Florida Senate - 2013 COMMITTEE AMENDMENT
Bill No. CS for SB 594
Barcode 556994
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/22/2013 .
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The Committee on Rules (Gardiner) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5
6 Section 1. Paragraph (n) of subsection (1) of section
7 154.11, Florida Statutes, is amended to read:
8 154.11 Powers of board of trustees.—
9 (1) The board of trustees of each public health trust shall
10 be deemed to exercise a public and essential governmental
11 function of both the state and the county and in furtherance
12 thereof it shall, subject to limitation by the governing body of
13 the county in which such board is located, have all of the
14 powers necessary or convenient to carry out the operation and
15 governance of designated health care facilities, including, but
16 without limiting the generality of, the foregoing:
17 (n) To appoint originally the staff of physicians to
18 practice in a any designated facility owned or operated by the
19 board and to approve the bylaws and rules to be adopted by the
20 medical staff of a any designated facility owned and operated by
21 the board, such governing regulations shall to be in accordance
22 with the standards of the Joint Commission on the Accreditation
23 of Hospitals which provide, among other things, for the method
24 of appointing additional staff members and for the removal of
25 staff members.
26 Section 2. Subsection (2) of section 394.741, Florida
27 Statutes, is amended to read:
28 394.741 Accreditation requirements for providers of
29 behavioral health care services.—
30 (2) Notwithstanding any provision of law to the contrary,
31 accreditation shall be accepted by the agency and department in
32 lieu of the agency’s and department’s facility licensure onsite
33 review requirements and shall be accepted as a substitute for
34 the department’s administrative and program monitoring
35 requirements, except as required by subsections (3) and (4),
36 for:
37 (a) An Any organization from which the department purchases
38 behavioral health care services which that is accredited by an
39 accrediting organization whose standards incorporate comparable
40 licensure regulations required by this state the Joint
41 Commission on Accreditation of Healthcare Organizations or the
42 Council on Accreditation for Children and Family Services, or
43 has those services that are being purchased by the department
44 accredited by CARF—the Rehabilitation Accreditation Commission.
45 (b) A Any mental health facility licensed by the agency or
46 a any substance abuse component licensed by the department which
47 that is accredited by an accrediting organization whose
48 standards incorporate comparable licensure regulations required
49 by this state the Joint Commission on Accreditation of
50 Healthcare Organizations, CARF—the Rehabilitation Accreditation
51 Commission, or the Council on Accreditation of Children and
52 Family Services.
53 (c) A Any network of providers from which the department or
54 the agency purchases behavioral health care services accredited
55 by an accrediting organization whose standards incorporate
56 comparable licensure regulations required by this state the
57 Joint Commission on Accreditation of Healthcare Organizations,
58 CARF—the Rehabilitation Accreditation Commission, the Council on
59 Accreditation of Children and Family Services, or the National
60 Committee for Quality Assurance. A provider organization that,
61 which is part of an accredited network, is afforded the same
62 rights under this part.
63 Section 3. Section 395.3038, Florida Statutes, is amended
64 to read:
65 395.3038 State-listed primary stroke centers and
66 comprehensive stroke centers; notification of hospitals.—
67 (1) The agency shall make available on its website and to
68 the department a list of the name and address of each hospital
69 that meets the criteria for a primary stroke center and the name
70 and address of each hospital that meets the criteria for a
71 comprehensive stroke center. The list of primary and
72 comprehensive stroke centers must shall include only those
73 hospitals that attest in an affidavit submitted to the agency
74 that the hospital meets the named criteria, or those hospitals
75 that attest in an affidavit submitted to the agency that the
76 hospital is certified as a primary or a comprehensive stroke
77 center by an accrediting organization the Joint Commission on
78 Accreditation of Healthcare Organizations.
79 (2)(a) If a hospital no longer chooses to meet the criteria
80 for a primary or comprehensive stroke center, the hospital shall
81 notify the agency and the agency shall immediately remove the
82 hospital from the list.
