HB 1121

CS

CHAMBER ACTION

1	The Committee on Judiciary recommends the following:
2
3	Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to health care providers; amending s.
7	766.1115, F.S.; revising definitions; providing
8	qualifications for volunteer, uncompensated services;
9	extending protection of sovereign immunity to free clinics
10	as health care providers; authorizing the Department of
11	Health to adopt certain rules to specify methods for
12	determination and approval of patient eligibility;
13	providing requirements for such rules; providing an
14	effective date.
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1.  Paragraphs (a) and (d) of subsection (3),
19	subsection (4), and subsection (10) of section 766.1115, Florida
20	Statutes, are amended to read:
21	766.1115  Health care providers; creation of agency
22	relationship with governmental contractors.--
23	(3)  DEFINITIONS.--As used in this section, the term:
24	(a)  "Contract" means an agreement executed in compliance
25	with this section between a health care provider and a
26	governmental contractor. This contract shall allow the health
27	care provider to deliver health care services to low-income
28	recipients as an agent of the governmental contractor. The
29	contract must be for volunteer, uncompensated services. For
30	services to qualify as volunteer, uncompensated services under
31	this section, the health care provider must receive no
32	compensation from the governmental contractor for any services
33	provided under the contract and must not bill or accept
34	compensation from the recipient, or any public or private third-
35	party payor, for the specific services provided to the low-
36	income recipients covered by the contract.
37	(d)  "Health care provider" or "provider" means:
38	1.  A birth center licensed under chapter 383.
39	2.  An ambulatory surgical center licensed under chapter
40	395.
41	3.  A hospital licensed under chapter 395.
42	4.  A physician or physician assistant licensed under
43	chapter 458.
44	5.  An osteopathic physician or osteopathic physician
45	assistant licensed under chapter 459.
46	6.  A chiropractic physician licensed under chapter 460.
47	7.  A podiatric physician licensed under chapter 461.
48	8.  A registered nurse, nurse midwife, licensed practical
49	nurse, or advanced registered nurse practitioner licensed or
50	registered under part I of chapter 464 or any facility which
51	employs nurses licensed or registered under part I of chapter
52	464 to supply all or part of the care delivered under this
53	section.
54	9.  A midwife licensed under chapter 467.
55	10.  A health maintenance organization certificated under
56	part I of chapter 641.
57	11.  A health care professional association and its
58	employees or a corporate medical group and its employees.
59	12.  Any other medical facility the primary purpose of
60	which is to deliver human medical diagnostic services or which
61	delivers nonsurgical human medical treatment, and which includes
62	an office maintained by a provider.
63	13.  A dentist or dental hygienist licensed under chapter
64	466.
65	14.  A free clinic that delivers only medical diagnostic
66	services or nonsurgical medical treatment free of charge to all
67	low-income recipients.
68	15.14.  Any other health care professional, practitioner,
69	provider, or facility under contract with a governmental
70	contractor, including a student enrolled in an accredited
71	program that prepares the student for licensure as any one of
72	the professionals listed in subparagraphs 4.-9.
73
74	The term includes any nonprofit corporation qualified as exempt
75	from federal income taxation under s. 501(a) of the Internal
76	Revenue Code, and described in s. 501(c) of the Internal Revenue
77	Code, which delivers health care services provided by licensed
78	professionals listed in this paragraph, any federally funded
79	community health center, and any volunteer corporation or
80	volunteer health care provider that delivers health care
81	services.
82	(4)  CONTRACT REQUIREMENTS.--A health care provider that
83	executes a contract with a governmental contractor to deliver
84	health care services on or after April 17, 1992, as an agent of
85	the governmental contractor is an agent for purposes of s.
86	768.28(9), while acting within the scope of duties under
87	pursuant to the contract, if the contract complies with the
88	requirements of this section and regardless of whether the
89	individual treated is later found to be ineligible. A health
90	care provider under contract with the state may not be named as
91	a defendant in any action arising out of the medical care or
92	treatment provided on or after April 17, 1992, under pursuant to
93	contracts entered into under this section. The contract must
94	provide that:
95	(a)  The right of dismissal or termination of any health
96	care provider delivering services under pursuant to the contract
97	is retained by the governmental contractor.
98	(b)  The governmental contractor has access to the patient
99	records of any health care provider delivering services under
100	pursuant to the contract.
101	(c)  Adverse incidents and information on treatment
102	outcomes must be reported by any health care provider to the
103	governmental contractor if the such incidents and information
104	pertain to a patient treated under pursuant to the contract. The
105	health care provider shall submit the reports required by s.
106	395.0197. If an incident involves a professional licensed by the
107	Department of Health or a facility licensed by the Agency for
108	Health Care Administration, the governmental contractor shall
109	submit such incident reports to the appropriate department or
110	agency, which shall review each incident and determine whether
111	it involves conduct by the licensee that is subject to
112	disciplinary action. All patient medical records and any
113	identifying information contained in adverse incident reports
114	and treatment outcomes which are obtained by governmental
115	entities under pursuant to this paragraph are confidential and
116	exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
117	of the State Constitution.
118	(d)  Patient selection and initial referral must be made
119	solely by the governmental contractor, and the provider must
120	accept all referred patients. However, the number of patients
121	that must be accepted may be limited by the contract, and
122	patients may not be transferred to the provider based on a
123	violation of the antidumping provisions of the Omnibus Budget
124	Reconciliation Act of 1989, the Omnibus Budget Reconciliation
125	Act of 1990, or chapter 395.
126	(e)  If emergency care is required, the patient need not be
127	referred before receiving treatment, but must be referred within
128	48 hours after treatment is commenced or within 48 hours after
129	the patient has the mental capacity to consent to treatment,
130	whichever occurs later.
131	(f)  Patient care, including any followup or hospital care,
132	is subject to approval by the governmental contractor.
133	(g)  The provider is subject to supervision and regular
134	inspection by the governmental contractor.
135
136	A governmental contractor that is also a health care provider is
137	not required to enter into a contract under this section with
138	respect to the health care services delivered by its employees.
139	(10)  RULES.--The department shall adopt rules to
140	administer this section in a manner consistent with its purpose
141	to provide and facilitate access to appropriate, safe, and cost-
142	effective health care services and to maintain health care
143	quality. The rules may include services to be provided and
144	authorized procedures. Notwithstanding the requirements of
145	paragraph (4)(d), the department shall adopt rules that specify
146	required methods for determination and approval of patient
147	eligibility and referral and the contractual conditions under
148	which a health care provider may perform the patient eligibility
149	and referral process on behalf of the department. These rules
150	shall include, but not be limited to, the following
151	requirements:
152	(a)  The provider must accept all patients referred by the
153	department. However, the number of patients that must be
154	accepted may be limited by the contract, and patients may not be
155	transferred to the provider based on a violation of the
156	antidumping provisions of the Omnibus Budget Reconciliation Act
157	of 1989, the Omnibus Budget Reconciliation Act of 1990, or
158	chapter 395.
159	(b)  The provider shall comply with departmental rules
160	regarding the determination and approval of patient eligibility
161	and referral.
162	(c)  The provider shall complete training conducted by the
163	department regarding compliance with the approved methods for
164	determination and approval of patient eligibility and referral.
165	(d)  The department shall retain review and oversight
166	authority of the patient eligibility and referral determination.
167	Section 2.  This act shall take effect upon becoming a law.

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