Florida Senate - 2015                        COMMITTEE AMENDMENT
       Bill No. CS for CS for SB 614
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: WD            .                                
                  04/20/2015           .                                

       The Committee on Rules (Benacquisto) recommended the following:
    1         Senate Amendment to Amendment (395678) (with title
    2  amendment)
    4         Between lines 830 and 831
    5  insert:
    6         Section 23. Section 288.924, Florida Statutes, is created
    7  to read:
    8         288.924 Medical tourism for quality health care services;
    9  medical tourism marketing advisory council and plan.—
   10         (1) ADVISORY COUNCIL FOR MEDICAL TOURISM.—The Advisory
   11  Council for Medical Tourism is created within the Florida
   12  Tourism Industry Marketing Corporation to serve as an advisory
   13  body to the Division of Tourism Industry Marketing Corporation
   14  within Enterprise Florida, Inc. The council shall provide
   15  insight and expertise related to developing, marketing, and
   16  promoting this state’s medical tourism industry.
   17         (2) MEMBERSHIP.—
   18         (a) The council shall consist of 12 members with three
   19  members appointed by the Governor, three members appointed by
   20  the President of the Senate, three members appointed by Speaker
   21  of the House of Representatives, and three members appointed by
   22  VISIT Florida, Inc. The council shall be chaired by the
   23  President and CEO of VISIT Florida or his or her designee.
   24         (b) Members shall be appointed to 4-year terms. All terms
   25  end on September 30. Initial appointments must be made by
   26  September 1, 2015. To allow for staggered terms, one appointee
   27  from each appointing official will serve a term of 2 years for
   28  the initial term.
   29         (c) A council member’s absence from three consecutive
   30  meetings will result in his or her automatic removal from the
   31  council.
   32         (d) No more than one member of the council may be an
   33  employee of a single company, organization, or association.
   34         (e) A council member is eligible for re-appointment, but
   35  may not serve more than two consecutive terms.
   36         (3) MEETINGS; ORGANIZATION.—
   37         (a) The council shall meet at least once per quarter, but
   38  may meet as often as the council deems necessary.
   39         (b) The Division of Tourism Marketing shall provide staff
   40  assistance to the council, whose duties must include, but are
   41  not limited to, keeping records of the proceedings of the
   42  council, and serving as custodian of all books, documents, and
   43  papers filed with the council.
   44         (c) A majority of the members of the council constitutes a
   45  quorum.
   46         (d) Council members are entitled to receive, from funds of
   47  the corporation, reimbursement for per diem and travel expenses
   48  as provided by s. 112.061.
   49         (4)POWERS AND DUTIES.— The council’s responsibilities
   50  include, but are not limited to:
   51         (a)Develop and implement a 4-year marketing plan in
   52  coordination with the Division of Tourism Marketing with
   53  specific initiatives to advance this state as a destination for
   54  medical tourism.
   55         (b)Adopt bylaws for the governance of council affairs and
   56  the conduct of its business under this act.
   57         (c)Advise the Florida Tourism Industry Marketing
   58  Corporation on its medical tourism program and any changes that
   59  might facilitate meeting the marketing plan objectives.
   60         (d) Consider and study the needs of the medical tourism
   61  industry for the purpose of advising the Florida Tourism
   62  Marketing Corporation.
   63         (e) Identify state and local government actions that may
   64  impact the medical tourism industry, or that may appear to
   65  industry representatives as affecting medical tourism in the
   66  state, and advising the Florida Tourism Industry Marketing
   67  Corporation of such actions.
   68         (f) Promote national and international awareness of the
   69  qualifications, scope of services, and specialized expertise of
   70  health care providers throughout this state; and
   71         (g) Promote national and international awareness of
   72  medical-related conferences, training, or business opportunities
   73  to attract practitioners from the medical field to destinations
   74  in this state.
