Florida Senate - 2011                          SENATOR AMENDMENT
       Bill No. CS for CS for HB 935
       
       
       
       
       
       
                                Barcode 322804                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AD/2R         .            Floor: C            
             05/02/2011 05:03 PM       .      05/04/2011 04:40 PM       
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       Senator Negron moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (2) and paragraph (c) of subsection
    6  (4) of section 381.026, Florida Statutes, are amended to read:
    7         381.026 Florida Patient’s Bill of Rights and
    8  Responsibilities.—
    9         (2) DEFINITIONS.—As used in this section and s. 381.0261,
   10  the term:
   11         (a) “Department” means the Department of Health.
   12         (b) “Health care facility” means a facility licensed under
   13  chapter 395.
   14         (c) “Health care provider” means a physician licensed under
   15  chapter 458, an osteopathic physician licensed under chapter
   16  459, or a podiatric physician licensed under chapter 461.
   17         (d) “Primary care provider” means a health care provider
   18  licensed under chapter 458, chapter 459, or chapter 464 who
   19  provides medical services to patients which are commonly
   20  provided without referral from another health care provider,
   21  including family and general practice, general pediatrics, and
   22  general internal medicine.
   23         (e)(d) “Responsible provider” means a health care provider
   24  who is primarily responsible for patient care in a health care
   25  facility or provider’s office.
   26         (4) RIGHTS OF PATIENTS.—Each health care facility or
   27  provider shall observe the following standards:
   28         (c) Financial information and disclosure.—
   29         1. A patient has the right to be given, upon request, by
   30  the responsible provider, his or her designee, or a
   31  representative of the health care facility full information and
   32  necessary counseling on the availability of known financial
   33  resources for the patient’s health care.
   34         2. A health care provider or a health care facility shall,
   35  upon request, disclose to each patient who is eligible for
   36  Medicare, before in advance of treatment, whether the health
   37  care provider or the health care facility in which the patient
   38  is receiving medical services accepts assignment under Medicare
   39  reimbursement as payment in full for medical services and
   40  treatment rendered in the health care provider’s office or
   41  health care facility.
   42         3. A primary care provider may publish a schedule of
   43  charges for the medical services that the provider offers to
   44  patients. The schedule must include the prices charged to an
   45  uninsured person paying for such services by cash, check, credit
   46  card, or debit card. The schedule must be posted in a
   47  conspicuous place in the reception area of the provider’s office
   48  and must include, but is not limited to, the 50 services most
   49  frequently provided by the primary care provider. The schedule
   50  may group services by three price levels, listing services in
   51  each price level. The posting must be at least 15 square feet in
   52  size. A primary care provider who publishes and maintains a
   53  schedule of charges for medical services is exempt from the
   54  license fee requirements for a single period of renewal of a
   55  professional license under chapter 456 for that licensure term
   56  and is exempt from the continuing education requirements of
   57  chapter 456 and the rules implementing those requirements for a
   58  single 2-year period.
   59         4. If a primary care provider publishes a schedule of
   60  charges pursuant to subparagraph 3., he or she must continually
   61  post it at all times for the duration of active licensure in
   62  this state when primary care services are provided to patients.
   63  If a primary care provider fails to post the schedule of charges
   64  in accordance with this subparagraph, the provider shall be
   65  required to pay any license fee and comply with any continuing
   66  education requirements for which an exemption was received.
   67         5.3. A health care provider or a health care facility
   68  shall, upon request, furnish a person, before the prior to
   69  provision of medical services, a reasonable estimate of charges
   70  for such services. The health care provider or the health care
   71  facility shall provide an uninsured person, before prior to the
   72  provision of a planned nonemergency medical service, a
   73  reasonable estimate of charges for such service and information
   74  regarding the provider’s or facility’s discount or charity
   75  policies for which the uninsured person may be eligible. Such
   76  estimates by a primary care provider must be consistent with the
   77  schedule posted under subparagraph 3. Estimates shall, to the
   78  extent possible, be written in a language comprehensible to an
   79  ordinary layperson. Such reasonable estimate does shall not
   80  preclude the health care provider or health care facility from
   81  exceeding the estimate or making additional charges based on
   82  changes in the patient’s condition or treatment needs.
