SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
                            CHAMBER ACTION
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11  Senator Alexander moved the following amendment:
12  
13         Senate Amendment (with title amendment) 
14         Delete everything after the enacting clause
15  
16  and insert:  
17         Section 1.  Paragraph (c) of subsection (4) of section
18  381.026, Florida Statutes, is amended to read:
19         381.026  Florida Patient's Bill of Rights and
20  Responsibilities.--
21         (4)  RIGHTS OF PATIENTS.--Each health care facility or
22  provider shall observe the following standards:
23         (c)  Financial information and disclosure.--
24         1.  A patient has the right to be given, upon request,
25  by the responsible provider, his or her designee, or a
26  representative of the health care facility full information
27  and necessary counseling on the availability of known
28  financial resources for the patient's health care.
29         2.  A health care provider or a health care facility
30  shall, upon request, disclose to each patient who is eligible
31  for Medicare, in advance of treatment, whether the health care
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  provider or the health care facility in which the patient is
 2  receiving medical services accepts assignment under Medicare
 3  reimbursement as payment in full for medical services and
 4  treatment rendered in the health care provider's office or
 5  health care facility.
 6         3.  A health care provider or a health care facility
 7  shall, upon request, furnish a patient, prior to provision of
 8  medical services, a reasonable estimate of charges for such
 9  services.  Such reasonable estimate shall not preclude the
10  health care provider or health care facility from exceeding
11  the estimate or making additional charges based on changes in
12  the patient's condition or treatment needs.
13         4.  Each licensed facility not operated by the state
14  shall make available to the public on its Internet website or
15  by other electronic means a description of and a link to the
16  performance outcome and financial data that is published by
17  the agency pursuant to s. 408.05(3)(l). The facility shall
18  place a notice in the reception areas that such information is
19  available electronically and the website address. The licensed
20  facility may indicate that the pricing information is based on
21  a compilation of charges for the average patient and that each
22  patient's bill may vary from the average depending upon the
23  severity of illness and individual resources consumed. The
24  licensed facility may also indicate that the price of service
25  is negotiable for eligible patients based upon the patient's
26  ability to pay.
27         5.4.  A patient has the right to receive a copy of an
28  itemized bill upon request.  A patient has a right to be given
29  an explanation of charges upon request.
30         Section 2.  Subsections (1), (2), and (3) of section
31  395.301, Florida Statutes, are amended, and subsections (7),
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  (8), (9), (10), and (11) are added to that section, to read:
 2         395.301  Itemized patient bill; form and content
 3  prescribed by the agency.--
 4         (1)  A licensed facility not operated by the state
 5  shall notify each patient during admission and at discharge of
 6  his or her right to receive an itemized bill upon request.
 7  Within 7 days following the patient's discharge or release
 8  from a licensed facility not operated by the state, or within
 9  7 days after the earliest date at which the loss or expense
10  from the service may be determined, the licensed facility
11  providing the service shall, upon request, submit to the
12  patient, or to the patient's survivor or legal guardian as may
13  be appropriate, an itemized statement detailing in language
14  comprehensible to an ordinary layperson the specific nature of
15  charges or expenses incurred by the patient, which in the
16  initial billing shall contain a statement of specific services
17  received and expenses incurred for such items of service,
18  enumerating in detail the constituent components of the
19  services received within each department of the licensed
20  facility and including unit price data on rates charged by the
21  licensed facility, as prescribed by the agency.
22         (2)(a)  Each such statement submitted pursuant to this
23  section:
24         1.(a)  May not include charges of hospital-based
25  physicians if billed separately.
26         2.(b)  May not include any generalized category of
27  expenses such as "other" or "miscellaneous" or similar
28  categories.
29         3.(c)  Shall list drugs by brand or generic name and
30  not refer to drug code numbers when referring to drugs of any
31  sort.
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         4.(d)  Shall specifically identify therapy treatment as
 2  to the date, type, and length of treatment when therapy
 3  treatment is a part of the statement.
