Florida Senate - 2025             CONFERENCE COMMITTEE AMENDMENT
       Bill No. SB 2514
       
       
       
       
       
       
                                Ì225196?Î225196                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                 Floor: AD/CR          .           Floor: AD            
             06/16/2025 09:54 PM       .      06/16/2025 10:20 PM       
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       The Conference Committee on SB 2514 recommended the following:
       
    1         Senate Conference Committee Amendment (with title
    2  amendment)
    3  
    4         Delete everything after the enacting clause
    5  and insert:
    6         Section 1. Present subsections (5) through (10) of section
    7  381.4019, Florida Statutes, are redesignated as subsections (6)
    8  through (11), respectively, and a new subsection (5) is added to
    9  that section, to read:
   10         381.4019 Dental Student Loan Repayment Program.—The Dental
   11  Student Loan Repayment Program is established to support the
   12  state Medicaid program and promote access to dental care by
   13  supporting qualified dentists and dental hygienists who treat
   14  medically underserved populations in dental health professional
   15  shortage areas or medically underserved areas.
   16         (5) A dental student or dental hygiene student who
   17  demonstrates an offer of employment in a public health program
   18  or private practice as specified in paragraph (2)(a) may apply
   19  for the loan program before obtaining active employment but may
   20  not be awarded funds from the loan program until he or she meets
   21  the requirements of subsection (2).
   22         Section 2. Present paragraphs (c), (d), and (e) of
   23  subsection (3) and present subsections (12) and (13) of section
   24  381.915, Florida Statutes, are redesignated as paragraphs (d),
   25  (e), and (f) of subsection (3) and subsections (13) and (14),
   26  respectively, a new paragraph (c) is added to subsection (3),
   27  paragraph (d) is added to subsection (10), a new subsection (12)
   28  is added to that section, and paragraph (b) and present
   29  paragraph (c) of subsection (3), paragraphs (a), (b), (e), (f),
   30  and (h) of subsection (8), and subsections (9) and (11) of that
   31  section are amended, to read:
   32         381.915 Casey DeSantis Cancer Research Program.—
   33         (3) On or before September 15 of each year, the department
   34  shall calculate an allocation fraction to be used for
   35  distributing funds to participating cancer centers. On or before
   36  the final business day of each quarter of the state fiscal year,
   37  the department shall distribute to each participating cancer
   38  center one-fourth of that cancer center’s annual allocation
   39  calculated under subsection (6). The allocation fraction for
   40  each participating cancer center is based on the cancer center’s
   41  tier-designated weight under subsection (4) multiplied by each
   42  of the following allocation factors based on activities in this
   43  state: number of reportable cases, peer-review costs, and
   44  biomedical education and training. As used in this section, the
   45  term:
   46         (b) “Cancer center” means a comprehensive center with at
   47  least one geographic site in the state, a freestanding center
   48  located in the state, a center situated within an academic
   49  institution, or a Florida-based formal research-based consortium
   50  under centralized leadership that has achieved NCI designation
   51  or is prepared to achieve NCI designation by June 30, 2024.
   52         (c) “Cancer Connect Collaborative” or “collaborative” means
   53  the council created under subsection (8).
   54         (d)(c) “Florida-based” means that a cancer center’s actual
   55  or sought designated status is or would be recognized by the NCI
   56  as primarily located in Florida and not in another state, or
   57  that a health care provider or facility is physically located in
   58  Florida and provides services in Florida.
   59         (8) The Cancer Connect Collaborative, a council as defined
   60  in s. 20.03, is created within the department to advise the
   61  department and the Legislature on developing a holistic approach
   62  to the state’s efforts to fund cancer research, cancer
   63  facilities, and treatments for cancer patients. The
   64  collaborative may make recommendations on proposed legislation,
   65  proposed rules, best practices, data collection and reporting,
   66  issuance of grant funds, and other proposals for state policy
   67  relating to cancer research or treatment.
   68         (a) The Surgeon General shall serve as an ex officio,
   69  nonvoting member of the collaborative and shall serve as the
   70  chair.
   71         (b) The collaborative shall be composed of the following
   72  voting members, to be appointed by September 1, 2024:
   73         1. Two members appointed by the Governor, three members one
   74  member appointed by the President of the Senate, and three
   75  members one member appointed by the Speaker of the House of
   76  Representatives, based on the criteria of this subparagraph. The
   77  appointing officers shall make their appointments prioritizing
   78  members who have the following experience or expertise:
   79         a. The practice of a health care profession specializing in
   80  oncology clinical care or research;
   81         b. The development of preventive and therapeutic treatments
   82  to control cancer;
   83         c. The development of innovative research into the causes
   84  of cancer, the development of effective treatments for persons
   85  with cancer, or cures for cancer; or
   86         d. Management-level experience with a cancer center
   87  licensed under chapter 395.
   88         2. One member who is a resident of this state who can
   89  represent the interests of cancer patients in this state,
   90  appointed by the Governor.
   91         (e) Members of the collaborative whose terms have expired
   92  may continue to serve until replaced or reappointed, but for no
   93  more than 6 months after the expiration of their terms.
   94         (f) Members of the collaborative shall serve without
   95  compensation but are entitled to reimbursement for per diem and
   96  travel expenses pursuant to s. 112.061.
   97         (h) The collaborative shall develop a long-range
   98  comprehensive plan for the Casey DeSantis Cancer Research
   99  Program. In the development of the plan, the collaborative must
  100  solicit input from cancer centers, research institutions,
  101  biomedical education institutions, hospitals, and medical
  102  providers. The collaborative shall submit the plan to the
  103  Governor, the President of the Senate, and the Speaker of the
  104  House of Representatives no later than December 1, 2024. The
  105  plan must include, but need not be limited to, all of the
  106  following components:
  107         1. Expansion of grant fund opportunities to include a
  108  broader pool of Florida-based cancer centers, research
  109  institutions, biomedical education institutions, hospitals, and
  110  medical providers to receive funding through the Cancer
  111  Innovation Fund.
  112         2. An evaluation to determine metrics that focus on patient
  113  outcomes, quality of care, and efficacy of treatment.
  114         3. A compilation of best practices relating to cancer
  115  research or treatment.
  116         (9)(a) The collaborative shall advise the department on the
  117  awarding of grants issued through the Cancer Innovation Fund.
  118  During any fiscal year for which funds are appropriated to the
  119  fund, the collaborative shall review all submitted grant
  120  applications using the parameters provided in paragraph (c) and
  121  make recommendations to the department for awarding grants to
  122  support innovative cancer research and treatment models,
  123  including emerging research and treatment trends and promising
  124  treatments that may serve as catalysts for further research and
  125  treatments. The department shall make the final grant allocation
  126  awards. The collaborative shall give priority to applications
  127  seeking to expand the reach of cancer screening efforts and
  128  innovative cancer treatment models into underserved areas of
  129  this state.
  130         (b) To be eligible for grant funding under this subsection,
  131  a licensed or certified health care provider, facility, or
  132  entity must meet at least one of the following criteria:
  133         1. Operates as a licensed hospital that has a minimum of 30
  134  percent of its current cancer patients residing in rural or
  135  underserved areas.
  136         2. Operates as a licensed health care clinic or facility
  137  that employs or contracts with at least one physician licensed
  138  under chapter 458 or chapter 459 who is board certified in
  139  oncology and that administers chemotherapy treatments for
  140  cancer.
  141         3. Operates as a licensed facility that employs or
  142  contracts with at least one physician licensed under chapter 458
  143  or chapter 459 who is board certified in oncology and that
  144  administers radiation therapy treatments for cancer.
  145         4. Operates as a licensed health care clinic or facility
  146  that provides cancer screening services at no cost or a minimal
  147  cost to patients.
  148         5. Operates as a rural hospital as defined in s.
  149  395.602(2)(b).
  150         6. Operates as a critical access hospital as defined in s.
  151  408.07(14).
  152         7. Operates as a specialty hospital as defined in s.
  153  395.002(28)(a) which provides cancer treatment for patients from
  154  birth to 18 years of age.
  155         8. Operates as a licensed hospital that is accredited by
  156  the American College of Surgeons as a Comprehensive Community
  157  Cancer Program or Integrated Network Cancer Program.
  158         9. Engages in biomedical research intended to develop
  159  therapies, medical pharmaceuticals, treatment protocols, or
  160  medical procedures intended to cure cancer or improve the
  161  quality of life of cancer patients.
  162         10. Educates or trains students, postdoctoral fellows, or
  163  licensed or certified health care practitioners in the
  164  screening, diagnosis, or treatment of cancer.
