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.