Florida Senate - 2009 COMMITTEE AMENDMENT
Bill No. CS for SB 2286
Barcode 304236
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/21/2009 .
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The Committee on Judiciary (Baker) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. The Legislature finds that:
6 (1) Immediate and proactive measures are necessary to
7 prevent, reduce, and mitigate health care fraud, waste, and
8 abuse and are essential to maintaining the integrity and
9 financial viability of health care delivery systems, including
10 those funded in whole or in part by the Medicare and Medicaid
11 trust funds. Without these measures, health care delivery
12 systems in this state will be depleted of necessary funds to
13 deliver patient care, and taxpayers’ dollars will be devalued
14 and not used for their intended purposes.
15 (2) Sufficient justification exists for increased oversight
16 of health care clinics, home health agencies, providers of home
17 medical equipment, and other health care providers throughout
18 the state, and in particular, in Miami-Dade County.
19 (3) The state’s best interest is served by deterring health
20 care fraud, abuse, and waste and identifying patterns of
21 fraudulent or abusive Medicare and Medicaid activity early,
22 especially in high-risk localities, such as Miami-Dade County,
23 in order to prevent inappropriate expenditures of public funds
24 and harm to the state’s residents.
25 (4) The Legislature designates Miami-Dade County as a
26 health care fraud crisis area for purposes of implementing
27 increased scrutiny of home health agencies, home medical
28 equipment providers, health care clinics, and other health care
29 providers in Miami-Dade County in order to assist the state’s
30 efforts to prevent Medicaid fraud, waste, and abuse in the
31 county and throughout the state.
32 Section 2. Section 68.085, Florida Statutes, is amended to
33 read:
34 68.085 Awards to plaintiffs bringing action.—
35 (1) If the department proceeds with and prevails in an
36 action brought by a person under this act, except as provided in
37 subsection (2), the court shall order the distribution to the
38 person of at least 15 percent but not more than 25 percent of
39 the proceeds recovered under any judgment obtained by the
40 department in an action under s. 68.082 or of the proceeds of
41 any settlement of the claim, depending upon the extent to which
42 the person substantially contributed to the prosecution of the
43 action.
44 (2) If the department proceeds with an action which the
45 court finds to be based primarily on disclosures of specific
46 information, other than that provided by the person bringing the
47 action, relating to allegations or transactions in a criminal,
48 civil, or administrative hearing; a legislative, administrative,
49 inspector general, or auditor general report, hearing, audit, or
50 investigation; or from the news media, the court may award such
51 sums as it considers appropriate, but in no case more than 10
52 percent of the proceeds recovered under a judgment or received
53 in settlement of a claim under this act, taking into account the
54 significance of the information and the role of the person
55 bringing the action in advancing the case to litigation.
56 (3) If the department does not proceed with an action under
57 this section, the person bringing the action or settling the
58 claim shall receive an amount which the court decides is
59 reasonable for collecting the civil penalty and damages. The
60 amount shall be not less than 25 percent and not more than 30
61 percent of the proceeds recovered under a judgment rendered in
62 an action under this act or in settlement of a claim under this
63 act.
64 (4) Following any distributions under subsection (1),
65 subsection (2), or subsection (3), the agency injured by the
66 submission of a false or fraudulent claim shall be awarded an
67 amount not to exceed its compensatory damages. If the action was
68 based on a claim of funds from the state Medicaid program, 10
69 percent of any remaining proceeds shall be deposited into the
70 Legal Affairs Revolving Trust Fund to fund rewards for persons
71 who report and provide information relating to Medicaid fraud
72 pursuant to s. 409.9203. Any remaining proceeds, including civil
73 penalties awarded under s. 68.082, shall be deposited in the
74 General Revenue Fund.
75 (5) Any payment under this section to the person bringing
76 the action shall be paid only out of the proceeds recovered from
77 the defendant.
78 (6) Whether or not the department proceeds with the action,
79 if the court finds that the action was brought by a person who
80 planned and initiated the violation of s. 68.082 upon which the
81 action was brought, the court may, to the extent the court
82 considers appropriate, reduce the share of the proceeds of the
83 action which the person would otherwise receive under this
84 section, taking into account the role of the person in advancing
85 the case to litigation and any relevant circumstances pertaining
86 to the violation. If the person bringing the action is convicted
87 of criminal conduct arising from his or her role in the
88 violation of s. 68.082, the person shall be dismissed from the
89 civil action and shall not receive any share of the proceeds of
90 the action. Such dismissal shall not prejudice the right of the
91 department to continue the action.
92 Section 3. Section 68.086, Florida Statutes, is amended to
93 read:
94 68.086 Expenses; attorney’s fees and costs.—
95 (1) If the department initiates an action under this act or
96 assumes control of an action brought by a person under this act,
97 the department shall be awarded its reasonable attorney’s fees,
98 expenses, and costs.
99 (2) If the court awards the person bringing the action
100 proceeds under this act, the person shall also be awarded an
101 amount for reasonable attorney’s fees and costs. Payment for
102 reasonable attorney’s fees and costs shall be made from the
103 recovered proceeds before the distribution of any award.
104 (3) If the department does not proceed with an action under
105 this act and the person bringing the action conducts the action
106 defendant is the prevailing party, the court may shall award to
107 the defendant its reasonable attorney’s fees and costs if the
108 defendant prevails in the action and the court finds that the
109 claim of against the person bringing the action was clearly
110 frivolous, clearly vexatious, or brought primarily for purposes
111 of harassment.
112 (4) No liability shall be incurred by the state government,
113 the affected agency, or the department for any expenses,
114 attorney’s fees, or other costs incurred by any person in
115 bringing or defending an action under this act.
116 Section 4. Subsection (10) is added to section 400.471,
117 Florida Statutes, to read:
118 400.471 Application for license; fee.—
119 (10) The agency may not issue a renewal license for a home
120 health agency in any county having at least one licensed home
121 health agency and that has more than one home health agency per
122 5,000 persons, as indicated by the most recent population
123 estimates published by the Legislature’s Office of Economic and
124 Demographic Research, if the applicant or any controlling
125 interest has been administratively sanctioned by the agency
126 since the last licensure renewal application for one or more of
127 the following acts:
128 (a) An intentional or negligent act that materially affects
129 the health or safety of a client of the provider;
130 (b) Knowingly providing home health services in an
131 unlicensed assisted living facility or unlicensed adult family
132 care home, unless the home health agency or employee reports the
133 unlicensed facility or home to the agency within 72 hours after
134 providing the services;
135 (c) Preparing or maintaining fraudulent patient records,
136 such as, but not limited to, charting ahead, recording vital
137 signs or symptoms which were not personally obtained or observed
138 by the home health agency’s staff at the time indicated,
139 borrowing patients or patient records from other home health
140 agencies to pass a survey or inspection, or falsifying
141 signatures;
142 (d) Failing to provide at least one service directly to a
143 patient for a period of 60 days;
144 (e) Demonstrating a pattern of falsifying documents
145 relating to the training of home health aides or certified
146 nursing assistants or demonstrating a pattern of falsifying
147 health statements for staff who provide direct care to patients.
148 A pattern may be demonstrated by a showing of at least three
149 fraudulent entries or documents;
150 (f) Demonstrating a pattern of billing any payor for
151 services not provided. A pattern may be demonstrated by a
152 showing of at least three billings for services not provided
153 within a 12-month period;
154 (g) Demonstrating a pattern of failing to provide a service
155 specified in the home health agency’s written agreement with a
156 patient or the patient’s legal representative, or the plan of
157 care for that patient, unless a reduction in service is mandated
158 by Medicare, Medicaid, or a state program or as provided in s.
159 400.492(3). A pattern may be demonstrated by a showing of at
160 least three incidents, regardless of the patient or service, in
161 which the home health agency did not provide a service specified
162 in a written agreement or plan of care during a 3-month period;
163 (h) Giving remuneration to a case manager, discharge
164 planner, facility-based staff member, or third-party vendor who
165 is involved in the discharge planning process of a facility
166 licensed under chapter 395, chapter 429, or this chapter from
167 whom the home health agency receives referrals or gives
168 remuneration as prohibited in s. 400.474(6)(a);
169 (i) Giving cash, or its equivalent, to a Medicare or
170 Medicaid beneficiary;
171 (j) Demonstrating a pattern of billing the Medicaid program
172 for services to Medicaid recipients which are medically
173 unnecessary. A pattern may be demonstrated by a showing of at
174 least two fraudulent entries or documents;
175 (k) Providing services to residents in an assisted living
176 facility for which the home health agency does not receive fair
177 market value remuneration; or
178 (l) Providing staffing to an assisted living facility for
179 which the home health agency does not receive fair market value
180 remuneration.
181 Section 5. Paragraph (e) of subsection (6) of section
182 400.474, Florida Statutes, is amended, and paragraph (l) is
183 added to that subsection, to read:
184 400.474 Administrative penalties.—
185 (6) The agency may deny, revoke, or suspend the license of
186 a home health agency and shall impose a fine of $5,000 against a
187 home health agency that:
188 (e) Gives remuneration to a case manager, discharge
189 planner, facility-based staff member, or third-party vendor who
190 is involved in the discharge planning process of a facility
191 licensed under chapter 395, chapter 429, or this chapter from
192 whom the home health agency receives referrals.
193 (l) Demonstrates a pattern of billing the Medicaid program
194 for services to Medicaid recipients which are medically
195 unnecessary. A pattern may be demonstrated by a showing of at
196 least two medically unnecessary services.
197 Section 6. Paragraph (a) of subsection (15) of section
198 400.506, Florida Statutes, is amended to read:
199 400.506 Licensure of nurse registries; requirements;
200 penalties.—
201 (15)(a) The agency may deny, suspend, or revoke the license
202 of a nurse registry and shall impose a fine of $5,000 against a
203 nurse registry that:
204 1. Provides services to residents in an assisted living
205 facility for which the nurse registry does not receive fair
206 market value remuneration.
207 2. Provides staffing to an assisted living facility for
208 which the nurse registry does not receive fair market value
209 remuneration.
210 3. Fails to provide the agency, upon request, with copies
211 of all contracts with assisted living facilities which were
212 executed within the last 5 years.
213 4. Gives remuneration to a case manager, discharge planner,
214 facility-based staff member, or third-party vendor who is
215 involved in the discharge planning process of a facility
216 licensed under chapter 395 or this chapter and from whom the
217 nurse registry receives referrals. However, this subparagraph
218 does not prohibit a nurse registry from providing promotional
219 items or promotional products, food, or beverages. The
220 cumulative value of these items may not exceed $50 for a single
221 event. The cumulative value of these items may not exceed $100
222 in a calendar year for all persons specified in this
223 subparagraph who are affiliated with a facility.
224 5. Gives remuneration to a physician, a member of the
225 physician’s office staff, or an immediate family member of the
226 physician, and the nurse registry received a patient referral in
227 the last 12 months from that physician or the physician’s office
228 staff. However, this subparagraph does not prohibit a nurse
229 registry from providing promotional items or promotional
230 products, food, or beverages. The cumulative value of these
231 items may not exceed $50 for a single event. The cumulative
232 value of these items may not exceed $100 in a calendar year for
233 all persons specified in this subparagraph who are affiliated
234 with a physician’s office.
235 Section 7. Section 408.8065, Florida Statutes, is created
236 to read:
237 408.8065 Additional licensure requirements for home health
238 agencies, home medical equipment providers, and health care
239 clinics.—
240 (1) An applicant for initial licensure, or initial
241 licensure due to a change of ownership, as a home health agency,
242 home medical equipment provider, or health care clinic shall:
243 (a) Demonstrate financial ability to operate, as required
244 under s. 408.810(8).
245 (b) Submit pro forma financial statements, including a
246 balance sheet, income and expense statement, and a statement of
247 cash flows for the first 2 years of operation which provide
248 evidence that the applicant has sufficient assets, credit, and
249 projected revenues to cover liabilities and expenses.
250 (c) Submit a statement of the applicant’s estimated startup
251 costs and sources of funds through the break-even point in
252 operations demonstrating that the applicant has the ability to
253 fund all startup costs, working capital, and contingency
254 financing. The statement must show that the applicant has at a
255 minimum 3 months of average projected expenses to cover startup
256 costs, working capital, and contingency financing. The minimum
257 amount for contingency funding may not be less than 1 month of
258 average projected expenses.
259 (d) Demonstrate the financial ability to operate if the
260 applicant’s assets, credit, and projected revenues meet or
261 exceed projected liabilities and expenses, and provide
262 independent evidence that the funds necessary for startup costs,
263 working capital, and contingency financing exist and will be
264 available as needed.
265
266 All documents required under this subsection must be prepared in
267 accordance with generally accepted accounting principles and may
268 be in a compilation form. The financial statements must be
269 signed by a certified public accountant.
270 (2) In addition to the penalties provided in s. 408.812,
271 any person offering services requiring licensure under part III,
272 part VII, or part X of chapter 400, who knowingly files a false
273 or misleading license or license renewal application or who
274 submits false or misleading information related to such
275 application, and any person who violates or conspires to violate
276 this section, commits a felony of the third degree, punishable
277 as provided in s. 775.082, s. 775.083, or s. 775.084.
278 Section 8. Subsection (3) and paragraph (a) of subsection
279 (5) of section 408.810, Florida Statutes, are amended to read:
280 408.810 Minimum licensure requirements.—In addition to the
281 licensure requirements specified in this part, authorizing
282 statutes, and applicable rules, each applicant and licensee must
283 comply with the requirements of this section in order to obtain
284 and maintain a license.
285 (3) Unless otherwise specified in this part, authorizing
286 statutes, or applicable rules, any information required to be
287 reported to the agency must be submitted within 21 calendar days
288 after the report period or effective date of the information,
289 whichever is earlier, including, but not limited to, any change
290 of:
291 (a) Information contained in the most recent application
292 for licensure.
293 (b) Required insurance or bonds.
294 (5)(a) On or before the first day services are provided to
295 a client, a licensee must inform the client and his or her
296 immediate family or representative, if appropriate, of the right
297 to report:
298 1. Complaints. The statewide toll-free telephone number for
299 reporting complaints to the agency must be provided to clients
300 in a manner that is clearly legible and must include the words:
301 “To report a complaint regarding the services you receive,
302 please call toll-free (phone number).”
303 2. Abusive, neglectful, or exploitative practices. The
304 statewide toll-free telephone number for the central abuse
305 hotline must be provided to clients in a manner that is clearly
306 legible and must include the words: “To report abuse, neglect,
307 or exploitation, please call toll-free (phone number).”
308 3. Medicaid fraud. An agency-written description of
309 Medicaid fraud and the statewide toll-free telephone number for
310 the central Medicaid fraud hotline must be provided to clients
311 in a manner that is clearly legible and must include the words:
312 “To report suspected Medicaid fraud, please call toll-free
313 (phone number).”
314
315 The agency shall publish a minimum of a 90-day advance notice of
316 a change in the toll-free telephone numbers.
317 Section 9. Subsection (4) is added to section 408.815,
318 Florida Statutes, to read:
319 408.815 License or application denial; revocation.—
320 (4) In addition to the grounds provided in authorizing
321 statutes, the agency shall deny an application for a license or
322 license renewal if the applicant or a person having a
323 controlling interest in an applicant has been:
324 (a) Convicted of, or enters a plea of guilty or nolo
325 contendere to, regardless of adjudication, a felony under
326 chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or
327 42 U.S.C. ss. 1395-1396; or
328 (b) Terminated for cause, pursuant to the appeals
329 procedures established by the state or Federal Government, from
330 any state Medicaid program or the federal Medicare program.
331 Section 10. Subsection (4) of section 409.905, Florida
332 Statutes, is amended to read:
333 409.905 Mandatory Medicaid services.—The agency may make
334 payments for the following services, which are required of the
335 state by Title XIX of the Social Security Act, furnished by
336 Medicaid providers to recipients who are determined to be
337 eligible on the dates on which the services were provided. Any
338 service under this section shall be provided only when medically
339 necessary and in accordance with state and federal law.
340 Mandatory services rendered by providers in mobile units to
341 Medicaid recipients may be restricted by the agency. Nothing in
342 this section shall be construed to prevent or limit the agency
343 from adjusting fees, reimbursement rates, lengths of stay,
344 number of visits, number of services, or any other adjustments
345 necessary to comply with the availability of moneys and any
346 limitations or directions provided for in the General
347 Appropriations Act or chapter 216.
348 (4) HOME HEALTH CARE SERVICES.—The agency shall pay for
349 nursing and home health aide services, supplies, appliances, and
350 durable medical equipment, necessary to assist a recipient
351 living at home. An entity that provides services pursuant to
352 this subsection shall be licensed under part III of chapter 400.
353 These services, equipment, and supplies, or reimbursement
354 therefor, may be limited as provided in the General
355 Appropriations Act and do not include services, equipment, or
356 supplies provided to a person residing in a hospital or nursing
357 facility.
358 (a) In providing home health care services, the agency may
359 require prior authorization of care based on diagnosis or
360 utilization rates. The agency shall require prior authorization
361 for visits for home health services that are not associated with
362 a skilled nursing visit when the home health agency utilization
363 rates exceed the state average by 50 percent or more. The home
364 health agency must submit the recipient’s plan of care and
365 documentation that supports the recipient’s diagnosis to the
366 agency when requesting prior authorization.
367 (b) The agency shall implement a comprehensive utilization
368 management program that requires prior authorization of all
369 private duty nursing services, an individualized treatment plan
370 that includes information about medication and treatment orders,
371 treatment goals, methods of care to be used, and plans for care
372 coordination by nurses and other health professionals. The
373 utilization management program shall also include a process for
374 periodically reviewing the ongoing use of private duty nursing
375 services. The assessment of need shall be based on a child’s
376 condition, family support and care supplements, a family’s
377 ability to provide care, and a family’s and child’s schedule
378 regarding work, school, sleep, and care for other family
379 dependents. When implemented, the private duty nursing
380 utilization management program shall replace the current
381 authorization program used by the Agency for Health Care
382 Administration and the Children’s Medical Services program of
383 the Department of Health. The agency may competitively bid on a
384 contract to select a qualified organization to provide
385 utilization management of private duty nursing services. The
386 agency is authorized to seek federal waivers to implement this
387 initiative.
388 (c) The agency may not pay for home health services, unless
389 the services are medically necessary, and:
390 1. The services are ordered by a physician.
391 2. The written prescription for the services is signed and
392 dated by the recipient’s physician before the development of a
393 plan of care and before any request requiring prior
394 authorization.
395 3. The physician ordering the services is not employed,
396 under contract with, or otherwise affiliated with the home
397 health agency rendering the services. However, this subparagraph
398 does not apply to a home health agency affiliated with a
399 retirement community, of which the parent corporation or a
400 related legal entity owns a rural health clinic certified under
401 42 C.F.R. part 491, subpart A, ss. 1-11, a nursing home licensed
402 under part II of chapter 400, or an apartment or single-family
403 home for independent living.
404 4. The physician ordering the services has examined the
405 recipient within the 30 days preceding the initial request for
406 the services and biannually thereafter.
407 5. The written prescription for the services includes the
408 recipient’s acute or chronic medical condition or diagnosis, the
409 home health service required, and, for skilled nursing services,
410 the frequency and duration of the services.
411 6. The national provider identifier, Medicaid
412 identification number, or medical practitioner license number of
413 the physician ordering the services is listed on the written
414 prescription for the services, the claim for home health
415 reimbursement, and the prior authorization request.
416 Section 11. Subsection (1) of section 409.907, Florida
417 Statutes, is amended to read:
418 (1) Each provider agreement shall require the provider to
419 comply fully with all state and federal laws pertaining to the
420 Medicaid program, as well as all federal, state, and local laws
421 pertaining to licensure, if required, and the practice of any of
422 the healing arts, and shall require the provider to provide
423 services or goods of not less than the scope and quality it
424 provides to the general public. Providers physically located in
425 the State of Florida may be enrolled as Medicaid providers. A
426 provider located outside the State of Florida may be enrolled if
427 the provider’s location is no more than 50 miles from the
428 Florida state line, and the agency determines a need for that
429 provider type to ensure adequate access to care.
430 Section 12. Subsection (14) of section 409.912, Florida
431 Statutes, is amended to read:
432 409.912 Cost-effective purchasing of health care.—The
433 agency shall purchase goods and services for Medicaid recipients
434 in the most cost-effective manner consistent with the delivery
435 of quality medical care. To ensure that medical services are
436 effectively utilized, the agency may, in any case, require a
437 confirmation or second physician’s opinion of the correct
438 diagnosis for purposes of authorizing future services under the
439 Medicaid program. This section does not restrict access to
440 emergency services or poststabilization care services as defined
441 in 42 C.F.R. part 438.114. Such confirmation or second opinion
442 shall be rendered in a manner approved by the agency. The agency
443 shall maximize the use of prepaid per capita and prepaid
444 aggregate fixed-sum basis services when appropriate and other
445 alternative service delivery and reimbursement methodologies,
446 including competitive bidding pursuant to s. 287.057, designed
447 to facilitate the cost-effective purchase of a case-managed
448 continuum of care. The agency shall also require providers to
449 minimize the exposure of recipients to the need for acute
450 inpatient, custodial, and other institutional care and the
451 inappropriate or unnecessary use of high-cost services. The
452 agency shall contract with a vendor to monitor and evaluate the
453 clinical practice patterns of providers in order to identify
454 trends that are outside the normal practice patterns of a
455 provider’s professional peers or the national guidelines of a
456 provider’s professional association. The vendor must be able to
457 provide information and counseling to a provider whose practice
458 patterns are outside the norms, in consultation with the agency,
459 to improve patient care and reduce inappropriate utilization.
