Florida Senate - 2011 SB 1226
By Senator Joyner
18-00963-11 20111226__
1 A bill to be entitled
2 An act relating to health care fraud; amending s.
3 456.0635, F.S.; revising the grounds under which the
4 Department of Health or corresponding board is
5 required to refuse to admit a candidate to an
6 examination and refuse to issue or renew a license,
7 certificate, or registration of a health care
8 practitioner; providing an exception; requiring the
9 department to adopt rules; providing an effective
10 date.
11
12 Be It Enacted by the Legislature of the State of Florida:
13
14 Section 1. Section 456.0635, Florida Statutes, is amended
15 to read:
16 456.0635 Health care Medicaid fraud; disqualification for
17 license, certificate, or registration.—
18 (1) Medicaid Fraud in the practice of a health care
19 profession is prohibited.
20 (2) Each board within the jurisdiction of the department,
21 or the department if there is no board, shall refuse to admit a
22 candidate to any examination and refuse to issue or renew a
23 license, certificate, or registration to any applicant if the
24 candidate or applicant or any principal, officer, agent,
25 managing employee, or affiliated person of the applicant, has
26 been:
27 (a) Has been convicted of, or entered a plea of guilty or
28 nolo contendere to, regardless of adjudication, a felony under
29 chapter 409, chapter 817, or chapter 893, or a similar felony
30 offense committed in another state or jurisdiction 21 U.S.C. ss.
31 801-970, or 42 U.S.C. ss. 1395-1396, unless the sentence and any
32 subsequent period of probation for such conviction or plea pleas
33 ended: more than 15 years prior to the date of the application;
34 1. For felonies of the first or second degree, more than 15
35 years before the date of application.
36 2. For felonies of the third degree, more than 10 years
37 before the date of application, except for felonies of the third
38 degree under s. 893.13(6)(a).
39 3. For felonies of the third degree under s. 893.13(6)(a),
40 more than 5 years before the date of application.
41
42 For felonies in which the defendant entered a plea of guilty or
43 nolo contendere in an agreement with the court to enter a
44 pretrial intervention or drug diversion program, the department
45 may not approve or deny the application for a license,
46 certificate, or registration until the final resolution of the
47 case;
48 (b) Has been convicted of, or entered a plea of guilty or
49 nolo contendere to, regardless of adjudication, a felony under
50 21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the
51 sentence and any subsequent period of probation for such
52 conviction or plea ended more than 15 years before the date of
53 the application;
54 (c)(b) Has been terminated for cause from the Florida
55 Medicaid program pursuant to s. 409.913, unless the applicant
56 has been in good standing with the Florida Medicaid program for
57 the most recent 5 years;
58 (d)(c) Has been terminated for cause, pursuant to the
59 appeals procedures established by the state or Federal
60 Government, from any other state Medicaid program or the federal
61 Medicare program, unless the applicant has been in good standing
62 with a state Medicaid program or the federal Medicare program
63 for the most recent 5 years and the termination occurred at
64 least 20 years before prior to the date of the application; or.
65 (e) Is currently listed on the United States Department of
66 Health and Human Services Office of Inspector General’s List of
67 Excluded Individuals and Entities.
68
69 This subsection does not apply to applicants for initial
70 licensure or certification who were enrolled in an educational
71 or training program on or before July 1, 2010, which was
72 recognized by a board or, if there is no board, recognized by
73 the department, and who applied for licensure after July 1,
74 2010.
75 (3) Each board within the jurisdiction of the department,
76 or the department if there is no board, shall refuse to renew a
77 license, certificate, or registration of any applicant if the
78 candidate or applicant or any principal, officer, agent,
79 managing employee, or affiliated person of the applicant:
80 (a) Has been convicted of, or entered a plea of guilty or
81 nolo contendere to, regardless of adjudication, a felony under:
82 chapter 409, chapter 817, or chapter 893, or a similar felony
83 offense committed in another state or jurisdiction since July 1,
84 2010.
85 (b) Has been convicted of, or entered a plea of guilty or
86 nolo contendere to, regardless of adjudication, a felony under
87 21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396 since July 1,
88 2010.
89 (c) Has been terminated for cause from the Florida Medicaid
90 program pursuant to s. 409.913, unless the applicant has been in
91 good standing with the Florida Medicaid program for the most
92 recent 5 years.
93 (d) Has been terminated for cause, pursuant to the appeals
94 procedures established by the state, from any other state
95 Medicaid program, unless the applicant has been in good standing
96 with a state Medicaid program for the most recent 5 years and
97 the termination occurred at least 20 years before the date of
98 the application.
99 (e) Is currently listed on the United States Department of
100 Health and Human Services Office of Inspector General’s List of
101 Excluded Individuals and Entities.
102
103 For felonies in which the defendant entered a plea of guilty or
104 nolo contendere in an agreement with the court to enter a
105 pretrial intervention or drug diversion program, the department
106 may not approve or deny the application for a renewal of a
107 license, certificate, or registration until the final resolution
108 of the case.
109 (4)(3) Licensed health care practitioners shall report
110 allegations of health care Medicaid fraud to the department,
111 regardless of the practice setting in which the alleged Medicaid
112 fraud occurred.
113 (5)(4) The acceptance by a licensing authority of a
114 candidate’s relinquishment of a license which is offered in
115 response to or anticipation of the filing of administrative
116 charges alleging health care Medicaid fraud or similar charges
117 constitutes the permanent revocation of the license.
118 (6) The department shall adopt rules to administer the
119 provisions of this section related to denial of licensure
120 renewal.
121 Section 2. This act shall take effect July 1, 2011.