Senate Bill sb0430
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Florida Senate - 2007 SB 430
By Senator Saunders
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1 A bill to be entitled
2 An act relating to mental health facilities;
3 amending s. 394.461, F.S.; requiring mental
4 health receiving and treatment facilities
5 designated by the Department of Children and
6 Family Services to report financial and health
7 service data to the department; amending s.
8 408.05, F.S.; requiring the Agency for Health
9 Care Administration to make certain health care
10 data collected from specified mental health
11 care providers available to consumers; amending
12 s. 408.061, F.S.; requiring that certain data
13 be collected by specified mental health care
14 providers and submitted to the agency each
15 quarter; defining the term "payer class";
16 requiring the agency to publish an annual
17 report from the data collected; reenacting s.
18 381.026(4)(c), F.S., relating to the patient's
19 bill of rights and responsibilities, to
20 incorporate the amendments made to s. 408.05,
21 F.S., in a reference thereto; providing an
22 effective date.
23
24 Be It Enacted by the Legislature of the State of Florida:
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26 Section 1. Subsections (3) and (4) of section 394.461,
27 Florida Statutes, are amended to read:
28 394.461 Designation of receiving and treatment
29 facilities.--The department is authorized to designate and
30 monitor receiving facilities and treatment facilities and may
31 suspend or withdraw such designation for failure to comply
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1 with this part and rules adopted under this part. Unless
2 designated by the department, facilities are not permitted to
3 hold or treat involuntary patients under this part.
4 (3) PRIVATE FACILITIES.--Private facilities designated
5 as receiving and treatment facilities by the department may
6 provide examination and treatment of involuntary patients, as
7 well as voluntary patients, are entitled to reimbursement from
8 the department, and are subject to all the provisions of this
9 part.
10 (4) RULES.--The department shall adopt rules relating
11 to:
12 (a) Procedures and criteria for receiving and
13 evaluating facility applications for designation, which may
14 include onsite facility inspection and evaluation of an
15 applicant's licensing status and performance history, as well
16 as consideration of local service needs.
17 (b) Minimum standards consistent with this part which
18 that a facility must meet and maintain in order to be
19 designated as a receiving or treatment facility and procedures
20 for monitoring continued adherence to such standards. Licensed
21 facilities must report financial and health service data to
22 the department pursuant to s. 408.061.
23 (c) Procedures for receiving complaints against a
24 designated facility and for initiating inspections and
25 investigations of facilities alleged to have violated the
26 provisions of this part or rules adopted under this part.
27 (d) Procedures and criteria for the suspension or
28 withdrawal of designation.
29 Section 2. Paragraph (k) of subsection (3) of section
30 408.05, Florida Statutes, is amended to read:
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1 408.05 Florida Center for Health Information and
2 Policy Analysis.--
3 (3) COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order
4 to produce comparable and uniform health information and
5 statistics for the development of policy recommendations, the
6 agency shall perform the following functions:
7 (k) Develop, in conjunction with the State Consumer
8 Health Information and Policy Advisory Council, and implement
9 a long-range plan for making available health care quality
10 measures and financial data that will allow consumers to
11 compare health care services. The health care quality measures
12 and financial data the agency must make available shall
13 include, but is not limited to, pharmaceuticals, physicians,
14 health care facilities, including health care facilities
15 licensed under s. 394.875, and health plans and managed care
16 entities. The agency shall submit the initial plan to the
17 Governor, the President of the Senate, and the Speaker of the
18 House of Representatives by January 1, 2006, and shall update
19 the plan and report on the status of its implementation
20 annually thereafter. The agency shall also make the plan and
21 status report available to the public on its Internet website.
22 As part of the plan, the agency shall identify the process and
23 timeframes for implementation, any barriers to implementation,
24 and recommendations of changes in the law that may be enacted
25 by the Legislature to eliminate the barriers. As preliminary
26 elements of the plan, the agency shall:
27 1. Make available patient-safety indicators, inpatient
28 quality indicators, and performance outcome and patient charge
29 data collected from health care facilities pursuant to s.