460 The agency may mandate prior authorization, drug therapy
461 management, or disease management participation for certain
462 populations of Medicaid beneficiaries, certain drug classes, or
463 particular drugs to prevent fraud, abuse, overuse, and possible
464 dangerous drug interactions. The Pharmaceutical and Therapeutics
465 Committee shall make recommendations to the agency on drugs for
466 which prior authorization is required. The agency shall inform
467 the Pharmaceutical and Therapeutics Committee of its decisions
468 regarding drugs subject to prior authorization. The agency is
469 authorized to limit the entities it contracts with or enrolls as
470 Medicaid providers by developing a provider network through
471 provider credentialing. The agency may competitively bid single
472 source-provider contracts if procurement of goods or services
473 results in demonstrated cost savings to the state without
474 limiting access to care. The agency may limit its network based
475 on the assessment of beneficiary access to care, provider
476 availability, provider quality standards, time and distance
477 standards for access to care, the cultural competence of the
478 provider network, demographic characteristics of Medicaid
479 beneficiaries, practice and provider-to-beneficiary standards,
480 appointment wait times, beneficiary use of services, provider
481 turnover, provider profiling, provider licensure history,
482 previous program integrity investigations and findings, peer
483 review, provider Medicaid policy and billing compliance records,
484 clinical and medical record audits, and other factors. Providers
485 shall not be entitled to enrollment in the Medicaid provider
486 network. The agency shall determine instances in which allowing
487 Medicaid beneficiaries to purchase durable medical equipment and
488 other goods is less expensive to the Medicaid program than long
489 term rental of the equipment or goods. The agency may establish
490 rules to facilitate purchases in lieu of long-term rentals in
491 order to protect against fraud and abuse in the Medicaid program
492 as defined in s. 409.913. The agency may seek federal waivers
493 necessary to administer these policies.
494 (14)(a) The agency shall operate or contract for the
495 operation of utilization management and incentive systems
496 designed to encourage cost-effective use of services and to
497 eliminate services that are medically unnecessary. The agency
498 shall track Medicaid provider prescription and billing patterns
499 and evaluate them against Medicaid medical necessity criteria
500 and coverage and limitation guidelines adopted by rule. Medical
501 necessity determination requires that service be consistent with
502 symptoms or confirmed diagnosis of illness or injury under
503 treatment and not in excess of the patient’s needs. The agency
504 shall conduct reviews of provider exceptions to peer group norms
505 and shall, using statistical methodologies, provider profiling,
506 and analysis of billing patterns, detect and investigate
507 abnormal or unusual increases in billing or payment of claims
508 for Medicaid services and medically unnecessary provision of
509 services. Providers that demonstrate a pattern of submitting
510 claims for medically unnecessary services shall be referred to
511 the Medicaid program integrity unit for investigation. In its
512 annual report, required in s. 409.913, the agency shall report
513 on its efforts to control overutilization as described in this
514 paragraph.
515 (b) The agency shall develop a procedure for determining
516 whether health care providers and service vendors can provide
517 the Medicaid program using a business case that demonstrates
518 whether a particular good or service can offset the cost of
519 providing the good or service in an alternative setting or
520 through other means and therefore should receive a higher
521 reimbursement. The business case must include, but need not be
522 limited to:
523 1. A detailed description of the good or service to be
524 provided, a description and analysis of the agency’s current
525 performance of the service, and a rationale documenting how
526 providing the service in an alternative setting would be in the
527 best interest of the state, the agency, and its clients.
528 2. A cost-benefit analysis documenting the estimated
529 specific direct and indirect costs, savings, performance
530 improvements, risks, and qualitative and quantitative benefits
531 involved in or resulting from providing the service. The cost
532 benefit analysis must include a detailed plan and timeline
533 identifying all actions that must be implemented to realize
534 expected benefits. The Secretary of Health Care Administration
535 shall verify that all costs, savings, and benefits are valid and
536 achievable.
537 (c) If the agency determines that the increased
538 reimbursement is cost-effective, the agency shall recommend a
539 change in the reimbursement schedule for that particular good or
540 service. If, within 12 months after implementing any rate change
541 under this procedure, the agency determines that costs were not
542 offset by the increased reimbursement schedule, the agency may
543 revert to the former reimbursement schedule for the particular
544 good or service.
545 Section 13. Subsections (2), (7), (11), (13), (14), (15),
546 (21), (22), (24), (25), (27), (30), (31), and (36) of section
547 409.913, Florida Statutes, are amended, and subsections (37) and
548 (38) are added to that section, to read:
549 409.913 Oversight of the integrity of the Medicaid
550 program.—The agency shall operate a program to oversee the
551 activities of Florida Medicaid recipients, and providers and
552 their representatives, to ensure that fraudulent and abusive
553 behavior and neglect of recipients occur to the minimum extent
554 possible, and to recover overpayments and impose sanctions as
555 appropriate. Beginning January 1, 2003, and each year
556 thereafter, the agency and the Medicaid Fraud Control Unit of
557 the Department of Legal Affairs shall submit a joint report to
558 the Legislature documenting the effectiveness of the state’s
559 efforts to control Medicaid fraud and abuse and to recover
560 Medicaid overpayments during the previous fiscal year. The
561 report must describe the number of cases opened and investigated
562 each year; the sources of the cases opened; the disposition of
563 the cases closed each year; the amount of overpayments alleged
564 in preliminary and final audit letters; the number and amount of
565 fines or penalties imposed; any reductions in overpayment
566 amounts negotiated in settlement agreements or by other means;
567 the amount of final agency determinations of overpayments; the
568 amount deducted from federal claiming as a result of
569 overpayments; the amount of overpayments recovered each year;
570 the amount of cost of investigation recovered each year; the
571 average length of time to collect from the time the case was
572 opened until the overpayment is paid in full; the amount
573 determined as uncollectible and the portion of the uncollectible
574 amount subsequently reclaimed from the Federal Government; the
575 number of providers, by type, that are terminated from
576 participation in the Medicaid program as a result of fraud and
577 abuse; and all costs associated with discovering and prosecuting
578 cases of Medicaid overpayments and making recoveries in such
579 cases. The report must also document actions taken to prevent
580 overpayments and the number of providers prevented from
581 enrolling in or reenrolling in the Medicaid program as a result
582 of documented Medicaid fraud and abuse and must include policy
583 recommendations recommend changes necessary to prevent or
584 recover overpayments and changes necessary to prevent and detect
585 Medicaid fraud. All policy recommendations in the report must
586 include a detailed fiscal analysis, including, but not limited
587 to, implementation costs, estimated savings to the Medicaid
588 program, and the return on investment. The agency must submit
589 the policy recommendations and fiscal analyses in the report to
590 the appropriate estimating conference, pursuant to s. 216.137,
591 by February 15 of each year. The agency and the Medicaid Fraud
592 Control Unit of the Department of Legal Affairs each must
593 include detailed unit-specific performance standards,
594 benchmarks, and metrics in the report, including projected cost
595 savings to the state Medicaid program during the following
596 fiscal year.
597 (2) The agency shall conduct, or cause to be conducted by
598 contract or otherwise, reviews, investigations, analyses,
599 audits, or any combination thereof, to determine possible fraud,
600 abuse, overpayment, or recipient neglect in the Medicaid program
601 and shall report the findings of any overpayments in audit
602 reports as appropriate. At least 5 percent of all audits shall
603 be conducted on a random basis. As part of its ongoing fraud
604 detection activities, the agency shall identify and monitor, by
605 contract or otherwise, patterns of overutilization of Medicaid
606 services based on state averages. The agency shall track
607 Medicaid provider prescription and billing patterns and evaluate
608 them against Medicaid medical necessity criteria and coverage
609 and limitation guidelines adopted by rule. Medical necessity
610 determination requires that service be consistent with symptoms
611 or confirmed diagnosis of illness or injury under treatment and
612 not in excess of the patient’s needs. The agency shall conduct
613 reviews of provider exceptions to peer group norms and shall,
614 using statistical methodologies, provider profiling, and
615 analysis of billing patterns, detect and investigate abnormal or
616 unusual increases in billing or payment of claims for Medicaid
617 services and medically unnecessary provision of services.
618 (7) When presenting a claim for payment under the Medicaid
619 program, a provider has an affirmative duty to supervise the
620 provision of, and be responsible for, goods and services claimed
621 to have been provided, to supervise and be responsible for
622 preparation and submission of the claim, and to present a claim
623 that is true and accurate and that is for goods and services
624 that:
625 (a) Have actually been furnished to the recipient by the
626 provider prior to submitting the claim.
627 (b) Are Medicaid-covered goods or services that are
628 medically necessary.
629 (c) Are of a quality comparable to those furnished to the
630 general public by the provider’s peers.
631 (d) Have not been billed in whole or in part to a recipient
632 or a recipient’s responsible party, except for such copayments,
633 coinsurance, or deductibles as are authorized by the agency.
634 (e) Are provided in accord with applicable provisions of
635 all Medicaid rules, regulations, handbooks, and policies and in
636 accordance with federal, state, and local law.
637 (f) Are documented by records made at the time the goods or
638 services were provided, demonstrating the medical necessity for
639 the goods or services rendered. Medicaid goods or services are
640 excessive or not medically necessary unless both the medical
641 basis and the specific need for them are fully and properly
642 documented in the recipient’s medical record.
643
644 The agency shall may deny payment or require repayment for goods
645 or services that are not presented as required in this
646 subsection.
647 (11) The agency shall may deny payment or require repayment
648 for inappropriate, medically unnecessary, or excessive goods or
649 services from the person furnishing them, the person under whose
650 supervision they were furnished, or the person causing them to
651 be furnished.
652 (13) The agency shall immediately may terminate
653 participation of a Medicaid provider in the Medicaid program and
654 may seek civil remedies or impose other administrative sanctions
655 against a Medicaid provider, if the provider or any principal,
656 officer, director, agent, managing employee, or affiliated
657 person of the provider, or any partner or shareholder having an
658 ownership interest in the provider equal to 5 percent or
659 greater, has been:
660 (a) Convicted of a criminal offense related to the delivery
661 of any health care goods or services, including the performance
662 of management or administrative functions relating to the
663 delivery of health care goods or services;
664 (b) Convicted of a criminal offense under federal law or
665 the law of any state relating to the practice of the provider’s
666 profession; or
667 (c) Found by a court of competent jurisdiction to have
668 neglected or physically abused a patient in connection with the
669 delivery of health care goods or services.
670
671 If the agency determines a provider did not participate or
672 acquiesce in an offense specified in paragraph (a), paragraph
673 (b), or paragraph (c), termination will not be imposed. If the
674 agency effects a termination under this subsection, the agency
675 shall issue an immediate final order pursuant to s.
676 120.569(2)(n).
677 (14) If the provider has been suspended or terminated from
678 participation in the Medicaid program or the Medicare program by
679 the Federal Government or any state, the agency must immediately
680 suspend or terminate, as appropriate, the provider’s
681 participation in this state’s the Florida Medicaid program for a
682 period no less than that imposed by the Federal Government or
683 any other state, and may not enroll such provider in this
684 state’s the Florida Medicaid program while such foreign
685 suspension or termination remains in effect. The agency shall
686 also immediately suspend or terminate, as appropriate, a
687 provider’s participation in this state’s Medicaid program if the
688 provider participated or acquiesced in any action for which any
689 principal, officer, director, agent, managing employee, or
690 affiliated person of the provider, or any partner or shareholder
691 having an ownership interest in the provider equal to 5 percent
692 or greater, was suspended or terminated from participating in
693 the Medicaid program or the Medicare program by the Federal
694 Government or any state. This sanction is in addition to all
695 other remedies provided by law.
696 (15) The agency shall may seek a any remedy provided by
697 law, including, but not limited to, any remedy the remedies
698 provided in subsections (13) and (16) and s. 812.035, if:
699 (a) The provider’s license has not been renewed, or has
700 been revoked, suspended, or terminated, for cause, by the
701 licensing agency of any state;
702 (b) The provider has failed to make available or has
703 refused access to Medicaid-related records to an auditor,
704 investigator, or other authorized employee or agent of the
705 agency, the Attorney General, a state attorney, or the Federal
706 Government;
707 (c) The provider has not furnished or has failed to make
708 available such Medicaid-related records as the agency has found
709 necessary to determine whether Medicaid payments are or were due
710 and the amounts thereof;
711 (d) The provider has failed to maintain medical records
712 made at the time of service, or prior to service if prior
713 authorization is required, demonstrating the necessity and
714 appropriateness of the goods or services rendered;
715 (e) The provider is not in compliance with provisions of
716 Medicaid provider publications that have been adopted by
717 reference as rules in the Florida Administrative Code; with
718 provisions of state or federal laws, rules, or regulations; with
719 provisions of the provider agreement between the agency and the
720 provider; or with certifications found on claim forms or on
721 transmittal forms for electronically submitted claims that are
722 submitted by the provider or authorized representative, as such
723 provisions apply to the Medicaid program;
724 (f) The provider or person who ordered or prescribed the
725 care, services, or supplies has furnished, or ordered the
726 furnishing of, goods or services to a recipient which are
727 inappropriate, unnecessary, excessive, or harmful to the
728 recipient or are of inferior quality;
729 (g) The provider has demonstrated a pattern of failure to
730 provide goods or services that are medically necessary;
731 (h) The provider or an authorized representative of the
732 provider, or a person who ordered or prescribed the goods or
733 services, has submitted or caused to be submitted false or a
734 pattern of erroneous Medicaid claims;
735 (i) The provider or an authorized representative of the
736 provider, or a person who has ordered or prescribed the goods or
737 services, has submitted or caused to be submitted a Medicaid
738 provider enrollment application, a request for prior
739 authorization for Medicaid services, a drug exception request,
740 or a Medicaid cost report that contains materially false or
741 incorrect information;
742 (j) The provider or an authorized representative of the
743 provider has collected from or billed a recipient or a
744 recipient’s responsible party improperly for amounts that should
745 not have been so collected or billed by reason of the provider’s
746 billing the Medicaid program for the same service;
747 (k) The provider or an authorized representative of the
748 provider has included in a cost report costs that are not
749 allowable under a Florida Title XIX reimbursement plan, after
750 the provider or authorized representative had been advised in an
751 audit exit conference or audit report that the costs were not
752 allowable;
753 (l) The provider is charged by information or indictment
754 with fraudulent billing practices. The sanction applied for this
755 reason is limited to suspension of the provider’s participation
756 in the Medicaid program for the duration of the indictment
757 unless the provider is found guilty pursuant to the information
758 or indictment;
759 (m) The provider or a person who has ordered, or prescribed
760 the goods or services is found liable for negligent practice
761 resulting in death or injury to the provider’s patient;
762 (n) The provider fails to demonstrate that it had available
763 during a specific audit or review period sufficient quantities
764 of goods, or sufficient time in the case of services, to support
765 the provider’s billings to the Medicaid program;
766 (o) The provider has failed to comply with the notice and
767 reporting requirements of s. 409.907;
768 (p) The agency has received reliable information of patient
769 abuse or neglect or of any act prohibited by s. 409.920; or
770 (q) The provider has failed to comply with an agreed-upon
771 repayment schedule.
772
773 A provider is subject to sanctions for violations of this
774 subsection as the result of actions or inactions of the
775 provider, or actions or inactions of any principal, officer,
776 director, agent, managing employee, or affiliated person of the
777 provider, or any partner or shareholder having an ownership
778 interest in the provider equal to 5 percent or greater, in which
779 the provider participated or acquiesced.
780 (21) When making a determination that an overpayment has
781 occurred, the agency shall prepare and issue an audit report to
782 the provider showing the calculation of overpayments. If the
783 agency’s determination that an overpayment has occurred is based
784 upon a review of the provider’s records, the calculation of the
785 overpayment shall be based upon documentation created prior to
786 the start of any investigation or created at the request of the
787 agency.
788 (22) The audit report, supported by agency work papers,
789 showing an overpayment to a provider constitutes evidence of the
790 overpayment. A provider may not present or elicit testimony,
791 either on direct examination or cross-examination in any court
792 or administrative proceeding, regarding the purchase or
793 acquisition by any means of drugs, goods, or supplies; sales or
794 divestment by any means of drugs, goods, or supplies; or
795 inventory of drugs, goods, or supplies, unless such acquisition,
796 sales, divestment, or inventory is documented by written
797 invoices, written inventory records, or other competent written
798 documentary evidence maintained in the normal course of the
799 provider’s business. Notwithstanding the applicable rules of
800 discovery, all documentation that will be offered as evidence at
801 an administrative hearing on a Medicaid overpayment must be
802 exchanged by all parties at least 14 days before the
803 administrative hearing or must be excluded from consideration.
804 The documentation or data that a provider may rely upon or
805 present as evidence that an overpayment has not occurred must
806 have been created prior to the start of any agency investigation
807 and must be made available to the agency before issuance of a
808 final audit report, unless the documentation or data was created
809 at the request of the agency. Documentation or data that was
810 recreated due to extenuating circumstances beyond the provider’s
811 control, such as a disaster or the loss of records due to change
812 of ownership, may be presented as evidence if evidence of the
813 extenuating circumstance is also provided. This subsection does
814 not prohibit the introduction of expert witness reports
815 regarding an overpayment or the issues addressed in the audit.
816 (24) If the agency imposes an administrative sanction
817 pursuant to subsection (13), subsection (14), or subsection
818 (15), except paragraphs (15)(e) and (o), upon any provider or
819 any principal, officer, director, agent, managing employee, or
820 affiliated person of the provider other person who is regulated
821 by another state entity, the agency shall notify that other
822 entity of the imposition of the sanction within 5 business days.
823 Such notification must include the provider’s or person’s name
824 and license number and the specific reasons for sanction.
825 (25)(a) The agency shall may withhold Medicaid payments, in
826 whole or in part, to a provider upon receipt of reliable
827 evidence that the circumstances giving rise to the need for a
828 withholding of payments involve fraud, willful
829 misrepresentation, or abuse under the Medicaid program, or a
830 crime committed while rendering goods or services to Medicaid
831 recipients. If it is determined that fraud, willful
832 misrepresentation, abuse, or a crime did not occur, the payments
833 withheld must be paid to the provider within 14 days after such
834 determination with interest at the rate of 10 percent a year.
835 Any money withheld in accordance with this paragraph shall be
836 placed in a suspended account, readily accessible to the agency,
837 so that any payment ultimately due the provider shall be made
838 within 14 days.
839 (b) The agency shall may deny payment, or require
840 repayment, if the goods or services were furnished, supervised,
841 or caused to be furnished by a person who has been suspended or
842 terminated from the Medicaid program or Medicare program by the
843 Federal Government or any state.
844 (c) Overpayments owed to the agency bear interest at the
845 rate of 10 percent per year from the date of determination of
846 the overpayment by the agency, and payment arrangements must be
847 made at the conclusion of legal proceedings. A provider who does
848 not enter into or adhere to an agreed-upon repayment schedule
849 may be terminated by the agency for nonpayment or partial
850 payment.
851 (d) The agency, upon entry of a final agency order, a
852 judgment or order of a court of competent jurisdiction, or a
853 stipulation or settlement, may collect the moneys owed by all
854 means allowable by law, including, but not limited to, notifying
855 any fiscal intermediary of Medicare benefits that the state has
856 a superior right of payment. Upon receipt of such written
857 notification, the Medicare fiscal intermediary shall remit to
858 the state the sum claimed.
859 (e) The agency may institute amnesty programs to allow
860 Medicaid providers the opportunity to voluntarily repay
861 overpayments. The agency may adopt rules to administer such
862 programs.
863 (27) When the Agency for Health Care Administration has
864 made a probable cause determination and alleged that an
865 overpayment to a Medicaid provider has occurred, the agency,
866 after notice to the provider, shall may:
867 (a) Withhold, and continue to withhold during the pendency
868 of an administrative hearing pursuant to chapter 120, any
869 medical assistance reimbursement payments until such time as the
870 overpayment is recovered, unless within 30 days after receiving
871 notice thereof the provider:
872 1. Makes repayment in full; or
873 2. Establishes a repayment plan that is satisfactory to the
874 Agency for Health Care Administration.
875 (b) Withhold, and continue to withhold during the pendency
876 of an administrative hearing pursuant to chapter 120, medical
877 assistance reimbursement payments if the terms of a repayment
878 plan are not adhered to by the provider.
879 (30) The agency shall may terminate a provider’s
880 participation in the Medicaid program if the provider fails to
881 reimburse an overpayment that has been determined by final
882 order, not subject to further appeal, within 35 days after the
883 date of the final order, unless the provider and the agency have
884 entered into a repayment agreement.
885 (31) If a provider requests an administrative hearing
886 pursuant to chapter 120, such hearing must be conducted within
887 90 days following assignment of an administrative law judge,
888 absent exceptionally good cause shown as determined by the
889 administrative law judge or hearing officer. Upon issuance of a
890 final order, the outstanding balance of the amount determined to
891 constitute the overpayment shall become due. If a provider fails
892 to make payments in full, fails to enter into a satisfactory
893 repayment plan, or fails to comply with the terms of a repayment
894 plan or settlement agreement, the agency shall may withhold
895 medical assistance reimbursement payments until the amount due
896 is paid in full.
897 (36) At least three times a year, the agency shall provide
898 to each Medicaid recipient or his or her representative an
899 explanation of benefits in the form of a letter that is mailed
900 to the most recent address of the recipient on the record with
901 the Department of Children and Family Services. The explanation
902 of benefits must include the patient’s name, the name of the
903 health care provider and the address of the location where the
904 service was provided, a description of all services billed to
905 Medicaid in terminology that should be understood by a
906 reasonable person, and information on how to report
907 inappropriate or incorrect billing to the agency or other law
908 enforcement entities for review or investigation. At least once
909 a year, the letter also must include information on how to
910 report criminal Medicaid fraud, the Medicaid Fraud Control
911 Unit’s toll-free hotline number, and information about the
912 rewards available under s. 409.9203. The explanation of benefits
913 may not be mailed for Medicaid independent laboratory services
914 as described in s. 409.905(7) or for Medicaid certified match
915 services as described in ss. 409.9071 and 1011.70.