 4         (b)  Any person receiving a statement pursuant to this
 5  section shall be fully and accurately informed as to each
 6  charge and service provided by the institution preparing the
 7  statement.
 8         (3)  On each such itemized statement submitted pursuant
 9  to subsection (1) there shall appear the words "A FOR-PROFIT
10  (or NOT-FOR-PROFIT or PUBLIC) HOSPITAL (or AMBULATORY SURGICAL
11  CENTER) LICENSED BY THE STATE OF FLORIDA" or substantially
12  similar words sufficient to identify clearly and plainly the
13  ownership status of the licensed facility.  Each itemized
14  statement must prominently display the phone number of the
15  medical facility's patient liaison who is responsible for
16  expediting the resolution of any billing dispute between the
17  patient, or his or her representative, and the billing
18  department.
19         (7)  Each licensed facility not operated by the state
20  shall provide, prior to provision of any nonemergency medical
21  services, a written good-faith estimate of reasonably
22  anticipated charges for the facility to treat the patient's
23  condition upon written request of a prospective patient. The
24  estimate shall be provided to the prospective patient within 7
25  business days of the receipt of the request. The estimate may
26  be the average charges for that diagnosis related group or the
27  average charges for that procedure. Upon request, the facility
28  shall notify the patient of any revision to the good-faith
29  estimate. Such estimate shall not preclude the actual charges
30  from exceeding the estimate. The facility shall place a notice
31  in reception areas that such information is available. Failure
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  to provide the estimate within the provisions established
 2  pursuant to this section shall result in a fine of $500 for
 3  each instance of the facility's failure to provide the
 4  requested information.
 5         (8)  A licensed facility shall make available to a
 6  patient all records necessary for verification of the accuracy
 7  of the patient's bill within 30 business days after the
 8  request for such records. The verification information must be
 9  made available in the facility's offices. Such records shall
10  be available to the patient prior to and after payment of the
11  bill or claim. The facility may not charge the patient for
12  making such verification records available; however, the
13  facility may charge its usual fee for providing copies of
14  records as specified in s. 395.3025.
15         (9)  Each facility shall establish a method for
16  reviewing and responding to questions from patients concerning
17  the patient's itemized bill. Such response shall be provided
18  within 30 days after the date a question is received. If the
19  patient is not satisfied with the response, the facility must
20  provide the patient with the address of the agency to which
21  the issue may be sent for review.
22         (10)  Each licensed facility shall make available on
23  its Internet website a link to the performance outcome and
24  financial data that is published by the Agency for Health Care
25  Administration pursuant to s. 408.05(3)(l). The facility shall
26  place a notice in the reception area that the information is
27  availability electronically and the website address.
28         (11)  Each rural hospital as defined in s. 395.602
29  which has fewer than 50 beds is exempt from subsection (10).
30  The agency shall evaluate the most cost-efficient method for
31  collecting and reporting data for these qualifying rural
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  hospitals and shall, by December 1, 2005, submit a report to
 2  the Governor, the President of the Senate, and the Speaker of
 3  the House of Representatives.
 4         Section 3.  Subsection (1) of section 408.061, Florida
 5  Statutes, is amended to read:
 6         408.061  Data collection; uniform systems of financial
 7  reporting; information relating to physician charges;
 8  confidential information; immunity.--
 9         (1)  The agency shall may require the submission by
10  health care facilities, health care providers, and health
11  insurers of data necessary to carry out the agency's duties.
12  Specifications for data to be collected under this section
13  shall be developed by the agency with the assistance of
14  technical advisory panels including representatives of
15  affected entities, consumers, purchasers, and such other
16  interested parties as may be determined by the agency.
