Bill Text: FL S0212 | 2016 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Health Care

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Failed) 2016-03-08 - Laid on Table, companion bill(s) passed, see HB 423 (Ch. 2016-224) [S0212 Detail]

Download: Florida-2016-S0212-Introduced.html

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       Florida Senate - 2016                                     SB 212
       
       
        
       By Senator Gaetz
       
       
       
       
       
       1-00100A-16                                            2016212__
    1                        A bill to be entitled                      
    2         An act relating to recovery care services; amending s.
    3         395.001, F.S.; providing legislative intent regarding
    4         recovery care centers; amending s. 395.002, F.S.;
    5         revising and providing definitions; amending s.
    6         395.003, F.S.; including recovery care centers as
    7         facilities licensed under chapter 395, F.S.; creating
    8         s. 395.0171, F.S.; providing admission criteria for a
    9         recovery care center; requiring emergency care,
   10         transfer, and discharge protocols; authorizing the
   11         Agency for Health Care Administration to adopt rules;
   12         amending s. 395.1055, F.S.; authorizing the agency to
   13         establish separate standards for the care and
   14         treatment of patients in recovery care centers;
   15         amending s. 395.10973, F.S.; directing the agency to
   16         enforce special-occupancy provisions of the Florida
   17         Building Code applicable to recovery care centers;
   18         amending s. 395.301, F.S.; providing for format and
   19         content of a patient bill from a recovery care center;
   20         amending s. 408.802, F.S.; providing applicability of
   21         the Health Care Licensing Procedures Act to recovery
   22         care centers; amending s. 408.820, F.S.; exempting
   23         recovery care centers from specified minimum licensure
   24         requirements; amending ss. 394.4787 and 409.975, F.S.;
   25         conforming cross-references; providing an effective
   26         date.
   27          
   28  Be It Enacted by the Legislature of the State of Florida:
   29  
   30         Section 1. Section 395.001, Florida Statutes, is amended to
   31  read:
   32         395.001 Legislative intent.—It is the intent of the
   33  Legislature to provide for the protection of public health and
   34  safety in the establishment, construction, maintenance, and
   35  operation of hospitals, ambulatory surgical centers, recovery
   36  care centers, and mobile surgical facilities by providing for
   37  licensure of same and for the development, establishment, and
   38  enforcement of minimum standards with respect thereto.
   39         Section 2. Subsections (3), (16), and (23) of section
   40  395.002, Florida Statutes, are amended, subsections (25) through
   41  (33) are renumbered as subsections (27) through (35),
   42  respectively, and new subsections (25) and (26) are added to
   43  that section, to read:
   44         395.002 Definitions.—As used in this chapter:
   45         (3) “Ambulatory surgical center” or “mobile surgical
   46  facility” means a facility the primary purpose of which is to
   47  provide elective surgical care, in which the patient is admitted
   48  to and discharged from such facility within 24 hours the same
   49  working day and is not permitted to stay overnight, and which is
   50  not part of a hospital. However, a facility existing for the
   51  primary purpose of performing terminations of pregnancy, an
   52  office maintained by a physician for the practice of medicine,
   53  or an office maintained for the practice of dentistry shall not
   54  be construed to be an ambulatory surgical center, provided that
   55  any facility or office which is certified or seeks certification
   56  as a Medicare ambulatory surgical center shall be licensed as an
   57  ambulatory surgical center pursuant to s. 395.003. Any structure
   58  or vehicle in which a physician maintains an office and
   59  practices surgery, and which can appear to the public to be a
   60  mobile office because the structure or vehicle operates at more
   61  than one address, shall be construed to be a mobile surgical
   62  facility.
   63         (16) “Licensed facility” means a hospital, ambulatory
   64  surgical center, recovery care center, or mobile surgical
   65  facility licensed in accordance with this chapter.
   66         (23) “Premises” means those buildings, beds, and equipment
   67  located at the address of the licensed facility and all other
   68  buildings, beds, and equipment for the provision of hospital,
   69  ambulatory surgical, recovery, or mobile surgical care located
   70  in such reasonable proximity to the address of the licensed
   71  facility as to appear to the public to be under the dominion and
   72  control of the licensee. For any licensee that is a teaching
   73  hospital as defined in s. 408.07(45), reasonable proximity
   74  includes any buildings, beds, services, programs, and equipment
   75  under the dominion and control of the licensee that are located
   76  at a site with a main address that is within 1 mile of the main
   77  address of the licensed facility; and all such buildings, beds,
   78  and equipment may, at the request of a licensee or applicant, be
   79  included on the facility license as a single premises.
   80         (25) “Recovery care center” means a facility the primary
   81  purpose of which is to provide recovery care services, to which