   75         (h). Consider all matters submitted to it by the Florida
   76  Tourism Industry Marketing Corporation.
   77         (i) Suggest policies and practices that may improve
   78  interaction with the medical tourism industry and enhance
   79  related state economic development initiatives.
   80         (j) Establish an evaluation plan to determine the return on
   81  the use of investment of state and local funds for medical
   82  tourism or other mechanisms to determine the effectiveness of
   83  the state’s medical tourism plans.
   84         (5)ALLOCATION OF FUNDS FOR MARKETING PLAN.—Annually, at
   85  least $2 million of the funds appropriated in the General
   86  Appropriations Act to the Florida Tourism Industry Marketing
   87  Corporation shall be allocated for the development and
   88  implementation of the medical tourism marketing plan.
   89         (6) REPEAL.—This section is repealed July 1, 2020.
   90         Section 24. Paragraph (c) of subsection (4) of section
   91  288.923, Florida Statutes, is amended to read
   92         288.923 Division of Tourism Marketing; definitions;
   93  responsibilities.—
   94         (4) The division’s responsibilities and duties include, but
   95  are not limited to:
   96         (c) Developing a 4-year marketing plan.
   97         1. At a minimum, the marketing plan shall discuss the
   98  following:
   99         a. Continuation of overall tourism growth in this state.
  100         b. Expansion to new or under-represented tourist markets.
  101         c. Maintenance of traditional and loyal tourist markets.
  102         d. Coordination of efforts with county destination
  103  marketing organizations, other local government marketing
  104  groups, privately owned attractions and destinations, and other
  105  private sector partners to create a seamless, four-season
  106  advertising campaign for the state and its regions.
  107         e. Development of innovative techniques or promotions to
  108  build repeat visitation by targeted segments of the tourist
  109  population.
  110         f. Consideration of innovative sources of state funding for
  111  tourism marketing.
  112         g. Promotion of nature-based tourism and heritage tourism.
  113         h. Development of a component to address emergency response
  114  to natural and manmade disasters from a marketing standpoint.
  115         2. The plan shall be annual in construction and ongoing in
  116  nature. Any annual revisions of the plan shall carry forward the
  117  concepts of the remaining 3-year portion of the plan and
  118  consider a continuum portion to preserve the 4-year timeframe of
  119  the plan. The plan also shall include recommendations for
  120  specific performance standards and measurable outcomes for the
  121  division and direct-support organization. The department, in
  122  consultation with the board of directors of Enterprise Florida,
  123  Inc., shall base the actual performance metrics on these
  124  recommendations.
  125         3. The 4-year marketing plan shall be developed in
  126  collaboration with the Florida Tourism Industry Marketing
  127  Corporation. The plan shall be annually reviewed and approved by
  128  the board of directors of Enterprise Florida, Inc.
  129         (d) Developing a 4-year marketing plan for the promotion of
  130  medical tourism as provided under s. 288.924.
  131         Section 25. Section 296.42, Florida Statutes, is created to
  132  read:
  133         296.42 Site selection process for state veterans’ nursing
  134  homes.—
  135         (1) The department shall contract for a study to determine
  136  the need for new state veterans’ nursing homes and the most
  137  appropriate counties in which to locate the homes based on the
  138  greatest level of need. The department shall submit the study to
  139  the Governor, the President of the Senate, and the Speaker of
  140  the House of Representatives by November 1, 2015.
  141         (2) The study shall use the following criteria to rank each
  142  county according to need:
  143         (a) The distance from the geographic center of the county
  144  to the nearest existing state veterans’ nursing home.
  145         (b) The number of veterans age 65 years or older residing
  146  in the county.
  147         (c) The presence of an existing federal Veterans’ Health
  148  Administration medical center or outpatient clinic in the
  149  county.
  150         (d) Elements of emergency health care in the county, as
  151  determined by:
  152         1. The number of general hospitals.
  153         2. The number of emergency room holding beds per hospital.
