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The Committee on Health Policy (Joyner) recommended the following

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amendment:

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     Senate Amendment (with title amendment)

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     Delete everything after the enacting clause

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and insert:

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     Section 1.  Section 395.301, Florida Statutes, is amended to

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read:

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     395.301  Itemized patient bill; form and content prescribed

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by the agency; hospital staffing disclosure.--

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     (1)  A licensed facility not operated by the state shall

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notify each patient during admission and at discharge of his or

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her right to receive an itemized bill upon request. Within 7 days

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following the patient's discharge or release from a licensed

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facility not operated by the state, the licensed facility

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providing the service shall, upon request, submit to the patient,

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or to the patient's survivor or legal guardian as may be

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appropriate, an itemized statement detailing in language

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comprehensible to an ordinary layperson the specific nature of

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charges or expenses incurred by the patient, which in the initial

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billing shall contain a statement of specific services received

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and expenses incurred for such items of service, enumerating in

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detail the constituent components of the services received within

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each department of the licensed facility and including unit price

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data on rates charged by the licensed facility, as prescribed by

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the agency.

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     (2)(a)  Each such statement submitted pursuant to this

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section:

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     1.  May not include charges of hospital-based physicians if

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billed separately.

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     2.  May not include any generalized category of expenses

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such as "other" or "miscellaneous" or similar categories.

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     3.  Shall list drugs by brand or generic name and not refer

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to drug code numbers when referring to drugs of any sort.

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     4.  Shall specifically identify therapy treatment as to the

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date, type, and length of treatment when therapy treatment is a

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part of the statement.

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     (b)  Any person receiving a statement pursuant to this

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section shall be fully and accurately informed as to each charge

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and service provided by the institution preparing the statement.

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     (3)  On each itemized statement submitted pursuant to

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subsection (1) there shall appear the words "A FOR-PROFIT (or

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NOT-FOR-PROFIT or PUBLIC) HOSPITAL (or AMBULATORY SURGICAL

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CENTER) LICENSED BY THE STATE OF FLORIDA" or substantially

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similar words sufficient to identify clearly and plainly the

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ownership status of the licensed facility. Each itemized

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statement must prominently display the phone number of the

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medical facility's patient liaison who is responsible for

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expediting the resolution of any billing dispute between the

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patient, or his or her representative, and the billing

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department.

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     (4)  An itemized bill shall be provided once to the

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patient's physician at the physician's request, at no charge.

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     (5)  In any billing for services subsequent to the initial

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billing for such services, the patient, or the patient's survivor

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or legal guardian, may elect, at his or her option, to receive a

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copy of the detailed statement of specific services received and

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expenses incurred for each such item of service as provided in

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subsection (1).

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     (6)  No physician, dentist, podiatric physician, or licensed

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facility may add to the price charged by any third party except

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for a service or handling charge representing a cost actually

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incurred as an item of expense; however, the physician, dentist,

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podiatric physician, or licensed facility is entitled to fair

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compensation for all professional services rendered. The amount

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of the service or handling charge, if any, shall be set forth

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clearly in the bill to the patient.

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     (7)  Each licensed facility not operated by the state shall

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provide, prior to provision of any nonemergency medical services,

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a written good faith estimate of reasonably anticipated charges

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for the facility to treat the patient's condition upon written

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request of a prospective patient. The estimate shall be provided

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to the prospective patient within 7 business days after the

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receipt of the request. The estimate may be the average charges

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for that diagnosis related group or the average charges for that

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procedure. Upon request, the facility shall notify the patient of

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any revision to the good faith estimate. Such estimate shall not

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preclude the actual charges from exceeding the estimate. The

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facility shall place a notice in the reception area that such

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information is available. Failure to provide the estimate within

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the provisions established pursuant to this section shall result

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in a fine of $500 for each instance of the facility's failure to

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provide the requested information.

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     (8)  A licensed facility shall make available to a patient

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all records necessary for verification of the accuracy of the

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patient's bill within 30 business days after the request for such

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records. The verification information must be made available in

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the facility's offices. Such records shall be available to the

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patient prior to and after payment of the bill or claim. The

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facility may not charge the patient for making such verification

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records available; however, the facility may charge its usual fee

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for providing copies of records as specified in s. 395.3025.

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     (9)  Each facility shall establish a method for reviewing

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and responding to questions from patients concerning the

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patient's itemized bill. Such response shall be provided within

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30 days after the date a question is received. If the patient is

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not satisfied with the response, the facility must provide the

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patient with the address of the agency to which the issue may be

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sent for review.

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     (10)  Each licensed facility shall make available on its

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Internet website a link to the performance outcome and financial

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data that is published by the Agency for Health Care

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Administration pursuant to s. 408.05(3)(k). The facility shall

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place a notice in the reception area that the information is

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available electronically and the facility's Internet website

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address.

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     (11) An acute care hospital shall provide to any person,

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within 48 hours after receiving a written request, a report of

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the daily staffing level of the direct care nursing staff,

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registered nurses, licensed practical nurses, and certified

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nursing assistants in each patient care unit for each shift and

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each day of the month preceding the request, the daily census by

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patient care unit for each shift and each day of the month

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preceding the request, and the projected schedule and anticipated

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average daily census by patient care unit of the hospital for a

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minimum period of 30 days following the date of the request.

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     Section 2.  This act shall take effect July 1, 2008.

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================ T I T L E  A M E N D M E N T ================

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And the title is amended as follows:

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     Delete everything before the enacting clause

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and insert:

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A bill to be entitled

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An act relating to the staffing of health care facilities;

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amending s. 395.301, F.S.; requiring acute care hospitals

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to make information concerning staffing levels at the

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hospital available to the public upon request; providing

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an effective date.

4/14/2008  10:34:00 AM     18-07458-08