Amendment
Bill No. 1503
Amendment No. 609467
CHAMBER ACTION
Senate House
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1Representative(s) Robaina offered the following:
2     Amendment (with title amendment)
3     Between line(s) 68 and 69, insert:
4     Section 1.  Subsection (1) of section 400.925, Florida
5Statutes, is amended, and subsections (17), (18), (19), and (20)
6are added to that section, to read:
7     400.925  Definitions.--As used in this part, the term:
8     (1)  "Accrediting organizations" means the Joint Commission
9on Accreditation of Healthcare Organizations, the Community
10Health Accreditation Program (CHAP), the Accreditation
11Commission for Health Care, Inc. (ACHC), or other national
12accreditation agencies whose standards for accreditation are
13comparable to those required by this part for licensure.
14     (17)  "High-tech medical equipment provider" means any home
15medical equipment company that provides life-sustaining
16equipment, technologically advanced equipment, or any other
17similar equipment or product to any patient.
18     (18)  "Life-sustaining equipment" means mechanical
19ventilators or other equipment that is essential to the
20restoration or continuation of a bodily function important to
21the continuation of human life.
22     (19)  "Technologically advanced equipment" means equipment
23of such complexity that a licensed respiratory therapist or
24registered nurse must set it up and train the patient in its
25use.
26     (20)  "From its own inventory" means to provide the items
27or service directly to the patient.
28     Section 2.  Paragraph (i) of subsection (5) of section
29400.93, Florida Statutes, is amended to read:
30     400.93  Licensure required; exemptions; unlawful acts;
31penalties.--
32     (5)  The following are exempt from home medical equipment
33provider licensure, unless they have a separate company,
34corporation, or division that is in the business of providing
35home medical equipment and services for sale or rent to
36consumers at their regular or temporary place of residence
37pursuant to the provisions of this part:
38     (i)  Licensed health care practitioners who utilize home
39medical equipment in the course of their practice, but do not
40sell or rent home medical equipment to their patients, or
41physicians who sell, rent, or supply to their patients equipment
42or devices in the physicians' offices.
43     Section 3.  Paragraph (a) of subsection (2) and subsections
44(6) and (7) of section 400.931, Florida Statutes, are amended to
45read:
46     400.931  Application for license; fee; provisional license;
47temporary permit.--
48     (2)  The applicant must file with the application
49satisfactory proof that the home medical equipment provider is
50in compliance with this part and applicable rules, including:
51     (a)  A report, by category, of the equipment to be
52provided, indicating those offered either directly by the
53applicant or through contractual arrangements with existing
54providers. Categories of equipment include:
55     1.  Respiratory modalities.
56     2.  Ambulation aids.
57     3.  Mobility aids.
58     4.  Sickroom setup.
59     5.  Disposables.
60     6.  Life-sustaining equipment.
61     7.  Technologically advanced equipment.
62     (6)  The home medical equipment provider must also obtain
63and maintain professional and commercial liability insurance.
64Proof of liability insurance, as defined in s. 624.605, must be
65submitted with the application. The agency shall set the
66required amounts of liability insurance by rule, but the
67required amount must not be less than $300,000 $250,000 per
68claim. In the case of contracted services, it is required that
69the contractor have liability insurance not less than $300,000
70$250,000 per claim.
71     (7)  A provisional license shall be issued to an approved
72applicant for initial licensure for a period of 90 days, during
73which time a survey must be conducted demonstrating substantial
74compliance with this section. A temporary provisional license
75shall also be issued pending the results of an applicant's
76Federal Bureau of Investigation report of background screening
77confirming that all standards have been met. If substantial
78compliance is demonstrated, a standard license shall be issued
79to expire 2 years after the effective date of the provisional
80license.
81     Section 4.  Subsection (2) of section 400.933, Florida
82Statutes, is amended, and subsection (3) is added to that
83section, to read:
84     400.933  Licensure inspections and investigations.--
85     (2)  The agency shall accept, in lieu of its own periodic
86inspections for licensure, submission of the following:
87     (a)  the survey or inspection of an accrediting
88organization, provided the accreditation of the licensed home
89medical equipment provider is not provisional and provided the
90licensed home medical equipment provider authorizes release of,
91and the agency receives the report of, the accrediting
92organization.; or
93     (b)  A copy of a valid medical oxygen retail establishment
94permit issued by the Department of Health, pursuant to chapter
95499.
96     (3)  In addition to any administrative fines imposed, the
97agency may assess a survey fee of $500 to cover the cost of
98conducting complaint investigations that result in the finding
99of a violation that was the subject of the compliant and any
100followup visits conducted to verify the correction of the
101violations found in complaints.
