Florida Senate - 2014 SENATOR AMENDMENT Bill No. CS for CS for SB 1276 Ì564984VÎ564984 LEGISLATIVE ACTION Senate . House . . . Floor: WD/2R . 04/30/2014 02:00 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Soto moved the following: 1 Senate Amendment (with title amendment) 2 3 Between lines 146 and 147 4 insert: 5 Section 4. 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 ananyentity 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 ananyentity 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 ananyentity 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 ananyentity 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, aanycommunity college or university clinic, 76 and ananyentity 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 mustshallcontain 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 22 180 and insert: 181 expiration; amending s. 400.9905, F.S.; exempting 182 certain federally certified clinics from licensure; 183 providing an effective date.