30 408.061(1)(a) and (2). The terms "patient-safety indicators"
31 and "inpatient quality indicators" shall be as defined by the
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1 Centers for Medicare and Medicaid Services, the National
2 Quality Forum, the Joint Commission on Accreditation of
3 Healthcare Organizations, the Agency for Healthcare Research
4 and Quality, the Centers for Disease Control and Prevention,
5 or a similar national entity that establishes standards to
6 measure the performance of health care providers, or by other
7 states. The agency shall determine which conditions,
8 procedures, health care quality measures, and patient charge
9 data to disclose based upon input from the council. When
10 determining which conditions and procedures are to be
11 disclosed, the council and the agency shall consider variation
12 in costs, variation in outcomes, and magnitude of variations
13 and other relevant information. When determining which health
14 care quality measures to disclose, the agency:
15 a. Shall consider such factors as volume of cases;
16 average patient charges; average length of stay; complication
17 rates; mortality rates; and infection rates, among others,
18 which shall be adjusted for case mix and severity, if
19 applicable.
20 b. May consider such additional measures that are
21 adopted by the Centers for Medicare and Medicaid Studies,
22 National Quality Forum, the Joint Commission on Accreditation
23 of Healthcare Organizations, the Agency for Healthcare
24 Research and Quality, Centers for Disease Control and
25 Prevention, or a similar national entity that establishes
26 standards to measure the performance of health care providers,
27 or by other states.
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29 When determining which patient charge data to disclose, the
30 agency shall consider such measures as average charge, average
31 net revenue per adjusted patient day, average cost per
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1 adjusted patient day, and average cost per admission, among
2 others.
3 2. Make available performance measures, benefit
4 design, and premium cost data from health plans licensed
5 pursuant to chapter 627 or chapter 641. The agency shall
6 determine which health care quality measures and member and
7 subscriber cost data to disclose, based upon input from the
8 council. When determining which data to disclose, the agency
9 shall consider information that may be required by either
10 individual or group purchasers to assess the value of the
11 product, which may include membership satisfaction, quality of
12 care, current enrollment or membership, coverage areas,
13 accreditation status, premium costs, plan costs, premium
14 increases, range of benefits, copayments and deductibles,
15 accuracy and speed of claims payment, credentials of
16 physicians, number of providers, names of network providers,
17 and hospitals in the network. Health plans shall make
18 available to the agency any such data or information that is
19 not currently reported to the agency or the office.
20 3. Determine the method and format for public
21 disclosure of data reported pursuant to this paragraph. The
22 agency shall make its determination based upon input from the
23 State Consumer Health Information and Policy Advisory Council.
24 At a minimum, the data shall be made available on the agency's
25 Internet website in a manner that allows consumers to conduct
26 an interactive search that allows them to view and compare the
27 information for specific providers. The website must include
28 such additional information as is determined necessary to
29 ensure that the website enhances informed decisionmaking among
30 consumers and health care purchasers, which shall include, at
31 a minimum, appropriate guidance on how to use the data and an
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1 explanation of why the data may vary from provider to
2 provider. The data specified in subparagraph 1. shall be
3 released no later than January 1, 2006, for the reporting of
4 infection rates, and no later than October 1, 2005, for
5 mortality rates and complication rates. The data specified in
6 subparagraph 2. shall be released no later than October 1,
7 2006.
8 Section 3. Present paragraph (e) of subsection (1) of
9 section 408.061, Florida Statutes, is redesignated as
10 paragraph (f), and a new paragraph (e) is added to that
11 subsection, to read:
12 408.061 Data collection; uniform systems of financial
13 reporting; information relating to physician charges;
14 confidential information; immunity.--
15 (1) The agency shall require the submission by health
16 care facilities, health care providers, and health insurers of
17 data necessary to carry out the agency's duties.
18 Specifications for data to be collected under this section
19 shall be developed by the agency with the assistance of
20 technical advisory panels including representatives of
21 affected entities, consumers, purchasers, and such other
22 interested parties as may be determined by the agency.