916 (37) The agency shall post on its website a current list of
917 each Medicaid provider, including any principal, officer,
918 director, agent, managing employee, or affiliated person of the
919 provider, or any partner or shareholder having an ownership
920 interest in the provider equal to 5 percent or greater, who has
921 been terminated from the Medicaid program or sanctioned under
922 this section. The list must be searchable by a variety of search
923 parameters and provide for the creation of formatted lists that
924 may be printed or imported into other applications, including
925 spreadsheets. The agency shall update the list at least monthly.
926 (38) In order to improve the detection of health care
927 fraud, use technology to prevent and detect fraud, and maximize
928 the electronic exchange of health care fraud information, the
929 agency shall:
930 (a) Compile, maintain, and publish on its website a
931 detailed list of all state and federal databases that contain
932 health care fraud information and update the list at least
933 biannually;
934 (b) Develop a strategic plan to connect all databases that
935 contain health care fraud information to facilitate the
936 electronic exchange of health information between the agency,
937 the Department of Health, the Department of Law Enforcement, and
938 the Attorney General’s Office. The plan must include recommended
939 standard data formats, fraud-identification strategies, and
940 specifications for the technical interface between state and
941 federal health care fraud databases;
942 (c) Monitor innovations in health information technology,
943 specifically as it pertains to Medicaid fraud prevention and
944 detection; and
945 (d) Periodically publish policy briefs that highlight
946 available new technology to prevent or detect health care fraud
947 and projects implemented by other states, the private sector, or
948 the Federal Government which use technology to prevent or detect
949 health care fraud.
950 Section 14. Subsections (1) and (2) of section 409.920,
951 Florida Statutes, are amended, present subsections (8) and (9)
952 of that section are renumbered as subsections (9) and (10),
953 respectively, and a new subsection (8) is added to that section,
954 to read:
955 409.920 Medicaid provider fraud.—
956 (1) For the purposes of this section, the term:
957 (a) “Agency” means the Agency for Health Care
958 Administration.
959 (b) “Fiscal agent” means any individual, firm, corporation,
960 partnership, organization, or other legal entity that has
961 contracted with the agency to receive, process, and adjudicate
962 claims under the Medicaid program.
963 (c) “Item or service” includes:
964 1. Any particular item, device, medical supply, or service
965 claimed to have been provided to a recipient and listed in an
966 itemized claim for payment; or
967 2. In the case of a claim based on costs, any entry in the
968 cost report, books of account, or other documents supporting
969 such claim.
970 (d) “Knowingly” means that the act was done voluntarily and
971 intentionally and not because of mistake or accident. As used in
972 this section, the term “knowingly” also includes the word
973 “willfully” or “willful” which, as used in this section, means
974 that an act was committed voluntarily and purposely, with the
975 specific intent to do something that the law forbids, and that
976 the act was committed with bad purpose, either to disobey or
977 disregard the law.
978 (e) “Managed care plan” means a health maintenance
979 organization authorized pursuant to chapter 641, a prepaid
980 health plan authorized in s. 409.912, or an entity authorized
981 pursuant to s. 409.91211(12) which contracts with the agency to
982 provide medical services to Medicaid recipients.
983 (2)(a) A person may not It is unlawful to:
984 1.(a) Knowingly make, cause to be made, or aid and abet in
985 the making of any false statement or false representation of a
986 material fact, by commission or omission, in any claim submitted
987 to the agency, or its fiscal agent, or a managed care plan for
988 payment.
989 2.(b) Knowingly make, cause to be made, or aid and abet in
990 the making of a claim for items or services that are not
991 authorized to be reimbursed by the Medicaid program.
992 3.(c) Knowingly charge, solicit, accept, or receive
993 anything of value, other than an authorized copayment from a
994 Medicaid recipient, from any source in addition to the amount
995 legally payable for an item or service provided to a Medicaid
996 recipient under the Medicaid program or knowingly fail to credit
997 the agency or its fiscal agent for any payment received from a
998 third-party source.
999 4.(d) Knowingly make or in any way cause to be made any
1000 false statement or false representation of a material fact, by
1001 commission or omission, in any document containing items of
1002 income and expense that is or may be used by the agency to
1003 determine a general or specific rate of payment for an item or
1004 service provided by a provider.
1005 5.(e) Knowingly solicit, offer, pay, or receive any
1006 remuneration, including any kickback, bribe, or rebate, directly
1007 or indirectly, overtly or covertly, in cash or in kind, in
1008 return for referring an individual to a person for the
1009 furnishing or arranging for the furnishing of any item or
1010 service for which payment may be made, in whole or in part,
1011 under the Medicaid program, or in return for obtaining,
1012 purchasing, leasing, ordering, or arranging for or recommending,
1013 obtaining, purchasing, leasing, or ordering any goods, facility,
1014 item, or service, for which payment may be made, in whole or in
1015 part, under the Medicaid program.
1016 6.(f) Knowingly submit false or misleading information or
1017 statements to the Medicaid program for the purpose of being
1018 accepted as a Medicaid provider.
1019 7.(g) Knowingly use or endeavor to use a Medicaid
1020 provider’s identification number or a Medicaid recipient’s
1021 identification number to make, cause to be made, or aid and abet
1022 in the making of a claim for items or services that are not
1023 authorized to be reimbursed by the Medicaid program.
1024 (b)1. A person who violates this subsection and receives or
1025 endeavors to receive anything of value of:
1026 a. Ten thousand dollars or less commits a felony of the
1027 third degree, punishable as provided in s. 775.082, s. 775.083,
1028 or s. 775.084.
1029 b. More than $10,000, but less than $50,000, commits a
1030 felony of the second degree, punishable as provided in s.
1031 775.082, s. 775.083, or s. 775.084.
1032 c. Fifty thousand dollars or more commits a felony of the
1033 first degree, punishable as provided in s. 775.082, s. 775.083,
1034 or s. 775.084.
1035 2. The value of separate funds, goods, or services that a
1036 person received or attempted to receive pursuant to a scheme or
1037 course of conduct may be aggregated in determining the degree of
1038 the offense.
1039 3. In addition to the sentence authorized by law, a person
1040 who is convicted of a violation of this subsection shall pay a
1041 fine in an amount equal to five times the pecuniary gain
1042 unlawfully received or the loss incurred by the Medicaid program
1043 or managed care organization, whichever is greater.
1044 (8) A person who provides the state, any state agency, any
1045 of the state’s political subdivisions, or any agency of the
1046 state’s political subdivisions with information about fraud or
1047 suspected fraud by a Medicaid provider, including a managed care
1048 organization, is immune from civil liability for providing the
1049 information unless the person acted with knowledge that the
1050 information was false or with reckless disregard for the truth
1051 or falsity of the information.
1052 Section 15. Section 409.9203, Florida Statutes, is created
1053 to read:
1054 409.9203 Rewards for reporting Medicaid fraud.—
1055 (1) The Department of Law Enforcement or director of the
1056 Medicaid Fraud Control Unit shall, subject to availability of
1057 funds, pay a reward to a person who furnishes original
1058 information relating to and reports a violation of the state’s
1059 Medicaid fraud laws, unless the person declines the reward, if
1060 the information and report:
1061 (a) Is made to the Office of the Attorney General, the
1062 Agency for Health Care Administration, the Department of Health,
1063 or the Department of Law Enforcement;
1064 (b) Relates to criminal fraud upon Medicaid funds or a
1065 criminal violation of Medicaid laws by another person; and
1066 (c) Leads to a recovery of a fine, penalty, or forfeiture
1067 of property.
1068 (2) The reward may not exceed the lesser of 25 percent of
1069 the amount recovered or $500,000 in a single case.
1070 (3) The reward shall be paid from the Legal Affairs
1071 Revolving Trust Fund from moneys collected pursuant to s.
1072 68.085.
1073 (4) A person who receives a reward pursuant to this section
1074 is not eligible to receive any funds pursuant to the Florida
1075 False Claims Act for Medicaid fraud for which a reward is
1076 received pursuant to this section.
1077 Section 16. Subsection (11) is added to section 456.004,
1078 Florida Statutes, to read:
1079 456.004 Department; powers and duties.—The department, for
1080 the professions under its jurisdiction, shall:
1081 (11) Work cooperatively with the Agency for Health Care
1082 Administration and the judicial system to recover Medicaid
1083 overpayments by the Medicaid program. The department shall
1084 investigate and prosecute health care practitioners who have not
1085 remitted amounts owed to the state for an overpayment from the
1086 Medicaid program pursuant to a final order, judgment, or
1087 stipulation or settlement.
1088 Section 17. Present subsections (6) through (10) of section
1089 456.041, Florida Statutes, are renumbered as subsections (7)
1090 through (11), respectively, and a new subsection (6) is added to
1091 that section, to read:
1092 456.041 Practitioner profile; creation.—
1093 (6) The Department of Health shall provide in each
1094 practitioner profile for every physician or advanced registered
1095 nurse practitioner terminated from participating in the Medicaid
1096 program, pursuant to s. 409.913, or sanctioned by the Medicaid
1097 program a statement that the practitioner has been terminated
1098 from participating in the Florida Medicaid program or sanctioned
1099 by the Medicaid program.
1100 Section 18. Section 456.0635, Florida Statutes, is created
1101 to read:
1102 456.0635 Medicaid fraud; disqualification for license,
1103 certificate, or registration.—
1104 (1) Medicaid fraud in the practice of a health care
1105 profession is prohibited.
1106 (2) Each board within the jurisdiction of the department,
1107 or the department if there is no board, shall refuse to admit a
1108 candidate to any examination and refuse to issue or renew a
1109 license, certificate, or registration to any applicant if the
1110 candidate or applicant or any principle, officer, agent,
1111 managing employee, or affiliated person of the applicant, has
1112 been:
1113 (a) Convicted of, or entered a plea of guilty or nolo
1114 contendere to, regardless of adjudication, a felony under
1115 chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or
1116 42 U.S.C. ss. 1395-1396; or
1117 (b) Terminated for cause, pursuant to the appeals
1118 procedures established by the state or Federal Government, from
1119 any state Medicaid program or the federal Medicare program.
1120 (3) Licensed health care practitioners shall report
1121 allegations of Medicaid fraud to the department, regardless of
1122 the practice setting in which the alleged Medicaid fraud
1123 occurred.
1124 (4) The acceptance by a licensing authority of a
1125 candidate’s relinquishment of a license which is offered in
1126 response to or anticipation of the filing of administrative
1127 charges alleging Medicaid fraud or similar charges constitutes
1128 the permanent revocation of the license.
1129 Section 19. Paragraphs (ii), (jj), (kk), and (ll) are added
1130 to subsection (1) of section 456.072, Florida Statutes, to read:
1131 456.072 Grounds for discipline; penalties; enforcement.—
1132 (1) The following acts shall constitute grounds for which
1133 the disciplinary actions specified in subsection (2) may be
1134 taken:
1135 (ii) Being convicted of, or entering a plea of guilty or
1136 nolo contendere to, any misdemeanor or felony, regardless of
1137 adjudication, under 18 U.S.C. s. 669, ss. 285-287, s. 371, s.
1138 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518,
1139 or 42 U.S.C. ss. 1320a-7b, relating to the Medicaid program.
1140 (jj) Failing to remit the sum owed to the state for an
1141 overpayment from the Medicaid program pursuant to a final order,
1142 judgment, or stipulation or settlement.
1143 (kk) Being terminated from the state Medicaid program
1144 pursuant to s. 409.913, any other state Medicaid program, or the
1145 federal Medicare program.
1146 (ll) Being convicted of, or entering a plea of guilty or
1147 nolo contendere to, any misdemeanor or felony, regardless of
1148 adjudication, a crime in any jurisdiction which relates to
1149 health care fraud.
1150 Section 20. Subsection (1) of section 456.074, Florida
1151 Statutes, is amended to read:
1152 456.074 Certain health care practitioners; immediate
1153 suspension of license.—
1154 (1) The department shall issue an emergency order
1155 suspending the license of any person licensed under chapter 458,
1156 chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
1157 chapter 464, chapter 465, chapter 466, or chapter 484 who pleads
1158 guilty to, is convicted or found guilty of, or who enters a plea
1159 of nolo contendere to, regardless of adjudication, to:
1160 (a) A felony under chapter 409, chapter 817, or chapter 893
1161 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C. ss. 1395-1396;
1162 or.
1163 (b) A misdemeanor or felony under 18 U.S.C. s. 669, ss.
1164 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s.
1165 1349, or s. 1518 or 42 U.S.C. ss. 1320a-7b, relating to the
1166 Medicaid program.
1167 Section 21. Subsections (2) and (3) of section 465.022,
1168 Florida Statutes, are amended, present subsections (4), (5),
1169 (6), and (7) of that section are renumbered as subsections (5),
1170 (6), (7), and (8), respectively, and a new subsection (4) is
1171 added to that section, to read:
1172 465.022 Pharmacies; general requirements; fees.—
1173 (2) A pharmacy permit shall be issued only to a person who
1174 is at least 18 years of age, a partnership whose partners are
1175 all at least 18 years of age, or to a corporation that which is
1176 registered pursuant to chapter 607 or chapter 617 whose
1177 officers, directors, and shareholders are at least 18 years of
1178 age.
1179 (3) Any person, partnership, or corporation before engaging
1180 in the operation of a pharmacy shall file with the board a sworn
1181 application on forms provided by the department.
1182 (a) An application for a pharmacy permit must include a set
1183 of fingerprints from each person having an ownership interest of
1184 5 percent or greater and from any person who, directly or
1185 indirectly, manages, oversees, or controls the operation of the
1186 applicant, including officers and members of the board of
1187 directors of an applicant that is a corporation. The applicant
1188 must provide payment in the application for the cost of state
1189 and national criminal history records checks.
1190 1. For corporations having more than $100 million of
1191 business taxable assets in this state, in lieu of these
1192 fingerprint requirements, the department shall require the
1193 prescription department manager who will be directly involved in
1194 the management and operation of the pharmacy to submit a set of
1195 fingerprints.
1196 2. A representative of a corporation described in
1197 subparagraph 1. satisfies the requirement to submit a set of his
1198 or her fingerprints if the fingerprints are on file with the
1199 department or the Agency for Health Care Administration, meet
1200 the fingerprint specifications for submission by the Department
1201 of Law Enforcement, and are available to the department.
1202 (b) The department shall submit the fingerprints provided
1203 by the applicant to the Department of Law Enforcement for a
1204 state criminal history records check. The Department of Law
1205 Enforcement shall forward the fingerprints to the Federal Bureau
1206 of Investigation for a national criminal history records check.
1207 (4) The department or board shall deny an application for a
1208 pharmacy permit if the applicant or an affiliated person,
1209 partner, officer, director, or prescription department manager
1210 of the applicant has:
1211 (a) Obtained a permit by misrepresentation or fraud;
1212 (b) Attempted to procure, or has procured, a permit for any
1213 other person by making, or causing to be made, any false
1214 representation;
1215 (c) Been convicted of, or entered a plea of guilty or nolo
1216 contendere to, regardless of adjudication, a crime in any
1217 jurisdiction which relates to the practice of, or the ability to
1218 practice, the profession of pharmacy;
1219 (d) Been convicted of, or entered a plea of guilty or nolo
1220 contendere to, regardless of adjudication, a crime in any
1221 jurisdiction which relates to health care fraud;
1222 (e) Been terminated for cause, pursuant to the appeals
1223 procedures established by the state or Federal Government, from
1224 any state Medicaid program or the federal Medicare program; or
1225 (f) Dispensed any medicinal drug based upon a communication
1226 that purports to be a prescription as defined by s. 465.003(14)
1227 or s. 893.02 when the pharmacist knows or has reason to believe
1228 that the purported prescription is not based upon a valid
1229 practitioner-patient relationship that includes a documented
1230 patient evaluation, including history and a physical examination
1231 adequate to establish the diagnosis for which any drug is
1232 prescribed and any other requirement established by board rule
1233 under chapter 458, chapter 459, chapter 461, chapter 463,
1234 chapter 464, or chapter 466.
1235 Section 22. Subsection (1) of section 465.023, Florida
1236 Statutes, is amended to read:
1237 465.023 Pharmacy permittee; disciplinary action.—
1238 (1) The department or the board may revoke or suspend the
1239 permit of any pharmacy permittee, and may fine, place on
1240 probation, or otherwise discipline any pharmacy permittee if the
1241 permittee, or any affiliated person, partner, officer, director,
1242 or agent of the permittee, including a person fingerprinted
1243 under s. 465.022(3), who has:
1244 (a) Obtained a permit by misrepresentation or fraud or
1245 through an error of the department or the board;
1246 (b) Attempted to procure, or has procured, a permit for any
1247 other person by making, or causing to be made, any false
1248 representation;
1249 (c) Violated any of the requirements of this chapter or any
1250 of the rules of the Board of Pharmacy; of chapter 499, known as
1251 the “Florida Drug and Cosmetic Act”; of 21 U.S.C. ss. 301-392,
1252 known as the “Federal Food, Drug, and Cosmetic Act”; of 21
1253 U.S.C. ss. 821 et seq., known as the Comprehensive Drug Abuse
1254 Prevention and Control Act; or of chapter 893;
1255 (d) Been convicted or found guilty, regardless of
1256 adjudication, of a felony or any other crime involving moral
1257 turpitude in any of the courts of this state, of any other
1258 state, or of the United States; or
1259 (e) Been convicted or disciplined by a regulatory agency of
1260 the Federal Government or a regulatory agency of another state
1261 for any offense that would constitute a violation of this
1262 chapter;
1263 (f) Been convicted of, or entered a plea of guilty or nolo
1264 contendere to, regardless of adjudication, a crime in any
1265 jurisdiction which relates to the practice of, or the ability to
1266 practice, the profession of pharmacy;
1267 (g) Been convicted of, or entered a plea of guilty or nolo
1268 contendere to, regardless of adjudication, a crime in any
1269 jurisdiction which relates to health care fraud; or
1270 (h)(e) Dispensed any medicinal drug based upon a
1271 communication that purports to be a prescription as defined by
1272 s. 465.003(14) or s. 893.02 when the pharmacist knows or has
1273 reason to believe that the purported prescription is not based
1274 upon a valid practitioner-patient relationship that includes a
1275 documented patient evaluation, including history and a physical
1276 examination adequate to establish the diagnosis for which any
1277 drug is prescribed and any other requirement established by
1278 board rule under chapter 458, chapter 459, chapter 461, chapter
1279 463, chapter 464, or chapter 466.
1280 Section 23. Section 825.103, Florida Statutes, is amended
1281 to read:
1282 825.103 Exploitation of an elderly person or disabled
1283 adult; penalties.—
1284 (1) “Exploitation of an elderly person or disabled adult”
1285 means:
1286 (a) Knowingly, by deception or intimidation, obtaining or
1287 using, or endeavoring to obtain or use, an elderly person’s or
1288 disabled adult’s funds, assets, or property with the intent to
1289 temporarily or permanently deprive the elderly person or
1290 disabled adult of the use, benefit, or possession of the funds,
1291 assets, or property, or to benefit someone other than the
1292 elderly person or disabled adult, by a person who:
1293 1. Stands in a position of trust and confidence with the
1294 elderly person or disabled adult; or
1295 2. Has a business relationship with the elderly person or
1296 disabled adult; or
1297 (b) Obtaining or using, endeavoring to obtain or use, or
1298 conspiring with another to obtain or use an elderly person’s or
1299 disabled adult’s funds, assets, or property with the intent to
1300 temporarily or permanently deprive the elderly person or
1301 disabled adult of the use, benefit, or possession of the funds,
1302 assets, or property, or to benefit someone other than the
1303 elderly person or disabled adult, by a person who knows or
1304 reasonably should know that the elderly person or disabled adult
1305 lacks the capacity to consent; or.
1306 (c) Breach of a fiduciary duty to an elderly person or
1307 disabled adult by the person’s guardian or agent under a power
1308 of attorney which results in an unauthorized appropriation,
1309 sale, or transfer of property.
1310 (2)(a) If the funds, assets, or property involved in the
1311 exploitation of the elderly person or disabled adult is valued
1312 at $100,000 or more, the offender commits a felony of the first
1313 degree, punishable as provided in s. 775.082, s. 775.083, or s.
1314 775.084.
1315 (b) If the funds, assets, or property involved in the
1316 exploitation of the elderly person or disabled adult is valued
1317 at $20,000 or more, but less than $100,000, the offender commits
1318 a felony of the second degree, punishable as provided in s.
1319 775.082, s. 775.083, or s. 775.084.
1320 (c) If the funds, assets, or property involved in the
1321 exploitation of an elderly person or disabled adult is valued at
1322 less than $20,000, the offender commits a felony of the third
1323 degree, punishable as provided in s. 775.082, s. 775.083, or s.
1324 775.084.
1325 Section 24. Paragraphs (g) and (i) of subsection (3) of
1326 section 921.0022, Florida Statutes, are amended to read:
1327 921.0022 Criminal Punishment Code; offense severity ranking
1328 chart.—
1329 (3) OFFENSE SEVERITY RANKING CHART
1330 (g) LEVEL 7
1331 FloridaStatute FelonyDegree Description
1332 316.027(1)(b) 1st Accident involving death, failure to stop; leaving scene.
1333 316.193(3)(c)2. 3rd DUI resulting in serious bodily injury.
1334 316.1935(3)(b) 1st Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated.
1335 327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury.
1336 402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
1337 409.920(2)(b)1.a. 3rd Medicaid provider fraud; $10,000 or less.
1338 409.920(2)(b)1.b. 2nd Medicaid provider fraud; more than $10,000, but less than $50,000.
1339 456.065(2) 3rd Practicing a health care profession without a license.
1340 456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury.
1341 458.327(1) 3rd Practicing medicine without a license.
1342 459.013(1) 3rd Practicing osteopathic medicine without a license.
1343 460.411(1) 3rd Practicing chiropractic medicine without a license.
1344 461.012(1) 3rd Practicing podiatric medicine without a license.
1345 462.17 3rd Practicing naturopathy without a license.
1346 463.015(1) 3rd Practicing optometry without a license.
1347 464.016(1) 3rd Practicing nursing without a license.
