HB 7073

1	A bill to be entitled
2	An act relating to health care information; providing a
3	short title; providing purpose; amending s. 408.05, F.S.;
4	renaming the State Center for Health Statistics; revising
5	criteria for collection and use of certain health-related
6	data; providing responsibilities of the Agency for Health
7	Care Administration; providing for agency consultation
8	with the State Consumer Health Information and Policy
9	Advisory Council for the dissemination of certain consumer
10	information; requiring the Florida Center for Health
11	Information and Policy Analysis to provide certain
12	technical assistance services; authorizing the agency to
13	monitor certain grants; removing a provision that
14	establishes the Comprehensive Health Information System
15	Trust Fund as the repository of certain funds; renaming
16	the State Comprehensive Health Information System Advisory
17	Council; providing for duties and responsibilities of the
18	State Consumer Health Information and Policy Advisory
19	Council; providing for membership, terms, officers, and
20	meetings; amending s. 408.061, F.S.; providing for health
21	care providers to submit additional data to the agency;
22	correcting a reference; amending s. 408.062, F.S.;
23	revising provisions relating to availability of specified
24	information on the agency's Internet website; requiring a
25	report; removing an obsolete provision; authorizing the
26	agency to develop an electronic health information
27	network; amending ss. 20.42, 381.001, 395.602, 395.6025,
28	408.07, and 408.18, F.S.; conforming references to changes
29	made by the act; amending ss. 381.026, 395.301, 627.6499,
30	and 641.54, F.S.; conforming a cross-reference; amending
31	s. 465.0244, F.S.; conforming a cross-reference; providing
32	responsibility of the Agency for Health Care
33	Administration for security of certain data and backup
34	systems; providing requirements for a secure storage
35	facility; providing an effective date.
36
37	Be It Enacted by the Legislature of the State of Florida:
38
39	Section 1.  This act may be cited as the "Coordinated
40	Health Care Information and Transparency Act of 2006."
41	Section 2.  The purpose of this act is to provide better
42	coordination of health information for purposes of public
43	health, policy analysis, and transparency of consumer health
44	care information.
45	Section 3.  Section 408.05, Florida Statutes, is amended to
46	read:
47	408.05  Florida State Center for Health Information and
48	Policy Analysis Statistics.--
49	(1)  ESTABLISHMENT.--The agency shall establish a Florida
50	State Center for Health Information and Policy Analysis
51	Statistics. The center shall establish a comprehensive health
52	information system to provide for the collection, compilation,
53	coordination, analysis, indexing, dissemination, and utilization
54	of both purposefully collected and extant health-related data
55	and statistics. The center shall be staffed with public health
56	experts, biostatisticians, information system analysts, health
57	policy experts, economists, and other staff necessary to carry
58	out its functions.
59	(2)  HEALTH-RELATED DATA STATISTICS.--The comprehensive
60	health information system operated by the Florida State Center
61	for Health Information and Policy Analysis Statistics shall
62	identify the best available data sources and coordinate the
63	compilation of extant health-related data and statistics and
64	purposefully collect data on:
65	(a)  The extent and nature of illness and disability of the
66	state population, including life expectancy, the incidence of
67	various acute and chronic illnesses, and infant and maternal
68	morbidity and mortality.
69	(b)  The impact of illness and disability of the state
70	population on the state economy and on other aspects of the
71	well-being of the people in this state.
72	(c)  Environmental, social, and other health hazards.
73	(d)  Health knowledge and practices of the people in this
74	state and determinants of health and nutritional practices and
75	status.
76	(e)  Health resources, including physicians, dentists,
77	nurses, and other health professionals, by specialty and type of
78	practice and acute, long-term care and other institutional care
79	facility supplies and specific services provided by hospitals,
80	nursing homes, home health agencies, and other health care
81	facilities.
82	(f)  Utilization of health care by type of provider.
83	(g)  Health care costs and financing, including trends in
84	health care prices and costs, the sources of payment for health
85	care services, and federal, state, and local expenditures for
86	health care.
87	(h)  Family formation, growth, and dissolution.
88	(i)  The extent of public and private health insurance
89	coverage in this state.
90	(j)  The quality of care provided by various health care
91	providers.
92	(3)  COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order to
93	produce comparable and uniform health information and statistics
94	for the development of policy recommendations, the agency shall
95	perform the following functions:
96	(a)  Coordinate the activities of state agencies involved
97	in the design and implementation of the comprehensive health
98	information system.
99	(b)  Undertake research, development, and evaluation
100	respecting the comprehensive health information system.
101	(c)  Review the statistical activities of state agencies to
102	ensure the Department of Health to assure that they are
103	consistent with the comprehensive health information system.
