House Bill hb0255c1

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    Florida House of Representatives - 2002              CS/HB 255

        By the Council for Healthy Communities and Representatives
    Carassas, Fasano, Meadows and Lynn





  1                      A bill to be entitled

  2         An act relating to nursing homes and related

  3         health care facilities; amending s. 400.235,

  4         F.S.; revising membership and terms of office

  5         of the Governor's Panel on Excellence in

  6         Long-Term Care; providing for selection of a

  7         panel chairperson; amending s. 400.4195, F.S.;

  8         providing conditions under which the

  9         prohibition against payment of referral fees by

10         assisted living facilities does not apply;

11         authorizing the Agency for Health Care

12         Administration to adopt rules; amending s.

13         817.505, F.S.; providing that certain penalties

14         for patient brokering do not apply under such

15         conditions; providing an effective date.

16

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

18

19         Section 1.  Paragraph (a) of subsection (3) of section

20  400.235, Florida Statutes, is amended to read:

21         400.235  Nursing home quality and licensure status;

22  Gold Seal Program.--

23         (3)(a)1.  The Gold Seal Program shall be developed and

24  implemented by the Governor's Panel on Excellence in Long-Term

25  Care, which shall operate under the authority of the Executive

26  Office of the Governor. The panel shall be composed of the

27  following members:

28         a.  A consumer advocate for senior citizens, appointed

29  by the Governor.

30

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  1         b.  Two persons having expertise in the field of

  2  quality management, service-delivery excellence, or

  3  public-sector accountability, appointed by the Governor.

  4         c.  A consumer advocate for senior citizens, appointed

  5  by the Secretary of Elderly Affairs.

  6         d.  An active member of a nursing facility family and

  7  resident care council, appointed by the Secretary of Elderly

  8  Affairs.

  9         e.  A member of the University Consortium on Aging,

10  appointed by the Secretary of Elderly Affairs.

11         f.  The State Long-Term Care Ombudsman.

12         g.  A consumer advocate for senior citizens, appointed

13  by the Florida Life Care Residents Association.

14         h.  A consumer advocate for senior citizens, appointed

15  by the Secretary of Health.

16         i.  A consumer advocate for senior citizens, appointed

17  by the Secretary of the Agency for Health Care Administration.

18         j.  The Deputy Secretary for Medicaid of the Agency for

19  Health Care Administration.

20         k.  One person appointed by the Florida Association of

21  Homes for the Aging.

22         l.  One person appointed by the Florida Health Care

23  Association.

24         m.  A member of the Florida Silver Hair Legislature,

25  appointed by the Florida Silver Hair Legislature.

26         n.  A member of the Florida Alliance for Retired

27  Americans, appointed by the Florida Alliance for Retired

28  Americans.

29         o.  An attorney with expertise in elder law, appointed

30  by The Florida Bar.

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  1  Persons serving on the panel on the effective date of this act

  2  shall continue to serve and, for terms beginning October 1,

  3  2002, persons shall be appointed according to the criteria

  4  described in sub-subparagraphs m., n., and o. However, for the

  5  dual purpose of staggering the terms of the members and

  6  maintaining continuity, the terms of the panel members serving

  7  on the effective date of this act who were appointed according

  8  to the criteria described in sub-subparagraphs b., d., g., i.,

  9  and k. expire September 30, 2002, and terms of the panel

10  members serving on the effective date of this act who were

11  appointed according to the criteria described in

12  sub-subparagraphs a., c., e., h., and l. expire September 30,

13  2003. Thereafter, each appointive member shall be appointed

14  for a 4-year term in the same manner as the original

15  appointment. A person may not be appointed to serve more than

16  two consecutive 4-year terms. However, an appointee serving on

17  the effective date of this act is not eligible for

18  reappointment.

19         2.  At the panel's first meeting after all panel

20  members have been appointed, the panel members shall, by a

21  majority vote, select a panel chairperson to serve a 3-year

22  term.

