5  disproportionate share of low-income patients.

  6         (1)  Definitions.--As used in this section and s.

  7  409.9112:

  8         (d)  "Charity care" or "uncompensated charity care"

  9  means that portion of hospital charges reported to the Agency

10  for Health Care Administration for which there is no

11  compensation, other than restricted or unrestricted revenues

12  provided to a hospital by local governments or tax districts

13  regardless of the method of payment, for care provided to a

14  patient whose family income for the 12 months preceding the

15  determination is less than or equal to 200 150 percent of the

16  federal poverty level, unless the amount of hospital charges

17  due from the patient exceeds 25 percent of the annual family

18  income.  However, in no case shall the hospital charges for a

19  patient whose family income exceeds four times the federal

20  poverty level for a family of four be considered charity.

21         Section 6.  Paragraph (c) of subsection (2) of section

22  409.9117, Florida Statutes, is amended to read:

23         409.9117  Primary care disproportionate share

24  program.--

25         (2)  In the establishment and funding of this program,

26  the agency shall use the following criteria in addition to

27  those specified in s. 409.911, payments may not be made to a

28  hospital unless the hospital agrees to:

29         (c)  Coordinate and provide primary care services free

30  of charge, except copayments, to all persons with incomes up

31  to 100 percent of the federal poverty level who are not


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  1  otherwise covered by Medicaid or another program administered

  2  by a governmental entity, and to provide such services based

  3  on a sliding fee scale to all persons with incomes up to 200

  4  percent of the federal poverty level who are not otherwise

  5  covered by Medicaid or another program administered by a

  6  governmental entity, except that eligibility may be limited to

  7  persons who reside within a more limited area, as agreed to by

  8  the agency and the hospital.

  9         Section 7.  Paragraph (d) of subsection (3) of section

10  409.912, Florida Statutes, is amended to read:

11         409.912  Cost-effective purchasing of health care.--The

12  agency shall purchase goods and services for Medicaid

13  recipients in the most cost-effective manner consistent with

14  the delivery of quality medical care.  The agency shall

15  maximize the use of prepaid per capita and prepaid aggregate

16  fixed-sum basis services when appropriate and other

17  alternative service delivery and reimbursement methodologies,

18  including competitive bidding pursuant to s. 287.057, designed

19  to facilitate the cost-effective purchase of a case-managed

20  continuum of care. The agency shall also require providers to

21  minimize the exposure of recipients to the need for acute

22  inpatient, custodial, and other institutional care and the

23  inappropriate or unnecessary use of high-cost services.

24         (3)  The agency may contract with:

25         (d)  No more than four provider service networks for

26  demonstration projects to test Medicaid direct contracting.

27  The demonstration projects may be reimbursed on a

28  fee-for-service or prepaid basis.  A provider service network

29  which is reimbursed by the agency on a prepaid basis shall be

30  exempt from parts I and III of chapter 641, but must meet

31  appropriate financial reserve, quality assurance, and patient


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  1  rights requirements as established by the agency.  The agency

  2  shall award contracts on a competitive bid basis and shall

  3  select bidders based upon price and quality of care. Medicaid

  4  recipients assigned to a demonstration project shall be chosen

  5  equally from those who would otherwise have been assigned to

  6  prepaid plans and MediPass.  The agency is authorized to seek

  7  federal Medicaid waivers as necessary to implement the

  8  provisions of this section.  A demonstration project awarded

  9  pursuant to this paragraph shall be for 4 2 years from the

10  date of implementation.

11         Section 8.  The Legislature finds that personally

12  identifying information, name, age, diagnosis, address, bank

13  account numbers, and debit and credit card numbers contained

14  in the records relating to an individual's personal health or

15  eligibility for health-related services made or received by

16  the individual's physician, pharmacist, and public or private

17  health facility should be held confidential. Furthermore, the

18  Legislature finds that every person has an expectation of and

19  a right to privacy in all matters concerning her or his

20  personal health when medical services are provided. Matters of

21  personal health are traditionally private and confidential

22  concerns between the patient and the health care provider. The

23  private and confidential nature of personal health matters

24  pervades both the public and private sectors. For these

25  reasons, it is the expressed intent of the Legislature to

26  protect confidential information and the individual's

27  expectations of and right to privacy in all matters regarding

28  her or his personal health, and to not have such information

29  exploited for purposes of solicitation or marketing the sale

30  of goods and services.

