Senate Bill sb2354c1

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    Florida Senate - 2007                           CS for SB 2354

    By the Committee on Health Regulation; and Senator Lawson





    588-2559-07

  1                      A bill to be entitled

  2         An act relating to the Health Care Clinic Act;

  3         amending s. 400.9905, F.S.; specifying certain

  4         types of sole proprietorships, group practices,

  5         partnerships, corporations, and other legal

  6         entities that are not subject to the licensure

  7         requirements of the act; amending s. 400.991,

  8         F.S.; requiring certain persons having a

  9         financial interest in a clinic, or having

10         control over certain activities relating to the

11         operations of a clinic, to undergo background

12         screening; authorizing the Agency for Health

13         Care Administration to adopt rules; authorizing

14         the agency to deny or revoke a license if an

15         applicant, licensee, or person having an

16         interest in a clinic has been excluded,

17         suspended, or terminated from the Medicare or

18         Medicaid programs or has committed certain

19         offenses prohibited under level 2 screening

20         standards; providing additional requirements

21         for background screening with respect to

22         offenses committed within the past 10 years;

23         providing that failure to provide such

24         information is a material omission; authorizing

25         the agency to deny, revoke, or suspend a

26         license or assess an administrative penalty if

27         a person fails to comply with the requirements

28         for background screening; authorizing the

29         agency to declare a loss of exempt status under

30         certain conditions; requiring an applicant that

31         performs magnetic resonance imaging, static

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 1         radiographs, computed tomography, or positron

 2         emission tomography to provide certain

 3         information to the agency; providing that the

 4         submission of fraudulent or misleading

 5         information on an application for licensure is

 6         a third-degree felony; amending s. 400.9935,

 7         F.S.; specifying additional duties of a medical

 8         director or clinic director; limiting the

 9         number of clinics and employees for which a

10         medical or clinic director may be responsible;

11         requiring that multiple clinics under the

12         control of the same medical or clinic director

13         must be within a specified proximity;

14         authorizing the agency to waive such

15         limitations upon a showing of good cause;

16         creating s. 400.9936, F.S.; providing for the

17         regulation of diagnostic testing facilities;

18         providing a definition; providing for the

19         background screening of certain persons;

20         providing limitations and guidelines for the

21         medical director or clinic director of such

22         facilities; providing for the waiver of certain

23         requirements and providing for past waivers or

24         variances; amending s. 456.072, F.S.; providing

25         that intentionally providing false information

26         on an application for a certificate of

27         exemption from clinic licensure is grounds for

28         discipline under provisions regulating medical

29         professionals; providing an effective date.

30  

31  Be It Enacted by the Legislature of the State of Florida:

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 1         Section 1.  Subsection (4) of section 400.9905, Florida

 2  Statutes, is amended to read:

 3         400.9905  Definitions.--

 4         (4)  "Clinic" means an entity at which health care

 5  services are provided to individuals and which tenders charges

 6  for reimbursement for such services, including a mobile clinic

 7  and a portable equipment provider. For purposes of this part,

 8  the term does not include and the licensure requirements of

 9  this part do not apply to:

10         (a)  Entities licensed or registered by the state under

11  chapter 395; or entities licensed or registered by the state

12  and providing only health care services within the scope of

13  services authorized under their respective licenses granted

14  under ss. 383.30-383.335, chapter 390, chapter 394, chapter

15  397, this chapter except part X, chapter 429, chapter 463,

16  chapter 465, chapter 466, chapter 478, part I of chapter 483,

17  chapter 484, or chapter 651; end-stage renal disease providers

18  authorized under 42 C.F.R. part 405, subpart U; or providers

19  certified under 42 C.F.R. part 485, subpart B or subpart H; or

20  any entity that provides neonatal or pediatric hospital-based

21  health care services or other health care services by licensed

22  practitioners solely within a hospital licensed under chapter

23  395.

