Florida Senate - 2009 CS for CS for CS for SB 1986
By the Committees on Health and Human Services Appropriations;
Criminal Justice; and Health Regulation; and Senators Gaetz and
Peaden
603-05127A-09 20091986c3
1 A bill to be entitled
2 An act relating to health care; providing legislative
3 findings; designating Miami-Dade County as a health
4 care fraud area of concern; amending s. 68.085, F.S.;
5 allocating certain funds recovered under the Florida
6 False Claims Act to fund rewards for persons who
7 report and provide information relating to Medicaid
8 fraud; amending s. 68.086, F.S.; providing that a
9 defendant who prevails in an action under the Florida
10 False Claims Act may be awarded attorney’s fees and
11 costs against the person bringing the action under
12 certain circumstances; amending s. 400.471, F.S.;
13 prohibiting the Agency for Health Care Administration
14 from renewing a license of a home health agency in
15 certain counties if the agency has been sanctioned for
16 certain misconduct; amending s. 400.474, F.S.;
17 authorizing the Agency for Health Care Administration
18 to deny, revoke, or suspend the license of or fine a
19 home health agency that provides remuneration to
20 certain facilities or bills the Medicaid program for
21 medically unnecessary services; amending s. 400.506,
22 F.S.; exempting certain items from a prohibition
23 against providing remuneration to certain persons by a
24 nurse registry; creating s. 408.8065, F.S.; providing
25 additional licensure requirements for home health
26 agencies, home medical equipment providers, and health
27 care clinics; imposing criminal penalties against a
28 person who knowingly submits misleading information to
29 the Agency for Health Care Administration in
30 connection with applications for certain licenses;
31 amending s. 408.810, F.S.; revising provisions
32 relating to information required for licensure;
33 requiring certain licensees to provide clients with a
34 description of Medicaid fraud and the statewide toll
35 free telephone number for the central Medicaid fraud
36 hotline; amending s. 408.815, F.S.; providing
37 additional grounds to deny an application for a
38 license; amending s. 409.905, F.S.; authorizing the
39 Agency for Health Care Administration to require prior
40 authorization of care based on utilization rates;
41 requiring a home health agency to submit a plan of
42 care and documentation of a recipient’s medical
43 condition to the Agency for Health Care Administration
44 when requesting prior authorization; prohibiting the
45 Agency for Health Care Administration from paying for
46 home health services unless specified requirements are
47 satisfied; amending s. 409.907, F.S.; providing for
48 certain out-of-state providers to enroll as Medicaid
49 providers; amending s. 409.912, F.S.; requiring the
50 Agency for Health Care Administration to establish
51 norms for the utilization of Medicaid services;
52 requiring the agency to submit a report relating to
53 the overutilization of Medicaid services; amending s.
54 409.913, F.S.; requiring that the annual report
55 submitted by the Agency for Health Care Administration
56 and the Medicaid Fraud Control Unit of the Department
57 of Legal Affairs recommend changes necessary to
58 prevent and detect Medicaid fraud; requiring the
59 Agency for Health Care Administration to monitor
60 patterns of overutilization of Medicaid services;
61 requiring the agency to deny payment or require
62 repayment for Medicaid services under certain
63 circumstances; requiring the Agency for Health Care
64 Administration to immediately terminate a Medicaid
65 provider’s participation in the Medicaid program as a
66 result of certain adjudications against the provider
67 or certain affiliated persons; requiring the Agency
68 for Health Care Administration to suspend or terminate
69 a Medicaid provider’s participation in the Medicaid
70 program if the provider or certain affiliated persons
71 participating in the Medicaid program have been
72 suspended or terminated by the Federal Government or
73 another state; providing that a provider is subject to
74 sanctions for violations of law as the result of
75 actions or inactions of the provider or certain
76 affiliated persons; requiring the Agency for Health
77 Care Administration to use specified documents from a
78 provider’s records to calculate an overpayment by the
79 Medicaid program; prohibiting a provider from using
80 certain documents or data as evidence when challenging
81 a claim of overpayment by the Agency for Health Care
82 Administration; providing an exception; requiring that
83 the agency provide notice of certain administrative
84 sanctions to other regulatory agencies within a
85 specified period; requiring the Agency for Health Care
86 Administration to withhold or deny Medicaid payments
87 under certain circumstances; requiring the agency to
88 terminate a provider’s participation in the Medicaid
89 program if the provider fails to repay certain
90 overpayments from the Medicaid program; requiring the
91 agency to provide at least annually information on
92 Medicaid fraud in an explanation of benefits letter;
93 requiring the Agency for Health Care Administration to
94 post a list on its website of Medicaid providers and
95 affiliated persons of providers who have been
96 terminated or sanctioned; requiring the agency to take
97 certain actions to improve the prevention and
98 detection of health care fraud through the use of
99 technology; amending s. 409.920, F.S.; defining the
100 term “managed care organization”; providing criminal
101 penalties and fines for Medicaid fraud; granting civil
102 immunity to certain persons who report suspected
103 Medicaid fraud; creating s. 409.9203, F.S.;
104 authorizing the payment of rewards to persons who
105 report and provide information relating to Medicaid
106 fraud; amending s. 456.004, F.S.; requiring the
107 Department of Health to work cooperatively with the
108 Agency for Health Care Administration and the judicial
109 system to recover overpayments by the Medicaid
110 program; amending s. 456.041, F.S.; requiring the
111 Department of Health to include a statement in the
112 practitioner profile if a practitioner has been
113 terminated from participating in the Medicaid program;
114 creating s. 456.0635, F.S.; prohibiting Medicaid fraud
115 in the practice of health care professions; requiring
116 the Department of Health or boards within the
117 department to refuse to admit to exams and to deny
118 licenses, permits, or certificates to certain persons
119 who have engaged in certain acts; requiring health
120 care practitioners to report allegations of Medicaid
121 fraud; specifying that acceptance of the
122 relinquishment of a license in anticipation of charges
123 relating to Medicaid fraud constitutes permanent
124 revocation of a license; amending s. 456.072, F.S.;
125 creating additional grounds for the Department of
126 Health to take disciplinary action against certain
127 applicants or licensees for misconduct relating to a
128 Medicaid program or to health care fraud; amending s.
129 456.074, F.S.; requiring the Department of Health to
130 issue an emergency order suspending the license of a
131 person who engages in certain criminal conduct
132 relating to the Medicaid program; amending s. 465.022,
133 F.S.; authorizing partnerships and corporations to
134 obtain pharmacy permits; requiring applicants or
135 certain persons affiliated with an applicant for a
136 pharmacy permit to submit a set of fingerprints for a
137 criminal history records check and pay the costs of
138 the criminal history records check; requiring the
139 Department of Health or Board of Pharmacy to deny an
140 application for a pharmacy permit for certain
141 misconduct by the applicant; or persons affiliated
142 with the applicant; amending s. 465.023, F.S.;
143 authorizing the Department of Health or the Board of
144 Pharmacy to take disciplinary action against a
145 permitee for certain misconduct by the permitee, or
146 persons affiliated with the permitee; amending s.
147 825.103, F.S.; redefining the term “exploitation of an
148 elderly person or disabled adult”; amending s.
149 921.0022, F.S.; revising the severity level ranking of
150 Medicaid fraud under the Criminal Punishment Code;
151 creating a pilot project to monitor and verify the
152 delivery of home health services and provide for
153 electronic claims for home health services; requiring
154 the Agency for Health Care Administration to issue a
155 report evaluating the pilot project; creating a pilot
156 project for home health care management in Miami-Dade
157 County; amending ss. 400.0077 and 430.608, F.S.;
158 conforming cross-references to changes made by the
159 act; repealing s. 395.0199, F.S., relating to private
160 utilization review of health care services; amending
161 ss. 395.405 and 400.0712, F.S.; conforming cross
162 references; repealing s. 400.118(2), F.S.; removing
163 provisions requiring quality-of-care monitors for
164 nursing facilities in agency district offices;
165 amending s. 400.141, F.S.; deleting a requirement that
166 licensed nursing home facilities provide the agency
167 with a monthly report on the number of vacant beds in
168 the facility; amending s. 400.147, F.S.; revising the
169 definition of the term “adverse incident” for
170 reporting purposes; requiring abuse, neglect, and
171 exploitation to be reported to the agency and the
172 Department of Children and Family Services; deleting a
173 requirement that the agency submit an annual report on
174 nursing home adverse incidents to the Legislature;
175 amending s. 400.162, F.S.; revising requirements for
176 policies and procedures regarding the safekeeping of a
177 resident’s personal effects and property; amending s.
178 400.191; F.S.; revising the information on the
179 agency’s Internet site regarding nursing homes;
180 deleting the provision that requires the agency to
181 provide information about nursing homes in printed
182 form; amending s. 400.195, F.S.; conforming a cross
183 reference; amending s. 400.23, F.S.; deleting the
184 requirement of the agency to adopt rules regarding the
185 eating assistance provided to residents; amending s.
186 400.9935, F.S.; revising accreditation requirements
187 for clinics providing magnetic resonance imaging
188 services; amending s. 400.995, F.S.; revising agency
189 responsibilities with respect to agency administrative
190 penalties; amending s. 408.803, F.S.; revising
191 definitions applicable to part II of ch. 408, F.S.,
192 the “Health Care Licensing Procedures Act”; amending
193 s. 408.806, F.S.; revising contents of and procedures
194 relating to health care provider applications for
195 licensure; providing an exception from certain
196 licensure inspections for adult family-care homes;
197 authorizing the agency to provide electronic access to
198 certain information and documents; amending s.
199 408.808, F.S.; providing for a provisional license to
200 be issued to applicants applying for a change of
201 ownership; providing a time limit on provisional
202 licenses; amending s. 408.809, F.S.; revising
203 provisions relating to background screening of
204 specified employees; requiring health care providers
205 to submit to the agency an affidavit of compliance
206 with background screening requirements at the time of
207 license renewal; deleting a provision to conform to
208 changes made by the act; amending s. 408.811, F.S.;
209 providing for certain inspections to be accepted in
210 lieu of complete licensure inspections; granting
211 agency access to records requested during an offsite
212 review; providing timeframes for correction of certain
213 deficiencies and submission of plans to correct the
214 deficiencies; amending s. 408.813, F.S.; providing
215 classifications of violations of part II of ch. 408,
216 F.S.; providing for fines; amending s. 408.820, F.S.;
217 revising applicability of certain exemptions from
218 specified requirements of part II of ch. 408, F.S.;
219 creating s. 408.821, F.S.; requiring entities
220 regulated or licensed by the agency to designate a
221 liaison officer for emergency operations; authorizing
222 entities regulated or licensed by the agency to
223 temporarily exceed their licensed capacity to act as
224 receiving providers under specified circumstances;
225 providing requirements that apply while such entities
226 are in an overcapacity status; providing for issuance
227 of an inactive license to such licensees under
228 specified conditions; providing requirements and
229 procedures with respect to the issuance and
230 reactivation of an inactive license; authorizing the
231 agency to adopt rules; amending s. 408.831, F.S.;
232 deleting provisions relating to the authorization for
233 entities regulated or licensed by the agency to exceed
234 their licensed capacity to act as receiving facilities
235 and issuance and reactivation of inactive licenses;
236 amending s. 408.918, F.S.; revising the requirements
237 of a provider to participate in the Florida 211
238 network; requiring the Public Service Commission to
239 request the Federal Communications Commission to
240 direct the revocation of a 211 number under certain
241 circumstances; deleting the requirement for the Agency
242 for Health Care Administration to seek assistance in
243 resolving jurisdictional disputes related to 211
244 numbers; providing that the Florida Alliance of
245 Information and Referral Services is the collaborative
246 organization for the state; amending s. 409.221, F.S.;
247 conforming a cross-reference; amending s. 409.901,
248 F.S.; redefining the term “change of ownership” as it
249 relates to Medicaid providers; repealing s. 429.071,
250 F.S., relating to the intergenerational respite care
251 assisted living facility pilot program; amending s.
252 429.08, F.S.; authorizing the agency to provide
253 information regarding licensed assisted living
254 facilities on its Internet website; abolishing local
255 coordinating workgroups established by agency field
256 offices; amending s. 429.14, F.S.; conforming a
257 reference; amending s. 429.19, F.S.; revising agency
258 procedures for imposition of fines for violations of
259 part I of ch. 429, F.S., the “Assisted Living
260 Facilities Act”; amending s. 429.23, F.S.; redefining
261 the term “adverse incident” for reporting purposes;
262 requiring abuse, neglect, and exploitation to be
263 reported to the agency and the Department of Children
264 and Family Services; deleting a requirement that the
265 agency submit an annual report on assisted living
266 facility adverse incidents to the Legislature;
267 repealing s. 429.26(9), F.S., relating to the removal
268 of the requirement for a resident of an assisted
269 living facility to undergo examinations and
270 evaluations under certain circumstances; amending s.
271 430.80, F.S.; conforming a cross-reference; amending
272 ss. 435.04 and 435.05, F.S.; requiring employers of
273 certain employees to submit an affidavit of compliance
274 with level 2 screening requirements at the time of
275 license renewal; amending s. 483.031, F.S.; revising a
276 provision relating to the exemption of certain
277 clinical laboratories, to conform to changes made by
278 the act; amending s. 483.041, F.S.; redefining the
279 term “waived test” as it is used in part I of ch. 483,
280 F.S., the “Florida Clinical Laboratory Law”; repealing
281 s. 483.106, F.S., relating to applications for
282 certificates of exemption by clinical laboratories
283 that perform certain tests; amending ss. 483.172,
284 F.S.; conforming provisions; amending s. 627.4239,
285 F.S.; revising the term “standard reference
286 compendium”; amending s. 651.118, F.S.; conforming a
287 cross-reference; providing an effective date.
