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CHAMBER ACTION |
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The Committee on State Administration recommends the following: |
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Committee Substitute |
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Remove the entire bill and insert: |
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A bill to be entitled |
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An act relating to hospitals; amending ss. 395.602 and |
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408.07, F.S.; revising the definition of the term "rural |
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hospital"; declaring and continuing such designation for |
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certain hospitals for a specified period; authorizing the |
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granting of such designation for certain other hospitals |
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upon application with supporting documentation; creating |
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s. 395.6025, F.S.; providing exemption for a statutory |
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rural hospital or a not-for-profit operator of rural |
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hospitals from certificate-of-need review for the |
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construction of a new or replacement facility; providing |
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conditions for eligibility for the exemption; creating s. |
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395.6063, F.S.; permitting any statutory rural hospital to |
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contract with the Department of Management Services in |
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order to purchase coverage in the state group health |
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insurance plan for the hospital's employees; requiring a |
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participating hospital to make the employer contributions |
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required and pay an annual administrative fee; providing |
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exemption from nonprofit multiple-employer welfare |
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arrangements; requiring the request of an Internal Revenue |
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Service private letter ruling; providing for contingent |
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effect; amending s. 766.314, F.S.; excluding infants born |
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in certain family practice teaching hospitals from |
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assessments used to fund the Florida Birth-Related |
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Neurological Injury Compensation Plan; providing an |
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effective date. |
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Be It Enacted by the Legislature of the State of Florida: |
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Section 1. Paragraph (e) of subsection (2) of section |
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395.602, Florida Statutes, is amended to read: |
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395.602 Rural hospitals.-- |
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(2) DEFINITIONS.--As used in this part: |
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(e) "Rural hospital" means an acute care hospital licensed |
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under this chapter, having 100 or fewer licensed beds and an |
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emergency room, which is: |
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1. The sole provider within a county with a population |
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density of no greater than 100 persons per square mile; |
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2. An acute care hospital, in a county with a population |
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density of no greater than 100 persons per square mile, which is |
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at least 30 minutes of travel time, on normally traveled roads |
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under normal traffic conditions, from any other acute care |
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hospital within the same county; |
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3. A hospital supported by a tax district or subdistrict |
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whose boundaries encompass a population of 100 persons or fewer |
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per square mile; |
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4. A hospital in a constitutional charter county with a |
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population of over 1 million persons that has imposed a local |
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option health service tax pursuant to law and in an area that |
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was directly impacted by a catastrophic event on August 24, |
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1992, for which the Governor of Florida declared a state of |
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emergency pursuant to chapter 125, and has 120 beds or less that |
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serves an agricultural community with an emergency room |
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utilization of no less than 20,000 visits and a Medicaid in- |
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patient utilization rate greater than 15 percent; |
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5. A hospital with a service area that has a population of |
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100 persons or fewer per square mile. As used in this |
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subparagraph, the term "service area" means the fewest number of |
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zip codes that account for 75 percent of the hospital's |
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discharges for the most recent 5-year period, based on |
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information available from the hospital inpatient discharge |
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database in the State Center for Health Statistics at the Agency |
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for Health Care Administration; or |
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6. A hospital designated as a Critical Access Hospital by |
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the Department of Health in accordance with federal regulations |
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and state requirements. |
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Population densities used in this paragraph must be based upon |
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the most recently completed United States census. A hospital |
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that received funds under s. 409.9116 for a quarter beginning no |
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later than July 1, 2002, is deemed to have been and shall |
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continue to be a rural hospital from that date through June 30, |
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2012, if the hospital continues to have 100 or fewer licensed |
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beds and an emergency room, or meets the criteria of |
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subparagraph 4. An acute care hospital that has not previously |
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been designated as a rural hospital and that meets the criteria |
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of this paragraph shall be granted such designation upon |
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application, including supporting documentation, to the Agency |
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for Health Care Administration. |
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Section 2. Subsection (42) of section 408.07, Florida |
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Statutes, is amended to read: |
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408.07 Definitions.--As used in this chapter, with the |
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exception of ss. 408.031-408.045, the term: |
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(42) "Rural hospital" means an acute care hospital |
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licensed under chapter 395, having 100 or fewer licensed beds |
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and an emergency room, and which is: |
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(a) The sole provider within a county with a population |
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density of no greater than 100 persons per square mile; |
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(b) An acute care hospital, in a county with a population |
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density of no greater than 100 persons per square mile, which is |
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at least 30 minutes of travel time, on normally traveled roads |
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under normal traffic conditions, from another acute care |
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hospital within the same county; |
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(c) A hospital supported by a tax district or subdistrict |
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whose boundaries encompass a population of 100 persons or fewer |
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per square mile; |
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(d) A hospital with a service area that has a population |
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of 100 persons or fewer per square mile. As used in this |
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paragraph, the term "service area" means the fewest number of |
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zip codes that account for 75 percent of the hospital's |
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discharges for the most recent 5-year period, based on |
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information available from the hospital inpatient discharge |
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database in the State Center for Health Statistics at the Agency |
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for Health Care Administration; or |
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(e) A hospital designated as a Critical Access Hospital by |
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the Department of Health in accordance with federal regulations |
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and state requirements. |
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Population densities used in this subsection must be based upon |
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the most recently completed United States census. A hospital |
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that received funds under s. 409.9116 for a quarter beginning no |
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later than July 1, 2002, is deemed to have been and shall |
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continue to be a rural hospital from that date through June 30, |
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2012, if the hospital continues to have 100 or fewer licensed |
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beds and an emergency room, or meets the criteria of s. |
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395.602(2)(e)4. An acute care hospital that has not previously |
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been designated as a rural hospital and that meets the criteria |
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of this subsection shall be granted such designation upon |
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application, including supporting documentation, to the Agency |
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for Health Care Administration.