24         (b)  Entities that own, directly or indirectly,

25  entities licensed or registered by the state pursuant to

26  chapter 395; or entities that own, directly or indirectly,

27  entities licensed or registered by the state and providing

28  only health care services within the scope of services

29  authorized pursuant to their respective licenses granted under

30  ss. 383.30-383.335, chapter 390, chapter 394, chapter 397,

31  this chapter except part X, chapter 429, chapter 463, chapter

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 1  465, chapter 466, chapter 478, part I of chapter 483, chapter

 2  484, chapter 651; end-stage renal disease providers authorized

 3  under 42 C.F.R. part 405, subpart U; or providers certified

 4  under 42 C.F.R. part 485, subpart B or subpart H; or any

 5  entity that provides neonatal or pediatric hospital-based

 6  health care services by licensed practitioners solely within a

 7  hospital licensed under chapter 395.

 8         (c)  Entities that are owned, directly or indirectly,

 9  by an entity licensed or registered by the state pursuant to

10  chapter 395; or entities that are owned, directly or

11  indirectly, by an entity licensed or registered by the state

12  and providing only health care services within the scope of

13  services authorized pursuant to their respective licenses

14  granted under ss. 383.30-383.335, chapter 390, chapter 394,

15  chapter 397, this chapter except part X, chapter 429, chapter

16  463, chapter 465, chapter 466, chapter 478, part I of chapter

17  483, chapter 484, or chapter 651; end-stage renal disease

18  providers authorized under 42 C.F.R. part 405, subpart U; or

19  providers certified under 42 C.F.R. part 485, subpart B or

20  subpart H; or any entity that provides neonatal or pediatric

21  hospital-based health care services by licensed practitioners

22  solely within a hospital under chapter 395.

23         (d)  Entities that are under common ownership, directly

24  or indirectly, with an entity licensed or registered by the

25  state pursuant to chapter 395; or entities that are under

26  common ownership, directly or indirectly, with an entity

27  licensed or registered by the state and providing only health

28  care services within the scope of services authorized pursuant

29  to their respective licenses granted under ss. 383.30-383.335,

30  chapter 390, chapter 394, chapter 397, this chapter except

31  part X, chapter 429, chapter 463, chapter 465, chapter 466,

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 1  chapter 478, part I of chapter 483, chapter 484, or chapter

 2  651; end-stage renal disease providers authorized under 42

 3  C.F.R. part 405, subpart U; or providers certified under 42

 4  C.F.R. part 485, subpart B or subpart H; or any entity that

 5  provides neonatal or pediatric hospital-based health care

 6  services by licensed practitioners solely within a hospital

 7  licensed under chapter 395.

 8         (e)  An entity that is exempt from federal taxation

 9  under 26 U.S.C. s. 501(c)(3) or (4), an employee stock

10  ownership plan under 26 U.S.C. s. 409 that has a board of

11  trustees not less than two-thirds of which are

12  Florida-licensed health care practitioners and provides only

13  physical therapy services under physician orders, any

14  community college or university clinic, and any entity owned

15  or operated by the federal or state government, including

16  agencies, subdivisions, or municipalities thereof.

17         (f)  A sole proprietorship, group practice,

18  partnership, or corporation, or other legal entity that

19  provides health care services by physicians licensed under

20  chapter 458, chapter 459, chapter 460, chapter 461, or chapter

21  466 covered by s. 627.419, that is directly supervised by one

22  or more of such physicians, and that is wholly owned by one or

23  more of those physicians or by a physician and the spouse,

24  parent, child, or sibling of that physician.