  165         (c) To ensure that all proposals for grant funding issued
  166  through the Cancer Innovation Fund are appropriate and are
  167  evaluated fairly on the basis of scientific merit, the
  168  department shall appoint peer review panels of independent,
  169  scientifically qualified individuals to review the scientific
  170  merit of each proposal and establish its priority score. The
  171  priority scores must be forwarded to the collaborative and must
  172  be considered in determining which proposals the collaborative
  173  recommends for grant funding through the Cancer Innovation Fund.
  174         (d) The collaborative and the peer review panels shall
  175  establish and follow rigorous guidelines for ethical conduct and
  176  adhere to a strict policy with regard to conflicts of interest
  177  regarding the assessment of Cancer Innovation Fund grant
  178  applications. A member of the collaborative or a panel may not
  179  participate in any discussion or decision of the collaborative
  180  or a panel with respect to a research proposal by any firm,
  181  entity, or agency with which the member is associated as a
  182  member of the governing body or as an employee or with which the
  183  member has entered into a contractual arrangement.
  184         (e) Beginning December 1, 2025, and annually thereafter,
  185  the collaborative shall prepare and submit a report to the
  186  Governor, the President of the Senate, and the Speaker of the
  187  House of Representatives which identifies and evaluates the
  188  performance and the impact of grants issued through the Cancer
  189  Innovation Fund on cancer treatment, research, screening,
  190  diagnosis, prevention, practitioner training, workforce
  191  education, and cancer patient survivorship. The report must
  192  include all of the following:
  193         1. Amounts of grant funds awarded to each recipient.
  194         2. Descriptions of each recipient’s research or project
  195  which include, but need not be limited to, the following:
  196         a.Goals or projected outcomes.
  197         b.Population to be served.
  198         c.Research methods or project implementation plan.
  199         3.An assessment of grant recipients which evaluates their
  200  progress toward achieving objectives specified in each
  201  recipient’s grant application.
  202         4.Recommendations for best practices that may be
  203  implemented by health care providers in this state who diagnose,
  204  treat, and screen for cancer, based on the outcomes of projects
  205  funded through the Cancer Innovation Fund.
  206         (10) Beginning July 1, 2025, and each year thereafter, the
  207  department, in conjunction with participating cancer centers,
  208  shall submit a report to the Cancer Control and Research
  209  Advisory Council and the collaborative on specific metrics
  210  relating to cancer mortality and external funding for cancer
  211  related research in this state. If a cancer center does not
  212  endorse this report or produce an equivalent independent report,
  213  the cancer center is ineligible to receive program funding for 1
  214  year. The department must submit this annual report, and any
  215  equivalent independent reports, to the Governor, the President
  216  of the Senate, and the Speaker of the House of Representatives
  217  no later than September 15 of each year the report or reports
  218  are submitted by the department. The report must include:
  219         (d) A description of the numbers and types of cancer cases
  220  treated annually at each participating cancer center, including
  221  reportable and nonreportable cases.
  222         (11) Beginning July 1, 2025 2024, each allocation agreement
  223  issued by the department relating to cancer center payments
  224  under paragraph (2)(a) subsection (2) must include all of the
  225  following:
  226         (a) A line-item budget narrative documenting the annual
  227  allocation of funds to a cancer center.
  228         (b) A cap on the annual award of 15 percent for
  229  administrative expenses.
  230         (c) A requirement for the cancer center to submit quarterly
  231  reports of all expenditures made by the cancer center with funds
  232  received through the Casey DeSantis Cancer Research Program.
  233         (d) A provision to allow the department and other state
  234  auditing bodies to audit all financial records, supporting
  235  documents, statistical records, and any other documents
  236  pertinent to the allocation agreement.
  237         (e) A provision requiring the annual reporting of outcome
  238  data and protocols used in achieving those outcomes.
  239         (12)(a)The Legislature finds that targeted areas of cancer
  240  research require increased resources and that Florida should
  241  become a leader in promoting research opportunities for these
  242  targeted areas. Floridians should not have to leave the state to
  243  receive the most advanced cancer care and treatment. To meet
  244  this need, the Cancer Connect Collaborative Research Incubator,
  245  or “incubator” as used in this subsection, is created within the
  246  department, to be overseen by the collaborative, to provide
  247  funding for a targeted area of cancer research over a 5-year
  248  period. For the 5-year period beginning July 1, 2025, the
  249  incubator’s targeted area of cancer research is pediatric
  250  cancer.
  251         (b)Contingent upon the appropriation of funds by the
  252  Legislature, grants issued through the incubator must be awarded
  253  through a peer-reviewed, competitive process. Priority must be
  254  given to applicants that focus on enhancing both research and
  255  treatment by increasing participation in clinical trials related
  256  to the targeted area of cancer research, including all of the
  257  following:
  258         1. Identifying strategies to increase enrollment in cancer
  259  clinical trials.
  260         2. Supporting public and private professional education
  261  programs to raise awareness and knowledge about cancer clinical
  262  trials.
  263         3. Providing tools for cancer patients and community-based
  264  oncologists to help identify available cancer clinical trials in
  265  this state.
  266         4. Creating opportunities for the state’s academic cancer
  267  centers to collaborate with community-based oncologists in
  268  cancer clinical trial networks.
  269         (c) Priority may be given to grant proposals that foster
  270  collaborations among institutions, researchers, and community
  271  practitioners to support the advancement of cures through basic
  272  or applied research, including clinical trials involving cancer
  273  patients and related networks.
  274         (d) Applications for incubator funding may be submitted by
  275  any Florida-based specialty hospital as defined in s.
  276  395.002(28)(a) which provides cancer treatment for patients from
  277  birth to 18 years of age. All qualified applicants must have
  278  equal access and opportunity to compete for research funding.
  279  Incubator grants must be recommended by the collaborative and
  280  awarded by the department on the basis of scientific merit, as
  281  determined by a competitively open and peer-reviewed process to
  282  ensure objectivity, consistency, and high quality.
  283         (e) To ensure that all proposals for research funding are
  284  appropriate and are evaluated fairly on the basis of scientific
  285  merit, the department shall appoint peer review panels of
  286  independent, scientifically qualified individuals to review the
  287  scientific merit of each proposal and establish its priority
  288  score. The priority scores must be forwarded to the
  289  collaborative and must be considered in determining which
  290  proposals the collaborative recommends for funding.
  291         (f) The collaborative and the peer review panels shall
  292  establish and follow rigorous guidelines for ethical conduct and
  293  adhere to a strict policy with regard to conflicts of interest
  294  regarding the assessment of incubator grant applications. A
  295  member of the collaborative or a panel may not participate in
  296  any discussion or decision of the collaborative or a panel
  297  regarding a research proposal from any firm, entity, or agency
  298  with which the member is associated as a governing body member,
  299  as an employee, or through a contractual arrangement.
  300         (g) Each recipient of incubator grant funds must enter into
  301  an allocation agreement with the department. Each such
  302  allocation agreement must include all of the following:
  303         1. A line-item budget narrative documenting the annual
  304  allocation of funds to a recipient.
  305         2. A cap on the annual award of 15 percent for
  306  administrative expenses.
  307         3. A requirement for the recipient to submit quarterly
  308  reports of all expenditures made by the recipient with funds
  309  received through the incubator.
  310         4. A provision to allow the department and other state
  311  auditing bodies to audit all financial records, supporting
  312  documents, statistical records, and any other documents
  313  pertinent to the allocation agreement.
  314         5. A provision requiring the annual reporting of outcome
  315  data and protocols used in achieving those outcomes.
  316         (h) Beginning December 1, 2026, and annually through
  317  December 1, 2030, the collaborative shall prepare and submit a
  318  report to the Governor, the President of the Senate, and the
  319  Speaker of the House of Representatives which evaluates research
  320  conducted through the incubator and provides details on outcomes
  321  and findings available through the end of the fiscal year
  322  immediately preceding each report. If the collaborative
  323  recommends that the incubator be extended beyond its 5-year
  324  lifespan, the collaborative shall make such recommendation in
  325  the report due December 1, 2029, and shall include a
  326  recommendation for the next targeted area of cancer research.
  327  The report due on December 1, 2030, must include all of the
  328  following:
  329         1.Details of all results of the research conducted with
  330  incubator funding which has been completed or the status of
  331  research in progress.
  332         2.An evaluation of all research conducted with incubator
  333  funding during the 5 fiscal years preceding the report.
  334         Section 3. Paragraph (d) is added to subsection (2) of
  335  section 381.922, Florida Statutes, to read:
  336         381.922 William G. “Bill” Bankhead, Jr., and David Coley
  337  Cancer Research Program.—
  338         (2) The program shall provide grants for cancer research to
  339  further the search for cures for cancer.
  340         (d) There is established within the program the Bascom
  341  Palmer Eye Institute VisionGen Initiative. The purpose of the
  342  initiative is to advance genetic and epigenetic research on
  343  inherited eye diseases and ocular oncology by awarding grants
  344  through the peer-reviewed, competitive process established under
  345  subsection (3). Funding for the initiative is subject to the
  346  annual appropriation of funds by the Legislature.
