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