288
289 Be It Enacted by the Legislature of the State of Florida:
290
291 Section 1. The Legislature finds that:
292 (1) Immediate and proactive measures are necessary to
293 prevent, reduce, and mitigate health care fraud, waste, and
294 abuse and are essential to maintaining the integrity and
295 financial viability of health care delivery systems, including
296 those funded in whole or in part by the Medicare and Medicaid
297 trust funds. Without these measures, health care delivery
298 systems in this state will be depleted of necessary funds to
299 deliver patient care, and taxpayers’ dollars will be devalued
300 and not used for their intended purposes.
301 (2) Sufficient justification exists for increased oversight
302 of health care clinics, home health agencies, providers of home
303 medical equipment, and other health care providers throughout
304 the state, and in particular, in Miami-Dade County.
305 (3) The state’s best interest is served by deterring health
306 care fraud, abuse, and waste and identifying patterns of
307 fraudulent or abusive Medicare and Medicaid activity early,
308 especially in high-risk localities, such as Miami-Dade County,
309 in order to prevent inappropriate expenditures of public funds
310 and harm to the state’s residents.
311 (4) The Legislature designates Miami-Dade County as a
312 health care fraud crisis area for purposes of implementing
313 increased scrutiny of home health agencies, home medical
314 equipment providers, health care clinics, and other health care
315 providers in Miami-Dade County in order to assist the state’s
316 efforts to prevent Medicaid fraud, waste, and abuse in the
317 county and throughout the state.
318 Section 2. Section 68.085, Florida Statutes, is amended to
319 read:
320 68.085 Awards to plaintiffs bringing action.—
321 (1) If the department proceeds with and prevails in an
322 action brought by a person under this act, except as provided in
323 subsection (2), the court shall order the distribution to the
324 person of at least 15 percent but not more than 25 percent of
325 the proceeds recovered under any judgment obtained by the
326 department in an action under s. 68.082 or of the proceeds of
327 any settlement of the claim, depending upon the extent to which
328 the person substantially contributed to the prosecution of the
329 action.
330 (2) If the department proceeds with an action which the
331 court finds to be based primarily on disclosures of specific
332 information, other than that provided by the person bringing the
333 action, relating to allegations or transactions in a criminal,
334 civil, or administrative hearing; a legislative, administrative,
335 inspector general, or auditor general report, hearing, audit, or
336 investigation; or from the news media, the court may award such
337 sums as it considers appropriate, but in no case more than 10
338 percent of the proceeds recovered under a judgment or received
339 in settlement of a claim under this act, taking into account the
340 significance of the information and the role of the person
341 bringing the action in advancing the case to litigation.
342 (3) If the department does not proceed with an action under
343 this section, the person bringing the action or settling the
344 claim shall receive an amount which the court decides is
345 reasonable for collecting the civil penalty and damages. The
346 amount shall be not less than 25 percent and not more than 30
347 percent of the proceeds recovered under a judgment rendered in
348 an action under this act or in settlement of a claim under this
349 act.
350 (4) Following any distributions under subsection (1),
351 subsection (2), or subsection (3), the agency injured by the
352 submission of a false or fraudulent claim shall be awarded an
353 amount not to exceed its compensatory damages. If the action was
354 based on a claim of funds from the state Medicaid program, 10
355 percent of any remaining proceeds shall be deposited into the
356 Legal Affairs Revolving Trust Fund to fund rewards for persons
357 who report and provide information relating to Medicaid fraud
358 pursuant to s. 409.9203. Any remaining proceeds, including civil
359 penalties awarded under s. 68.082, shall be deposited in the
360 General Revenue Fund.
361 (5) Any payment under this section to the person bringing
362 the action shall be paid only out of the proceeds recovered from
363 the defendant.
364 (6) Whether or not the department proceeds with the action,
365 if the court finds that the action was brought by a person who
366 planned and initiated the violation of s. 68.082 upon which the
367 action was brought, the court may, to the extent the court
368 considers appropriate, reduce the share of the proceeds of the
369 action which the person would otherwise receive under this
370 section, taking into account the role of the person in advancing
371 the case to litigation and any relevant circumstances pertaining
372 to the violation. If the person bringing the action is convicted
373 of criminal conduct arising from his or her role in the
374 violation of s. 68.082, the person shall be dismissed from the
375 civil action and shall not receive any share of the proceeds of
376 the action. Such dismissal shall not prejudice the right of the
377 department to continue the action.
378 Section 3. Section 68.086, Florida Statutes, is amended to
379 read:
380 68.086 Expenses; attorney’s fees and costs.—
381 (1) If the department initiates an action under this act or
382 assumes control of an action brought by a person under this act,
383 the department shall be awarded its reasonable attorney’s fees,
384 expenses, and costs.
385 (2) If the court awards the person bringing the action
386 proceeds under this act, the person shall also be awarded an
387 amount for reasonable attorney’s fees and costs. Payment for
388 reasonable attorney’s fees and costs shall be made from the
389 recovered proceeds before the distribution of any award.
390 (3) If the department does not proceed with an action under
391 this act and the person bringing the action conducts the action
392 defendant is the prevailing party, the court may shall award to
393 the defendant its reasonable attorney’s fees and costs if the
394 defendant prevails in the action and the court finds that the
395 claim of against the person bringing the action was clearly
396 frivolous, clearly vexatious, or brought primarily for purposes
397 of harassment.
398 (4) No liability shall be incurred by the state government,
399 the affected agency, or the department for any expenses,
400 attorney’s fees, or other costs incurred by any person in
401 bringing or defending an action under this act.
402 Section 4. Subsection (10) is added to section 400.471,
403 Florida Statutes, to read:
404 400.471 Application for license; fee.—
405 (10) The agency may not issue a renewal license for a home
406 health agency in any county having at least one licensed home
407 health agency and that has more than one home health agency per
408 5,000 persons, as indicated by the most recent population
409 estimates published by the Legislature’s Office of Economic and
410 Demographic Research, if the applicant or any controlling
411 interest has been administratively sanctioned by the agency
412 since the last licensure renewal application for one or more of
413 the following acts:
414 (a) An intentional or negligent act that materially affects
415 the health or safety of a client of the provider;
416 (b) Knowingly providing home health services in an
417 unlicensed assisted living facility or unlicensed adult family
418 care home, unless the home health agency or employee reports the
419 unlicensed facility or home to the agency within 72 hours after
420 providing the services;
421 (c) Preparing or maintaining fraudulent patient records,
422 such as, but not limited to, charting ahead, recording vital
423 signs or symptoms which were not personally obtained or observed
424 by the home health agency’s staff at the time indicated,
425 borrowing patients or patient records from other home health
426 agencies to pass a survey or inspection, or falsifying
427 signatures;
428 (d) Failing to provide at least one service directly to a
429 patient for a period of 60 days;
430 (e) Demonstrating a pattern of falsifying documents
431 relating to the training of home health aides or certified
432 nursing assistants or demonstrating a pattern of falsifying
433 health statements for staff who provide direct care to patients.
434 A pattern may be demonstrated by a showing of at least three
435 fraudulent entries or documents;
436 (f) Demonstrating a pattern of billing any payor for
437 services not provided. A pattern may be demonstrated by a
438 showing of at least three billings for services not provided
439 within a 12-month period;
440 (g) Demonstrating a pattern of failing to provide a service
441 specified in the home health agency’s written agreement with a
442 patient or the patient’s legal representative, or the plan of
443 care for that patient, unless a reduction in service is mandated
444 by Medicare, Medicaid, or a state program or as provided in s.
445 400.492(3). A pattern may be demonstrated by a showing of at
446 least three incidents, regardless of the patient or service, in
447 which the home health agency did not provide a service specified
448 in a written agreement or plan of care during a 3-month period;
449 (h) Giving remuneration to a case manager, discharge
450 planner, facility-based staff member, or third-party vendor who
451 is involved in the discharge planning process of a facility
452 licensed under chapter 395, chapter 429, or this chapter from
453 whom the home health agency receives referrals or gives
454 remuneration as prohibited in s. 400.474(6)(a);
455 (i) Giving cash, or its equivalent, to a Medicare or
456 Medicaid beneficiary;
457 (j) Demonstrating a pattern of billing the Medicaid program
458 for services to Medicaid recipients which are medically
459 unnecessary. A pattern may be demonstrated by a showing of at
460 least two fraudulent entries or documents;
461 (k) Providing services to residents in an assisted living
462 facility for which the home health agency does not receive fair
463 market value remuneration; or
464 (l) Providing staffing to an assisted living facility for
465 which the home health agency does not receive fair market value
466 remuneration.
467 Section 5. Paragraph (e) of subsection (6) of section
468 400.474, Florida Statutes, is amended, and paragraph (l) is
469 added to that subsection, to read:
470 400.474 Administrative penalties.—
471 (6) The agency may deny, revoke, or suspend the license of
472 a home health agency and shall impose a fine of $5,000 against a
473 home health agency that:
474 (e) Gives remuneration to a case manager, discharge
475 planner, facility-based staff member, or third-party vendor who
476 is involved in the discharge planning process of a facility
477 licensed under chapter 395, chapter 429, or this chapter from
478 whom the home health agency receives referrals.
479 (l) Demonstrates a pattern of billing the Medicaid program
480 for services to Medicaid recipients which are medically
481 unnecessary. A pattern may be demonstrated by a showing of at
482 least two medically unnecessary services.
483 Section 6. Paragraph (a) of subsection (15) of section
484 400.506, Florida Statutes, is amended to read:
485 400.506 Licensure of nurse registries; requirements;
486 penalties.—
487 (15)(a) The agency may deny, suspend, or revoke the license
488 of a nurse registry and shall impose a fine of $5,000 against a
489 nurse registry that:
490 1. Provides services to residents in an assisted living
491 facility for which the nurse registry does not receive fair
492 market value remuneration.
493 2. Provides staffing to an assisted living facility for
494 which the nurse registry does not receive fair market value
495 remuneration.
496 3. Fails to provide the agency, upon request, with copies
497 of all contracts with assisted living facilities which were
498 executed within the last 5 years.
499 4. Gives remuneration to a case manager, discharge planner,
500 facility-based staff member, or third-party vendor who is
501 involved in the discharge planning process of a facility
502 licensed under chapter 395 or this chapter and from whom the
503 nurse registry receives referrals. However, this subparagraph
504 does not prohibit a nurse registry from providing promotional
505 items or promotional products, food, or beverages. The
506 cumulative value of these items may not exceed $50 for a single
507 event. The cumulative value of these items may not exceed $100
508 in a calendar year for all persons specified in this
509 subparagraph who are affiliated with a facility.
510 5. Gives remuneration to a physician, a member of the
511 physician’s office staff, or an immediate family member of the
512 physician, and the nurse registry received a patient referral in
513 the last 12 months from that physician or the physician’s office
514 staff. However, this subparagraph does not prohibit a nurse
515 registry from providing promotional items or promotional
516 products, food, or beverages. The cumulative value of these
517 items may not exceed $50 for a single event. The cumulative
518 value of these items may not exceed $100 in a calendar year for
519 all persons specified in this subparagraph who are affiliated
520 with a physician’s office.
521 Section 7. Section 408.8065, Florida Statutes, is created
522 to read:
523 408.8065 Additional licensure requirements for home health
524 agencies, home medical equipment providers, and health care
525 clinics.—
526 (1) An applicant for initial licensure, or initial
527 licensure due to a change of ownership, as a home health agency,
528 home medical equipment provider, or health care clinic shall:
529 (a) Demonstrate financial ability to operate, as required
530 under s. 408.810(8).
531 (b) Submit pro forma financial statements, including a
532 balance sheet, income and expense statement, and a statement of
533 cash flows for the first 2 years of operation which provide
534 evidence that the applicant has sufficient assets, credit, and
535 projected revenues to cover liabilities and expenses.
536 (c) Submit a statement of the applicant’s estimated startup
537 costs and sources of funds through the break-even point in
538 operations demonstrating that the applicant has the ability to
539 fund all startup costs, working capital, and contingency
540 financing. The statement must show that the applicant has at a
541 minimum 3 months of average projected expenses to cover startup
542 costs, working capital, and contingency financing. The minimum
543 amount for contingency funding may not be less than 1 month of
544 average projected expenses.
545 (d) Demonstrate the financial ability to operate if the
546 applicant’s assets, credit, and projected revenues meet or
547 exceed projected liabilities and expenses, and provide
548 independent evidence that the funds necessary for startup costs,
549 working capital, and contingency financing exist and will be
550 available as needed.
551
552 All documents required under this subsection must be prepared in
553 accordance with generally accepted accounting principles and may
554 be in a compilation form. The financial statements must be
555 signed by a certified public accountant.
556 (2) In addition to the penalties provided in s. 408.812,
557 any person offering services requiring licensure under part III,
558 part VII, or part X of chapter 400, who knowingly files a false
559 or misleading license or license renewal application or who
560 submits false or misleading information related to such
561 application, and any person who violates or conspires to violate
562 this section, commits a felony of the third degree, punishable
563 as provided in s. 775.082, s. 775.083, or s. 775.084.