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    CS for CS for SB 2092                          First Engrossed



  1         Section 9.  Subsection (5) of section 456.057, Florida

  2  Statutes, is amended to read:

  3         456.057  Ownership and control of patient records;

  4  report or copies of records to be furnished.--

  5         (5)(a)  Except as otherwise provided in this section

  6  and in s. 440.13(4)(c), such records may not be furnished to,

  7  and the medical condition of a patient may not be discussed

  8  with, any person other than the patient or the patient's legal

  9  representative or other health care practitioners and

10  providers involved in the care or treatment of the patient,

11  except upon written authorization of the patient. However,

12  such records may be furnished without written authorization

13  under the following circumstances:

14         1.(a)  To any person, firm, or corporation that has

15  procured or furnished such examination or treatment with the

16  patient's consent.

17         2.(b)  When compulsory physical examination is made

18  pursuant to Rule 1.360, Florida Rules of Civil Procedure, in

19  which case copies of the medical records shall be furnished to

20  both the defendant and the plaintiff.

21         3.(c)  In any civil or criminal action, unless

22  otherwise prohibited by law, upon the issuance of a subpoena

23  from a court of competent jurisdiction and proper notice to

24  the patient or the patient's legal representative by the party

25  seeking such records.

26         4.(d)  For statistical and scientific research,

27  provided the information is abstracted in such a way as to

28  protect the identity of the patient or provided written

29  permission is received from the patient or the patient's legal

30  representative.

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    CS for CS for SB 2092                          First Engrossed



  1         (b)  Absent a specific written release or authorization

  2  permitting utilization of patient information for solicitation

  3  or marketing the sale of goods or services, any use of that

  4  information for those purposes is prohibited.

  5         Section 10.  Subsection (7) of section 395.3025,

  6  Florida Statutes, is amended to read:

  7         395.3025  Patient and personnel records; copies;

  8  examination.--

  9         (7)(a)  If the content of any record of patient

10  treatment is provided under this section, the recipient, if

11  other than the patient or the patient's representative, may

12  use such information only for the purpose provided and may not

13  further disclose any information to any other person or

14  entity, unless expressly permitted by the written consent of

15  the patient.  A general authorization for the release of

16  medical information is not sufficient for this purpose.  The

17  content of such patient treatment record is confidential and

18  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

19  I of the State Constitution.

20         (b)  Absent a specific written release or authorization

21  permitting utilization of patient information for solicitation

22  or marketing the sale of goods or services, any use of that

23  information for those purposes is prohibited.

24         Section 11.  Subsection (1) of section 400.1415,

25  Florida Statutes, is amended to read:

26         400.1415  Patient records; penalties for alteration.--

27         (1)  Any person who fraudulently alters, defaces, or

28  falsifies any medical record or releases medical records for

29  the purposes of solicitation or marketing the sale of goods or

30  services absent a specific written release or authorization

31  permitting utilization of patient information; or other


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    CS for CS for SB 2092                          First Engrossed



  1  nursing home record, or causes or procures any of these

  2  offenses to be committed, commits a misdemeanor of the second

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

  4         Section 12.  Section 626.9651, Florida Statutes, is

  5  created to read:

  6         626.9651  Privacy.--The department shall adopt rules

  7  consistent with other provisions of the Florida Insurance Code

  8  to govern the use of a consumer's nonpublic personal financial

  9  and health information. These rules must be based on,

10  consistent with, and not more restrictive than the Privacy of

11  Consumer Financial and Health Information Regulation, adopted

12  September 26, 2000, by the National Association of Insurance

13  Commissioners, however, the rules must permit the use and

14  disclosure of nonpublic personal health information for

15  scientific, medical, or public policy research, in accordance

16  with federal law. In addition, these rules must be consistent

17  with, and not more restrictive than, the standards contained

18  in Title V of the Gramm-Leach-Bliley Act of 1999, Pub. L. No.

19  106-102. If the department determines that a health insurer or

20  health maintenance organization is in compliance with, or is

21  actively undertaking compliance with, the consumer privacy

22  protection rules adopted by the United States Department of

23  Health and Human Services, in conformance with the Health

24  Insurance Portability and Affordability Act, that health

25  insurer or health maintenance organization is in compliance

26  with this section.

27         Section 13.  This act shall take effect July 1, 2001.

28

29

30

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