HB 0697

1	A bill to be entitled
2	An act relating to health care price disclosure; amending
3	s. 395.301, F.S.; requiring certain licensed facilities to
4	provide prospective patients certain information relating
5	to billing and collection policies; requiring notice of
6	certain interest charged and its rate and of the right to
7	appeal charges; requiring facilities to provide certain
8	information relating to alternative treatments;
9	prohibiting facilities from requiring a patient to sign a
10	form requiring certain payments or waiving right to
11	appeal; providing circumstances in which additional
12	itemized charges may be imposed; requiring provision of
13	certain records to a designee of the patient within a
14	specified period of time, under certain circumstances;
15	requiring facilities to establish an appeal methodology;
16	requiring facilities to provide public Internet access to
17	certain information; providing an effective date.
18
19	Be It Enacted by the Legislature of the State of Florida:
20
21	Section 1.  Section 395.301, Florida Statutes, is amended
22	to read:
23	395.301  Itemized patient bill; form and content prescribed
24	by the agency.--
25	(1)  A licensed facility not operated by the state shall
26	notify each patient prior to during admission and at discharge
27	of his or her right to receive an itemized bill and a copy of
28	the facility's billing and collection policies upon request.
29	Within 7 days following the patient's discharge or release from
30	a licensed facility not operated by the state, the licensed
31	facility providing the service shall, upon request, submit to
32	the patient, or to the patient's survivor or legal guardian as
33	may be appropriate, an itemized statement detailing in language
34	comprehensible to an ordinary layperson the specific nature of
35	charges or expenses incurred by the patient, which in the
36	initial billing shall contain a statement of specific services
37	received and expenses incurred for such items of service,
38	enumerating in detail the constituent components of the services
39	received within each department of the licensed facility and
40	including unit price data on rates charged by the licensed
41	facility, as prescribed by the agency.
42	(2)(a)  Each such statement submitted pursuant to this
43	section:
44	1.  May not include charges of hospital-based physicians if
45	billed separately.
46	2.  May not include any generalized category of expenses
47	such as "other" or "miscellaneous" or similar categories.
48	3.  Shall list drugs by brand or generic name and not refer
49	to drug code numbers when referring to drugs of any sort.
50	4.  Shall specifically identify therapy treatment as to the
51	date, type, and length of treatment when therapy treatment is a
52	part of the statement.
53	5.  Shall conspicuously display a notice of the right of a
54	patient or designee to appeal any of the charges itemized in the
55	patient's bill, and whether interest will be charged on the
56	amount not covered by a third-party payor, and the interest rate
57	charged, if applicable.
58	(b)  Any person receiving a statement pursuant to this
59	section shall be fully and accurately informed as to each charge
60	and service provided by the institution preparing the statement.
61	(3)  On each itemized statement submitted pursuant to
62	subsection (1) there shall appear the words "A FOR-PROFIT (or
63	NOT-FOR-PROFIT or PUBLIC) HOSPITAL (or AMBULATORY SURGICAL
64	CENTER) LICENSED BY THE STATE OF FLORIDA" or substantially
65	similar words sufficient to identify clearly and plainly the
66	ownership status of the licensed facility. Each itemized
67	statement must prominently display the phone number of the
68	medical facility's patient liaison who is responsible for
69	expediting the resolution of any billing dispute between the
70	patient, or his or her representative, and the billing
71	department.
72	(4)  An itemized bill shall be provided once to the
73	patient's physician at the physician's request, at no charge.
74	(5)  In any billing for services subsequent to the initial
75	billing for such services, the patient, or the patient's
76	survivor or legal guardian, may elect, at his or her option, to
77	receive a copy of the detailed statement of specific services
78	received and expenses incurred for each such item of service as
79	provided in subsection (1).
80	(6)  No physician, dentist, podiatric physician, or
81	licensed facility may add to the price charged by any third
82	party except for a service or handling charge representing a
83	cost actually incurred as an item of expense; however, the
84	physician, dentist, podiatric physician, or licensed facility is
85	entitled to fair compensation for all professional services
86	rendered. The amount of the service or handling charge, if any,
87	shall be set forth clearly in the bill to the patient.
88	(7)  Each licensed facility not operated by the state shall
89	provide, prior to provision of any nonemergency medical
90	services, a written good faith estimate of reasonably
91	anticipated charges for the facility to treat the patient's
92	condition upon written request of a prospective patient. A
93	licensed facility shall also provide information relating to
94	alternative treatments for the medical condition, including, but
95	not limited to, outpatient services or drug therapies, that the
96	patient may want to discuss with his or her physician. The
97	estimate shall be provided to the prospective patient within 7
98	business days after the receipt of the request. The estimate may
99	be the average charges for that diagnosis related group or the
100	average charges for that procedure. Upon request, The facility
101	shall notify the patient of any revision to the good faith
102	estimate. Such estimate shall not preclude the actual charges
103	from exceeding the estimate. The facility shall place a notice
104	in the reception area that such information is available.
105	Failure to provide the estimate within the provisions
106	established pursuant to this section shall result in a fine of
107	$500 for each instance of the facility's failure to provide the
108	requested information.
109	(8)(a)  A licensed facility shall not, as a condition of
110	admission or the provision of service, require a patient to sign
111	any form that requires the patient to make an unspecified or
112	unlimited financial payment to the facility or to waive the
113	patient's right to appeal charges billed.
114	(b)  In the event of any unanticipated complications, a
115	licensed facility may charge the patient for additional
116	treatment, services, or supplies rendered in connection with the
117	complication and such charges must be itemized on the patient's
118	bill.
119	(9)(8)  A licensed facility shall make available to a
120	patient or designee all records necessary for verification of
121	the accuracy of the patient's bill within 30 business days after
122	the request for such records. The verification information must
123	be made available in the facility's offices. Such records shall
124	be available to the patient or designee prior to and after
125	payment of the bill or claim. The facility may not charge the
126	patient or designee for making such verification records
127	available; however, the facility may charge its usual fee for
128	providing copies of records as specified in s. 395.3025.
129	(10)(9)  Each licensed facility shall establish a method
130	for the patient to appeal any charge on the patient's bill. Each
131	facility shall establish a method for reviewing and responding
132	to an appeal submitted by a patient questions from patients
133	concerning the patient's itemized bill that includes:.
134	(a)  Review by an individual who was not involved in the
135	initial billing.
136	(b)  A written decision with a clear explanation of the
137	grounds for the decision which shall be provided to the patient
138	who made the appeal Such response shall be provided within 30
139	days after the date an appeal a question is received. If the
140	patient is not satisfied with the decision response, the
141	facility must provide the patient with the address of the agency
142	to which the issue may be sent for review.
143	(11)(10)  Each licensed facility shall make available on
144	its Internet website a link to the performance outcome and
145	financial data that is published by the Agency for Health Care
146	Administration pursuant to s. 408.05(3)(l) and a copy of the
147	facility's billing and collection policies. The facility shall
148	place a notice in the reception area indicating that the
149	information is available electronically and the facility's
150	Internet website address.
151	Section 2.  This act shall take effect July 1, 2005.

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