  347         Section 4. Paragraphs (d) and (e) of subsection (5) of
  348  section 381.986, Florida Statutes, are amended to read:
  349         381.986 Medical use of marijuana.—
  350         (5) MEDICAL MARIJUANA USE REGISTRY.—
  351         (d) The department shall immediately suspend the
  352  registration of a qualified patient charged with a violation of
  353  chapter 893 until final disposition of the any alleged offense.
  354  Based upon such final disposition Thereafter, the department may
  355  extend the suspension, revoke the registration, or reinstate the
  356  registration. However, the department must revoke the
  357  registration of the qualified patient upon such final
  358  disposition if the qualified patient was convicted of, or pled
  359  guilty or nolo contendere to, regardless of adjudication, a
  360  violation of chapter 893 if such violation was for trafficking
  361  in, the sale, manufacture, or delivery of, or possession with
  362  intent to sell, manufacture, or deliver a controlled substance.
  363  If such person wishes to seek reinstatement of his or her
  364  registration as a qualified patient, the person may submit a new
  365  application accompanied by a notarized attestation by the
  366  applicant that he or she has completed all terms of
  367  incarceration, probation, community control, or supervision
  368  related to the offense. A person who knowingly makes a false
  369  attestation under this paragraph commits a misdemeanor of the
  370  second degree, punishable as provided in s. 775.082 or s.
  371  775.083.
  372         (e) The department shall immediately suspend the
  373  registration of a any caregiver charged with a violation of
  374  chapter 893 until final disposition of the any alleged offense.
  375  The department must revoke the registration of the caregiver
  376  upon such final disposition if the caregiver was convicted of,
  377  or pled guilty or nolo contendere to, regardless of
  378  adjudication, a violation of chapter 893 if such violation was
  379  for trafficking in, the sale, manufacture, or delivery of, or
  380  possession with intent to sell, manufacture, or deliver a
  381  controlled substance. If such person wishes to seek
  382  reinstatement of his or her registration as a caregiver, the
  383  person may submit a new application accompanied by a notarized
  384  attestation by the applicant that he or she has completed all
  385  terms of incarceration, probation, community control, or
  386  supervision related to the offense. A person who knowingly makes
  387  a false attestation under this paragraph commits a misdemeanor
  388  of the second degree, punishable as provided in s. 775.082 or s.
  389  775.083. Additionally, the department must shall revoke a
  390  caregiver registration if the caregiver does not meet the
  391  requirements of subparagraph (6)(b)6.
  392         Section 5. Notwithstanding the repeal of section 400.0225,
  393  Florida Statutes, in section 14 of chapter 2001-377, Laws of
  394  Florida, that section is revived, reenacted, and amended to
  395  read:
  396         400.0225 Consumer satisfaction surveys.—
  397         (1) The agency shall develop user-friendly consumer
  398  satisfaction surveys to capture resident and family member
  399  satisfaction with care provided by nursing home facilities. The
  400  consumer satisfaction surveys must be based on a core set of
  401  consumer satisfaction questions to allow for consistent
  402  measurement and must be administered annually to a random sample
  403  of long-stay and short-stay residents of each facility and their
  404  family members. The survey tool must be based on an agency
  405  validated survey instrument whose measures have received an
  406  endorsement by the National Quality Forum.
  407         (2)Family members, guardians, or other resident designees
  408  may assist a resident in completing the consumer satisfaction
  409  survey.
  410         (3)Employees and volunteers of the nursing home facility
  411  or of a corporation or business entity with an ownership
  412  interest in the nursing home facility are prohibited from
  413  attempting to influence a resident’s responses to the consumer
  414  satisfaction survey.
  415         (4)The agency shall specify the protocols for conducting
  416  the consumer satisfaction surveys, ensuring survey validity,
  417  reporting survey results, and protecting the identity of
  418  individual respondents. The agency shall make aggregated survey
  419  data available to consumers on the agency’s website pursuant to
  420  s. 400.191(2)(a)15. in a manner that allows for comparison
  421  between nursing home facilities, or its contractor, in
  422  consultation with the nursing home industry and consumer
  423  representatives, shall develop an easy-to-use consumer
  424  satisfaction survey, shall ensure that every nursing facility
  425  licensed pursuant to this part participates in assessing
  426  consumer satisfaction, and shall establish procedures to ensure
  427  that, at least annually, a representative sample of residents of
  428  each facility is selected to participate in the survey. The
  429  sample shall be of sufficient size to allow comparisons between
  430  and among facilities. Family members, guardians, or other
  431  resident designees may assist the resident in completing the
  432  survey. Employees and volunteers of the nursing facility or of a
  433  corporation or business entity with an ownership interest in the
  434  facility are prohibited from assisting a resident with or
  435  attempting to influence a resident’s responses to the consumer
  436  satisfaction survey. The agency, or its contractor, shall survey
  437  family members, guardians, or other resident designees. The
  438  agency, or its contractor, shall specify the protocol for
  439  conducting and reporting the consumer satisfaction surveys.
  440  Reports of consumer satisfaction surveys shall protect the
  441  identity of individual respondents. The agency shall contract
  442  for consumer satisfaction surveys and report the results of
  443  those surveys in the consumer information materials prepared and
  444  distributed by the agency.
  445         (5) The agency may adopt rules as necessary to implement
  446  administer this section.
  447         Section 6. Paragraph (b) of subsection (1) of section
  448  400.141, Florida Statutes, is amended, and paragraph (x) is
  449  added to that subsection, to read:
  450         400.141 Administration and management of nursing home
  451  facilities.—
  452         (1) Every licensed facility shall comply with all
  453  applicable standards and rules of the agency and shall:
  454         (b) Appoint a medical director licensed pursuant to chapter
  455  458 or chapter 459. By January 1, 2026, the medical director of
  456  each nursing home facility must obtain designation as a
  457  certified medical director by the American Medical Directors
  458  Association, hold a similar credential bestowed by an
  459  organization recognized by the agency, or be in the process of
  460  seeking such designation or credentialing, according to
  461  parameters adopted by agency rule. The agency shall include the
  462  name of each nursing home facility’s medical director on the
  463  facility’s provider profile published by the agency on its
  464  website. The agency may establish by rule more specific criteria
  465  for the appointment of a medical director.
  466         (x) Conduct, at least biennially, a patient safety culture
  467  survey using the applicable Survey on Patient Safety Culture
  468  developed by the federal Agency for Healthcare Research and
  469  Quality. Each facility shall conduct the survey anonymously to
  470  encourage completion of the survey by staff working in or
  471  employed by the facility. A facility may contract with a third
  472  party to administer the survey. Each facility shall biennially
  473  submit the survey data to the agency in a format specified by
  474  agency rule, which must include the survey participation rate.
  475  Each facility may develop an internal action plan between
  476  conducting surveys to identify measures to improve the survey
  477  and submit such plan to the agency.
  478         Section 7. Paragraph (a) of subsection (2) of section
  479  400.191, Florida Statutes, is amended to read:
  480         400.191 Availability, distribution, and posting of reports
  481  and records.—
  482         (2) The agency shall publish the Nursing Home Guide
  483  quarterly in electronic form to assist consumers and their
  484  families in comparing and evaluating nursing home facilities.
  485         (a) The agency shall provide an Internet site which must
  486  shall include at least the following information either directly
  487  or indirectly through a link to another established site or
  488  sites of the agency’s choosing:
  489         1. A section entitled “Have you considered programs that
  490  provide alternatives to nursing home care?” which must shall be
  491  the first section of the Nursing Home Guide and must which shall
  492  prominently display information about available alternatives to
  493  nursing homes and how to obtain additional information regarding
  494  these alternatives. The Nursing Home Guide must shall explain
  495  that this state offers alternative programs that allow permit
  496  qualified elderly persons to stay in their homes instead of
  497  being placed in nursing homes and must shall encourage
  498  interested persons to call the Comprehensive Assessment Review
  499  and Evaluation for Long-Term Care Services (CARES) Program to
  500  inquire as to whether if they qualify. The Nursing Home Guide
  501  must shall list available home and community-based programs and
  502  must which shall clearly state the services that are provided,
  503  including and indicate whether nursing home services are covered
  504  under those programs when necessary included if needed.
  505         2. A list by name and address of all nursing home
  506  facilities in this state, including any prior name by which a
  507  facility was known during the previous 24-month period.
  508         3. Whether such nursing home facilities are proprietary or
  509  nonproprietary.
  510         4. The current owner of the facility’s license and the year
  511  that that entity became the owner of the license.
  512         5. The name of the owner or owners of each facility and
  513  whether the facility is affiliated with a company or other
  514  organization owning or managing more than one nursing facility
  515  in this state.
  516         6. The total number of beds in each facility and the most
  517  recently available occupancy levels.