104	(d)  Develop written agreements with local, state, and
105	federal agencies for the sharing of health-care-related data or
106	using the facilities and services of such agencies. State
107	agencies, local health councils, and other agencies under state
108	contract with the Department of Health shall assist the center
109	in obtaining, compiling, and transferring health-care-related
110	data maintained by state and local agencies. Written agreements
111	must specify the types, methods, and periodicity of data
112	exchanges and specify the types of data that will be transferred
113	to the center.
114	(e)  The agency shall Establish by rule the types of data
115	collected, compiled, processed, used, or shared. Decisions
116	regarding center data sets should be made based on consultation
117	with the State Consumer Comprehensive Health Information and
118	Policy System Advisory Council and other public and private
119	users regarding the types of data which should be collected and
120	their uses.
121	(f)  The center shall establish standardized means for
122	collecting health information and statistics under laws and
123	rules administered by the agency.
124	(f)(g)  Establish minimum health-care-related data sets
125	which are necessary on a continuing basis to fulfill the
126	collection requirements of the center and which shall be used by
127	state agencies in collecting and compiling health-care-related
128	data. The agency shall periodically review ongoing health care
129	data collections of the Department of Health and other state
130	agencies to determine if the collections are being conducted in
131	accordance with the established minimum sets of data.
132	(g)(h)  Establish advisory standards to ensure assure the
133	quality of health statistical and epidemiological data
134	collection, processing, and analysis by local, state, and
135	private organizations.
136	(h)(i)  Prescribe standards for the publication of health-
137	care-related data reported pursuant to this section which ensure
138	the reporting of accurate, valid, reliable, complete, and
139	comparable data. Such standards should include advisory warnings
140	to users of the data regarding the status and quality of any
141	data reported by or available from the center.
142	(i)(j)  Prescribe standards for the maintenance and
143	preservation of the center's data. This should include methods
144	for archiving data, retrieval of archived data, and data editing
145	and verification.
146	(j)(k)  Ensure that strict quality control measures are
147	maintained for the dissemination of data through publications,
148	studies, or user requests.
149	(k)(l)  Develop, in conjunction with the State Consumer
150	Comprehensive Health Information and Policy System Advisory
151	Council, and implement a long-range plan for making available
152	health care quality measures performance outcome and financial
153	data that will allow consumers to compare health care services.
154	The health care quality measures performance outcomes and
155	financial data the agency must make available shall include, but
156	is not limited to, pharmaceuticals, physicians, health care
157	facilities, and health plans and managed care entities. The
158	agency shall submit the initial plan to the Governor, the
159	President of the Senate, and the Speaker of the House of
160	Representatives by January 1, 2006, and shall update the plan
161	and report on the status of its implementation annually
162	thereafter. The agency shall also make the plan and status
163	report available to the public on its Internet website. As part
164	of the plan, the agency shall identify the process and
165	timeframes for implementation, any barriers to implementation,
166	and recommendations of changes in the law that may be enacted by
167	the Legislature to eliminate the barriers. As preliminary
168	elements of the plan, the agency shall:
169	1.  Make available patient-safety indicators, inpatient
170	quality indicators, and performance outcome and patient charge
171	data collected from health care facilities pursuant to s.
172	408.061(1)(a) and (2). The terms "patient-safety indicators" and
173	"inpatient quality indicators" shall be as defined by the
174	Centers for Medicare and Medicaid Services, the National Quality
175	Forum, the Joint Commission on Accreditation of Healthcare
176	Organizations, the Agency for Healthcare Research and Quality,
177	the Centers for Disease Control and Prevention, or a similar
178	national entity that establishes standards to measure the
179	performance of health care providers, or by other states. The
180	agency shall determine which conditions, and procedures, health
181	care quality measures performance outcomes, and patient charge
182	data to disclose based upon input from the council. When
183	determining which conditions and procedures are to be disclosed,
184	the council and the agency shall consider variation in costs,
185	variation in outcomes, and magnitude of variations and other
186	relevant information. When determining which health care quality
187	measures performance outcomes to disclose, the agency:
188	a.  Shall consider such factors as volume of cases; average
189	patient charges; average length of stay; complication rates;
190	mortality rates; and infection rates, among others, which shall
191	be adjusted for case mix and severity, if applicable.
192	b.  May consider such additional measures that are adopted
193	by the Centers for Medicare and Medicaid Studies, National
194	Quality Forum, the Joint Commission on Accreditation of
195	Healthcare Organizations, the Agency for Healthcare Research and
196	Quality, Centers for Disease Control and Prevention, or a
197	similar national entity that establishes standards to measure
198	the performance of health care providers, or by other states.
199
200	When determining which patient charge data to disclose, the
201	agency shall consider such measures as average charge, average
202	net revenue per adjusted patient day, average cost per adjusted
203	patient day, and average cost per admission, among others.