  154  The term “emergency room holding bed” means a bed located in the
  155  emergency room of a hospital licensed under ch. 395 which is
  156  used for a patient admitted to the hospital through the
  157  emergency room, but is waiting for an available bed in an
  158  inpatient unit of the hospital.
  159         3. The number of employed physicians per hospital in the
  160  emergency room 24 hours per day.
  161         (e) The number of existing community nursing home beds per
  162  1,000 males age 65 years or older residing in the county.
  163         (f) The presence of an accredited educational institution
  164  offering health care programs in the county.
  165         (g) The county poverty rate.
  166         (3) For each new nursing home, the department shall select
  167  the highest-ranked county in the applicable study under this
  168  section which does not have a veterans’ nursing home. If the
  169  highest-ranked county cannot serve as the site, the department
  170  shall select the next-highest ranked county. The selection is
  171  subject to the approval of the Governor and Cabinet.
  172         (4) The department shall use the 2014 site selection study
  173  to select a county for any new state veterans’ nursing home
  174  authorized before November 1, 2015.
  175         (5) The department shall use the November 2015 site
  176  selection study ranking to select each new state veterans’
  177  nursing home site authorized before July 1, 2020.
  178         (6) The department shall contract for and submit a new site
  179  selection study to the Governor, the President of the Senate,
  180  and the Speaker of the House of Representatives using the county
  181  ranking criteria in paragraph (3) by November 1, 2019 for site
  182  selections on or after July 1, 2020. The department must conduct
  183  new site selection studies every 4 years using the county
  184  ranking criteria under paragraph (3) with each report due by
  185  November 1st for the selection period that begins the following
  186  July 1st.
  187         Section 26. Section 624.27, Florida Statutes, is created to
  188  read:
  189         624.27 Application of code as to direct primary care
  190  agreements.—
  191         (1) As used in this section, the term:
  192         (a) “Direct primary care agreement” means a contract
  193  between a primary care provider or primary care group practice
  194  and a patient, the patient’s legal representative, or an
  195  employer which must satisfy the criteria in subsection (4) and
  196  does not indemnify for services provided by a third party.
  197         (b) “Primary care provider” means a health care provider
  198  licensed under chapter 458, chapter 459, or chapter 464 who
  199  provides medical services to patients which are commonly
  200  provided without referral from another health care provider.
  201         (c) “Primary care service” means the screening, assessment,
  202  diagnosis, and treatment of a patient for the purpose of
  203  promoting health or detecting and managing disease or injury
  204  within the competency and training of the primary care provider.
  205         (2) A direct primary care agreement does not constitute
  206  insurance and is not subject to this code. The act of entering
  207  into a direct primary care agreement does not constitute the
  208  business of insurance and is not subject to this code.
  209         (3) A primary care provider or an agent of a primary care
  210  provider is not required to obtain a certificate of authority or
  211  license under this code to market, sell, or offer to sell a
  212  direct primary care agreement.
  213         (4) For purposes of this section, a direct primary care
  214  agreement must:
  215         (a) Be in writing.
  216         (b) Be signed by the primary care provider or an agent of
  217  the primary care provider and the patient or the patient’s legal
  218  representative.
  219         (c) Allow a party to terminate the agreement by written
  220  notice to the other party after a period specified in the
  221  agreement.
  222         (d) Describe the scope of the primary care services that
  223  are covered by the monthly fee.
  224         (e) Specify the monthly fee and any fees for primary care
  225  services not covered by the monthly fee.
  226         (f) Specify the duration of the agreement and any automatic
  227  renewal provisions.
  228         (g) Offer a refund to the patient of monthly fees paid in
  229  advance if the primary care provider ceases to offer primary
  230  care services for any reason.
  231         (h) State that the agreement is not health insurance.
