| 1 | The Committee on Health Care recommends the following: |
| 2 |
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| 3 | Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to self-pay patients; providing |
| 7 | legislative findings; amending s. 395.301, F.S.; requiring |
| 8 | hospitals to develop and make available two payment |
| 9 | allowance programs for qualified self-pay patients; |
| 10 | providing program guidelines and requirements; providing |
| 11 | exclusions; providing a definition of patients qualified |
| 12 | for such programs; providing exceptions; prohibiting |
| 13 | hospitals from pursuing certain civil remedies against |
| 14 | such patients; providing an effective date. |
| 15 |
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| 16 | Be It Enacted by the Legislature of the State of Florida: |
| 17 |
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| 18 | Section 1. Legislative findings.-- |
| 19 | (1) The Legislature recognizes that 2.8 million Floridians |
| 20 | are uninsured, which represents one of every five Florida |
| 21 | residents aged 65 years or younger. |
| 22 | (2) The Legislature finds that the cost of providing care |
| 23 | to the uninsured population in Florida hospitals is in excess of |
| 24 | $1.5 billion. |
| 25 | (3) The Legislature intends to make health care more |
| 26 | affordable and accessible to its uninsured residents. |
| 27 | (4) The Legislature intends to extend discounts for |
| 28 | hospital services to low-income uninsured individuals who have |
| 29 | established a domicile in this state as evidence by residing in |
| 30 | and maintaining a place of abode in a Florida county which he or |
| 31 | she recognizes and intends to maintain as his or her permanent |
| 32 | home. |
| 33 | Section 2. Subsection (7) is added to section 395.301, |
| 34 | Florida Statutes, to read: |
| 35 | 395.301 Itemized patient bill; form and content prescribed |
| 36 | by the agency.-- |
| 37 | (7) Each hospital shall develop two programs of payment |
| 38 | allowances for qualified self-pay patients. Each program shall |
| 39 | consist of one of the following: |
| 40 | (a) A program of payment allowances for qualified self-pay |
| 41 | patients who are treated in the emergency room, admitted through |
| 42 | the emergency room, or present for labor and delivery. All |
| 43 | patients shall continue to be charged the same rate, but |
| 44 | qualified self-pay patients shall be eligible for discounts |
| 45 | based on family income. The discount shall be determined by each |
| 46 | facility. The discount program shall not apply to patients who |
| 47 | are eligible for, or enrolled in, private or public insurance |
| 48 | plans providing hospital coverage, including indemnity plans, |
| 49 | except high deductible plans. |
| 50 | (b) A program for payment allowances for patients with |
| 51 | household incomes up to 300 percent of the federal poverty |
| 52 | guidelines, who are qualified self-pay patients who are treated |
| 53 | in the emergency room, admitted through the emergency room, or |
| 54 | present for labor and delivery. All patients shall continue to |
| 55 | be charged the same rate, but qualified self-pay patients shall |
| 56 | be eligible for discounts based on family income. The discount |
| 57 | program shall not apply to patients who are eligible for or |
| 58 | enrolled in private or public insurance plans providing hospital |
| 59 | coverage, including indemnity plans. The policy must include a |
| 60 | minimum discount of 200 percent of Medicare rates and a |
| 61 | description of the methodologies developed by the hospital for |
| 62 | the following: |
| 63 | 1. Identifying patients who may be eligible for a payment |
| 64 | allowance, notifying them of the availability of the program, |
| 65 | and providing appropriate information, including application |
| 66 | forms, for a payment allowance. |
| 67 | 2. Identifying public or private insurance or other |
| 68 | payment mechanisms for which the patient might be eligible. |
| 69 | 3. Determining the payment allowance or credit. |
| 70 | 4. Notifying patients of their qualification either for a |
| 71 | public source of payment or a discount pursuant to this program. |
| 72 | 5. Developing payment plans and procedures preceding |
| 73 | assignment of a patient's account to a third party or reporting |
| 74 | nonpayment to a patient's consumer credit agency. For purposes |
| 75 | of this program, these patients are considered as qualified |
| 76 | self-pay patients. |
| 77 | (c) The term "qualified self-pay patient" means any |
| 78 | resident who has established a domicile in Florida, as evidenced |
| 79 | by residing in a Florida county which he or she intends to |
| 80 | maintain as his or her permanent home, with no public or private |
| 81 | source of payment for medical services who would otherwise be |
| 82 | expected to pay the hospital's billed charges. The term does not |
| 83 | include: |
| 84 | 1. Patients presenting for services that are not covered |
| 85 | by Medicare, Medicaid, or workers' compensation in this state or |
| 86 | elective, nonmedically necessary services. |
| 87 | 2. Patients who fail to provide income and asset |
| 88 | information to determine if the patient is eligible for public |
| 89 | or private coverage or for a discount under this program. |
| 90 | 3. Patients with discretionary assets in excess of 50 |
| 91 | percent of the billed charges, with discretionary assets defined |
| 92 | as the fair market value of personal savings, personal |
| 93 | investments, and personal nonhomestead property. Discretionary |
| 94 | assets shall not include personal automobiles or business |
| 95 | assets. |
| 96 | (d) No hospital shall foreclose on homestead property that |
| 97 | is owned by a qualified self-pay patient. No hospital shall seek |
| 98 | a court order to issue a writ of bodily attachment to enforce |
| 99 | payment of hospital bills for medical services provided to |
| 100 | qualified self-pay patients. |
| 101 | Section 3. This act shall take effect upon becoming a law. |