17         (a)  Data to be submitted by health care facilities,
18  including the facilities as defined in chapter 395, shall may
19  include, but are not limited to: case-mix data, patient
20  admission and or discharge data, hospital emergency department
21  data shall include the number of patients treated in the
22  emergency department of a licensed hospital reported by
23  patient acuity level, data on hospital-acquired infections as
24  specified by rule, data on complications as specified by rule,
25  data on readmissions as specified by rule, with patient and
26  provider-specific identifiers included, actual charge data by
27  diagnostic groups, financial data, accounting data, operating
28  expenses, expenses incurred for rendering services to patients
29  who cannot or do not pay, interest charges, depreciation
30  expenses based on the expected useful life of the property and
31  equipment involved, and demographic data. The agency shall
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  adopt nationally recognized risk adjustment methodologies or
 2  software consistent with the standards of the Agency for
 3  Healthcare Research and Quality for all data submitted as
 4  required by this section. Data may be obtained from documents
 5  such as, but not limited to: leases, contracts, debt
 6  instruments, itemized patient bills, medical record abstracts,
 7  and related diagnostic information. Reported data elements
 8  shall be reported electronically in accordance with Rule
 9  59E-7.012, Florida Administrative Code. Data submitted shall
10  be certified by the chief executive officer or an appropriate
11  and duly authorized representative or employee of the licensed
12  facility that the information is true and accurate.
13         (b)  Data to be submitted by health care providers may
14  include, but are not limited to: Medicare and Medicaid
15  participation, types of services offered to patients, amount
16  of revenue and expenses of the health care provider, and such
17  other data which are reasonably necessary to study utilization
18  patterns. Data submitted shall be certified as true and
19  accurate by the health care provider or by an appropriate and
20  duly authorized representative or employee of the health care
21  provider.
22         (c)  Data to be submitted by health insurers may
23  include, but are not limited to: claims, premium,
24  administration, and financial information. Data submitted
25  shall be certified as by the appropriate and duly authorized
26  representative, or employee of the insurer that the
27  information submitted is true and accurate.
28         (d)  Data required to be submitted by health care
29  facilities, health care providers, or health insurers shall
30  not include specific provider contract reimbursement
31  information. However, such specific provider reimbursement
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  data shall be reasonably available for onsite inspection by
 2  the agency as is necessary to carry out the agency's
 3  regulatory duties. Any such data obtained by the agency as a
 4  result of onsite inspections may not be used by the state for
 5  purposes of direct provider contracting and are confidential
 6  and exempt from the provisions of s. 119.07(1) and s. 24(a),
 7  Art. I of the State Constitution.
 8         (e)  A requirement to submit data shall be adopted by
 9  rule if the submission of data is being required of all
10  members of any type of health care facility, health care
11  provider, or health insurer. Rules are not required, however,
12  for the submission of data for a special study mandated by the
13  Legislature or when information is being requested for a
14  single health care facility, health care provider, or health
15  insurer.
16         Section 4.  Subsections (1) and (4) of section 408.062,
17  Florida Statutes, are amended, and subsection (5) is added to
18  that section, to read:
19         408.062  Research, analyses, studies, and reports.--
20         (1)  The agency shall have the authority to conduct
21  research, analyses, and studies relating to health care costs
22  and access to and quality of health care services as access
23  and quality are affected by changes in health care costs. Such
24  research, analyses, and studies shall include, but not be
25  limited to, research and analysis relating to:
26         (a)  The financial status of any health care facility
27  or facilities subject to the provisions of this chapter.
28         (b)  The impact of uncompensated charity care on health
29  care facilities and health care providers.
30         (c)  The state's role in assisting to fund indigent
31  care.
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         (d)  In conjunction with the Office of Insurance
 2  Regulation, the availability and affordability of health
 3  insurance for small businesses.
 4         (e)  Total health care expenditures in the state
 5  according to the sources of payment and the type of
 6  expenditure.
 7         (f)  The quality of health services, using techniques
 8  such as small area analysis, severity adjustments, and
 9  risk-adjusted mortality rates.