1348 465.015(2) 3rd Practicing pharmacy without a license.
1349 466.026(1) 3rd Practicing dentistry or dental hygiene without a license.
1350 467.201 3rd Practicing midwifery without a license.
1351 468.366 3rd Delivering respiratory care services without a license.
1352 483.828(1) 3rd Practicing as clinical laboratory personnel without a license.
1353 483.901(9) 3rd Practicing medical physics without a license.
1354 484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription.
1355 484.053 3rd Dispensing hearing aids without a license.
1356 494.0018(2) 1st Conviction of any violation of ss. 494.001-494.0077 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
1357 560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by a money services business.
1358 560.125(5)(a) 3rd Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
1359 655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
1360 775.21(10)(a) 3rd Sexual predator; failure to register; failure to renew driver’s license or identification card; other registration violations.
1361 775.21(10)(b) 3rd Sexual predator working where children regularly congregate.
1362 775.21(10)(g) 3rd Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
1363 782.051(3) 2nd Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
1364 782.07(1) 2nd Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
1365 782.071 2nd Killing of a human being or viable fetus by the operation of a motor vehicle in a reckless manner (vehicular homicide).
1366 782.072 2nd Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
1367 784.045(1)(a)1. 2nd Aggravated battery; intentionally causing great bodily harm or disfigurement.
1368 784.045(1)(a)2. 2nd Aggravated battery; using deadly weapon.
1369 784.045(1)(b) 2nd Aggravated battery; perpetrator aware victim pregnant.
1370 784.048(4) 3rd Aggravated stalking; violation of injunction or court order.
1371 784.048(7) 3rd Aggravated stalking; violation of court order.
1372 784.07(2)(d) 1st Aggravated battery on law enforcement officer.
1373 784.074(1)(a) 1st Aggravated battery on sexually violent predators facility staff.
1374 784.08(2)(a) 1st Aggravated battery on a person 65 years of age or older.
1375 784.081(1) 1st Aggravated battery on specified official or employee.
1376 784.082(1) 1st Aggravated battery by detained person on visitor or other detainee.
1377 784.083(1) 1st Aggravated battery on code inspector.
1378 790.07(4) 1st Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
1379 790.16(1) 1st Discharge of a machine gun under specified circumstances.
1380 790.165(2) 2nd Manufacture, sell, possess, or deliver hoax bomb.
1381 790.165(3) 2nd Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
1382 790.166(3) 2nd Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
1383 790.166(4) 2nd Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
1384 790.23 1st,PBL Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04.
1385 794.08(4) 3rd Female genital mutilation; consent by a parent, guardian, or a person in custodial authority to a victim younger than 18 years of age.
1386 796.03 2nd Procuring any person under 16 years for prostitution.
1387 800.04(5)(c)1. 2nd Lewd or lascivious molestation; victim less than 12 years of age; offender less than 18 years.
1388 800.04(5)(c)2. 2nd Lewd or lascivious molestation; victim 12 years of age or older but less than 16 years; offender 18 years or older.
1389 806.01(2) 2nd Maliciously damage structure by fire or explosive.
1390 810.02(3)(a) 2nd Burglary of occupied dwelling; unarmed; no assault or battery.
1391 810.02(3)(b) 2nd Burglary of unoccupied dwelling; unarmed; no assault or battery.
1392 810.02(3)(d) 2nd Burglary of occupied conveyance; unarmed; no assault or battery.
1393 810.02(3)(e) 2nd Burglary of authorized emergency vehicle.
1394 812.014(2)(a)1. 1st Property stolen, valued at $100,000 or more or a semitrailer deployed by a law enforcement officer; property stolen while causing other property damage; 1st degree grand theft.
1395 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
1396 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft.
1397 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle.
1398 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more.
1399 812.019(2) 1st Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
1400 812.131(2)(a) 2nd Robbery by sudden snatching.
1401 812.133(2)(b) 1st Carjacking; no firearm, deadly weapon, or other weapon.
1402 817.234(8)(a) 2nd Solicitation of motor vehicle accident victims with intent to defraud.
1403 817.234(9) 2nd Organizing, planning, or participating in an intentional motor vehicle collision.
1404 817.234(11)(c) 1st Insurance fraud; property value $100,000 or more.
1405 817.2341(2)(b) & (3)(b)1st Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity.
1406 825.102(3)(b) 2nd Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
1407 825.103(2)(b) 2nd Exploiting an elderly person or disabled adult and property is valued at $20,000 or more, but less than $100,000.
1408 827.03(3)(b) 2nd Neglect of a child causing great bodily harm, disability, or disfigurement.
1409 827.04(3) 3rd Impregnation of a child under 16 years of age by person 21 years of age or older.
1410 837.05(2) 3rd Giving false information about alleged capital felony to a law enforcement officer.
1411 838.015 2nd Bribery.
1412 838.016 2nd Unlawful compensation or reward for official behavior.
1413 838.021(3)(a) 2nd Unlawful harm to a public servant.
1414 838.22 2nd Bid tampering.
1415 847.0135(3) 3rd Solicitation of a child, via a computer service, to commit an unlawful sex act.
1416 847.0135(4) 2nd Traveling to meet a minor to commit an unlawful sex act.
1417 872.06 2nd Abuse of a dead human body.
1418 874.10 1st,PBL Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity.
1419 893.13(1)(c)1. 1st Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center.
1420 893.13(1)(e)1. 1st Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4., within 1,000 feet of property used for religious services or a specified business site.
1421 893.13(4)(a) 1st Deliver to minor cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
1422 893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
1423 893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams.
1424 893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
1425 893.135(1)(d)1. 1st Trafficking in phencyclidine, more than 28 grams, less than 200 grams.
1426 893.135(1)(e)1. 1st Trafficking in methaqualone, more than 200 grams, less than 5 kilograms.
1427 893.135(1)(f)1. 1st Trafficking in amphetamine, more than 14 grams, less than 28 grams.
1428 893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
1429 893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
1430 893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
1431 893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
1432 893.1351(2) 2nd Possession of place for trafficking in or manufacturing of controlled substance.
1433 896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000.
1434 896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
1435 943.0435(4)(c) 2nd Sexual offender vacating permanent residence; failure to comply with reporting requirements.
1436 943.0435(8) 2nd Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
1437 943.0435(9)(a) 3rd Sexual offender; failure to comply with reporting requirements.
1438 943.0435(13) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1439 943.0435(14) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1440 944.607(9) 3rd Sexual offender; failure to comply with reporting requirements.
1441 944.607(10)(a) 3rd Sexual offender; failure to submit to the taking of a digitized photograph.
1442 944.607(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1443 944.607(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1444 985.4815(10) 3rd Sexual offender; failure to submit to the taking of a digitized photograph.
1445 985.4815(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1446 985.4815(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1447
1448 (i) LEVEL 9
1449 FloridaStatute FelonyDegree Description
1450 316.193(3)(c)3.b. 1st DUI manslaughter; failing to render aid or give information.
1451 327.35(3)(c)3.b. 1st BUI manslaughter; failing to render aid or give information.
1452 409.920(2)(b)1.c. 1st Medicaid provider fraud; $50,000 or more.
1453 499.0051(9) 1st Knowing sale or purchase of contraband prescription drugs resulting in great bodily harm.
1454 560.123(8)(b)3. 1st Failure to report currency or payment instruments totaling or exceeding $100,000 by money transmitter.
1455 560.125(5)(c) 1st Money transmitter business by unauthorized person, currency, or payment instruments totaling or exceeding $100,000.
1456 655.50(10)(b)3. 1st Failure to report financial transactions totaling or exceeding $100,000 by financial institution.
1457 775.0844 1st Aggravated white collar crime.
1458 782.04(1) 1st Attempt, conspire, or solicit to commit premeditated murder.
1459 782.04(3) 1st,PBL Accomplice to murder in connection with arson, sexual battery, robbery, burglary, and other specified felonies.
1460 782.051(1) 1st Attempted felony murder while perpetrating or attempting to perpetrate a felony enumerated in s. 782.04(3).
1461 782.07(2) 1st Aggravated manslaughter of an elderly person or disabled adult.
1462 787.01(1)(a)1. 1st,PBL Kidnapping; hold for ransom or reward or as a shield or hostage.
1463 787.01(1)(a)2. 1st,PBL Kidnapping with intent to commit or facilitate commission of any felony.
1464 787.01(1)(a)4. 1st,PBL Kidnapping with intent to interfere with performance of any governmental or political function.
1465 787.02(3)(a) 1st False imprisonment; child under age 13; perpetrator also commits aggravated child abuse, sexual battery, or lewd or lascivious battery, molestation, conduct, or exhibition.
1466 790.161 1st Attempted capital destructive device offense.
1467 790.166(2) 1st,PBL Possessing, selling, using, or attempting to use a weapon of mass destruction.
1468 794.011(2) 1st Attempted sexual battery; victim less than 12 years of age.
1469 794.011(2) Life Sexual battery; offender younger than 18 years and commits sexual battery on a person less than 12 years.
1470 794.011(4) 1st Sexual battery; victim 12 years or older, certain circumstances.
1471 794.011(8)(b) 1st Sexual battery; engage in sexual conduct with minor 12 to 18 years by person in familial or custodial authority.
1472 794.08(2) 1st Female genital mutilation; victim younger than 18 years of age.
1473 800.04(5)(b) Life Lewd or lascivious molestation; victim less than 12 years; offender 18 years or older.
1474 812.13(2)(a) 1st,PBL Robbery with firearm or other deadly weapon.
1475 812.133(2)(a) 1st,PBL Carjacking; firearm or other deadly weapon.
1476 812.135(2)(b) 1st Home-invasion robbery with weapon.
1477 817.568(7) 2nd,PBL Fraudulent use of personal identification information of an individual under the age of 18 by his or her parent, legal guardian, or person exercising custodial authority.
1478 827.03(2) 1st Aggravated child abuse.
1479 847.0145(1) 1st Selling, or otherwise transferring custody or control, of a minor.
1480 847.0145(2) 1st Purchasing, or otherwise obtaining custody or control, of a minor.
1481 859.01 1st Poisoning or introducing bacteria, radioactive materials, viruses, or chemical compounds into food, drink, medicine, or water with intent to kill or injure another person.
1482 893.135 1st Attempted capital trafficking offense.
1483 893.135(1)(a)3. 1st Trafficking in cannabis, more than 10,000 lbs.
1484 893.135(1)(b)1.c. 1st Trafficking in cocaine, more than 400 grams, less than 150 kilograms.
1485 893.135(1)(c)1.c. 1st Trafficking in illegal drugs, more than 28 grams, less than 30 kilograms.
1486 893.135(1)(d)1.c. 1st Trafficking in phencyclidine, more than 400 grams.
1487 893.135(1)(e)1.c. 1st Trafficking in methaqualone, more than 25 kilograms.
1488 893.135(1)(f)1.c. 1st Trafficking in amphetamine, more than 200 grams.
1489 893.135(1)(h)1.c. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 10 kilograms or more.
1490 893.135(1)(j)1.c. 1st Trafficking in 1,4-Butanediol, 10 kilograms or more.
1491 893.135(1)(k)2.c. 1st Trafficking in Phenethylamines, 400 grams or more.
1492 896.101(5)(c) 1st Money laundering, financial instruments totaling or exceeding $100,000.
1493 896.104(4)(a)3. 1st Structuring transactions to evade reporting or registration requirements, financial transactions totaling or exceeding $100,000.
1494 Section 25. Pilot project to monitor home health services.
1495 The Agency for Health Care Administration shall develop and
1496 implement a home health agency monitoring pilot project in
1497 Miami-Dade County by January 1, 2010. The agency shall contract
1498 with a vendor to verify the utilization and delivery of home
1499 health services and provide an electronic billing interface for
1500 home health services. The contract must require the creation of
1501 a program to submit claims electronically for the delivery of
1502 home health services. The program must verify telephonically
1503 visits for the delivery of home health services using voice
1504 biometrics. The agency may seek amendments to the Medicaid state
1505 plan and waivers of federal laws, as necessary, to implement the
1506 pilot project. Notwithstanding s. 287.057(5)(f), Florida
1507 Statutes, the agency must award the contract through the
1508 competitive solicitation process. The agency shall submit a
1509 report to the Governor, the President of the Senate, and the
1510 Speaker of the House of Representatives evaluating the pilot
1511 project by February 1, 2011.
1512 Section 26. Pilot project for home health care management.
1513 The Agency for Health Care Administration shall implement a
1514 comprehensive care management pilot project for home health
1515 services by January 1, 2010, which includes face-to-face
1516 assessments by a nurse licensed pursuant to chapter 464, Florida
1517 Statutes, consultation with physicians ordering services to
1518 substantiate the medical necessity for services, and on-site or
1519 desk reviews of recipients’ medical records in Miami-Dade
1520 County. The agency may enter into a contract with a qualified
1521 organization to implement the pilot project. The agency may seek
1522 amendments to the Medicaid state plan and waivers of federal
1523 laws, as necessary, to implement the pilot project.
1524 Section 27. Subsection (6) of section 400.0077, Florida
1525 Statutes, is amended to read:
1526 400.0077 Confidentiality.—
1527 (6) This section does not limit the subpoena power of the
1528 Attorney General pursuant to s. 409.920(10)(b) s. 409.920(9)(b).
1529 Section 28. Subsection (2) of section 430.608, Florida
1530 Statutes, is amended to read:
1531 430.608 Confidentiality of information.—
1532 (2) This section does not, however, limit the subpoena
1533 authority of the Medicaid Fraud Control Unit of the Department
1534 of Legal Affairs pursuant to s. 409.920(10)(b) s. 409.920(9)(b).
1535 Section 29. Section 395.0199, Florida Statutes, is
1536 repealed.
1537 Section 30. Section 395.405, Florida Statutes, is amended
1538 to read:
1539 395.405 Rulemaking.—The department shall adopt and enforce
1540 all rules necessary to administer ss. 395.0199, 395.401,
1541 395.4015, 395.402, 395.4025, 395.403, 395.404, and 395.4045.
1542 Section 31. Subsection (1) of section 400.0712, Florida
1543 Statutes, is amended to read:
1544 400.0712 Application for inactive license.—
1545 (1) As specified in s. 408.831(4) and this section, the
1546 agency may issue an inactive license to a nursing home facility
1547 for all or a portion of its beds. Any request by a licensee that
1548 a nursing home or portion of a nursing home become inactive must
1549 be submitted to the agency in the approved format. The facility
1550 may not initiate any suspension of services, notify residents,
1551 or initiate inactivity before receiving approval from the
1552 agency; and a licensee that violates this provision may not be
1553 issued an inactive license.
1554 Section 32. Subsection (2) of section 400.118, Florida
1555 Statutes, is repealed.
1556 Section 33. Section 400.141, Florida Statutes, is amended
1557 to read:
1558 400.141 Administration and management of nursing home
1559 facilities.—
1560 (1) Every licensed facility shall comply with all
1561 applicable standards and rules of the agency and shall:
1562 (a)(1) Be under the administrative direction and charge of
1563 a licensed administrator.
1564 (b)(2) Appoint a medical director licensed pursuant to
1565 chapter 458 or chapter 459. The agency may establish by rule
1566 more specific criteria for the appointment of a medical
1567 director.
1568 (c)(3) Have available the regular, consultative, and
1569 emergency services of physicians licensed by the state.
1570 (d)(4) Provide for resident use of a community pharmacy as
1571 specified in s. 400.022(1)(q). Any other law to the contrary
1572 notwithstanding, a registered pharmacist licensed in Florida,
1573 that is under contract with a facility licensed under this
1574 chapter or chapter 429, shall repackage a nursing facility
1575 resident’s bulk prescription medication which has been packaged
1576 by another pharmacist licensed in any state in the United States
1577 into a unit dose system compatible with the system used by the
1578 nursing facility, if the pharmacist is requested to offer such
1579 service. In order to be eligible for the repackaging, a resident
1580 or the resident’s spouse must receive prescription medication
1581 benefits provided through a former employer as part of his or
1582 her retirement benefits, a qualified pension plan as specified
1583 in s. 4972 of the Internal Revenue Code, a federal retirement
1584 program as specified under 5 C.F.R. s. 831, or a long-term care
1585 policy as defined in s. 627.9404(1). A pharmacist who correctly
1586 repackages and relabels the medication and the nursing facility
1587 which correctly administers such repackaged medication under the
1588 provisions of this paragraph may subsection shall not be held
1589 liable in any civil or administrative action arising from the
1590 repackaging. In order to be eligible for the repackaging, a
1591 nursing facility resident for whom the medication is to be
1592 repackaged shall sign an informed consent form provided by the
1593 facility which includes an explanation of the repackaging
1594 process and which notifies the resident of the immunities from
1595 liability provided in this paragraph herein. A pharmacist who
1596 repackages and relabels prescription medications, as authorized
1597 under this paragraph subsection, may charge a reasonable fee for
1598 costs resulting from the implementation of this provision.
1599 (e)(5) Provide for the access of the facility residents to
1600 dental and other health-related services, recreational services,
1601 rehabilitative services, and social work services appropriate to
1602 their needs and conditions and not directly furnished by the
1603 licensee. When a geriatric outpatient nurse clinic is conducted
1604 in accordance with rules adopted by the agency, outpatients
1605 attending such clinic shall not be counted as part of the
1606 general resident population of the nursing home facility, nor
1607 shall the nursing staff of the geriatric outpatient clinic be
1608 counted as part of the nursing staff of the facility, until the
1609 outpatient clinic load exceeds 15 a day.
1610 (f)(6) Be allowed and encouraged by the agency to provide
1611 other needed services under certain conditions. If the facility
1612 has a standard licensure status, and has had no class I or class
1613 II deficiencies during the past 2 years or has been awarded a
1614 Gold Seal under the program established in s. 400.235, it may be
1615 encouraged by the agency to provide services, including, but not
1616 limited to, respite and adult day services, which enable
1617 individuals to move in and out of the facility. A facility is
1618 not subject to any additional licensure requirements for
1619 providing these services. Respite care may be offered to persons
1620 in need of short-term or temporary nursing home services.
1621 Respite care must be provided in accordance with this part and
1622 rules adopted by the agency. However, the agency shall, by rule,
1623 adopt modified requirements for resident assessment, resident
1624 care plans, resident contracts, physician orders, and other
1625 provisions, as appropriate, for short-term or temporary nursing
1626 home services. The agency shall allow for shared programming and
1627 staff in a facility which meets minimum standards and offers
1628 services pursuant to this paragraph subsection, but, if the
1629 facility is cited for deficiencies in patient care, may require
1630 additional staff and programs appropriate to the needs of
1631 service recipients. A person who receives respite care may not
1632 be counted as a resident of the facility for purposes of the
1633 facility’s licensed capacity unless that person receives 24-hour
1634 respite care. A person receiving either respite care for 24
1635 hours or longer or adult day services must be included when
1636 calculating minimum staffing for the facility. Any costs and
1637 revenues generated by a nursing home facility from
1638 nonresidential programs or services shall be excluded from the
1639 calculations of Medicaid per diems for nursing home
1640 institutional care reimbursement.
1641 (g)(7) If the facility has a standard license or is a Gold
1642 Seal facility, exceeds the minimum required hours of licensed
1643 nursing and certified nursing assistant direct care per resident
1644 per day, and is part of a continuing care facility licensed
1645 under chapter 651 or a retirement community that offers other
1646 services pursuant to part III of this chapter or part I or part
1647 III of chapter 429 on a single campus, be allowed to share
1648 programming and staff. At the time of inspection and in the
1649 semiannual report required pursuant to paragraph (o) subsection
1650 (15), a continuing care facility or retirement community that
1651 uses this option must demonstrate through staffing records that
1652 minimum staffing requirements for the facility were met.
1653 Licensed nurses and certified nursing assistants who work in the
1654 nursing home facility may be used to provide services elsewhere
1655 on campus if the facility exceeds the minimum number of direct
1656 care hours required per resident per day and the total number of
1657 residents receiving direct care services from a licensed nurse
1658 or a certified nursing assistant does not cause the facility to
1659 violate the staffing ratios required under s. 400.23(3)(a).
1660 Compliance with the minimum staffing ratios shall be based on
1661 total number of residents receiving direct care services,
1662 regardless of where they reside on campus. If the facility
1663 receives a conditional license, it may not share staff until the
1664 conditional license status ends. This paragraph subsection does
1665 not restrict the agency’s authority under federal or state law
1666 to require additional staff if a facility is cited for
1667 deficiencies in care which are caused by an insufficient number
1668 of certified nursing assistants or licensed nurses. The agency
1669 may adopt rules for the documentation necessary to determine
1670 compliance with this provision.
1671 (h)(8) Maintain the facility premises and equipment and
1672 conduct its operations in a safe and sanitary manner.
1673 (i)(9) If the licensee furnishes food service, provide a
1674 wholesome and nourishing diet sufficient to meet generally
1675 accepted standards of proper nutrition for its residents and
1676 provide such therapeutic diets as may be prescribed by attending
1677 physicians. In making rules to implement this paragraph
1678 subsection, the agency shall be guided by standards recommended
1679 by nationally recognized professional groups and associations
1680 with knowledge of dietetics.
1681 (j)(10) Keep full records of resident admissions and
1682 discharges; medical and general health status, including medical
1683 records, personal and social history, and identity and address
1684 of next of kin or other persons who may have responsibility for
1685 the affairs of the residents; and individual resident care plans
1686 including, but not limited to, prescribed services, service
1687 frequency and duration, and service goals. The records shall be
1688 open to inspection by the agency.
1689 (k)(11) Keep such fiscal records of its operations and
1690 conditions as may be necessary to provide information pursuant
1691 to this part.
1692 (l)(12) Furnish copies of personnel records for employees
1693 affiliated with such facility, to any other facility licensed by
1694 this state requesting this information pursuant to this part.
1695 Such information contained in the records may include, but is
1696 not limited to, disciplinary matters and any reason for
1697 termination. Any facility releasing such records pursuant to
1698 this part shall be considered to be acting in good faith and may
1699 not be held liable for information contained in such records,
1700 absent a showing that the facility maliciously falsified such
1701 records.