   82  a patient is admitted and discharged within 72 hours, and which
   83  is not part of a hospital.
   84         (26) “Recovery care services” means postsurgical and
   85  postdiagnostic medical and general nursing care provided to
   86  patients for whom acute care hospitalization is not required and
   87  an uncomplicated recovery is reasonably expected. The term
   88  includes postsurgical rehabilitation services. The term does not
   89  include intensive care services, coronary care services, or
   90  critical care services.
   91         Section 3. Subsection (1) of section 395.003, Florida
   92  Statutes, is amended to read:
   93         395.003 Licensure; denial, suspension, and revocation.—
   94         (1)(a) The requirements of part II of chapter 408 apply to
   95  the provision of services that require licensure pursuant to ss.
   96  395.001-395.1065 and part II of chapter 408 and to entities
   97  licensed by or applying for such licensure from the Agency for
   98  Health Care Administration pursuant to ss. 395.001-395.1065. A
   99  license issued by the agency is required in order to operate a
  100  hospital, ambulatory surgical center, recovery care center, or
  101  mobile surgical facility in this state.
  102         (b)1. It is unlawful for a person to use or advertise to
  103  the public, in any way or by any medium whatsoever, any facility
  104  as a “hospital,” “ambulatory surgical center,” “recovery care
  105  center,” or “mobile surgical facility” unless such facility has
  106  first secured a license under the provisions of this part.
  107         2. This part does not apply to veterinary hospitals or to
  108  commercial business establishments using the word “hospital,”
  109  “ambulatory surgical center,” “recovery care center,” or “mobile
  110  surgical facility” as a part of a trade name if no treatment of
  111  human beings is performed on the premises of such
  112  establishments.
  113         (c) Until July 1, 2006, additional emergency departments
  114  located off the premises of licensed hospitals may not be
  115  authorized by the agency.
  116         Section 4. Section 395.0171, Florida Statutes, is created
  117  to read:
  118         395.0171 Recovery care center admissions; emergency and
  119  transfer protocols; discharge planning and protocols.—
  120         (1) Admissions to a recovery care center shall be
  121  restricted to patients who need recovery care services.
  122         (2) All patients must be certified by their attending or
  123  referring physician or by a physician on staff at the facility
  124  as medically stable and not in need of acute care
  125  hospitalization before admission.
  126         (3) A patient may be admitted for recovery care services
  127  upon discharge from a hospital or an ambulatory surgery center.
  128  A patient may also be admitted postdiagnosis and posttreatment
  129  for recovery care services.
  130         (4) A recovery care center must have emergency care and
  131  transfer protocols, including transportation arrangements, and
  132  referral or admission agreements with at least one hospital.
  133         (5) A recovery care center must have procedures for
  134  discharge planning and discharge protocols.
  135         (6) The agency may adopt rules to implement this
  136  subsection.
  137         Section 5. Subsections (2) and (8) of section 395.1055,
  138  Florida Statutes, are amended, and subsection (10) is added to
  139  that section, to read:
  140         395.1055 Rules and enforcement.—
  141         (2) Separate standards may be provided for general and
  142  specialty hospitals, ambulatory surgical centers, recovery care
  143  centers, mobile surgical facilities, and statutory rural
  144  hospitals as defined in s. 395.602.
  145         (8) The agency may not adopt any rule governing the design,
  146  construction, erection, alteration, modification, repair, or
  147  demolition of any public or private hospital, intermediate
  148  residential treatment facility, recovery care center, or
  149  ambulatory surgical center. It is the intent of the Legislature
  150  to preempt that function to the Florida Building Commission and
  151  the State Fire Marshal through adoption and maintenance of the
  152  Florida Building Code and the Florida Fire Prevention Code.
  153  However, the agency shall provide technical assistance to the
  154  commission and the State Fire Marshal in updating the
  155  construction standards of the Florida Building Code and the
  156  Florida Fire Prevention Code which govern hospitals,
  157  intermediate residential treatment facilities, recovery care
  158  centers, and ambulatory surgical centers.
  159         (10) The agency shall adopt rules for recovery care centers
  160  which provide for an annual review of recovery care center
  161  policies and protocols governing licensure, utilization, patient
  162  safety, pharmacy services, infection control, and medical and
  163  nursing practices by a panel comprised of a physician, a nurse
  164  and a pharmacist who are licensed in Florida and who are not
  165  employed by or receiving compensation from a recovery care
  166  center. The rules must include fair and reasonable minimum
  167  standards for ensuring that recovery care centers have:
  168         (a) A dietetic department, service, or other similarly
  169  titled unit, either on the premises or under contract, which
  170  shall be organized, directed, and staffed to ensure the
  171  provision of appropriate nutritional care and quality food
  172  service.
  173         (b) Procedures to ensure the proper administration of
  174  medications. Such procedures shall address the prescribing,