  232         Section 26. Paragraphs (a) and (e) of subsection (3) and
  233  subsections (4) and (5) of section 766.1115, Florida Statutes,
  234  are amended to read:
  235         Section 27. Paragraphs (a) and (d) of subsection (3) and
  236  subsections (4) and (5) of section 766.1115, Florida Statutes,
  237  are amended to read:
  238         766.1115 Health care providers; creation of agency
  239  relationship with governmental contractors.—
  240         (3) DEFINITIONS.—As used in this section, the term:
  241         (a) “Contract” means an agreement executed in compliance
  242  with this section between a health care provider and a
  243  governmental contractor which allows the health care provider,
  244  or any employee or agent of the health care provider, to deliver
  245  health care services to low-income recipients as an agent of the
  246  governmental contractor. The contract must be for volunteer,
  247  uncompensated services, except as provided in paragraph (4)(g).
  248  For services to qualify as volunteer, uncompensated services
  249  under this section, the health care provider must receive no
  250  compensation from the governmental contractor for any services
  251  provided under the contract and must not bill or accept
  252  compensation from the recipient, or a public or private third
  253  party payor, for the specific services provided to the low
  254  income recipients covered by the contract, except as provided in
  255  paragraph (4)(g). A free clinic as described in subparagraph
  256  (3)(d)14. may receive a legislative appropriation, a grant
  257  through a legislative appropriation, or a grant from a
  258  governmental entity or nonprofit corporation to support the
  259  delivery of such contracted services by volunteer health care
  260  providers, including the employment of health care providers to
  261  supplement, coordinate, or support the delivery of services by
  262  volunteer health care providers. Such an appropriation or grant
  263  does not constitute compensation under this paragraph from the
  264  governmental contractor for services provided under the
  265  contract, nor does receipt and use of the appropriation or grant
  266  constitute the acceptance of compensation under this paragraph
  267  for the specific services provided to the low-income recipients
  268  covered by the contract.
  269         (d) “Health care provider” or “provider” means:
  270         1. A birth center licensed under chapter 383.
  271         2. An ambulatory surgical center licensed under chapter
  272  395.
  273         3. A hospital licensed under chapter 395.
  274         4. A physician or physician assistant licensed under
  275  chapter 458.
  276         5. An osteopathic physician or osteopathic physician
  277  assistant licensed under chapter 459.
  278         6. A chiropractic physician licensed under chapter 460.
  279         7. A podiatric physician licensed under chapter 461.
  280         8. A registered nurse, nurse midwife, licensed practical
  281  nurse, or advanced registered nurse practitioner licensed or
  282  registered under part I of chapter 464 or any facility which
  283  employs nurses licensed or registered under part I of chapter
  284  464 to supply all or part of the care delivered under this
  285  section.
  286         9. A midwife licensed under chapter 467.
  287         10. A health maintenance organization certificated under
  288  part I of chapter 641.
  289         11. A health care professional association and its
  290  employees or a corporate medical group and its employees.
  291         12. Any other medical facility the primary purpose of which
  292  is to deliver human medical diagnostic services or which
  293  delivers nonsurgical human medical treatment, and which includes
  294  an office maintained by a provider.
  295         13. A dentist or dental hygienist licensed under chapter
  296  466.
  297         14. A free clinic that delivers only medical diagnostic
  298  services or nonsurgical medical treatment free of charge to all
  299  low-income recipients.
  300         15. Any other health care professional, practitioner,
  301  provider, or facility under contract with a governmental
  302  contractor, including a student enrolled in an accredited
  303  program that prepares the student for licensure as any one of
  304  the professionals listed in subparagraphs 4.-9.
  306  The term includes any nonprofit corporation qualified as exempt
  307  from federal income taxation under s. 501(a) of the Internal
  308  Revenue Code, and described in s. 501(c) of the Internal Revenue
  309  Code, which delivers health care services provided by licensed
  310  professionals listed in this paragraph, any federally funded
  311  community health center, and any volunteer corporation or
  312  volunteer health care provider that delivers health care
  313  services.