564 Section 8. Subsection (3) and paragraph (a) of subsection
565 (5) of section 408.810, Florida Statutes, are amended to read:
566 408.810 Minimum licensure requirements.—In addition to the
567 licensure requirements specified in this part, authorizing
568 statutes, and applicable rules, each applicant and licensee must
569 comply with the requirements of this section in order to obtain
570 and maintain a license.
571 (3) Unless otherwise specified in this part, authorizing
572 statutes, or applicable rules, any information required to be
573 reported to the agency must be submitted within 21 calendar days
574 after the report period or effective date of the information,
575 whichever is earlier, including, but not limited to, any change
576 of:
577 (a) Information contained in the most recent application
578 for licensure.
579 (b) Required insurance or bonds.
580 (5)(a) On or before the first day services are provided to
581 a client, a licensee must inform the client and his or her
582 immediate family or representative, if appropriate, of the right
583 to report:
584 1. Complaints. The statewide toll-free telephone number for
585 reporting complaints to the agency must be provided to clients
586 in a manner that is clearly legible and must include the words:
587 “To report a complaint regarding the services you receive,
588 please call toll-free (phone number).”
589 2. Abusive, neglectful, or exploitative practices. The
590 statewide toll-free telephone number for the central abuse
591 hotline must be provided to clients in a manner that is clearly
592 legible and must include the words: “To report abuse, neglect,
593 or exploitation, please call toll-free (phone number).”
594 3. Medicaid fraud. An agency-written description of
595 Medicaid fraud and the statewide toll-free telephone number for
596 the central Medicaid fraud hotline must be provided to clients
597 in a manner that is clearly legible and must include the words:
598 “To report suspected Medicaid fraud, please call toll-free
599 (phone number).”
600
601 The agency shall publish a minimum of a 90-day advance notice of
602 a change in the toll-free telephone numbers.
603 Section 9. Subsection (4) is added to section 408.815,
604 Florida Statutes, to read:
605 408.815 License or application denial; revocation.—
606 (4) In addition to the grounds provided in authorizing
607 statutes, the agency shall deny an application for a license or
608 license renewal if the applicant or a person having a
609 controlling interest in an applicant has been:
610 (a) Convicted of, or enters a plea of guilty or nolo
611 contendere to, regardless of adjudication, a felony under
612 chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or
613 42 U.S.C. ss. 1395-1396; or
614 (b) Terminated for cause, pursuant to the appeals
615 procedures established by the state or Federal Government, from
616 any state Medicaid program or the federal Medicare program.
617 Section 10. Subsection (4) of section 409.905, Florida
618 Statutes, is amended to read:
619 409.905 Mandatory Medicaid services.—The agency may make
620 payments for the following services, which are required of the
621 state by Title XIX of the Social Security Act, furnished by
622 Medicaid providers to recipients who are determined to be
623 eligible on the dates on which the services were provided. Any
624 service under this section shall be provided only when medically
625 necessary and in accordance with state and federal law.
626 Mandatory services rendered by providers in mobile units to
627 Medicaid recipients may be restricted by the agency. Nothing in
628 this section shall be construed to prevent or limit the agency
629 from adjusting fees, reimbursement rates, lengths of stay,
630 number of visits, number of services, or any other adjustments
631 necessary to comply with the availability of moneys and any
632 limitations or directions provided for in the General
633 Appropriations Act or chapter 216.
634 (4) HOME HEALTH CARE SERVICES.—The agency shall pay for
635 nursing and home health aide services, supplies, appliances, and
636 durable medical equipment, necessary to assist a recipient
637 living at home. An entity that provides services pursuant to
638 this subsection shall be licensed under part III of chapter 400.
639 These services, equipment, and supplies, or reimbursement
640 therefor, may be limited as provided in the General
641 Appropriations Act and do not include services, equipment, or
642 supplies provided to a person residing in a hospital or nursing
643 facility.
644 (a) In providing home health care services, the agency may
645 require prior authorization of care based on diagnosis or
646 utilization rates. The agency shall require prior authorization
647 for visits for home health services that are not associated with
648 a skilled nursing visit when the home health agency utilization
649 rates exceed the state average by 50 percent or more. The home
650 health agency must submit the recipient’s plan of care and
651 documentation that supports the recipient’s diagnosis to the
652 agency when requesting prior authorization.
653 (b) The agency shall implement a comprehensive utilization
654 management program that requires prior authorization of all
655 private duty nursing services, an individualized treatment plan
656 that includes information about medication and treatment orders,
657 treatment goals, methods of care to be used, and plans for care
658 coordination by nurses and other health professionals. The
659 utilization management program shall also include a process for
660 periodically reviewing the ongoing use of private duty nursing
661 services. The assessment of need shall be based on a child’s
662 condition, family support and care supplements, a family’s
663 ability to provide care, and a family’s and child’s schedule
664 regarding work, school, sleep, and care for other family
665 dependents. When implemented, the private duty nursing
666 utilization management program shall replace the current
667 authorization program used by the Agency for Health Care
668 Administration and the Children’s Medical Services program of
669 the Department of Health. The agency may competitively bid on a
670 contract to select a qualified organization to provide
671 utilization management of private duty nursing services. The
672 agency is authorized to seek federal waivers to implement this
673 initiative.
674 (c) The agency may not pay for home health services, unless
675 the services are medically necessary, and:
676 1. The services are ordered by a physician.
677 2. The written prescription for the services is signed and
678 dated by the recipient’s physician before the development of a
679 plan of care and before any request requiring prior
680 authorization.
681 3. The physician ordering the services is not employed,
682 under contract with, or otherwise affiliated with the home
683 health agency rendering the services. However, this subparagraph
684 does not apply to a home health agency affiliated with a
685 retirement community, of which the parent corporation or a
686 related legal entity owns a rural health clinic certified under
687 42 C.F.R. part 491, subpart A, ss. 1-11, a nursing home licensed
688 under part II of chapter 400, or an apartment or single-family
689 home for independent living.
690 4. The physician ordering the services has examined the
691 recipient within the 30 days preceding the initial request for
692 the services and biannually thereafter.
693 5. The written prescription for the services includes the
694 recipient’s acute or chronic medical condition or diagnosis, the
695 home health service required, and, for skilled nursing services,
696 the frequency and duration of the services.
697 6. The national provider identifier, Medicaid
698 identification number, or medical practitioner license number of
699 the physician ordering the services is listed on the written
700 prescription for the services, the claim for home health
701 reimbursement, and the prior authorization request.
702 Section 11. Subsection (1) of section 409.907, Florida
703 Statutes, is amended to read:
704 (1) Each provider agreement shall require the provider to
705 comply fully with all state and federal laws pertaining to the
706 Medicaid program, as well as all federal, state, and local laws
707 pertaining to licensure, if required, and the practice of any of
708 the healing arts, and shall require the provider to provide
709 services or goods of not less than the scope and quality it
710 provides to the general public. Providers physically located in
711 the State of Florida may be enrolled as Medicaid providers. A
712 provider located outside the State of Florida may be enrolled if
713 the provider’s location is no more than 50 miles from the
714 Florida state line, and the agency determines a need for that
715 provider type to ensure adequate access to care.
716 Section 12. Subsection (14) of section 409.912, Florida
717 Statutes, is amended to read:
718 409.912 Cost-effective purchasing of health care.—The
719 agency shall purchase goods and services for Medicaid recipients
720 in the most cost-effective manner consistent with the delivery
721 of quality medical care. To ensure that medical services are
722 effectively utilized, the agency may, in any case, require a
723 confirmation or second physician’s opinion of the correct
724 diagnosis for purposes of authorizing future services under the
725 Medicaid program. This section does not restrict access to
726 emergency services or poststabilization care services as defined
727 in 42 C.F.R. part 438.114. Such confirmation or second opinion
728 shall be rendered in a manner approved by the agency. The agency
729 shall maximize the use of prepaid per capita and prepaid
730 aggregate fixed-sum basis services when appropriate and other
731 alternative service delivery and reimbursement methodologies,
732 including competitive bidding pursuant to s. 287.057, designed
733 to facilitate the cost-effective purchase of a case-managed
734 continuum of care. The agency shall also require providers to
735 minimize the exposure of recipients to the need for acute
736 inpatient, custodial, and other institutional care and the
737 inappropriate or unnecessary use of high-cost services. The
738 agency shall contract with a vendor to monitor and evaluate the
739 clinical practice patterns of providers in order to identify
740 trends that are outside the normal practice patterns of a
741 provider’s professional peers or the national guidelines of a
742 provider’s professional association. The vendor must be able to
743 provide information and counseling to a provider whose practice
744 patterns are outside the norms, in consultation with the agency,
745 to improve patient care and reduce inappropriate utilization.
746 The agency may mandate prior authorization, drug therapy
747 management, or disease management participation for certain
748 populations of Medicaid beneficiaries, certain drug classes, or
749 particular drugs to prevent fraud, abuse, overuse, and possible
750 dangerous drug interactions. The Pharmaceutical and Therapeutics
751 Committee shall make recommendations to the agency on drugs for
752 which prior authorization is required. The agency shall inform
753 the Pharmaceutical and Therapeutics Committee of its decisions
754 regarding drugs subject to prior authorization. The agency is
755 authorized to limit the entities it contracts with or enrolls as
756 Medicaid providers by developing a provider network through
757 provider credentialing. The agency may competitively bid single
758 source-provider contracts if procurement of goods or services
759 results in demonstrated cost savings to the state without
760 limiting access to care. The agency may limit its network based
761 on the assessment of beneficiary access to care, provider
762 availability, provider quality standards, time and distance
763 standards for access to care, the cultural competence of the
764 provider network, demographic characteristics of Medicaid
765 beneficiaries, practice and provider-to-beneficiary standards,
766 appointment wait times, beneficiary use of services, provider
767 turnover, provider profiling, provider licensure history,
768 previous program integrity investigations and findings, peer
769 review, provider Medicaid policy and billing compliance records,
770 clinical and medical record audits, and other factors. Providers
771 shall not be entitled to enrollment in the Medicaid provider
772 network. The agency shall determine instances in which allowing
773 Medicaid beneficiaries to purchase durable medical equipment and
774 other goods is less expensive to the Medicaid program than long
775 term rental of the equipment or goods. The agency may establish
776 rules to facilitate purchases in lieu of long-term rentals in
777 order to protect against fraud and abuse in the Medicaid program
778 as defined in s. 409.913. The agency may seek federal waivers
779 necessary to administer these policies.
780 (14)(a) The agency shall operate or contract for the
781 operation of utilization management and incentive systems
782 designed to encourage cost-effective use of services and to
783 eliminate services that are medically unnecessary. The agency
784 shall track Medicaid provider prescription and billing patterns
785 and evaluate them against Medicaid medical necessity criteria
786 and coverage and limitation guidelines adopted by rule. Medical
787 necessity determination requires that service be consistent with
788 symptoms or confirmed diagnosis of illness or injury under
789 treatment and not in excess of the patient’s needs. The agency
790 shall conduct reviews of provider exceptions to peer group norms
791 and shall, using statistical methodologies, provider profiling,
792 and analysis of billing patterns, detect and investigate
793 abnormal or unusual increases in billing or payment of claims
794 for Medicaid services and medically unnecessary provision of
795 services. Providers that demonstrate a pattern of submitting
796 claims for medically unnecessary services shall be referred to
797 the Medicaid program integrity unit for investigation. In its
798 annual report, required in s. 409.913, the agency shall report
799 on its efforts to control overutilization as described in this
800 paragraph.
801 (b) The agency shall develop a procedure for determining
802 whether health care providers and service vendors can provide
803 the Medicaid program using a business case that demonstrates
804 whether a particular good or service can offset the cost of
805 providing the good or service in an alternative setting or
806 through other means and therefore should receive a higher
807 reimbursement. The business case must include, but need not be
808 limited to:
809 1. A detailed description of the good or service to be
810 provided, a description and analysis of the agency’s current
811 performance of the service, and a rationale documenting how
812 providing the service in an alternative setting would be in the
813 best interest of the state, the agency, and its clients.
814 2. A cost-benefit analysis documenting the estimated
815 specific direct and indirect costs, savings, performance
816 improvements, risks, and qualitative and quantitative benefits
817 involved in or resulting from providing the service. The cost
818 benefit analysis must include a detailed plan and timeline
819 identifying all actions that must be implemented to realize
820 expected benefits. The Secretary of Health Care Administration
821 shall verify that all costs, savings, and benefits are valid and
822 achievable.
823 (c) If the agency determines that the increased
824 reimbursement is cost-effective, the agency shall recommend a
825 change in the reimbursement schedule for that particular good or
826 service. If, within 12 months after implementing any rate change
827 under this procedure, the agency determines that costs were not
828 offset by the increased reimbursement schedule, the agency may
829 revert to the former reimbursement schedule for the particular
830 good or service.
