HB 1487

1	A bill to be entitled
2	An act relating to licensure of home health agencies, home
3	medical equipment providers, and health care clinics;
4	designating Miami-Dade County as a health care fraud area
5	of special concern for certain purposes; creating s.
6	408.8065, F.S.; providing requirements for licensure of
7	home health agencies, home medical equipment providers,
8	and health care clinics; requiring the posting of a surety
9	bond in a specified minimum amount under certain
10	circumstances; requiring demonstration of financial
11	viability; providing limitations on licensing of home
12	health agencies in certain counties; providing an
13	exception for certain established home health agencies;
14	providing penalties; authorizing the Agency for Health
15	Care Administration to adopt rules; providing for
16	construction; providing an effective date.
17
18	WHEREAS, the Legislature finds that the standards for
19	licensure of home health agencies, home medical equipment
20	providers, and health care clinics need to be strengthened and
21	enhanced, and
22	WHEREAS, the Legislature recognizes that immediate and
23	proactive measures are necessary to prevent, reduce, and
24	mitigate health care fraud, waste, and abuse and are essential
25	to maintaining the integrity and financial viability of health
26	care delivery systems, including those funded in whole or in
27	part by Medicare and Medicaid trust funds, and
28	WHEREAS, without such measures, health care delivery
29	systems will be depleted of necessary funds to deliver patient
30	care, taxpayer dollars will be undervalued and not used for
31	their intended purposes, and the impact of those dollars will be
32	reduced, and
33	WHEREAS, Miami-Dade County experiences an extremely high
34	rate of health care fraud, waste, and abuse compared to the rest
35	of the state, and
36	WHEREAS, Miami-Dade County is considered and found to be a
37	locality posing an inordinately high risk for Medicare and
38	Medicaid fraud, waste, and abuse and is commonly known
39	throughout the United States for its high incidence of health
40	care fraud and abuse and related criminal activities perpetuated
41	by entities operating under the guise of legitimate health care
42	providers, and
43	WHEREAS, the Legislature finds that there is sufficient
44	justification for increased regulation and oversight of home
45	health agencies, home medical equipment providers, and health
46	care clinics throughout the State of Florida and, in particular,
47	in Miami-Dade County, and
48	WHEREAS, the Legislature further finds it to be in the
49	best interest of the state to deter and identify patterns of
50	fraudulent or abusive Medicare and Medicaid activity early,
51	especially in high-risk localities such as Miami-Dade County, to
52	prevent health care fraud and harm to the citizens of the state,
53	NOW, THEREFORE,
54
55	Be It Enacted by the Legislature of the State of Florida:
56
57	Section 1.  The Legislature hereby designates Miami-Dade
58	County as a health care fraud area of special concern for
59	purposes of implementing increased scrutiny of home health
60	agencies, home medical equipment providers, and health care
61	clinics in Miami-Dade County in order to assist the state's
62	efforts to prevent Medicaid fraud, waste, and abuse in the
63	county and throughout the state.
64	Section 2.  Section 408.8065, Florida Statutes, is created
65	to read:
66	408.8065  Licensure requirements for home health agencies,
67	home medical equipment providers, and health care clinics.--
68	(1)  As used in this section, the term "agency" means the
69	Agency for Health Care Administration.
70	(2)  An applicant for licensure as a home health agency,
71	home medical equipment provider, or health care clinic shall
72	comply with the following requirements:
73	(a)  To be an applicant or controlling interest in a home
74	health agency, a home medical equipment provider, or a health
75	care clinic licensed under this section, an applicant must have
76	been a legal resident of the United States for at least 5 years,
77	unless the applicant files a surety bond of at least $500,000,
78	payable to the agency, which guarantees that the home health
79	agency, home medical equipment provider, or health care clinic
80	will act in full conformity with all legal requirements for
81	operation. The agency may adopt rules to specify related
82	requirements for such surety bond.
83	(b)  An applicant must demonstrate financial ability to
84	operate, as required under s. 408.810(8), and submit a financial
85	statement, including a balance sheet and an income and expense
86	statement, for the first year of operation that provides
87	evidence that the applicant has sufficient assets, credit, and
88	projected revenues to cover liabilities and expenses. The
89	applicant must demonstrate the financial ability to operate if
90	the applicant's assets, credit, and projected revenues do not
91	meet or exceed projected liabilities and expenses. The applicant
92	must also prove it has the ability to fund all startup costs
93	through the break-even point in operations by submitting a
94	statement of estimated provider startup costs and sources of
95	funds. The statement shall disclose, at a minimum, reasonable
96	anticipated startup costs, including operating funds needed to
97	reach the break-even point when operating receipts equal or
98	exceed expenditures. At a minimum, operating funds to reach the
99	break-even point must equal 2 months of average expenses to
100	cover working capital and contingencies. The applicant must
101	provide documented proof that these funds will be available as
102	needed. All documents required under this subsection must be
103	prepared in accordance with generally accepted accounting
104	principles and may be in a compilation form. The financial
105	statement must be signed by a certified public accountant.
106	(3)  The agency may not issue a license to a home health
107	agency under part III of chapter 400 or this part for the
108	purpose of opening a new home health agency until July 1, 2012,
109	in any county where the ratio of persons 65 years of age or
110	older, as indicated in the most recent United States Census, to
111	the number of home health agencies is 1,500:1 or less. For the
112	purposes of this subsection, the agency may continue to process
113	and issue a license to a home health agency only if the home
114	health agency has received full accreditation before May 1,
115	2009.
116	(4)  In addition to the requirements of s. 408.812, any
117	person establishing, operating, or managing an unlicensed
118	facility otherwise required to be licensed under this part or
119	part III, part VII, or part X of chapter 400; any person who
120	knowingly files a false or misleading license application or
121	license renewal application or who submits false or misleading
122	information related to such application or agency rule; or any
123	person who violates or conspires to violate this section commits
124	a felony of the third degree, punishable as provided in s.
125	775.082, s. 775.083, or s. 775.084.
126	(5)  The agency may adopt rules pursuant to ss. 120.536(1)
127	and 120.54 to implement this section.
128	(6)  A provision of this section controls over any
129	conflicting provision of part III, part VII, or part X of
130	chapter 400.
131	Section 3.  This act shall take effect July 1, 2009.

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