83 (b)1. This subsection does not apply if the hospital is
84 unable to provide stroke treatment services for a period of time
85 not to exceed 2 months. The hospital shall immediately notify
86 all local emergency medical services providers when the
87 temporary unavailability of stroke treatment services begins and
88 when the services resume.
89 2. If stroke treatment services are unavailable for more
90 than 2 months, the agency shall remove the hospital from the
91 list of primary or comprehensive stroke centers until the
92 hospital notifies the agency that stroke treatment services have
93 been resumed.
94 (3) The agency shall notify all hospitals in this state by
95 February 15, 2005, that the agency is compiling a list of
96 primary stroke centers and comprehensive stroke centers in this
97 state. The notice shall include an explanation of the criteria
98 necessary for designation as a primary stroke center and the
99 criteria necessary for designation as a comprehensive stroke
100 center. The notice shall also advise hospitals of the process by
101 which a hospital might be added to the list of primary or
102 comprehensive stroke centers.
103 (3)(4) The agency shall adopt by rule criteria for a
104 primary stroke center which are substantially similar to the
105 certification standards for primary stroke centers of the Joint
106 Commission on Accreditation of Healthcare Organizations.
107 (4)(5) The agency shall adopt by rule criteria for a
108 comprehensive stroke center. However, if the Joint Commission on
109 Accreditation of Healthcare Organizations establishes criteria
110 for a comprehensive stroke center, the agency rules shall be
111 establish criteria for a comprehensive stroke center which are
112 substantially similar to those criteria established by the Joint
113 Commission on Accreditation of Healthcare Organizations.
114 (5)(6) This act is not a medical practice guideline and may
115 not be used to restrict the authority of a hospital to provide
116 services for which it is licensed has received a license under
117 chapter 395. The Legislature intends that all patients be
118 treated individually based on each patient’s needs and
119 circumstances.
120 Section 4. Subsection (3) of section 397.403, Florida
121 Statutes, is amended to read:
122 397.403 License application.—
123 (3) The department shall accept proof of accreditation by
124 an accrediting organization whose standards incorporate
125 comparable licensure regulations required by this state the
126 Commission on Accreditation of Rehabilitation Facilities(CARF)
127 or the joint commission, or through another any other nationally
128 recognized certification process that is acceptable to the
129 department and meets the minimum licensure requirements under
130 this chapter, in lieu of requiring the applicant to submit the
131 information required by paragraphs (1)(a)-(c).
132 Section 5. Subsection (1) of section 400.925, Florida
133 Statutes, is amended to read:
134 400.925 Definitions.—As used in this part, the term:
135 (1) “Accrediting organizations” means an organization the
136 Joint Commission on Accreditation of Healthcare Organizations or
137 other national accreditation agencies whose standards
138 incorporate licensure regulations for accreditation are
139 comparable to those required by this state part for licensure.
140 Section 6. Paragraph (g) of subsection (1) and paragraph
141 (a) of subsection (7) of section 400.9935, Florida Statutes, are
142 amended to read:
143 400.9935 Clinic responsibilities.—
144 (1) Each clinic shall appoint a medical director or clinic
145 director who shall agree in writing to accept legal
146 responsibility for the following activities on behalf of the
147 clinic. The medical director or the clinic director shall:
148 (g) Conduct systematic reviews of clinic billings to ensure
149 that the billings are not fraudulent or unlawful. Upon discovery
150 of an unlawful charge, the medical director or clinic director
151 shall take immediate corrective action. If the clinic performs
152 only the technical component of magnetic resonance imaging,
153 static radiographs, computed tomography, or positron emission
154 tomography, and provides the professional interpretation of such
155 services, in a fixed facility that is accredited by a national
156 accrediting organization that is approved by the Centers for
157 Medicare and Medicaid Services for magnetic resonance imaging
158 and advanced diagnostic imaging services the Joint Commission on
159 Accreditation of Healthcare Organizations or the Accreditation
160 Association for Ambulatory Health Care, and the American College
161 of Radiology; and if, in the preceding quarter, the percentage
162 of scans performed by that clinic which was billed to all
163 personal injury protection insurance carriers was less than 15
164 percent, the chief financial officer of the clinic may, in a
165 written acknowledgment provided to the agency, assume the
166 responsibility for the conduct of the systematic reviews of
167 clinic billings to ensure that the billings are not fraudulent
168 or unlawful.
