December 09, 2019
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Amendment CaShTmL-985708.HTM
                                                  SENATE AMENDMENT
    Bill No. CS for CS for CS for SB 2910
    Amendment No. ___   Barcode 985708
                            CHAMBER ACTION
              Senate                               House
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 1                  WD/2R          .                    
       04/26/2004 10:55 AM         .                    
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11  Senator Saunders moved the following amendment:
12  
13         Senate Amendment (with title amendment) 
14         On page 127, between lines 21 and 22
15  
16  insert:  
17         Section 51.  Subsections (3) and (4) of section
18  400.9905, Florida Statutes, are amended, and subsections (5)
19  and (6) are added to that section, to read: (attached)
20         400.9905  Definitions.--
21         (3)  "Clinic" means an entity at which health care
22  services are provided to individuals and which tenders charges
23  for reimbursement for such services, including a mobile clinic
24  and a portable equipment provider. For purposes of this part,
25  the term does not include and the licensure requirements of
26  this part do not apply to:
27         (a)  Entities licensed or registered by the state under
28  chapter 395; or entities licensed or registered by the state
29  and providing only health care services within the scope of
30  services authorized under their respective licenses granted
31  under ss. 383.30-383.335, chapter 390, chapter 394, chapter
                                  1
    12:18 PM   04/24/04                             s2910c3c-3725x

SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 395, chapter 397, this chapter except part XIII, chapter 463, 2 chapter 465, chapter 466, chapter 478, part I of chapter 483 3 480, chapter 484, or chapter 651, end-stage renal disease 4 providers authorized under 42 C.F.R. part 405, subpart U, or 5 providers certified under 42 C.F.R. part 485, subpart B or 6 subpart H, or any entity that provides neonatal or pediatric 7 hospital-based healthcare services by licensed practitioners 8 solely within a hospital licensed under chapter 395. 9 (b) Entities that own, directly or indirectly, 10 entities licensed or registered by the state pursuant to 11 chapter 395; or entities that own, directly or indirectly, 12 entities licensed or registered by the state and providing 13 only health care services within the scope of services 14 authorized pursuant to their respective licenses granted under 15 ss. 383.30-383.335, chapter 390, chapter 394, chapter 395, 16 chapter 397, this chapter except part XIII, chapter 463, 17 chapter 465, chapter 466, chapter 478, part I of chapter 483 18 480, chapter 484, or chapter 651, end-stage renal disease 19 providers authorized under 42 C.F.R. part 405, subpart U, or 20 providers certified under 42 C.F.R. part 485, subpart B or 21 subpart H, or any entity that provides neonatal or pediatric 22 hospital-based healthcare services by licensed practitioners 23 solely within a hospital licensed under chapter 395. 24 (c) Entities that are owned, directly or indirectly, 25 by an entity licensed or registered by the state pursuant to 26 chapter 395; or entities that are owned, directly or 27 indirectly, by an entity licensed or registered by the state 28 and providing only health care services within the scope of 29 services authorized pursuant to their respective licenses 30 granted under ss. 383.30-383.335, chapter 390, chapter 394, 31 chapter 395, chapter 397, this chapter except part XIII, 2 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 chapter 463, chapter 465, chapter 466, chapter 478, part I of 2 chapter 483 480, chapter 484, or chapter 651, end-stage renal 3 disease providers authorized under 42 C.F.R. part 405, subpart 4 U, or providers certified under 42 C.F.R. part 485, subpart B 5 or subpart H, or any entity that provides neonatal or 6 pediatric hospital-based healthcare services by licensed 7 practitioners solely within a hospital licensed under chapter 8 395. 9 (d) Entities that are under common ownership, directly 10 or indirectly, with an entity licensed or registered by the 11 state pursuant to chapter 395; or entities that are under 12 common ownership, directly or indirectly, with an entity 13 licensed or registered by the state and providing only health 14 care services within the scope of services authorized pursuant 15 to its respective license granted under ss. 383.30-383.335, 16 chapter 390, chapter 394, chapter 395, chapter 397, this 17 chapter except part XIII, chapter 463, chapter 465, chapter 18 466, chapter 478, part I of chapter 483 480, chapter 484, or 19 chapter 651, end-stage renal disease providers authorized 20 under 42 C.F.R. part 405, subpart U, or providers certified 21 under 42 C.F.R. part 485, subpart B or subpart H, or any 22 entity that provides neonatal or pediatric hospital-based 23 services by licensed practitioners solely within a hospital 24 licensed under chapter 395. 