831 Section 13. Subsections (2), (7), (11), (13), (14), (15),
832 (21), (22), (24), (25), (27), (30), (31), and (36) of section
833 409.913, Florida Statutes, are amended, and subsections (37) and
834 (38) are added to that section, to read:
835 409.913 Oversight of the integrity of the Medicaid
836 program.—The agency shall operate a program to oversee the
837 activities of Florida Medicaid recipients, and providers and
838 their representatives, to ensure that fraudulent and abusive
839 behavior and neglect of recipients occur to the minimum extent
840 possible, and to recover overpayments and impose sanctions as
841 appropriate. Beginning January 1, 2003, and each year
842 thereafter, the agency and the Medicaid Fraud Control Unit of
843 the Department of Legal Affairs shall submit a joint report to
844 the Legislature documenting the effectiveness of the state’s
845 efforts to control Medicaid fraud and abuse and to recover
846 Medicaid overpayments during the previous fiscal year. The
847 report must describe the number of cases opened and investigated
848 each year; the sources of the cases opened; the disposition of
849 the cases closed each year; the amount of overpayments alleged
850 in preliminary and final audit letters; the number and amount of
851 fines or penalties imposed; any reductions in overpayment
852 amounts negotiated in settlement agreements or by other means;
853 the amount of final agency determinations of overpayments; the
854 amount deducted from federal claiming as a result of
855 overpayments; the amount of overpayments recovered each year;
856 the amount of cost of investigation recovered each year; the
857 average length of time to collect from the time the case was
858 opened until the overpayment is paid in full; the amount
859 determined as uncollectible and the portion of the uncollectible
860 amount subsequently reclaimed from the Federal Government; the
861 number of providers, by type, that are terminated from
862 participation in the Medicaid program as a result of fraud and
863 abuse; and all costs associated with discovering and prosecuting
864 cases of Medicaid overpayments and making recoveries in such
865 cases. The report must also document actions taken to prevent
866 overpayments and the number of providers prevented from
867 enrolling in or reenrolling in the Medicaid program as a result
868 of documented Medicaid fraud and abuse and must include policy
869 recommendations recommend changes necessary to prevent or
870 recover overpayments and changes necessary to prevent and detect
871 Medicaid fraud. All policy recommendations in the report must
872 include a detailed fiscal analysis, including, but not limited
873 to, implementation costs, estimated savings to the Medicaid
874 program, and the return on investment. The agency must submit
875 the policy recommendations and fiscal analyses in the report to
876 the appropriate estimating conference, pursuant to s. 216.137,
877 by February 15 of each year. The agency and the Medicaid Fraud
878 Control Unit of the Department of Legal Affairs each must
879 include detailed unit-specific performance standards,
880 benchmarks, and metrics in the report, including projected cost
881 savings to the state Medicaid program during the following
882 fiscal year.
883 (2) The agency shall conduct, or cause to be conducted by
884 contract or otherwise, reviews, investigations, analyses,
885 audits, or any combination thereof, to determine possible fraud,
886 abuse, overpayment, or recipient neglect in the Medicaid program
887 and shall report the findings of any overpayments in audit
888 reports as appropriate. At least 5 percent of all audits shall
889 be conducted on a random basis. As part of its ongoing fraud
890 detection activities, the agency shall identify and monitor, by
891 contract or otherwise, patterns of overutilization of Medicaid
892 services based on state averages. The agency shall track
893 Medicaid provider prescription and billing patterns and evaluate
894 them against Medicaid medical necessity criteria and coverage
895 and limitation guidelines adopted by rule. Medical necessity
896 determination requires that service be consistent with symptoms
897 or confirmed diagnosis of illness or injury under treatment and
898 not in excess of the patient’s needs. The agency shall conduct
899 reviews of provider exceptions to peer group norms and shall,
900 using statistical methodologies, provider profiling, and
901 analysis of billing patterns, detect and investigate abnormal or
902 unusual increases in billing or payment of claims for Medicaid
903 services and medically unnecessary provision of services.
904 (7) When presenting a claim for payment under the Medicaid
905 program, a provider has an affirmative duty to supervise the
906 provision of, and be responsible for, goods and services claimed
907 to have been provided, to supervise and be responsible for
908 preparation and submission of the claim, and to present a claim
909 that is true and accurate and that is for goods and services
910 that:
911 (a) Have actually been furnished to the recipient by the
912 provider prior to submitting the claim.
913 (b) Are Medicaid-covered goods or services that are
914 medically necessary.
915 (c) Are of a quality comparable to those furnished to the
916 general public by the provider’s peers.
917 (d) Have not been billed in whole or in part to a recipient
918 or a recipient’s responsible party, except for such copayments,
919 coinsurance, or deductibles as are authorized by the agency.
920 (e) Are provided in accord with applicable provisions of
921 all Medicaid rules, regulations, handbooks, and policies and in
922 accordance with federal, state, and local law.
923 (f) Are documented by records made at the time the goods or
924 services were provided, demonstrating the medical necessity for
925 the goods or services rendered. Medicaid goods or services are
926 excessive or not medically necessary unless both the medical
927 basis and the specific need for them are fully and properly
928 documented in the recipient’s medical record.
929
930 The agency shall may deny payment or require repayment for goods
931 or services that are not presented as required in this
932 subsection.
933 (11) The agency shall may deny payment or require repayment
934 for inappropriate, medically unnecessary, or excessive goods or
935 services from the person furnishing them, the person under whose
936 supervision they were furnished, or the person causing them to
937 be furnished.
938 (13) The agency shall immediately may terminate
939 participation of a Medicaid provider in the Medicaid program and
940 may seek civil remedies or impose other administrative sanctions
941 against a Medicaid provider, if the provider or any principal,
942 officer, director, agent, managing employee, or affiliated
943 person of the provider, or any partner or shareholder having an
944 ownership interest in the provider equal to 5 percent or
945 greater, has been:
946 (a) Convicted of a criminal offense related to the delivery
947 of any health care goods or services, including the performance
948 of management or administrative functions relating to the
949 delivery of health care goods or services;
950 (b) Convicted of a criminal offense under federal law or
951 the law of any state relating to the practice of the provider’s
952 profession; or
953 (c) Found by a court of competent jurisdiction to have
954 neglected or physically abused a patient in connection with the
955 delivery of health care goods or services.
956
957 If the agency determines a provider did not participate or
958 acquiesce in an offense specified in paragraph (a), paragraph
959 (b), or paragraph (c), termination will not be imposed. If the
960 agency effects a termination under this subsection, the agency
961 shall issue an immediate final order pursuant to s.
962 120.569(2)(n).
963 (14) If the provider has been suspended or terminated from
964 participation in the Medicaid program or the Medicare program by
965 the Federal Government or any state, the agency must immediately
966 suspend or terminate, as appropriate, the provider’s
967 participation in this state’s the Florida Medicaid program for a
968 period no less than that imposed by the Federal Government or
969 any other state, and may not enroll such provider in this
970 state’s the Florida Medicaid program while such foreign
971 suspension or termination remains in effect. The agency shall
972 also immediately suspend or terminate, as appropriate, a
973 provider’s participation in this state’s Medicaid program if the
974 provider participated or acquiesced in any action for which any
975 principal, officer, director, agent, managing employee, or
976 affiliated person of the provider, or any partner or shareholder
977 having an ownership interest in the provider equal to 5 percent
978 or greater, was suspended or terminated from participating in
979 the Medicaid program or the Medicare program by the Federal
980 Government or any state. This sanction is in addition to all
981 other remedies provided by law.
982 (15) The agency shall may seek a any remedy provided by
983 law, including, but not limited to, any remedy the remedies
984 provided in subsections (13) and (16) and s. 812.035, if:
985 (a) The provider’s license has not been renewed, or has
986 been revoked, suspended, or terminated, for cause, by the
987 licensing agency of any state;
988 (b) The provider has failed to make available or has
989 refused access to Medicaid-related records to an auditor,
990 investigator, or other authorized employee or agent of the
991 agency, the Attorney General, a state attorney, or the Federal
992 Government;
993 (c) The provider has not furnished or has failed to make
994 available such Medicaid-related records as the agency has found
995 necessary to determine whether Medicaid payments are or were due
996 and the amounts thereof;
997 (d) The provider has failed to maintain medical records
998 made at the time of service, or prior to service if prior
999 authorization is required, demonstrating the necessity and
1000 appropriateness of the goods or services rendered;
1001 (e) The provider is not in compliance with provisions of
1002 Medicaid provider publications that have been adopted by
1003 reference as rules in the Florida Administrative Code; with
1004 provisions of state or federal laws, rules, or regulations; with
1005 provisions of the provider agreement between the agency and the
1006 provider; or with certifications found on claim forms or on
1007 transmittal forms for electronically submitted claims that are
1008 submitted by the provider or authorized representative, as such
1009 provisions apply to the Medicaid program;
1010 (f) The provider or person who ordered or prescribed the
1011 care, services, or supplies has furnished, or ordered the
1012 furnishing of, goods or services to a recipient which are
1013 inappropriate, unnecessary, excessive, or harmful to the
1014 recipient or are of inferior quality;
1015 (g) The provider has demonstrated a pattern of failure to
1016 provide goods or services that are medically necessary;
1017 (h) The provider or an authorized representative of the
1018 provider, or a person who ordered or prescribed the goods or
1019 services, has submitted or caused to be submitted false or a
1020 pattern of erroneous Medicaid claims;
1021 (i) The provider or an authorized representative of the
1022 provider, or a person who has ordered or prescribed the goods or
1023 services, has submitted or caused to be submitted a Medicaid
1024 provider enrollment application, a request for prior
1025 authorization for Medicaid services, a drug exception request,
1026 or a Medicaid cost report that contains materially false or
1027 incorrect information;
1028 (j) The provider or an authorized representative of the
1029 provider has collected from or billed a recipient or a
1030 recipient’s responsible party improperly for amounts that should
1031 not have been so collected or billed by reason of the provider’s
1032 billing the Medicaid program for the same service;
1033 (k) The provider or an authorized representative of the
1034 provider has included in a cost report costs that are not
1035 allowable under a Florida Title XIX reimbursement plan, after
1036 the provider or authorized representative had been advised in an
1037 audit exit conference or audit report that the costs were not
1038 allowable;
1039 (l) The provider is charged by information or indictment
1040 with fraudulent billing practices. The sanction applied for this
1041 reason is limited to suspension of the provider’s participation
1042 in the Medicaid program for the duration of the indictment
1043 unless the provider is found guilty pursuant to the information
1044 or indictment;
1045 (m) The provider or a person who has ordered, or prescribed
1046 the goods or services is found liable for negligent practice
1047 resulting in death or injury to the provider’s patient;
1048 (n) The provider fails to demonstrate that it had available
1049 during a specific audit or review period sufficient quantities
1050 of goods, or sufficient time in the case of services, to support
1051 the provider’s billings to the Medicaid program;
1052 (o) The provider has failed to comply with the notice and
1053 reporting requirements of s. 409.907;
1054 (p) The agency has received reliable information of patient
1055 abuse or neglect or of any act prohibited by s. 409.920; or
1056 (q) The provider has failed to comply with an agreed-upon
1057 repayment schedule.
1058
1059 A provider is subject to sanctions for violations of this
1060 subsection as the result of actions or inactions of the
1061 provider, or actions or inactions of any principal, officer,
1062 director, agent, managing employee, or affiliated person of the
1063 provider, or any partner or shareholder having an ownership
1064 interest in the provider equal to 5 percent or greater, in which
1065 the provider participated or acquiesced.
1066 (21) When making a determination that an overpayment has
1067 occurred, the agency shall prepare and issue an audit report to
1068 the provider showing the calculation of overpayments. If the
1069 agency’s determination that an overpayment has occurred is based
1070 upon a review of the provider’s records, the calculation of the
1071 overpayment shall be based upon documentation created prior to
1072 the start of any investigation or created at the request of the
1073 agency.
1074 (22) The audit report, supported by agency work papers,
1075 showing an overpayment to a provider constitutes evidence of the
1076 overpayment. A provider may not present or elicit testimony,
1077 either on direct examination or cross-examination in any court
1078 or administrative proceeding, regarding the purchase or
1079 acquisition by any means of drugs, goods, or supplies; sales or
1080 divestment by any means of drugs, goods, or supplies; or
1081 inventory of drugs, goods, or supplies, unless such acquisition,
1082 sales, divestment, or inventory is documented by written
1083 invoices, written inventory records, or other competent written
1084 documentary evidence maintained in the normal course of the
1085 provider’s business. Notwithstanding the applicable rules of
1086 discovery, all documentation that will be offered as evidence at
1087 an administrative hearing on a Medicaid overpayment must be
1088 exchanged by all parties at least 14 days before the
1089 administrative hearing or must be excluded from consideration.
1090 The documentation or data that a provider may rely upon or
1091 present as evidence that an overpayment has not occurred must
1092 have been created prior to the start of any agency investigation
1093 and must be made available to the agency before issuance of a
1094 final audit report, unless the documentation or data was created
1095 at the request of the agency. Documentation or data that was
1096 recreated due to extenuating circumstances beyond the provider’s
1097 control, such as a disaster or the loss of records due to change
1098 of ownership, may be presented as evidence if evidence of the
1099 extenuating circumstance is also provided. This subsection does
1100 not prohibit the introduction of expert witness reports
1101 regarding an overpayment or the issues addressed in the audit.
1102 (24) If the agency imposes an administrative sanction
1103 pursuant to subsection (13), subsection (14), or subsection
1104 (15), except paragraphs (15)(e) and (o), upon any provider or
1105 any principal, officer, director, agent, managing employee, or
1106 affiliated person of the provider other person who is regulated
1107 by another state entity, the agency shall notify that other
1108 entity of the imposition of the sanction within 5 business days.
1109 Such notification must include the provider’s or person’s name
1110 and license number and the specific reasons for sanction.
1111 (25)(a) The agency shall may withhold Medicaid payments, in
1112 whole or in part, to a provider upon receipt of reliable
1113 evidence that the circumstances giving rise to the need for a
1114 withholding of payments involve fraud, willful
1115 misrepresentation, or abuse under the Medicaid program, or a
1116 crime committed while rendering goods or services to Medicaid
1117 recipients. If it is determined that fraud, willful
1118 misrepresentation, abuse, or a crime did not occur, the payments
1119 withheld must be paid to the provider within 14 days after such
1120 determination with interest at the rate of 10 percent a year.