10         (g)  The development of physician information payment
11  systems which are capable of providing data for health care
12  consumers taking into account the amount of resources
13  consumed, including at licensed facilities as defined in
14  chapter 395, and the outcomes produced in the delivery of
15  care.
16         (h)  The collection of a statistically valid sample of
17  data on the retail prices charged by pharmacies for the 50
18  most frequently prescribed medicines from any pharmacy
19  licensed by this state as a special study authorized by the
20  Legislature to be performed by the agency quarterly. If the
21  drug is available generically, price data shall be reported
22  for the generic drug and price data of a brand-named drug for
23  which the generic drug is the equivalent shall be reported.
24  The agency shall make available on its Internet website for
25  each pharmacy, no later than October 1, 2005, drug prices for
26  a 30-day supply at a standard dose. The data collected shall
27  be reported for each drug by pharmacy and by metropolitan
28  statistical area or region and updated quarterly. The impact
29  of subacute admissions on hospital revenues and expenses for
30  purposes of calculating adjusted admissions as defined in s.
31  408.07.
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         (i)  The use of emergency department services by
 2  patient acuity level and the implication of increasing
 3  hospital cost by providing nonurgent care in emergency
 4  departments. The agency shall submit an annual report based on
 5  this monitoring and assessment to the Governor, the President
 6  of the Senate, and the Speaker of the House of
 7  Representatives, and the substantive legislative committees
 8  with the first report due January 1, 2006.
 9         (j)  Making available on its Internet website no later
10  than October 1, 2004, and in a hard-copy format upon request,
11  patient charge, volumes, length of stay, and performance
12  outcome indicators collected from health care facilities
13  pursuant to s. 408.061(1)(a) for not less than 50 inpatient
14  and 50 outpatient procedures provided in inpatient and
15  outpatient facilities as determined by the agency. In making
16  the determination of specific medical conditions, surgeries,
17  and procedures to include, the agency shall consider such
18  factors as volume, severity of the illness, urgency of
19  admission, individual and societal costs, and whether the
20  condition is acute or chronic. Performance outcome indicators
21  shall re risk adjusted or severity adjusted, as applicable,
22  using nationally recognized risk adjustment methodologies or
23  software consistent with the standards of the Agency for
24  Healthcare Research and Quality and as selected by the agency.
25  The website shall also provide an interactive search that
26  allows consumers to view and compare the information for
27  specific facilities, a map that allows consumers to select a
28  county or region, definitions of all of the data, descriptions
29  of each procedure, and an explanation about why the data may
30  differ from facility to facility. Such public data shall be
31  updated quarterly. The agency shall submit an annual status
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  report on the collection of data and publication of
 2  performance outcome indicators to the Governor, the Speaker of
 3  the House of Representatives, the President of the Senate, and
 4  the substantive legislative committees with the first status
 5  report due January 1, 2005.
 6         (4)(a)  The agency shall may conduct data-based studies
 7  and evaluations and make recommendations to the Legislature
 8  and the Governor concerning exemptions, the effectiveness of
 9  limitations of referrals, restrictions on investment interests
10  and compensation arrangements, and the effectiveness of public
11  disclosure. Such analysis shall may include, but need not be
12  limited to, utilization of services, cost of care, quality of
13  care, and access to care. The agency may require the
14  submission of data necessary to carry out this duty, which may
15  include, but need not be limited to, data concerning
16  ownership, Medicare and Medicaid, charity care, types of
17  services offered to patients, revenues and expenses,
18  patient-encounter data, and other data reasonably necessary to
19  study utilization patterns and the impact of health care
20  provider ownership interests in health-care-related entities
21  on the cost, quality, and accessibility of health care.
22         (b)  The agency may collect such data from any health
23  facility or licensed health care provider as a special study.
24         (5)  The agency shall develop and implement a strategy
25  for the adoption and use of electronic health records. The
26  agency may develop rules to facilitate the functionality and
27  protect the confidentiality of electronic health records. The
28  agency shall report to the Governor, the President of the
29  Senate, and the Speaker of the House of Representatives on
30  legislative recommendations to protect the confidentiality of
31  electronic health records.