25 (e) An entity that is exempt from federal taxation 26 under 26 U.S.C. s. 501(c)(3) or s. 501(c)(4), and any 27 community college or university clinic, and any entity owned 28 or operated by federal or state government, including 29 agencies, subdivisions, or municipalities thereof. 30 (f) A sole proprietorship, group practice, 31 partnership, or corporation that provides health care services 3 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 by physicians covered by s. 627.419, that is directly 2 supervised by one or more of such physicians, and that is 3 wholly owned by one or more of those physicians or by a 4 physician and the spouse, parent, child, or sibling of that 5 physician. 6 (g)(f) A sole proprietorship, group practice, 7 partnership, or corporation that provides health care services 8 by licensed health care practitioners under chapter 457, 9 chapter 458, chapter 459, chapter 460, chapter 461, chapter 10 462, chapter 463, chapter 466, chapter 467, chapter 480, 11 chapter 484, chapter 486, chapter 490, chapter 491, or part I, 12 part III, part X, part XIII, or part XIV of chapter 468, or s. 13 464.012, which are wholly owned by one or more a licensed 14 health care practitioners practitioner, or the licensed health 15 care practitioners set forth in this paragraph practitioner 16 and the spouse, parent, or child, or sibling of a licensed 17 health care practitioner, so long as one of the owners who is 18 a licensed health care practitioner is supervising the 19 services performed therein and is legally responsible for the 20 entity's compliance with all federal and state laws. However, 21 a health care practitioner may not supervise services beyond 22 the scope of the practitioner's license, except that, for the 23 purposes of this part, a clinic owned by a licensee in s. 24 456.053(3)(b) that provides only services authorized pursuant 25 to s. 456.053(3)(b) may be supervised by a licensee specified 26 in s. 456.053(3)(b). 27 (h)(g) Clinical facilities affiliated with an 28 accredited medical school at which training is provided for 29 medical students, residents, or fellows. 30 (i) Entities that provide only oncology or radiation 31 therapy services by physicians licensed under chapter 458 or 4 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 459. 2 (4) "Medical director" means a physician who is 3 employed or under contract with a clinic and who maintains a 4 full and unencumbered physician license in accordance with 5 chapter 458, chapter 459, chapter 460, or chapter 461. 6 However, if the clinic does not provide services pursuant to 7 the respective physician practice acts listed in this 8 subsection, it is limited to providing health care services 9 pursuant to chapter 457, chapter 484, chapter 486, chapter 10 490, or chapter 491 or part I, part III, part X, part XIII, or 11 part XIV of chapter 468, the clinic may appoint a 12 Florida-licensed health care practitioner who does not provide 13 services pursuant to the respective physician practice acts 14 listed in this subsection licensed under that chapter to serve 15 as a clinic director who is responsible for the clinic's 16 activities. A health care practitioner may not serve as the 17 clinic director if the services provided at the clinic are 18 beyond the scope of that practitioner's license, except that a 19 licensee specified in s. 456.053(3)(b) that provides only 20 services authorized pursuant to s. 456.053(3)(b) may serve as 21 clinic director of an entity providing services as specified 22 in s. 456.053(3)(b). 23 (5) "Mobile clinic" means a movable or detached 24 self-contained health care unit within or from which direct 25 health care services are provided to individuals and that 26 otherwise meets the definition of a clinic in subsection (3). 27 (6) "Portable equipment provider" means an entity that 28 contracts with or employs persons to provide portable 29 equipment to multiple locations performing treatment or 30 diagnostic testing of individuals, that bills third-party 31 payors for those services, and that otherwise meets the 5 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 definition of a clinic in subsection (3). 2 Section 52. The creation of paragraph 400.9905(3)(i), 3 Florida Statutes, by this act is intended to clarify the 4 legislative intent of this provision as it existed at the time 5 the provision initially took effect as section 456.0375(1)(b), 6 Florida Statutes, and paragraph 400.9905(3)(i), Florida 7 Statutes, as created by this act, shall operate retroactively 8 to October 1, 2001. Nothing in this section shall be construed 9 as amending, modifying, limiting, or otherwise affecting in 10 any way the legislative intent, scope, terms, prohibition, or 11 requirements of section 456.053, Florida Statutes. 12 Section 53. Subsections (1), (2), and (3) and 13 paragraphs (a) and (b) of subsection (7) of section 400.991, 14 Florida Statutes, are amended to read: 15 400.991 License requirements; background screenings; 16 prohibitions.