   83         6.4. Each licensed facility not operated by the state shall
   84  make available to the public on its Internet website or by other
   85  electronic means a description of and a link to the performance
   86  outcome and financial data that is published by the agency
   87  pursuant to s. 408.05(3)(k). The facility shall place a notice
   88  in the reception area that such information is available
   89  electronically and the website address. The licensed facility
   90  may indicate that the pricing information is based on a
   91  compilation of charges for the average patient and that each
   92  patient’s bill may vary from the average depending upon the
   93  severity of illness and individual resources consumed. The
   94  licensed facility may also indicate that the price of service is
   95  negotiable for eligible patients based upon the patient’s
   96  ability to pay.
   97         7.5. A patient has the right to receive a copy of an
   98  itemized bill upon request. A patient has a right to be given an
   99  explanation of charges upon request.
  100         Section 2. Subsections (30) through (32) of section
  101  395.002, Florida Statutes, are renumbered as subsections (31)
  102  through (33), respectively, and a new subsection (30) is added
  103  to that section to read:
  104         395.002 Definitions.—As used in this chapter:
  105         (30) “Urgent care center” means a facility or clinic that
  106  provides immediate but not emergent ambulatory medical care to
  107  patients with or without an appointment. It does not include the
  108  emergency department of a hospital.
  109         Section 3. Section 395.107, Florida Statutes, is created to
  110  read:
  111         395.107Urgent care centers; publishing and posting
  112  schedule of charges.—An urgent care center must publish a
  113  schedule of charges for the medical services offered to
  114  patients. The schedule must include the prices charged to an
  115  uninsured person paying for such services by cash, check, credit
  116  card, or debit card. The schedule must be posted in a
  117  conspicuous place in the reception area of the urgent care
  118  center and must include, but is not limited to, the 50 services
  119  most frequently provided by the urgent care center. The schedule
  120  may group services by three price levels, listing services in
  121  each price level. The posting must be at least 15 square feet in
  122  size. The failure of an urgent care center to publish and post a
  123  schedule of charges as required by this section shall result in
  124  a fine of not more than $1,000, per day, until the schedule is
  125  published and posted.
  126         Section 4. Subsections (1) and (6) of section 400.9935,
  127  Florida Statutes, are amended to read:
  128         400.9935 Clinic responsibilities.—
  129         (1) Each clinic shall appoint a medical director or clinic
  130  director who shall agree in writing to accept legal
  131  responsibility for the following activities on behalf of the
  132  clinic. The medical director or the clinic director shall:
  133         (a) Have signs identifying the medical director or clinic
  134  director posted in a conspicuous location within the clinic
  135  readily visible to all patients.
  136         (b) Ensure that all practitioners providing health care
  137  services or supplies to patients maintain a current active and
  138  unencumbered Florida license.
  139         (c) Review any patient referral contracts or agreements
  140  executed by the clinic.
  141         (d) Ensure that all health care practitioners at the clinic
  142  have active appropriate certification or licensure for the level
  143  of care being provided.
  144         (e) Serve as the clinic records owner as defined in s.
  145  456.057.
  146         (f) Ensure compliance with the recordkeeping, office
  147  surgery, and adverse incident reporting requirements of chapter
  148  456, the respective practice acts, and rules adopted under this
  149  part and part II of chapter 408.
  150         (g) Conduct systematic reviews of clinic billings to ensure
  151  that the billings are not fraudulent or unlawful. Upon discovery
  152  of an unlawful charge, the medical director or clinic director
  153  shall take immediate corrective action. If the clinic performs
  154  only the technical component of magnetic resonance imaging,
  155  static radiographs, computed tomography, or positron emission
  156  tomography, and provides the professional interpretation of such
  157  services, in a fixed facility that is accredited by the Joint
  158  Commission on Accreditation of Healthcare Organizations or the
  159  Accreditation Association for Ambulatory Health Care, and the
  160  American College of Radiology; and if, in the preceding quarter,
  161  the percentage of scans performed by that clinic which was
  162  billed to all personal injury protection insurance carriers was
  163  less than 15 percent, the chief financial officer of the clinic
  164  may, in a written acknowledgment provided to the agency, assume
  165  the responsibility for the conduct of the systematic reviews of
  166  clinic billings to ensure that the billings are not fraudulent
  167  or unlawful.