169 (7)(a) Each clinic engaged in magnetic resonance imaging
170 services must be accredited by a national accrediting
171 organization that is approved by the Centers for Medicare and
172 Medicaid Services for magnetic resonance imaging and advanced
173 diagnostic imaging services the Joint Commission on
174 Accreditation of Healthcare Organizations, the American College
175 of Radiology, or the Accreditation Association for Ambulatory
176 Health Care, within 1 year after licensure. A clinic that is
177 accredited by the American College of Radiology or that is
178 within the original 1-year period after licensure and replaces
179 its core magnetic resonance imaging equipment shall be given 1
180 year after the date on which the equipment is replaced to attain
181 accreditation. However, a clinic may request a single, 6-month
182 extension if it provides evidence to the agency establishing
183 that, for good cause shown, such clinic cannot be accredited
184 within 1 year after licensure, and that such accreditation will
185 be completed within the 6-month extension. After obtaining
186 accreditation as required by this subsection, each such clinic
187 must maintain accreditation as a condition of renewal of its
188 license. A clinic that files a change of ownership application
189 must comply with the original accreditation timeframe
190 requirements of the transferor. The agency shall deny a change
191 of ownership application if the clinic is not in compliance with
192 the accreditation requirements. When a clinic adds, replaces, or
193 modifies magnetic resonance imaging equipment and the
194 accrediting accreditation agency requires new accreditation, the
195 clinic must be accredited within 1 year after the date of the
196 addition, replacement, or modification but may request a single,
197 6-month extension if the clinic provides evidence of good cause
198 to the agency.
199 Section 7. Subsections (1) and (2) of section 402.7306,
200 Florida Statutes, are amended to read:
201 402.7306 Administrative monitoring of child welfare
202 providers, and administrative, licensure, and programmatic
203 monitoring of mental health and substance abuse service
204 providers.—The Department of Children and Family Services, the
205 Department of Health, the Agency for Persons with Disabilities,
206 the Agency for Health Care Administration, community-based care
207 lead agencies, managing entities as defined in s. 394.9082, and
208 agencies who have contracted with monitoring agents shall
209 identify and implement changes that improve the efficiency of
210 administrative monitoring of child welfare services, and the
211 administrative, licensure, and programmatic monitoring of mental
212 health and substance abuse service providers. For the purpose of
213 this section, the term “mental health and substance abuse
214 service provider” means a provider who provides services to this
215 state’s priority population as defined in s. 394.674. To assist
216 with that goal, each such agency shall adopt the following
217 policies:
218 (1) Limit administrative monitoring to once every 3 years
219 if the child welfare provider is accredited by an accrediting
220 organization whose standards incorporate comparable licensure
221 regulations required by this state the Joint Commission, the
222 Commission on Accreditation of Rehabilitation Facilities, or the
223 Council on Accreditation. If the accrediting body does not
224 require documentation that the state agency requires, that
225 documentation shall be requested by the state agency and may be
226 posted by the service provider on the data warehouse for the
227 agency’s review. Notwithstanding the survey or inspection of an
228 accrediting organization specified in this subsection, an agency
229 specified in and subject to this section may continue to monitor
230 the service provider as necessary with respect to:
231 (a) Ensuring that services for which the agency is paying
232 are being provided.
233 (b) Investigating complaints or suspected problems and
234 monitoring the service provider’s compliance with any resulting
235 negotiated terms and conditions, including provisions relating
236 to consent decrees that are unique to a specific service and are
237 not statements of general applicability.
238 (c) Ensuring compliance with federal and state laws,
239 federal regulations, or state rules if such monitoring does not
240 duplicate the accrediting organization’s review pursuant to
241 accreditation standards.
242
243 Medicaid certification and precertification reviews are exempt
244 from this subsection to ensure Medicaid compliance.