204	2.  Make available performance measures, benefit design,
205	and premium cost data from health plans licensed pursuant to
206	chapter 627 or chapter 641. The agency shall determine which
207	health care quality measures performance outcome and member and
208	subscriber cost data to disclose, based upon input from the
209	council. When determining which data to disclose, the agency
210	shall consider information that may be required by either
211	individual or group purchasers to assess the value of the
212	product, which may include membership satisfaction, quality of
213	care, current enrollment or membership, coverage areas,
214	accreditation status, premium costs, plan costs, premium
215	increases, range of benefits, copayments and deductibles,
216	accuracy and speed of claims payment, credentials of physicians,
217	number of providers, names of network providers, and hospitals
218	in the network. Health plans shall make available to the agency
219	any such data or information that is not currently reported to
220	the agency or the office.
221	3.  Determine the method and format for public disclosure
222	of data reported pursuant to this paragraph. The agency shall
223	make its determination based upon input from the State Consumer
224	Comprehensive Health Information and Policy System Advisory
225	Council. At a minimum, the data shall be made available on the
226	agency's Internet website in a manner that allows consumers to
227	conduct an interactive search that allows them to view and
228	compare the information for specific providers. The website must
229	include such additional information as is determined necessary
230	to ensure that the website enhances informed decisionmaking
231	among consumers and health care purchasers, which shall include,
232	at a minimum, appropriate guidance on how to use the data and an
233	explanation of why the data may vary from provider to provider.
234	The data specified in subparagraph 1. shall be released no later
235	than January 1, 2006, for the reporting of infection rates, and
236	no later than October 1, 2005, for mortality rates and
237	complication rates. The data specified in subparagraph 2. shall
238	be released no later than October 1, 2006.
239	(4)  TECHNICAL ASSISTANCE.--
240	(a)  The center shall provide technical assistance to
241	persons or organizations engaged in health planning activities
242	in the effective use of statistics collected and compiled by the
243	center. The center shall also provide the following additional
244	technical assistance services:
245	1.(a)  Establish procedures identifying the circumstances
246	under which, the places at which, the persons from whom, and the
247	methods by which a person may secure data from the center,
248	including procedures governing requests, the ordering of
249	requests, timeframes for handling requests, and other procedures
250	necessary to facilitate the use of the center's data. To the
251	extent possible, the center should provide current data timely
252	in response to requests from public or private agencies.
253	2.(b)  Provide assistance to data sources and users in the
254	areas of database design, survey design, sampling procedures,
255	statistical interpretation, and data access to promote improved
256	health-care-related data sets.
257	3.(c)  Identify health care data gaps and provide technical
258	assistance to seek cooperative agreements with other public or
259	private organizations for meeting documented health care data
260	needs.
261	4.(d)  Assist other organizations in developing statistical
262	abstracts of their data sets that could be used by the center.
263	5.(e)  Provide statistical support to state agencies with
264	regard to the use of databases maintained by the center.
265	6.(f)  To the extent possible, respond to multiple requests
266	for information not currently collected by the center or
267	available from other sources by initiating data collection.
268	7.(g)  Maintain detailed information on data maintained by
269	other local, state, federal, and private agencies in order to
270	advise those who use the center of potential sources of data
271	which are requested but which are not available from the center.
272	8.(h)  Respond to requests for data which are not available
273	in published form by initiating special computer runs on data
274	sets available to the center.
275	9.  Monitor innovations in health information technology,
276	informatics, and the exchange of health information and maintain
277	a repository of technical resources to support the development
278	of a health information network.
279	(b)  The agency shall administer, manage, and monitor
280	grants to not-for-profit organizations, regional health
281	information organizations, public health departments, or state
282	agencies that submit proposals for planning, implementation, or
283	training projects to advance the development of a health
284	information network. Any grant contract shall be evaluated to
285	ensure the effective outcome of the health information project.
286	(c)  The agency shall initiate, oversee, manage, and
287	evaluate the integration of health care data from each state
288	agency that collects, stores, and reports on health care issues
289	and make that data available to any health care practitioner
290	through a state health information network.
291	(5)  PUBLICATIONS; REPORTS; SPECIAL STUDIES.--The center
292	shall provide for the widespread dissemination of data which it
293	collects and analyzes. The center shall have the following
294	publication, reporting, and special study functions:
295	(a)  The center shall publish and make available
296	periodically to agencies and individuals health statistics
297	publications of general interest, including health plan consumer
298	reports and health maintenance organization member satisfaction
299	surveys HMO report cards; publications providing health
300	statistics on topical health policy issues; publications that
301	provide health status profiles of the people in this state; and
302	other topical health statistics publications.
303	(b)  The center shall publish, make available, and
304	disseminate, promptly and as widely as practicable, the results
305	of special health surveys, health care research, and health care
306	evaluations conducted or supported under this section. Any
307	publication by the center must include a statement of the
308	limitations on the quality, accuracy, and completeness of the
309	data.