  518         7. The number of private and semiprivate rooms in each
  519  facility.
  520         8. The religious affiliation, if any, of each facility.
  521         9. The languages spoken by the administrator and staff of
  522  each facility.
  523         10. Whether or not each facility accepts Medicare or
  524  Medicaid recipients or insurance, health maintenance
  525  organization, United States Department of Veterans Affairs,
  526  CHAMPUS program, or workers’ compensation coverage.
  527         11. Recreational and other programs available at each
  528  facility.
  529         12. Special care units or programs offered at each
  530  facility.
  531         13. Whether the facility is a part of a retirement
  532  community that offers other services pursuant to part III of
  533  this chapter or part I or part III of chapter 429.
  534         14. Survey and deficiency information, including all
  535  federal and state recertification, licensure, revisit, and
  536  complaint survey information, for each facility. For
  537  noncertified nursing homes, state survey and deficiency
  538  information, including licensure, revisit, and complaint survey
  539  information, shall be provided.
  540         15. The results of consumer satisfaction surveys conducted
  541  pursuant to s. 400.0225.
  542         Section 8. Present subsections (6) and (7) of section
  543  408.051, Florida Statutes, are redesignated as subsections (7)
  544  and (8), respectively, and a new subsection (6) is added to that
  545  section, to read:
  546         408.051 Florida Electronic Health Records Exchange Act.—
  547         (6) NURSING HOME DATA.—A nursing home facility as defined
  548  in s. 400.021 which maintains certified electronic health record
  549  technology shall make available all admission, transfer, and
  550  discharge data to the agency’s Florida Health Information
  551  Exchange program for the purpose of supporting public health
  552  data registries and patient care coordination. The agency may
  553  adopt rules to implement this subsection.
  554         Section 9. Present subsections (7) through (15) of section
  555  408.061, Florida Statutes, are redesignated as subsections (8)
  556  through (16), respectively, a new subsection (7) is added to
  557  that section, and subsections (5) and (6) of that section are
  558  amended, to read:
  559         408.061 Data collection; uniform systems of financial
  560  reporting; information relating to physician charges;
  561  confidential information; immunity.—
  562         (5) Within 120 days after the end of its fiscal year, each
  563  nursing home as defined in s. 408.07, excluding nursing homes
  564  operated by state agencies, shall file with the agency, on forms
  565  adopted by the agency and based on the uniform system of
  566  financial reporting, its actual financial experience for that
  567  fiscal year, including expenditures, revenues, and statistical
  568  measures. Such data may be based on internal financial reports
  569  that are certified to be complete and accurate by the chief
  570  financial officer of the nursing home. However, a nursing home’s
  571  actual financial experience shall be its audited actual
  572  experience. This audited actual experience must include the
  573  fiscal year-end balance sheet, income statement, statement of
  574  cash flow, and statement of retained earnings and must be
  575  submitted to the agency in addition to the information filed in
  576  the uniform system of financial reporting. The financial
  577  statements must tie to the information submitted in the uniform
  578  system of financial reporting, and a crosswalk must be submitted
  579  along with the financial statements.
  580         (6) Within 120 days after the end of its fiscal year, the
  581  home office of each nursing home as defined in s. 408.07,
  582  excluding nursing homes operated by state agencies, shall file
  583  with the agency, on forms adopted by the agency and based on the
  584  uniform system of financial reporting, its actual financial
  585  experience for that fiscal year, including expenditures,
  586  revenues, and statistical measures. Such data may be based on
  587  internal financial reports that are certified to be complete and
  588  accurate by the chief financial officer of the nursing home.
  589  However, the home office’s actual financial experience shall be
  590  its audited actual experience. This audited actual experience
  591  must include the fiscal year-end balance sheet, income
  592  statement, statement of cash flow, and statement of retained
  593  earnings and must be submitted to the agency in addition to the
  594  information filed in the uniform system of financial reporting.
  595  The financial statements must tie to the information submitted
  596  in the uniform system of financial reporting, and a crosswalk
  597  must be submitted along with the audited financial statements.
  598         (7)(a)Beginning January 1, 2026, the agency shall impose
  599  an administrative fine of $10,000 per violation against a
  600  nursing home or home office that fails to comply with subsection
  601  (5) or subsection (6), as applicable. For purposes of this
  602  paragraph, the term “violation” means failing to file the
  603  financial report required by subsection (5) or subsection (6),
  604  as applicable, on or before the report’s due date. Failing to
  605  file the report during any subsequent 10-day period occurring
  606  after the due date constitutes a separate violation until the
  607  report has been submitted.
  608         (b) The agency shall adopt rules to implement this
  609  subsection. The rules must include provisions for a nursing home
  610  or home office to present factors in mitigation of the
  611  imposition of the fine’s full dollar amount. The agency may
  612  determine not to impose the fine’s full dollar amount upon a
  613  showing that the full fine is inappropriate under the
  614  circumstances.
  615         Section 10. Subsection (2) of section 408.08, Florida
  616  Statutes, is amended to read:
  617         408.08 Inspections and audits; violations; penalties;
  618  fines; enforcement.—
  619         (2) Any health care facility that refuses to file a report,
  620  fails to timely file a report, files a false report, or files an
  621  incomplete report and upon notification fails to timely file a
  622  complete report required under s. 408.061; that violates this
  623  section, s. 408.061, or s. 408.20, or rule adopted thereunder;
  624  or that fails to provide documents or records requested by the
  625  agency under this chapter shall be punished by a fine not
  626  exceeding $1,000 per day for each day in violation, to be
  627  imposed and collected by the agency. Pursuant to rules adopted
  628  by the agency, the agency may, upon a showing of good cause,
  629  grant a one-time extension of any deadline for a health care
  630  facility to timely file a report as required by this section, s.
  631  408.061, or s. 408.20. A facility fined under s. 408.061(7) may
  632  not be additionally fined under this subsection for the same
  633  violation.
  634         Section 11. Subsection (1) of section 409.904, Florida
  635  Statutes, is amended to read:
  636         409.904 Optional payments for eligible persons.—The agency
  637  may make payments for medical assistance and related services on
  638  behalf of the following persons who are determined to be
  639  eligible subject to the income, assets, and categorical
  640  eligibility tests set forth in federal and state law. Payment on
  641  behalf of these Medicaid eligible persons is subject to the
  642  availability of moneys and any limitations established by the
  643  General Appropriations Act or chapter 216.
  644         (1)(a) Subject to federal waiver approval, a person who is
  645  age 65 or older or is determined to be disabled, whose income is
  646  at or below 88 percent of the federal poverty level, whose
  647  assets do not exceed established limitations, and who is not
  648  eligible for Medicare or, if eligible for Medicare, is also
  649  eligible for and receiving Medicaid-covered institutional care
  650  services, hospice services, or home and community-based
  651  services. The agency shall seek federal authorization through a
  652  waiver to provide this coverage.
  653         (b)1. A person who was initially determined eligible for
  654  Medicaid under paragraph (a) and is receiving Medicaid-covered
  655  institutional care services or hospice services, or a person who
  656  is receiving home and community-based services pursuant to s.
  657  393.066 or s. 409.978, shall be presumed eligible for continued
  658  coverage for such Medicaid-covered services during any
  659  redetermination process, and the agency shall continue to make
  660  payments for such services, unless the person experiences a
  661  material change in his or her disability or economic status
  662  which results in a loss of eligibility. In the event of such a
  663  change in disability or economic status, the person or his or
  664  her designated caregiver or responsible party must notify the
  665  agency and the Department of Children and Families of such
  666  change, and the department may conduct a redetermination of
  667  eligibility. If such redetermination is conducted, the
  668  department must notify the person or his or her designated
  669  caregiver or responsible party before the commencement of the
  670  redetermination and, at its conclusion, the results of the
  671  redetermination.
  672         2. The agency shall, no later than October 1, 2025, seek
  673  federal authorization to exempt a Medicaid-eligible disabled
  674  person from annual redetermination of eligibility pursuant to
  675  this paragraph.
  676         3. The agency and the department shall develop a process to
  677  facilitate the notifications required under subparagraph 1.
