HB 1125

CS

CHAMBER ACTION

1	The Health Care Regulation Committee recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to studies on health care; creating a
7	commission to study the effect of the 2004 hurricane
8	season on certain hospitals and identify hospitals unable
9	to comply with the Florida Building Code or located in
10	flood-prone areas; providing for membership,
11	reimbursement, and duties of the study commission;
12	requiring the Department of Community Affairs to provide
13	staff for the study commission; requiring the commission
14	to submit a report and recommendations to the Governor and
15	the Legislature; creating a health insurance plan study
16	group; specifying membership; requiring the study group to
17	investigate certain issues relating to health insurance
18	plans; requiring the group to meet and submit
19	recommendations to the Governor and the Legislature;
20	directing the Office of Program Policy Analysis and
21	Government Accountability to conduct a study to evaluate
22	whether the State of Florida should join the Nurse
23	Licensure Compact; providing an effective date.
24
25	WHEREAS, the State of Florida experienced four major
26	hurricanes during 2004, and
27	WHEREAS, the state recognizes the importance of maintaining
28	a system of hospitals throughout the state to ensure that the
29	underserved population has access to hospitals when the need
30	arises and acknowledges that these hospitals serve a critical
31	state purpose in providing this care, and
32	WHEREAS, it is an important state interest to ensure that
33	these hospitals continue to provide health care services to the
34	state's underserved populations, and
35	WHEREAS, many hospitals and health care facilities
36	sustained significant structural damage to their facilities in
37	2004, and
38	WHEREAS, hospitals that provide the majority of safety net
39	care for indigent and charity cases were forced to operate in
40	facilities that were not structurally sound, and
41	WHEREAS, these hospitals do not have the ability to care
42	for patients at alternative sites during natural disasters, and
43	WHEREAS, these hospitals do not have the capital needed to
44	invest in the significant infrastructure costs associated with
45	hurricane damage, and
46	WHEREAS, these hospitals have been in existence for many
47	years and have become geographically place-bound, with little
48	opportunity to expand beyond their current property lines, NOW,
49	THEREFORE,
50
51	Be It Enacted by the Legislature of the State of Florida:
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53	Section 1.  (1)  STUDY COMMISSION.--There is created a
54	study commission to address critical issues relating to
55	hospitals serving indigent populations and licensed under
56	chapter 395, Florida Statutes, which sustained significant
57	damage to their facilities during the 2004 hurricane season.
58	(2)  SUBJECT OF STUDY.--
59	(a)  The commission shall identify:
60	1.  All hospitals that are currently not able to comply
61	with the provisions of the Florida Building Code as defined in
62	chapter 553, Florida Statutes, and any associated administrative
63	rules;
64	2.  Hospitals that are located within 10 miles of the
65	coastline; and
66	3.  Hospitals that are located in a designated flood zone.
67	(b)  The study commission shall make recommendations for
68	allowing these hospitals to find alternative methods of
69	renovating their existing facility in order to meet the
70	requirements of the Florida Building Code. The commission shall
71	review all alternatives that could be made available to those
72	hospitals when renovation is not financially practicable or
73	structurally feasible. The commission shall review existing laws
74	and agency rules and recommend needed changes to address these
75	issues.
76	(3)  REPORT.--The commission shall meet by September 1,
77	2005, and shall submit recommendations, including
78	recommendations for statutory changes, to the Governor, the
79	President of the Senate, and the Speaker of the House of
80	Representatives by January 1, 2006. Such recommendations shall
81	also include an evaluation of whether grant funds should be made
82	available to assist hospitals with the cost of reconstructing
83	existing facilities.
84	(4)  MEMBERSHIP.--The study commission shall be staffed by
85	the Department of Community Affairs and shall include:
86	(a)  The Secretary of Community Affairs, or his or her
87	designee.
88	(b)  The director of the Division of Emergency Management,
89	or his or her designee.
90	(c)  The Secretary of Health Care Administration, or his or
91	her designee.
92	(d)  Four representatives of hospitals from regions of the
