Bill Text: FL S1094 | 2013 | Regular Session | Comm Sub

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-Comm_Sub.html

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       Florida Senate - 2013                             CS for SB 1094
       
       
       
       By the Committee on Health Policy; and Senator Flores
       
       
       
       
       588-03417-13                                          20131094c1
    1                        A bill to be entitled                      
    2         An act relating to home health agencies; amending s.
    3         400.474, F.S.; revising the requirements for the
    4         quarterly reporting by a home health agency of certain
    5         data submitted to the Agency for Health Care
    6         Administration; imposing a fine for failure to timely
    7         submit the quarterly report; providing an exemption to
    8         the imposition of the fine; providing an effective
    9         date.
   10  
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Present subsection (7) of section 400.474,
   14  Florida Statutes, is renumbered as subsection (8), a new
   15  subsection (7) is added to that section, and subsection (6) of
   16  that section is amended, to read:
   17         400.474 Administrative penalties.—
   18         (6) The agency may deny, revoke, or suspend the license of
   19  a home health agency and shall impose a fine of $5,000 against a
   20  home health agency that:
   21         (a) Gives remuneration for staffing services to:
   22         1. Another home health agency with which it has formal or
   23  informal patient-referral transactions or arrangements; or
   24         2. A health services pool with which it has formal or
   25  informal patient-referral transactions or arrangements,
   26  
   27  unless the home health agency has activated its comprehensive
   28  emergency management plan in accordance with s. 400.492. This
   29  paragraph does not apply to a Medicare-certified home health
   30  agency that provides fair market value remuneration for staffing
   31  services to a non-Medicare-certified home health agency that is
   32  part of a continuing care facility licensed under chapter 651
   33  for providing services to its own residents if each resident
   34  receiving home health services pursuant to this arrangement
   35  attests in writing that he or she made a decision without
   36  influence from staff of the facility to select, from a list of
   37  Medicare-certified home health agencies provided by the
   38  facility, that Medicare-certified home health agency to provide
   39  the services.
   40         (b) Provides services to residents in an assisted living
   41  facility for which the home health agency does not receive fair
   42  market value remuneration.
   43         (c) Provides staffing to an assisted living facility for
   44  which the home health agency does not receive fair market value
   45  remuneration.
   46         (d) Fails to provide the agency, upon request, with copies
   47  of all contracts with assisted living facilities which were
   48  executed within 5 years before the request.
   49         (e) Gives remuneration to a case manager, discharge
   50  planner, facility-based staff member, or third-party vendor who
   51  is involved in the discharge planning process of a facility
   52  licensed under chapter 395, chapter 429, or this chapter from
   53  whom the home health agency receives referrals.
   54         (f) Fails to submit to the agency, within 15 days after the
   55  end of each calendar quarter, a written report that includes the
   56  following data based on data as it existed on the last day of
   57  the quarter:
   58         1. The number of insulin-dependent diabetic patients
   59  receiving insulin-injection services from the home health
   60  agency;
   61         2. The number of patients receiving both home health
   62  services from the home health agency and hospice services;
   63         3. The number of patients receiving home health services
   64  from that home health agency; and
   65         4. The names and license numbers of nurses whose primary
   66  job responsibility is to provide home health services to
   67  patients and who received remuneration from the home health
   68  agency in excess of $25,000 during the calendar quarter.
   69         (f)(g) Gives cash, or its equivalent, to a Medicare or
   70  Medicaid beneficiary.
   71         (g)(h) Has more than one medical director contract in
   72  effect at one time or more than one medical director contract
   73  and one contract with a physician-specialist whose services are
   74  mandated for the home health agency in order to qualify to
   75  participate in a federal or state health care program at one
   76  time.
   77         (h)(i) Gives remuneration to a physician without a medical
   78  director contract being in effect. The contract must:
   79         1. Be in writing and signed by both parties;
   80         2. Provide for remuneration that is at fair market value
   81  for an hourly rate, which must be supported by invoices
   82  submitted by the medical director describing the work performed,
   83  the dates on which that work was performed, and the duration of
   84  that work; and
   85         3. Be for a term of at least 1 year.
   86  
   87  The hourly rate specified in the contract may not be increased
   88  during the term of the contract. The home health agency may not
   89  execute a subsequent contract with that physician which has an
   90  increased hourly rate and covers any portion of the term that
   91  was in the original contract.
   92         (i)(j) Gives remuneration to:
   93         1. A physician, and the home health agency is in violation
   94  of paragraph (g)(h) or paragraph (h)(i);
   95         2. A member of the physician’s office staff; or
   96         3. An immediate family member of the physician,
   97  
   98  if the home health agency has received a patient referral in the
   99  preceding 12 months from that physician or physician’s office
  100  staff.
  101         (j)(k) Fails to provide to the agency, upon request, copies
  102  of all contracts with a medical director which were executed
  103  within 5 years before the request.
  104         (k)(l) Demonstrates a pattern of billing the Medicaid
  105  program for services to Medicaid recipients which are medically
  106  unnecessary as determined by a final order. A pattern may be
  107  demonstrated by a showing of at least two such medically
  108  unnecessary services within one Medicaid program integrity audit
  109  period.
  110  
  111  Nothing in paragraph (e) or paragraph (i)(j) shall be
  112  interpreted as applying to or precluding any discount,
  113  compensation, waiver of payment, or payment practice permitted
  114  by 42 U.S.C. s. 1320a-7(b) or regulations adopted thereunder,
  115  including 42 C.F.R. s. 1001.952 or s. 1395nn or regulations
  116  adopted thereunder.
  117         (7) A home health agency shall submit to the agency, within
  118  15 days after the end of each calendar quarter, a written report
  119  that includes the following data as they existed on the last day
  120  of the quarter:
  121         (a) The number of insulin-dependent diabetic patients who
  122  receive insulin-injection services from the home health agency.
  123         (b) The number of patients who receive both home health
  124  services from the home health agency and hospice services.
  125         (c) The number of patients who receive home health services
  126  from the home health agency.
  127         (d) The name and license number of each nurse whose primary
  128  job responsibility is to provide home health services to
  129  patients and who received remuneration from the home health
  130  agency in excess of $25,000 during the calendar quarter.
  131  
  132  If the home health agency fails to submit the written quarterly
  133  report within 15 days after the end of each calendar quarter,
  134  the Agency for Health Care Administration shall impose a fine
  135  against the home health agency in the amount of $200 per day
  136  until the Agency for Health Care Administration receives the
  137  report, except that the total fine imposed pursuant to this
  138  subsection may not exceed $5,000 per quarter. A home health
  139  agency is exempt from the imposition of the fine if it is not a
  140  Medicaid or Medicare provider or if it does not share a
  141  controlling interest with an entity licensed, registered, or
  142  certified under part II of chapter 408 which bills the Florida
  143  Medicaid program or the Medicare program.
  144         Section 2. This act shall take effect July 1, 2013.