245 (2) Limit administrative, licensure, and programmatic
246 monitoring to once every 3 years if the mental health or
247 substance abuse service provider is accredited by an accrediting
248 organization whose standards incorporate comparable licensure
249 regulations required by this state the Joint Commission, the
250 Commission on Accreditation of Rehabilitation Facilities, or the
251 Council on Accreditation. If the services being monitored are
252 not the services for which the provider is accredited, the
253 limitations of this subsection do not apply. If the accrediting
254 body does not require documentation that the state agency
255 requires, that documentation, except documentation relating to
256 licensure applications and fees, must be requested by the state
257 agency and may be posted by the service provider on the data
258 warehouse for the agency’s review. Notwithstanding the survey or
259 inspection of an accrediting organization specified in this
260 subsection, an agency specified in and subject to this section
261 may continue to monitor the service provider as necessary with
262 respect to:
263 (a) Ensuring that services for which the agency is paying
264 are being provided.
265 (b) Investigating complaints, identifying problems that
266 would affect the safety or viability of the service provider,
267 and monitoring the service provider’s compliance with any
268 resulting negotiated terms and conditions, including provisions
269 relating to consent decrees that are unique to a specific
270 service and are not statements of general applicability.
271 (c) Ensuring compliance with federal and state laws,
272 federal regulations, or state rules if such monitoring does not
273 duplicate the accrediting organization’s review pursuant to
274 accreditation standards.
275
276 Federal certification and precertification reviews are exempt
277 from this subsection to ensure Medicaid compliance.
278 Section 8. Paragraph (k) of subsection (3) of section
279 408.05, Florida Statutes, is amended to read:
280 408.05 Florida Center for Health Information and Policy
281 Analysis.—
282 (3) COMPREHENSIVE HEALTH INFORMATION SYSTEM.—In order to
283 produce comparable and uniform health information and statistics
284 for the development of policy recommendations, the agency shall
285 perform the following functions:
286 (k) Develop, in conjunction with the State Consumer Health
287 Information and Policy Advisory Council, and implement a long
288 range plan for making available health care quality measures and
289 financial data that will allow consumers to compare health care
290 services. The health care quality measures and financial data
291 the agency must make available includes shall include, but is
292 not limited to, pharmaceuticals, physicians, health care
293 facilities, and health plans and managed care entities. The
294 agency shall update the plan and report on the status of its
295 implementation annually. The agency shall also make the plan and
296 status report available to the public on its Internet website.
297 As part of the plan, the agency shall identify the process and
298 timeframes for implementation, any barriers to implementation,
299 and recommendations of changes in the law that may be enacted by
300 the Legislature to eliminate the barriers. As preliminary
301 elements of the plan, the agency shall:
302 1. Make available patient-safety indicators, inpatient
303 quality indicators, and performance outcome and patient charge
304 data collected from health care facilities pursuant to s.
305 408.061(1)(a) and (2). The terms “patient-safety indicators” and
306 “inpatient quality indicators” have the same meaning as that
307 ascribed shall be as defined by the Centers for Medicare and
308 Medicaid Services, an accrediting organization whose standards
309 incorporate comparable regulations required by this state, the
310 National Quality Forum, the Joint Commission on Accreditation of
311 Healthcare Organizations, the Agency for Healthcare Research and
312 Quality, the Centers for Disease Control and Prevention, or a
313 similar national entity that establishes standards to measure
314 the performance of health care providers, or by other states.
315 The agency shall determine which conditions, procedures, health
316 care quality measures, and patient charge data to disclose based
317 upon input from the council. When determining which conditions
318 and procedures are to be disclosed, the council and the agency
319 shall consider variation in costs, variation in outcomes, and
320 magnitude of variations and other relevant information. When
321 determining which health care quality measures to disclose, the
322 agency:
323 a. Shall consider such factors as volume of cases; average
324 patient charges; average length of stay; complication rates;
325 mortality rates; and infection rates, among others, which shall
326 be adjusted for case mix and severity, if applicable.