1121 Any money withheld in accordance with this paragraph shall be
1122 placed in a suspended account, readily accessible to the agency,
1123 so that any payment ultimately due the provider shall be made
1124 within 14 days.
1125 (b) The agency shall may deny payment, or require
1126 repayment, if the goods or services were furnished, supervised,
1127 or caused to be furnished by a person who has been suspended or
1128 terminated from the Medicaid program or Medicare program by the
1129 Federal Government or any state.
1130 (c) Overpayments owed to the agency bear interest at the
1131 rate of 10 percent per year from the date of determination of
1132 the overpayment by the agency, and payment arrangements must be
1133 made at the conclusion of legal proceedings. A provider who does
1134 not enter into or adhere to an agreed-upon repayment schedule
1135 may be terminated by the agency for nonpayment or partial
1136 payment.
1137 (d) The agency, upon entry of a final agency order, a
1138 judgment or order of a court of competent jurisdiction, or a
1139 stipulation or settlement, may collect the moneys owed by all
1140 means allowable by law, including, but not limited to, notifying
1141 any fiscal intermediary of Medicare benefits that the state has
1142 a superior right of payment. Upon receipt of such written
1143 notification, the Medicare fiscal intermediary shall remit to
1144 the state the sum claimed.
1145 (e) The agency may institute amnesty programs to allow
1146 Medicaid providers the opportunity to voluntarily repay
1147 overpayments. The agency may adopt rules to administer such
1148 programs.
1149 (27) When the Agency for Health Care Administration has
1150 made a probable cause determination and alleged that an
1151 overpayment to a Medicaid provider has occurred, the agency,
1152 after notice to the provider, shall may:
1153 (a) Withhold, and continue to withhold during the pendency
1154 of an administrative hearing pursuant to chapter 120, any
1155 medical assistance reimbursement payments until such time as the
1156 overpayment is recovered, unless within 30 days after receiving
1157 notice thereof the provider:
1158 1. Makes repayment in full; or
1159 2. Establishes a repayment plan that is satisfactory to the
1160 Agency for Health Care Administration.
1161 (b) Withhold, and continue to withhold during the pendency
1162 of an administrative hearing pursuant to chapter 120, medical
1163 assistance reimbursement payments if the terms of a repayment
1164 plan are not adhered to by the provider.
1165 (30) The agency shall may terminate a provider’s
1166 participation in the Medicaid program if the provider fails to
1167 reimburse an overpayment that has been determined by final
1168 order, not subject to further appeal, within 35 days after the
1169 date of the final order, unless the provider and the agency have
1170 entered into a repayment agreement.
1171 (31) If a provider requests an administrative hearing
1172 pursuant to chapter 120, such hearing must be conducted within
1173 90 days following assignment of an administrative law judge,
1174 absent exceptionally good cause shown as determined by the
1175 administrative law judge or hearing officer. Upon issuance of a
1176 final order, the outstanding balance of the amount determined to
1177 constitute the overpayment shall become due. If a provider fails
1178 to make payments in full, fails to enter into a satisfactory
1179 repayment plan, or fails to comply with the terms of a repayment
1180 plan or settlement agreement, the agency shall may withhold
1181 medical assistance reimbursement payments until the amount due
1182 is paid in full.
1183 (36) At least three times a year, the agency shall provide
1184 to each Medicaid recipient or his or her representative an
1185 explanation of benefits in the form of a letter that is mailed
1186 to the most recent address of the recipient on the record with
1187 the Department of Children and Family Services. The explanation
1188 of benefits must include the patient’s name, the name of the
1189 health care provider and the address of the location where the
1190 service was provided, a description of all services billed to
1191 Medicaid in terminology that should be understood by a
1192 reasonable person, and information on how to report
1193 inappropriate or incorrect billing to the agency or other law
1194 enforcement entities for review or investigation. At least once
1195 a year, the letter also must include information on how to
1196 report criminal Medicaid fraud, the Medicaid Fraud Control
1197 Unit’s toll-free hotline number, and information about the
1198 rewards available under s. 409.9203. The explanation of benefits
1199 may not be mailed for Medicaid independent laboratory services
1200 as described in s. 409.905(7) or for Medicaid certified match
1201 services as described in ss. 409.9071 and 1011.70.
1202 (37) The agency shall post on its website a current list of
1203 each Medicaid provider, including any principal, officer,
1204 director, agent, managing employee, or affiliated person of the
1205 provider, or any partner or shareholder having an ownership
1206 interest in the provider equal to 5 percent or greater, who has
1207 been terminated from the Medicaid program or sanctioned under
1208 this section. The list must be searchable by a variety of search
1209 parameters and provide for the creation of formatted lists that
1210 may be printed or imported into other applications, including
1211 spreadsheets. The agency shall update the list at least monthly.
1212 (38) In order to improve the detection of health care
1213 fraud, use technology to prevent and detect fraud, and maximize
1214 the electronic exchange of health care fraud information, the
1215 agency shall:
1216 (a) Compile, maintain, and publish on its website a
1217 detailed list of all state and federal databases that contain
1218 health care fraud information and update the list at least
1219 biannually;
1220 (b) Develop a strategic plan to connect all databases that
1221 contain health care fraud information to facilitate the
1222 electronic exchange of health information between the agency,
1223 the Department of Health, the Department of Law Enforcement, and
1224 the Attorney General’s Office. The plan must include recommended
1225 standard data formats, fraud-identification strategies, and
1226 specifications for the technical interface between state and
1227 federal health care fraud databases;
1228 (c) Monitor innovations in health information technology,
1229 specifically as it pertains to Medicaid fraud prevention and
1230 detection; and
1231 (d) Periodically publish policy briefs that highlight
1232 available new technology to prevent or detect health care fraud
1233 and projects implemented by other states, the private sector, or
1234 the Federal Government which use technology to prevent or detect
1235 health care fraud.
1236 Section 14. Subsections (1) and (2) of section 409.920,
1237 Florida Statutes, are amended, present subsections (8) and (9)
1238 of that section are renumbered as subsections (9) and (10),
1239 respectively, and a new subsection (8) is added to that section,
1240 to read:
1241 409.920 Medicaid provider fraud.—
1242 (1) For the purposes of this section, the term:
1243 (a) “Agency” means the Agency for Health Care
1244 Administration.
1245 (b) “Fiscal agent” means any individual, firm, corporation,
1246 partnership, organization, or other legal entity that has
1247 contracted with the agency to receive, process, and adjudicate
1248 claims under the Medicaid program.
1249 (c) “Item or service” includes:
1250 1. Any particular item, device, medical supply, or service
1251 claimed to have been provided to a recipient and listed in an
1252 itemized claim for payment; or
1253 2. In the case of a claim based on costs, any entry in the
1254 cost report, books of account, or other documents supporting
1255 such claim.
1256 (d) “Knowingly” means that the act was done voluntarily and
1257 intentionally and not because of mistake or accident. As used in
1258 this section, the term “knowingly” also includes the word
1259 “willfully” or “willful” which, as used in this section, means
1260 that an act was committed voluntarily and purposely, with the
1261 specific intent to do something that the law forbids, and that
1262 the act was committed with bad purpose, either to disobey or
1263 disregard the law.
1264 (e) “Managed care organization” means a private insurance
1265 carrier, health care cooperative or alliance, health maintenance
1266 organization, insurer, organization, entity, association,
1267 affiliation, or person that contracts with the agency to
1268 provide, or is reimbursed by the agency for goods and services
1269 provided, which are a required benefit of a state or federally
1270 funded health care benefit program. The term includes a person
1271 who provides or contracts to provide goods and services to a
1272 managed care organization.
1273 (2)(a) A person may not It is unlawful to:
1274 1.(a) Knowingly make, cause to be made, or aid and abet in
1275 the making of any false statement or false representation of a
1276 material fact, by commission or omission, in any claim submitted
1277 to the agency or its fiscal agent or a managed care organization
1278 for payment.
1279 2.(b) Knowingly make, cause to be made, or aid and abet in
1280 the making of a claim for items or services that are not
1281 authorized to be reimbursed by the Medicaid program.
1282 3.(c) Knowingly charge, solicit, accept, or receive
1283 anything of value, other than an authorized copayment from a
1284 Medicaid recipient, from any source in addition to the amount
1285 legally payable for an item or service provided to a Medicaid
1286 recipient under the Medicaid program or knowingly fail to credit
1287 the agency or its fiscal agent for any payment received from a
1288 third-party source.
1289 4.(d) Knowingly make or in any way cause to be made any
1290 false statement or false representation of a material fact, by
1291 commission or omission, in any document containing items of
1292 income and expense that is or may be used by the agency to
1293 determine a general or specific rate of payment for an item or
1294 service provided by a provider.
1295 5.(e) Knowingly solicit, offer, pay, or receive any
1296 remuneration, including any kickback, bribe, or rebate, directly
1297 or indirectly, overtly or covertly, in cash or in kind, in
1298 return for referring an individual to a person for the
1299 furnishing or arranging for the furnishing of any item or
1300 service for which payment may be made, in whole or in part,
1301 under the Medicaid program, or in return for obtaining,
1302 purchasing, leasing, ordering, or arranging for or recommending,
1303 obtaining, purchasing, leasing, or ordering any goods, facility,
1304 item, or service, for which payment may be made, in whole or in
1305 part, under the Medicaid program.
1306 6.(f) Knowingly submit false or misleading information or
1307 statements to the Medicaid program for the purpose of being
1308 accepted as a Medicaid provider.
1309 7.(g) Knowingly use or endeavor to use a Medicaid
1310 provider’s identification number or a Medicaid recipient’s
1311 identification number to make, cause to be made, or aid and abet
1312 in the making of a claim for items or services that are not
1313 authorized to be reimbursed by the Medicaid program.
1314 (b)1. A person who violates this subsection and receives or
1315 endeavors to receive anything of value of:
1316 a. Ten thousand dollars or less commits a felony of the
1317 third degree, punishable as provided in s. 775.082, s. 775.083,
1318 or s. 775.084.
1319 b. More than $10,000, but less than $50,000, commits a
1320 felony of the second degree, punishable as provided in s.
1321 775.082, s. 775.083, or s. 775.084.
1322 c. Fifty thousand dollars or more commits a felony of the
1323 first degree, punishable as provided in s. 775.082, s. 775.083,
1324 or s. 775.084.
1325 2. The value of separate funds, goods, or services that a
1326 person received or attempted to receive pursuant to a scheme or
1327 course of conduct may be aggregated in determining the degree of
1328 the offense.
1329 3. In addition to the sentence authorized by law, a person
1330 who is convicted of a violation of this subsection shall pay a
1331 fine in an amount equal to five times the pecuniary gain
1332 unlawfully received or the loss incurred by the Medicaid program
1333 or managed care organization, whichever is greater.
1334 (8) A person who provides the state, any state agency, any
1335 of the state’s political subdivisions, or any agency of the
1336 state’s political subdivisions with information about fraud or
1337 suspected fraud by a Medicaid provider, including a managed care
1338 organization, is immune from civil liability for providing the
1339 information unless the person acted with knowledge that the
1340 information was false or with reckless disregard for the truth
1341 or falsity of the information.
1342 Section 15. Section 409.9203, Florida Statutes, is created
1343 to read:
1344 409.9203 Rewards for reporting Medicaid fraud.—
1345 (1) The Department of Law Enforcement or director of the
1346 Medicaid Fraud Control Unit shall, subject to availability of
1347 funds, pay a reward to a person who furnishes original
1348 information relating to and reports a violation of the state’s
1349 Medicaid fraud laws, unless the person declines the reward, if
1350 the information and report:
1351 (a) Is made to the Office of the Attorney General, the
1352 Agency for Health Care Administration, the Department of Health,
1353 or the Department of Law Enforcement;
1354 (b) Relates to criminal fraud upon Medicaid funds or a
1355 criminal violation of Medicaid laws by another person; and
1356 (c) Leads to a recovery of a fine, penalty, or forfeiture
1357 of property.
1358 (2) The reward may not exceed the lesser of 25 percent of
1359 the amount recovered or $500,000 in a single case.
1360 (3) The reward shall be paid from the Legal Affairs
1361 Revolving Trust Fund from moneys collected pursuant to s.
1362 68.085.
1363 (4) A person who receives a reward pursuant to this section
1364 is not eligible to receive any funds pursuant to the Florida
1365 False Claims Act for Medicaid fraud for which a reward is
1366 received pursuant to this section.
1367 Section 16. Subsection (11) is added to section 456.004,
1368 Florida Statutes, to read:
1369 456.004 Department; powers and duties.—The department, for
1370 the professions under its jurisdiction, shall:
1371 (11) Work cooperatively with the Agency for Health Care
1372 Administration and the judicial system to recover Medicaid
1373 overpayments by the Medicaid program. The department shall
1374 investigate and prosecute health care practitioners who have not
1375 remitted amounts owed to the state for an overpayment from the
1376 Medicaid program pursuant to a final order, judgment, or
1377 stipulation or settlement.
1378 Section 17. Present subsections (6) through (10) of section
1379 456.041, Florida Statutes, are renumbered as subsections (7)
1380 through (11), respectively, and a new subsection (6) is added to
1381 that section, to read:
1382 456.041 Practitioner profile; creation.—
1383 (6) The Department of Health shall provide in each
1384 practitioner profile for every physician or advanced registered
1385 nurse practitioner terminated from participating in the Medicaid
1386 program, pursuant to s. 409.913, or sanctioned by the Medicaid
1387 program a statement that the practitioner has been terminated
1388 from participating in the Florida Medicaid program or sanctioned
1389 by the Medicaid program.