1702 (m)(13) Publicly display a poster provided by the agency
1703 containing the names, addresses, and telephone numbers for the
1704 state’s abuse hotline, the State Long-Term Care Ombudsman, the
1705 Agency for Health Care Administration consumer hotline, the
1706 Advocacy Center for Persons with Disabilities, the Florida
1707 Statewide Advocacy Council, and the Medicaid Fraud Control Unit,
1708 with a clear description of the assistance to be expected from
1709 each.
1710 (n)(14) Submit to the agency the information specified in
1711 s. 400.071(1)(b) for a management company within 30 days after
1712 the effective date of the management agreement.
1713 (o)1.(15) Submit semiannually to the agency, or more
1714 frequently if requested by the agency, information regarding
1715 facility staff-to-resident ratios, staff turnover, and staff
1716 stability, including information regarding certified nursing
1717 assistants, licensed nurses, the director of nursing, and the
1718 facility administrator. For purposes of this reporting:
1719 a.(a) Staff-to-resident ratios must be reported in the
1720 categories specified in s. 400.23(3)(a) and applicable rules.
1721 The ratio must be reported as an average for the most recent
1722 calendar quarter.
1723 b.(b) Staff turnover must be reported for the most recent
1724 12-month period ending on the last workday of the most recent
1725 calendar quarter prior to the date the information is submitted.
1726 The turnover rate must be computed quarterly, with the annual
1727 rate being the cumulative sum of the quarterly rates. The
1728 turnover rate is the total number of terminations or separations
1729 experienced during the quarter, excluding any employee
1730 terminated during a probationary period of 3 months or less,
1731 divided by the total number of staff employed at the end of the
1732 period for which the rate is computed, and expressed as a
1733 percentage.
1734 c.(c) The formula for determining staff stability is the
1735 total number of employees that have been employed for more than
1736 12 months, divided by the total number of employees employed at
1737 the end of the most recent calendar quarter, and expressed as a
1738 percentage.
1739 d.(d) A nursing facility that has failed to comply with
1740 state minimum-staffing requirements for 2 consecutive days is
1741 prohibited from accepting new admissions until the facility has
1742 achieved the minimum-staffing requirements for a period of 6
1743 consecutive days. For the purposes of this sub-subparagraph
1744 paragraph, any person who was a resident of the facility and was
1745 absent from the facility for the purpose of receiving medical
1746 care at a separate location or was on a leave of absence is not
1747 considered a new admission. Failure to impose such an admissions
1748 moratorium constitutes a class II deficiency.
1749 e.(e) A nursing facility which does not have a conditional
1750 license may be cited for failure to comply with the standards in
1751 s. 400.23(3)(a)1.a. only if it has failed to meet those
1752 standards on 2 consecutive days or if it has failed to meet at
1753 least 97 percent of those standards on any one day.
1754 f.(f) A facility which has a conditional license must be in
1755 compliance with the standards in s. 400.23(3)(a) at all times.
1756
1757 2. Nothing in This paragraph does not section shall limit
1758 the agency’s ability to impose a deficiency or take other
1759 actions if a facility does not have enough staff to meet the
1760 residents’ needs.
1761 (16) Report monthly the number of vacant beds in the
1762 facility which are available for resident occupancy on the day
1763 the information is reported.
1764 (p)(17) Notify a licensed physician when a resident
1765 exhibits signs of dementia or cognitive impairment or has a
1766 change of condition in order to rule out the presence of an
1767 underlying physiological condition that may be contributing to
1768 such dementia or impairment. The notification must occur within
1769 30 days after the acknowledgment of such signs by facility
1770 staff. If an underlying condition is determined to exist, the
1771 facility shall arrange, with the appropriate health care
1772 provider, the necessary care and services to treat the
1773 condition.
1774 (q)(18) If the facility implements a dining and hospitality
1775 attendant program, ensure that the program is developed and
1776 implemented under the supervision of the facility director of
1777 nursing. A licensed nurse, licensed speech or occupational
1778 therapist, or a registered dietitian must conduct training of
1779 dining and hospitality attendants. A person employed by a
1780 facility as a dining and hospitality attendant must perform
1781 tasks under the direct supervision of a licensed nurse.
1782 (r)(19) Report to the agency any filing for bankruptcy
1783 protection by the facility or its parent corporation,
1784 divestiture or spin-off of its assets, or corporate
1785 reorganization within 30 days after the completion of such
1786 activity.
1787 (s)(20) Maintain general and professional liability
1788 insurance coverage that is in force at all times. In lieu of
1789 general and professional liability insurance coverage, a state
1790 designated teaching nursing home and its affiliated assisted
1791 living facilities created under s. 430.80 may demonstrate proof
1792 of financial responsibility as provided in s. 430.80(3)(h).
1793 (t)(21) Maintain in the medical record for each resident a
1794 daily chart of certified nursing assistant services provided to
1795 the resident. The certified nursing assistant who is caring for
1796 the resident must complete this record by the end of his or her
1797 shift. This record must indicate assistance with activities of
1798 daily living, assistance with eating, and assistance with
1799 drinking, and must record each offering of nutrition and
1800 hydration for those residents whose plan of care or assessment
1801 indicates a risk for malnutrition or dehydration.
1802 (u)(22) Before November 30 of each year, subject to the
1803 availability of an adequate supply of the necessary vaccine,
1804 provide for immunizations against influenza viruses to all its
1805 consenting residents in accordance with the recommendations of
1806 the United States Centers for Disease Control and Prevention,
1807 subject to exemptions for medical contraindications and
1808 religious or personal beliefs. Subject to these exemptions, any
1809 consenting person who becomes a resident of the facility after
1810 November 30 but before March 31 of the following year must be
1811 immunized within 5 working days after becoming a resident.
1812 Immunization shall not be provided to any resident who provides
1813 documentation that he or she has been immunized as required by
1814 this paragraph subsection. This paragraph subsection does not
1815 prohibit a resident from receiving the immunization from his or
1816 her personal physician if he or she so chooses. A resident who
1817 chooses to receive the immunization from his or her personal
1818 physician shall provide proof of immunization to the facility.
1819 The agency may adopt and enforce any rules necessary to comply
1820 with or implement this subsection.
1821 (v)(23) Assess all residents for eligibility for
1822 pneumococcal polysaccharide vaccination (PPV) and vaccinate
1823 residents when indicated within 60 days after the effective date
1824 of this act in accordance with the recommendations of the United
1825 States Centers for Disease Control and Prevention, subject to
1826 exemptions for medical contraindications and religious or
1827 personal beliefs. Residents admitted after the effective date of
1828 this act shall be assessed within 5 working days of admission
1829 and, when indicated, vaccinated within 60 days in accordance
1830 with the recommendations of the United States Centers for
1831 Disease Control and Prevention, subject to exemptions for
1832 medical contraindications and religious or personal beliefs.
1833 Immunization shall not be provided to any resident who provides
1834 documentation that he or she has been immunized as required by
1835 this paragraph subsection. This paragraph subsection does not
1836 prohibit a resident from receiving the immunization from his or
1837 her personal physician if he or she so chooses. A resident who
1838 chooses to receive the immunization from his or her personal
1839 physician shall provide proof of immunization to the facility.
1840 The agency may adopt and enforce any rules necessary to comply
1841 with or implement this paragraph subsection.
1842 (w)(24) Annually encourage and promote to its employees the
1843 benefits associated with immunizations against influenza viruses
1844 in accordance with the recommendations of the United States
1845 Centers for Disease Control and Prevention. The agency may adopt
1846 and enforce any rules necessary to comply with or implement this
1847 paragraph subsection.
1848 (2) Facilities that have been awarded a Gold Seal under the
1849 program established in s. 400.235 may develop a plan to provide
1850 certified nursing assistant training as prescribed by federal
1851 regulations and state rules and may apply to the agency for
1852 approval of their program.
1853 Section 34. Subsections (5), (9), (10), (11), (12), (13),
1854 (14), and (15) of section 400.147, Florida Statutes, are amended
1855 to read:
1856 400.147 Internal risk management and quality assurance
1857 program.—
1858 (5) For purposes of reporting to the agency under this
1859 section, the term “adverse incident” means:
1860 (a) An event over which facility personnel could exercise
1861 control and which is associated in whole or in part with the
1862 facility’s intervention, rather than the condition for which
1863 such intervention occurred, and which results in one of the
1864 following:
1865 1. Death;
1866 2. Brain or spinal damage;
1867 3. Permanent disfigurement;
1868 4. Fracture or dislocation of bones or joints;
1869 5. A limitation of neurological, physical, or sensory
1870 function;
1871 6. Any condition that required medical attention to which
1872 the resident has not given his or her informed consent,
1873 including failure to honor advanced directives; or
1874 7. Any condition that required the transfer of the
1875 resident, within or outside the facility, to a unit providing a
1876 more acute level of care due to the adverse incident, rather
1877 than the resident’s condition prior to the adverse incident; or
1878 8. An event that is reported to law enforcement or its
1879 personnel for investigation; or
1880 (b) Abuse, neglect, or exploitation as defined in s.
1881 415.102;
1882 (c) Abuse, neglect and harm as defined in s. 39.01;
1883 (b)(d) Resident elopement, if the elopement places the
1884 resident at risk of harm or injury.; or
1885 (e) An event that is reported to law enforcement.
1886 (9) Abuse, neglect, or exploitation must be reported to the
1887 agency as required by 42 C.F.R. s. 483.13(c) and to the
1888 department as required by chapters 39 and 415.
1889 (10)(9) By the 10th of each month, each facility subject to
1890 this section shall report any notice received pursuant to s.
1891 400.0233(2) and each initial complaint that was filed with the
1892 clerk of the court and served on the facility during the
1893 previous month by a resident or a resident’s family member,
1894 guardian, conservator, or personal legal representative. The
1895 report must include the name of the resident, the resident’s
1896 date of birth and social security number, the Medicaid
1897 identification number for Medicaid-eligible persons, the date or
1898 dates of the incident leading to the claim or dates of
1899 residency, if applicable, and the type of injury or violation of
1900 rights alleged to have occurred. Each facility shall also submit
1901 a copy of the notices received pursuant to s. 400.0233(2) and
1902 complaints filed with the clerk of the court. This report is
1903 confidential as provided by law and is not discoverable or
1904 admissible in any civil or administrative action, except in such
1905 actions brought by the agency to enforce the provisions of this
1906 part.
1907 (11)(10) The agency shall review, as part of its licensure
1908 inspection process, the internal risk management and quality
1909 assurance program at each facility regulated by this section to
1910 determine whether the program meets standards established in
1911 statutory laws and rules, is being conducted in a manner
1912 designed to reduce adverse incidents, and is appropriately
1913 reporting incidents as required by this section.
1914 (12)(11) There is no monetary liability on the part of, and
1915 a cause of action for damages may not arise against, any risk
1916 manager for the implementation and oversight of the internal
1917 risk management and quality assurance program in a facility
1918 licensed under this part as required by this section, or for any
1919 act or proceeding undertaken or performed within the scope of
1920 the functions of such internal risk management and quality
1921 assurance program if the risk manager acts without intentional
1922 fraud.
1923 (13)(12) If the agency, through its receipt of the adverse
1924 incident reports prescribed in subsection (7), or through any
1925 investigation, has a reasonable belief that conduct by a staff
1926 member or employee of a facility is grounds for disciplinary
1927 action by the appropriate regulatory board, the agency shall
1928 report this fact to the regulatory board.
1929 (14)(13) The agency may adopt rules to administer this
1930 section.
1931 (14) The agency shall annually submit to the Legislature a
1932 report on nursing home adverse incidents. The report must
1933 include the following information arranged by county:
1934 (a) The total number of adverse incidents.
1935 (b) A listing, by category, of the types of adverse
1936 incidents, the number of incidents occurring within each
1937 category, and the type of staff involved.
1938 (c) A listing, by category, of the types of injury caused
1939 and the number of injuries occurring within each category.
1940 (d) Types of liability claims filed based on an adverse
1941 incident or reportable injury.
1942 (e) Disciplinary action taken against staff, categorized by
1943 type of staff involved.
1944 (15) Information gathered by a credentialing organization
1945 under a quality assurance program is not discoverable from the
1946 credentialing organization. This subsection does not limit
1947 discovery of, access to, or use of facility records, including
1948 those records from which the credentialing organization gathered
1949 its information.
1950 Section 35. Subsection (3) of section 400.162, Florida
1951 Statutes, is amended to read:
1952 400.162 Property and personal affairs of residents.—
1953 (3) A licensee shall provide for the safekeeping of
1954 personal effects, funds, and other property of the resident in
1955 the facility. Whenever necessary for the protection of
1956 valuables, or in order to avoid unreasonable responsibility
1957 therefor, the licensee may require that such valuables be
1958 excluded or removed from the facility and kept at some place not
1959 subject to the control of the licensee. At the request of a
1960 resident, the facility shall mark the resident’s personal
1961 property with the resident’s name or another type of
1962 identification, without defacing the property. Any theft or loss
1963 of a resident’s personal property shall be documented by the
1964 facility. The facility shall develop policies and procedures to
1965 minimize the risk of theft or loss of the personal property of
1966 residents. A copy of the policy shall be provided to every
1967 employee and to each resident and the resident’s representative
1968 if appropriate at admission and when revised. Facility policies
1969 must include provisions related to reporting theft or loss of a
1970 resident’s property to law enforcement and any facility waiver
1971 of liability for loss or theft. The facility shall post notice
1972 of these policies and procedures, and any revision thereof, in
1973 places accessible to residents.
1974 Section 36. Paragraphs (a) and (b) of subsection (2) of
1975 section 400.191, Florida Statutes, are amended to read:
1976 400.191 Availability, distribution, and posting of reports
1977 and records.—
1978 (2) The agency shall publish the Nursing Home Guide
1979 annually in consumer-friendly printed form and quarterly in
1980 electronic form to assist consumers and their families in
1981 comparing and evaluating nursing home facilities.
1982 (a) The agency shall provide an Internet site which shall
1983 include at least the following information either directly or
1984 indirectly through a link to another established site or sites
1985 of the agency’s choosing:
1986 1. A section entitled “Have you considered programs that
1987 provide alternatives to nursing home care?” which shall be the
1988 first section of the Nursing Home Guide and which shall
1989 prominently display information about available alternatives to
1990 nursing homes and how to obtain additional information regarding
1991 these alternatives. The Nursing Home Guide shall explain that
1992 this state offers alternative programs that permit qualified
1993 elderly persons to stay in their homes instead of being placed
1994 in nursing homes and shall encourage interested persons to call
1995 the Comprehensive Assessment Review and Evaluation for Long-Term
1996 Care Services (CARES) Program to inquire if they qualify. The
1997 Nursing Home Guide shall list available home and community-based
1998 programs which shall clearly state the services that are
1999 provided and indicate whether nursing home services are included
2000 if needed.
2001 2. A list by name and address of all nursing home
2002 facilities in this state, including any prior name by which a
2003 facility was known during the previous 24-month period.
2004 3. Whether such nursing home facilities are proprietary or
2005 nonproprietary.
2006 4. The current owner of the facility’s license and the year
2007 that that entity became the owner of the license.
2008 5. The name of the owner or owners of each facility and
2009 whether the facility is affiliated with a company or other
2010 organization owning or managing more than one nursing facility
2011 in this state.
2012 6. The total number of beds in each facility and the most
2013 recently available occupancy levels.
2014 7. The number of private and semiprivate rooms in each
2015 facility.
2016 8. The religious affiliation, if any, of each facility.
2017 9. The languages spoken by the administrator and staff of
2018 each facility.
2019 10. Whether or not each facility accepts Medicare or
2020 Medicaid recipients or insurance, health maintenance
2021 organization, Veterans Administration, CHAMPUS program, or
2022 workers’ compensation coverage.
2023 11. Recreational and other programs available at each
2024 facility.
2025 12. Special care units or programs offered at each
2026 facility.
2027 13. Whether the facility is a part of a retirement
2028 community that offers other services pursuant to part III of
2029 this chapter or part I or part III of chapter 429.
2030 14. Survey and deficiency information, including all
2031 federal and state recertification, licensure, revisit, and
2032 complaint survey information, for each facility for the past 30
2033 months. For noncertified nursing homes, state survey and
2034 deficiency information, including licensure, revisit, and
2035 complaint survey information for the past 30 months shall be
2036 provided.
2037 15. A summary of the deficiency data for each facility over
2038 the past 30 months. The summary may include a score, rating, or
2039 comparison ranking with respect to other facilities based on the
2040 number of citations received by the facility on recertification,
2041 licensure, revisit, and complaint surveys; the severity and
2042 scope of the citations; and the number of recertification
2043 surveys the facility has had during the past 30 months. The
2044 score, rating, or comparison ranking may be presented in either
2045 numeric or symbolic form for the intended consumer audience.
2046 (b) The agency shall provide the following information in
2047 printed form:
2048 1. A section entitled “Have you considered programs that
2049 provide alternatives to nursing home care?” which shall be the
2050 first section of the Nursing Home Guide and which shall
2051 prominently display information about available alternatives to
2052 nursing homes and how to obtain additional information regarding
2053 these alternatives. The Nursing Home Guide shall explain that
2054 this state offers alternative programs that permit qualified
2055 elderly persons to stay in their homes instead of being placed
2056 in nursing homes and shall encourage interested persons to call
2057 the Comprehensive Assessment Review and Evaluation for Long-Term
2058 Care Services (CARES) Program to inquire if they qualify. The
2059 Nursing Home Guide shall list available home and community-based
2060 programs which shall clearly state the services that are
2061 provided and indicate whether nursing home services are included
2062 if needed.
2063 2. A list by name and address of all nursing home
2064 facilities in this state.
2065 3. Whether the nursing home facilities are proprietary or
2066 nonproprietary.
2067 4. The current owner or owners of the facility’s license
2068 and the year that entity became the owner of the license.
2069 5. The total number of beds, and of private and semiprivate
2070 rooms, in each facility.
2071 6. The religious affiliation, if any, of each facility.
2072 7. The name of the owner of each facility and whether the
2073 facility is affiliated with a company or other organization
2074 owning or managing more than one nursing facility in this state.
2075 8. The languages spoken by the administrator and staff of
2076 each facility.
2077 9. Whether or not each facility accepts Medicare or
2078 Medicaid recipients or insurance, health maintenance
2079 organization, Veterans Administration, CHAMPUS program, or
2080 workers’ compensation coverage.
2081 10. Recreational programs, special care units, and other
2082 programs available at each facility.
2083 11. The Internet address for the site where more detailed
2084 information can be seen.
2085 12. A statement advising consumers that each facility will
2086 have its own policies and procedures related to protecting
2087 resident property.
2088 13. A summary of the deficiency data for each facility over
2089 the past 30 months. The summary may include a score, rating, or
2090 comparison ranking with respect to other facilities based on the
2091 number of citations received by the facility on recertification,
2092 licensure, revisit, and complaint surveys; the severity and
2093 scope of the citations; the number of citations; and the number
2094 of recertification surveys the facility has had during the past
2095 30 months. The score, rating, or comparison ranking may be
2096 presented in either numeric or symbolic form for the intended
2097 consumer audience.
2098 Section 37. Paragraph (d) of subsection (1) of section
2099 400.195, Florida Statutes, is amended to read:
2100 400.195 Agency reporting requirements.—
2101 (1) For the period beginning June 30, 2001, and ending June
2102 30, 2005, the Agency for Health Care Administration shall
2103 provide a report to the Governor, the President of the Senate,
2104 and the Speaker of the House of Representatives with respect to
2105 nursing homes. The first report shall be submitted no later than
2106 December 30, 2002, and subsequent reports shall be submitted
2107 every 6 months thereafter. The report shall identify facilities
2108 based on their ownership characteristics, size, business
2109 structure, for-profit or not-for-profit status, and any other
2110 characteristics the agency determines useful in analyzing the
2111 varied segments of the nursing home industry and shall report:
2112 (d) Information regarding deficiencies cited, including
2113 information used to develop the Nursing Home Guide WATCH LIST
2114 pursuant to s. 400.191, and applicable rules, a summary of data
2115 generated on nursing homes by Centers for Medicare and Medicaid
2116 Services Nursing Home Quality Information Project, and
2117 information collected pursuant to s. 400.147(10) s. 400.147(9),
2118 relating to litigation.
2119 Section 38. Subsection (3) of section 400.23, Florida
2120 Statutes, is amended to read:
2121 400.23 Rules; evaluation and deficiencies; licensure
2122 status.—
2123 (3)(a)1. The agency shall adopt rules providing minimum
2124 staffing requirements for nursing homes. These requirements
2125 shall include, for each nursing home facility:
2126 a. A minimum certified nursing assistant staffing of 2.6
2127 hours of direct care per resident per day beginning January 1,
2128 2003, and increasing to 2.7 hours of direct care per resident
2129 per day beginning January 1, 2007. Beginning January 1, 2002, no
2130 facility shall staff below one certified nursing assistant per
2131 20 residents, and a minimum licensed nursing staffing of 1.0
2132 hour of direct care per resident per day but never below one
2133 licensed nurse per 40 residents.
2134 b. Beginning January 1, 2007, a minimum weekly average
2135 certified nursing assistant staffing of 2.9 hours of direct care
2136 per resident per day. For the purpose of this sub-subparagraph,
2137 a week is defined as Sunday through Saturday.
2138 2. Nursing assistants employed under s. 400.211(2) may be
2139 included in computing the staffing ratio for certified nursing
2140 assistants only if their job responsibilities include only
2141 nursing-assistant-related duties.
2142 3. Each nursing home must document compliance with staffing
2143 standards as required under this paragraph and post daily the
2144 names of staff on duty for the benefit of facility residents and
2145 the public.