102     Section 5.  Subsections (3), (4), and (18) of section
103400.934, Florida Statutes, are amended, and subsection (20) is
104added to that section, to read:
105     400.934  Minimum standards.--As a requirement of licensure,
106home medical equipment providers shall:
107     (3)  Respond to orders received for other equipment by
108filling those orders from its own inventory or inventory from
109other companies with which it has contracted to fill such
110orders; or by customizing or fitting items for sale from
111supplies purchased under contract, except that high-tech medical
112equipment providers shall fill all orders for technologically
113advanced equipment directly from their own inventory and shall
114not contract with any entity for the delivery of such orders
115unless such entity is also licensed and accredited pursuant to
116this subsection.
117     (4)  Maintain trained personnel to coordinate order
118fulfillment and schedule timely equipment and service delivery.
119High-tech medical equipment providers shall have on staff, at a
120minimum, one licensed respiratory therapist, who is either a
121certified respiratory therapist (CRT), a registered respiratory
122therapist (RRT), or a registered nurse.
123     (18)  Maintain safe premises that are fully accessible to
124all patients between the hours of 9 a.m. and 5 p.m.
125     (20)  Provide consumers with after-hours emergency service
126appropriately staffed by personnel equipped to offer necessary
127services to the public. High-tech medical equipment providers
128shall have on call, at a minimum, one licensed respiratory
129therapist who is either a certified respiratory therapist (CRT),
130a registered respiratory therapist (RRT), or a registered nurse.
131     Section 6.  Subsections (11) and (12) are added to section
132400.935, Florida Statutes, to read:
133     400.935  Rules establishing minimum standards.--The agency
134shall adopt, publish, and enforce rules to implement this part,
135which must provide reasonable and fair minimum standards
136relating to:
137     (11)  The designation of equipment as life sustaining or
138technologically advanced.
139     (12)  The designation of appropriate accrediting
140organizations.
141     Section 7.  Section 400.936, Florida Statutes, is created
142to read:
143     400.936  Mandatory accreditation.--
144     (1)  Effective January 1, 2006, all home medical equipment
145providers licensed under this part shall submit to the agency
146proof of accreditation as a prerequisite for licensure or
147license renewal. Any provider that does not submit proof of
148accreditation shall be issued a temporary license and shall have
14960 days to submit proof of application to an accrediting
150organization. Such provider shall submit proof of accreditation
151within 180 days after submitting an application in order to
152receive a permanent license. Any home medical equipment provider
153licenses as of January 1, 2006, shall have a reasonable period
154of time, not to exceed its next licensure renewal date, to
155comply with the accreditation requirement. Applicants that
156submit proof of accreditation, a completed licensure
157application, and the required fee may receive a temporary
158license until completion of the review of accreditation.
159     (2)  The agency shall adopt rules designating appropriate
160accrediting organizations whose standards for accreditation are
161comparable to those required by this part for licensure.
162     Section 8.  Section 400.95, Florida Statutes, is amended to
163read:
164     400.95  Notice of toll-free telephone number for central
165fraud and abuse hotline.--On or before the first day home
166medical equipment is delivered to the patient's home, any home
167medical equipment provider licensed under this part must inform
168the consumer and his or her immediate family, if appropriate, of
169the right to report fraudulent, abusive, neglectful, or
170exploitative practices. The statewide toll-free telephone number
171for the central fraud and abuse hotline must be provided to
172consumers in a manner that is clearly legible and must include
173the words: "To report fraud, abuse, neglect, or exploitation,
174please call toll-free 1-800-962-2873." Home medical equipment
175providers shall establish appropriate policies and procedures
176for providing such notice to consumers.
177
178=========== T I T L E  A M E N D M E N T ===========
179     Remove line(s) 6 and insert:
180An act relating to health care regulation; amending s.
181400.925, F.S.; revising and providing definitions;
182amending s. 400.93, F.S.; providing that physicians who
183sell, rent, or supply equipment or devices to their
184patients are exempt from licensure as a home medical
185equipment provider; amending s. 400.931, F.S.; including
186additional categories of equipment in a report required by
187applicants for licensure; increasing the amount of
188liability insurance required of home medical equipment
189providers; amending s. 400.933, F.S.; revising
190requirements for licensure and assessment of fees;
191amending s. 400.934, F.S.; revising minimum standards
192required for licensure; amending s. 400.935, F.S.;
193requiring the Agency for Health Care Administration to
194provide additional regulatory standards by rule; creating
195s. 400.936, F.S.; requiring proof of accreditation as a
196prerequisite for licensure or license renewal; providing
197for temporary licensure; providing for rules relating to
198designation of accrediting organizations; amending s.
199400.95, F.S.; providing for notice of a toll-free
200telephone number to report fraud and abuse by providers;
201amending s. 408.05,


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