1390 Section 18. Section 456.0635, Florida Statutes, is created
1391 to read:
1392 456.0635 Medicaid fraud; disqualification for license,
1393 certificate, or registration.—
1394 (1) Medicaid fraud in the practice of a health care
1395 profession is prohibited.
1396 (2) Each board within the jurisdiction of the department,
1397 or the department if there is no board, shall refuse to admit a
1398 candidate to any examination and refuse to issue or renew a
1399 license, certificate, or registration to any applicant if the
1400 candidate or applicant or any principle, officer, agent,
1401 managing employee, or affiliated person of the applicant, has
1402 been:
1403 (a) Convicted of, or entered a plea of guilty or nolo
1404 contendere to, regardless of adjudication, a felony under
1405 chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or
1406 42 U.S.C. ss. 1395-1396; or
1407 (b) Terminated for cause, pursuant to the appeals
1408 procedures established by the state or Federal Government, from
1409 any state Medicaid program or the federal Medicare program.
1410 (3) Licensed health care practitioners shall report
1411 allegations of Medicaid fraud to the department, regardless of
1412 the practice setting in which the alleged Medicaid fraud
1413 occurred.
1414 (4) The acceptance by a licensing authority of a
1415 candidate’s relinquishment of a license which is offered in
1416 response to or anticipation of the filing of administrative
1417 charges alleging Medicaid fraud or similar charges constitutes
1418 the permanent revocation of the license.
1419 Section 19. Paragraphs (ii), (jj), (kk), and (ll) are added
1420 to subsection (1) of section 456.072, Florida Statutes, to read:
1421 456.072 Grounds for discipline; penalties; enforcement.—
1422 (1) The following acts shall constitute grounds for which
1423 the disciplinary actions specified in subsection (2) may be
1424 taken:
1425 (ii) Being convicted of, or entering a plea of guilty or
1426 nolo contendere to, any misdemeanor or felony, regardless of
1427 adjudication, under 18 U.S.C. s. 669, ss. 285-287, s. 371, s.
1428 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518,
1429 or 42 U.S.C. ss. 1320a-7b, relating to the Medicaid program.
1430 (jj) Failing to remit the sum owed to the state for an
1431 overpayment from the Medicaid program pursuant to a final order,
1432 judgment, or stipulation or settlement.
1433 (kk) Being terminated from the state Medicaid program
1434 pursuant to s. 409.913, any other state Medicaid program, or the
1435 federal Medicare program.
1436 (ll) Being convicted of, or entering a plea of guilty or
1437 nolo contendere to, any misdemeanor or felony, regardless of
1438 adjudication, a crime in any jurisdiction which relates to
1439 health care fraud.
1440 Section 20. Subsection (1) of section 456.074, Florida
1441 Statutes, is amended to read:
1442 456.074 Certain health care practitioners; immediate
1443 suspension of license.—
1444 (1) The department shall issue an emergency order
1445 suspending the license of any person licensed under chapter 458,
1446 chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
1447 chapter 464, chapter 465, chapter 466, or chapter 484 who pleads
1448 guilty to, is convicted or found guilty of, or who enters a plea
1449 of nolo contendere to, regardless of adjudication, to:
1450 (a) A felony under chapter 409, chapter 817, or chapter 893
1451 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C. ss. 1395-1396;
1452 or.
1453 (b) A misdemeanor or felony under 18 U.S.C. s. 669, ss.
1454 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s.
1455 1349, or s. 1518 or 42 U.S.C. ss. 1320a-7b, relating to the
1456 Medicaid program.
1457 Section 21. Subsections (2) and (3) of section 465.022,
1458 Florida Statutes, are amended, present subsections (4), (5),
1459 (6), and (7) of that section are renumbered as subsections (5),
1460 (6), (7), and (8), respectively, and a new subsection (4) is
1461 added to that section, to read:
1462 465.022 Pharmacies; general requirements; fees.—
1463 (2) A pharmacy permit shall be issued only to a person who
1464 is at least 18 years of age, a partnership whose partners are
1465 all at least 18 years of age, or to a corporation that which is
1466 registered pursuant to chapter 607 or chapter 617 whose
1467 officers, directors, and shareholders are at least 18 years of
1468 age.
1469 (3) Any person, partnership, or corporation before engaging
1470 in the operation of a pharmacy shall file with the board a sworn
1471 application on forms provided by the department.
1472 (a) An application for a pharmacy permit must include a set
1473 of fingerprints from each person having an ownership interest of
1474 5 percent or greater and from any person who, directly or
1475 indirectly, manages, oversees, or controls the operation of the
1476 applicant, including officers and members of the board of
1477 directors of an applicant that is a corporation. The applicant
1478 must provide payment in the application for the cost of state
1479 and national criminal history records checks.
1480 1. For corporations having more than $100 million of
1481 business taxable assets in this state, in lieu of these
1482 fingerprint requirements, the department shall require the
1483 prescription department manager who will be directly involved in
1484 the management and operation of the pharmacy to submit a set of
1485 fingerprints.
1486 2. A representative of a corporation described in
1487 subparagraph 1. satisfies the requirement to submit a set of his
1488 or her fingerprints if the fingerprints are on file with the
1489 department or the Agency for Health Care Administration, meet
1490 the fingerprint specifications for submission by the Department
1491 of Law Enforcement, and are available to the department.
1492 (b) The department shall submit the fingerprints provided
1493 by the applicant to the Department of Law Enforcement for a
1494 state criminal history records check. The Department of Law
1495 Enforcement shall forward the fingerprints to the Federal Bureau
1496 of Investigation for a national criminal history records check.
1497 (4) The department or board shall deny an application for a
1498 pharmacy permit if the applicant or an affiliated person,
1499 partner, officer, director, or prescription department manager
1500 of the applicant has:
1501 (a) Obtained a permit by misrepresentation or fraud;
1502 (b) Attempted to procure, or has procured, a permit for any
1503 other person by making, or causing to be made, any false
1504 representation;
1505 (c) Been convicted of, or entered a plea of guilty or nolo
1506 contendere to, regardless of adjudication, a crime in any
1507 jurisdiction which relates to the practice of, or the ability to
1508 practice, the profession of pharmacy;
1509 (d) Been convicted of, or entered a plea of guilty or nolo
1510 contendere to, regardless of adjudication, a crime in any
1511 jurisdiction which relates to health care fraud;
1512 (e) Been terminated for cause, pursuant to the appeals
1513 procedures established by the state or Federal Government, from
1514 any state Medicaid program or the federal Medicare program; or
1515 (f) Dispensed any medicinal drug based upon a communication
1516 that purports to be a prescription as defined by s. 465.003(14)
1517 or s. 893.02 when the pharmacist knows or has reason to believe
1518 that the purported prescription is not based upon a valid
1519 practitioner-patient relationship that includes a documented
1520 patient evaluation, including history and a physical examination
1521 adequate to establish the diagnosis for which any drug is
1522 prescribed and any other requirement established by board rule
1523 under chapter 458, chapter 459, chapter 461, chapter 463,
1524 chapter 464, or chapter 466.
1525 Section 22. Subsection (1) of section 465.023, Florida
1526 Statutes, is amended to read:
1527 465.023 Pharmacy permittee; disciplinary action.—
1528 (1) The department or the board may revoke or suspend the
1529 permit of any pharmacy permittee, and may fine, place on
1530 probation, or otherwise discipline any pharmacy permittee if the
1531 permittee, or any affiliated person, partner, officer, director,
1532 or agent of the permittee, including a person fingerprinted
1533 under s. 465.022(3), who has:
1534 (a) Obtained a permit by misrepresentation or fraud or
1535 through an error of the department or the board;
1536 (b) Attempted to procure, or has procured, a permit for any
1537 other person by making, or causing to be made, any false
1538 representation;
1539 (c) Violated any of the requirements of this chapter or any
1540 of the rules of the Board of Pharmacy; of chapter 499, known as
1541 the “Florida Drug and Cosmetic Act”; of 21 U.S.C. ss. 301-392,
1542 known as the “Federal Food, Drug, and Cosmetic Act”; of 21
1543 U.S.C. ss. 821 et seq., known as the Comprehensive Drug Abuse
1544 Prevention and Control Act; or of chapter 893;
1545 (d) Been convicted or found guilty, regardless of
1546 adjudication, of a felony or any other crime involving moral
1547 turpitude in any of the courts of this state, of any other
1548 state, or of the United States; or
1549 (e) Been convicted or disciplined by a regulatory agency of
1550 the Federal Government or a regulatory agency of another state
1551 for any offense that would constitute a violation of this
1552 chapter;
1553 (f) Been convicted of, or entered a plea of guilty or nolo
1554 contendere to, regardless of adjudication, a crime in any
1555 jurisdiction which relates to the practice of, or the ability to
1556 practice, the profession of pharmacy;
1557 (g) Been convicted of, or entered a plea of guilty or nolo
1558 contendere to, regardless of adjudication, a crime in any
1559 jurisdiction which relates to health care fraud; or
1560 (h)(e) Dispensed any medicinal drug based upon a
1561 communication that purports to be a prescription as defined by
1562 s. 465.003(14) or s. 893.02 when the pharmacist knows or has
1563 reason to believe that the purported prescription is not based
1564 upon a valid practitioner-patient relationship that includes a
1565 documented patient evaluation, including history and a physical
1566 examination adequate to establish the diagnosis for which any
1567 drug is prescribed and any other requirement established by
1568 board rule under chapter 458, chapter 459, chapter 461, chapter
1569 463, chapter 464, or chapter 466.
1570 Section 23. Section 825.103, Florida Statutes, is amended
1571 to read:
1572 825.103 Exploitation of an elderly person or disabled
1573 adult; penalties.—
1574 (1) “Exploitation of an elderly person or disabled adult”
1575 means:
1576 (a) Knowingly, by deception or intimidation, obtaining or
1577 using, or endeavoring to obtain or use, an elderly person’s or
1578 disabled adult’s funds, assets, or property with the intent to
1579 temporarily or permanently deprive the elderly person or
1580 disabled adult of the use, benefit, or possession of the funds,
1581 assets, or property, or to benefit someone other than the
1582 elderly person or disabled adult, by a person who:
1583 1. Stands in a position of trust and confidence with the
1584 elderly person or disabled adult; or
1585 2. Has a business relationship with the elderly person or
1586 disabled adult; or
1587 (b) Obtaining or using, endeavoring to obtain or use, or
1588 conspiring with another to obtain or use an elderly person’s or
1589 disabled adult’s funds, assets, or property with the intent to
1590 temporarily or permanently deprive the elderly person or
1591 disabled adult of the use, benefit, or possession of the funds,
1592 assets, or property, or to benefit someone other than the
1593 elderly person or disabled adult, by a person who knows or
1594 reasonably should know that the elderly person or disabled adult
1595 lacks the capacity to consent; or.
1596 (c) Breach of a fiduciary duty to an elderly person or
1597 disabled adult by the person’s guardian or agent under a power
1598 of attorney which results in an unauthorized appropriation,
1599 sale, or transfer of property.
1600 (2)(a) If the funds, assets, or property involved in the
1601 exploitation of the elderly person or disabled adult is valued
1602 at $100,000 or more, the offender commits a felony of the first
1603 degree, punishable as provided in s. 775.082, s. 775.083, or s.
1604 775.084.
1605 (b) If the funds, assets, or property involved in the
1606 exploitation of the elderly person or disabled adult is valued
1607 at $20,000 or more, but less than $100,000, the offender commits
1608 a felony of the second degree, punishable as provided in s.
1609 775.082, s. 775.083, or s. 775.084.
1610 (c) If the funds, assets, or property involved in the
1611 exploitation of an elderly person or disabled adult is valued at
1612 less than $20,000, the offender commits a felony of the third
1613 degree, punishable as provided in s. 775.082, s. 775.083, or s.
1614 775.084.
1615 Section 24. Paragraphs (g) and (i) of subsection (3) of
1616 section 921.0022, Florida Statutes, are amended to read:
1617 921.0022 Criminal Punishment Code; offense severity ranking
1618 chart.—
1619 (3) OFFENSE SEVERITY RANKING CHART
1620 (g) LEVEL 7
1621 FloridaStatute FelonyDegree Description
1622 316.027(1)(b) 1st Accident involving death, failure to stop; leaving scene.
1623 316.193(3)(c)2. 3rd DUI resulting in serious bodily injury.
1624 316.1935(3)(b) 1st Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated.
1625 327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury.
1626 402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
1627 409.920(2)(b)1.a. 3rd Medicaid provider fraud; $10,000 or less.
1628 409.920(2)(b)1.b. 2nd Medicaid provider fraud; more than $10,000, but less than $50,000.
1629 456.065(2) 3rd Practicing a health care profession without a license.
1630 456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury.
1631 458.327(1) 3rd Practicing medicine without a license.
1632 459.013(1) 3rd Practicing osteopathic medicine without a license.
1633 460.411(1) 3rd Practicing chiropractic medicine without a license.
1634 461.012(1) 3rd Practicing podiatric medicine without a license.
1635 462.17 3rd Practicing naturopathy without a license.
1636 463.015(1) 3rd Practicing optometry without a license.
1637 464.016(1) 3rd Practicing nursing without a license.