  175  ordering, preparing, and dispensing of medications and
  176  appropriate monitoring of the effects of such medications on the
  177  patient.
  178         (c) A pharmacy, pharmaceutical department, or
  179  pharmaceutical service, or similarly titled unit, on the
  180  premises or under contract.
  181         Section 6. Subsection (8) of section 395.10973, Florida
  182  Statutes, is amended to read:
  183         395.10973 Powers and duties of the agency.—It is the
  184  function of the agency to:
  185         (8) Enforce the special-occupancy provisions of the Florida
  186  Building Code which apply to hospitals, intermediate residential
  187  treatment facilities, recovery care centers, and ambulatory
  188  surgical centers in conducting any inspection authorized by this
  189  chapter and part II of chapter 408.
  190         Section 7. Subsection (3) of section 395.301, Florida
  191  Statutes, is amended to read:
  192         395.301 Itemized patient bill; form and content prescribed
  193  by the agency; patient admission status notification.—
  194         (3) On each itemized statement submitted pursuant to
  195  subsection (1) there shall appear the words “A FOR-PROFIT (or
  196  NOT-FOR-PROFIT or PUBLIC) HOSPITAL (or AMBULATORY SURGICAL
  197  CENTER or RECOVERY CARE CENTER) LICENSED BY THE STATE OF
  198  FLORIDA” or substantially similar words sufficient to identify
  199  clearly and plainly the ownership status of the licensed
  200  facility. Each itemized statement must prominently display the
  201  phone number of the medical facility’s patient liaison who is
  202  responsible for expediting the resolution of any billing dispute
  203  between the patient, or his or her representative, and the
  204  billing department.
  205         Section 8. Subsection (30) is added to section 408.802,
  206  Florida Statutes, to read:
  207         408.802 Applicability.—The provisions of this part apply to
  208  the provision of services that require licensure as defined in
  209  this part and to the following entities licensed, registered, or
  210  certified by the agency, as described in chapters 112, 383, 390,
  211  394, 395, 400, 429, 440, 483, and 765:
  212         (30) Recovery care centers, as provided under part I of
  213  chapter 395.
  214         Section 9. Subsection (29) is added to section 408.820,
  215  Florida Statutes, to read:
  216         408.820 Exemptions.—Except as prescribed in authorizing
  217  statutes, the following exemptions shall apply to specified
  218  requirements of this part:
  219         (29) Recovery care centers, as provided under part I of
  220  chapter 395, are exempt from s. 408.810(7)-(10).
  221         Section 10. Subsection (7) of section 394.4787, Florida
  222  Statutes, is amended to read:
  223         394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, and
  224  394.4789.—As used in this section and ss. 394.4786, 394.4788,
  225  and 394.4789:
  226         (7) “Specialty psychiatric hospital” means a hospital
  227  licensed by the agency pursuant to s. 395.002(30) 395.002(28)
  228  and part II of chapter 408 as a specialty psychiatric hospital.
  229         Section 11. Paragraph (b) of subsection (1) of section
  230  409.975, Florida Statutes, is amended to read:
  231         409.975 Managed care plan accountability.—In addition to
  232  the requirements of s. 409.967, plans and providers
  233  participating in the managed medical assistance program shall
  234  comply with the requirements of this section.
  235         (1) PROVIDER NETWORKS.—Managed care plans must develop and
  236  maintain provider networks that meet the medical needs of their
  237  enrollees in accordance with standards established pursuant to
  238  s. 409.967(2)(c). Except as provided in this section, managed
  239  care plans may limit the providers in their networks based on
  240  credentials, quality indicators, and price.
  241         (b) Certain providers are statewide resources and essential
  242  providers for all managed care plans in all regions. All managed
  243  care plans must include these essential providers in their
  244  networks. Statewide essential providers include:
  245         1. Faculty plans of Florida medical schools.
  246         2. Regional perinatal intensive care centers as defined in
  247  s. 383.16(2).
  248         3. Hospitals licensed as specialty children’s hospitals as
  249  defined in s. 395.002(30) 395.002(28).
  250         4. Accredited and integrated systems serving medically
  251  complex children that are comprised of separately licensed, but
  252  commonly owned, health care providers delivering at least the
  253  following services: medical group home, in-home and outpatient
  254  nursing care and therapies, pharmacy services, durable medical
  255  equipment, and Prescribed Pediatric Extended Care.
  256  
  257  Managed care plans that have not contracted with all statewide
  258  essential providers in all regions as of the first date of
  259  recipient enrollment must continue to negotiate in good faith.
  260  Payments to physicians on the faculty of nonparticipating
  261  Florida medical schools shall be made at the applicable Medicaid
  262  rate. Payments for services rendered by regional perinatal
  263  intensive care centers shall be made at the applicable Medicaid
  264  rate as of the first day of the contract between the agency and
  265  the plan. Payments to nonparticipating specialty children’s
  266  hospitals shall equal the highest rate established by contract
  267  between that provider and any other Medicaid managed care plan.
  268         Section 12. This act shall take effect July 1, 2016.