August 03, 2020
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Senate Bill 1374

Senate Bill sb1374c1

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                           CS for SB 1374

    By the Committee on Health, Aging, and Long-Term Care; and
    Senator Saunders




    317-1973-04

  1                      A bill to be entitled

  2         An act relating to health care providers;

  3         amending s. 766.1115, F.S.; revising a

  4         definition for purposes of the Access to Health

  5         Care Act to provide that a contract with a

  6         health care provider to serve low-income

  7         patients requires the provider to deliver the

  8         services without compensation and prohibits the

  9         health care provider from billing any

10         third-party payor for any services rendered to

11         low-income patients; redefining the term

12         "health care provider" to include certain

13         free-clinics; requiring the Department of

14         Health to adopt rules to establish procedures

15         for patient referral and eligibility for use by

16         governmental contractors; defining the term

17         "health care practitioner"; providing for

18         waiver of biennial license renewal fees and

19         fulfillment of a portion of continuing

20         education hours for specified health care

21         practitioners who provide services, without

22         compensation, to low-income recipients as an

23         agent of governmental contractors; amending s.

24         381.00593, F.S.; providing that for purposes of

25         the public school volunteer health care

26         practitioner program, a licensed

27         dietitian/nutritionist is a health care

28         practitioner; providing an effective date.

29  

30  Be It Enacted by the Legislature of the State of Florida:

31  

                                  1

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1         Section 1.  Subsections (3), (4), and (10) of section

 2  766.1115, Florida Statutes, are amended to read:

 3         766.1115  Health care providers; creation of agency

 4  relationship with governmental contractors.--

 5         (3)  DEFINITIONS.--As used in this section, the term:

 6         (a)  "Contract" means an agreement executed in

 7  compliance with this section between a health care provider

 8  and a governmental contractor. This contract shall allow the

 9  health care provider to deliver health care services to

10  low-income recipients as an agent of the governmental

11  contractor. The contract must be for volunteer, uncompensated

12  services. For a service to qualify as a volunteer,

13  uncompensated service under this section, the health care

14  provider may not receive any compensation from the

15  governmental contractor for any service rendered under the

16  contract and may not bill or accept any compensation from the

17  recipient, or any public or private third-party payor, for the

18  specific service rendered to the low-income recipient covered

19  by the contract.

20         (b)  "Department" means the Department of Health.

21         (c)  "Governmental contractor" means the department,

22  county health departments, a special taxing district with

23  health care responsibilities, or a hospital owned and operated

24  by a governmental entity.

25         (d)  "Health care provider" or "provider" means:

26         1.  A birth center licensed under chapter 383.

27         2.  An ambulatory surgical center licensed under

28  chapter 395.

29         3.  A hospital licensed under chapter 395.

30         4.  A physician or physician assistant licensed under

31  chapter 458.

                                  2

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1         5.  An osteopathic physician or osteopathic physician

 2  assistant licensed under chapter 459.

 3         6.  A chiropractic physician licensed under chapter

 4  460.

 5         7.  A podiatric physician licensed under chapter 461.

 6         8.  A registered nurse, nurse midwife, licensed

 7  practical nurse, or advanced registered nurse practitioner

 8  licensed or registered under part I of chapter 464 or any

 9  facility which employs nurses licensed or registered under

10  part I of chapter 464 to supply all or part of the care

11  delivered under this section.

12         9.  A midwife licensed under chapter 467.

13         10.  A health maintenance organization certificated

14  under part I of chapter 641.

15         11.  A health care professional association and its

16  employees or a corporate medical group and its employees.

17         12.  Any other medical facility the primary purpose of

18  which is to deliver human medical diagnostic services or which

19  delivers nonsurgical human medical treatment, and which

20  includes an office maintained by a provider.

21         13.  A dentist or dental hygienist licensed under

22  chapter 466.

23         14.  A free clinic that delivers only medical

24  diagnostic services or nonsurgical medical treatment free of

25  charge to all low-income recipients.

26         15.14.  Any other health care professional,

27  practitioner, provider, or facility under contract with a

28  governmental contractor, including a student enrolled in an

29  accredited program that prepares the student for licensure as

30  any one of the professionals listed in subparagraphs 4.-9.

31  

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1  The term includes any nonprofit corporation qualified as

 2  exempt from federal income taxation under s. 501(a) of the

 3  Internal Revenue Code and described in s. 501(c) of the

 4  Internal Revenue Code which delivers health care services

 5  provided by licensed professionals listed in this paragraph,

 6  any federally funded community health center, and any

 7  volunteer corporation or volunteer health care provider that

 8  delivers health care services.