93	state where hospitals experienced significant hurricane damage
94	during 2004, with two members appointed by the President of the
95	Senate and two members appointed by the Speaker of the House of
96	Representatives.
97	(e)  The Secretary of Health, or his or her designee.
98	(f)  A director of county emergency management, selected by
99	the Florida Emergency Preparedness Association.
100	(5)  REIMBURSEMENT.--Members of the study commission shall
101	serve without remuneration, but are entitled to reimbursement in
102	accordance with section 112.061, Florida Statutes, for per diem
103	and travel expenses incurred in performing their duties in
104	accordance with this section.
105	Section 2.  (1)  A 13-member health insurance plan study
106	group is created, to be composed of:
107	(a)  Three representatives of employers offering high
108	deductible health plans to their employees, one each who will be
109	appointed by the Florida Chamber of Commerce, the National
110	Federation of Independent Business, and Associated Industries of
111	Florida. Of these representatives, one shall be a small employer
112	as defined in s. 627.6699, Florida Statutes.
113	(b)  Three representatives of commercial health plans, to
114	be appointed by America's Health Insurance Plans.
115	(c)  Three representatives of hospitals, to be appointed by
116	the Florida Hospital Association.
117	(d)  Two physician representatives, one to be appointed by
118	the Florida Medical Association and one to be appointed by the
119	Florida Osteopathic Medical Association.
120	(e)  The Secretary of Health Care Administration, who shall
121	serve as co-chair.
122	(f)  The Director of the Office of Insurance Regulation,
123	who shall serve as co-chair.
124	(2)  Staff support for the study group shall be provided
125	jointly by the Agency for Health Care Administration and the
126	Office of Insurance Regulation.
127	(3)  The study group shall study the following issues
128	related to high deductible health insurance plans, including,
129	but not limited to, health savings accounts and health
130	reimbursement arrangements:
131	(a)  The impact of high deductibles on access to health
132	care services and pharmaceutical benefits.
133	(b)  The impact of high deductibles on utilization of
134	health care services and overutilization of health care
135	services.
136	(c)  The impact on hospitals' inability to collect
137	deductibles and copayments.
138	(d)  The ability of hospitals and insureds to determine,
139	prior to service delivery, the level of deductible and copayment
140	required of the insured.
141	(e)  The methods to assist hospitals and insureds to
142	determine, prior to service delivery, status of the insured in
143	meeting annual deductible requirements and any subsequent
144	copayments.
145	(f)  The methods to assist hospitals in the collection of
146	deductibles and copayments, including electronic payments.
147	(g)  Alternative approaches to the collection of
148	deductibles and copayments when either the amounts of patient
149	financial responsibility are unknown in advance or there are no
150	funds electronically available from the patient to pay for the
151	deductible and any associated copayment.
152	(4)  The study group shall also study the following issues
153	in addition to those specified in subsection (3):
154	(a)  The assignment of benefits attestations and contract
155	provisions which nullify the attestations of insureds.
156	(b)  The standardization of insured or subscriber
157	identifications cards.
158	(c)  The standardization of claim edits or assurance that
159	claim edits comply with nationally recognized editing
160	guidelines.
161	(d)  The provision of comparative cost information to
162	insureds and subscribers.
163	(5)  The study group shall meet by August 1, 2005, and
164	shall submit recommendations to the Governor, the President of
165	the Senate, and the Speaker of the House of Representatives by
166	January 1, 2006.
167	Section 3.  The Office of Program Policy Analysis and
168	Government Accountability (OPPAGA) shall conduct a study to
169	evaluate whether the State of Florida should join the Nurse
170	Licensure Compact. The study's scope shall include, but not be
171	limited to, identifying the potential impact on the state's
172	nursing shortage, benefits to the state, implementation
173	barriers, and any fiscal impact. OPPAGA shall submit a report to
174	the President of the Senate and the Speaker of the House of
175	Representatives by February 1, 2006.
176	Section 4.  This act shall take effect upon becoming a law.

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