327 b. May consider such additional measures that are adopted
328 by the Centers for Medicare and Medicaid Studies, an accrediting
329 organization whose standards incorporate comparable regulations
330 required by this state, the National Quality Forum, the Joint
331 Commission on Accreditation of Healthcare Organizations, the
332 Agency for Healthcare Research and Quality, the Centers for
333 Disease Control and Prevention, or a similar national entity
334 that establishes standards to measure the performance of health
335 care providers, or by other states.
336
337 When determining which patient charge data to disclose, the
338 agency shall include such measures as the average of
339 undiscounted charges on frequently performed procedures and
340 preventive diagnostic procedures, the range of procedure charges
341 from highest to lowest, average net revenue per adjusted patient
342 day, average cost per adjusted patient day, and average cost per
343 admission, among others.
344 2. Make available performance measures, benefit design, and
345 premium cost data from health plans licensed pursuant to chapter
346 627 or chapter 641. The agency shall determine which health care
347 quality measures and member and subscriber cost data to
348 disclose, based upon input from the council. When determining
349 which data to disclose, the agency shall consider information
350 that may be required by either individual or group purchasers to
351 assess the value of the product, which may include membership
352 satisfaction, quality of care, current enrollment or membership,
353 coverage areas, accreditation status, premium costs, plan costs,
354 premium increases, range of benefits, copayments and
355 deductibles, accuracy and speed of claims payment, credentials
356 of physicians, number of providers, names of network providers,
357 and hospitals in the network. Health plans shall make available
358 to the agency any such data or information that is not currently
359 reported to the agency or the office.
360 3. Determine the method and format for public disclosure of
361 data reported pursuant to this paragraph. The agency shall make
362 its determination based upon input from the State Consumer
363 Health Information and Policy Advisory Council. At a minimum,
364 the data shall be made available on the agency’s Internet
365 website in a manner that allows consumers to conduct an
366 interactive search that allows them to view and compare the
367 information for specific providers. The website must include
368 such additional information as is determined necessary to ensure
369 that the website enhances informed decisionmaking among
370 consumers and health care purchasers, which shall include, at a
371 minimum, appropriate guidance on how to use the data and an
372 explanation of why the data may vary from provider to provider.
373 4. Publish on its website undiscounted charges for no fewer
374 than 150 of the most commonly performed adult and pediatric
375 procedures, including outpatient, inpatient, diagnostic, and
376 preventative procedures.
377 Section 9. Paragraph (b) of subsection (3) of section
378 430.80, Florida Statutes, is amended to read:
379 430.80 Implementation of a teaching nursing home pilot
380 project.—
381 (3) To be designated as a teaching nursing home, a nursing
382 home licensee must, at a minimum:
383 (b) Participate in a nationally recognized accrediting
384 accreditation program and hold a valid accreditation, such as
385 the accreditation awarded by the Joint Commission on
386 Accreditation of Healthcare Organizations, or, at the time of
387 initial designation, possess a Gold Seal Award as conferred by
388 the state on its licensed nursing home;
389 Section 10. Paragraph (a) of subsection (2) of section
390 440.13, Florida Statutes, is amended to read:
391 440.13 Medical services and supplies; penalty for
392 violations; limitations.—
393 (2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.—
394 (a) Subject to the limitations specified elsewhere in this
395 chapter, the employer shall furnish to the employee such
396 medically necessary remedial treatment, care, and attendance for
397 such period as the nature of the injury or the process of
398 recovery may require, which is in accordance with established
399 practice parameters and protocols of treatment as provided for
400 in this chapter, including medicines, medical supplies, durable
401 medical equipment, orthoses, prostheses, and other medically
402 necessary apparatus. Remedial treatment, care, and attendance,
403 including work-hardening programs or pain-management programs
404 accredited by an accrediting organization whose standards
405 incorporate comparable regulations required by this state the
406 Commission on Accreditation of Rehabilitation Facilities or
407 Joint Commission on the Accreditation of Health Organizations or
408 pain-management programs affiliated with medical schools, shall
409 be considered as covered treatment only when such care is given
410 based on a referral by a physician as defined in this chapter.