 9         (e)  "Low-income" means:

10         1.  A person who is Medicaid-eligible under Florida

11  law;

12         2.  A person who is without health insurance and whose

13  family income does not exceed 150 percent of the federal

14  poverty level as defined annually by the federal Office of

15  Management and Budget; or

16         3.  Any client of the department who voluntarily

17  chooses to participate in a program offered or approved by the

18  department and meets the program eligibility guidelines of the

19  department.

20         (4)  CONTRACT REQUIREMENTS.--A health care provider

21  that executes a contract with a governmental contractor to

22  deliver health care services on or after April 17, 1992, as an

23  agent of the governmental contractor is an agent for purposes

24  of s. 768.28(9), while acting within the scope of duties under

25  pursuant to the contract, if the contract complies with the

26  requirements of this section and regardless of whether the

27  individual treated is later found to be ineligible.  A health

28  care provider under contract with the state may not be named

29  as a defendant in any action arising out of the medical care

30  or treatment provided on or after April 17, 1992, under

31  

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1  pursuant to contracts entered into under this section.  The

 2  contract must provide that:

 3         (a)  The right of dismissal or termination of any

 4  health care provider delivering services under pursuant to the

 5  contract is retained by the governmental contractor.

 6         (b)  The governmental contractor has access to the

 7  patient records of any health care provider delivering

 8  services under pursuant to the contract.

 9         (c)  Adverse incidents and information on treatment

10  outcomes must be reported by any health care provider to the

11  governmental contractor if the such incidents and information

12  pertain to a patient treated under pursuant to the contract.

13  The health care provider shall submit the reports required by

14  s. 395.0197. If an incident involves a professional licensed

15  by the Department of Health or a facility licensed by the

16  Agency for Health Care Administration, the governmental

17  contractor shall submit such incident reports to the

18  appropriate department or agency, which shall review each

19  incident and determine whether it involves conduct by the

20  licensee that is subject to disciplinary action. All patient

21  medical records and any identifying information contained in

22  adverse incident reports and treatment outcomes which are

23  obtained by governmental entities under pursuant to this

24  paragraph are confidential and exempt from the provisions of

25  s. 119.07(1) and s. 24(a), Art. I of the State Constitution.

26         (d)  Patient selection and initial referral must be

27  made solely by the governmental contractor, and the provider

28  must accept all referred patients. However, the number of

29  patients that must be accepted may be limited by the contract,

30  and patients may not be transferred to the provider based on a

31  violation of the antidumping provisions of the Omnibus Budget

                                  5

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1  Reconciliation Act of 1989, the Omnibus Budget Reconciliation

 2  Act of 1990, or chapter 395.

 3         (e)  If emergency care is required, the patient need

 4  not be referred before receiving treatment, but must be

 5  referred within 48 hours after treatment is commenced or

 6  within 48 hours after the patient has the mental capacity to

 7  consent to treatment, whichever occurs later.

 8         (f)  Patient care, including any followup or hospital

 9  care, is subject to approval by the governmental contractor.

10         (g)  The provider is subject to supervision and regular

11  inspection by the governmental contractor.

12  

13  A governmental contractor that is also a health care provider

14  is not required to enter into a contract under this section

15  with respect to the health care services delivered by its

16  employees.

17         (10)  RULES.--The department shall adopt rules to

18  administer this section in a manner consistent with its

19  purpose to provide and facilitate access to appropriate, safe,

20  and cost-effective health care services and to maintain health

21  care quality. The rules may include services to be provided

22  and authorized procedures. The department shall adopt rules to

23  administer procedures to be used by a governmental contractor

24  for patient referral and eligibility, including the

25  designation of allowable methods for determination and

26  approval of eligibility performed by the governmental

27  contractor.

28         Section 2.  (1)  As used in this section, the term

29  "health care practitioner" means a physician or physician

30  assistant licensed under chapter 458, Florida Statutes; an

31  osteopathic physician or physician assistant licensed under

                                  6

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1  chapter 459, Florida Statutes; a chiropractic physician

 2  licensed under chapter 460, a podiatric physician licensed

 3  under chapter 461, Florida Statutes; an advanced registered

 4  nurse practitioner, registered nurse, or licensed practical

 5  nurse licensed under part I of chapter 464, Florida Statutes;

 6  a dentist or dental hygienist licensed under chapter 466,

 7  Florida Statutes; or a midwife licensed under chapter 467,

 8  Florida Statutes, who participates as a health care provider

 9  under section 766.1115, Florida Statutes.

