Bill Text: FL S2504 | 2010 | Regular Session | Introduced
Bill Title: Hospital-based Physicians [SPSC]
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2010-04-16 - Withdrawn from Health Regulation; Banking and Insurance; Health and Human Services Appropriations -SJ 00635; Withdrawn from further consideration -SJ 00635 [S2504 Detail]
Download: Florida-2010-S2504-Introduced.html
Florida Senate - 2010 SB 2504 By Senator Lawson 6-01822-10 20102504__ 1 A bill to be entitled 2 An act relating to hospital-based physicians; 3 providing definitions; prohibiting a licensed facility 4 from employing a hospital-based physician or group of 5 hospital-based physicians or entering into a contract 6 with such physicians unless those physicians are under 7 contract with each health insurer that has contracted 8 with the licensed facility to provide medical 9 services; requiring the contract between a licensed 10 facility and a hospital-based physician or group of 11 hospital-based physicians to contain provisions that 12 prohibit the physician or group of physicians from 13 collecting from the enrollees or subscribers of a 14 health insurer an amount in excess of the payment 15 received from the health insurer other than the 16 applicable copayment and certain other payments; 17 prohibiting a hospital-based physician or group of 18 hospital-based physicians from collecting from the 19 enrollees or subscribers of a health insurer any 20 amount in excess of the payment received from the 21 health insurer other than the applicable copayment and 22 certain other payments; providing for disciplinary 23 action; providing an effective date. 24 25 Be It Enacted by the Legislature of the State of Florida: 26 27 Section 1. Hospital-based physicians.— 28 (1) As used in this section, the term: 29 (a) “Hospital-based physician” or “group of hospital-based 30 physicians” means any physician or group of physicians, 31 including, but not limited to, pathologists, emergency room 32 physicians, anesthesiologists, and radiologists, who have 33 entered into an arrangement, understanding, or contract with a 34 licensed facility which: 35 1. Allows the physician or group of physicians to provide 36 medical services for a facility’s inpatients and outpatients 37 without being specifically chosen by the patients; 38 2. Precludes physicians of a similar specialty from 39 providing medical services to the facility’s inpatients and 40 outpatients; or 41 3. Fosters the opportunity for the physician or group of 42 physicians to be the providers of medical services to the 43 facility’s inpatients and outpatients within that physician’s or 44 group of physicians’ specialty type. 45 (b) “Licensed facility” means a hospital, ambulatory 46 surgical center, or mobile surgical facility licensed in 47 accordance with chapter 395, Florida Statutes. 48 (2) A licensed facility may not employ a hospital-based 49 physician or group of hospital-based physicians, and may not 50 enter into an arrangement, understanding, or contract with a 51 hospital-based physician or group of hospital-based physicians 52 unless the hospital-based physician or group of hospital-based 53 physicians is under written contract, or agrees to a written 54 contract within 90 days after the effective date of the 55 arrangement with each health insurance company or health 56 maintenance organization that has contracted with the licensed 57 facility to provide medical services to its enrollees or 58 subscribers. The hospital-based physician or group of hospital 59 based physicians shall contract on terms that are reasonably 60 comparable to the terms between similar health insurance 61 companies, health maintenance organizations, and hospital-based 62 physicians of a similar specialty in the facility’s geographic 63 area. 64 (3) Each arrangement, understanding, or contract between a 65 licensed facility and a hospital-based physician or group of 66 hospital-based physicians must contain terms that prohibit each 67 such physician or group of physicians from collecting, or 68 attempting to collect, from the enrollees or subscribers of a 69 health insurance company or health maintenance organization any 70 amount in excess of the payment received from the health 71 insurance company or health maintenance organization other than 72 the applicable copayment, deductible, coinsurance, or amounts 73 for noncovered medical services. 74 (4) A hospital-based physician or group of hospital-based 75 physicians, in an arrangement, understanding, or contract as 76 described in this section, may not collect, or attempt to 77 collect, from the enrollees or subscribers of a health insurance 78 company or health maintenance organization any amount other than 79 the amount specified in subsection (3). 80 (5) A violation of this section constitutes grounds for 81 disciplinary actions specified in ss. 395.1065 and 456.072(2), 82 Florida Statutes. 83 Section 2. This act shall take effect July 1, 2010.