23         3.  For the purposes of this paragraph, the term

24  "consumer advocate for senior citizens" means a person who:

25         a.  Does not receive more than 20 percent of his or her

26  personal income from any business involved in the delivery of

27  long-term care services, from any attorney or law firm that

28  represents nursing home facilities or nursing home residents

29  in personal injury actions, or from any affiliated membership

30  organizations or corporations;

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  1         b.  Is not an employee of the Agency for Health Care

  2  Administration, the Department of Health, or the Department of

  3  Elderly Affairs; and

  4         c.  Is either a member of an organized senior advocacy

  5  group or has had or currently has a relative in a nursing

  6  home. three persons appointed by the Governor, to include a

  7  consumer advocate for senior citizens and two persons with

  8  expertise in the fields of quality management, service

  9  delivery excellence, or public sector accountability; three

10  persons appointed by the Secretary of Elderly Affairs, to

11  include an active member of a nursing facility family and

12  resident care council and a member of the University

13  Consortium on Aging; the State Long-Term Care Ombudsman; one

14  person appointed by the Florida Life Care Residents

15  Association; one person appointed by the Secretary of Health;

16  two persons appointed by the Secretary of Health Care

17  Administration; one person appointed by the Florida

18  Association of Homes for the Aging; and one person appointed

19  by the Florida Health Care Association. Vacancies on the panel

20  shall be filled in the same manner as the original

21  appointments.

22         Section 2.  Section 400.4195, Florida Statutes, is

23  amended to read:

24         400.4195  Rebates prohibited; penalties.--

25         (1)  Except as provided in subsection (2), it is

26  unlawful for any assisted living facility, or any person or

27  agency employed by or contracting with the facility, licensed

28  under this part to contract or promise to pay or receive any

29  commission, bonus, kickback, or rebate or engage in any

30  split-fee arrangement in any form whatsoever with any health

31  care practitioner, health care facility, or other physician,

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  1  surgeon, organization, agency, or person, either directly or

  2  indirectly, for residents referred to an assisted living

  3  facility licensed under this part.

  4         (2)  A facility may employ or contract with persons or

  5  agencies to market the facility for a fee or commission not

  6  based on the volume or value of referrals. Fees or commissions

  7  may be based on the volume or value of referrals to the

  8  facility when:, provided

  9         (a)  The facility is not subject to the provisions of

10  42 U.S.C. s. 1320a-7b;

11         (b)  Payment to the contract provider is made under a

12  nonexclusive contract;

13         (c)  The contract provider represents multiple

14  facilities with different owners;

15         (d)  The employee or contract provider clearly

16  indicates to all clients prior to referral that he or she

17  represents and is being compensated by the facility, in

18  addition to all other facilities represented by the person or

19  agency;

20         (e)  The employee or contract provider:

21         1.  Is not a health care practitioner, or an employee,

22  vendor, or other contract provider of a health care facility,

23  in a position to make referrals to an assisted living

24  facility;

25         2.  Is not employed by a health care facility, social

26  service agency, or any other organization or agency in a

27  position to make referrals to an assisted living facility;

28         3.  Does not have an ownership interest in an assisted

29  living facility;

30         4.  Does not contract with or pay a health care

31  facility, or its employees, vendors, or other contract

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    Florida House of Representatives - 2002              CS/HB 255

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  1  providers, for access to internal or external processes for

  2  discharge of seniors to assisted living facilities; and

  3         5.  Cannot offer the client or referral any money or

  4  gift of value as an enticement for services;

  5         (f)  A level 2 background screening must be conducted

  6  for the contract provider or related employees for the

  7  purposes of conducting screening under chapter 435;

  8         (g)  Referral is made to a duly licensed facility; and

  9         (h)  The contract does not require either the facility

10  or the individual being referred to use any other services

11  affiliated with or owned in whole or in part by the contract

12  provider.

13         (3)  A person or agency independent of and not under

14  contract with a the facility may provide placement or referral

15  services for a fee to individuals seeking assistance in

16  finding a suitable facility; however, any fee paid for

17  placement or referral services must be paid by the individual

18  looking for a facility, not by the facility.

19         (4)  The agency shall adopt rules pursuant to ss.

20  120.536(1) and 120.54 to implement this section.

21         (5)(2)  A violation of this section shall be considered

22  patient brokering and is punishable as provided in s. 817.505.

23         Section 3.  Paragraph (j) is added to subsection (3) of

24  section 817.505, Florida Statutes, to read:

25         817.505  Patient brokering prohibited; exceptions;

26  penalties.--

27         (3)  This section shall not apply to:

28         (j)  Services as authorized in s. 400.4195(2).

29         Section 4.  This act shall take effect upon becoming a

30  law.

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