  168         (h) Not refer a patient to the clinic if the clinic
  169  performs magnetic resonance imaging, static radiographs,
  170  computed tomography, or positron emission tomography. The term
  171  “refer a patient” means the referral of one or more patients of
  172  the medical or clinical director or a member of the medical or
  173  clinical director’s group practice to the clinic for magnetic
  174  resonance imaging, static radiographs, computed tomography, or
  175  positron emission tomography. A medical director who is found to
  176  violate this paragraph commits a felony of the third degree,
  177  punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
  178         (i) Ensure that the clinic publishes a schedule of charges
  179  for the medical services offered to patients. The schedule must
  180  include the prices charged to an uninsured person paying for
  181  such services by cash, check, credit card, or debit card. The
  182  schedule must be posted in a conspicuous place in the reception
  183  area of the urgent care center and must include, but is not
  184  limited to, the 50 services most frequently provided by the
  185  clinic. The schedule may group services by three price levels,
  186  listing services in each price level. The posting must be at
  187  least 15 square feet in size. The failure of a clinic to publish
  188  and post a schedule of charges as required by this section shall
  189  result in a fine of not more than $1,000, per day, until the
  190  schedule is published and posted.
  191         (6) Any person or entity providing health care services
  192  which is not a clinic, as defined under s. 400.9905, may
  193  voluntarily apply for a certificate of exemption from licensure
  194  under its exempt status with the agency on a form that sets
  195  forth its name or names and addresses, a statement of the
  196  reasons why it cannot be defined as a clinic, and other
  197  information deemed necessary by the agency. An exemption is not
  198  transferable. The agency may charge an applicant for a
  199  certificate of exemption in an amount equal to $100 or the
  200  actual cost of processing the certificate, whichever is less. An
  201  entity seeking a certificate of exemption must publish and
  202  maintain a schedule of charges for the medical services offered
  203  to patients. The schedule must include the prices charged to an
  204  uninsured person paying for such services by cash, check, credit
  205  card, or debit card. The schedule must be posted in a
  206  conspicuous place in the reception area of the entity and must
  207  include, but is not limited to, the 50 services most frequently
  208  provided by the entity. The schedule may group services by three
  209  price levels, listing services in each price level. The posting
  210  must be at least 15 square feet in size. As a condition
  211  precedent to receiving a certificate of exemption, an applicant
  212  must provide to the agency documentation of compliance with
  213  these requirements.
  214         Section 5. This act shall take effect July 1, 2011.
  215  
  216  
  217  ================= T I T L E  A M E N D M E N T ================
  218         And the title is amended as follows:
  219         Delete everything before the enacting clause
  220  and insert:
  221                        A bill to be entitled                      
  222         An act relating to health care price transparency;
  223         amending s. 381.026, F.S.; providing a definition;
  224         authorizing a primary care provider to publish and
  225         post a schedule of certain charges for medical
  226         services offered to patients; providing a minimum size
  227         for the posting; requiring a schedule of charges to
  228         include certain information regarding medical services
  229         offered; providing that the schedule may group the
  230         provider’s services by price levels and list the
  231         services in each price level; providing an exemption
  232         from license fee and continuing education requirements
  233         for a provider who publishes and maintains a schedule
  234         of charges; requiring a primary care provider’s
  235         estimates of charges for medical services to be
  236         consistent with the posted schedule; requiring a
  237         provider to post the schedule of charges for a certain
  238         time period; providing for repayment of license fees
  239         and compliance with continuing education requirements
  240         previously waived if the schedule of charges was not
  241         posted for a certain time period; amending s. 395.002,
  242         F.S.; providing a definition; creating s. 395.107,
  243         F.S.; requiring urgent care centers to publish and
  244         post a schedule of certain charges for medical
  245         services offered to patients; providing a minimum size
  246         for the posting; requiring a schedule of charges to
  247         include certain information regarding medical services
  248         offered; providing that the schedule may group the
  249         urgent care center’s services by price levels and list
  250         the services in each price level; providing a fine for
  251         failure to publish and post a schedule of medical
  252         services; amending s. 400.9935, F.S.; requiring
  253         medical directors or clinic directors of health care
  254         clinics and entities with a certificate of exemption
  255         under the Health Care Clinic Act to publish and post a
  256         schedule of certain charges for medical services
  257         offered to patients; providing a minimum size for the
  258         posting; requiring a schedule of charges to include
  259         certain information regarding medical services
  260         offered; providing that the schedule may group the
  261         urgent care center’s services by price levels and list
  262         the services in each price level; providing a fine for
  263         clinic failure to publish and post a schedule of
  264         medical services; providing an effective date.
  265