2146 4. The agency shall recognize the use of licensed nurses
2147 for compliance with minimum staffing requirements for certified
2148 nursing assistants, provided that the facility otherwise meets
2149 the minimum staffing requirements for licensed nurses and that
2150 the licensed nurses are performing the duties of a certified
2151 nursing assistant. Unless otherwise approved by the agency,
2152 licensed nurses counted toward the minimum staffing requirements
2153 for certified nursing assistants must exclusively perform the
2154 duties of a certified nursing assistant for the entire shift and
2155 not also be counted toward the minimum staffing requirements for
2156 licensed nurses. If the agency approved a facility’s request to
2157 use a licensed nurse to perform both licensed nursing and
2158 certified nursing assistant duties, the facility must allocate
2159 the amount of staff time specifically spent on certified nursing
2160 assistant duties for the purpose of documenting compliance with
2161 minimum staffing requirements for certified and licensed nursing
2162 staff. In no event may the hours of a licensed nurse with dual
2163 job responsibilities be counted twice.
2164 (b) The agency shall adopt rules to allow properly trained
2165 staff of a nursing facility, in addition to certified nursing
2166 assistants and licensed nurses, to assist residents with eating.
2167 The rules shall specify the minimum training requirements and
2168 shall specify the physiological conditions or disorders of
2169 residents which would necessitate that the eating assistance be
2170 provided by nursing personnel of the facility. Nonnursing staff
2171 providing eating assistance to residents under the provisions of
2172 this subsection shall not count toward compliance with minimum
2173 staffing standards.
2174 (c) Licensed practical nurses licensed under chapter 464
2175 who are providing nursing services in nursing home facilities
2176 under this part may supervise the activities of other licensed
2177 practical nurses, certified nursing assistants, and other
2178 unlicensed personnel providing services in such facilities in
2179 accordance with rules adopted by the Board of Nursing.
2180 Section 39. Paragraph (a) of subsection (7) of section
2181 400.9935, Florida Statutes, is amended to read:
2182 400.9935 Clinic responsibilities.—
2183 (7)(a) Each clinic engaged in magnetic resonance imaging
2184 services must be accredited by the Joint Commission on
2185 Accreditation of Healthcare Organizations, the American College
2186 of Radiology, or the Accreditation Association for Ambulatory
2187 Health Care, within 1 year after licensure. A clinic that is
2188 accredited by the American College of Radiology or is within the
2189 original 1-year period after licensure and replaces its core
2190 magnetic resonance imaging equipment shall be given 1 year after
2191 the date on which the equipment is replaced to attain
2192 accreditation. However, a clinic may request a single, 6-month
2193 extension if it provides evidence to the agency establishing
2194 that, for good cause shown, such clinic cannot can not be
2195 accredited within 1 year after licensure, and that such
2196 accreditation will be completed within the 6-month extension.
2197 After obtaining accreditation as required by this subsection,
2198 each such clinic must maintain accreditation as a condition of
2199 renewal of its license. A clinic that files a change of
2200 ownership application must comply with the original
2201 accreditation timeframe requirements of the transferor. The
2202 agency shall deny a change of ownership application if the
2203 clinic is not in compliance with the accreditation requirements.
2204 When a clinic adds, replaces, or modifies magnetic resonance
2205 imaging equipment and the accreditation agency requires new
2206 accreditation, the clinic must be accredited within 1 year after
2207 the date of the addition, replacement, or modification but may
2208 request a single, 6-month extension if the clinic provides
2209 evidence of good cause to the agency.
2210 Section 40. Subsection (6) of section 400.995, Florida
2211 Statutes, is amended to read:
2212 400.995 Agency administrative penalties.—
2213 (6) During an inspection, the agency, as an alternative to
2214 or in conjunction with an administrative action against a clinic
2215 for violations of this part and adopted rules, shall make a
2216 reasonable attempt to discuss each violation and recommended
2217 corrective action with the owner, medical director, or clinic
2218 director of the clinic, prior to written notification. The
2219 agency, instead of fixing a period within which the clinic shall
2220 enter into compliance with standards, may request a plan of
2221 corrective action from the clinic which demonstrates a good
2222 faith effort to remedy each violation by a specific date,
2223 subject to the approval of the agency.
2224 Section 41. Subsections (5), (9), and (13) of section
2225 408.803, Florida Statutes, are amended to read:
2226 408.803 Definitions.—As used in this part, the term:
2227 (5) “Change of ownership” means:
2228 (a) An event in which the licensee sells or otherwise
2229 transfers its ownership changes to a different individual or
2230 legal entity as evidenced by a change in federal employer
2231 identification number or taxpayer identification number; or
2232 (b) An event in which 51 45 percent or more of the
2233 ownership, voting shares, membership, or controlling interest of
2234 a licensee is in any manner transferred or otherwise assigned.
2235 This paragraph does not apply to a licensee that is publicly
2236 traded on a recognized stock exchange in a corporation whose
2237 shares are not publicly traded on a recognized stock exchange is
2238 transferred or assigned, including the final transfer or
2239 assignment of multiple transfers or assignments over a 2-year
2240 period that cumulatively total 45 percent or greater.
2241
2242 A change solely in the management company or board of directors
2243 is not a change of ownership.
2244 (9) “Licensee” means an individual, corporation,
2245 partnership, firm, association, or governmental entity, or other
2246 entity that is issued a permit, registration, certificate, or
2247 license by the agency. The licensee is legally responsible for
2248 all aspects of the provider operation.
2249 (13) “Voluntary board member” means a board member or
2250 officer of a not-for-profit corporation or organization who
2251 serves solely in a voluntary capacity, does not receive any
2252 remuneration for his or her services on the board of directors,
2253 and has no financial interest in the corporation or
2254 organization. The agency shall recognize a person as a voluntary
2255 board member following submission of a statement to the agency
2256 by the board member and the not-for-profit corporation or
2257 organization that affirms that the board member conforms to this
2258 definition. The statement affirming the status of the board
2259 member must be submitted to the agency on a form provided by the
2260 agency.
2261 Section 42. Paragraph (a) of subsection (1), subsection
2262 (2), paragraph (c) of subsection (7), and subsection (8) of
2263 section 408.806, Florida Statutes, are amended to read:
2264 408.806 License application process.—
2265 (1) An application for licensure must be made to the agency
2266 on forms furnished by the agency, submitted under oath, and
2267 accompanied by the appropriate fee in order to be accepted and
2268 considered timely. The application must contain information
2269 required by authorizing statutes and applicable rules and must
2270 include:
2271 (a) The name, address, and social security number of:
2272 1. The applicant;
2273 2. The administrator or a similarly titled person who is
2274 responsible for the day-to-day operation of the provider;
2275 3. The financial officer or similarly titled person who is
2276 responsible for the financial operation of the licensee or
2277 provider; and
2278 4. Each controlling interest if the applicant or
2279 controlling interest is an individual.
2280 (2)(a) The applicant for a renewal license must submit an
2281 application that must be received by the agency at least 60 days
2282 but no more than 120 days before prior to the expiration of the
2283 current license. An application received more than 120 days
2284 before the expiration of the current license shall be returned
2285 to the applicant. If the renewal application and fee are
2286 received prior to the license expiration date, the license shall
2287 not be deemed to have expired if the license expiration date
2288 occurs during the agency’s review of the renewal application.
2289 (b) The applicant for initial licensure due to a change of
2290 ownership must submit an application that must be received by
2291 the agency at least 60 days prior to the date of change of
2292 ownership.
2293 (c) For any other application or request, the applicant
2294 must submit an application or request that must be received by
2295 the agency at least 60 days but no more than 120 days before
2296 prior to the requested effective date, unless otherwise
2297 specified in authorizing statutes or applicable rules. An
2298 application received more than 120 days before the requested
2299 effective date shall be returned to the applicant.
2300 (d) The agency shall notify the licensee by mail or
2301 electronically at least 90 days before prior to the expiration
2302 of a license that a renewal license is necessary to continue
2303 operation. The failure to timely submit a renewal application
2304 and license fee shall result in a $50 per day late fee charged
2305 to the licensee by the agency; however, the aggregate amount of
2306 the late fee may not exceed 50 percent of the licensure fee or
2307 $500, whichever is less. If an application is received after the
2308 required filing date and exhibits a hand-canceled postmark
2309 obtained from a United States post office dated on or before the
2310 required filing date, no fine will be levied.
2311 (7)
2312 (c) If an inspection is required by the authorizing statute
2313 for a license application other than an initial application, the
2314 inspection must be unannounced. This paragraph does not apply to
2315 inspections required pursuant to ss. 383.324, 395.0161(4),
2316 429.67(6), and 483.061(2).
2317 (8) The agency may establish procedures for the electronic
2318 notification and submission of required information, including,
2319 but not limited to:
2320 (a) Licensure applications.
2321 (b) Required signatures.
2322 (c) Payment of fees.
2323 (d) Notarization of applications.
2324
2325 Requirements for electronic submission of any documents required
2326 by this part or authorizing statutes may be established by rule.
2327 As an alternative to sending documents as required by
2328 authorizing statutes, the agency may provide electronic access
2329 to information or documents.
2330 Section 43. Subsection (2) of section 408.808, Florida
2331 Statutes, is amended to read:
2332 408.808 License categories.—
2333 (2) PROVISIONAL LICENSE.—A provisional license may be
2334 issued to an applicant pursuant to s. 408.809(3). An applicant
2335 against whom a proceeding denying or revoking a license is
2336 pending at the time of license renewal may be issued a
2337 provisional license effective until final action not subject to
2338 further appeal. A provisional license may also be issued to an
2339 applicant applying for a change of ownership. A provisional
2340 license shall be limited in duration to a specific period of
2341 time, not to exceed 12 months, as determined by the agency.
2342 Section 44. Subsection (5) of section 408.809, Florida
2343 Statutes, is amended, and subsection (6) is added to that
2344 section, to read:
2345 408.809 Background screening; prohibited offenses.—
2346 (5) Effective October 1, 2009, in addition to the offenses
2347 listed in ss. 435.03 and 435.04, all persons required to undergo
2348 background screening pursuant to this part or authorizing
2349 statutes must not have been found guilty of, regardless of
2350 adjudication, or entered a plea of nolo contendere or guilty to,
2351 any of the following offenses or any similar offense of another
2352 jurisdiction:
2353 (a) Any authorizing statutes, if the offense was a felony.
2354 (b) This chapter, if the offense was a felony.
2355 (c) Section 409.920, relating to Medicaid provider fraud,
2356 if the offense was a felony.
2357 (d) Section 409.9201, relating to Medicaid fraud, if the
2358 offense was a felony.
2359 (e) Section 741.28, relating to domestic violence.
2360 (f) Chapter 784, relating to assault, battery, and culpable
2361 negligence, if the offense was a felony.
2362 (g) Section 810.02, relating to burglary.
2363 (h) Section 817.034, relating to fraudulent acts through
2364 mail, wire, radio, electromagnetic, photoelectronic, or
2365 photooptical systems.
2366 (i) Section 817.234, relating to false and fraudulent
2367 insurance claims.
2368 (j) Section 817.505, relating to patient brokering.
2369 (k) Section 817.568, relating to criminal use of personal
2370 identification information.
2371 (l) Section 817.60, relating to obtaining a credit card
2372 through fraudulent means.
2373 (m) Section 817.61, relating to fraudulent use of credit
2374 cards, if the offense was a felony.
2375 (n) Section 831.01, relating to forgery.
2376 (o) Section 831.02, relating to uttering forged
2377 instruments.
2378 (p) Section 831.07, relating to forging bank bills, checks,
2379 drafts, or promissory notes.
2380 (q) Section 831.09, relating to uttering forged bank bills,
2381 checks, drafts, or promissory notes.
2382 (r) Section 831.30, relating to fraud in obtaining
2383 medicinal drugs.
2384 (s) Section 831.31, relating to the sale, manufacture,
2385 delivery, or possession with the intent to sell, manufacture, or
2386 deliver any counterfeit controlled substance, if the offense was
2387 a felony.
2388
2389 A person who serves as a controlling interest of or is employed
2390 by a licensee on September 30, 2009, is not required by law to
2391 submit to rescreening if that licensee has in its possession
2392 written evidence that the person has been screened and qualified
2393 according to the standards specified in s. 435.03 or s. 435.04.
2394 However, if such person has a disqualifying offense listed in
2395 this section, he or she may apply for an exemption from the
2396 appropriate licensing agency before September 30, 2009, and if
2397 agreed to by the employer, may continue to perform his or her
2398 duties until the licensing agency renders a decision on the
2399 application for exemption for offenses listed in this section.
2400 Exemptions from disqualification may be granted pursuant to s.
2401 435.07. Background screening is not required to obtain a
2402 certificate of exemption issued under s. 483.106.
2403 (6) The attestations required under ss. 435.04(5) and
2404 435.05(3) must be submitted at the time of license renewal,
2405 notwithstanding the provisions of ss. 435.04(5) and 435.05(3)
2406 which require annual submission of an affidavit of compliance
2407 with background screening requirements.
2408 Section 45. Section 408.811, Florida Statutes, is amended
2409 to read:
2410 408.811 Right of inspection; copies; inspection reports;
2411 plan for correction of deficiencies.—
2412 (1) An authorized officer or employee of the agency may
2413 make or cause to be made any inspection or investigation deemed
2414 necessary by the agency to determine the state of compliance
2415 with this part, authorizing statutes, and applicable rules. The
2416 right of inspection extends to any business that the agency has
2417 reason to believe is being operated as a provider without a
2418 license, but inspection of any business suspected of being
2419 operated without the appropriate license may not be made without
2420 the permission of the owner or person in charge unless a warrant
2421 is first obtained from a circuit court. Any application for a
2422 license issued under this part, authorizing statutes, or
2423 applicable rules constitutes permission for an appropriate
2424 inspection to verify the information submitted on or in
2425 connection with the application.
2426 (a) All inspections shall be unannounced, except as
2427 specified in s. 408.806.
2428 (b) Inspections for relicensure shall be conducted
2429 biennially unless otherwise specified by authorizing statutes or
2430 applicable rules.
2431 (2) Inspections conducted in conjunction with
2432 certification, comparable licensure requirements, or a
2433 recognized or approved accreditation organization may be
2434 accepted in lieu of a complete licensure inspection. However, a
2435 licensure inspection may also be conducted to review any
2436 licensure requirements that are not also requirements for
2437 certification.
2438 (3) The agency shall have access to and the licensee shall
2439 provide, or if requested send, copies of all provider records
2440 required during an inspection or other review at no cost to the
2441 agency, including records requested during an offsite review.
2442 (4) A deficiency must be corrected within 30 calendar days
2443 after the provider is notified of inspection results unless an
2444 alternative timeframe is required or approved by the agency.
2445 (5) The agency may require an applicant or licensee to
2446 submit a plan of correction for deficiencies. If required, the
2447 plan of correction must be filed with the agency within 10
2448 calendar days after notification unless an alternative timeframe
2449 is required.
2450 (6)(a)(4)(a) Each licensee shall maintain as public
2451 information, available upon request, records of all inspection
2452 reports pertaining to that provider that have been filed by the
2453 agency unless those reports are exempt from or contain
2454 information that is exempt from s. 119.07(1) and s. 24(a), Art.
2455 I of the State Constitution or is otherwise made confidential by
2456 law. Effective October 1, 2006, copies of such reports shall be
2457 retained in the records of the provider for at least 3 years
2458 following the date the reports are filed and issued, regardless
2459 of a change of ownership.
2460 (b) A licensee shall, upon the request of any person who
2461 has completed a written application with intent to be admitted
2462 by such provider, any person who is a client of such provider,
2463 or any relative, spouse, or guardian of any such person, furnish
2464 to the requester a copy of the last inspection report pertaining
2465 to the licensed provider that was issued by the agency or by an
2466 accrediting organization if such report is used in lieu of a
2467 licensure inspection.
2468 Section 46. Section 408.813, Florida Statutes, is amended
2469 to read:
2470 408.813 Administrative fines; violations.—As a penalty for
2471 any violation of this part, authorizing statutes, or applicable
2472 rules, the agency may impose an administrative fine.
2473 (1) Unless the amount or aggregate limitation of the fine
2474 is prescribed by authorizing statutes or applicable rules, the
2475 agency may establish criteria by rule for the amount or
2476 aggregate limitation of administrative fines applicable to this
2477 part, authorizing statutes, and applicable rules. Each day of
2478 violation constitutes a separate violation and is subject to a
2479 separate fine. For fines imposed by final order of the agency
2480 and not subject to further appeal, the violator shall pay the
2481 fine plus interest at the rate specified in s. 55.03 for each
2482 day beyond the date set by the agency for payment of the fine.
2483 (2) Violations of this part, authorizing statutes, or
2484 applicable rules shall be classified according to the nature of
2485 the violation and the gravity of its probable effect on clients.
2486 The scope of a violation may be cited as an isolated, patterned,
2487 or widespread deficiency. An isolated deficiency is a deficiency
2488 affecting one or a very limited number of clients, or involving
2489 one or a very limited number of staff, or a situation that
2490 occurred only occasionally or in a very limited number of
2491 locations. A patterned deficiency is a deficiency in which more
2492 than a very limited number of clients are affected, or more than
2493 a very limited number of staff are involved, or the situation
2494 has occurred in several locations, or the same client or clients
2495 have been affected by repeated occurrences of the same deficient
2496 practice but the effect of the deficient practice is not found
2497 to be pervasive throughout the provider. A widespread deficiency
2498 is a deficiency in which the problems causing the deficiency are
2499 pervasive in the provider or represent systemic failure that has
2500 affected or has the potential to affect a large portion of the
2501 provider’s clients. This subsection does not affect the
2502 legislative determination of the amount of a fine imposed under
2503 authorizing statutes. Violations shall be classified on the
2504 written notice as follows:
2505 (a) Class “I” violations are those conditions or
2506 occurrences related to the operation and maintenance of a
2507 provider or to the care of clients which the agency determines
2508 present an imminent danger to the clients of the provider or a
2509 substantial probability that death or serious physical or
2510 emotional harm would result therefrom. The condition or practice
2511 constituting a class I violation shall be abated or eliminated
2512 within 24 hours, unless a fixed period, as determined by the
2513 agency, is required for correction. The agency shall impose an
2514 administrative fine as provided by law for a cited class I
2515 violation. A fine shall be levied notwithstanding the correction
2516 of the violation.
2517 (b) Class “II” violations are those conditions or
2518 occurrences related to the operation and maintenance of a
2519 provider or to the care of clients which the agency determines
2520 directly threaten the physical or emotional health, safety, or
2521 security of the clients, other than class I violations. The
2522 agency shall impose an administrative fine as provided by law
2523 for a cited class II violation. A fine shall be levied
2524 notwithstanding the correction of the violation.
2525 (c) Class “III” violations are those conditions or
2526 occurrences related to the operation and maintenance of a
2527 provider or to the care of clients which the agency determines
2528 indirectly or potentially threaten the physical or emotional
2529 health, safety, or security of clients, other than class I or
2530 class II violations. The agency shall impose an administrative
2531 fine as provided in this section for a cited class III
2532 violation. A citation for a class III violation must specify the
2533 time within which the violation is required to be corrected. If
2534 a class III violation is corrected within the time specified, a
2535 fine may not be imposed.
2536 (d) Class “IV” violations are those conditions or
2537 occurrences related to the operation and maintenance of a
2538 provider or to required reports, forms, or documents that do not
2539 have the potential of negatively affecting clients. These
2540 violations are of a type that the agency determines do not
2541 threaten the health, safety, or security of clients. The agency
2542 shall impose an administrative fine as provided in this section
2543 for a cited class IV violation. A citation for a class IV
2544 violation must specify the time within which the violation is
2545 required to be corrected. If a class IV violation is corrected
2546 within the time specified, a fine may not be imposed.
2547 Section 47. Subsections (11), (12), (13), (14), (15), (16),
2548 (17), (18), (19), (20), (21), (22), (23), (24), (25), (26),
2549 (27), (28), and (29) of section 408.820, Florida Statutes, are
2550 amended to read:
2551 408.820 Exemptions.—Except as prescribed in authorizing
2552 statutes, the following exemptions shall apply to specified
2553 requirements of this part:
2554 (11) Private review agents, as provided under part I of
2555 chapter 395, are exempt from ss. 408.806(7), 408.810, and
2556 408.811.
2557 (11)(12) Health care risk managers, as provided under part
2558 I of chapter 395, are exempt from ss. 408.806(7), 408.810(4)
2559 (10) 408.810, and 408.811.
2560 (12)(13) Nursing homes, as provided under part II of
2561 chapter 400, are exempt from ss. 408.810(7) and 408.813(2) s.
2562 408.810(7).
2563 (13)(14) Assisted living facilities, as provided under part
2564 I of chapter 429, are exempt from s. 408.810(10).
2565 (14)(15) Home health agencies, as provided under part III
2566 of chapter 400, are exempt from s. 408.810(10).
2567 (15)(16) Nurse registries, as provided under part III of
2568 chapter 400, are exempt from s. 408.810(6) and (10).
2569 (16)(17) Companion services or homemaker services
2570 providers, as provided under part III of chapter 400, are exempt
2571 from s. 408.810(6)-(10).
2572 (17)(18) Adult day care centers, as provided under part III
2573 of chapter 429, are exempt from s. 408.810(10).
2574 (18)(19) Adult family-care homes, as provided under part II
2575 of chapter 429, are exempt from s. 408.810(7)-(10).
2576 (18)(20) Homes for special services, as provided under part
2577 V of chapter 400, are exempt from s. 408.810(7)-(10).
2578 (20)(21) Transitional living facilities, as provided under
2579 part V of chapter 400, are exempt from s. 408.810(10) s.
2580 408.810(7)-(10).
2581 (21)(22) Prescribed pediatric extended care centers, as
2582 provided under part VI of chapter 400, are exempt from s.
2583 408.810(10).
2584 (22)(23) Home medical equipment providers, as provided
2585 under part VII of chapter 400, are exempt from s. 408.810(10).
2586 (23)(24) Intermediate care facilities for persons with
2587 developmental disabilities, as provided under part VIII of
2588 chapter 400, are exempt from s. 408.810(7).