  314         (4) CONTRACT REQUIREMENTS.—A health care provider that
  315  executes a contract with a governmental contractor to deliver
  316  health care services on or after April 17, 1992, as an agent of
  317  the governmental contractor, or any employee or agent of such
  318  health care provider, is an agent for purposes of s. 768.28(9),
  319  while acting within the scope of duties under the contract, if
  320  the contract complies with the requirements of this section and
  321  regardless of whether the individual treated is later found to
  322  be ineligible. A health care provider, or any employee or agent
  323  of the health care provider, shall continue to be an agent for
  324  purposes of s. 768.28(9) for 30 days after a determination of
  325  ineligibility to allow for treatment until the individual
  326  transitions to treatment by another health care provider. A
  327  health care provider under contract with the state, or any
  328  employee or agent of such health care provider, may not be named
  329  as a defendant in any action arising out of medical care or
  330  treatment provided on or after April 17, 1992, under contracts
  331  entered into under this section. The contract must provide that:
  332         (a) The right of dismissal or termination of any health
  333  care provider delivering services under the contract is retained
  334  by the governmental contractor.
  335         (b) The governmental contractor has access to the patient
  336  records of any health care provider delivering services under
  337  the contract.
  338         (c) Adverse incidents and information on treatment outcomes
  339  must be reported by any health care provider to the governmental
  340  contractor if the incidents and information pertain to a patient
  341  treated under the contract. The health care provider shall
  342  submit the reports required by s. 395.0197. If an incident
  343  involves a professional licensed by the Department of Health or
  344  a facility licensed by the Agency for Health Care
  345  Administration, the governmental contractor shall submit such
  346  incident reports to the appropriate department or agency, which
  347  shall review each incident and determine whether it involves
  348  conduct by the licensee that is subject to disciplinary action.
  349  All patient medical records and any identifying information
  350  contained in adverse incident reports and treatment outcomes
  351  which are obtained by governmental entities under this paragraph
  352  are confidential and exempt from the provisions of s. 119.07(1)
  353  and s. 24(a), Art. I of the State Constitution.
  354         (d) Patient selection and initial referral must be made by
  355  the governmental contractor or the provider. Patients may not be
  356  transferred to the provider based on a violation of the
  357  antidumping provisions of the Omnibus Budget Reconciliation Act
  358  of 1989, the Omnibus Budget Reconciliation Act of 1990, or
  359  chapter 395.
  360         (e) If emergency care is required, the patient need not be
  361  referred before receiving treatment, but must be referred within
  362  48 hours after treatment is commenced or within 48 hours after
  363  the patient has the mental capacity to consent to treatment,
  364  whichever occurs later.
  365         (f) The provider is subject to supervision and regular
  366  inspection by the governmental contractor.
  367         (g) As an agent of the governmental contractor for purposes
  368  of s. 768.28(9), while acting within the scope of duties under
  369  the contract, A health care provider licensed under chapter 466,
  370  as an agent of the governmental contractor for purposes of s.
  371  768.28(9), may allow a patient, or a parent or guardian of the
  372  patient, to voluntarily contribute a monetary amount to cover
  373  costs of dental laboratory work related to the services provided
  374  to the patient within the scope of duties under the contract.
  375  This contribution may not exceed the actual cost of the dental
  376  laboratory charges.
  378  A governmental contractor that is also a health care provider is
  379  not required to enter into a contract under this section with
  380  respect to the health care services delivered by its employees.