25         (g)  A sole proprietorship, group practice,

26  partnership, or corporation, or other legal entity that

27  provides health care services by licensed health care

28  practitioners under chapter 457, physician assistants under

29  chapter 458, chapter 459, chapter 460, or chapter 461, or

30  practitioners under chapter 462, chapter 463, chapter 466,

31  chapter 467, chapter 480, chapter 484, chapter 486, chapter

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 1  490, chapter 491, or part I, part III, part X, part XIII, or

 2  part XIV of chapter 468, or s. 464.012, which entities are

 3  wholly owned by one or more licensed health care

 4  practitioners, or the licensed health care practitioners set

 5  forth in this paragraph and the spouse, parent, child, or

 6  sibling of a licensed health care practitioner, so long as one

 7  of the owners who is a licensed health care practitioner is

 8  supervising the health care services business activities and

 9  is legally responsible for the entity's compliance with all

10  federal and state laws. However, health care services provided

11  may not exceed the scope of the licensed owner's health care a

12  health care practitioner may not supervise services beyond the

13  scope of the practitioner's license, except that, for the

14  purposes of this part, a clinic owned by a licensee in s.

15  456.053(3)(b) that provides only services authorized pursuant

16  to s. 456.053(3)(b) may be supervised by a licensee specified

17  in s. 456.053(3)(b).

18         (h)  Clinical facilities affiliated with an accredited

19  medical school at which training is provided for medical

20  students, residents, or fellows.

21         (i)  Entities that provide only oncology or radiation

22  therapy services by physicians licensed under chapter 458 or

23  chapter 459 or entities that provide oncology or radiation

24  therapy services by physicians licensed under chapter 458 or

25  chapter 459 which are owned by a corporation whose shares are

26  publicly traded on a recognized stock exchange.

27         (j)  Clinical facilities affiliated with a college of

28  chiropractic accredited by the Council on Chiropractic

29  Education at which training is provided for chiropractic

30  students.

31  

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 1         (k)  Entities that provide licensed practitioners to

 2  staff emergency departments or to deliver anesthesia services

 3  in facilities licensed under chapter 395 and that derive at

 4  least 90 percent of their gross annual revenues from the

 5  provision of such services. Entities claiming an exemption

 6  from licensure under this paragraph must provide documentation

 7  demonstrating compliance.

 8         (l)  Clinical facilities that are wholly owned,

 9  directly or indirectly, by a publicly traded corporation. As

10  used in this paragraph, the term "publicly traded corporation"

11  means a corporation that issues securities traded on an

12  exchange registered with the United States Securities and

13  Exchange Commission as a national securities exchange.

14         Section 2.  Section 400.991, Florida Statutes, is

15  amended to read:

16         400.991  License requirements; background screenings;

17  prohibitions.--

18         (1)(a)  Each clinic, as defined in s. 400.9905, must be

19  licensed and shall at all times maintain a valid license with

20  the agency. Each clinic location shall be licensed separately

21  regardless of whether the clinic is operated under the same

22  business name or management as another clinic.

23         (b)  Each mobile clinic must obtain a separate health

24  care clinic license and must provide to the agency, at least

25  quarterly, its projected street location to enable the agency

26  to locate and inspect such clinic. A portable equipment

27  provider must obtain a health care clinic license for a single

28  administrative office and is not required to submit quarterly

29  projected street locations.

30         (2)  The initial clinic license application shall be

31  filed with the agency by all clinics, as defined in s.

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 1  400.9905, on or before July 1, 2004. A clinic license must be

 2  renewed biennially.

 3         (3)  Applicants that submit an application on or before

 4  July 1, 2004, which meets all requirements for initial

 5  licensure as specified in this section shall receive a

 6  temporary license until the completion of an initial

 7  inspection verifying that the applicant meets all requirements

 8  in rules authorized in s. 400.9925. However, a clinic engaged

 9  in magnetic resonance imaging services may not receive a

10  temporary license unless it presents evidence satisfactory to

11  the agency that such clinic is making a good faith effort and

12  substantial progress in seeking accreditation required under

13  s. 400.9935.

14         (4)  Application for an initial clinic license or for

15  renewal of an existing license shall be notarized on forms

16  furnished by the agency and must be accompanied by the

17  appropriate license fee as provided in s. 400.9925. The agency

18  shall take final action on an initial license application

19  within 60 days after receipt of all required documentation.