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         Section 5.  Paragraph (l) is added to subsection (3) of
 2  section 408.05, Florida Statutes, and paragraph (a) of
 3  subsection (8) of that section is amended, to read:
 4         408.05  State Center for Health Statistics.--
 5         (3)  COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order
 6  to produce comparable and uniform health information and
 7  statistics, the agency shall perform the following functions:
 8         (l)  Develop, in conjunction with the State
 9  Comprehensive Health Information System Advisory Council, and
10  implement a long-range plan for making available performance
11  outcome and financial data that will allow consumers to
12  compare health care services. The performance outcomes and
13  financial data the agency must make available shall include,
14  but is not limited to, pharmaceuticals, physicians, health
15  care facilities, and health plans and managed care entities.
16  The agency shall submit the initial plan to the Governor, the
17  President of the Senate, and the Speaker of the House of
18  Representatives by March 1, 2005, and shall update the plan
19  and report on the status of its implementation annually
20  thereafter. The agency shall also make the plan and status
21  report available to the public on its Internet website. As
22  part of the plan, the agency shall identify the process and
23  timeframes for implementation, any barriers to implementation,
24  and recommendations of changes in the law that may be enacted
25  by the Legislature to eliminate the barriers. As preliminary
26  elements of the plan, the agency shall:
27         1.  Make available performance outcome and patient
28  charge data collected from health care facilities pursuant to
29  s. 408.061(1)(a) and (2). The agency shall determine which
30  conditions and procedures, performance outcomes, and patient
31  charge data to disclose based upon input from the council.
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  When determining which conditions and procedures are to be
 2  disclosed, the council and the agency shall consider variation
 3  in costs, variation in outcomes, and magnitude of variations
 4  and other relevant information. When determining which
 5  performance outcomes to disclose, the agency: 
 6         a.  Shall consider such factors as volume of cases;
 7  average patient charges; average length of stay; complication
 8  rates; mortality rates; and infection rates, among others,
 9  which shall he adjusted for case mix and severity, if
10  applicable.
11         b.  May consider such additional measures that are
12  adopted by the Centers for Medicare and Medicaid Studies,
13  National Quality Forum, the Joint Commission on Accreditation
14  of Healthcare Organizations, the Agency for Healthcare
15  Research and Quality, or a similar national entity that
16  establishes standards to measure the performance of health
17  care providers, or by other states.
18  
19  When determining which patient charge data to disclose, the
20  agency shall consider such measures as average charge, average
21  net revenue per adjusted patient day, average cost per
22  adjusted patient day, and average cost per admission, among
23  others.
24         2.  Make available performance measures, benefit
25  design, and premium cost data from health plans licensed
26  pursuant to chapter 627 or chapter 641. The agency shall
27  determine which performance outcome and member and subscriber
28  cost data to disclose, based upon input from the council. When
29  determining which data to disclose, the agency shall consider
30  information that may be required by either individual or group
31  purchasers to assess the value of the product, which may
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 1  include membership satisfaction, quality of care, current
 2  enrollment or membership, coverage areas, accreditation
 3  status, premium costs, plan costs, premium increases, range of
 4  benefits, copayments and deductibles, accuracy and speed of
 5  claims payment, credentials of physicians, number of
 6  providers, names of network providers, and hospitals in the
 7  network. Health plans shall make available to the agency any
 8  such data or information that is not currently reported to the
 9  agency or the office.
10         3.  Determine the method and format for public
11  disclosure of data reported pursuant to this paragraph. The
12  agency shall make its determination based upon input from the
13  Comprehensive Health Information System Advisory Council. At a
14  minimum, the data shall be made available on the agency's
15  Internet website in a manner that allows consumers to conduct
16  an interactive search that allows them to view and compare the
17  information for specific providers. The website must include
18  such additional information as is determined necessary to
19  ensure that the website enhances informed decision-making
20  among consumers and health care purchasers, which shall
21  include, at a minimum, appropriate guidance on how to use the
22  data and an explanation of why the data may vary from provider
23  to provider. The data specified in subparagraph 1. shall be
24  released no later than March 1, 2005. The data specified in
25  subparagraph 2. shall be released no later than March 1, 2006.