23 (e)1. Data to be submitted by a health care provider
24 licensed under s. 394.875 must include, but need not be
25 limited to, admission data and the source of patient referral;
26 discharge data; the patient's status at discharge; the average
27 patient length of stay by payer class; total patient days and
28 total patient admissions by payer class; the primary and
29 secondary diagnoses of each patient; the number of licensed
30 beds in the facility; the number of contracted beds as defined
31 in s. 394.455(25); total revenues by payer class; and
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1 operating expenses, including expenses incurred for rendering
2 services to patients who cannot or do not pay for their care
3 and for whom there is no other means by which to collect
4 payment and demographic data.
5 2. For the purpose of this paragraph, the term "payer
6 class" includes, but is not limited to, Medicare, Medicare
7 HMO, Medicaid, Medicaid HMO, private-pay insurance, private
8 health care maintenance organization, private preferred
9 provider organization, services contracted by the Department
10 of Children and Family Services, self-pay, charity, and other
11 government programs.
12 3. The data collected by a health care provider
13 licensed under s. 394.875 must be submitted to the agency
14 quarterly. The chief executive officer or an authorized
15 representative or employee of the licensed facility must
16 certify that the information submitted is true and accurate.
17 Data elements shall be reported electronically. The agency
18 shall publish an annual report detailing the information
19 submitted by health care providers.
20 Section 4. For the purpose of incorporating the
21 amendment made by this act to section 408.05, Florida
22 Statutes, in a reference thereto, paragraph (c) of subsection
23 (4) of section 381.026, Florida Statutes, is reenacted to
24 read:
25 381.026 Florida Patient's Bill of Rights and
26 Responsibilities.--
27 (4) RIGHTS OF PATIENTS.--Each health care facility or
28 provider shall observe the following standards:
29 (c) Financial information and disclosure.--
30 1. A patient has the right to be given, upon request,
31 by the responsible provider, his or her designee, or a
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1 representative of the health care facility full information
2 and necessary counseling on the availability of known
3 financial resources for the patient's health care.
4 2. A health care provider or a health care facility
5 shall, upon request, disclose to each patient who is eligible
6 for Medicare, in advance of treatment, whether the health care
7 provider or the health care facility in which the patient is
8 receiving medical services accepts assignment under Medicare
9 reimbursement as payment in full for medical services and
10 treatment rendered in the health care provider's office or
11 health care facility.
12 3. A health care provider or a health care facility
13 shall, upon request, furnish a person, prior to provision of
14 medical services, a reasonable estimate of charges for such
15 services. Such reasonable estimate shall not preclude the
16 health care provider or health care facility from exceeding
17 the estimate or making additional charges based on changes in
18 the patient's condition or treatment needs.
19 4. Each licensed facility not operated by the state
20 shall make available to the public on its Internet website or
21 by other electronic means a description of and a link to the
22 performance outcome and financial data that is published by
23 the agency pursuant to s. 408.05(3)(k). The facility shall
24 place a notice in the reception area that such information is
25 available electronically and the website address. The licensed
26 facility may indicate that the pricing information is based on
27 a compilation of charges for the average patient and that each
28 patient's bill may vary from the average depending upon the
29 severity of illness and individual resources consumed. The
30 licensed facility may also indicate that the price of service
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1 is negotiable for eligible patients based upon the patient's
2 ability to pay.
3 5. A patient has the right to receive a copy of an
4 itemized bill upon request. A patient has a right to be given
5 an explanation of charges upon request.
6 Section 5. This act shall take effect July 1, 2007.
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9 SENATE SUMMARY
10 Requires mental health receiving and treatment facilities
designated by the Department of Children and Family
11 Services to report financial and health service data to
the department. Requires the Agency for Health Care
12 Administration to make certain health care data collected
from specified mental health care providers available to
13 consumers. Requires that certain data be collected by
specified mental health care providers and submitted to
14 the agency each quarter. Requires the agency to publish
an annual report from the data collected.
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