Florida Senate - 2015                                    SB 1146
       By Senator Simmons
       10-00698B-15                                          20151146__
    1                        A bill to be entitled                      
    2         An act relating to agency relationships with
    3         governmental health care contractors; amending s.
    4         766.1115, F.S.; redefining terms; deleting an obsolete
    5         date; extending sovereign immunity to employees or
    6         agents of a health care provider that executes a
    7         contract with a governmental contractor; authorizing
    8         such health care provider to collect from a patient,
    9         or the parent or guardian of a patient, a nominal fee
   10         for administrative costs under certain circumstances;
   11         limiting the nominal fee; clarifying that a receipt of
   12         specified notice must be acknowledged by a patient or
   13         the patient’s representative at the initial visit;
   14         requiring the posting of notice that a specified
   15         health care provider is an agent of a governmental
   16         contractor; amending s. 768.28, F.S.; redefining the
   17         term “officer, employee, or agent” to include
   18         employees or agents of a health care provider;
   19         providing an effective date.
   21  Be It Enacted by the Legislature of the State of Florida:
   23         Section 1. Paragraphs (a) and (d) of subsection (3) and
   24  subsections (4) and (5) of section 766.1115, Florida Statutes,
   25  are amended to read:
   26         766.1115 Health care providers; creation of agency
   27  relationship with governmental contractors.—
   28         (3) DEFINITIONS.—As used in this section, the term:
   29         (a) “Contract” means an agreement executed in compliance
   30  with this section between a health care provider and a
   31  governmental contractor which allows the health care provider,
   32  or any employee or agent of the health care provider, to deliver
   33  health care services to low-income recipients as an agent of the
   34  governmental contractor. The contract must be for volunteer,
   35  uncompensated services, except as provided in paragraph (4)(g).
   36  For services to qualify as volunteer, uncompensated services
   37  under this section, the health care provider must receive no
   38  compensation from the governmental contractor for any services
   39  provided under the contract and must not bill or accept
   40  compensation from the recipient, or a public or private third
   41  party payor, for the specific services provided to the low
   42  income recipients covered by the contract, except as provided in
   43  paragraphs(4)(g) and (h).
   44         (d) “Health care provider” or “provider” means:
   45         1. A birth center licensed under chapter 383.
   46         2. An ambulatory surgical center licensed under chapter
   47  395.
   48         3. A hospital licensed under chapter 395.
   49         4. A physician or physician assistant licensed under
   50  chapter 458.
   51         5. An osteopathic physician or osteopathic physician
   52  assistant licensed under chapter 459.
   53         6. A chiropractic physician licensed under chapter 460.
   54         7. A podiatric physician licensed under chapter 461.
   55         8. A registered nurse, nurse midwife, licensed practical
   56  nurse, or advanced registered nurse practitioner licensed or
   57  registered under part I of chapter 464 or any facility which
   58  employs nurses licensed or registered under part I of chapter
   59  464 to supply all or part of the care delivered under this
   60  section.
   61         9. A midwife licensed under chapter 467.
   62         10. A health maintenance organization certificated under
   63  part I of chapter 641.
   64         11. A health care professional association and its
   65  employees or a corporate medical group and its employees.
   66         12. Any other medical facility the primary purpose of which
   67  is to deliver human medical diagnostic services or which
   68  delivers nonsurgical human medical treatment, and which includes
   69  an office maintained by a provider.
   70         13. A dentist or dental hygienist licensed under chapter
   71  466.
   72         14. A free clinic that delivers only medical diagnostic
   73  services or nonsurgical medical treatment free of charge to all
   74  low-income recipients, except as provided in paragraph (4)(h).
   75         15. Any other health care professional, practitioner,
   76  provider, or facility under contract with a governmental
   77  contractor, including a student enrolled in an accredited
   78  program that prepares the student for licensure as any one of
   79  the professionals listed in subparagraphs 4.-9.
   81  The term includes any nonprofit corporation qualified as exempt
   82  from federal income taxation under s. 501(a) of the Internal
   83  Revenue Code, and described in s. 501(c) of the Internal Revenue
   84  Code, which delivers health care services provided by licensed
   85  professionals listed in this paragraph, any federally funded
   86  community health center, and any volunteer corporation or
   87  volunteer health care provider that delivers health care
   88  services.
   89         (4) CONTRACT REQUIREMENTS.—A health care provider that
   90  executes a contract with a governmental contractor to deliver
   91  health care services on or after April 17, 1992, as an agent of
   92  the governmental contractor, or any employee or agent of such
   93  health care provider, is an agent for purposes of s. 768.28(9),
   94  while acting within the scope of duties under the contract, if
   95  the contract complies with the requirements of this section and
   96  regardless of whether the individual treated is later found to
   97  be ineligible. A health care provider, or any employee or agent
   98  of the health care provider, shall continue to be an agent for
   99  purposes of s. 768.28(9) for 30 days after a determination of
  100  ineligibility to allow for treatment until the individual
  101  transitions to treatment by another health care provider. A
  102  health care provider under contract with the state, or any
  103  employee or agent of such health care provider, may not be named
  104  as a defendant in any action arising out of medical care or
  105  treatment provided on or after April 17, 1992, under contracts
  106  entered into under this section. The contract must provide that:
  107         (a) The right of dismissal or termination of any health
  108  care provider delivering services under the contract is retained
  109  by the governmental contractor.
