HB 587

1	A bill to be entitled
2	An act relating to mental health facilities; amending s.
3	394.461, F.S.; authorizing reimbursement of certain
4	private mental health receiving and treatment facilities
5	by the Department of Children and Family Services;
6	requiring licensed mental health receiving and treatment
7	facilities designated by the department to report
8	financial and health service data to the department;
9	amending s. 408.05, F.S.; requiring the Agency for Health
10	Care Administration to make certain health care data
11	collected from specified mental health care providers
12	available to consumers; amending s. 408.061, F.S.;
13	requiring that certain data be collected by specified
14	mental health care providers and submitted to the agency
15	each quarter; defining the term "payer class"; requiring
16	the agency to publish an annual report from the data
17	collected; reenacting s. 381.026(4)(c), F.S., relating to
18	the patient's bill of rights and responsibilities, to
19	incorporate the amendments made to s. 408.05, F.S., in a
20	reference thereto; providing an effective date.
21
22	Be It Enacted by the Legislature of the State of Florida:
23
24	Section 1.  Subsections (3) and (4) of section 394.461,
25	Florida Statutes, are amended to read:
26	394.461  Designation of receiving and treatment
27	facilities.--The department is authorized to designate and
28	monitor receiving facilities and treatment facilities and may
29	suspend or withdraw such designation for failure to comply with
30	this part and rules adopted under this part. Unless designated
31	by the department, facilities are not permitted to hold or treat
32	involuntary patients under this part.
33	(3)  PRIVATE FACILITIES.--Private facilities designated as
34	receiving and treatment facilities by the department may provide
35	examination and treatment of involuntary patients, as well as
36	voluntary patients, are entitled to reimbursement from the
37	department, and are subject to all the provisions of this part.
38	(4)  RULES.--The department shall adopt rules relating to:
39	(a)  Procedures and criteria for receiving and evaluating
40	facility applications for designation, which may include onsite
41	facility inspection and evaluation of an applicant's licensing
42	status and performance history, as well as consideration of
43	local service needs.
44	(b)  Minimum standards consistent with this part which that
45	a facility must meet and maintain in order to be designated as a
46	receiving or treatment facility and procedures for monitoring
47	continued adherence to such standards. Licensed facilities must
48	report financial and health service data to the department
49	pursuant to s. 408.061.
50	(c)  Procedures for receiving complaints against a
51	designated facility and for initiating inspections and
52	investigations of facilities alleged to have violated the
53	provisions of this part or rules adopted under this part.
54	(d)  Procedures and criteria for the suspension or
55	withdrawal of designation.
56	Section 2.  Paragraph (k) of subsection (3) of section
57	408.05, Florida Statutes, is amended to read:
58	408.05  Florida Center for Health Information and Policy
59	Analysis.--
60	(3)  COMPREHENSIVE HEALTH INFORMATION SYSTEM.--In order to
61	produce comparable and uniform health information and statistics
62	for the development of policy recommendations, the agency shall
63	perform the following functions:
64	(k)  Develop, in conjunction with the State Consumer Health
65	Information and Policy Advisory Council, and implement a long-
66	range plan for making available health care quality measures and
67	financial data that will allow consumers to compare health care
68	services. The health care quality measures and financial data
69	the agency must make available shall include, but is not limited
70	to, pharmaceuticals, physicians, health care facilities,
71	including health care facilities licensed under s. 394.875, and
72	health plans and managed care entities. The agency shall submit
73	the initial plan to the Governor, the President of the Senate,
74	and the Speaker of the House of Representatives by January 1,
75	2006, and shall update the plan and report on the status of its
76	implementation annually thereafter. The agency shall also make
77	the plan and status report available to the public on its
78	Internet website. As part of the plan, the agency shall identify
79	the process and timeframes for implementation, any barriers to
80	implementation, and recommendations of changes in the law that
81	may be enacted by the Legislature to eliminate the barriers. As
82	preliminary elements of the plan, the agency shall:
83	1.  Make available patient-safety indicators, inpatient
84	quality indicators, and performance outcome and patient charge
85	data collected from health care facilities pursuant to s.
86	408.061(1)(a) and (2). The terms "patient-safety indicators" and
87	"inpatient quality indicators" shall be as defined by the
88	Centers for Medicare and Medicaid Services, the National Quality
89	Forum, the Joint Commission on Accreditation of Healthcare
90	Organizations, the Agency for Healthcare Research and Quality,
91	the Centers for Disease Control and Prevention, or a similar
92	national entity that establishes standards to measure the
93	performance of health care providers, or by other states. The
94	agency shall determine which conditions, procedures, health care
95	quality measures, and patient charge data to disclose based upon
96	input from the council. When determining which conditions and
97	procedures are to be disclosed, the council and the agency shall
98	consider variation in costs, variation in outcomes, and
99	magnitude of variations and other relevant information. When
100	determining which health care quality measures to disclose, the
101	agency:
102	a.  Shall consider such factors as volume of cases; average
103	patient charges; average length of stay; complication rates;
104	mortality rates; and infection rates, among others, which shall
105	be adjusted for case mix and severity, if applicable.
106	b.  May consider such additional measures that are adopted
107	by the Centers for Medicare and Medicaid Studies, National
108	Quality Forum, the Joint Commission on Accreditation of
109	Healthcare Organizations, the Agency for Healthcare Research and
110	Quality, Centers for Disease Control and Prevention, or a
111	similar national entity that establishes standards to measure
112	the performance of health care providers, or by other states.
113
114	When determining which patient charge data to disclose, the
115	agency shall consider such measures as average charge, average
116	net revenue per adjusted patient day, average cost per adjusted
117	patient day, and average cost per admission, among others.