411 Medically necessary treatment, care, and attendance does not
412 include chiropractic services in excess of 24 treatments or
413 rendered 12 weeks beyond the date of the initial chiropractic
414 treatment, whichever comes first, unless the carrier authorizes
415 additional treatment or the employee is catastrophically
416 injured.
417
418 Failure of the carrier to timely comply with this subsection
419 shall be a violation of this chapter and the carrier shall be
420 subject to penalties as provided for in s. 440.525.
421 Section 11. Subsection (1) of section 627.645, Florida
422 Statutes, is amended to read:
423 627.645 Denial of health insurance claims restricted.—
424 (1) A No claim for payment under a health insurance policy
425 or self-insured program of health benefits for treatment, care,
426 or services in a licensed hospital that which is accredited by
427 an accrediting organization whose standards incorporate
428 comparable regulations required by this state may not the Joint
429 Commission on the Accreditation of Hospitals, the American
430 Osteopathic Association, or the Commission on the Accreditation
431 of Rehabilitative Facilities shall be denied because such
432 hospital lacks major surgical facilities and is primarily of a
433 rehabilitative nature, if such rehabilitation is specifically
434 for treatment of physical disability.
435 Section 12. Paragraph (c) of subsection (2) of section
436 627.668, Florida Statutes, is amended to read:
437 627.668 Optional coverage for mental and nervous disorders
438 required; exception.—
439 (2) Under group policies or contracts, inpatient hospital
440 benefits, partial hospitalization benefits, and outpatient
441 benefits consisting of durational limits, dollar amounts,
442 deductibles, and coinsurance factors shall not be less favorable
443 than for physical illness generally, except that:
444 (c) Partial hospitalization benefits shall be provided
445 under the direction of a licensed physician. For purposes of
446 this part, the term “partial hospitalization services” is
447 defined as those services offered by a program that is
448 accredited by an accrediting organization whose standards
449 incorporate comparable regulations required by this state the
450 Joint Commission on Accreditation of Hospitals (JCAH) or in
451 compliance with equivalent standards. Alcohol rehabilitation
452 programs accredited by an accrediting organization whose
453 standards incorporate comparable regulations required by this
454 state the Joint Commission on Accreditation of Hospitals or
455 approved by the state and licensed drug abuse rehabilitation
456 programs shall also be qualified providers under this section.
457 In a given any benefit year, if partial hospitalization services
458 or a combination of inpatient and partial hospitalization are
459 used utilized, the total benefits paid for all such services may
460 shall not exceed the cost of 30 days after of inpatient
461 hospitalization for psychiatric services, including physician
462 fees, which prevail in the community in which the partial
463 hospitalization services are rendered. If partial
464 hospitalization services benefits are provided beyond the limits
465 set forth in this paragraph, the durational limits, dollar
466 amounts, and coinsurance factors thereof need not be the same as
467 those applicable to physical illness generally.
468 Section 13. Subsection (3) of section 627.669, Florida
469 Statutes, is amended to read:
470 627.669 Optional coverage required for substance abuse
471 impaired persons; exception.—
472 (3) The benefits provided under this section are shall be
473 applicable only if treatment is provided by, or under the
474 supervision of, or is prescribed by, a licensed physician or
475 licensed psychologist and if services are provided in a program
476 that is accredited by an accrediting organization whose
477 standards incorporate comparable regulations required by this
478 state the Joint Commission on Accreditation of Hospitals or that
479 is approved by this the state.