  678         Section 12. Paragraph (d) of subsection (29) of section
  679  409.906, Florida Statutes, is amended to read:
  680         409.906 Optional Medicaid services.—Subject to specific
  681  appropriations, the agency may make payments for services which
  682  are optional to the state under Title XIX of the Social Security
  683  Act and are furnished by Medicaid providers to recipients who
  684  are determined to be eligible on the dates on which the services
  685  were provided. Any optional service that is provided shall be
  686  provided only when medically necessary and in accordance with
  687  state and federal law. Optional services rendered by providers
  688  in mobile units to Medicaid recipients may be restricted or
  689  prohibited by the agency. Nothing in this section shall be
  690  construed to prevent or limit the agency from adjusting fees,
  691  reimbursement rates, lengths of stay, number of visits, or
  692  number of services, or making any other adjustments necessary to
  693  comply with the availability of moneys and any limitations or
  694  directions provided for in the General Appropriations Act or
  695  chapter 216. If necessary to safeguard the state’s systems of
  696  providing services to elderly and disabled persons and subject
  697  to the notice and review provisions of s. 216.177, the Governor
  698  may direct the Agency for Health Care Administration to amend
  699  the Medicaid state plan to delete the optional Medicaid service
  700  known as “Intermediate Care Facilities for the Developmentally
  701  Disabled.” Optional services may include:
  702         (29) BIOMARKER TESTING SERVICES.—
  703         (d) This subsection does not require coverage of biomarker
  704  testing for screening purposes. The agency may pay for blood
  705  based biomarker tests at an in-network or out-of-network
  706  laboratory facility for colorectal cancer screening covered
  707  under a National Coverage Determination from the Centers for
  708  Medicare and Medicaid Services.
  709         Section 13. Paragraph (b) of subsection (2) of section
  710  409.908, Florida Statutes, is amended to read:
  711         409.908 Reimbursement of Medicaid providers.—Subject to
  712  specific appropriations, the agency shall reimburse Medicaid
  713  providers, in accordance with state and federal law, according
  714  to methodologies set forth in the rules of the agency and in
  715  policy manuals and handbooks incorporated by reference therein.
  716  These methodologies may include fee schedules, reimbursement
  717  methods based on cost reporting, negotiated fees, competitive
  718  bidding pursuant to s. 287.057, and other mechanisms the agency
  719  considers efficient and effective for purchasing services or
  720  goods on behalf of recipients. If a provider is reimbursed based
  721  on cost reporting and submits a cost report late and that cost
  722  report would have been used to set a lower reimbursement rate
  723  for a rate semester, then the provider’s rate for that semester
  724  shall be retroactively calculated using the new cost report, and
  725  full payment at the recalculated rate shall be effected
  726  retroactively. Medicare-granted extensions for filing cost
  727  reports, if applicable, shall also apply to Medicaid cost
  728  reports. Payment for Medicaid compensable services made on
  729  behalf of Medicaid-eligible persons is subject to the
  730  availability of moneys and any limitations or directions
  731  provided for in the General Appropriations Act or chapter 216.
  732  Further, nothing in this section shall be construed to prevent
  733  or limit the agency from adjusting fees, reimbursement rates,
  734  lengths of stay, number of visits, or number of services, or
  735  making any other adjustments necessary to comply with the
  736  availability of moneys and any limitations or directions
  737  provided for in the General Appropriations Act, provided the
  738  adjustment is consistent with legislative intent.
  739         (2)
  740         (b) Subject to any limitations or directions in the General
  741  Appropriations Act, the agency shall establish and implement a
  742  state Title XIX Long-Term Care Reimbursement Plan for nursing
  743  home care in order to provide care and services in conformance
  744  with the applicable state and federal laws, rules, regulations,
  745  and quality and safety standards and to ensure that individuals
  746  eligible for medical assistance have reasonable geographic
  747  access to such care.
  748         1. The agency shall amend the long-term care reimbursement
  749  plan and cost reporting system to create direct care and
  750  indirect care subcomponents of the patient care component of the
  751  per diem rate. These two subcomponents together shall equal the
  752  patient care component of the per diem rate. Separate prices
  753  shall be calculated for each patient care subcomponent,
  754  initially based on the September 2016 rate setting cost reports
  755  and subsequently based on the most recently audited cost report
  756  used during a rebasing year. The direct care subcomponent of the
  757  per diem rate for any providers still being reimbursed on a cost
  758  basis shall be limited by the cost-based class ceiling, and the
  759  indirect care subcomponent may be limited by the lower of the
  760  cost-based class ceiling, the target rate class ceiling, or the
  761  individual provider target. The ceilings and targets apply only
  762  to providers being reimbursed on a cost-based system. Effective
  763  October 1, 2018, a prospective payment methodology shall be
  764  implemented for rate setting purposes with the following
  765  parameters:
  766         a. Peer Groups, including:
  767         (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
  768  Counties; and
  769         (II) South-SMMC Regions 10-11, plus Palm Beach and
  770  Okeechobee Counties.
  771         b. Percentage of Median Costs based on the cost reports
  772  used for September 2016 rate setting:
  773         (I) Direct Care Costs........................100 percent.
  774         (II) Indirect Care Costs......................92 percent.
  775         (III) Operating Costs.........................86 percent.
  776         c. Floors:
  777         (I) Direct Care Component.....................95 percent.
  778         (II) Indirect Care Component................92.5 percent.
  779         (III) Operating Component...........................None.
  780         d. Pass-through Payments..................Real Estate and
  781  ...............................................Personal Property
  782  ...................................Taxes and Property Insurance.
  783         e. Quality Incentive Program Payment
  784  Pool.....................................10 percent of September
  785  .......................................2016 non-property related
  786  ................................payments of included facilities.
  787         f. Quality Score Threshold to Qualify Quality for Quality
  788  Incentive Payment...........................................20th
  789  ..............................percentile of included facilities.
  790         g. Fair Rental Value System Payment Parameters:
  791         (I) Building Value per Square Foot based on 2018 RS Means.
  792         (II) Land Valuation...10 percent of Gross Building value.
  793         (III) Facility Square Footage......Actual Square Footage.
  794         (IV) Movable Equipment Allowance..........$8,000 per bed.
  795         (V) Obsolescence Factor......................1.5 percent.
  796         (VI) Fair Rental Rate of Return................8 percent.
  797         (VII) Minimum Occupancy.......................90 percent.
  798         (VIII) Maximum Facility Age.....................40 years.
  799         (IX) Minimum Square Footage per Bed..................350.
  800         (X) Maximum Square Footage for Bed...................500.
  801         (XI) Minimum Cost of a renovation/replacements$500 per bed.
  802         h. Ventilator Supplemental payment of $200 per Medicaid day
  803  of 40,000 ventilator Medicaid days per fiscal year.
  804         2. The agency shall revise its methodology for calculating
  805  Quality Incentive Program payments to include the results of
  806  consumer satisfaction surveys conducted pursuant to s. 400.0225
  807  as a measure of nursing home quality. The agency shall so revise
  808  the methodology after the surveys have been in effect for an
  809  amount of time the agency deems sufficient for statistical and
  810  scientific validity as a meaningful quality measure that may be
  811  incorporated into the methodology.
  812         3. The direct care subcomponent shall include salaries and
  813  benefits of direct care staff providing nursing services
  814  including registered nurses, licensed practical nurses, and
  815  certified nursing assistants who deliver care directly to
  816  residents in the nursing home facility, allowable therapy costs,
  817  and dietary costs. This excludes nursing administration, staff
  818  development, the staffing coordinator, and the administrative
  819  portion of the minimum data set and care plan coordinators. The
  820  direct care subcomponent also includes medically necessary
  821  dental care, vision care, hearing care, and podiatric care.
  822         4.3. All other patient care costs shall be included in the
  823  indirect care cost subcomponent of the patient care per diem
  824  rate, including complex medical equipment, medical supplies, and
  825  other allowable ancillary costs. Costs may not be allocated
  826  directly or indirectly to the direct care subcomponent from a
  827  home office or management company.
  828         5.4. On July 1 of each year, the agency shall report to the
  829  Legislature direct and indirect care costs, including average
  830  direct and indirect care costs per resident per facility and
  831  direct care and indirect care salaries and benefits per category
  832  of staff member per facility.
  833         6.5. Every fourth year, the agency shall rebase nursing
  834  home prospective payment rates to reflect changes in cost based
  835  on the most recently audited cost report for each participating
  836  provider.
  837         7.6. A direct care supplemental payment may be made to
  838  providers whose direct care hours per patient day are above the
  839  80th percentile and who provide Medicaid services to a larger
  840  percentage of Medicaid patients than the state average.
  841         8.7. Pediatric, Florida Department of Veterans Affairs, and
  842  government-owned facilities are exempt from the pricing model
  843  established in this subsection and shall remain on a cost-based
  844  prospective payment system. Effective October 1, 2018, the
  845  agency shall set rates for all facilities remaining on a cost
  846  based prospective payment system using each facility’s most
  847  recently audited cost report, eliminating retroactive
  848  settlements.
  849         9.By October 1, 2025, and each year thereafter, the agency
  850  shall submit to the Governor, the President of the Senate, and
  851  the Speaker of the House of Representatives a report on each
  852  Quality Incentive Program payment made pursuant to sub
  853  subparagraph 1.e. The report must, at a minimum, include all of
  854  the following information:
  855         a.The name of each facility that received a Quality
  856  Incentive Program payment and the dollar amount of such payment
  857  each facility received.
