Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS for CS for CS for SB 1254
       
       
       
       
       
       
                                Ì664204zÎ664204                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                                       .                                
                                       .                                
                                       .                                
                Floor: 1/F/2R          .                                
             04/30/2014 11:00 AM       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       Senator Soto moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 963 and 964
    4  insert:
    5         Section 20. Subsection (4) of section 400.9905, Florida
    6  Statutes, is amended to read:
    7         400.9905 Definitions.—
    8         (4) “Clinic” means an entity where health care services are
    9  provided to individuals and which tenders charges for
   10  reimbursement for such services, including a mobile clinic and a
   11  portable equipment provider. As used in this part, the term does
   12  not include and the licensure requirements of this part do not
   13  apply to:
   14         (a) Entities licensed or registered by the state under
   15  chapter 395; entities licensed or registered by the state and
   16  providing only health care services within the scope of services
   17  authorized under their respective licenses under ss. 383.30
   18  383.335, chapter 390, chapter 394, chapter 397, this chapter
   19  except part X, chapter 429, chapter 463, chapter 465, chapter
   20  466, chapter 478, part I of chapter 483, chapter 484, or chapter
   21  651; end-stage renal disease providers authorized under 42
   22  C.F.R. part 405, subpart U; providers certified under 42 C.F.R.
   23  part 485, subpart B or subpart H; or an any entity that provides
   24  neonatal or pediatric hospital-based health care services or
   25  other health care services by licensed practitioners solely
   26  within a hospital licensed under chapter 395.
   27         (b) Entities that own, directly or indirectly, entities
   28  licensed or registered by the state pursuant to chapter 395;
   29  entities that own, directly or indirectly, entities licensed or
   30  registered by the state and providing only health care services
   31  within the scope of services authorized pursuant to their
   32  respective licenses under ss. 383.30-383.335, chapter 390,
   33  chapter 394, chapter 397, this chapter except part X, chapter
   34  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   35  of chapter 483, chapter 484, or chapter 651; end-stage renal
   36  disease providers authorized under 42 C.F.R. part 405, subpart
   37  U; providers certified under 42 C.F.R. part 485, subpart B or
   38  subpart H; or an any entity that provides neonatal or pediatric
   39  hospital-based health care services by licensed practitioners
   40  solely within a hospital licensed under chapter 395.
   41         (c) Entities that are owned, directly or indirectly, by an
   42  entity licensed or registered by the state pursuant to chapter
   43  395; entities that are owned, directly or indirectly, by an
   44  entity licensed or registered by the state and providing only
   45  health care services within the scope of services authorized
   46  pursuant to their respective licenses under ss. 383.30-383.335,
   47  chapter 390, chapter 394, chapter 397, this chapter except part
   48  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
   49  478, part I of chapter 483, chapter 484, or chapter 651; end
   50  stage renal disease providers authorized under 42 C.F.R. part
   51  405, subpart U; providers certified under 42 C.F.R. part 485,
   52  subpart B or subpart H; or an any entity that provides neonatal
   53  or pediatric hospital-based health care services by licensed
   54  practitioners solely within a hospital under chapter 395.
   55         (d) Entities that are under common ownership, directly or
   56  indirectly, with an entity licensed or registered by the state
   57  pursuant to chapter 395; entities that are under common
   58  ownership, directly or indirectly, with an entity licensed or
   59  registered by the state and providing only health care services
   60  within the scope of services authorized pursuant to their
   61  respective licenses under ss. 383.30-383.335, chapter 390,
   62  chapter 394, chapter 397, this chapter except part X, chapter
   63  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   64  of chapter 483, chapter 484, or chapter 651; end-stage renal
   65  disease providers authorized under 42 C.F.R. part 405, subpart
   66  U; providers certified under 42 C.F.R. part 485, subpart B or
   67  subpart H; or an any entity that provides neonatal or pediatric
   68  hospital-based health care services by licensed practitioners
   69  solely within a hospital licensed under chapter 395.
   70         (e) An entity that is exempt from federal taxation under 26
   71  U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan
   72  under 26 U.S.C. s. 409 that has a board of trustees at least
   73  two-thirds of which are Florida-licensed health care
   74  practitioners and provides only physical therapy services under
   75  physician orders, a any community college or university clinic,
   76  and an any entity owned or operated by the federal or state
   77  government, including agencies, subdivisions, or municipalities
   78  thereof.
   79         (f) A sole proprietorship, group practice, partnership, or
   80  corporation that provides health care services by physicians
   81  covered by s. 627.419, that is directly supervised by one or
   82  more of such physicians, and that is wholly owned by one or more
   83  of those physicians or by a physician and the spouse, parent,
   84  child, or sibling of that physician.
   85         (g) A sole proprietorship, group practice, partnership, or
   86  corporation that provides health care services by licensed