310	(c)  The center shall provide indexing, abstracting,
311	translation, publication, and other services leading to a more
312	effective and timely dissemination of health care statistics.
313	(d)  The center shall be responsible for publishing and
314	disseminating an annual report on the center's activities.
315	(e)  The center shall be responsible, to the extent
316	resources are available, for conducting a variety of special
317	studies and surveys to expand the health care information and
318	statistics available for health policy analyses, particularly
319	for the review of public policy issues. The center shall develop
320	a process by which users of the center's data are periodically
321	surveyed regarding critical data needs and the results of the
322	survey considered in determining which special surveys or
323	studies will be conducted. The center shall select problems in
324	health care for research, policy analyses, or special data
325	collections on the basis of their local, regional, or state
326	importance; the unique potential for definitive research on the
327	problem; and opportunities for application of the study
328	findings.
329	(6)  PROVIDER DATA REPORTING.--This section does not confer
330	on the agency the power to demand or require that a health care
331	provider or professional furnish information, records of
332	interviews, written reports, statements, notes, memoranda, or
333	data other than as expressly required by law.
334	(7)  BUDGET; FEES; TRUST FUND.--
335	(a)  The Legislature intends that funding for the Florida
336	State Center for Health Information and Policy Analysis
337	Statistics be appropriated from the General Revenue Fund.
338	(b)  The Florida State Center for Health Information and
339	Policy Analysis Statistics may apply for and receive and accept
340	grants, gifts, and other payments, including property and
341	services, from any governmental or other public or private
342	entity or person and make arrangements as to the use of same,
343	including the undertaking of special studies and other projects
344	relating to health-care-related topics. Funds obtained pursuant
345	to this paragraph may not be used to offset annual
346	appropriations from the General Revenue Fund.
347	(c)  The center may charge such reasonable fees for
348	services as the agency prescribes by rule. The established fees
349	may not exceed the reasonable cost for such services. Fees
350	collected may not be used to offset annual appropriations from
351	the General Revenue Fund.
352	(d)  The agency shall establish a Comprehensive Health
353	Information System Trust Fund as the repository of all funds
354	appropriated to, and fees and grants collected for, services of
355	the State Center for Health Statistics. Any funds, other than
356	funds appropriated to the center from the General Revenue Fund,
357	which are raised or collected by the agency for the operation of
358	the center and which are not needed to meet the expenses of the
359	center for its current fiscal year shall be available to the
360	agency in succeeding years.
361	(8)  STATE CONSUMER COMPREHENSIVE HEALTH INFORMATION AND
362	POLICY SYSTEM ADVISORY COUNCIL.--
363	(a)  There is established in the agency the State Consumer
364	Comprehensive Health Information and Policy System Advisory
365	Council to assist the center in reviewing the comprehensive
366	health information system, including the identification,
367	collection, standardization, sharing, and coordination of
368	health-related data, fraud and abuse data, and professional and
369	facility licensing data among federal, state, local, and private
370	entities and to recommend improvements for purposes of public
371	health, policy analysis, and transparency of consumer health
372	care information such system. The council shall consist of the
373	following members:
374	1.  An employee of the Executive Office of the Governor, to
375	be appointed by the Governor.
376	2.  An employee of the Office of Insurance Regulation, to
377	be appointed by the director of the office.
378	3.  An employee of the Department of Education, to be
379	appointed by the Commissioner of Education.
380	4.  Ten persons, to be appointed by the Secretary of Health
381	Care Administration, representing other state and local
382	agencies, state universities, business and health the Florida
383	Association of Business/Health coalitions, local health
384	councils, professional health-care-related associations,
385	consumers, and purchasers.
386	(b)  Each member of the council shall be appointed to serve
387	for a term of 2 4 years following from the date of appointment,
388	except the term of appointment shall end 3 years following the
389	date of appointment for members appointed in 2003, 2004, and
390	2005. that A vacancy shall be filled by appointment for the
391	remainder of the term, and each appointing authority retains the
392	right to reappoint members whose terms of appointment have
393	expired. and except that:
394	1.  Three of the members initially appointed by the
395	Director of Health Care Administration shall each be appointed
396	for a term of 3 years.
397	2.  Two of the members initially appointed by the Director
398	of Health Care Administration shall each be appointed for a term
399	of 2 years.
400	3.  Two of the members initially appointed by the Director
401	of Health Care Administration shall each be appointed for a term
402	of 1 year.
403	(c)  The council may meet at the call of its chair, at the
404	request of the agency department, or at the request of a
405	majority of its membership, but the council must meet at least
406	quarterly.
407	(d)  Members shall elect a chair and vice chair annually.
408	(e)  A majority of the members constitutes a quorum, and
409	the affirmative vote of a majority of a quorum is necessary to
410	take action.