2589 (24)(25) Health care services pools, as provided under part
2590 IX of chapter 400, are exempt from s. 408.810(6)-(10).
2591 (25)(26) Health care clinics, as provided under part X of
2592 chapter 400, are exempt from s. 408.810(6), (7), (10) ss.
2593 408.809 and 408.810(1), (6), (7), and (10).
2594 (26)(27) Clinical laboratories, as provided under part I of
2595 chapter 483, are exempt from s. 408.810(5)-(10).
2596 (27)(28) Multiphasic health testing centers, as provided
2597 under part II of chapter 483, are exempt from s. 408.810(5)
2598 (10).
2599 (28)(29) Organ and tissue procurement agencies, as provided
2600 under chapter 765, are exempt from s. 408.810(5)-(10).
2601 Section 48. Section 408.821, Florida Statutes, is created
2602 to read:
2603 408.821 Emergency management planning; emergency
2604 operations; inactive license.—
2605 (1) A licensee required by authorizing statutes to have an
2606 emergency operations plan must designate a safety liaison to
2607 serve as the primary contact for emergency operations.
2608 (2) An entity subject to this part may temporarily exceed
2609 its licensed capacity to act as a receiving provider in
2610 accordance with an approved emergency operations plan for up to
2611 15 days. While in an overcapacity status, each provider must
2612 furnish or arrange for appropriate care and services to all
2613 clients. In addition, the agency may approve requests for
2614 overcapacity in excess of 15 days, which approvals may be based
2615 upon satisfactory justification and need as provided by the
2616 receiving and sending providers.
2617 (3)(a) An inactive license may be issued to a licensee
2618 subject to this section when the provider is located in a
2619 geographic area in which a state of emergency was declared by
2620 the Governor if the provider:
2621 1. Suffered damage to its operation during the state of
2622 emergency.
2623 2. Is currently licensed.
2624 3. Does not have a provisional license.
2625 4. Will be temporarily unable to provide services but is
2626 reasonably expected to resume services within 12 months.
2627 (b) An inactive license may be issued for a period not to
2628 exceed 12 months but may be renewed by the agency for up to 12
2629 additional months upon demonstration to the agency of progress
2630 toward reopening. A request by a licensee for an inactive
2631 license or to extend the previously approved inactive period
2632 must be submitted in writing to the agency, accompanied by
2633 written justification for the inactive license, which states the
2634 beginning and ending dates of inactivity and includes a plan for
2635 the transfer of any clients to other providers and appropriate
2636 licensure fees. Upon agency approval, the licensee shall notify
2637 clients of any necessary discharge or transfer as required by
2638 authorizing statutes or applicable rules. The beginning of the
2639 inactive licensure period shall be the date the provider ceases
2640 operations. The end of the inactive period shall become the
2641 license expiration date, and all licensure fees must be current,
2642 must be paid in full, and may be prorated. Reactivation of an
2643 inactive license requires the prior approval by the agency of a
2644 renewal application, including payment of licensure fees and
2645 agency inspections indicating compliance with all requirements
2646 of this part and applicable rules and statutes.
2647 (4) The agency may adopt rules relating to emergency
2648 management planning, communications, and operations. Licensees
2649 providing residential or inpatient services must utilize an
2650 online database approved by the agency to report information to
2651 the agency regarding the provider’s emergency status, planning,
2652 or operations.
2653 Section 49. Section 408.831, Florida Statutes, is amended
2654 to read:
2655 408.831 Denial, suspension, or revocation of a license,
2656 registration, certificate, or application.—
2657 (1) In addition to any other remedies provided by law, the
2658 agency may deny each application or suspend or revoke each
2659 license, registration, or certificate of entities regulated or
2660 licensed by it:
2661 (a) If the applicant, licensee, or a licensee subject to
2662 this part which shares a common controlling interest with the
2663 applicant has failed to pay all outstanding fines, liens, or
2664 overpayments assessed by final order of the agency or final
2665 order of the Centers for Medicare and Medicaid Services, not
2666 subject to further appeal, unless a repayment plan is approved
2667 by the agency; or
2668 (b) For failure to comply with any repayment plan.
2669 (2) In reviewing any application requesting a change of
2670 ownership or change of the licensee, registrant, or
2671 certificateholder, the transferor shall, prior to agency
2672 approval of the change, repay or make arrangements to repay any
2673 amounts owed to the agency. Should the transferor fail to repay
2674 or make arrangements to repay the amounts owed to the agency,
2675 the issuance of a license, registration, or certificate to the
2676 transferee shall be delayed until repayment or until
2677 arrangements for repayment are made.
2678 (3) An entity subject to this section may exceed its
2679 licensed capacity to act as a receiving facility in accordance
2680 with an emergency operations plan for clients of evacuating
2681 providers from a geographic area where an evacuation order has
2682 been issued by a local authority having jurisdiction. While in
2683 an overcapacity status, each provider must furnish or arrange
2684 for appropriate care and services to all clients. In addition,
2685 the agency may approve requests for overcapacity beyond 15 days,
2686 which approvals may be based upon satisfactory justification and
2687 need as provided by the receiving and sending facilities.
2688 (4)(a) An inactive license may be issued to a licensee
2689 subject to this section when the provider is located in a
2690 geographic area where a state of emergency was declared by the
2691 Governor if the provider:
2692 1. Suffered damage to its operation during that state of
2693 emergency.
2694 2. Is currently licensed.
2695 3. Does not have a provisional license.
2696 4. Will be temporarily unable to provide services but is
2697 reasonably expected to resume services within 12 months.
2698 (b) An inactive license may be issued for a period not to
2699 exceed 12 months but may be renewed by the agency for up to 12
2700 additional months upon demonstration to the agency of progress
2701 toward reopening. A request by a licensee for an inactive
2702 license or to extend the previously approved inactive period
2703 must be submitted in writing to the agency, accompanied by
2704 written justification for the inactive license, which states the
2705 beginning and ending dates of inactivity and includes a plan for
2706 the transfer of any clients to other providers and appropriate
2707 licensure fees. Upon agency approval, the licensee shall notify
2708 clients of any necessary discharge or transfer as required by
2709 authorizing statutes or applicable rules. The beginning of the
2710 inactive licensure period shall be the date the provider ceases
2711 operations. The end of the inactive period shall become the
2712 licensee expiration date, and all licensure fees must be
2713 current, paid in full, and may be prorated. Reactivation of an
2714 inactive license requires the prior approval by the agency of a
2715 renewal application, including payment of licensure fees and
2716 agency inspections indicating compliance with all requirements
2717 of this part and applicable rules and statutes.
2718 (3)(5) This section provides standards of enforcement
2719 applicable to all entities licensed or regulated by the Agency
2720 for Health Care Administration. This section controls over any
2721 conflicting provisions of chapters 39, 383, 390, 391, 394, 395,
2722 400, 408, 429, 468, 483, and 765 or rules adopted pursuant to
2723 those chapters.
2724 Section 50. Subsection (2) of section 408.918, Florida
2725 Statutes, is amended, and subsection (3) is added to that
2726 section, to read:
2727 408.918 Florida 211 Network; uniform certification
2728 requirements.—
2729 (2) In order to participate in the Florida 211 Network, a
2730 211 provider must be fully accredited by the National certified
2731 by the Agency for Health Care Administration. The agency shall
2732 develop criteria for certification, as recommended by the
2733 Florida Alliance of Information and Referral Services or have
2734 received approval to operate, pending accreditation, from its
2735 affiliate, the Florida Alliance of Information and Referral
2736 Services, and shall adopt the criteria as administrative rules.
2737 (a) If any provider of information and referral services or
2738 other entity leases a 211 number from a local exchange company
2739 and is not authorized as described in this section, certified by
2740 the agency, the agency shall, after consultation with the local
2741 exchange company and the Public Service Commission shall,
2742 request that the Federal Communications Commission direct the
2743 local exchange company to revoke the use of the 211 number.
2744 (b) The agency shall seek the assistance and guidance of
2745 the Public Service Commission and the Federal Communications
2746 Commission in resolving any disputes arising over jurisdiction
2747 related to 211 numbers.
2748 (3) The Florida Alliance of Information and Referral
2749 Services is the 211 collaborative organization for the state
2750 which is responsible for studying, designing, implementing,
2751 supporting, and coordinating the Florida 211 Network and for
2752 receiving federal grants.
2753 Section 51. Paragraph (e) of subsection (4) of section
2754 409.221, Florida Statutes, is amended to read:
2755 409.221 Consumer-directed care program.—
2756 (4) CONSUMER-DIRECTED CARE.—
2757 (e) Services.—Consumers shall use the budget allowance only
2758 to pay for home and community-based services that meet the
2759 consumer’s long-term care needs and are a cost-efficient use of
2760 funds. Such services may include, but are not limited to, the
2761 following:
2762 1. Personal care.
2763 2. Homemaking and chores, including housework, meals,
2764 shopping, and transportation.
2765 3. Home modifications and assistive devices which may
2766 increase the consumer’s independence or make it possible to
2767 avoid institutional placement.
2768 4. Assistance in taking self-administered medication.
2769 5. Day care and respite care services, including those
2770 provided by nursing home facilities pursuant to s. 400.141(1)(f)
2771 s. 400.141(6) or by adult day care facilities licensed pursuant
2772 to s. 429.907.
2773 6. Personal care and support services provided in an
2774 assisted living facility.
2775 Section 52. Subsection (5) of section 409.901, Florida
2776 Statutes, is amended to read:
2777 409.901 Definitions; ss. 409.901-409.920.—As used in ss.
2778 409.901-409.920, except as otherwise specifically provided, the
2779 term:
2780 (5) “Change of ownership” means:
2781 (a) An event in which the provider ownership changes to a
2782 different individual legal entity as evidenced by a change in
2783 federal employer identification number or taxpayer
2784 identification number; or
2785 (b) An event in which 51 45 percent or more of the
2786 ownership, voting shares, membership, or controlling interest of
2787 a provider is in any manner transferred or otherwise assigned.
2788 This paragraph does not apply to a licensee that is publicly
2789 traded on a recognized stock exchange; or
2790 (c) When the provider is licensed or registered by the
2791 agency, an event considered a change of ownership for licensure
2792 as defined in s. 408.803 in a corporation whose shares are not
2793 publicly traded on a recognized stock exchange is transferred or
2794 assigned, including the final transfer or assignment of multiple
2795 transfers or assignments over a 2-year period that cumulatively
2796 total 45 percent or more.
2797
2798 A change solely in the management company or board of directors
2799 is not a change of ownership.
2800 Section 53. Section 429.071, Florida Statutes, is repealed.
2801 Section 54. Paragraph (e) of subsection (1) and subsections
2802 (2) and (3) of section 429.08, Florida Statutes, are amended to
2803 read:
2804 429.08 Unlicensed facilities; referral of person for
2805 residency to unlicensed facility; penalties; verification of
2806 licensure status.—
2807 (1)
2808 (e) The agency shall publish provide to the department’s
2809 elder information and referral providers a list, by county, of
2810 licensed assisted living facilities, to assist persons who are
2811 considering an assisted living facility placement in locating a
2812 licensed facility. This information may be provided
2813 electronically or through the agency’s Internet site.
2814 (2) Each field office of the Agency for Health Care
2815 Administration shall establish a local coordinating workgroup
2816 which includes representatives of local law enforcement
2817 agencies, state attorneys, the Medicaid Fraud Control Unit of
2818 the Department of Legal Affairs, local fire authorities, the
2819 Department of Children and Family Services, the district long
2820 term care ombudsman council, and the district human rights
2821 advocacy committee to assist in identifying the operation of
2822 unlicensed facilities and to develop and implement a plan to
2823 ensure effective enforcement of state laws relating to such
2824 facilities. The workgroup shall report its findings, actions,
2825 and recommendations semiannually to the Director of Health
2826 Quality Assurance of the agency.
2827 (2)(3) It is unlawful to knowingly refer a person for
2828 residency to an unlicensed assisted living facility; to an
2829 assisted living facility the license of which is under denial or
2830 has been suspended or revoked; or to an assisted living facility
2831 that has a moratorium pursuant to part II of chapter 408. Any
2832 person who violates this subsection commits a noncriminal
2833 violation, punishable by a fine not exceeding $500 as provided
2834 in s. 775.083.
2835 (a) Any health care practitioner, as defined in s. 456.001,
2836 who is aware of the operation of an unlicensed facility shall
2837 report that facility to the agency. Failure to report a facility
2838 that the practitioner knows or has reasonable cause to suspect
2839 is unlicensed shall be reported to the practitioner’s licensing
2840 board.
2841 (b) Any provider as defined in s. 408.803 hospital or
2842 community mental health center licensed under chapter 395 or
2843 chapter 394 which knowingly discharges a patient or client to an
2844 unlicensed facility is subject to sanction by the agency.
2845 (c) Any employee of the agency or department, or the
2846 Department of Children and Family Services, who knowingly refers
2847 a person for residency to an unlicensed facility; to a facility
2848 the license of which is under denial or has been suspended or
2849 revoked; or to a facility that has a moratorium pursuant to part
2850 II of chapter 408 is subject to disciplinary action by the
2851 agency or department, or the Department of Children and Family
2852 Services.
2853 (d) The employer of any person who is under contract with
2854 the agency or department, or the Department of Children and
2855 Family Services, and who knowingly refers a person for residency
2856 to an unlicensed facility; to a facility the license of which is
2857 under denial or has been suspended or revoked; or to a facility
2858 that has a moratorium pursuant to part II of chapter 408 shall
2859 be fined and required to prepare a corrective action plan
2860 designed to prevent such referrals.
2861 (e) The agency shall provide the department and the
2862 Department of Children and Family Services with a list of
2863 licensed facilities within each county and shall update the list
2864 at least quarterly.
2865 (f) At least annually, the agency shall notify, in
2866 appropriate trade publications, physicians licensed under
2867 chapter 458 or chapter 459, hospitals licensed under chapter
2868 395, nursing home facilities licensed under part II of chapter
2869 400, and employees of the agency or the department, or the
2870 Department of Children and Family Services, who are responsible
2871 for referring persons for residency, that it is unlawful to
2872 knowingly refer a person for residency to an unlicensed assisted
2873 living facility and shall notify them of the penalty for
2874 violating such prohibition. The department and the Department of
2875 Children and Family Services shall, in turn, notify service
2876 providers under contract to the respective departments who have
2877 responsibility for resident referrals to facilities. Further,
2878 the notice must direct each noticed facility and individual to
2879 contact the appropriate agency office in order to verify the
2880 licensure status of any facility prior to referring any person
2881 for residency. Each notice must include the name, telephone
2882 number, and mailing address of the appropriate office to
2883 contact.
2884 Section 55. Paragraph (e) of subsection (1) of section
2885 429.14, Florida Statutes, is amended to read:
2886 429.14 Administrative penalties.—
2887 (1) In addition to the requirements of part II of chapter
2888 408, the agency may deny, revoke, and suspend any license issued
2889 under this part and impose an administrative fine in the manner
2890 provided in chapter 120 against a licensee of an assisted living
2891 facility for a violation of any provision of this part, part II
2892 of chapter 408, or applicable rules, or for any of the following
2893 actions by a licensee of an assisted living facility, for the
2894 actions of any person subject to level 2 background screening
2895 under s. 408.809, or for the actions of any facility employee:
2896 (e) A citation of any of the following deficiencies as
2897 specified defined in s. 429.19:
2898 1. One or more cited class I deficiencies.
2899 2. Three or more cited class II deficiencies.
2900 3. Five or more cited class III deficiencies that have been
2901 cited on a single survey and have not been corrected within the
2902 times specified.
2903 Section 56. Section 429.19, Florida Statutes, is amended to
2904 read:
2905 429.19 Violations; imposition of administrative fines;
2906 grounds.—
2907 (1) In addition to the requirements of part II of chapter
2908 408, the agency shall impose an administrative fine in the
2909 manner provided in chapter 120 for the violation of any
2910 provision of this part, part II of chapter 408, and applicable
2911 rules by an assisted living facility, for the actions of any
2912 person subject to level 2 background screening under s. 408.809,
2913 for the actions of any facility employee, or for an intentional
2914 or negligent act seriously affecting the health, safety, or
2915 welfare of a resident of the facility.
2916 (2) Each violation of this part and adopted rules shall be
2917 classified according to the nature of the violation and the
2918 gravity of its probable effect on facility residents. The agency
2919 shall indicate the classification on the written notice of the
2920 violation as follows:
2921 (a) Class “I” violations are defined in s. 408.813 those
2922 conditions or occurrences related to the operation and
2923 maintenance of a facility or to the personal care of residents
2924 which the agency determines present an imminent danger to the
2925 residents or guests of the facility or a substantial probability
2926 that death or serious physical or emotional harm would result
2927 therefrom. The condition or practice constituting a class I
2928 violation shall be abated or eliminated within 24 hours, unless
2929 a fixed period, as determined by the agency, is required for
2930 correction. The agency shall impose an administrative fine for a
2931 cited class I violation in an amount not less than $5,000 and
2932 not exceeding $10,000 for each violation. A fine may be levied
2933 notwithstanding the correction of the violation.
2934 (b) Class “II” violations are defined in s. 408.813 those
2935 conditions or occurrences related to the operation and
2936 maintenance of a facility or to the personal care of residents
2937 which the agency determines directly threaten the physical or
2938 emotional health, safety, or security of the facility residents,
2939 other than class I violations. The agency shall impose an
2940 administrative fine for a cited class II violation in an amount
2941 not less than $1,000 and not exceeding $5,000 for each
2942 violation. A fine shall be levied notwithstanding the correction
2943 of the violation.
2944 (c) Class “III” violations are defined in s. 408.813 those
2945 conditions or occurrences related to the operation and
2946 maintenance of a facility or to the personal care of residents
2947 which the agency determines indirectly or potentially threaten
2948 the physical or emotional health, safety, or security of
2949 facility residents, other than class I or class II violations.
2950 The agency shall impose an administrative fine for a cited class
2951 III violation in an amount not less than $500 and not exceeding
2952 $1,000 for each violation. A citation for a class III violation
2953 must specify the time within which the violation is required to
2954 be corrected. If a class III violation is corrected within the
2955 time specified, no fine may be imposed, unless it is a repeated
2956 offense.
2957 (d) Class “IV” violations are defined in s. 408.813 those
2958 conditions or occurrences related to the operation and
2959 maintenance of a building or to required reports, forms, or
2960 documents that do not have the potential of negatively affecting
2961 residents. These violations are of a type that the agency
2962 determines do not threaten the health, safety, or security of
2963 residents of the facility. The agency shall impose an
2964 administrative fine for a cited class IV violation in an amount
2965 not less than $100 and not exceeding $200 for each violation. A
2966 citation for a class IV violation must specify the time within
2967 which the violation is required to be corrected. If a class IV
2968 violation is corrected within the time specified, no fine shall
2969 be imposed. Any class IV violation that is corrected during the
2970 time an agency survey is being conducted will be identified as
2971 an agency finding and not as a violation.
2972 (3) For purposes of this section, in determining if a
2973 penalty is to be imposed and in fixing the amount of the fine,
2974 the agency shall consider the following factors:
2975 (a) The gravity of the violation, including the probability
2976 that death or serious physical or emotional harm to a resident
2977 will result or has resulted, the severity of the action or
2978 potential harm, and the extent to which the provisions of the
2979 applicable laws or rules were violated.
2980 (b) Actions taken by the owner or administrator to correct
2981 violations.
2982 (c) Any previous violations.
2983 (d) The financial benefit to the facility of committing or
2984 continuing the violation.
2985 (e) The licensed capacity of the facility.
2986 (4) Each day of continuing violation after the date fixed
2987 for termination of the violation, as ordered by the agency,
2988 constitutes an additional, separate, and distinct violation.
2989 (5) Any action taken to correct a violation shall be
2990 documented in writing by the owner or administrator of the
2991 facility and verified through followup visits by agency
2992 personnel. The agency may impose a fine and, in the case of an
2993 owner-operated facility, revoke or deny a facility’s license
2994 when a facility administrator fraudulently misrepresents action
2995 taken to correct a violation.
2996 (6) Any facility whose owner fails to apply for a change
2997 of-ownership license in accordance with part II of chapter 408
2998 and operates the facility under the new ownership is subject to
2999 a fine of $5,000.
3000 (7) In addition to any administrative fines imposed, the
3001 agency may assess a survey fee, equal to the lesser of one half
3002 of the facility’s biennial license and bed fee or $500, to cover
3003 the cost of conducting initial complaint investigations that
3004 result in the finding of a violation that was the subject of the
3005 complaint or monitoring visits conducted under s. 429.28(3)(c)
3006 to verify the correction of the violations.
3007 (8) During an inspection, the agency, as an alternative to
3008 or in conjunction with an administrative action against a
3009 facility for violations of this part and adopted rules, shall
3010 make a reasonable attempt to discuss each violation and
3011 recommended corrective action with the owner or administrator of
3012 the facility, prior to written notification. The agency, instead
3013 of fixing a period within which the facility shall enter into
3014 compliance with standards, may request a plan of corrective
3015 action from the facility which demonstrates a good faith effort
3016 to remedy each violation by a specific date, subject to the
3017 approval of the agency.
3018 (9) The agency shall develop and disseminate an annual list
3019 of all facilities sanctioned or fined $5,000 or more for
3020 violations of state standards, the number and class of
3021 violations involved, the penalties imposed, and the current
3022 status of cases. The list shall be disseminated, at no charge,
3023 to the Department of Elderly Affairs, the Department of Health,
3024 the Department of Children and Family Services, the Agency for
3025 Persons with Disabilities, the area agencies on aging, the
3026 Florida Statewide Advocacy Council, and the state and local
3027 ombudsman councils. The Department of Children and Family
3028 Services shall disseminate the list to service providers under
3029 contract to the department who are responsible for referring
3030 persons to a facility for residency. The agency may charge a fee
3031 commensurate with the cost of printing and postage to other
3032 interested parties requesting a copy of this list. This
3033 information may be provided electronically or through the
3034 agency’s Internet site.