26         (8)  STATE COMPREHENSIVE HEALTH INFORMATION SYSTEM
27  ADVISORY COUNCIL.--
28         (a)  There is established in the agency the State
29  Comprehensive Health Information System Advisory Council to
30  assist the center in reviewing the comprehensive health
31  information system and to recommend improvements for such
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  system. The council shall consist of the following members:
 2         1.  An employee of the Executive Office of the
 3  Governor, to be appointed by the Governor.
 4         2.  An employee of the Office of Insurance Regulation
 5   Department of Financial Services, to be appointed by the
 6  Chief Financial Officer.
 7         3.  An employee of the Department of Education, to be
 8  appointed by the Commissioner of Education.
 9         4.  Ten persons, to be appointed by the Secretary of
10  Health Care Administration, representing other state and local
11  agencies, state universities, the Florida Association of
12  Business/Health Coalitions, local health councils,
13  professional health-care-related associations, consumers, and
14  purchasers.
15         Section 6.  Subsection (3) of section 409.9066, Florida
16  Statutes, is amended to read:
17         409.9066  Medicare prescription discount program.--
18         (3)  The Agency for Health Care Administration shall
19  publish, on a free website available to the public, the most
20  recent average wholesale prices for the 200 drugs most
21  frequently dispensed to the elderly and, to the extent
22  possible, shall provide a mechanism that consumers may use to
23  calculate the retail price and the price that should be paid
24  after the discount required in subsection (1) is applied. The
25  agency shall provide retail information by geographic area and
26  retail information by provider within geographical areas.
27         Section 7.  Section 465.0244, Florida Statutes, is
28  created to read:
29         465.0244  Information disclosure.--Every pharmacy shall
30  make available on its Internet website a link to the financial
31  data that is published by the Agency for Health Care
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  Administration pursuant to ss. 408.06(2)(l) and 409.9066 and
 2  shall place in the area where customers receive filled
 3  prescriptions notice that such information is available
 4  electronically and the address of its Internet website.
 5         Section 8.  Section 627.6499, Florida Statutes, is
 6  amended to read:
 7         627.6499  Reporting by insurers and third-party
 8  administrators.--
 9         (1)  The office may require any insurer, third-party
10  administrator, or service company to report any information
11  reasonably required to assist the board in assessing insurers
12  as required by this act.
13         (2)  Each health insurance issuer shall make available
14  on its Internet website a link to the performance outcome and
15  financial data that is published by the Agency for Health Care
16  Administration pursuant to s. 408.05(3)(l) and shall include
17  in every policy delivered or issued for delivery to any person
18  in the state or any materials provided as required by s.
19  627.64725 notice that such information is available
20  electronically and the address of its Internet website.
21         Section 9.  Subsections (6) and (7) are added to
22  section 641.54, Florida Statutes, to read:
23         641.54  Information disclosure.--
24         (6)  Each health maintenance organization shall make
25  available to its subscribers the estimated co-pay, coinsurance
26  percentage, or deductible, whichever is applicable, for any
27  covered services, the status of the subscriber's maximum
28  annual out-of-pocket payments for a covered individual or
29  family, and the status of the subscriber's maximum lifetime
30  benefit. Such estimate shall not preclude the actual co-pay,
31  coinsurance percentage, or deductible, whichever is
                                  16
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1  applicable, from exceeding the estimate.
 2         (7)  Each health maintenance organization shall make
 3  available on its Internet website a link to the performance
 4  outcome and financial data that is published by the Agency for
 5  Health Care Administration pursuant to s. 408.05(3)(l) and
 6  shall include in every policy delivered or issued for delivery
 7  to any person in the state or any materials provided as
 8  required by s. 627.64725 notice that such information is
 9  available electronically and the address of its Internet
10  website.