480 Section 14. Paragraph (a) of subsection (1) of section
481 627.736, Florida Statutes, is amended to read:
482 627.736 Required personal injury protection benefits;
483 exclusions; priority; claims.—
484 (1) REQUIRED BENEFITS.—An insurance policy complying with
485 the security requirements of s. 627.733 must provide personal
486 injury protection to the named insured, relatives residing in
487 the same household, persons operating the insured motor vehicle,
488 passengers in the motor vehicle, and other persons struck by the
489 motor vehicle and suffering bodily injury while not an occupant
490 of a self-propelled vehicle, subject to subsection (2) and
491 paragraph (4)(e), to a limit of $10,000 in medical and
492 disability benefits and $5,000 in death benefits resulting from
493 bodily injury, sickness, disease, or death arising out of the
494 ownership, maintenance, or use of a motor vehicle as follows:
495 (a) Medical benefits.—Eighty percent of all reasonable
496 expenses for medically necessary medical, surgical, X-ray,
497 dental, and rehabilitative services, including prosthetic
498 devices and medically necessary ambulance, hospital, and nursing
499 services if the individual receives initial services and care
500 pursuant to subparagraph 1. within 14 days after the motor
501 vehicle accident. The medical benefits provide reimbursement
502 only for:
503 1. Initial services and care that are lawfully provided,
504 supervised, ordered, or prescribed by a physician licensed under
505 chapter 458 or chapter 459, a dentist licensed under chapter
506 466, or a chiropractic physician licensed under chapter 460 or
507 that are provided in a hospital or in a facility that owns, or
508 is wholly owned by, a hospital. Initial services and care may
509 also be provided by a person or entity licensed under part III
510 of chapter 401 which provides emergency transportation and
511 treatment.
512 2. Upon referral by a provider described in subparagraph
513 1., followup services and care consistent with the underlying
514 medical diagnosis rendered pursuant to subparagraph 1. which may
515 be provided, supervised, ordered, or prescribed only by a
516 physician licensed under chapter 458 or chapter 459, a
517 chiropractic physician licensed under chapter 460, a dentist
518 licensed under chapter 466, or, to the extent permitted by
519 applicable law and under the supervision of such physician,
520 osteopathic physician, chiropractic physician, or dentist, by a
521 physician assistant licensed under chapter 458 or chapter 459 or
522 an advanced registered nurse practitioner licensed under chapter
523 464. Followup services and care may also be provided by any of
524 the following persons or entities:
525 a. A hospital or ambulatory surgical center licensed under
526 chapter 395.
527 b. An entity wholly owned by one or more physicians
528 licensed under chapter 458 or chapter 459, chiropractic
529 physicians licensed under chapter 460, or dentists licensed
530 under chapter 466 or by such practitioners and the spouse,
531 parent, child, or sibling of such practitioners.
532 c. An entity that owns or is wholly owned, directly or
533 indirectly, by a hospital or hospitals.
534 d. A physical therapist licensed under chapter 486, based
535 upon a referral by a provider described in this subparagraph.
536 e. A health care clinic licensed under part X of chapter
537 400 which is accredited by an accrediting organization whose
538 standards incorporate comparable regulations required by this
539 state the Joint Commission on Accreditation of Healthcare
540 Organizations, the American Osteopathic Association, the
541 Commission on Accreditation of Rehabilitation Facilities, or the
542 Accreditation Association for Ambulatory Health Care, Inc., or
543 (I) Has a medical director licensed under chapter 458,
544 chapter 459, or chapter 460;
545 (II) Has been continuously licensed for more than 3 years
546 or is a publicly traded corporation that issues securities
547 traded on an exchange registered with the United States
548 Securities and Exchange Commission as a national securities
549 exchange; and
550 (III) Provides at least four of the following medical
551 specialties:
552 (A) General medicine.
553 (B) Radiography.
554 (C) Orthopedic medicine.
555 (D) Physical medicine.
556 (E) Physical therapy.
557 (F) Physical rehabilitation.
558 (G) Prescribing or dispensing outpatient prescription
559 medication.
560 (H) Laboratory services.
561 3. Reimbursement for services and care provided in
562 subparagraph 1. or subparagraph 2. up to $10,000 if a physician
563 licensed under chapter 458 or chapter 459, a dentist licensed
564 under chapter 466, a physician assistant licensed under chapter
565 458 or chapter 459, or an advanced registered nurse practitioner
566 licensed under chapter 464 has determined that the injured
567 person had an emergency medical condition.
568 4. Reimbursement for services and care provided in
569 subparagraph 1. or subparagraph 2. is limited to $2,500 if a any
570 provider listed in subparagraph 1. or subparagraph 2. determines
571 that the injured person did not have an emergency medical
572 condition.