  858         b.The total number of quality incentive metric points
  859  awarded by the agency to each facility and the number of points
  860  awarded by the agency for each individual quality metric
  861  measured.
  862         c.An examination of any trends in the improvement of the
  863  quality of care provided to nursing home residents which may be
  864  attributable to incentive payments received under the Quality
  865  Incentive Program. The agency shall include examination of
  866  trends both for the program as a whole as well as for each
  867  individual quality metric used by the agency to award program
  868  payments.
  869  
  870  It is the intent of the Legislature that the reimbursement plan
  871  achieve the goal of providing access to health care for nursing
  872  home residents who require large amounts of care while
  873  encouraging diversion services as an alternative to nursing home
  874  care for residents who can be served within the community. The
  875  agency shall base the establishment of any maximum rate of
  876  payment, whether overall or component, on the available moneys
  877  as provided for in the General Appropriations Act. The agency
  878  may base the maximum rate of payment on the results of
  879  scientifically valid analysis and conclusions derived from
  880  objective statistical data pertinent to the particular maximum
  881  rate of payment. The agency shall base the rates of payments in
  882  accordance with the minimum wage requirements as provided in the
  883  General Appropriations Act.
  884         Section 14. Present subsection (10) of section 409.909,
  885  Florida Statutes, as amended by section 5 of chapter 2024-12,
  886  Laws of Florida, is redesignated as subsection (9), and
  887  paragraph (a) of subsection (6) and present subsection (9) of
  888  that section are amended, to read:
  889         409.909 Statewide Medicaid Residency Program.—
  890         (6) The Slots for Doctors Program is established to address
  891  the physician workforce shortage by increasing the supply of
  892  highly trained physicians through the creation of new resident
  893  positions, which will increase access to care and improve health
  894  outcomes for Medicaid recipients.
  895         (a)1. Notwithstanding subsection (4), the agency shall
  896  annually allocate $100,000 to hospitals, qualifying
  897  institutions, and behavioral health teaching hospitals
  898  designated under s. 395.902, for each newly created resident
  899  position that is first filled on or after June 1, 2023, and
  900  filled thereafter, and that is accredited by the Accreditation
  901  Council for Graduate Medical Education or the Osteopathic
  902  Postdoctoral Training Institution in an initial or established
  903  accredited training program which is in a physician specialty or
  904  subspecialty in a statewide supply-and-demand deficit.
  905         2. Notwithstanding the requirement that a new resident
  906  position be created to receive funding under this subsection,
  907  the agency may allocate $100,000 to hospitals and qualifying
  908  institutions, pursuant to subparagraph 1., for up to 100 200
  909  resident positions that existed before July 1, 2023, if such
  910  resident position:
  911         a. Is in a physician specialty or subspecialty experiencing
  912  a statewide supply-and-demand deficit;
  913         b. Has been unfilled for a period of 3 or more years;
  914         c. Is subsequently filled on or after June 1, 2024, and
  915  remains filled thereafter; and
  916         d. Is accredited by the Accreditation Council for Graduate
  917  Medical Education or the Osteopathic Postdoctoral Training
  918  Institution in an initial or established accredited training
  919  program.
  920         3. If applications for resident positions under this
  921  paragraph exceed the number of authorized resident positions or
  922  the available funding allocated, the agency shall prioritize
  923  applications for resident positions that are in a primary care
  924  specialty as specified in paragraph (2)(a).
  925         (9) The Graduate Medical Education Committee is created
  926  within the agency.
  927         (a) The committee shall be composed of the following
  928  members:
  929         1. Three deans, or their designees, from medical schools in
  930  this state, appointed by the chair of the Council of Florida
  931  Medical School Deans.
  932         2. Four members appointed by the Governor, one of whom is a
  933  representative of the Florida Medical Association or the Florida
  934  Osteopathic Medical Association who has supervised or is
  935  currently supervising residents, one of whom is a member of the
  936  Florida Hospital Association, one of whom is a member of the
  937  Safety Net Hospital Alliance, and one of whom is a physician
  938  licensed under chapter 458 or chapter 459 practicing at a
  939  qualifying institution.
  940         3. Two members appointed by the Secretary of Health Care
  941  Administration, one of whom represents a statutory teaching
  942  hospital as defined in s. 408.07(46) and one of whom is a
  943  physician who has supervised or is currently supervising
  944  residents.
  945         4. Two members appointed by the State Surgeon General, one
  946  of whom must represent a teaching hospital as defined in s.
  947  408.07 and one of whom is a physician who has supervised or is
  948  currently supervising residents or interns.
  949         5. Two members, one appointed by the President of the
  950  Senate and one appointed by the Speaker of the House of
  951  Representatives.
  952         (b)1. The members of the committee appointed under
  953  subparagraph (a)1. shall serve 4-year terms. When such members’
  954  terms expire, the chair of the Council of Florida Medical School
  955  Deans shall appoint new members as detailed in subparagraph
  956  (a)1. from different medical schools on a rotating basis and may
  957  not reappoint a dean from a medical school that has been
  958  represented on the committee until all medical schools in the
  959  state have had an opportunity to be represented on the
  960  committee.
  961         2. The members of the committee appointed under
  962  subparagraphs (a)2.-4. shall serve 4-year terms, with the
  963  initial term being 3 years for members appointed under
  964  subparagraph (a)4. and 2 years for members appointed under
  965  subparagraph (a)3. The committee shall elect a chair to serve
  966  for a 1-year term.
  967         (c) Members shall serve without compensation but are
  968  entitled to reimbursement for per diem and travel expenses
  969  pursuant to s. 112.061.
  970         (d) The committee shall convene its first meeting by July
  971  1, 2024, and shall meet as often as necessary to conduct its
  972  business, but at least twice annually, at the call of the chair.
  973  The committee may conduct its meetings through teleconference or
  974  other electronic means. A majority of the members of the
  975  committee constitutes a quorum, and a meeting may not be held
  976  with less than a quorum present. The affirmative vote of a
  977  majority of the members of the committee present is necessary
  978  for any official action by the committee.
  979         (e) Beginning on July 1, 2025, the committee shall submit
  980  an annual report to the Governor, the President of the Senate,
  981  and the Speaker of the House of Representatives which must, at a
  982  minimum, detail all of the following:
  983         1. The role of residents and medical faculty in the
  984  provision of health care.
  985         2. The relationship of graduate medical education to the
  986  state’s physician workforce.
  987         3. The typical workload for residents and the role such
  988  workload plays in retaining physicians in the long-term
  989  workforce.
  990         4. The costs of training medical residents for hospitals
  991  and qualifying institutions.
  992         5. The availability and adequacy of all sources of revenue
  993  available to support graduate medical education.
  994         6. The use of state funds, including, but not limited to,
  995  intergovernmental transfers, for graduate medical education for
  996  each hospital or qualifying institution receiving such funds.
  997         (f) The agency shall provide reasonable and necessary
  998  support staff and materials to assist the committee in the
  999  performance of its duties. The agency shall also provide the
 1000  information obtained pursuant to subsection (8) to the committee
 1001  and assist the committee, as requested, in obtaining any other
 1002  information deemed necessary by the committee to produce its
 1003  report.
 1004         Section 15. Subsection (1), paragraph (d) of subsection
 1005  (2), and paragraph (a) of subsection (5) of section 409.91256,
 1006  Florida Statutes, are amended to read:
 1007         409.91256 Training, Education, and Clinicals in Health
 1008  (TEACH) Funding Program.—
 1009         (1) PURPOSE AND INTENT.—The Training, Education, and
 1010  Clinicals in Health (TEACH) Funding Program is created to
 1011  provide a high-quality educational experience while supporting
 1012  participating federally qualified health centers, community
 1013  mental health centers, rural health clinics, and certified
 1014  community behavioral health clinics, and publicly funded
 1015  nonprofit organizations serving Medicaid recipients or other
 1016  low-income patients in areas designated as health professional
 1017  shortage areas and approved by the agency by offsetting
 1018  administrative costs and loss of revenue associated with
 1019  training residents and students to become licensed health care
 1020  practitioners. Further, it is the intent of the Legislature to
 1021  use the program to support the state Medicaid program and
 1022  underserved populations by expanding the available health care
 1023  workforce.
 1024         (2) DEFINITIONS.—As used in this section, the term:
 1025         (d) “Qualified facility” means a federally qualified health
 1026  center, a community mental health center, a rural health clinic,
 1027  or a certified community behavioral health clinic, or a publicly
 1028  funded nonprofit organization serving Medicaid recipients or
 1029  other low-income patients in an area designated as a health
 1030  professional shortage area and approved by the agency.
 1031         (5) REIMBURSEMENT.—Qualified facilities may be reimbursed
 1032  under this section only to offset the administrative costs or
 1033  lost revenue associated with training students, allopathic
 1034  residents, osteopathic residents, or dental residents who are
 1035  enrolled in an accredited educational or residency program based
 1036  in this state.