3035 Section 57. Subsections (2) and (6) of section 429.23,
3036 Florida Statutes, are amended to read:
3037 429.23 Internal risk management and quality assurance
3038 program; adverse incidents and reporting requirements.—
3039 (2) Every facility licensed under this part is required to
3040 maintain adverse incident reports. For purposes of this section,
3041 the term, “adverse incident” means:
3042 (a) An event over which facility personnel could exercise
3043 control rather than as a result of the resident’s condition and
3044 results in:
3045 1. Death;
3046 2. Brain or spinal damage;
3047 3. Permanent disfigurement;
3048 4. Fracture or dislocation of bones or joints;
3049 5. Any condition that required medical attention to which
3050 the resident has not given his or her consent, including failure
3051 to honor advanced directives;
3052 6. Any condition that requires the transfer of the resident
3053 from the facility to a unit providing more acute care due to the
3054 incident rather than the resident’s condition before the
3055 incident; or.
3056 7. An event that is reported to law enforcement or its
3057 personnel for investigation; or
3058 (b) Abuse, neglect, or exploitation as defined in s.
3059 415.102;
3060 (c) Events reported to law enforcement; or
3061 (b)(d) Resident elopement, if the elopement places the
3062 resident at risk of harm or injury.
3063 (6) Abuse, neglect, or exploitation must be reported to the
3064 Department of Children and Family Services as required under
3065 chapter 415 The agency shall annually submit to the Legislature
3066 a report on assisted living facility adverse incident reports.
3067 The report must include the following information arranged by
3068 county:
3069 (a) A total number of adverse incidents;
3070 (b) A listing, by category, of the type of adverse
3071 incidents occurring within each category and the type of staff
3072 involved;
3073 (c) A listing, by category, of the types of injuries, if
3074 any, and the number of injuries occurring within each category;
3075 (d) Types of liability claims filed based on an adverse
3076 incident report or reportable injury; and
3077 (e) Disciplinary action taken against staff, categorized by
3078 the type of staff involved.
3079 Section 58. Subsection (9) of section 429.26, Florida
3080 Statutes, is repealed.
3081 Section 59. Subsection (3) of section 430.80, Florida
3082 Statutes, is amended to read:
3083 430.80 Implementation of a teaching nursing home pilot
3084 project.—
3085 (3) To be designated as a teaching nursing home, a nursing
3086 home licensee must, at a minimum:
3087 (a) Provide a comprehensive program of integrated senior
3088 services that include institutional services and community-based
3089 services;
3090 (b) Participate in a nationally recognized accreditation
3091 program and hold a valid accreditation, such as the
3092 accreditation awarded by the Joint Commission on Accreditation
3093 of Healthcare Organizations;
3094 (c) Have been in business in this state for a minimum of 10
3095 consecutive years;
3096 (d) Demonstrate an active program in multidisciplinary
3097 education and research that relates to gerontology;
3098 (e) Have a formalized contractual relationship with at
3099 least one accredited health profession education program located
3100 in this state;
3101 (f) Have a formalized contractual relationship with an
3102 accredited hospital that is designated by law as a teaching
3103 hospital; and
3104 (g) Have senior staff members who hold formal faculty
3105 appointments at universities, which must include at least one
3106 accredited health profession education program.
3107 (h) Maintain insurance coverage pursuant to s.
3108 400.141(1)(s) s. 400.141(20) or proof of financial
3109 responsibility in a minimum amount of $750,000. Such proof of
3110 financial responsibility may include:
3111 1. Maintaining an escrow account consisting of cash or
3112 assets eligible for deposit in accordance with s. 625.52; or
3113 2. Obtaining and maintaining pursuant to chapter 675 an
3114 unexpired, irrevocable, nontransferable and nonassignable letter
3115 of credit issued by any bank or savings association organized
3116 and existing under the laws of this state or any bank or savings
3117 association organized under the laws of the United States that
3118 has its principal place of business in this state or has a
3119 branch office which is authorized to receive deposits in this
3120 state. The letter of credit shall be used to satisfy the
3121 obligation of the facility to the claimant upon presentment of a
3122 final judgment indicating liability and awarding damages to be
3123 paid by the facility or upon presentment of a settlement
3124 agreement signed by all parties to the agreement when such final
3125 judgment or settlement is a result of a liability claim against
3126 the facility.
3127 Section 60. Subsection (5) of section 435.04, Florida
3128 Statutes, is amended to read:
3129 435.04 Level 2 screening standards.—
3130 (5) Under penalty of perjury, all employees in such
3131 positions of trust or responsibility shall attest to meeting the
3132 requirements for qualifying for employment and agreeing to
3133 inform the employer immediately if convicted of any of the
3134 disqualifying offenses while employed by the employer. Each
3135 employer of employees in such positions of trust or
3136 responsibilities which is licensed or registered by a state
3137 agency shall submit to the licensing agency annually or at the
3138 time of license renewal, under penalty of perjury, an affidavit
3139 of compliance with the provisions of this section.
3140 Section 61. Subsection (3) of section 435.05, Florida
3141 Statutes, is amended to read:
3142 435.05 Requirements for covered employees.—Except as
3143 otherwise provided by law, the following requirements shall
3144 apply to covered employees:
3145 (3) Each employer required to conduct level 2 background
3146 screening must sign an affidavit annually or at the time of
3147 license renewal, under penalty of perjury, stating that all
3148 covered employees have been screened or are newly hired and are
3149 awaiting the results of the required screening checks.
3150 Section 62. Subsection (2) of section 483.031, Florida
3151 Statutes, is amended to read:
3152 483.031 Application of part; exemptions.—This part applies
3153 to all clinical laboratories within this state, except:
3154 (2) A clinical laboratory that performs only waived tests
3155 and has received a certificate of exemption from the agency
3156 under s. 483.106.
3157 Section 63. Subsection (10) of section 483.041, Florida
3158 Statutes, is amended to read:
3159 483.041 Definitions.—As used in this part, the term:
3160 (10) “Waived test” means a test that the federal Centers
3161 for Medicare and Medicaid Services Health Care Financing
3162 Administration has determined qualifies for a certificate of
3163 waiver under the federal Clinical Laboratory Improvement
3164 Amendments of 1988, and the federal rules adopted thereunder.
3165 Section 64. Section 483.106, Florida Statutes, is repealed.
3166 Section 65. Subsection (3) of section 483.172, Florida
3167 Statutes, is amended to read:
3168 483.172 License fees.—
3169 (3) The agency shall assess a biennial fee of $100 for a
3170 certificate of exemption and a $100 biennial license fee under
3171 this section for facilities surveyed by an approved accrediting
3172 organization.
3173 Section 66. Paragraph (b) of subsection (1) of section
3174 627.4239, Florida Statutes, is amended to read:
3175 627.4239 Coverage for use of drugs in treatment of cancer.—
3176 (1) DEFINITIONS.—As used in this section, the term:
3177 (b) “Standard reference compendium” means authoritative
3178 compendia identified by the Secretary of the United States
3179 Department of Health and Human Services and recognized by the
3180 federal Centers for Medicare and Medicaid Services:
3181 1. The United States Pharmacopeia Drug Information;
3182 2. The American Medical Association Drug Evaluations; or
3183 3. The American Hospital Formulary Service Drug
3184 Information.
3185 Section 67. Subsection (13) of section 651.118, Florida
3186 Statutes, is amended to read:
3187 651.118 Agency for Health Care Administration; certificates
3188 of need; sheltered beds; community beds.—
3189 (13) Residents, as defined in this chapter, are not
3190 considered new admissions for the purpose of s. 400.141
3191 (1)(o)1.d. s. 400.141(15)(d).
3192 Section 68. This act shall take effect July 1, 2009.
3193
3194
3195 ================= T I T L E A M E N D M E N T ================
3196 And the title is amended as follows:
3197 Delete everything before the enacting clause
3198 and insert:
3199 A bill to be entitled
3200 An act relating to health care; providing legislative
3201 findings; designating Miami-Dade County as a health
3202 care fraud area of concern; amending s. 68.085, F.S.;
3203 allocating certain funds recovered under the Florida
3204 False Claims Act to fund rewards for persons who
3205 report and provide information relating to Medicaid
3206 fraud; amending s. 68.086, F.S.; providing that a
3207 defendant who prevails in an action under the Florida
3208 False Claims Act may be awarded attorney’s fees and
3209 costs against the person bringing the action under
3210 certain circumstances; amending s. 400.471, F.S.;
3211 prohibiting the Agency for Health Care Administration
3212 from renewing a license of a home health agency in
3213 certain counties if the agency has been sanctioned for
3214 certain misconduct; amending s. 400.474, F.S.;
3215 authorizing the Agency for Health Care Administration
3216 to deny, revoke, or suspend the license of or fine a
3217 home health agency that provides remuneration to
3218 certain facilities or bills the Medicaid program for
3219 medically unnecessary services; amending s. 400.506,
3220 F.S.; exempting certain items from a prohibition
3221 against providing remuneration to certain persons by a
3222 nurse registry; creating s. 408.8065, F.S.; providing
3223 additional licensure requirements for home health
3224 agencies, home medical equipment providers, and health
3225 care clinics; imposing criminal penalties against a
3226 person who knowingly submits misleading information to
3227 the Agency for Health Care Administration in
3228 connection with applications for certain licenses;
3229 amending s. 408.810, F.S.; revising provisions
3230 relating to information required for licensure;
3231 requiring certain licensees to provide clients with a
3232 description of Medicaid fraud and the statewide toll
3233 free telephone number for the central Medicaid fraud
3234 hotline; amending s. 408.815, F.S.; providing
3235 additional grounds to deny an application for a
3236 license; amending s. 409.905, F.S.; authorizing the
3237 Agency for Health Care Administration to require prior
3238 authorization of care based on utilization rates;
3239 requiring a home health agency to submit a plan of
3240 care and documentation of a recipient’s medical
3241 condition to the Agency for Health Care Administration
3242 when requesting prior authorization; prohibiting the
3243 Agency for Health Care Administration from paying for
3244 home health services unless specified requirements are
3245 satisfied; amending s. 409.907, F.S.; providing for
3246 certain out-of-state providers to enroll as Medicaid
3247 providers; amending s. 409.912, F.S.; requiring the
3248 Agency for Health Care Administration to establish
3249 norms for the utilization of Medicaid services;
3250 requiring the agency to submit a report relating to
3251 the overutilization of Medicaid services; amending s.
3252 409.913, F.S.; requiring that the annual report
3253 submitted by the Agency for Health Care Administration
3254 and the Medicaid Fraud Control Unit of the Department
3255 of Legal Affairs recommend changes necessary to
3256 prevent and detect Medicaid fraud; requiring the
3257 Agency for Health Care Administration to monitor
3258 patterns of overutilization of Medicaid services;
3259 requiring the agency to deny payment or require
3260 repayment for Medicaid services under certain
3261 circumstances; requiring the Agency for Health Care
3262 Administration to immediately terminate a Medicaid
3263 provider’s participation in the Medicaid program as a
3264 result of certain adjudications against the provider
3265 or certain affiliated persons; requiring the Agency
3266 for Health Care Administration to suspend or terminate
3267 a Medicaid provider’s participation in the Medicaid
3268 program if the provider or certain affiliated persons
3269 participating in the Medicaid program have been
3270 suspended or terminated by the Federal Government or
3271 another state; providing that a provider is subject to
3272 sanctions for violations of law as the result of
3273 actions or inactions of the provider or certain
3274 affiliated persons; requiring the Agency for Health
3275 Care Administration to use specified documents from a
3276 provider’s records to calculate an overpayment by the
3277 Medicaid program; prohibiting a provider from using
3278 certain documents or data as evidence when challenging
3279 a claim of overpayment by the Agency for Health Care
3280 Administration; providing an exception; requiring that
3281 the agency provide notice of certain administrative
3282 sanctions to other regulatory agencies within a
3283 specified period; requiring the Agency for Health Care
3284 Administration to withhold or deny Medicaid payments
3285 under certain circumstances; requiring the agency to
3286 terminate a provider’s participation in the Medicaid
3287 program if the provider fails to repay certain
3288 overpayments from the Medicaid program; requiring the
3289 agency to provide at least annually information on
3290 Medicaid fraud in an explanation of benefits letter;
3291 requiring the Agency for Health Care Administration to
3292 post a list on its website of Medicaid providers and
3293 affiliated persons of providers who have been
3294 terminated or sanctioned; requiring the agency to take
3295 certain actions to improve the prevention and
3296 detection of health care fraud through the use of
3297 technology; amending s. 409.920, F.S.; defining the
3298 term “managed care plan”; providing criminal penalties
3299 and fines for Medicaid fraud; granting civil immunity
3300 to certain persons who report suspected Medicaid
3301 fraud; creating s. 409.9203, F.S.; authorizing the
3302 payment of rewards to persons who report and provide
3303 information relating to Medicaid fraud; amending s.
3304 456.004, F.S.; requiring the Department of Health to
3305 work cooperatively with the Agency for Health Care
3306 Administration and the judicial system to recover
3307 overpayments by the Medicaid program; amending s.
3308 456.041, F.S.; requiring the Department of Health to
3309 include a statement in the practitioner profile if a
3310 practitioner has been terminated from participating in
3311 the Medicaid program; creating s. 456.0635, F.S.;
3312 prohibiting Medicaid fraud in the practice of health
3313 care professions; requiring the Department of Health
3314 or boards within the department to refuse to admit to
3315 exams and to deny licenses, permits, or certificates
3316 to certain persons who have engaged in certain acts;
3317 requiring health care practitioners to report
3318 allegations of Medicaid fraud; specifying that
3319 acceptance of the relinquishment of a license in
3320 anticipation of charges relating to Medicaid fraud
3321 constitutes permanent revocation of a license;
3322 amending s. 456.072, F.S.; creating additional grounds
3323 for the Department of Health to take disciplinary
3324 action against certain applicants or licensees for
3325 misconduct relating to a Medicaid program or to health
3326 care fraud; amending s. 456.074, F.S.; requiring the
3327 Department of Health to issue an emergency order
3328 suspending the license of a person who engages in
3329 certain criminal conduct relating to the Medicaid
3330 program; amending s. 465.022, F.S.; authorizing
3331 partnerships and corporations to obtain pharmacy
3332 permits; requiring applicants or certain persons
3333 affiliated with an applicant for a pharmacy permit to
3334 submit a set of fingerprints for a criminal history
3335 records check and pay the costs of the criminal
3336 history records check; requiring the Department of
3337 Health or Board of Pharmacy to deny an application for
3338 a pharmacy permit for certain misconduct by the
3339 applicant; or persons affiliated with the applicant;
3340 amending s. 465.023, F.S.; authorizing the Department
3341 of Health or the Board of Pharmacy to take
3342 disciplinary action against a permitee for certain
3343 misconduct by the permitee, or persons affiliated with
3344 the permitee; amending s. 825.103, F.S.; redefining
3345 the term “exploitation of an elderly person or
3346 disabled adult”; amending s. 921.0022, F.S.; revising
3347 the severity level ranking of Medicaid fraud under the
3348 Criminal Punishment Code; creating a pilot project to
3349 monitor and verify the delivery of home health
3350 services and provide for electronic claims for home
3351 health services; requiring the Agency for Health Care
3352 Administration to issue a report evaluating the pilot
3353 project; creating a pilot project for home health care
3354 management in Miami-Dade County; amending ss. 400.0077
3355 and 430.608, F.S.; conforming cross-references to
3356 changes made by the act; repealing s. 395.0199, F.S.,
3357 relating to private utilization review of health care
3358 services; amending ss. 395.405 and 400.0712, F.S.;
3359 conforming cross-references; repealing s. 400.118(2),
3360 F.S.; removing provisions requiring quality-of-care
3361 monitors for nursing facilities in agency district
3362 offices; amending s. 400.141, F.S.; deleting a
3363 requirement that licensed nursing home facilities
3364 provide the agency with a monthly report on the number
3365 of vacant beds in the facility; amending s. 400.147,
3366 F.S.; revising the definition of the term “adverse
3367 incident” for reporting purposes; requiring abuse,
3368 neglect, and exploitation to be reported to the agency
3369 and the Department of Children and Family Services;
3370 deleting a requirement that the agency submit an
3371 annual report on nursing home adverse incidents to the
3372 Legislature; amending s. 400.162, F.S.; revising
3373 requirements for policies and procedures regarding the
3374 safekeeping of a resident’s personal effects and
3375 property; amending s. 400.191; F.S.; revising the
3376 information on the agency’s Internet site regarding
3377 nursing homes; deleting the provision that requires
3378 the agency to provide information about nursing homes
3379 in printed form; amending s. 400.195, F.S.; conforming
3380 a cross-reference; amending s. 400.23, F.S.; deleting
3381 the requirement of the agency to adopt rules regarding
3382 the eating assistance provided to residents; amending
3383 s. 400.9935, F.S.; revising accreditation requirements
3384 for clinics providing magnetic resonance imaging
3385 services; amending s. 400.995, F.S.; revising agency
3386 responsibilities with respect to agency administrative
3387 penalties; amending s. 408.803, F.S.; revising
3388 definitions applicable to part II of ch. 408, F.S.,
3389 the “Health Care Licensing Procedures Act”; amending
3390 s. 408.806, F.S.; revising contents of and procedures
3391 relating to health care provider applications for
3392 licensure; providing an exception from certain
3393 licensure inspections for adult family-care homes;
3394 authorizing the agency to provide electronic access to
3395 certain information and documents; amending s.
3396 408.808, F.S.; providing for a provisional license to
3397 be issued to applicants applying for a change of
3398 ownership; providing a time limit on provisional
3399 licenses; amending s. 408.809, F.S.; revising
3400 provisions relating to background screening of
3401 specified employees; requiring health care providers
3402 to submit to the agency an affidavit of compliance
3403 with background screening requirements at the time of
3404 license renewal; deleting a provision to conform to
3405 changes made by the act; amending s. 408.811, F.S.;
3406 providing for certain inspections to be accepted in
3407 lieu of complete licensure inspections; granting
3408 agency access to records requested during an offsite
3409 review; providing timeframes for correction of certain
3410 deficiencies and submission of plans to correct the
3411 deficiencies; amending s. 408.813, F.S.; providing
3412 classifications of violations of part II of ch. 408,
3413 F.S.; providing for fines; amending s. 408.820, F.S.;
3414 revising applicability of certain exemptions from
3415 specified requirements of part II of ch. 408, F.S.;
3416 creating s. 408.821, F.S.; requiring entities
3417 regulated or licensed by the agency to designate a
3418 liaison officer for emergency operations; authorizing
3419 entities regulated or licensed by the agency to
3420 temporarily exceed their licensed capacity to act as
3421 receiving providers under specified circumstances;
3422 providing requirements that apply while such entities
3423 are in an overcapacity status; providing for issuance
3424 of an inactive license to such licensees under
3425 specified conditions; providing requirements and
3426 procedures with respect to the issuance and
3427 reactivation of an inactive license; authorizing the
3428 agency to adopt rules; amending s. 408.831, F.S.;
3429 deleting provisions relating to the authorization for
3430 entities regulated or licensed by the agency to exceed
3431 their licensed capacity to act as receiving facilities
3432 and issuance and reactivation of inactive licenses;
3433 amending s. 408.918, F.S.; revising the requirements
3434 of a provider to participate in the Florida 211
3435 network; requiring the Public Service Commission to
3436 request the Federal Communications Commission to
3437 direct the revocation of a 211 number under certain
3438 circumstances; deleting the requirement for the Agency
3439 for Health Care Administration to seek assistance in
3440 resolving jurisdictional disputes related to 211
3441 numbers; providing that the Florida Alliance of
3442 Information and Referral Services is the collaborative
3443 organization for the state; amending s. 409.221, F.S.;
3444 conforming a cross-reference; amending s. 409.901,
3445 F.S.; redefining the term “change of ownership” as it
3446 relates to Medicaid providers; repealing s. 429.071,
3447 F.S., relating to the intergenerational respite care
3448 assisted living facility pilot program; amending s.
3449 429.08, F.S.; authorizing the agency to provide
3450 information regarding licensed assisted living
3451 facilities on its Internet website; abolishing local
3452 coordinating workgroups established by agency field
3453 offices; amending s. 429.14, F.S.; conforming a
3454 reference; amending s. 429.19, F.S.; revising agency
3455 procedures for imposition of fines for violations of
3456 part I of ch. 429, F.S., the “Assisted Living
3457 Facilities Act”; amending s. 429.23, F.S.; redefining
3458 the term “adverse incident” for reporting purposes;
3459 requiring abuse, neglect, and exploitation to be
3460 reported to the agency and the Department of Children
3461 and Family Services; deleting a requirement that the
3462 agency submit an annual report on assisted living
3463 facility adverse incidents to the Legislature;
3464 repealing s. 429.26(9), F.S., relating to the removal
3465 of the requirement for a resident of an assisted
3466 living facility to undergo examinations and
3467 evaluations under certain circumstances; amending s.
3468 430.80, F.S.; conforming a cross-reference; amending
3469 ss. 435.04 and 435.05, F.S.; requiring employers of
3470 certain employees to submit an affidavit of compliance
3471 with level 2 screening requirements at the time of
3472 license renewal; amending s. 483.031, F.S.; revising a
3473 provision relating to the exemption of certain
3474 clinical laboratories, to conform to changes made by
3475 the act; amending s. 483.041, F.S.; redefining the
3476 term “waived test” as it is used in part I of ch. 483,
3477 F.S., the “Florida Clinical Laboratory Law”; repealing
3478 s. 483.106, F.S., relating to applications for
3479 certificates of exemption by clinical laboratories
3480 that perform certain tests; amending ss. 483.172,
3481 F.S.; conforming provisions; amending s. 627.4239,
3482 F.S.; revising the term “standard reference
3483 compendium”; amending s. 651.118, F.S.; conforming a
3484 cross-reference; providing an effective date.