-- 17 (1)(a) Each clinic, as defined in s. 400.9905, must be 18 licensed and shall at all times maintain a valid license with 19 the agency. Each clinic location shall be licensed separately 20 regardless of whether the clinic is operated under the same 21 business name or management as another clinic. 22 (b) Each mobile clinic must obtain a separate health 23 care clinic license and clinics must provide to the agency, at 24 least quarterly, its their projected street location locations 25 to enable the agency to locate and inspect such clinic 26 clinics. A portable equipment provider must obtain a health 27 care clinic license for a single administrative office and is 28 not required to submit quarterly projected street locations. 29 (2) The initial clinic license application shall be 30 filed with the agency by all clinics, as defined in s. 31 400.9905, on or before July March 1, 2004. A clinic license 6 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 must be renewed biennially. 2 (3) Applicants that submit an application on or before 3 July March 1, 2004, which meets all requirements for initial 4 licensure as specified in this section shall receive a 5 temporary license until the completion of an initial 6 inspection verifying that the applicant meets all requirements 7 in rules authorized by s. 400.9925. However, a clinic engaged 8 in magnetic resonance imaging services may not receive a 9 temporary license unless it presents evidence satisfactory to 10 the agency that such clinic is making a good faith effort and 11 substantial progress in seeking accreditation required under 12 s. 400.9935. 13 (7) Each applicant for licensure shall comply with the 14 following requirements: 15 (a) As used in this subsection, the term "applicant" 16 means individuals owning or controlling, directly or 17 indirectly, 5 percent or more of an interest in a clinic; the 18 medical or clinic director, or a similarly titled person who 19 is responsible for the day-to-day operation of the licensed 20 clinic; the financial officer or similarly titled individual 21 who is responsible for the financial operation of the clinic; 22 and licensed health care practitioners medical providers at 23 the clinic. 24 (b) Upon receipt of a completed, signed, and dated 25 application, the agency shall require background screening of 26 the applicant, in accordance with the level 2 standards for 27 screening set forth in chapter 435. Proof of compliance with 28 the level 2 background screening requirements of chapter 435 29 which has been submitted within the previous 5 years in 30 compliance with any other health care licensure requirements 31 of this state is acceptable in fulfillment of this paragraph. 7 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 Applicants who own less than 10 percent of a health care 2 clinic are not required to submit fingerprints under this 3 section. 4 Section 54. Subsections (9) and (11) of section 5 400.9935, Florida Statutes, are amended to read: 6 400.9935 Clinic responsibilities.-- 7 (9) Any person or entity providing health care 8 services which is not a clinic, as defined under s. 400.9905, 9 may voluntarily apply for a certificate of exemption from 10 licensure under its exempt status with the agency on a form 11 that sets forth its name or names and addresses, a statement 12 of the reasons why it cannot be defined as a clinic, and other 13 information deemed necessary by the agency. An exemption is 14 not transferable. The agency may charge an applicant for a 15 certificate of exemption $100 or the actual cost, whichever is 16 less, for processing the certificate. 17 (11)(a) Each clinic engaged in magnetic resonance 18 imaging services must be accredited by the Joint Commission on 19 Accreditation of Healthcare Organizations, the American 20 College of Radiology, or the Accreditation Association for 21 Ambulatory Health Care, within 1 year after licensure. 22 However, a clinic may request a single, 6-month extension if 23 it provides evidence to the agency establishing that, for good 24 cause shown, such clinic can not be accredited within 1 year 25 after licensure, and that such accreditation will be completed 26 within the 6-month extension. After obtaining accreditation as 27 required by this subsection, each such clinic must maintain 28 accreditation as a condition of renewal of its license. 29 (b) The agency may deny disallow the application or 30 revoke the license of any entity formed for the purpose of 31 avoiding compliance with the accreditation provisions of this 8 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 subsection and whose principals were previously principals of 2 an entity that was unable to meet the accreditation 3 requirements within the specified timeframes. The agency may 4 adopt rules as to the accreditation of magnetic resonance 5 imaging clinics. 6 Section 55. Subsections (1) and (3) of section 7 400.995, Florida Statutes, are amended, and subsection (10) is 8 added to said section, to read: 9 400.995 Agency administrative penalties.