Senate Bill sb0726e1

    CS for SB 726                            First Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to financial arrangements

  3         between referring health care providers and

  4         providers of health care services; amending s.

  5         456.053, F.S., the "Patient Self-Referral Act

  6         of 1992"; redefining the term "referral" by

  7         revising the list of practices that constitute

  8         exceptions; providing an effective date.

  9

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

11

12         Section 1.  Paragraph (o) of subsection (3) of section

13  456.053, Florida Statutes, is amended to read:

14         456.053  Financial arrangements between referring

15  health care providers and providers of health care services.--

16         (3)  DEFINITIONS.--For the purpose of this section, the

17  word, phrase, or term:

18         (o)  "Referral" means any referral of a patient by a

19  health care provider for health care services, including,

20  without limitation:

21         1.  The forwarding of a patient by a health care

22  provider to another health care provider or to an entity which

23  provides or supplies designated health services or any other

24  health care item or service; or

25         2.  The request or establishment of a plan of care by a

26  health care provider, which includes the provision of

27  designated health services or other health care item or

28  service.

29         3.  The following orders, recommendations, or plans of

30  care shall not constitute a referral by a health care

31  provider:


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






    CS for SB 726                            First Engrossed (ntc)



  1         a.  By a radiologist for diagnostic-imaging services.

  2         b.  By a physician specializing in the provision of

  3  radiation therapy services for such services.

  4         c.  By a medical oncologist for drugs and solutions to

  5  be prepared and administered intravenously to such

  6  oncologist's patient, as well as for the supplies and

  7  equipment used in connection therewith to treat such patient

  8  for cancer and the complications thereof.

  9         d.  By a cardiologist for cardiac catheterization

10  services.

11         e.  By a pathologist for diagnostic clinical laboratory

12  tests and pathological examination services, if furnished by

13  or under the supervision of such pathologist pursuant to a

14  consultation requested by another physician.

15         f.  By a health care provider who is the sole provider

16  or member of a group practice for designated health services

17  or other health care items or services that are prescribed or

18  provided solely for such referring health care provider's or

19  group practice's own patients, and that are provided or

20  performed by or under the direct supervision of such referring

21  health care provider or group practice; provided, however,

22  that effective July 1, 1999, a physician licensed pursuant to

23  chapter 458, chapter 459, chapter 460, or chapter 461 may

24  refer a patient to a sole provider or group practice for

25  diagnostic imaging services, excluding radiation therapy

26  services, for which the sole provider or group practice billed

27  both the technical and the professional fee for or on behalf

28  of the patient, if the referring physician has no investment

29  interest in the practice. The diagnostic imaging service

30  referred to a group practice or sole provider must be a

31  diagnostic imaging service normally provided within the scope


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    CS for SB 726                            First Engrossed (ntc)



  1  of practice to the patients of the group practice or sole

  2  provider. The group practice or sole provider may accept no

  3  more that 15 percent of their patients receiving diagnostic

  4  imaging services from outside referrals, excluding radiation

  5  therapy services.

  6         g.  By a health care provider for services provided by

  7  an ambulatory surgical center licensed under chapter 395.

  8         h.  By a health care provider for diagnostic clinical

  9  laboratory services where such services are directly related

10  to renal dialysis.

11         h.i.  By a urologist for lithotripsy services.

12         i.j.  By a dentist for dental services performed by an

13  employee of or health care provider who is an independent

14  contractor with the dentist or group practice of which the

15  dentist is a member.

16         j.k.  By a physician for infusion therapy services to a

17  patient of that physician or a member of that physician's

18  group practice.

19         k.l.  By a nephrologist for renal dialysis services and

20  supplies, except laboratory services.

21         l.  By a health care provider whose principal

22  professional practice consists of treating patients in their

23  private residences for services to be rendered in such private

24  residences, except for services rendered by a home health

25  agency licensed under chapter 400. For purposes of this

26  sub-subparagraph, the term "private residences" includes

27  patient's private homes, independent living centers, and

28  assisted living facilities, but does not include skilled

29  nursing facilities.

30         Section 2.  This act shall take effect July 1, 2002.

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