 1037         (a) Subject to an appropriation, the agency may reimburse a
 1038  qualified facility based on the number of clinical training
 1039  hours reported under subparagraph (3)(e)1. The allowed
 1040  reimbursement per student is as follows:
 1041         1. A medical or dental resident at a rate of $50 per hour.
 1042         2. A first-year medical student at a rate of $27 per hour.
 1043         3. A second-year medical student at a rate of $27 per hour.
 1044         4. A third-year medical student at a rate of $29 per hour.
 1045         5. A fourth-year medical student at a rate of $29 per hour.
 1046         6. A dental student at a rate of $22 per hour.
 1047         7. An advanced practice registered nursing student at a
 1048  rate of $22 per hour.
 1049         8. A physician assistant student at a rate of $22 per hour.
 1050         9. A nursing student at a rate of $22 per hour.
 1051         10. A behavioral health student at a rate of $15 per hour.
 1052         11.10. A dental hygiene student at a rate of $15 per hour.
 1053         Section 16. Paragraph (e) of subsection (3) of section
 1054  409.967, Florida Statutes, is amended to read:
 1055         409.967 Managed care plan accountability.—
 1056         (3) ACHIEVED SAVINGS REBATE.—
 1057         (e) Once the certified public accountant completes the
 1058  audit, the certified public accountant shall submit an audit
 1059  report to the agency attesting to the achieved savings of the
 1060  plan. The agency shall review the report to determine compliance
 1061  with the requirements of this subsection. The agency shall
 1062  notify the certified public accountant of any deficiencies in
 1063  the audit report. The certified public accountant must correct
 1064  such deficiencies in the audit report and resubmit the revised
 1065  audit report to the agency before the report is considered
 1066  final. Once finalized, the results of the audit report are
 1067  dispositive.
 1068         Section 17. Section 409.9745, Florida Statutes, is amended
 1069  to read:
 1070         409.9745 Managed care plan biomarker testing.—
 1071         (1) A managed care plan must provide coverage for biomarker
 1072  testing for recipients, as authorized under s. 409.906, at the
 1073  same scope, duration, and frequency as the Medicaid program
 1074  provides for other medically necessary treatments.
 1075         (a)(2) A recipient and health care provider shall have
 1076  access to a clear and convenient process to request
 1077  authorization for biomarker testing as provided under this
 1078  section. Such process shall be made readily accessible on the
 1079  website of the managed care plan.
 1080         (b)(3) This section does not require coverage of biomarker
 1081  testing for screening purposes.
 1082         (c)(4) The agency shall include the rate impact of this
 1083  section in the applicable Medicaid managed medical assistance
 1084  program and long-term care managed care program rates.
 1085         (2) A managed care plan must provide coverage for blood
 1086  based biomarker tests for colorectal cancer screening covered
 1087  under a National Coverage Determination from the Centers for
 1088  Medicare and Medicaid Services at the same scope and frequency
 1089  as described in the National Coverage Determination.
 1090         Section 18. Subsection (4) of section 409.977, Florida
 1091  Statutes, is amended to read:
 1092         409.977 Enrollment.—
 1093         (4) The agency shall develop a process to enable a
 1094  recipient with access to employer-sponsored health care coverage
 1095  to opt out of all managed care plans and to use Medicaid
 1096  financial assistance to pay for the recipient’s share of the
 1097  cost in such employer-sponsored coverage. The agency shall also
 1098  enable recipients with access to other insurance or related
 1099  products providing access to health care services created
 1100  pursuant to state law, including any product available under the
 1101  Florida Health Choices Program, or any health exchange, to opt
 1102  out. The amount of financial assistance provided for each
 1103  recipient may not exceed the amount of the Medicaid premium that
 1104  would have been paid to a managed care plan for that recipient.
 1105  The agency shall require Medicaid recipients with access to
 1106  employer-sponsored health care coverage to enroll in that
 1107  coverage and use Medicaid financial assistance to pay for the
 1108  recipient’s share of the cost for such coverage. The amount of
 1109  financial assistance provided for each recipient may not exceed
 1110  the amount of the Medicaid premium that would have been paid to
 1111  a managed care plan for that recipient. The agency may exceed
 1112  this amount for a high-cost patient if it determines it would be
 1113  cost effective to do so. The agency shall annually, beginning
 1114  June 30, 2026, submit an annual report on the program to the
 1115  Legislature including, but not limited to, the level of
 1116  participation; participant demographics, income levels, type of
 1117  employer-based coverage, and amount of health care utilization;
 1118  and a cost-effectiveness analysis both in the aggregate and on
 1119  an individual patient basis.
 1120         Section 19. Paragraph (b) of subsection (3) of section
 1121  430.84, Florida Statutes, is amended to read:
 1122         430.84 Program of All-Inclusive Care for the Elderly.—
 1123         (3) PACE ORGANIZATION SELECTION.—The agency, in
 1124  consultation with the department, shall, on a continuous basis,
 1125  review and consider applications required by the CMS for PACE
 1126  that have been submitted to the agency by entities seeking
 1127  initial state approval to become PACE organizations. Notice of
 1128  such applications shall be published in the Florida
 1129  Administrative Register.
 1130         (b) Each applicant must propose to serve a unique and
 1131  defined geographic service area. In designating a service area
 1132  under a contract with a PACE organization, the state
 1133  administering agency may exclude from designation an area that
 1134  is already covered under another PACE organization contract in
 1135  order to avoid unnecessary duplication of services and avoid
 1136  impairing the financial service viability of an existing PACE
 1137  organization. However, if a new applicant submits a letter of
 1138  intent to provide PACE services in an area where an existing
 1139  PACE organization is under contract and has been operating for
 1140  at least 10 years, the state shall determine whether there is an
 1141  unmet need that could be provided by the new PACE organization
 1142  and the applicant must satisfactorily demonstrate to the state
 1143  administering agency that there is justification for the
 1144  proposed PACE organization in such service area. All applicants
 1145  must demonstrate in the application that the PACE services
 1146  provided by the proposed PACE organization will be comprehensive
 1147  and organized to meet all state and CMS requirements without
 1148  duplication of services or target populations. No more than one
 1149  PACE organization may be authorized to provide services within
 1150  any unique and defined geographic service area.
 1151         Section 20. (1)To support and enhance quality outcomes in
 1152  Florida’s nursing homes, the Agency for Health Care
 1153  Administration shall contract with a third-party vendor to
 1154  conduct a comprehensive study of nursing home quality incentive
 1155  programs in other states.
 1156         (a)At a minimum, the study must include a detailed
 1157  analysis of quality incentive programs implemented in each of
 1158  the states examined, identify components of such programs which
 1159  have demonstrably improved nursing home quality outcomes, and
 1160  provide recommendations to modify or enhance this state’s
 1161  existing Medicaid Quality Incentive Program based on its
 1162  historical performance and trends since it was first
 1163  implemented.
 1164         (b)The study must also include:
 1165         1.An in-depth review of emerging and existing technologies
 1166  applicable to nursing home care and an analysis of how their
 1167  adoption in this state could improve quality of care,
 1168  operational efficiency, and quality of life outcomes for nursing
 1169  home residents; and
 1170         2.An examination of other states’ Medicaid add-on payment
 1171  structures related to the provision of ventilator care,
 1172  bariatric services, and behavioral health services.
