House Bill hb1233

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    Florida House of Representatives - 2002                HB 1233

        By Representative Harrell






  1                      A bill to be entitled

  2         An act relating to surgical first assistants;

  3         amending s. 395.0197, F.S.; revising a required

  4         component of internal risk management programs

  5         to include requirements for the use of

  6         physician surgical first assistants; creating

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

  8         health insurance policies to provide coverage

  9         for the medically necessary services of a

10         physician surgical first assistant selected by

11         the primary surgeon to assist in a covered

12         surgical procedure; amending s. 641.31, F.S.;

13         requiring health maintenance contracts to

14         provide coverage for the medically necessary

15         services of a physician surgical first

16         assistant selected by a primary surgeon

17         contracted with the health maintenance

18         organization to assist in a covered surgical

19         procedure; providing applicability to new or

20         renewed policies and contracts; providing an

21         effective date.

22

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

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25         Section 1.  Paragraph (b) of subsection (1) of section

26  395.0197, Florida Statutes, is amended to read:

27         395.0197  Internal risk management program.--

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

29  administrative functions, establish an internal risk

30  management program that includes all of the following

31  components:

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    Florida House of Representatives - 2002                HB 1233

    767-121-02






  1         (b)  The development of appropriate measures to

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

  3  but not limited to:

  4         1.  Risk management and risk prevention education and

  5  training of all nonphysician personnel as follows:

  6         a.  Such education and training of all nonphysician

  7  personnel as part of their initial orientation; and

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

  9  annually for all personnel of the licensed facility working in

10  clinical areas and providing patient care, except those

11  persons licensed as health care practitioners who are required

12  to complete continuing education coursework pursuant to

13  chapter 456 or the respective practice act.

14         2.  A prohibition, except when emergency circumstances

15  require otherwise, against a staff member of the licensed

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

17  staff member is authorized to attend the patient in the

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

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

20  two-person requirement if it has:

21         a.  Live visual observation;

22         b.  Electronic observation; or

23         c.  Any other reasonable measure taken to ensure

24  patient protection and privacy.

25         3.  A prohibition against an unlicensed person from

26  assisting or participating in any surgical procedure unless

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

28  competency assessment, and such assistance or participation is

29  done under the direct and immediate supervision of a licensed

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

31  performed by a licensed health care practitioner.  Moreover,

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    Florida House of Representatives - 2002                HB 1233

    767-121-02






  1  the primary operating surgeon may select a physician surgical

  2  first assistant in accordance with the guidelines of the

  3  American College of Surgeons from among the appropriately

  4  credentialed members of the facility's medical staff.

  5         4.  Development, implementation, and ongoing evaluation

  6  of procedures, protocols, and systems to accurately identify

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

  8  planned procedure so as to minimize the performance of a

  9  surgical procedure on the wrong patient, a wrong surgical

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

11  procedure otherwise unrelated to the patient's diagnosis or

12  medical condition.

13         Section 2.  Section 627.64165, Florida Statutes, is

14  created to read:

15         627.64165  Surgical first assistants.--A health

16  insurance policy must provide coverage for the medically

17  necessary services of a physician surgical first assistant, as

18  defined by the American College of Surgeons, selected by the

19  primary surgeon to assist in a covered surgical procedure.

20         Section 3.  Section 627.6572, Florida Statutes, is

21  created to read:

22         627.6572  Surgical first assistants.--A group, blanket,

23  or franchise health insurance policy must provide coverage for

24  the medically necessary services of a physician surgical first

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

26  selected by the primary surgeon to assist in a covered

27  surgical procedure.

28         Section 4.  Subsection (40) is added to section 641.31,

29  Florida Statutes, to read:

30         641.31  Health maintenance contracts.--

31

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    Florida House of Representatives - 2002                HB 1233

    767-121-02






  1         (40)  A health maintenance organization must provide

  2  coverage for the medically necessary services of a physician

  3  surgical first assistant, as defined by the American College

  4  of Surgeons, selected by a primary surgeon contracted with the

  5  health maintenance organization to assist in a covered

  6  surgical procedure.  If the use of contracted surgeons is

  7  mandated for a specific procedure, the health maintenance

  8  organization may also require that the physician surgical

  9  first assistant be contracted with the health maintenance

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

11  portion of the payment to the physician surgical first

12  assistant.

13         Section 5.  This act shall take effect July 1, 2002,

14  and shall apply to policies and contracts issued or renewed

15  after that date.

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17            *****************************************

18                          HOUSE SUMMARY

19
      Revises a required component of internal risk management
20    programs to include requirements for the use of physician
      surgical first assistants.  Requires health insurance
21    policies and health maintenance contracts to provide
      coverage for the medically necessary services of a
22    physician surgical first assistant selected by the
      primary surgeon to assist in a covered surgical
23    procedure.  See bill for details.

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