   87  health care practitioners under chapter 457, chapter 458,
   88  chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
   89  chapter 466, chapter 467, chapter 480, chapter 484, chapter 486,
   90  chapter 490, chapter 491, or part I, part III, part X, part
   91  XIII, or part XIV of chapter 468, or s. 464.012, and that is
   92  wholly owned by one or more licensed health care practitioners,
   93  or the licensed health care practitioners set forth in this
   94  paragraph and the spouse, parent, child, or sibling of a
   95  licensed health care practitioner if one of the owners who is a
   96  licensed health care practitioner is supervising the business
   97  activities and is legally responsible for the entity’s
   98  compliance with all federal and state laws. However, a health
   99  care practitioner may not supervise services beyond the scope of
  100  the practitioner’s license, except that, for the purposes of
  101  this part, a clinic owned by a licensee in s. 456.053(3)(b)
  102  which provides only services authorized pursuant to s.
  103  456.053(3)(b) may be supervised by a licensee specified in s.
  104  456.053(3)(b).
  105         (h) Clinical facilities affiliated with an accredited
  106  medical school at which training is provided for medical
  107  students, residents, or fellows.
  108         (i) Entities that provide only oncology or radiation
  109  therapy services by physicians licensed under chapter 458 or
  110  chapter 459 or entities that provide oncology or radiation
  111  therapy services by physicians licensed under chapter 458 or
  112  chapter 459 which are owned by a corporation whose shares are
  113  publicly traded on a recognized stock exchange.
  114         (j) Clinical facilities affiliated with a college of
  115  chiropractic accredited by the Council on Chiropractic Education
  116  at which training is provided for chiropractic students.
  117         (k) Entities that provide licensed practitioners to staff
  118  emergency departments or to deliver anesthesia services in
  119  facilities licensed under chapter 395 and that derive at least
  120  90 percent of their gross annual revenues from the provision of
  121  such services. Entities claiming an exemption from licensure
  122  under this paragraph must provide documentation demonstrating
  123  compliance.
  124         (l) Orthotic, prosthetic, pediatric cardiology, or
  125  perinatology clinical facilities or anesthesia clinical
  126  facilities that are not otherwise exempt under paragraph (a) or
  127  paragraph (k) and that are a publicly traded corporation or are
  128  wholly owned, directly or indirectly, by a publicly traded
  129  corporation. As used in this paragraph, a publicly traded
  130  corporation is a corporation that issues securities traded on an
  131  exchange registered with the United States Securities and
  132  Exchange Commission as a national securities exchange.
  133         (m) Entities that are owned by a corporation that has $250
  134  million or more in total annual sales of health care services
  135  provided by licensed health care practitioners where one or more
  136  of the persons responsible for the operations of the entity is a
  137  health care practitioner who is licensed in this state and who
  138  is responsible for supervising the business activities of the
  139  entity and is responsible for the entity’s compliance with state
  140  law for purposes of this part.
  141         (n) Entities that employ 50 or more licensed health care
  142  practitioners licensed under chapter 458 or chapter 459 where
  143  the billing for medical services is under a single tax
  144  identification number. The application for exemption under this
  145  subsection must shall contain information that includes: the
  146  name, residence, and business address and phone number of the
  147  entity that owns the practice; a complete list of the names and
  148  contact information of all the officers and directors of the
  149  corporation; the name, residence address, business address, and
  150  medical license number of each licensed Florida health care
  151  practitioner employed by the entity; the corporate tax
  152  identification number of the entity seeking an exemption; a
  153  listing of health care services to be provided by the entity at
  154  the health care clinics owned or operated by the entity and a
  155  certified statement prepared by an independent certified public
  156  accountant which states that the entity and the health care
  157  clinics owned or operated by the entity have not received
  158  payment for health care services under personal injury
  159  protection insurance coverage for the preceding year. If the
  160  agency determines that an entity which is exempt under this
  161  subsection has received payments for medical services under
  162  personal injury protection insurance coverage, the agency may
  163  deny or revoke the exemption from licensure under this
  164  subsection.
  165  
  166  Notwithstanding this subsection, an entity shall be deemed a
  167  clinic and must be licensed under this part in order to receive
  168  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  169  627.730-627.7405, unless exempted under s. 627.736(5)(h) or, as
  170  a provider certified pursuant to 42 C.F.R. part 485, subpart H,
  171  exempted under this subsection before July 1, 2014. However, if
  172  a single legal entity owned a clinic that is exempt under this
  173  subsection before July 1, 2014, the exemption extends beyond
  174  that date to other clinics owned by that entity which are
  175  certified under 42 C.F.R. part 485, subpart H.
  176  
  177  ================= T I T L E  A M E N D M E N T ================
  178  And the title is amended as follows:
  179         Delete line 43
  180  and insert:
  181         equipment and supply lists; amending s. 400.9905,
  182         F.S.; exempting certain federally certified clinics
  183         from licensure under the Health Care Clinic Act;
  184         amending s. 409.972, F.S.;