411	(f)  The council shall maintain minutes of each meeting and
412	shall make such minutes available to any person.
413	(g)  Members of the council shall serve without
414	compensation but shall be entitled to receive reimbursement for
415	per diem and travel expenses as provided in s. 112.061.
416	(h)  The council's duties and responsibilities include, but
417	are not limited to, the following:
418	1.  To develop a mission statement, goals, and a plan of
419	action based on the guiding principles specified in s. 282.3032
420	for the identification, collection, standardization, sharing,
421	and coordination of health-related data across federal, state,
422	and local government and private-sector entities.
423	2.  To develop a review process to ensure cooperative
424	planning among agencies that collect or maintain health-related
425	data.
426	3.  To create ad hoc issue-oriented technical workgroups on
427	an as-needed basis to make recommendations to the council.
428	(9)  APPLICATION TO OTHER AGENCIES.--Nothing in this
429	section shall limit, restrict, affect, or control the
430	collection, analysis, release, or publication of data by any
431	state agency pursuant to its statutory authority, duties, or
432	responsibilities.
433	Section 4.  Paragraph (b) of subsection (1) and subsection
434	(10) of section 408.061, Florida Statutes, are amended to read:
435	408.061  Data collection; uniform systems of financial
436	reporting; information relating to physician charges;
437	confidential information; immunity.--
438	(1)  The agency shall require the submission by health care
439	facilities, health care providers, and health insurers of data
440	necessary to carry out the agency's duties. Specifications for
441	data to be collected under this section shall be developed by
442	the agency with the assistance of technical advisory panels
443	including representatives of affected entities, consumers,
444	purchasers, and such other interested parties as may be
445	determined by the agency.
446	(b)  Data to be submitted by health care providers may
447	include, but are not limited to: professional organization and
448	specialty board affiliations, Medicare and Medicaid
449	participation, types of services offered to patients, amount of
450	revenue and expenses of the health care provider, and such other
451	data which are reasonably necessary to study utilization
452	patterns. Data submitted shall be certified by the appropriate
453	duly authorized representative or employee of the health care
454	provider that the information submitted is true and accurate.
455	(10)  The agency shall be the primary source for collection
456	and dissemination of health care data. No other agency of state
457	government may gather data from a health care provider licensed
458	or regulated under this chapter without first determining if the
459	data is currently being collected by the agency and
460	affirmatively demonstrating that it would be more cost-effective
461	for an agency of state government other than the agency to
462	gather the health care data. The secretary director shall ensure
463	that health care data collected by the divisions within the
464	agency is coordinated. It is the express intent of the
465	Legislature that all health care data be collected by a single
466	source within the agency and that other divisions within the
467	agency, and all other agencies of state government, obtain data
468	for analysis, regulation, and public dissemination purposes from
469	that single source. Confidential information may be released to
470	other governmental entities or to parties contracting with the
471	agency to perform agency duties or functions as needed in
472	connection with the performance of the duties of the receiving
473	entity. The receiving entity or party shall retain the
474	confidentiality of such information as provided for herein.
475	Section 5.  Paragraphs (h) and (j) of subsection (1) and
476	subsections (2) and (5) of section 408.062, Florida Statutes,
477	are amended to read:
478	408.062  Research, analyses, studies, and reports.--
479	(1)  The agency shall conduct research, analyses, and
480	studies relating to health care costs and access to and quality
481	of health care services as access and quality are affected by
482	changes in health care costs. Such research, analyses, and
483	studies shall include, but not be limited to:
484	(h)  The collection of a statistically valid sample of data
485	on the retail prices charged by pharmacies for the 100 50 most
486	frequently prescribed medicines from any pharmacy licensed by
487	this state as a special study authorized by the Legislature to
488	be performed by the agency quarterly. If the drug is available
489	generically, price data shall be reported for the generic drug
490	and price data of a brand-named drug for which the generic drug
491	is the equivalent shall be reported. The agency shall make
492	available on its Internet website for each pharmacy, no later
493	than October 1, 2006 2005, drug prices for a 30-day supply at a
494	standard dose. The data collected shall be reported for each
495	drug by pharmacy and by metropolitan statistical area or region
496	and updated quarterly.