  381         (5) NOTICE OF AGENCY RELATIONSHIP.—The governmental
  382  contractor must provide written notice to each patient, or the
  383  patient’s legal representative, receipt of which must be
  384  acknowledged in writing at the initial visit, that the provider
  385  is an agent of the governmental contractor and that the
  386  exclusive remedy for injury or damage suffered as the result of
  387  any act or omission of the provider or of any employee or agent
  388  thereof acting within the scope of duties pursuant to the
  389  contract is by commencement of an action pursuant to the
  390  provisions of s. 768.28. Thereafter, and with respect to any
  391  federally funded community health center, the notice
  392  requirements may be met by posting in a place conspicuous to all
  393  persons a notice that the health care provider federally funded
  394  community health center is an agent of the governmental
  395  contractor and that the exclusive remedy for injury or damage
  396  suffered as the result of any act or omission of the provider or
  397  of any employee or agent thereof acting within the scope of
  398  duties pursuant to the contract is by commencement of an action
  399  pursuant to the provisions of s. 768.28.
  400         Section 28.  Section 7. Paragraph (b) of subsection (9) of
  401  section 768.28, Florida Statutes, is amended to read:
  402         768.28 Waiver of sovereign immunity in tort actions;
  403  recovery limits; limitation on attorney fees; statute of
  404  limitations; exclusions; indemnification; risk management
  405  programs.—
  406         (9)
  407         (b) As used in this subsection, the term:
  408         1. “Employee” includes any volunteer firefighter.
  409         2. “Officer, employee, or agent” includes, but is not
  410  limited to, any health care provider, and its employees or
  411  agents, when providing services pursuant to s. 766.1115; any
  412  nonprofit independent college or university located and
  413  chartered in this state which owns or operates an accredited
  414  medical school, and its employees or agents, when providing
  415  patient services pursuant to paragraph (10)(f); and any public
  416  defender or her or his employee or agent, including, among
  417  others, an assistant public defender and an investigator.
  420  ================= T I T L E  A M E N D M E N T ================
  421  And the title is amended as follows:
  422         Delete lines 882 - 962
  423  and insert:
  424         An act relating to access to health care services;
  425         amending s. 110.12315, F.S.; expanding the categories
  426         of persons who may prescribe brand drugs under the
  427         prescription drug program when medically necessary;
  428         amending ss. 310.071, 310.073, and 310.081, F.S.;
  429         exempting controlled substances prescribed by an
  430         advanced registered nurse practitioner or a physician
  431         assistant from the disqualifications for certification
  432         or licensure, and for continued certification or
  433         licensure, as a deputy pilot or state pilot; repealing
  434         s. 383.336, F.S., relating to provider hospitals,
  435         practice parameters, and peer review boards; amending
  436         s. 395.1051, F.S.; requiring a hospital to notify
  437         certain obstetrical physicians within a specified
  438         timeframe before the hospital closes its obstetrical
  439         department or ceases to provide obstetrical services;
  440         amending s. 456.072, F.S.; applying existing penalties
  441         for violations relating to the prescribing or
  442         dispensing of controlled substances by an advanced
  443         registered nurse practitioner; amending s. 456.44,
  444         F.S.; deleting an obsolete date; requiring advanced
  445         registered nurse practitioners and physician
  446         assistants who prescribe controlled substances for
  447         certain pain to make a certain designation, comply
  448         with registration requirements, and follow specified
  449         standards of practice; requiring certain respective
  450         entities review the information to determine whether
  451         disciplinary action is appropriate; requiring the
  452         respective board to forward certain findings to the
  453         Board of Nursing; providing applicability; amending s.
  454         458.326, F.S.; defining the term “interventional pain
  455         medicine”; limiting the practice of interventional
  456         pain medicine to specified circumstances; amending ss.
  457         458.3265 and 459.0137, F.S.; limiting the authority to
  458         prescribe a controlled substance in a pain-management
  459         clinic to a physician licensed under ch. 458 or ch.