118	2.  Make available performance measures, benefit design,
119	and premium cost data from health plans licensed pursuant to
120	chapter 627 or chapter 641. The agency shall determine which
121	health care quality measures and member and subscriber cost data
122	to disclose, based upon input from the council. When determining
123	which data to disclose, the agency shall consider information
124	that may be required by either individual or group purchasers to
125	assess the value of the product, which may include membership
126	satisfaction, quality of care, current enrollment or membership,
127	coverage areas, accreditation status, premium costs, plan costs,
128	premium increases, range of benefits, copayments and
129	deductibles, accuracy and speed of claims payment, credentials
130	of physicians, number of providers, names of network providers,
131	and hospitals in the network. Health plans shall make available
132	to the agency any such data or information that is not currently
133	reported to the agency or the office.
134	3.  Determine the method and format for public disclosure
135	of data reported pursuant to this paragraph. The agency shall
136	make its determination based upon input from the State Consumer
137	Health Information and Policy Advisory Council. At a minimum,
138	the data shall be made available on the agency's Internet
139	website in a manner that allows consumers to conduct an
140	interactive search that allows them to view and compare the
141	information for specific providers. The website must include
142	such additional information as is determined necessary to ensure
143	that the website enhances informed decisionmaking among
144	consumers and health care purchasers, which shall include, at a
145	minimum, appropriate guidance on how to use the data and an
146	explanation of why the data may vary from provider to provider.
147	The data specified in subparagraph 1. shall be released no later
148	than January 1, 2006, for the reporting of infection rates, and
149	no later than October 1, 2005, for mortality rates and
150	complication rates. The data specified in subparagraph 2. shall
151	be released no later than October 1, 2006.
152	Section 3.  Present paragraph (e) of subsection (1) of
153	section 408.061, Florida Statutes, is redesignated as paragraph
154	(f), and a new paragraph (e) is added to that subsection, to
155	read:
156	408.061  Data collection; uniform systems of financial
157	reporting; information relating to physician charges;
158	confidential information; immunity.--
159	(1)  The agency shall require the submission by health care
160	facilities, health care providers, and health insurers of data
161	necessary to carry out the agency's duties. Specifications for
162	data to be collected under this section shall be developed by
163	the agency with the assistance of technical advisory panels
164	including representatives of affected entities, consumers,
165	purchasers, and such other interested parties as may be
166	determined by the agency.
167	(e)1.  Data to be submitted by a health care provider
168	licensed under s. 394.875 must include, but need not be limited
169	to, admission data and the source of patient referral; discharge
170	data; the patient's status at discharge; the average patient
171	length of stay by payer class; total patient days and total
172	patient admissions by payer class; the primary and secondary
173	diagnoses of each patient; the number of licensed beds in the
174	facility; the number of contracted beds in a public facility as
175	defined in s. 394.455(25); total revenues by payer class; and
176	operating expenses.
177	2.  For the purpose of this paragraph, the term "payer
178	class" includes, but is not limited to, Medicare, Medicare HMO,
179	Medicaid, Medicaid HMO, private-pay insurance, private health
180	care maintenance organization, private preferred provider
181	organization, services contracted by the Department of Children
182	and Family Services, self-pay, charity, and other government
183	programs.
184	3.  The data collected by a health care provider licensed
185	under s. 394.875 must be submitted to the agency quarterly. The
186	chief executive officer or an authorized representative or
187	employee of the licensed facility must certify that the
188	information submitted is true and accurate. Data elements shall
189	be reported electronically. The agency shall publish an annual
190	report detailing the information submitted by health care
191	providers.
192	Section 4.  For the purpose of incorporating the amendment
193	made by this act to section 408.05, Florida Statutes, in a
194	reference thereto, paragraph (c) of subsection (4) of section
195	381.026, Florida Statutes, is reenacted to read:
196	381.026  Florida Patient's Bill of Rights and
197	Responsibilities.--
198	(4)  RIGHTS OF PATIENTS.--Each health care facility or
199	provider shall observe the following standards:
200	(c)  Financial information and disclosure.--
201	1.  A patient has the right to be given, upon request, by
202	the responsible provider, his or her designee, or a
203	representative of the health care facility full information and
204	necessary counseling on the availability of known financial
205	resources for the patient's health care.
206	2.  A health care provider or a health care facility shall,
207	upon request, disclose to each patient who is eligible for
208	Medicare, in advance of treatment, whether the health care
209	provider or the health care facility in which the patient is
210	receiving medical services accepts assignment under Medicare
211	reimbursement as payment in full for medical services and
212	treatment rendered in the health care provider's office or
213	health care facility.
214	3.  A health care provider or a health care facility shall,
215	upon request, furnish a person, prior to provision of medical
216	services, a reasonable estimate of charges for such services.
217	Such reasonable estimate shall not preclude the health care
218	provider or health care facility from exceeding the estimate or
219	making additional charges based on changes in the patient's
220	condition or treatment needs.
221	4.  Each licensed facility not operated by the state shall
222	make available to the public on its Internet website or by other
223	electronic means a description of and a link to the performance
224	outcome and financial data that is published by the agency
225	pursuant to s. 408.05(3)(k). The facility shall place a notice
226	in the reception area that such information is available
227	electronically and the website address. The licensed facility
228	may indicate that the pricing information is based on a
229	compilation of charges for the average patient and that each
230	patient's bill may vary from the average depending upon the
231	severity of illness and individual resources consumed. The
232	licensed facility may also indicate that the price of service is
233	negotiable for eligible patients based upon the patient's
234	ability to pay.
235	5.  A patient has the right to receive a copy of an
236	itemized bill upon request. A patient has a right to be given an
237	explanation of charges upon request.
238	Section 5.  This act shall take effect July 1, 2007.

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