10         (2)  Notwithstanding chapter 458, chapter 459, chapter

11  460, chapter 461, part I of chapter 464, chapter 466, or

12  chapter 467, Florida Statutes, to the contrary, any health

13  care practitioner who participates as a health care provider

14  under section 766.1115, Florida Statutes, and thereby agrees

15  with a governmental contractor to provide his or her services

16  without compensation and as an agent of the governmental

17  contractor to low-income recipients in accordance with section

18  766.1115, Florida Statutes, for at least 80 hours a year for

19  each year during the biennial licensure period, or, if the

20  health care practitioner is retired, for at least 400 hours a

21  year for each year during the licensure period, upon providing

22  sufficient proof from the applicable governmental contractor

23  that the health care practitioner has completed the hours at

24  the time of license renewal under procedures specified by the

25  Department of Health, shall be eligible for:

26         (a)  Waiver of the biennial license renewal fee for an

27  active license; and

28         (b)  Fulfillment of a maximum of 25 percent of the

29  continuing education hours required for license renewal under

30  section 456.013(9), Florida Statutes.

31  

                                  7

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1         Section 3.  Subsections (3) and (4) of section

 2  381.00593, Florida Statutes, are amended to read:

 3         381.00593  Public school volunteer health care

 4  practitioner program.--

 5         (3)  For purposes of this section, the term "health

 6  care practitioner" means a physician licensed under chapter

 7  458; an osteopathic physician licensed under chapter 459; a

 8  chiropractic physician licensed under chapter 460; a podiatric

 9  physician licensed under chapter 461; an optometrist licensed

10  under chapter 463; an advanced registered nurse practitioner,

11  registered nurse, or licensed practical nurse licensed under

12  part I of chapter 464; a pharmacist licensed under chapter

13  465; a dentist or dental hygienist licensed under chapter 466;

14  a midwife licensed under chapter 467; a speech-language

15  pathologist or audiologist licensed under part I of chapter

16  468; a dietitian/nutritionist licensed under part X of chapter

17  468; or a physical therapist licensed under chapter 486.

18         (4)(a)  Notwithstanding any provision of chapter 458,

19  chapter 459, chapter 460, chapter 461, chapter 463, part I of

20  chapter 464, chapter 465, chapter 466, chapter 467, parts part

21  I and X of chapter 468, or chapter 486 to the contrary, any

22  health care practitioner who participates in the program

23  established in this section and thereby agrees to provide his

24  or her services, without compensation, in a public school for

25  at least 80 hours a year for each school year during the

26  biennial licensure period, or, if the health care practitioner

27  is retired, for at least 400 hours a year for each school year

28  during the licensure period, upon providing sufficient proof

29  from the applicable school district that the health care

30  practitioner has completed such hours at the time of license

31  

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    Florida Senate - 2004                           CS for SB 1374
    317-1973-04




 1  renewal under procedures specified by the Department of

 2  Health, shall be eligible for the following:

 3         1.  Waiver of the biennial license renewal fee for an

 4  active license; and

 5         2.  Fulfillment of a maximum of 25 percent of the

 6  continuing education hours required for license renewal,

 7  pursuant to s. 456.013(9).

 8  

 9  The school district may establish a schedule for health care

10  practitioners who participate in the program.

11         (b)  A health care practitioner must complete all forms

12  and procedures for participation in the program prior to the

13  applicable license renewal date.

14         Section 4.  This act shall take effect July 1, 2004.

15  

16          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
17                         Senate Bill 1374

18                                 

19  
    The committee substitute revises the definition of "contract"
20  under the Access to Health Care Act to provide that for a
    service to qualify as a volunteer, uncompensated service, the
21  health care provider may not receive any compensation from the
    governmental contractor for any service rendered to low-income
22  persons and the provider may not bill or accept any
    compensation from the recipient or any third-party payor for
23  services rendered under the contract. The definition of
    "health care provider" is revised to include a "free clinic"
24  that delivers only medical diagnostic services or nonsurgical
    medical treatment free of charge to all low-income recipients.
25  The bill requires the Department of Health to adopt rules to
    administer procedures to be used by a governmental contractor
26  for patient referral and eligibility.

27  The committee substitute amends the "Public School Volunteer
    Health Care Practitioner Act," to add Florida-licensed
28  dietitians/nutritionists to the list of health care
    practitioners who may participate in the volunteer program.
29  

30  

31  

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