20         (5)(a)  The application shall contain information that

21  includes, but need not be limited to, information pertaining

22  to the name, residence and business address, phone number,

23  social security number, and license number of the medical or

24  clinic director, of the licensed medical providers employed or

25  under contract with the clinic, and of each person who,

26  directly or indirectly, owns or controls 5 percent or more of

27  an interest in the clinic, or general partners in limited

28  liability partnerships.

29         (b)  Any person having a financial interest in a

30  clinic, directly or indirectly, as set forth in this paragraph

31  is subject to background screening requirements under this

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 1  part. This includes any person who may or may not own stock or

 2  an equivalent interest in the clinic, but nonetheless has

 3  control over or the authority to approve, directly or

 4  indirectly, clinic billing, policy, business activities, or

 5  personnel decisions, including, but not limited to, contracted

 6  or employed persons or entities, managers, and management

 7  companies performing third-party billing services and persons

 8  and entities, directly or indirectly, which lend, give, or

 9  gift money of any denomination or any thing of value exceeding

10  an aggregate of $5,000 for clinic use, with or without an

11  expectation of a return of the money or thing of value, and

12  regardless of profit motive.

13         (c)  The agency may adopt rules to administer this

14  subsection.

15         (6)  The applicant must file with the application

16  satisfactory proof that the clinic is in compliance with this

17  part and applicable rules, including:

18         (a)  A listing of services to be provided either

19  directly by the applicant or through contractual arrangements

20  with existing providers;

21         (b)  The number and discipline of each professional

22  staff member to be employed; and

23         (c)  Proof of financial ability to operate. An

24  applicant must demonstrate financial ability to operate a

25  clinic by submitting a balance sheet and an income and expense

26  statement for the first year of operation which provide

27  evidence of the applicant's having sufficient assets, credit,

28  and projected revenues to cover liabilities and expenses. The

29  applicant shall have demonstrated financial ability to operate

30  if the applicant's assets, credit, and projected revenues meet

31  or exceed projected liabilities and expenses. All documents

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 1  required under this subsection must be prepared in accordance

 2  with generally accepted accounting principles, may be in a

 3  compilation form, and the financial statement must be signed

 4  by a certified public accountant. As an alternative to

 5  submitting a balance sheet and an income and expense statement

 6  for the first year of operation, the applicant may file a

 7  surety bond of at least $500,000 which guarantees that the

 8  clinic will act in full conformity with all legal requirements

 9  for operating a clinic, payable to the agency. The agency may

10  adopt rules to specify related requirements for such surety

11  bond.

12         (7)  Each applicant for licensure shall comply with the

13  following requirements:

14         (a)  As used in this subsection, the term "applicant"

15  means an individual individuals owning or controlling,

16  directly or indirectly, 5 percent or more of an interest in a

17  clinic; the medical or clinic director, or a similarly titled

18  person who is responsible for the day-to-day operation of the

19  licensed clinic; the financial officer or similarly titled

20  individual who is responsible for the financial operation of

21  the clinic; and licensed health care practitioners at the

22  clinic; and any person who has a controlling interest as

23  defined in s. 408.803(7).

24         (b)  Upon receipt of a completed, signed, and dated

25  application, the agency shall require background screening of

26  the applicant, in accordance with the level 2 standards for

27  screening set forth in paragraph (d) chapter 435. Proof of

28  compliance with the level 2 background screening requirements

29  of paragraph (d) chapter 435 which has been submitted within

30  the previous 5 years in compliance with the any other health

31  care clinic licensure requirements of this part state is

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 1  acceptable in fulfillment of this paragraph. Applicants who

 2  own less than 10 percent of a health care clinic are not

 3  required to submit fingerprints under this section.