1638 465.015(2) 3rd Practicing pharmacy without a license.
1639 466.026(1) 3rd Practicing dentistry or dental hygiene without a license.
1640 467.201 3rd Practicing midwifery without a license.
1641 468.366 3rd Delivering respiratory care services without a license.
1642 483.828(1) 3rd Practicing as clinical laboratory personnel without a license.
1643 483.901(9) 3rd Practicing medical physics without a license.
1644 484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription.
1645 484.053 3rd Dispensing hearing aids without a license.
1646 494.0018(2) 1st Conviction of any violation of ss. 494.001-494.0077 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
1647 560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by a money services business.
1648 560.125(5)(a) 3rd Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
1649 655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
1650 775.21(10)(a) 3rd Sexual predator; failure to register; failure to renew driver’s license or identification card; other registration violations.
1651 775.21(10)(b) 3rd Sexual predator working where children regularly congregate.
1652 775.21(10)(g) 3rd Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
1653 782.051(3) 2nd Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
1654 782.07(1) 2nd Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
1655 782.071 2nd Killing of a human being or viable fetus by the operation of a motor vehicle in a reckless manner (vehicular homicide).
1656 782.072 2nd Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
1657 784.045(1)(a)1. 2nd Aggravated battery; intentionally causing great bodily harm or disfigurement.
1658 784.045(1)(a)2. 2nd Aggravated battery; using deadly weapon.
1659 784.045(1)(b) 2nd Aggravated battery; perpetrator aware victim pregnant.
1660 784.048(4) 3rd Aggravated stalking; violation of injunction or court order.
1661 784.048(7) 3rd Aggravated stalking; violation of court order.
1662 784.07(2)(d) 1st Aggravated battery on law enforcement officer.
1663 784.074(1)(a) 1st Aggravated battery on sexually violent predators facility staff.
1664 784.08(2)(a) 1st Aggravated battery on a person 65 years of age or older.
1665 784.081(1) 1st Aggravated battery on specified official or employee.
1666 784.082(1) 1st Aggravated battery by detained person on visitor or other detainee.
1667 784.083(1) 1st Aggravated battery on code inspector.
1668 790.07(4) 1st Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
1669 790.16(1) 1st Discharge of a machine gun under specified circumstances.
1670 790.165(2) 2nd Manufacture, sell, possess, or deliver hoax bomb.
1671 790.165(3) 2nd Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
1672 790.166(3) 2nd Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
1673 790.166(4) 2nd Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
1674 790.23 1st,PBL Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04.
1675 794.08(4) 3rd Female genital mutilation; consent by a parent, guardian, or a person in custodial authority to a victim younger than 18 years of age.
1676 796.03 2nd Procuring any person under 16 years for prostitution.
1677 800.04(5)(c)1. 2nd Lewd or lascivious molestation; victim less than 12 years of age; offender less than 18 years.
1678 800.04(5)(c)2. 2nd Lewd or lascivious molestation; victim 12 years of age or older but less than 16 years; offender 18 years or older.
1679 806.01(2) 2nd Maliciously damage structure by fire or explosive.
1680 810.02(3)(a) 2nd Burglary of occupied dwelling; unarmed; no assault or battery.
1681 810.02(3)(b) 2nd Burglary of unoccupied dwelling; unarmed; no assault or battery.
1682 810.02(3)(d) 2nd Burglary of occupied conveyance; unarmed; no assault or battery.
1683 810.02(3)(e) 2nd Burglary of authorized emergency vehicle.
1684 812.014(2)(a)1. 1st Property stolen, valued at $100,000 or more or a semitrailer deployed by a law enforcement officer; property stolen while causing other property damage; 1st degree grand theft.
1685 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
1686 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft.
1687 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle.
1688 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more.
1689 812.019(2) 1st Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
1690 812.131(2)(a) 2nd Robbery by sudden snatching.
1691 812.133(2)(b) 1st Carjacking; no firearm, deadly weapon, or other weapon.
1692 817.234(8)(a) 2nd Solicitation of motor vehicle accident victims with intent to defraud.
1693 817.234(9) 2nd Organizing, planning, or participating in an intentional motor vehicle collision.
1694 817.234(11)(c) 1st Insurance fraud; property value $100,000 or more.
1695 817.2341(2)(b) & (3)(b)1st Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity.
1696 825.102(3)(b) 2nd Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
1697 825.103(2)(b) 2nd Exploiting an elderly person or disabled adult and property is valued at $20,000 or more, but less than $100,000.
1698 827.03(3)(b) 2nd Neglect of a child causing great bodily harm, disability, or disfigurement.
1699 827.04(3) 3rd Impregnation of a child under 16 years of age by person 21 years of age or older.
1700 837.05(2) 3rd Giving false information about alleged capital felony to a law enforcement officer.
1701 838.015 2nd Bribery.
1702 838.016 2nd Unlawful compensation or reward for official behavior.
1703 838.021(3)(a) 2nd Unlawful harm to a public servant.
1704 838.22 2nd Bid tampering.
1705 847.0135(3) 3rd Solicitation of a child, via a computer service, to commit an unlawful sex act.
1706 847.0135(4) 2nd Traveling to meet a minor to commit an unlawful sex act.
1707 872.06 2nd Abuse of a dead human body.
1708 874.10 1st,PBL Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity.
1709 893.13(1)(c)1. 1st Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center.
1710 893.13(1)(e)1. 1st Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4., within 1,000 feet of property used for religious services or a specified business site.
1711 893.13(4)(a) 1st Deliver to minor cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
1712 893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
1713 893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams.
1714 893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
1715 893.135(1)(d)1. 1st Trafficking in phencyclidine, more than 28 grams, less than 200 grams.
1716 893.135(1)(e)1. 1st Trafficking in methaqualone, more than 200 grams, less than 5 kilograms.
1717 893.135(1)(f)1. 1st Trafficking in amphetamine, more than 14 grams, less than 28 grams.
1718 893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
1719 893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
1720 893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
1721 893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
1722 893.1351(2) 2nd Possession of place for trafficking in or manufacturing of controlled substance.
1723 896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000.
1724 896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
1725 943.0435(4)(c) 2nd Sexual offender vacating permanent residence; failure to comply with reporting requirements.
1726 943.0435(8) 2nd Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
1727 943.0435(9)(a) 3rd Sexual offender; failure to comply with reporting requirements.
1728 943.0435(13) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1729 943.0435(14) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1730 944.607(9) 3rd Sexual offender; failure to comply with reporting requirements.
1731 944.607(10)(a) 3rd Sexual offender; failure to submit to the taking of a digitized photograph.
1732 944.607(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1733 944.607(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1734 985.4815(10) 3rd Sexual offender; failure to submit to the taking of a digitized photograph.
1735 985.4815(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
1736 985.4815(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
1737 (i) LEVEL 9
1738 FloridaStatute FelonyDegree Description
1739 316.193(3)(c)3.b. 1st DUI manslaughter; failing to render aid or give information.
1740 327.35(3)(c)3.b. 1st BUI manslaughter; failing to render aid or give information.
1741 409.920(2)(b)1.c. 1st Medicaid provider fraud; $50,000 or more.
1742 499.0051(9) 1st Knowing sale or purchase of contraband prescription drugs resulting in great bodily harm.
1743 560.123(8)(b)3. 1st Failure to report currency or payment instruments totaling or exceeding $100,000 by money transmitter.
1744 560.125(5)(c) 1st Money transmitter business by unauthorized person, currency, or payment instruments totaling or exceeding $100,000.
1745 655.50(10)(b)3. 1st Failure to report financial transactions totaling or exceeding $100,000 by financial institution.
1746 775.0844 1st Aggravated white collar crime.
1747 782.04(1) 1st Attempt, conspire, or solicit to commit premeditated murder.
1748 782.04(3) 1st,PBL Accomplice to murder in connection with arson, sexual battery, robbery, burglary, and other specified felonies.
1749 782.051(1) 1st Attempted felony murder while perpetrating or attempting to perpetrate a felony enumerated in s. 782.04(3).
1750 782.07(2) 1st Aggravated manslaughter of an elderly person or disabled adult.
1751 787.01(1)(a)1. 1st,PBL Kidnapping; hold for ransom or reward or as a shield or hostage.
1752 787.01(1)(a)2. 1st,PBL Kidnapping with intent to commit or facilitate commission of any felony.
1753 787.01(1)(a)4. 1st,PBL Kidnapping with intent to interfere with performance of any governmental or political function.
1754 787.02(3)(a) 1st False imprisonment; child under age 13; perpetrator also commits aggravated child abuse, sexual battery, or lewd or lascivious battery, molestation, conduct, or exhibition.
1755 790.161 1st Attempted capital destructive device offense.
1756 790.166(2) 1st,PBL Possessing, selling, using, or attempting to use a weapon of mass destruction.
1757 794.011(2) 1st Attempted sexual battery; victim less than 12 years of age.
1758 794.011(2) Life Sexual battery; offender younger than 18 years and commits sexual battery on a person less than 12 years.
1759 794.011(4) 1st Sexual battery; victim 12 years or older, certain circumstances.
1760 794.011(8)(b) 1st Sexual battery; engage in sexual conduct with minor 12 to 18 years by person in familial or custodial authority.
1761 794.08(2) 1st Female genital mutilation; victim younger than 18 years of age.
1762 800.04(5)(b) Life Lewd or lascivious molestation; victim less than 12 years; offender 18 years or older.
1763 812.13(2)(a) 1st,PBL Robbery with firearm or other deadly weapon.
1764 812.133(2)(a) 1st,PBL Carjacking; firearm or other deadly weapon.
1765 812.135(2)(b) 1st Home-invasion robbery with weapon.
1766 817.568(7) 2nd,PBL Fraudulent use of personal identification information of an individual under the age of 18 by his or her parent, legal guardian, or person exercising custodial authority.
1767 827.03(2) 1st Aggravated child abuse.
1768 847.0145(1) 1st Selling, or otherwise transferring custody or control, of a minor.
1769 847.0145(2) 1st Purchasing, or otherwise obtaining custody or control, of a minor.
1770 859.01 1st Poisoning or introducing bacteria, radioactive materials, viruses, or chemical compounds into food, drink, medicine, or water with intent to kill or injure another person.
1771 893.135 1st Attempted capital trafficking offense.
1772 893.135(1)(a)3. 1st Trafficking in cannabis, more than 10,000 lbs.
1773 893.135(1)(b)1.c. 1st Trafficking in cocaine, more than 400 grams, less than 150 kilograms.
1774 893.135(1)(c)1.c. 1st Trafficking in illegal drugs, more than 28 grams, less than 30 kilograms.
1775 893.135(1)(d)1.c. 1st Trafficking in phencyclidine, more than 400 grams.
1776 893.135(1)(e)1.c. 1st Trafficking in methaqualone, more than 25 kilograms.
1777 893.135(1)(f)1.c. 1st Trafficking in amphetamine, more than 200 grams.
1778 893.135(1)(h)1.c. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 10 kilograms or more.
1779 893.135(1)(j)1.c. 1st Trafficking in 1,4-Butanediol, 10 kilograms or more.
1780 893.135(1)(k)2.c. 1st Trafficking in Phenethylamines, 400 grams or more.
1781 896.101(5)(c) 1st Money laundering, financial instruments totaling or exceeding $100,000.
1782 896.104(4)(a)3. 1st Structuring transactions to evade reporting or registration requirements, financial transactions totaling or exceeding $100,000.
1783 Section 25. Pilot project to monitor home health services.
1784 The Agency for Health Care Administration shall develop and
1785 implement a home health agency monitoring pilot project in
1786 Miami-Dade County by January 1, 2010. The agency shall contract
1787 with a vendor to verify the utilization and delivery of home
1788 health services and provide an electronic billing interface for
1789 home health services. The contract must require the creation of
1790 a program to submit claims electronically for the delivery of
1791 home health services. The program must verify telephonically
1792 visits for the delivery of home health services using voice
1793 biometrics. The agency may seek amendments to the Medicaid state
1794 plan and waivers of federal laws, as necessary, to implement the
1795 pilot project. Notwithstanding s. 287.057(5)(f), Florida
1796 Statutes, the agency must award the contract through the
1797 competitive solicitation process. The agency shall submit a
1798 report to the Governor, the President of the Senate, and the
1799 Speaker of the House of Representatives evaluating the pilot
1800 project by February 1, 2011.
1801 Section 26. Pilot project for home health care management.
1802 The Agency for Health Care Administration shall implement a
1803 comprehensive care management pilot project for home health
1804 services by January 1, 2010, which includes face-to-face
1805 assessments by a nurse licensed pursuant to chapter 464, Florida
1806 Statutes, consultation with physicians ordering services to
1807 substantiate the medical necessity for services, and on-site or
1808 desk reviews of recipients’ medical records in Miami-Dade
1809 County. The agency may enter into a contract with a qualified
1810 organization to implement the pilot project. The agency may seek
1811 amendments to the Medicaid state plan and waivers of federal
1812 laws, as necessary, to implement the pilot project.
1813 Section 27. Subsection (6) of section 400.0077, Florida
1814 Statutes, is amended to read:
1815 400.0077 Confidentiality.—
1816 (6) This section does not limit the subpoena power of the
1817 Attorney General pursuant to s. 409.920(10)(b) s. 409.920(9)(b).
1818 Section 28. Subsection (2) of section 430.608, Florida
1819 Statutes, is amended to read:
1820 430.608 Confidentiality of information.—
1821 (2) This section does not, however, limit the subpoena
1822 authority of the Medicaid Fraud Control Unit of the Department
1823 of Legal Affairs pursuant to s. 409.920(10)(b) s. 409.920(9)(b).