-- 10 (1) The agency may deny the application for a license 11 renewal, revoke or suspend the license, and impose 12 administrative fines penalties against clinics of up to $5,000 13 per violation for violations of the requirements of this part 14 or rules of the agency. In determining if a penalty is to be 15 imposed and in fixing the amount of the fine, the agency shall 16 consider the following factors: 17 (a) The gravity of the violation, including the 18 probability that death or serious physical or emotional harm 19 to a patient will result or has resulted, the severity of the 20 action or potential harm, and the extent to which the 21 provisions of the applicable laws or rules were violated. 22 (b) Actions taken by the owner, medical director, or 23 clinic director to correct violations. 24 (c) Any previous violations. 25 (d) The financial benefit to the clinic of committing 26 or continuing the violation. 27 (3) Any action taken to correct a violation shall be 28 documented in writing by the owner, medical director, or 29 clinic director of the clinic and verified through followup 30 visits by agency personnel. The agency may impose a fine and, 31 in the case of an owner-operated clinic, revoke or deny a 9 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 clinic's license when a clinic medical director or clinic 2 director knowingly fraudulently misrepresents actions taken to 3 correct a violation. 4 (10) If the agency issues a notice of intent to deny a 5 license application after a temporary license has been issued 6 pursuant to s. 400.991(3), the temporary license shall expire 7 on the date of the notice and may not be extended during any 8 proceeding for administrative or judicial review pursuant to 9 chapter 120. 10 Section 56. The agency shall refund 90 percent of the 11 license application fee to applicants that submitted their 12 health care clinic licensure fees and applications but were 13 subsequently exempted from licensure by this act. 14 Section 57. Any person or entity defined as a clinic 15 under s. 400.9905, Florida Statutes, shall not be in violation 16 of part XIII of chapter 400, Florida Statutes, due to failure 17 to apply for a clinic license by March 1, 2004, as previously 18 required by s. 400.991, Florida Statutes. Payment to any such 19 person or entity by an insurer or other person liable for 20 payment to such person or entity may not be denied on the 21 grounds that the person or entity failed to apply for or 22 obtain a clinic license before March 1, 2004. 23 24 (Redesignate subsequent sections.) 25 26 27 ================ T I T L E A M E N D M E N T =============== 28 And the title is amended as follows: 29 On page 1, line 13, after the second semicolon 30 31 insert: 10 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 amending s. 400.9905, F.S.; revising the 2 definitions of "clinic" and "medical director" 3 and defining "mobile clinic" and "portable 4 equipment provider" for purposes of the Health 5 Care Clinic Act; providing that certain 6 entities providing oncology or radiation 7 therapy services are exempt from the licensure 8 requirements of part XIII of ch. 400, F.S.; 9 providing legislative intent with respect to 10 such exemption; providing for retroactive 11 application; amending s. 400.991, F.S.; 12 requiring each mobile clinic to obtain a health 13 care clinic license; requiring a portable 14 equipment provider to obtain a health care 15 clinic license for a single office and 16 exempting such a provider from submitting 17 certain information to the Agency for Health 18 Care Administration; revising the date by which 19 an initial application for a health care clinic 20 license must be filed with the agency; revising 21 the definition of "applicant"; amending s. 22 400.9935, F.S.; providing that an exemption 23 from licensure is not transferable; providing 24 that the agency may charge a fee of applicants 25 for certificates of exemption; providing that 26 the agency may deny an application or revoke a 27 license under certain circumstances; amending 28 s. 400.995, F.S.; providing that the agency may 29 deny, revoke, or suspend specified licenses and 30 impose fines for certain violations; providing 31 that a temporary license expires after a notice 11 12:18 PM 04/24/04 s2910c3c-3725x
SENATE AMENDMENT Bill No. CS for CS for CS for SB 2910 Amendment No. ___ Barcode 985708 1 of intent to deny an application is issued by 2 the agency; providing that persons or entities 3 made exempt under the act and which have paid 4 the clinic licensure fee to the agency are 5 entitled to a partial refund from the agency; 6 providing that certain persons or entities are 7 not in violation of part XIII of ch. 400, F.S., 8 due to failure to apply for a clinic license by 9 a specified date; providing that certain 10 payments may not be denied to such persons or 11 entities for failure to apply for or obtain a 12 clinic license before a specified date; 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 12 12:18 PM 04/24/04 s2910c3c-3725x
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