497	(j)  The making available on its Internet website beginning
498	no later than October 1, 2004, and in a hard-copy format upon
499	request, of patient charge, volumes, length of stay, and
500	performance outcome indicators collected from health care
501	facilities pursuant to s. 408.061(1)(a) for specific medical
502	conditions, surgeries, and procedures provided in inpatient and
503	outpatient facilities as determined by the agency. In making the
504	determination of specific medical conditions, surgeries, and
505	procedures to include, the agency shall consider such factors as
506	volume, severity of the illness, urgency of admission,
507	individual and societal costs, and whether the condition is
508	acute or chronic. Performance outcome indicators shall be risk
509	adjusted or severity adjusted, as applicable, using nationally
510	recognized risk adjustment methodologies or software consistent
511	with the standards of the Agency for Healthcare Research and
512	Quality and as selected by the agency. The website shall also
513	provide an interactive search that allows consumers to view and
514	compare the information for specific facilities, a map that
515	allows consumers to select a county or region, definitions of
516	all of the data, descriptions of each procedure, and an
517	explanation about why the data may differ from facility to
518	facility. Such public data shall be updated quarterly. The
519	agency shall submit an annual status report on the collection of
520	data and publication of health care quality measures performance
521	outcome indicators to the Governor, the Speaker of the House of
522	Representatives, the President of the Senate, and the
523	substantive legislative committees with the first status report
524	due January 1, 2005.
525	(2)  The agency may assess annually the caesarean section
526	rate in Florida hospitals using the analysis methodology that
527	the agency determines most appropriate. The data from this
528	assessment shall be published periodically on the agency's
529	Internet website. To assist the agency in determining the impact
530	of this chapter on Florida hospitals' caesarean section rates,
531	each provider hospital, as defined in s. 383.336, shall notify
532	the agency of the date of implementation of the practice
533	parameters and the date of the first meeting of the hospital
534	peer review board created pursuant to this chapter. The agency
535	shall use these dates in monitoring any change in provider
536	hospital caesarean section rates. An annual report based on this
537	monitoring and assessment shall be submitted to the Governor,
538	the Speaker of the House of Representatives, and the President
539	of the Senate by the agency, with the first annual report due
540	January 1, 1993.
541	(5)  The agency shall develop and implement a strategy for
542	the adoption and use of electronic health records, including the
543	development of an electronic health information network for the
544	sharing of electronic health records among health care
545	facilities, health care providers, and health insurers. The
546	agency may develop rules to facilitate the functionality and
547	protect the confidentiality of electronic health records. The
548	agency shall report to the Governor, the Speaker of the House of
549	Representatives, and the President of the Senate on legislative
550	recommendations to protect the confidentiality of electronic
551	health records.
552	Section 6.  Subsection (3) of section 20.42, Florida
553	Statutes, is amended to read:
554	20.42  Agency for Health Care Administration.--
555	(3)  The department shall be the chief health policy and
556	planning entity for the state. The department is responsible for
557	health facility licensure, inspection, and regulatory
558	enforcement; investigation of consumer complaints related to
559	health care facilities and managed care plans; the
560	implementation of the certificate of need program; the operation
561	of the Florida State Center for Health Information and Policy
562	Analysis Statistics; the administration of the Medicaid program;
563	the administration of the contracts with the Florida Healthy
564	Kids Corporation; the certification of health maintenance
565	organizations and prepaid health clinics as set forth in part
566	III of chapter 641; and any other duties prescribed by statute
567	or agreement.
568	Section 7.  Subsection (3) of section 381.001, Florida
569	Statutes, is amended to read:
570	381.001  Legislative intent; public health system.--
571	(3)  It is, furthermore, the intent of the Legislature that
572	the public health system include comprehensive planning, data
573	collection, technical support, and health resource development
574	functions. These functions include, but are not limited to,
575	state laboratory and pharmacy services, the state vital
576	statistics system, the Florida State Center for Health
577	Information and Policy Analysis Statistics, emergency medical
578	services coordination and support, and recruitment, retention,
579	and development of preventive and primary health care
580	professionals and managers.
581	Section 8.  Paragraph (e) of subsection (2) of section
582	395.602, Florida Statutes, is amended to read:
583	395.602  Rural hospitals.--
584	(2)  DEFINITIONS.--As used in this part:
585	(e)  "Rural hospital" means an acute care hospital licensed
586	under this chapter, having 100 or fewer licensed beds and an
587	emergency room, which is:
588	1.  The sole provider within a county with a population
589	density of no greater than 100 persons per square mile;
590	2.  An acute care hospital, in a county with a population
591	density of no greater than 100 persons per square mile, which is
592	at least 30 minutes of travel time, on normally traveled roads
593	under normal traffic conditions, from any other acute care
594	hospital within the same county;
595	3.  A hospital supported by a tax district or subdistrict
596	whose boundaries encompass a population of 100 persons or fewer
597	per square mile;
598	4.  A hospital in a constitutional charter county with a
599	population of over 1 million persons that has imposed a local
600	option health service tax pursuant to law and in an area that
601	was directly impacted by a catastrophic event on August 24,
602	1992, for which the Governor of Florida declared a state of
603	emergency pursuant to chapter 125, and has 120 beds or less that
604	serves an agricultural community with an emergency room
605	utilization of no less than 20,000 visits and a Medicaid
606	inpatient utilization rate greater than 15 percent;
607	5.  A hospital with a service area that has a population of
608	100 persons or fewer per square mile. As used in this
609	subparagraph, the term "service area" means the fewest number of
610	zip codes that account for 75 percent of the hospital's
611	discharges for the most recent 5-year period, based on
612	information available from the hospital inpatient discharge
613	database in the Florida State Center for Health Information and
614	Policy Analysis Statistics at the Agency for Health Care
615	Administration; or
616	6.  A hospital designated as a critical access hospital, as
617	defined in s. 408.07(15).
