Bill Text: FL S1094 | 2013 | Regular Session | Introduced

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

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Bill Title: Home Health Agencies

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Passed) 2013-06-10 - Chapter No. 2013-133 [S1094 Detail]

Download: Florida-2013-S1094-Introduced.html

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       Florida Senate - 2013                                    SB 1094
       
       
       
       By Senator Flores
       
       
       
       
       37-00921A-13                                          20131094__
    1                        A bill to be entitled                      
    2         An act relating to home health agencies; amending s.
    3         400.474, F.S.; deleting requirements for the quarterly
    4         reporting by a home health agency of certain data
    5         submitted to the Agency for Health Care
    6         Administration; providing an effective date.
    7  
    8  Be It Enacted by the Legislature of the State of Florida:
    9  
   10         Section 1. Subsection (6) of section 400.474, Florida
   11  Statutes, is amended to read:
   12         400.474 Administrative penalties.—
   13         (6) The agency may deny, revoke, or suspend the license of
   14  a home health agency and shall impose a fine of $5,000 against a
   15  home health agency that:
   16         (a) Gives remuneration for staffing services to:
   17         1. Another home health agency with which it has formal or
   18  informal patient-referral transactions or arrangements; or
   19         2. A health services pool with which it has formal or
   20  informal patient-referral transactions or arrangements,
   21  
   22  unless the home health agency has activated its comprehensive
   23  emergency management plan in accordance with s. 400.492. This
   24  paragraph does not apply to a Medicare-certified home health
   25  agency that provides fair market value remuneration for staffing
   26  services to a non-Medicare-certified home health agency that is
   27  part of a continuing care facility licensed under chapter 651
   28  for providing services to its own residents if each resident
   29  receiving home health services pursuant to this arrangement
   30  attests in writing that he or she made a decision without
   31  influence from staff of the facility to select, from a list of
   32  Medicare-certified home health agencies provided by the
   33  facility, that Medicare-certified home health agency to provide
   34  the services.
   35         (b) Provides services to residents in an assisted living
   36  facility for which the home health agency does not receive fair
   37  market value remuneration.
   38         (c) Provides staffing to an assisted living facility for
   39  which the home health agency does not receive fair market value
   40  remuneration.
   41         (d) Fails to provide the agency, upon request, with copies
   42  of all contracts with assisted living facilities which were
   43  executed within 5 years before the request.
   44         (e) Gives remuneration to a case manager, discharge
   45  planner, facility-based staff member, or third-party vendor who
   46  is involved in the discharge planning process of a facility
   47  licensed under chapter 395, chapter 429, or this chapter from
   48  whom the home health agency receives referrals.
   49         (f) Fails to submit to the agency, within 15 days after the
   50  end of each calendar quarter, a written report that includes the
   51  following data based on data as it existed on the last day of
   52  the quarter:
   53         1. The number of insulin-dependent diabetic patients
   54  receiving insulin-injection services from the home health
   55  agency;
   56         2. The number of patients receiving both home health
   57  services from the home health agency and hospice services;
   58         3. The number of patients receiving home health services
   59  from that home health agency; and
   60         4. The names and license numbers of nurses whose primary
   61  job responsibility is to provide home health services to
   62  patients and who received remuneration from the home health
   63  agency in excess of $25,000 during the calendar quarter.
   64         (f)(g) Gives cash, or its equivalent, to a Medicare or
   65  Medicaid beneficiary.
   66         (g)(h) Has more than one medical director contract in
   67  effect at one time or more than one medical director contract
   68  and one contract with a physician-specialist whose services are
   69  mandated for the home health agency in order to qualify to
   70  participate in a federal or state health care program at one
   71  time.
   72         (h)(i) Gives remuneration to a physician without a medical
   73  director contract being in effect. The contract must:
   74         1. Be in writing and signed by both parties;
   75         2. Provide for remuneration that is at fair market value
   76  for an hourly rate, which must be supported by invoices
   77  submitted by the medical director describing the work performed,
   78  the dates on which that work was performed, and the duration of
   79  that work; and
   80         3. Be for a term of at least 1 year.
   81  
   82  The hourly rate specified in the contract may not be increased
   83  during the term of the contract. The home health agency may not
   84  execute a subsequent contract with that physician which has an
   85  increased hourly rate and covers any portion of the term that
   86  was in the original contract.
   87         (i)(j) Gives remuneration to:
   88         1. A physician, and the home health agency is in violation
   89  of paragraph (g) (h) or paragraph (h) (i);
   90         2. A member of the physician’s office staff; or
   91         3. An immediate family member of the physician,
   92  
   93  if the home health agency has received a patient referral in the
   94  preceding 12 months from that physician or physician’s office
   95  staff.
   96         (j)(k) Fails to provide to the agency, upon request, copies
   97  of all contracts with a medical director which were executed
   98  within 5 years before the request.
   99         (k)(l) Demonstrates a pattern of billing the Medicaid
  100  program for services to Medicaid recipients which are medically
  101  unnecessary as determined by a final order. A pattern may be
  102  demonstrated by a showing of at least two such medically
  103  unnecessary services within one Medicaid program integrity audit
  104  period.
  105  
  106  Nothing in paragraph (e) or paragraph (i) (j) shall be
  107  interpreted as applying to or precluding any discount,
  108  compensation, waiver of payment, or payment practice permitted
  109  by 42 U.S.C. s. 1320a-7(b) or regulations adopted thereunder,
  110  including 42 C.F.R. s. 1001.952 or s. 1395nn or regulations
  111  adopted thereunder.
  112         Section 2. This act shall take effect July 1, 2013.