Amendment
Bill No. 1503
Amendment No. 854977
CHAMBER ACTION
Senate House
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1Representative(s) Robaina offered the following:
2
3     Amendment (with title amendment)
4     Between line(s) 68 and 69, insert:
5     Section 1.  Subsection (1) of section 400.925, Florida
6Statutes, is amended, and subsections (17), (18), (19), and (20)
7are added to that section, to read:
8     400.925  Definitions.--As used in this part, the term:
9     (1)  "Accrediting organizations" means the Joint Commission
10on Accreditation of Healthcare Organizations, the Community
11Health Accreditation Program (CHAP), the Accreditation
12Commission for Health Care, Inc. (ACHC), or other national
13accreditation agencies whose standards for accreditation are
14comparable to those required by this part for licensure.
15     (17)  "High-tech medical equipment provider" means any home
16medical equipment company that provides life-sustaining
17equipment, technologically advanced equipment, or any other
18similar equipment or product to any patient.
19     (18)  "Life-sustaining equipment" means mechanical
20ventilators or other equipment that is essential to the
21restoration or continuation of a bodily function important to
22the continuation of human life.
23     (19)  "Technologically advanced equipment" means equipment
24of such complexity that a licensed respiratory therapist or
25registered nurse must set it up and train the patient in its
26use.
27     (20)  "From its own inventory" means to provide the items
28or service directly to the patient.
29     Section 2.  Paragraph (i) of subsection (5) of section
30400.93, Florida Statutes, is amended to read:
31     400.93  Licensure required; exemptions; unlawful acts;
32penalties.--
33     (5)  The following are exempt from home medical equipment
34provider licensure, unless they have a separate company,
35corporation, or division that is in the business of providing
36home medical equipment and services for sale or rent to
37consumers at their regular or temporary place of residence
38pursuant to the provisions of this part:
39     (i)  Licensed health care practitioners who utilize home
40medical equipment in the course of their practice, but do not
41sell or rent home medical equipment to their patients, or
42physicians who sell, rent, or supply to their patients equipment
43or devices in the physicians' offices.
44     Section 3.  Paragraph (a) of subsection (2) and subsections
45(6) and (7) of section 400.931, Florida Statutes, are amended to
46read:
47     400.931  Application for license; fee; provisional license;
48temporary permit.--
49     (2)  The applicant must file with the application
50satisfactory proof that the home medical equipment provider is
51in compliance with this part and applicable rules, including:
52     (a)  A report, by category, of the equipment to be
53provided, indicating those offered either directly by the
54applicant or through contractual arrangements with existing
55providers. Categories of equipment include:
56     1.  Respiratory modalities.
57     2.  Ambulation aids.
58     3.  Mobility aids.
59     4.  Sickroom setup.
60     5.  Disposables.
61     6.  Life-sustaining equipment.
62     7.  Technologically advanced equipment.
63     (6)  The home medical equipment provider must also obtain
64and maintain professional and commercial liability insurance.
65Proof of liability insurance, as defined in s. 624.605, must be
66submitted with the application. The agency shall set the
67required amounts of liability insurance by rule, but the
68required amount must not be less than $300,000 $250,000 per
69claim. In the case of contracted services, it is required that
70the contractor have liability insurance not less than $300,000
71$250,000 per claim.
72     (7)  A provisional license shall be issued to an approved
73applicant for initial licensure for a period of 90 days, during
74which time a survey must be conducted demonstrating substantial
75compliance with this section. A temporary provisional license
76shall also be issued pending the results of an applicant's
77Federal Bureau of Investigation report of background screening
78confirming that all standards have been met. If substantial
79compliance is demonstrated, a standard license shall be issued
80to expire 2 years after the effective date of the provisional
81license.
82     Section 4.  Subsection (2) of section 400.933, Florida
83Statutes, is amended, and subsection (3) is added to that
84section, to read:
85     400.933  Licensure inspections and investigations.--
86     (2)  The agency shall accept, in lieu of its own periodic
87inspections for licensure, submission of the following:
88     (a)  the survey or inspection of an accrediting
89organization, provided the accreditation of the licensed home
90medical equipment provider is not provisional and provided the
91licensed home medical equipment provider authorizes release of,
92and the agency receives the report of, the accrediting
93organization.; or
94     (b)  A copy of a valid medical oxygen retail establishment
95permit issued by the Department of Health, pursuant to chapter
96499.
97     (3)  In addition to any administrative fines imposed, the
98agency may assess a survey fee of $500 to cover the cost of
99conducting complaint investigations that result in the finding
100of a violation that was the subject of the compliant and any
101followup visits conducted to verify the correction of the
102violations found in complaints.