 4         (c)  Each applicant must submit to the agency, with the

 5  application, a description and explanation of any exclusions,

 6  permanent suspensions, or terminations of an applicant from

 7  the Medicare or Medicaid programs. Proof of compliance with

 8  the requirements for disclosure of ownership and control

 9  interest under the Medicaid or Medicare programs may be

10  accepted in lieu of this submission. The description and

11  explanation may indicate whether such exclusions, suspensions,

12  or terminations were voluntary or not voluntary on the part of

13  the applicant. The agency may deny or revoke licensure based

14  on information received under this paragraph for exclusions,

15  permanent suspensions, or terminations of an applicant or

16  persons or entities identified in paragraph (5)(b) from the

17  Medicare or Medicaid programs.

18         (d)  A license may not be granted to a clinic if the

19  applicant, or a person or entity identified in paragraph

20  (5)(b), has been found guilty of, regardless of adjudication,

21  or has entered a plea of nolo contendere or guilty to, any

22  offense prohibited under the level 2 standards for screening

23  set forth in chapter 435 or this section. In addition to the

24  process and procedures set forth in s. 408.809 which are

25  specifically required, all persons who must meet level 2

26  standards of chapter 435 must also undergo level 2 background

27  screening for any felony committed within the past 10 years

28  under chapter 400, chapter 408, chapter 409, chapter 440,

29  chapter 456, chapter 624, chapter 626, chapter 627, chapter

30  812, chapter 817, chapter 831, chapter 837, chapter 838,

31  chapter 895, or chapter 896, or any substantially comparable

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 1  offense or crime of another state or of the United States if

 2  such offense is a felony in that jurisdiction. The agency may

 3  require each person who must undergo background screening to

 4  disclose, on forms provided by the agency, his or her name,

 5  address, social security number, and date of birth and any

 6  arrest for any crime for which any court disposition other

 7  than dismissal has been rendered within the past 10 years

 8  prior to an affiliation with an applicant or licensee under

 9  this part. Failure to provide such information may be

10  considered by the agency as a material omission in the

11  application or licensure process. Notwithstanding the time

12  provisions of chapter 120 for granting or denying an

13  application for a license, the agency may not approve an

14  initial, renewal, or change-of-ownership application for any

15  applicant whose background screening process is not complete

16  and all persons required to undergo such screening demonstrate

17  compliance with this paragraph. The agency shall deny a

18  pending application or revoke or suspend a license and assess

19  an administrative penalty in accordance with s. 400.995(1)

20  against a licensee if the agency substantiates that a person

21  who is required to meet background screening standards has

22  failed or refused to submit to background screening as set

23  forth in this part or does not meet the minimum requirements

24  of such screening after the timely submission of fingerprint

25  cards to the agency., or a violation of insurance fraud under

26  s. 817.234, within the past 5 years. If the applicant has been

27  convicted of an offense prohibited under the level 2 standards

28  or insurance fraud in any jurisdiction, the applicant must

29  show that his or her civil rights have been restored prior to

30  submitting an application.

31  

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 1         (e)  The agency may deny or revoke licensure or declare

 2  loss of an exempt status, effective on the date that the

 3  requirements for exempt status are not met, if the applicant

 4  has falsely represented any material fact or omitted any

 5  material fact from the application required by this part or by

 6  agency rule. An exempt status under this part ceases to exist

 7  on the date that a business fails to qualify for an exemption

 8  under this part or the Health Care Licensing Procedures Act.

 9         (f)  Each applicant that performs the technical

10  component of magnetic resonance imaging, static radiographs,

11  computed tomography, or positron emission tomography, and also

12  provides the professional components of such services through

13  an employee or independent contractor must provide to the

14  agency on a form provided by the agency, the name and address

15  of the clinic, the serial or operating number of each magnetic

16  resonance imaging, static radiograph, computed tomography, and

17  positron emission tomography machine, the name of the

18  manufacturer of the machine, and such other information as

19  required by the agency to identify the machine. The

20  information must be provided to the agency upon renewal of the

21  clinic's license and within 30 days after a clinic begins

22  using a machine for which it has not provided the information

23  to the agency.

24         (8)  Requested information omitted from an application

25  for licensure, license renewal, or transfer of ownership must

26  be filed with the agency within 21 days after receipt of the

27  agency's request for omitted information, or the application

28  shall be deemed incomplete and shall be withdrawn from further

29  consideration.