618
619	Population densities used in this paragraph must be based upon
620	the most recently completed United States census. A hospital
621	that received funds under s. 409.9116 for a quarter beginning no
622	later than July 1, 2002, is deemed to have been and shall
623	continue to be a rural hospital from that date through June 30,
624	2012, if the hospital continues to have 100 or fewer licensed
625	beds and an emergency room, or meets the criteria of
626	subparagraph 4. An acute care hospital that has not previously
627	been designated as a rural hospital and that meets the criteria
628	of this paragraph shall be granted such designation upon
629	application, including supporting documentation to the Agency
630	for Health Care Administration.
631	Section 9.  Section 395.6025, Florida Statutes, is amended
632	to read:
633	395.6025  Rural hospital replacement
634	facilities.--Notwithstanding the provisions of s. 408.036, a
635	hospital defined as a statutory rural hospital in accordance
636	with s. 395.602, or a not-for-profit operator of rural
637	hospitals, is not required to obtain a certificate of need for
638	the construction of a new hospital located in a county with a
639	population of at least 15,000 but no more than 18,000 and a
640	density of less than 30 persons per square mile, or a
641	replacement facility, provided that the replacement, or new,
642	facility is located within 10 miles of the site of the currently
643	licensed rural hospital and within the current primary service
644	area. As used in this section, the term "service area" means the
645	fewest number of zip codes that account for 75 percent of the
646	hospital's discharges for the most recent 5-year period, based
647	on information available from the hospital inpatient discharge
648	database in the Florida State Center for Health Information and
649	Policy Analysis Statistics at the Agency for Health Care
650	Administration.
651	Section 10.  Paragraph (d) of subsection (43) of section
652	408.07, Florida Statutes, is amended to read:
653	408.07  Definitions.--As used in this chapter, with the
654	exception of ss. 408.031-408.045, the term:
655	(43)  "Rural hospital" means an acute care hospital
656	licensed under chapter 395, having 100 or fewer licensed beds
657	and an emergency room, and which is:
658	(d)  A hospital with a service area that has a population
659	of 100 persons or fewer per square mile. As used in this
660	paragraph, the term "service area" means the fewest number of
661	zip codes that account for 75 percent of the hospital's
662	discharges for the most recent 5-year period, based on
663	information available from the hospital inpatient discharge
664	database in the Florida State Center for Health Information and
665	Policy Analysis Statistics at the Agency for Health Care
666	Administration; or
667
668	Population densities used in this subsection must be based upon
669	the most recently completed United States census. A hospital
670	that received funds under s. 409.9116 for a quarter beginning no
671	later than July 1, 2002, is deemed to have been and shall
672	continue to be a rural hospital from that date through June 30,
673	2012, if the hospital continues to have 100 or fewer licensed
674	beds and an emergency room, or meets the criteria of s.
675	395.602(2)(e)4. An acute care hospital that has not previously
676	been designated as a rural hospital and that meets the criteria
677	of this subsection shall be granted such designation upon
678	application, including supporting documentation, to the Agency
679	for Health Care Administration.
680	Section 11.  Paragraph (a) of subsection (4) of section
681	408.18, Florida Statutes, is amended to read:
682	408.18  Health Care Community Antitrust Guidance Act;
683	antitrust no-action letter; market-information collection and
684	education.--
685	(4)(a)  Members of the health care community who seek
686	antitrust guidance may request a review of their proposed
687	business activity by the Attorney General's office. In
688	conducting its review, the Attorney General's office may seek
689	whatever documentation, data, or other material it deems
690	necessary from the Agency for Health Care Administration, the
691	Florida State Center for Health Information and Policy Analysis
692	Statistics, and the Office of Insurance Regulation of the
693	Financial Services Commission.
694	Section 12.  Paragraph (c) of subsection (4) of section
695	381.026, Florida Statutes, is amended to read:
696	381.026  Florida Patient's Bill of Rights and
697	Responsibilities.--
698	(4)  RIGHTS OF PATIENTS.--Each health care facility or
699	provider shall observe the following standards:
700	(c)  Financial information and disclosure.--
701	1.  A patient has the right to be given, upon request, by
702	the responsible provider, his or her designee, or a
703	representative of the health care facility full information and
704	necessary counseling on the availability of known financial
705	resources for the patient's health care.