  110         (b) The governmental contractor has access to the patient
  111  records of any health care provider delivering services under
  112  the contract.
  113         (c) Adverse incidents and information on treatment outcomes
  114  must be reported by any health care provider to the governmental
  115  contractor if the incidents and information pertain to a patient
  116  treated under the contract. The health care provider shall
  117  submit the reports required by s. 395.0197. If an incident
  118  involves a professional licensed by the Department of Health or
  119  a facility licensed by the Agency for Health Care
  120  Administration, the governmental contractor shall submit such
  121  incident reports to the appropriate department or agency, which
  122  shall review each incident and determine whether it involves
  123  conduct by the licensee that is subject to disciplinary action.
  124  All patient medical records and any identifying information
  125  contained in adverse incident reports and treatment outcomes
  126  which are obtained by governmental entities under this paragraph
  127  are confidential and exempt from the provisions of s. 119.07(1)
  128  and s. 24(a), Art. I of the State Constitution.
  129         (d) Patient selection and initial referral must be made by
  130  the governmental contractor or the provider. Patients may not be
  131  transferred to the provider based on a violation of the
  132  antidumping provisions of the Omnibus Budget Reconciliation Act
  133  of 1989, the Omnibus Budget Reconciliation Act of 1990, or
  134  chapter 395.
  135         (e) If emergency care is required, the patient need not be
  136  referred before receiving treatment, but must be referred within
  137  48 hours after treatment is commenced or within 48 hours after
  138  the patient has the mental capacity to consent to treatment,
  139  whichever occurs later.
  140         (f) The provider is subject to supervision and regular
  141  inspection by the governmental contractor.
  142         (g) As an agent of the governmental contractor for purposes
  143  of s. 768.28(9), while acting within the scope of duties under
  144  the contract, A health care provider licensed under chapter 466,
  145  as an agent of the governmental contractor for purposes of s.
  146  768.28(9), may allow a patient, or a parent or guardian of the
  147  patient, to voluntarily contribute a monetary amount to cover
  148  costs of dental laboratory work related to the services provided
  149  to the patient within the scope of duties under the contract.
  150  This contribution may not exceed the actual cost of the dental
  151  laboratory charges.
  152         (h)A health care provider, as an agent of the governmental
  153  contractor for purposes of s. 768.28(9), may collect from a
  154  patient, or a parent or guardian of the patient, a nominal fee
  155  for administrative costs related to the services provided to the
  156  patient under the contract. For purposes of this paragraph, a
  157  nominal fee may not exceed $10.
  159  A governmental contractor that is also a health care provider is
  160  not required to enter into a contract under this section with
  161  respect to the health care services delivered by its employees.
  162         (5) NOTICE OF AGENCY RELATIONSHIP.—The governmental
  163  contractor must provide written notice to each patient, or the
  164  patient’s legal representative, receipt of which must be
  165  acknowledged in writing at the initial visit, that the provider
  166  is an agent of the governmental contractor and that the
  167  exclusive remedy for injury or damage suffered as the result of
  168  any act or omission of the provider or of any employee or agent
  169  thereof acting within the scope of duties pursuant to the
  170  contract is by commencement of an action pursuant to the
  171  provisions of s. 768.28. Thereafter, and with respect to any
  172  federally funded community health center, the notice
  173  requirements may be met by posting in a place conspicuous to all
  174  persons a notice that the health care provider federally funded
  175  community health center is an agent of the governmental
  176  contractor and that the exclusive remedy for injury or damage
  177  suffered as the result of any act or omission of the provider or
  178  of any employee or agent thereof acting within the scope of
  179  duties pursuant to the contract is by commencement of an action
  180  pursuant to the provisions of s. 768.28.
  181         Section 2. Paragraph (b) of subsection (9) of section
  182  768.28, Florida Statutes, is amended to read:
  183         768.28 Waiver of sovereign immunity in tort actions;
  184  recovery limits; limitation on attorney fees; statute of
  185  limitations; exclusions; indemnification; risk management
  186  programs.—
  187         (9)
  188         (b) As used in this subsection, the term:
  189         1. “Employee” includes any volunteer firefighter.
  190         2. “Officer, employee, or agent” includes, but is not
  191  limited to, any health care provider, and its employees or
  192  agents, when providing services pursuant to s. 766.1115; any
  193  nonprofit independent college or university located and
  194  chartered in this state which owns or operates an accredited
  195  medical school, and its employees or agents, when providing
  196  patient services pursuant to paragraph (10)(f); and any public
  197  defender or her or his employee or agent, including, among
  198  others, an assistant public defender and an investigator.
  199         Section 3. This act shall take effect July 1, 2015.