30  

31  

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 1         (9)  The failure to file a timely renewal application

 2  shall result in a late fee charged to the facility in an

 3  amount equal to 50 percent of the current license fee.

 4         (10)  Any person or entity that submits an application

 5  for a license which contains fraudulent or material and

 6  misleading information commits a felony of the third degree,

 7  punishable as provided in s. 775.082, s. 775.083, or s.

 8  775.084.

 9         Section 3.  Section 400.9935, Florida Statutes, is

10  amended to read:

11         400.9935  Clinic responsibilities.--

12         (1)  Each clinic shall appoint a medical director or

13  clinic director who shall agree in writing to accept legal

14  responsibility for the following activities on behalf of the

15  clinic. The medical director or the clinic director shall:

16         (a)  Have signs identifying the medical director or

17  clinic director posted in a conspicuous location within the

18  clinic readily visible to all patients.

19         (b)  Ensure that all practitioners providing health

20  care services or supplies to patients maintain a current

21  active and unencumbered Florida license and do not provide

22  health care services or supplies outside the scope of that

23  license or as otherwise prohibited by law.

24         (c)  Review any patient referral contracts or

25  agreements executed by the clinic.

26         (d)  Ensure that all health care practitioners at the

27  clinic have active appropriate certification or licensure for

28  the level of care being provided.

29         (e)  Serve as the clinic records owner as defined in s.

30  456.057.

31  

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 1         (f)  Ensure compliance with the recordkeeping, office

 2  surgery, and adverse incident reporting requirements of

 3  chapter 456, the respective practice acts, and rules adopted

 4  under this part.

 5         (g)  Conduct systematic reviews of clinic billings to

 6  ensure that the billings are not fraudulent or unlawful. Upon

 7  discovery of an unlawful charge, the medical director or

 8  clinic director shall take immediate corrective action. If the

 9  clinic performs only the technical component of magnetic

10  resonance imaging, static radiographs, computed tomography, or

11  positron emission tomography, and provides the professional

12  interpretation of such services, in a fixed facility that is

13  accredited by the Joint Commission on Accreditation of

14  Healthcare Organizations or the Accreditation Association for

15  Ambulatory Health Care, and the American College of Radiology;

16  and if, in the preceding quarter, the percentage of scans

17  performed by that clinic which was billed to all personal

18  injury protection insurance carriers was less than 15 percent,

19  the chief financial officer of the clinic may, in a written

20  acknowledgment provided to the agency, assume the

21  responsibility for the conduct of the systematic reviews of

22  clinic billings to ensure that the billings are not fraudulent

23  or unlawful.

24         (h)  Not refer a patient to the clinic if the clinic

25  performs magnetic resonance imaging, static radiographs,

26  computed tomography, or positron emission tomography. The term

27  "refer a patient" means the referral of one or more patients

28  of the medical or clinical director or a member of the medical

29  or clinical director's group practice to the clinic for

30  magnetic resonance imaging, static radiographs, computed

31  tomography, or positron emission tomography. A medical

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 1  director who is found to violate this paragraph commits a

 2  felony of the third degree, punishable as provided in s.

 3  775.082, s. 775.083, or s. 775.084.

 4         (i)  Serve in that capacity for no more than a maximum

 5  of three health care clinics that have a cumulative total of

 6  no more than 100 employees and persons under contract with the

 7  health care clinic at a given time. A medical or clinic

 8  director may not supervise a health care clinic more than 200

 9  miles away from any other health care clinic supervised by the

10  same medical or clinic director. The agency may allow for

11  waivers to the limitations of this paragraph upon a showing of

12  good cause and a determination by the agency that the medical

13  director will be able to adequately perform the requirements

14  of this subsection.

15         (2)  Any business that becomes a clinic after

16  commencing operations must, within 5 days after becoming a

17  clinic, file a license application under this part and shall

18  be subject to all provisions of this part applicable to a

19  clinic.