706	2.  A health care provider or a health care facility shall,
707	upon request, disclose to each patient who is eligible for
708	Medicare, in advance of treatment, whether the health care
709	provider or the health care facility in which the patient is
710	receiving medical services accepts assignment under Medicare
711	reimbursement as payment in full for medical services and
712	treatment rendered in the health care provider's office or
713	health care facility.
714	3.  A health care provider or a health care facility shall,
715	upon request, furnish a person, prior to provision of medical
716	services, a reasonable estimate of charges for such services.
717	Such reasonable estimate shall not preclude the health care
718	provider or health care facility from exceeding the estimate or
719	making additional charges based on changes in the patient's
720	condition or treatment needs.
721	4.  Each licensed facility not operated by the state shall
722	make available to the public on its Internet website or by other
723	electronic means a description of and a link to the performance
724	outcome and financial data that is published by the agency
725	pursuant to s. 408.05(3)(k)(l). The facility shall place a
726	notice in the reception area that such information is available
727	electronically and the website address. The licensed facility
728	may indicate that the pricing information is based on a
729	compilation of charges for the average patient and that each
730	patient's bill may vary from the average depending upon the
731	severity of illness and individual resources consumed. The
732	licensed facility may also indicate that the price of service is
733	negotiable for eligible patients based upon the patient's
734	ability to pay.
735	5.  A patient has the right to receive a copy of an
736	itemized bill upon request. A patient has a right to be given an
737	explanation of charges upon request.
738	Section 13.  Subsection (10) of section 395.301, Florida
739	Statutes, is amended to read:
740	395.301  Itemized patient bill; form and content prescribed
741	by the agency.--
742	(10)  Each licensed facility shall make available on its
743	Internet website a link to the performance outcome and financial
744	data that is published by the Agency for Health Care
745	Administration pursuant to s. 408.05(3)(k)(l). The facility
746	shall place a notice in the reception area that the information
747	is available electronically and the facility's Internet website
748	address.
749	Section 14.  Section 465.0244, Florida Statutes, is amended
750	to read:
751	465.0244  Information disclosure.--Every pharmacy shall
752	make available on its Internet website a link to the performance
753	outcome and financial data that is published by the Agency for
754	Health Care Administration pursuant to s. 408.05(3)(k)(l) and
755	shall place in the area where customers receive filled
756	prescriptions notice that such information is available
757	electronically and the address of its Internet website.
758	Section 15.  Subsection (2) of section 627.6499, Florida
759	Statutes, is amended to read:
760	627.6499  Reporting by insurers and third-party
761	administrators.--
762	(2)  Each health insurance issuer shall make available on
763	its Internet website a link to the performance outcome and
764	financial data that is published by the Agency for Health Care
765	Administration pursuant to s. 408.05(3)(k)(l) and shall include
766	in every policy delivered or issued for delivery to any person
767	in the state or any materials provided as required by s.
768	627.64725 notice that such information is available
769	electronically and the address of its Internet website.
770	Section 16.  Subsection (7) of section 641.54, Florida
771	Statutes, is amended to read:
772	641.54  Information disclosure.--
773	(7)  Each health maintenance organization shall make
774	available on its Internet website a link to the performance
775	outcome and financial data that is published by the Agency for
776	Health Care Administration pursuant to s. 408.05(3)(k)(l) and
777	shall include in every policy delivered or issued for delivery
778	to any person in the state or any materials provided as required
779	by s. 627.64725 notice that such information is available
780	electronically and the address of its Internet website.
781	Section 17.  For the purpose of protecting and ensuring the
782	safety and security of the data held by the Agency for Health
783	Care Administration, as described in s. 408.061, Florida
784	Statutes, the agency shall be responsible for ensuring that data
785	and data backup systems are housed at a secure facility that
786	meets or exceeds the following requirements:
787	(a)  The facility must be located in the state;
788	(b)  The facility must be designated as a critical facility
789	by the county emergency management agency, under s. 252.38,
790	Florida Statutes, in the county where the facility is located;
791	(c)  The facility must be designed to withstand a category
792	5 hurricane and be outside the 500-year flood zone established
793	by the Federal Emergency Management Agency;
794	(d)  The facility must have six or more tier?one
795	telecommunication carriers deployed at the facility;
796	(e)  The facility must have commercial power supplied by at
797	least two separate substation feeders and must be able to
798	operate continuously for at least 5 days on its own power
799	generation systems without refueling should such commercial
800	power be interrupted; and
801	(f)  The facility has successfully undergone a Statement on
802	Auditing Standards (SAS) No. 70 review, representing that the
803	facility has been through an in-depth review of the security and
804	information technology control process relating to its
805	operation.
806	Section 18.  This act shall take effect upon becoming a
807	law.

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