11         Section 10.  The Agency for Health Care Administration
12  shall adopt all rules necessary to implement this act no later
13  than January 1, 2005.
14         Section 11.  This act shall take effect July 1, 2004.
15  
16  
17  ================ T I T L E   A M E N D M E N T ===============
18  And the title is amended as follows:
19         Delete everything before the enacting clause
20  
21  and insert:
22                      A bill to be entitled
23         An act relating to health care; amending s.
24         381.026, F.S.; requiring certain licensed
25         facilities to provide public Internet access to
26         certain financial information; amending s.
27         395.301, F.S.; requiring certain licensed
28         facilities to provide prospective patients
29         certain estimates of charges for services;
30         requiring such facilities to provide patients
31         with certain bill verification information;
                                  17
    3:47 PM   04/19/04                              s2022c1c-17p0a
                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         providing for a fine for failure to provide
 2         such information; providing charge limitations;
 3         requiring such facilities to establish a
 4         patient question review and response
 5         methodology; providing requirements; requiring
 6         certain licensed facilities to provide public
 7         Internet access to certain financial
 8         information; providing an exception for
 9         specified rural hospitals; amending s. 408.061,
10         F.S.; requiring the Agency for Health Care
11         Administration to require health care
12         facilities, health care providers, and health
13         insurers to submit certain information;
14         providing requirements; requiring the agency to
15         adopt certain risk and severity adjustment
16         methodologies; requiring the agency to adopt
17         certain rules; requiring certain information to
18         be certified; amending s. 408.062, F.S.;
19         requiring the agency to conduct certain health
20         care costs and access research, analyses, and
21         studies; expanding the scope of such studies to
22         include collection of pharmacy retail price
23         data, use of emergency departments, physician
24         information, and Internet patient charge
25         information availability; requiring publication
26         of information collected on the Internet;
27         requiring a report; requiring the agency to
28         conduct additional data-based studies and make
29         recommendations to the Legislature; requiring
30         the agency to develop and implement a strategy
31         to adopt and use electronic health records;
                                  18
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                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         authorizing the agency to develop rules to
 2         protect electronic records confidentiality;
 3         requiring a report to the Governor and
 4         Legislature; amending s. 408.05, F.S.;
 5         requiring the agency to develop a plan to make
 6         performance outcome and financial data
 7         available to consumers for health care services
 8         comparison purposes; requiring submittal of the
 9         plan to the Governor and Legislature; requiring
10         the agency to update the plan; requiring the
11         agency to make the plan available
12         electronically; providing plan requirements;
13         amending s. 409.9066, F.S.; requiring the
14         agency to provide certain information relating
15         to the Medicare prescription discount program;
16         creating s. 465.0244, F.S.; requiring each
17         pharmacy to make available on its Internet
18         website a link to certain performance outcome
19         and financial data of the Agency for Health
20         Care Administration and a notice of the
21         availability of such information; amending s.
22         627.6499, F.S.; requiring each health insurer
23         to make available on its Internet website a
24         link to certain performance outcome and
25         financial data of the Agency for Health Care
26         Administration and a notice in policies of the
27         availability of such information; amending s.
28         641.54, F.S.; requiring health maintenance
29         organizations to make certain insurance
30         financial information available to subscribers;
31         requiring health maintenance organizations to
                                  19
    3:47 PM   04/19/04                              s2022c1c-17p0a
                                                  SENATE AMENDMENT
    Bill No. CS for SB 2022
    Amendment No. ___   Barcode 575672
 1         make available on its Internet website a link
 2         to certain performance outcome and financial
 3         data of the Agency for Health Care
 4         Administration and a notice in policies of the
 5         availability of such information; authorizing
 6         rule adoption; providing an effective date.
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