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Section 3. Section 395.6025, Florida Statutes, is created |
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to read: |
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395.6025 Rural hospitals; new or replacement |
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facilities.--Notwithstanding the provisions of s. 408.036, a |
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hospital defined as a statutory rural hospital in accordance |
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with s. 395.602, or a not-for-profit operator of rural |
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hospitals, is not required to obtain a certificate of need for |
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the construction of a new or replacement facility, provided that |
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the new or replacement facility is located within 10 miles of |
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the site of the currently licensed rural hospital and within the |
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current primary service area. As used in this section, the term |
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"service area" means the fewest number of zip codes that account |
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for 75 percent of the hospital's discharges for the most recent |
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5-year period, based on information available from the hospital |
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inpatient discharge database in the State Center for Health |
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Statistics at the Agency for Health Care Administration.
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Section 4. Section 395.6063, Florida Statutes, is created |
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to read: |
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395.6063 Rural hospital employee health insurance.--
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(1) Effective July 1, 2003, any statutory rural hospital |
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may contract with the Department of Management Services in order |
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to purchase coverage in the state group health insurance plan |
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for the hospital's employees and qualified family members at the |
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same premium cost as that for retirees and surviving spouses. |
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The hospital shall collect payroll deductions or other |
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remuneration from qualified employees as may be required for the |
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employee contribution in accordance with the department's |
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regulations. The hospital shall also make the employer |
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contributions required and pay an annual administrative fee of |
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not less than $2.61 per enrollee per month.
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(2) The provisions of ss. 624.436-624.446 do not apply to |
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the state group insurance program for purposes of this section. |
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(3) The Department of Management Services shall request a |
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private letter ruling from the Internal Revenue Service |
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determining whether the inclusion of employees of rural |
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hospitals in the state group insurance program, in accordance |
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with this section, jeopardizes the qualified tax status of the |
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state group insurance program. The department shall request this |
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determination no later than July 31, 2003. Implementation of |
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this section is contingent upon receipt of a favorable ruling by |
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the Internal Revenue Service.
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Section 5. Paragraph (a) of subsection (4) of section |
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766.314, Florida Statutes, is amended to read: |
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766.314 Assessments; plan of operation.-- |
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(4) The following persons and entities shall pay into the |
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association an initial assessment in accordance with the plan of |
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operation: |
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(a) On or before October 1, 1988, each hospital licensed |
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under chapter 395 shall pay an initial assessment of $50 per |
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infant delivered in the hospital during the prior calendar year, |
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as reported to the Agency for Health Care Administration; |
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provided, however, that a hospital owned or operated by the |
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state or a county, special taxing district, or other political |
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subdivision of the state shall not be required to pay the |
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initial assessment or any assessment required by subsection (5). |
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The term "infant delivered" includes live births and not |
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stillbirths, but the term does not include infants delivered by |
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employees or agents of the Board of Regents,orthose born in a |
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teaching hospital as defined in s. 408.07, or those born in a |
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family practice teaching hospital designated pursuant to s. |
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395.806 that was exempted by the association from assessments |
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for fiscal years 1997-1998 through 2001-2002. The initial |
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assessment and any assessment imposed pursuant to subsection (5) |
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may not include any infant born to a charity patient (as defined |
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by rule of the Agency for Health Care Administration) or born to |
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a patient for whom the hospital receives Medicaid reimbursement, |
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if the sum of the annual charges for charity patients plus the |
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annual Medicaid contractuals of the hospital exceeds 10 percent |
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of the total annual gross operating revenues of the hospital. |
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The hospital is responsible for documenting, to the satisfaction |
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of the association, the exclusion of any birth from the |
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computation of the assessment. Upon demonstration of financial |
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need by a hospital, the association may provide for installment |
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payments of assessments. |
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Section 6. This act shall take effect July 1, 2003. |