573 5. Medical benefits do not include massage as defined in s.
574 480.033 or acupuncture as defined in s. 457.102, regardless of
575 the person, entity, or licensee providing massage or
576 acupuncture, and a licensed massage therapist or licensed
577 acupuncturist may not be reimbursed for medical benefits under
578 this section.
579 6. The Financial Services Commission shall adopt by rule
580 the form that must be used by an insurer and a health care
581 provider specified in sub-subparagraph 2.b., sub-subparagraph
582 2.c., or sub-subparagraph 2.e. to document that the health care
583 provider meets the criteria of this paragraph. Such, which rule
584 must include a requirement for a sworn statement or affidavit.
585
586 Only insurers writing motor vehicle liability insurance in this
587 state may provide the required benefits of this section, and
588 such insurer may not require the purchase of any other motor
589 vehicle coverage other than the purchase of property damage
590 liability coverage as required by s. 627.7275 as a condition for
591 providing such benefits. Insurers may not require that property
592 damage liability insurance in an amount greater than $10,000 be
593 purchased in conjunction with personal injury protection. Such
594 insurers shall make benefits and required property damage
595 liability insurance coverage available through normal marketing
596 channels. An insurer writing motor vehicle liability insurance
597 in this state who fails to comply with such availability
598 requirement as a general business practice violates part IX of
599 chapter 626, and such violation constitutes an unfair method of
600 competition or an unfair or deceptive act or practice involving
601 the business of insurance. An insurer committing such violation
602 is subject to the penalties provided under that part, as well as
603 those provided elsewhere in the insurance code.
604 Section 15. Subsection (12) of section 641.495, Florida
605 Statutes, is amended to read:
606 641.495 Requirements for issuance and maintenance of
607 certificate.—
608 (12) The provisions of part I of chapter 395 do not apply
609 to a health maintenance organization that, on or before January
610 1, 1991, provides not more than 10 outpatient holding beds for
611 short-term and hospice-type patients in an ambulatory care
612 facility for its members, provided that such health maintenance
613 organization maintains current accreditation by an accrediting
614 organization whose standards incorporate comparable regulations
615 required by this state the Joint Commission on Accreditation of
616 Health Care Organizations, the Accreditation Association for
617 Ambulatory Health Care, or the National Committee for Quality
618 Assurance.
619 Section 16. Subsection (2) of section 766.1015, Florida
620 Statutes, is amended to read:
621 766.1015 Civil immunity for members of or consultants to
622 certain boards, committees, or other entities.—
623 (2) Such committee, board, group, commission, or other
624 entity must be established in accordance with state law, or in
625 accordance with requirements of an applicable accrediting
626 organization whose standards incorporate comparable regulations
627 required by this state the Joint Commission on Accreditation of
628 Healthcare Organizations, established and duly constituted by
629 one or more public or licensed private hospitals or behavioral
630 health agencies, or established by a governmental agency. To be
631 protected by this section, the act, decision, omission, or
632 utterance may not be made or done in bad faith or with malicious
633 intent.
634 Section 17. This act shall take effect July 1, 2013.
635
636 ================= T I T L E A M E N D M E N T ================
637 And the title is amended as follows:
638 Delete everything before the enacting clause
639 and insert:
640 A bill to be entitled
641 An act relating to health care accreditation; amending
642 ss. 154.11, 394.741, 397.403, 400.925, 400.9935,
643 402.7306, 408.05, 430.80, 440.13, 627.645, 627.668,
644 627.669, 627.736, 641.495, and 766.1015, F.S.;
645 conforming provisions to the revised definition of the
646 term “accrediting organizations” in s. 395.002, F.S.,
647 as amended by s. 4, ch. 2012-66, Laws of Florida, for
648 purposes of hospital licensing and regulation by the
649 Agency for Health Care Administration; amending s.
650 395.3038, F.S.; deleting an obsolete provision
651 relating to a requirement that the agency provide
652 certain notice relating to stroke centers to
653 hospitals; conforming provisions to changes made by
654 the act; providing an effective date.