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