103     Section 5.  Subsections (3), (4), and (18) of section
104400.934, Florida Statutes, are amended, and subsection (20) is
105added to that section, to read:
106     400.934  Minimum standards.--As a requirement of licensure,
107home medical equipment providers shall:
108     (3)  Respond to orders received for other equipment by
109filling those orders from its own inventory or inventory from
110other companies with which it has contracted to fill such
111orders; or by customizing or fitting items for sale from
112supplies purchased under contract, except that high-tech medical
113equipment providers shall fill all orders for technologically
114advanced equipment directly from their own inventory and shall
115not contract with any entity for the delivery of such orders
116unless such entity is also licensed and accredited pursuant to
117this subsection.
118     (4)  Maintain trained personnel to coordinate order
119fulfillment and schedule timely equipment and service delivery.
120High-tech medical equipment providers shall have on staff, at a
121minimum, one licensed respiratory therapist, who is either a
122certified respiratory therapist (CRT), a registered respiratory
123therapist (RRT), or a registered nurse.
124     (18)  Maintain safe premises that are fully accessible to
125all patients between the hours of 9 a.m. and 5 p.m.
126     (20)  Provide consumers with after-hours emergency service
127appropriately staffed by personnel equipped to offer necessary
128services to the public. High-tech medical equipment providers
129shall have on call, at a minimum, one licensed respiratory
130therapist who is either a certified respiratory therapist (CRT),
131a registered respiratory therapist (RRT), or a registered nurse.
132     Section 6.  Subsections (11) and (12) are added to section
133400.935, Florida Statutes, to read:
134     400.935  Rules establishing minimum standards.--The agency
135shall adopt, publish, and enforce rules to implement this part,
136which must provide reasonable and fair minimum standards
137relating to:
138     (11)  The designation of equipment as life sustaining or
139technologically advanced.
140     (12)  The designation of appropriate accrediting
141organizations.
142     Section 7.  Section 400.936, Florida Statutes, is created
143to read:
144     400.936  Mandatory accreditation.--
145     (1)  Effective January 1, 2006, all home medical equipment
146providers licensed under this part shall submit to the agency
147proof of accreditation as a prerequisite for licensure or
148license renewal. Any provider that does not submit proof of
149accreditation shall be issued a temporary license and shall have
15060 days to submit proof of application to an accrediting
151organization. Such provider shall submit proof of accreditation
152within 180 days after submitting an application in order to
153receive a permanent license. Any home medical equipment provider
154licenses as of January 1, 2006, shall have a reasonable period
155of time, not to exceed its next licensure renewal date, to
156comply with the accreditation requirement. Applicants that
157submit proof of accreditation, a completed licensure
158application, and the required fee may receive a temporary
159license until completion of the review of accreditation.
160     (2)  The agency shall adopt rules designating appropriate
161accrediting organizations whose standards for accreditation are
162comparable to those required by this part for licensure.
163     Section 8.  Section 400.95, Florida Statutes, is amended to
164read:
165     400.95  Notice of toll-free telephone number for central
166fraud and abuse hotline.--On or before the first day home
167medical equipment is delivered to the patient's home, any home
168medical equipment provider licensed under this part must inform
169the consumer and his or her immediate family, if appropriate, of
170the right to report fraudulent, abusive, neglectful, or
171exploitative practices. The statewide toll-free telephone number
172for the central fraud and abuse hotline must be provided to
173consumers in a manner that is clearly legible and must include
174the words: "To report fraud, abuse, neglect, or exploitation,
175please call toll-free 1-800-962-2873." Home medical equipment
176providers shall establish appropriate policies and procedures
177for providing such notice to consumers.
178
179=========== T I T L E  A M E N D M E N T ===========
180     Remove line(s) 6 and insert:
181An act relating to health care; amending s. 400.925, F.S.;
182revising and providing definitions; amending s. 400.93,
183F.S.; providing that physicians who sell, rent, or supply
184equipment or devices to their patients are exempt from
185licensure as a home medical equipment provider; amending
186s. 400.931, F.S.; including additional categories of
187equipment in a report required by applicants for
188licensure; increasing the amount of liability insurance
189required of home medical equipment providers; amending s.
190400.933, F.S.; revising requirements for licensure and
191assessment of fees; amending s. 400.934, F.S.; revising
192minimum standards required for licensure; amending s.
193400.935, F.S.; requiring the Agency for Health Care
194Administration to provide additional regulatory standards
195by rule; creating s. 400.936, F.S.; requiring proof of
196accreditation as a prerequisite for licensure or license
197renewal; providing for temporary licensure; providing for
198rules relating to designation of accrediting
199organizations; amending s. 400.95, F.S.; providing for
200notice of a toll-free telephone number to report fraud and
201abuse by providers; amending s. 408.05,


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