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



                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1233

    Amendment No. 1 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
                                   .
                                   .
  1                                .
                                   .
  2                                .
                                   .
  3                                .
                                   .
  4  ______________________________________________________________

  5                                           ORIGINAL STAMP BELOW

  6

  7

  8

  9

10  ______________________________________________________________

11  The Committee on Health Regulation offered the following:

12

13         Amendment (with title amendment) 

14  Remove everything after the enacting clause

15

16  and insert:

17         Section 1.  Subsections (31), (32), and (33), of

18  section 395.002, Florida Statutes, are renumbered as

19  subsections (32), (33), and (34) respectively, and a new

20  subsection (31) of section 395.002, Florida Statutes, is

21  created to read:

22         395.002  Definitions.--As used in this chapter:

23         (31)  "Surgical first assistant" means the first

24  assistant to the surgeon during a surgical operation.

25         (32)(31)  "Utilization review" means a system for

26  reviewing the medical necessity or appropriateness in the

27  allocation of health care resources of hospital services given

28  or proposed to be given to a patient or group of patients.

29         (33)(32)  "Utilization review plan" means a description

30  of the policies and procedures governing utilization review

31  activities performed by a private review agent.

                                  1

    File original & 9 copies    02/21/02
    hcs0005                     04:40 pm         01233-hr  -405293




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1233

    Amendment No. 1 (for drafter's use only)





  1         (34)(33)  "Validation inspection" means an inspection

  2  of the premises of a licensed facility by the agency to assess

  3  whether a review by an accrediting organization has adequately

  4  evaluated the licensed facility according to minimum state

  5  standards.

  6         Section 2.  Paragraph (b) of subsection (1) of section

  7  395.0197, Florida Statutes, is amended to read:

  8         395.0197  Internal risk management program.--

  9         (1)  Every licensed facility shall, as a part of its

10  administrative functions, establish an internal risk

11  management program that includes all of the following

12  components:

13         (b)  The development of appropriate measures to

14  minimize the risk of adverse incidents to patients, including,

15  but not limited to:

16         1.  Risk management and risk prevention education and

17  training of all nonphysician personnel as follows:

18         a.  Such education and training of all nonphysician

19  personnel as part of their initial orientation; and

20         b.  At least 1 hour of such education and training

21  annually for all personnel of the licensed facility working in

22  clinical areas and providing patient care, except those

23  persons licensed as health care practitioners who are required

24  to complete continuing education coursework pursuant to

25  chapter 456 or the respective practice act.

26         2.  A prohibition, except when emergency circumstances

27  require otherwise, against a staff member of the licensed

28  facility attending a patient in the recovery room, unless the

29  staff member is authorized to attend the patient in the

30  recovery room and is in the company of at least one other

31  person.  However, a licensed facility is exempt from the

                                  2

    File original & 9 copies    02/21/02
    hcs0005                     04:40 pm         01233-hr  -405293




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1233

    Amendment No. 1 (for drafter's use only)





  1  two-person requirement if it has:

  2         a.  Live visual observation;

  3         b.  Electronic observation; or

  4         c.  Any other reasonable measure taken to ensure

  5  patient protection and privacy.

  6         3.  A prohibition against an unlicensed person from

  7  assisting or participating in any surgical procedure unless

  8  the facility has authorized the person to do so following a

  9  competency assessment, and such assistance or participation is

10  done under the direct and immediate supervision of a licensed

11  physician and is not otherwise an activity that may only be

12  performed by a licensed health care practitioner.  Moreover,

13  the primary operating surgeon may select a surgical first

14  assistant from among available individuals who are approved or

15  credentialed by the facility.

16         4.  Development, implementation, and ongoing evaluation

17  of procedures, protocols, and systems to accurately identify

18  patients, planned procedures, and the correct site of the

19  planned procedure so as to minimize the performance of a

20  surgical procedure on the wrong patient, a wrong surgical

21  procedure, a wrong-site surgical procedure, or a surgical

22  procedure otherwise unrelated to the patient's diagnosis or

23  medical condition.

24         Section 3.  Section 627.64165, Florida Statutes, is

25  created to read:

26         627.64165  Surgical first assistants.--A health

27  insurance policy must provide coverage for the medically

28  necessary services of a surgical first assistant, as defined

29  by the American College of Surgeons, selected by the primary

30  surgeon to assist in a covered surgical procedure.

31         Section 4.  Section 627.6572, Florida Statutes, is

                                  3

    File original & 9 copies    02/21/02
    hcs0005                     04:40 pm         01233-hr  -405293




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1233

    Amendment No. 1 (for drafter's use only)





  1  created to read:

  2         627.6572  Surgical first assistants.--A group, blanket,

  3  or franchise health insurance policy must provide coverage for

  4  the medically necessary services of a surgical first

  5  assistant, as defined by the American College of Surgeons,

  6  selected by the primary surgeon to assist in a covered

  7  surgical procedure.

  8         Section 5.  Subsection (40) is added to section 641.31,

  9  Florida Statutes, to read:

10         641.31  Health maintenance contracts.--

11         (40)  A health maintenance organization must provide

12  coverage for the medically necessary services of a surgical

13  first assistant, as defined by the American College of

14  Surgeons, selected by a primary surgeon contracted with the

15  health maintenance organization to assist in a covered

16  surgical procedure.  If the use of contracted surgeons is

17  mandated for a specific procedure, the health maintenance

18  organization may also require that the surgical first

19  assistant be contracted with the health maintenance

20  organization.  Payment to a hospital may not be reduced by any

21  portion of the payment to the surgical first assistant.

22         Section 6.  This act shall take effect July 1, 2002,

23  and shall apply to policies and contracts issued or renewed

24  after that date.

25

26

27  ================ T I T L E   A M E N D M E N T ===============

28  And the title is amended as follows:

29  remove everything before the enacting clause

30

31  and insert:

                                  4

    File original & 9 copies    02/21/02
    hcs0005                     04:40 pm         01233-hr  -405293




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1233

    Amendment No. 1 (for drafter's use only)





  1                      A bill to be entitled

  2         An act relating to surgical first assistants;

  3         amending s. 395.002, F.S.; providing a

  4         definition; amending s. 395.0197, F.S.;

  5         revising a required component of internal risk

  6         management programs to include requirements for

  7         the use of surgical first assistants; creating

  8         ss. 627.64165 and 627.6572, F.S.; requiring

  9         health insurance policies to provide coverage

10         for the medically necessary services of a

11         surgical first assistant selected by the

12         primary surgeon to assist in a covered surgical

13         procedure; amending s. 641.31, F.S.; requiring

14         health maintenance contracts to provide

15         coverage for the medically necessary services

16         of a surgical first assistant selected by a

17         primary surgeon contracted with the health

18         maintenance organization to assist in a covered

19         surgical procedure; providing applicability to

20         new or renewed policies and contracts;

21         providing an effective date.

22

23

24

25

26

27

28

29

30

31

                                  5

    File original & 9 copies    02/21/02
    hcs0005                     04:40 pm         01233-hr  -405293