20         (3)  Any contract to serve as a medical director or a

21  clinic director entered into or renewed by a physician or a

22  licensed health care practitioner in violation of this part is

23  void as contrary to public policy. This subsection shall apply

24  to contracts entered into or renewed on or after March 1,

25  2004.

26         (4)  All charges or reimbursement claims made by or on

27  behalf of a clinic that is required to be licensed or to

28  obtain a certificate of exemption under this part, but that is

29  not so licensed or exempt, or that is otherwise operating in

30  violation of this part, part II of chapter 408, or rules

31  

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 1  adopted pursuant to either part, are unlawful charges, and

 2  therefore are noncompensable and unenforceable.

 3         (5)  Any person establishing, operating, or managing an

 4  unlicensed clinic otherwise required to be licensed under this

 5  part, or any person who knowingly files a false or misleading

 6  license application or license renewal application, or false

 7  or misleading information related to such application or

 8  department rule, commits a felony of the third degree,

 9  punishable as provided in s. 775.082, s. 775.083, or s.

10  775.084, part II of chapter 408, or rules adopted pursuant to

11  either part.

12         (6)  Any licensed health care provider who violates

13  this part is subject to discipline in accordance with this

14  chapter and his or her respective practice act.

15         (7)  The agency may fine, or suspend or revoke the

16  license of, any clinic licensed under this part for operating

17  in violation of the requirements of this part or the rules

18  adopted by the agency.

19         (8)  The agency shall investigate allegations of

20  noncompliance with this part and the rules adopted under this

21  part.

22         (9)  Any person or entity providing health care

23  services which is not a clinic, as defined under s. 400.9905,

24  may voluntarily apply for a certificate of exemption from

25  licensure under its exempt status with the agency on a form

26  that sets forth its name or names and addresses, a statement

27  of the reasons why it cannot be defined as a clinic, and other

28  information deemed necessary by the agency. An exemption is

29  not transferable. The agency may charge an applicant for a

30  certificate of exemption in an amount equal to $100 or the

31  actual cost of processing the certificate, whichever is less.

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 1  A certificate of exemption is valid for 2 years and may be

 2  renewed.

 3         (10)  The clinic shall display its license in a

 4  conspicuous location within the clinic readily visible to all

 5  patients.

 6         (11)(a)  Each clinic engaged in magnetic resonance

 7  imaging services must be accredited by the Joint Commission on

 8  Accreditation of Healthcare Organizations, the American

 9  College of Radiology, or the Accreditation Association for

10  Ambulatory Health Care, within 1 year after licensure.

11  However, a clinic may request a single, 6-month extension if

12  it provides evidence to the agency establishing that, for good

13  cause shown, such clinic can not be accredited within 1 year

14  after licensure, and that such accreditation will be completed

15  within the 6-month extension. After obtaining accreditation as

16  required by this subsection, each such clinic must maintain

17  accreditation as a condition of renewal of its license.

18         (b)  The agency may deny the application or revoke the

19  license of any entity formed for the purpose of avoiding

20  compliance with the accreditation provisions of this

21  subsection and whose principals were previously principals of

22  an entity that was unable to meet the accreditation

23  requirements within the specified timeframes. The agency may

24  adopt rules as to the accreditation of magnetic resonance

25  imaging clinics.

26         (12)  The agency shall give full faith and credit

27  pertaining to any past variance and waiver granted to a

28  magnetic resonance imaging clinic from rule 64-2002, Florida

29  Administrative Code, by the Department of Health, until

30  September 2004. After that date, such clinic must request a

31  variance and waiver from the agency under s. 120.542.

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 1         (13)  The clinic shall display a sign in a conspicuous

 2  location within the clinic readily visible to all patients

 3  indicating that, pursuant to s. 626.9892, the Department of

 4  Financial Services may pay rewards of up to $25,000 to persons

 5  providing information leading to the arrest and conviction of

 6  persons committing crimes investigated by the Division of

 7  Insurance Fraud arising from violations of s. 440.105, s.

 8  624.15, s. 626.9541, s. 626.989, or s. 817.234. An authorized

 9  employee of the Division of Insurance Fraud may make

10  unannounced inspections of a clinic licensed under this part

11  as necessary to determine whether the clinic is in compliance

12  with this subsection. A licensed clinic shall allow full and

13  complete access to the premises to such authorized employee of

14  the division who makes an inspection to determine compliance

15  with this subsection.