  460         459, F.S.; amending s. 458.347, F.S.; revising the
  461         required continuing education requirements for a
  462         physician assistant; amending s. 458.347, F.S.;
  463         requiring the Council of Physician Assistants to
  464         create a formulary which includes the controlled
  465         substances a physician assistant is authorized to
  466         prescribe; amending s. 464.003, F.S.; revising the
  467         definition of the term “advanced or specialized
  468         nursing practice”; deleting the joint committee
  469         established in the definition; amending s. 464.012,
  470         F.S.; requiring the Board of Nursing to establish a
  471         committee make recommendations regarding the need for
  472         adoption of a formulary of controlled substances that
  473         may be prescribed by an advanced registered nurse
  474         practitioner; specifying the membership of the
  475         committee; providing parameters for the
  476         recommendations of the committee; requiring that any
  477         formulary be adopted by board rule; specifying the
  478         process for amending the formulary and imposing a
  479         burden of proof; limiting the formulary’s application
  480         in certain instances; requiring the board to adopt the
  481         committee’s initial recommendations by a specified
  482         date; amending s. 464.012, F.S.; authorizing an
  483         advanced registered nurse practitioner to prescribe,
  484         dispense, administer, or order drugs, rather than to
  485         monitor and alter drug therapies; providing an
  486         exception; amending s. 464.013, F.S.; revising
  487         conditions for renewal of a license or certificate;
  488         amending s. 464.018, F.S.; specifying acts that
  489         constitute grounds for denial of a license or for
  490         disciplinary action against an advanced registered
  491         nurse practitioner; requiring that in certain
  492         disciplinary cases, the board notify certain entities
  493         and forward all materials to the respective board;
  494         amending s. 893.02, F.S.; redefining the term
  495         “practitioner” to include advanced registered nurse
  496         practitioners and physician assistants under the
  497         Florida Comprehensive Drug Abuse Prevention and
  498         Control Act; amending s. 948.03, F.S.; providing that
  499         possession of drugs or narcotics prescribed by an
  500         advanced registered nurse practitioner or physician
  501         assistant does not violate a prohibition relating to
  502         the possession of drugs or narcotics during probation;
  503         amending s. 288.923, F.S.; requiring the Division of
  504         Tourism Marketing to prepare a 4-year plan for the
  505         promotion of medical tourism for quality health care
  506         services; creating s. 288.924, F.S.; creating the
  507         Medical Tourism Advisory Council; designating
  508         membership terms and responsibilities for the council;
  509         allocating funds from the corporation to the council
  510         for development of the medical tourism marketing plan;
  511         creating s. 296.42, F.S.; directing the Department of
  512         Veterans’ Affairs to contract for a study to determine
  513         the need and location for additional state veterans’
  514         nursing homes; directing the department to submit the
  515         study to the Governor and Legislature; providing study
  516         criteria for ranking each county according to need;
  517         providing site selection criteria; requiring approval
  518         of the Governor and Cabinet for site selection;
  519         requiring the department to use specified studies to
  520         select new nursing home sites; directing the
  521         department to contract for subsequent studies and
  522         submit the studies to the Governor and Legislature;
  523         creating s. 624.27, F.S.; providing definitions;
  524         specifying that a direct primary care agreement does
  525         not constitute insurance and is not subject to the
  526         Florida Insurance Code; specifying that entering into
  527         a direct primary care agreement does not constitute
  528         the business of insurance and is not subject to the
  529         code; providing that a health care provider is not
  530         required to obtain a certificate of authority to
  531         market, sell, or offer to sell a direct primary care
  532         agreement; specifying criteria for a direct primary
  533         care agreement; amending s. 766.1115, F.S.; redefining
  534         terms relating to agency relationships with
  535         governmental health care contractors; deleting an
  536         obsolete date; extending sovereign immunity to
  537         employees or agents of a health care provider that
  538         executes a contract with a governmental contractor;
  539         clarifying that a receipt of specified notice must be
  540         acknowledged by a patient or the patient’s
  541         representative at the initial visit; requiring the
  542         posting of notice that a specified health care
  543         provider is an agent of a governmental contractor;
  544         amending s. 768.28, F.S.; redefining the term
  545         “officer, employee, or agent” to include employees or
  546         agents of a health care provider; conforming