| 1 | The Insurance Committee recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to surgical first assistance; creating s. |
| 7 | 458.3465, F.S.; providing procedures relating to certified |
| 8 | surgical first assistants; providing legislative intent; |
| 9 | providing definitions; establishing performance guidelines |
| 10 | for supervising physicians and certified surgical first |
| 11 | assistants; designating scope of section; establishing |
| 12 | liability of supervising physicians; amending s. 627.419, |
| 13 | F.S.; requiring certain payments to certified surgical |
| 14 | first assistants or their employers by health insurance |
| 15 | polices, health care services plans, or other contracts; |
| 16 | providing limitations; amending s. 641.30, F.S.; requiring |
| 17 | certain payments to certified surgical first assistants or |
| 18 | their employers by health maintenance organizations; |
| 19 | providing limitations; providing an effective date. |
| 20 |
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| 21 | Be It Enacted by the Legislature of the State of Florida: |
| 22 |
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| 23 | Section 1. Section 458.3465, Florida Statutes, is created |
| 24 | to read: |
| 25 | 458.3465 Certified surgical first assistants.-- |
| 26 | (1) LEGISLATIVE INTENT.--The purposes of this section are |
| 27 | to: |
| 28 | (a) Encourage the use of certified surgical first |
| 29 | assistants who meet the qualifications of this section by |
| 30 | physicians and hospitals to provide quality, cost-effective |
| 31 | surgical intervention to health care recipients in the state. |
| 32 | (b) Provide for the reimbursement for the certified |
| 33 | surgical first assistants from insurers and health maintenance |
| 34 | organizations. |
| 35 | (2) DEFINITIONS.--As used in this section: |
| 36 | (a) "Certified surgical first assistant" means a person |
| 37 | who, under the direct supervision of a physician, assists that |
| 38 | physician or group of physicians in exposure, hemostasis, |
| 39 | closures, and other intraoperative technical functions during a |
| 40 | surgical procedure, is listed in the operative record as the |
| 41 | first assistant, and holds and maintains a certification from |
| 42 | one of the following recognized certifying agencies: |
| 43 | 1. The Liaison Council on Certification for the Surgical |
| 44 | Technologist; |
| 45 | 2. The National Surgical Assistant Association; or |
| 46 | 3. The American Board of Surgical Assistants. |
| 47 | (b) "Direct supervision" means supervision by a delegating |
| 48 | physician who is physically present and who personally directs |
| 49 | delegated acts and remains immediately available to personally |
| 50 | respond to any emergency until the patient is released from the |
| 51 | operating room or the physician's care and has been transferred |
| 52 | to the care and responsibility of another physician. |
| 53 | (3) PERFORMANCE OF SUPERVISING PHYSICIAN.--Each physician |
| 54 | or group of physicians supervising a certified surgical first |
| 55 | assistant shall be qualified in the medical areas in which the |
| 56 | certified surgical first assistant is to perform and may be |
| 57 | individually or collectively responsible and liable for the |
| 58 | performance and the acts and omissions of the certified surgical |
| 59 | first assistant. |
| 60 | (4) PERFORMANCE OF CERTIFIED SURGICAL FIRST ASSISTANTS.-- |
| 61 | (a) A certified surgical first assistant may perform |
| 62 | duties limited to the scope of certification in surgical |
| 63 | assisting functions while under the direct supervision of a |
| 64 | physician. |
| 65 | (b) The scope of practice of a certified surgical first |
| 66 | assistant is limited to surgical assisting and tasks delegated |
| 67 | by the supervising physician. |
| 68 | (c) A certified surgical first assistant may only perform |
| 69 | his or her duties in a hospital or ambulatory surgical center |
| 70 | licensed under chapter 395. |
| 71 | (5) SCOPE.--The provisions of this section shall have no |
| 72 | application to other duly licensed health care practitioners |
| 73 | acting within their scope of practice authorized by statute. |
| 74 | (6) LIABILITY.--Each supervising physician using a |
| 75 | certified surgical first assistant may be liable for any acts or |
| 76 | omissions of the certified surgical first assistants acting |
| 77 | under the physician's supervision and control. |
| 78 | Section 2. Subsection (10) is added to section 627.419, |
| 79 | Florida Statutes, to read: |
| 80 | 627.419 Construction of policies.-- |
| 81 | (10) Notwithstanding any other provision of law, when any |
| 82 | health insurance policy, health care services plan, or other |
| 83 | contract provides for payment for surgical first assisting |
| 84 | benefits or services, the policy, plan, or contract is to be |
| 85 | construed as providing for payment to a certified surgical first |
| 86 | assistant as defined in s. 458.3465 or to employers of a |
| 87 | certified surgical first assistant who performs such services |
| 88 | that are within the scope of practice of a certified surgical |
| 89 | first assistant as set forth in s. 458.3465(4). The provisions |
| 90 | of this subsection apply only if reimbursement for an assisting |
| 91 | physician, licensed under chapter 458 or chapter 459, would be |
| 92 | covered and a certified surgical first assistant who performs |
| 93 | such services is used as a substitute for the assisting |
| 94 | physician. This subsection does not require an insurer to |
| 95 | directly reimburse a certified surgical first assistant if the |
| 96 | certified surgical first assistant is paid or will be paid for a |
| 97 | surgical procedure by a health care facility or surgeon. |
| 98 | Section 3. Subsection (6) is added to section 641.30, |
| 99 | Florida Statutes, to read: |
| 100 | 641.30 Construction and relationship to other laws.-- |
| 101 | (6) Notwithstanding any other provision of law, when any |
| 102 | health maintenance contract provides for payment of surgical |
| 103 | first assisting benefits or services, the contract is to be |
| 104 | construed as providing for payment to a certified surgical first |
| 105 | assistant as defined in s. 458.3465 or to employers of a |
| 106 | certified surgical first assistant who performs such services |
| 107 | that are within the scope of practice of a certified surgical |
| 108 | first assistant as set forth in s. 458.3465(4). The provisions |
| 109 | of this subsection apply only if reimbursement for an assisting |
| 110 | physician, licensed under chapter 458 or chapter 459, would be |
| 111 | covered and a certified surgical first assistant who performs |
| 112 | such services is used as a substitute for the assisting |
| 113 | physician. This subsection does not require a health maintenance |
| 114 | organization to directly reimburse a certified surgical first |
| 115 | assistant if the certified surgical first assistant is paid or |
| 116 | will be paid for a surgical procedure by a health care facility |
| 117 | or surgeon. |
| 118 | Section 4. This act shall take effect July 1, 2006. |