 1173         (2)The agency shall submit a final report on the study,
 1174  including findings and actionable recommendations, to the
 1175  Governor, the President of the Senate, and the Speaker of the
 1176  House of Representatives by January 5, 2026.
 1177         Section 21. This act shall take effect July 1, 2025.
 1178  
 1179  ================= T I T L E  A M E N D M E N T ================
 1180  And the title is amended as follows:
 1181         Delete everything before the enacting clause
 1182  and insert:
 1183                        A bill to be entitled                      
 1184         An act relating to health and human services; amending
 1185         s. 381.4019, F.S.; authorizing certain dental and
 1186         dental hygiene students to apply for the Dental
 1187         Student Loan Repayment Program before obtaining active
 1188         employment; amending s. 381.915, F.S.; revising the
 1189         definitions of the terms “cancer center” and “Florida
 1190         based”; defining the term “Cancer Connect
 1191         Collaborative” or “collaborative”; making clarifying
 1192         changes; deleting an obsolete date; revising the
 1193         composition of the collaborative; deleting obsolete
 1194         provisions; requiring the collaborative to review all
 1195         submitted Cancer Innovation Fund grant applications
 1196         using certain parameters; requiring the collaborative
 1197         to give priority to certain applications; requiring
 1198         that licensed or certified health care providers,
 1199         facilities, or entities meet certain criteria to be
 1200         eligible for specified grant funding; specifying such
 1201         criteria; requiring the Department of Health to
 1202         appoint peer review panels for a specified purpose;
 1203         requiring that priority scores be forwarded to the
 1204         collaborative and be considered in determining which
 1205         proposals the collaborative recommends for certain
 1206         grant funding; requiring the collaborative and peer
 1207         review panels to establish and follow certain
 1208         guidelines and adhere to a certain policy; prohibiting
 1209         a member of the collaborative or a panel from
 1210         participating in certain discussions or decisions
 1211         under certain circumstances; requiring, beginning on a
 1212         specified date and annually thereafter, the
 1213         collaborative to prepare and submit a specified report
 1214         to the Governor and the Legislature; requiring that
 1215         the report include certain information; revising the
 1216         requirements for a specified report by the department;
 1217         requiring, beginning on a specified date, that certain
 1218         allocation agreements include certain information;
 1219         providing legislative findings; creating the Cancer
 1220         Connect Collaborative Research Incubator within the
 1221         department, and overseen by the collaborative, to
 1222         provide funding for a specified purpose over a
 1223         specified timeframe; specifying the incubator’s
 1224         targeted area of cancer research for the first
 1225         specified timeframe; providing that grants issued
 1226         through the incubator are contingent upon the
 1227         appropriation of funds and must be awarded through a
 1228         specified process; requiring that priority be given to
 1229         certain applicants; authorizing the prioritization of
 1230         certain grant proposals; providing that applications
 1231         for incubator funding may be submitted by specified
 1232         hospitals; requiring that all qualified applicants
 1233         have equal access and opportunity to compete for
 1234         research funding; requiring that incubator grants be
 1235         recommended by the collaborative and awarded by the
 1236         department in a certain manner; requiring the
 1237         department to appoint peer review panels for a
 1238         specified purpose; requiring that priority scores be
 1239         forwarded to the collaborative and be considered in
 1240         determining which proposals the collaborative
 1241         recommends for funding; requiring the collaborative
 1242         and peer review panels to establish and follow certain
 1243         guidelines and adhere to a certain policy; prohibiting
 1244         a member of the collaborative or a panel from
 1245         participating in certain discussions or decisions;
 1246         requiring recipients of incubator grant funds to enter
 1247         into an allocation agreement with the department;
 1248         specifying requirements for such allocation
 1249         agreements; requiring, beginning on a specified date
 1250         and annually until a specified date, the collaborative
 1251         to prepare and submit a specified report to the
 1252         Governor and the Legislature; requiring the
 1253         collaborative to make a certain recommendation under
 1254         certain circumstances; requiring that a specified
 1255         report include certain information; amending s.
 1256         381.922, F.S.; establishing the Bascom Palmer Eye
 1257         Institute VisionGen Initiative within the William G.
 1258         “Bill” Bankhead, Jr., and David Coley Cancer Research
 1259         Program; providing the purpose of the initiative;
 1260         providing that funding for the initiative is subject
 1261         to annual appropriation; amending s. 381.986, F.S.;
 1262         requiring the department to revoke the medical
 1263         marijuana use registry registration of qualified
 1264         patients and caregivers who enter certain pleas or are
 1265         found guilty of certain offenses; authorizing a person
 1266         seeking reinstatement of qualified patient or
 1267         caregiver registration to submit a new application
 1268         with a certain attestation; providing criminal
 1269         penalties for knowingly making a false attestation;
 1270         reviving, reenacting, and amending s. 400.0225, F.S.,
 1271         relating to consumer satisfaction surveys; requiring
 1272         the Agency for Health Care Administration to develop
 1273         user-friendly consumer satisfaction surveys for
 1274         nursing home facilities; specifying requirements for
 1275         the surveys; authorizing family members, guardians,
 1276         and other resident designees to assist the resident in
 1277         completing the survey; prohibiting employees and
 1278         volunteers of the facility or of a corporation or
 1279         business entity with an ownership interest in the
 1280         facility from attempting to influence a resident’s
 1281         responses to the survey; requiring the agency to
 1282         specify certain protocols for administration of the
 1283         survey; requiring the agency to publish on its website
 1284         aggregated survey data in a manner that allows for
 1285         comparison between nursing home facilities; amending
 1286         s. 400.141, F.S.; requiring medical directors of
 1287         nursing home facilities to obtain, or to be in the
 1288         process of obtaining, certain qualifications by a
 1289         specified date; requiring the agency to include such
 1290         medical director’s name on each nursing home
 1291         facility’s online provider profile; requiring nursing
 1292         home facilities to conduct biennial patient safety
 1293         culture surveys; specifying requirements for
 1294         administration of such surveys; requiring nursing home
 1295         facilities to submit the results of such surveys
 1296         biennially to the agency in a format specified by
 1297         agency rule; authorizing nursing home facilities to
 1298         develop an internal action plan between surveys to
 1299         identify measures for improvement of the survey and
 1300         submit such plan to the agency; amending s. 400.191,
 1301         F.S.; requiring the agency to include the results from
 1302         specified consumer satisfaction surveys as part of the
 1303         Nursing Home Guide on its website; amending s.
 1304         408.051, F.S.; requiring nursing home facilities that
 1305         maintain certain electronic health records to make
 1306         available certain data to the agency’s Florida Health
 1307         Information Exchange program for a specified purpose;
 1308         authorizing the agency to adopt rules; amending s.
 1309         408.061, F.S.; exempting nursing homes operated by
 1310         state agencies from certain financial reporting
 1311         requirements; requiring the agency to impose
 1312         administrative fines against nursing homes and home
 1313         offices of nursing homes for failing to comply with
 1314         certain reporting requirements; defining the term
 1315         “violation”; providing construction; requiring the
 1316         agency to adopt rules; providing requirements for such
 1317         rules; amending s. 408.08, F.S.; prohibiting nursing
 1318         homes subject to certain administrative fines from
 1319         being fined under a specified provision for the same
 1320         violation; amending s. 409.904, F.S.; providing a
 1321         presumption of eligibility for continued coverage of
 1322         certain services for certain persons during a
 1323         redetermination process; requiring certain persons to
 1324         notify the agency and the Department of Children and
 1325         Families of certain material changes; authorizing the
 1326         department to conduct a redetermination of
 1327         eligibility; requiring the department to provide
 1328         certain persons notification and the results of such
 1329         redeterminations; requiring the agency to seek federal
 1330         authorization to exempt certain persons from annual
 1331         redetermination of eligibility by a certain date;
 1332         requiring the agency and department to develop a
 1333         certain process; amending s. 409.906, F.S.;
 1334         authorizing the agency to pay for certain blood-based
 1335         biomarker tests; amending s. 409.908, F.S.; requiring
 1336         the agency to revise its methodology for calculating
 1337         Quality Incentive Program payments; providing
 1338         requirements for such revision; requiring the agency
 1339         to submit an annual report to the Governor and the
 1340         Legislature on payments made under the Quality
 1341         Incentive Program; specifying requirements for the
 1342         report; amending s. 409.909, F.S.; revising the number
 1343         of resident positions for which the agency may
 1344         allocate certain funding to hospitals and qualifying
 1345         institutions; deleting provisions creating the
 1346         Graduate Medical Education Committee within the
 1347         agency; amending s. 409.91256, F.S.; revising the
 1348         purpose of the Training, Education, and Clinicals in
 1349         Health Funding Program; revising the definition of the
 1350         term “qualified facility”; specifying an allowed
 1351         reimbursement rate to qualified facilities under the
 1352         program for nursing students; amending s. 409.967,
 1353         F.S.; requiring the agency to review certain audit
 1354         reports for compliance; requiring a certified public
 1355         accountant to correct certain audit report
 1356         deficiencies and resubmit the report before the report
 1357         is considered final; amending s. 409.9745, F.S.;
 1358         requiring a managed care plan to provide coverage for
 1359         certain blood-based biomarker tests; amending s.
 1360         409.977, F.S.; authorizing the agency to exceed a
 1361         certain amount of financial assistance for a high-cost
 1362         patient under certain circumstances; requiring the
 1363         agency to submit a certain annual report to the
 1364         Legislature beginning on a specified date; requiring
 1365         that the report contain certain information; amending
 1366         s. 430.84, F.S.; authorizing the state administering
 1367         agency to exclude certain areas from designation as
 1368         service areas under contracts with PACE organizations
 1369         under certain circumstances; requiring the state to
 1370         determine whether a certain unmet need exists in a
 1371         certain area upon receipt of a letter of intent to
 1372         provide PACE services from a new applicant; requiring
 1373         such applicants to meet certain requirements;
 1374         requiring the agency to contract with a third-party
 1375         vendor to conduct a comprehensive study of nursing
 1376         home quality incentive programs in other states;
 1377         providing requirements for the study; requiring the
 1378         agency to submit a final report on the study to the
 1379         Governor and the Legislature by a specified date;
 1380         providing an effective date.