16         Section 4.  Section 400.9936, Florida Statutes, is

17  created to read:

18         400.9936  Diagnostic testing facility.--

19         (1)  As used in this section, the term "diagnostic

20  testing facility" means a clinic licensed under s. 400.991

21  which:

22         (a)  Performs the technical component of magnetic

23  resonance imaging, computed tomography, or positron emission

24  tomography;

25         (b)  Provides the professional component of such

26  services through an employee or independent contractor;

27         (c)  Is located in a fixed facility;

28         (d)  Is accredited by the Joint Commission on

29  Accreditation of Healthcare Organizations and the American

30  College of Radiology; and

31  

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 1         (e)  Does not directly or indirectly provide any

 2  services to patients other than magnetic resonance imaging,

 3  computed tomography, or positron emission tomography.

 4         (2)  Only a person having a financial interest in a

 5  diagnostic testing facility, including the chief executive

 6  officer, president, chief operations officer, vice president,

 7  or other corporate officer, is subject to the background

 8  screening requirements of part X of chapter 400.

 9         (3)(a)  The medical director or clinic director of a

10  clinic, in addition to the requirements of s. 400.9935, may

11  serve in that capacity only for a maximum of five clinics in a

12  diagnostic testing facility. In addition, a medical director

13  or clinic director in a diagnostic testing facility may not

14  supervise a clinic that is located more than 300 miles from

15  any other clinic supervised by that medical director or clinic

16  director.

17         (b)  The agency may waive the requirements of this

18  subsection upon a showing of good cause if it determines that

19  the medical director or clinic director can adequately satisfy

20  the other requirements of s. 400.9935.

21         (c)  Any variance approved by the agency for a

22  diagnostic testing facility as of May 1, 2007, remains in

23  effect for the term of the approved variance.

24         Section 5.  Paragraph (ii) is added to subsection (1)

25  of section 456.072, Florida Statutes, to read:

26         456.072  Grounds for discipline; penalties;

27  enforcement.--

28         (1)  The following acts shall constitute grounds for

29  which the disciplinary actions specified in subsection (2) may

30  be taken:

31  

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 1         (ii)  Intentionally providing false information on an

 2  application for a certificate of exemption from clinic

 3  licensure under part XIII of chapter 400.

 4         Section 6.  This act shall take effect October 1, 2007.

 5  

 6          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 7                         Senate Bill 2354

 8                                 

 9  The committee substitute:

10  -    Modifies the criteria under which certain health care
         providers and practitioners are exempt from licensure
11       under the Health Care Clinic Act (ss. 400.990 - 400.995,
         F.S.);
12  
    -    Expands the exemptions from clinic licensure;
13  
    -    Requires certain additional clinic personnel to undergo
14       background screening;

15  -    Adds additional offenses for which a license may be
         denied;
16  
    -    Requires serial or operating numbers for certain
17       equipment;

18  -    Limits the medical or clinic director to a maximum of
         three clinics with a total of no more than 100 employees;
19  
    -    Specifies that all charges made by a clinic that is
20       required to obtain a certificate of exemption, but that
         is not exempt, or that is operating in violation of part
21       II of chapter 408 are unlawful charges;

22  -    Provides 2-year expiration date on each certificate of
         exemption and allows renewal;
23  
    -    Provides penalties for submitting an application for
24       licensure containing fraudulent or material and
         misleading information;
25  
    -    Provides disciplinary action for intentionally giving
26       false information on an application for a certificate of
         exemption; and
27  
    -    Creates s. 400.9936, F.S., establishing separate
28       requirements under the Health Care Clinic Act for
         diagnostic testing facilities.
29  

30  

31  

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