1824 Section 29. Section 395.0199, Florida Statutes, is
1825 repealed.
1826 Section 30. Section 395.405, Florida Statutes, is amended
1827 to read:
1828 395.405 Rulemaking.—The department shall adopt and enforce
1829 all rules necessary to administer ss. 395.0199, 395.401,
1830 395.4015, 395.402, 395.4025, 395.403, 395.404, and 395.4045.
1831 Section 31. Subsection (1) of section 400.0712, Florida
1832 Statutes, is amended to read:
1833 400.0712 Application for inactive license.—
1834 (1) As specified in s. 408.831(4) and this section, the
1835 agency may issue an inactive license to a nursing home facility
1836 for all or a portion of its beds. Any request by a licensee that
1837 a nursing home or portion of a nursing home become inactive must
1838 be submitted to the agency in the approved format. The facility
1839 may not initiate any suspension of services, notify residents,
1840 or initiate inactivity before receiving approval from the
1841 agency; and a licensee that violates this provision may not be
1842 issued an inactive license.
1843 Section 32. Subsection (2) of section 400.118, Florida
1844 Statutes, is repealed.
1845 Section 33. Section 400.141, Florida Statutes, is amended
1846 to read:
1847 400.141 Administration and management of nursing home
1848 facilities.—
1849 (1) Every licensed facility shall comply with all
1850 applicable standards and rules of the agency and shall:
1851 (a)(1) Be under the administrative direction and charge of
1852 a licensed administrator.
1853 (b)(2) Appoint a medical director licensed pursuant to
1854 chapter 458 or chapter 459. The agency may establish by rule
1855 more specific criteria for the appointment of a medical
1856 director.
1857 (c)(3) Have available the regular, consultative, and
1858 emergency services of physicians licensed by the state.
1859 (d)(4) Provide for resident use of a community pharmacy as
1860 specified in s. 400.022(1)(q). Any other law to the contrary
1861 notwithstanding, a registered pharmacist licensed in Florida,
1862 that is under contract with a facility licensed under this
1863 chapter or chapter 429, shall repackage a nursing facility
1864 resident’s bulk prescription medication which has been packaged
1865 by another pharmacist licensed in any state in the United States
1866 into a unit dose system compatible with the system used by the
1867 nursing facility, if the pharmacist is requested to offer such
1868 service. In order to be eligible for the repackaging, a resident
1869 or the resident’s spouse must receive prescription medication
1870 benefits provided through a former employer as part of his or
1871 her retirement benefits, a qualified pension plan as specified
1872 in s. 4972 of the Internal Revenue Code, a federal retirement
1873 program as specified under 5 C.F.R. s. 831, or a long-term care
1874 policy as defined in s. 627.9404(1). A pharmacist who correctly
1875 repackages and relabels the medication and the nursing facility
1876 which correctly administers such repackaged medication under the
1877 provisions of this paragraph may subsection shall not be held
1878 liable in any civil or administrative action arising from the
1879 repackaging. In order to be eligible for the repackaging, a
1880 nursing facility resident for whom the medication is to be
1881 repackaged shall sign an informed consent form provided by the
1882 facility which includes an explanation of the repackaging
1883 process and which notifies the resident of the immunities from
1884 liability provided in this paragraph herein. A pharmacist who
1885 repackages and relabels prescription medications, as authorized
1886 under this paragraph subsection, may charge a reasonable fee for
1887 costs resulting from the implementation of this provision.
1888 (e)(5) Provide for the access of the facility residents to
1889 dental and other health-related services, recreational services,
1890 rehabilitative services, and social work services appropriate to
1891 their needs and conditions and not directly furnished by the
1892 licensee. When a geriatric outpatient nurse clinic is conducted
1893 in accordance with rules adopted by the agency, outpatients
1894 attending such clinic shall not be counted as part of the
1895 general resident population of the nursing home facility, nor
1896 shall the nursing staff of the geriatric outpatient clinic be
1897 counted as part of the nursing staff of the facility, until the
1898 outpatient clinic load exceeds 15 a day.
1899 (f)(6) Be allowed and encouraged by the agency to provide
1900 other needed services under certain conditions. If the facility
1901 has a standard licensure status, and has had no class I or class
1902 II deficiencies during the past 2 years or has been awarded a
1903 Gold Seal under the program established in s. 400.235, it may be
1904 encouraged by the agency to provide services, including, but not
1905 limited to, respite and adult day services, which enable
1906 individuals to move in and out of the facility. A facility is
1907 not subject to any additional licensure requirements for
1908 providing these services. Respite care may be offered to persons
1909 in need of short-term or temporary nursing home services.
1910 Respite care must be provided in accordance with this part and
1911 rules adopted by the agency. However, the agency shall, by rule,
1912 adopt modified requirements for resident assessment, resident
1913 care plans, resident contracts, physician orders, and other
1914 provisions, as appropriate, for short-term or temporary nursing
1915 home services. The agency shall allow for shared programming and
1916 staff in a facility which meets minimum standards and offers
1917 services pursuant to this paragraph subsection, but, if the
1918 facility is cited for deficiencies in patient care, may require
1919 additional staff and programs appropriate to the needs of
1920 service recipients. A person who receives respite care may not
1921 be counted as a resident of the facility for purposes of the
1922 facility’s licensed capacity unless that person receives 24-hour
1923 respite care. A person receiving either respite care for 24
1924 hours or longer or adult day services must be included when
1925 calculating minimum staffing for the facility. Any costs and
1926 revenues generated by a nursing home facility from
1927 nonresidential programs or services shall be excluded from the
1928 calculations of Medicaid per diems for nursing home
1929 institutional care reimbursement.
1930 (g)(7) If the facility has a standard license or is a Gold
1931 Seal facility, exceeds the minimum required hours of licensed
1932 nursing and certified nursing assistant direct care per resident
1933 per day, and is part of a continuing care facility licensed
1934 under chapter 651 or a retirement community that offers other
1935 services pursuant to part III of this chapter or part I or part
1936 III of chapter 429 on a single campus, be allowed to share
1937 programming and staff. At the time of inspection and in the
1938 semiannual report required pursuant to paragraph (o) subsection
1939 (15), a continuing care facility or retirement community that
1940 uses this option must demonstrate through staffing records that
1941 minimum staffing requirements for the facility were met.
1942 Licensed nurses and certified nursing assistants who work in the
1943 nursing home facility may be used to provide services elsewhere
1944 on campus if the facility exceeds the minimum number of direct
1945 care hours required per resident per day and the total number of
1946 residents receiving direct care services from a licensed nurse
1947 or a certified nursing assistant does not cause the facility to
1948 violate the staffing ratios required under s. 400.23(3)(a).
1949 Compliance with the minimum staffing ratios shall be based on
1950 total number of residents receiving direct care services,
1951 regardless of where they reside on campus. If the facility
1952 receives a conditional license, it may not share staff until the
1953 conditional license status ends. This paragraph subsection does
1954 not restrict the agency’s authority under federal or state law
1955 to require additional staff if a facility is cited for
1956 deficiencies in care which are caused by an insufficient number
1957 of certified nursing assistants or licensed nurses. The agency
1958 may adopt rules for the documentation necessary to determine
1959 compliance with this provision.
1960 (h)(8) Maintain the facility premises and equipment and
1961 conduct its operations in a safe and sanitary manner.
1962 (i)(9) If the licensee furnishes food service, provide a
1963 wholesome and nourishing diet sufficient to meet generally
1964 accepted standards of proper nutrition for its residents and
1965 provide such therapeutic diets as may be prescribed by attending
1966 physicians. In making rules to implement this paragraph
1967 subsection, the agency shall be guided by standards recommended
1968 by nationally recognized professional groups and associations
1969 with knowledge of dietetics.
1970 (j)(10) Keep full records of resident admissions and
1971 discharges; medical and general health status, including medical
1972 records, personal and social history, and identity and address
1973 of next of kin or other persons who may have responsibility for
1974 the affairs of the residents; and individual resident care plans
1975 including, but not limited to, prescribed services, service
1976 frequency and duration, and service goals. The records shall be
1977 open to inspection by the agency.
1978 (k)(11) Keep such fiscal records of its operations and
1979 conditions as may be necessary to provide information pursuant
1980 to this part.
1981 (l)(12) Furnish copies of personnel records for employees
1982 affiliated with such facility, to any other facility licensed by
1983 this state requesting this information pursuant to this part.
1984 Such information contained in the records may include, but is
1985 not limited to, disciplinary matters and any reason for
1986 termination. Any facility releasing such records pursuant to
1987 this part shall be considered to be acting in good faith and may
1988 not be held liable for information contained in such records,
1989 absent a showing that the facility maliciously falsified such
1990 records.
1991 (m)(13) Publicly display a poster provided by the agency
1992 containing the names, addresses, and telephone numbers for the
1993 state’s abuse hotline, the State Long-Term Care Ombudsman, the
1994 Agency for Health Care Administration consumer hotline, the
1995 Advocacy Center for Persons with Disabilities, the Florida
1996 Statewide Advocacy Council, and the Medicaid Fraud Control Unit,
1997 with a clear description of the assistance to be expected from
1998 each.
1999 (n)(14) Submit to the agency the information specified in
2000 s. 400.071(1)(b) for a management company within 30 days after
2001 the effective date of the management agreement.
2002 (o)1.(15) Submit semiannually to the agency, or more
2003 frequently if requested by the agency, information regarding
2004 facility staff-to-resident ratios, staff turnover, and staff
2005 stability, including information regarding certified nursing
2006 assistants, licensed nurses, the director of nursing, and the
2007 facility administrator. For purposes of this reporting:
2008 a.(a) Staff-to-resident ratios must be reported in the
2009 categories specified in s. 400.23(3)(a) and applicable rules.
2010 The ratio must be reported as an average for the most recent
2011 calendar quarter.
2012 b.(b) Staff turnover must be reported for the most recent
2013 12-month period ending on the last workday of the most recent
2014 calendar quarter prior to the date the information is submitted.
2015 The turnover rate must be computed quarterly, with the annual
2016 rate being the cumulative sum of the quarterly rates. The
2017 turnover rate is the total number of terminations or separations
2018 experienced during the quarter, excluding any employee
2019 terminated during a probationary period of 3 months or less,
2020 divided by the total number of staff employed at the end of the
2021 period for which the rate is computed, and expressed as a
2022 percentage.
2023 c.(c) The formula for determining staff stability is the
2024 total number of employees that have been employed for more than
2025 12 months, divided by the total number of employees employed at
2026 the end of the most recent calendar quarter, and expressed as a
2027 percentage.
2028 d.(d) A nursing facility that has failed to comply with
2029 state minimum-staffing requirements for 2 consecutive days is
2030 prohibited from accepting new admissions until the facility has
2031 achieved the minimum-staffing requirements for a period of 6
2032 consecutive days. For the purposes of this sub-subparagraph
2033 paragraph, any person who was a resident of the facility and was
2034 absent from the facility for the purpose of receiving medical
2035 care at a separate location or was on a leave of absence is not
2036 considered a new admission. Failure to impose such an admissions
2037 moratorium constitutes a class II deficiency.
2038 e.(e) A nursing facility which does not have a conditional
2039 license may be cited for failure to comply with the standards in
2040 s. 400.23(3)(a)1.a. only if it has failed to meet those
2041 standards on 2 consecutive days or if it has failed to meet at
2042 least 97 percent of those standards on any one day.
2043 f.(f) A facility which has a conditional license must be in
2044 compliance with the standards in s. 400.23(3)(a) at all times.
2045
2046 2. Nothing in This paragraph does not section shall limit
2047 the agency’s ability to impose a deficiency or take other
2048 actions if a facility does not have enough staff to meet the
2049 residents’ needs.
2050 (16) Report monthly the number of vacant beds in the
2051 facility which are available for resident occupancy on the day
2052 the information is reported.
2053 (p)(17) Notify a licensed physician when a resident
2054 exhibits signs of dementia or cognitive impairment or has a
2055 change of condition in order to rule out the presence of an
2056 underlying physiological condition that may be contributing to
2057 such dementia or impairment. The notification must occur within
2058 30 days after the acknowledgment of such signs by facility
2059 staff. If an underlying condition is determined to exist, the
2060 facility shall arrange, with the appropriate health care
2061 provider, the necessary care and services to treat the
2062 condition.
2063 (q)(18) If the facility implements a dining and hospitality
2064 attendant program, ensure that the program is developed and
2065 implemented under the supervision of the facility director of
2066 nursing. A licensed nurse, licensed speech or occupational
2067 therapist, or a registered dietitian must conduct training of
2068 dining and hospitality attendants. A person employed by a
2069 facility as a dining and hospitality attendant must perform
2070 tasks under the direct supervision of a licensed nurse.
2071 (r)(19) Report to the agency any filing for bankruptcy
2072 protection by the facility or its parent corporation,
2073 divestiture or spin-off of its assets, or corporate
2074 reorganization within 30 days after the completion of such
2075 activity.
2076 (s)(20) Maintain general and professional liability
2077 insurance coverage that is in force at all times. In lieu of
2078 general and professional liability insurance coverage, a state
2079 designated teaching nursing home and its affiliated assisted
2080 living facilities created under s. 430.80 may demonstrate proof
2081 of financial responsibility as provided in s. 430.80(3)(h).
2082 (t)(21) Maintain in the medical record for each resident a
2083 daily chart of certified nursing assistant services provided to
2084 the resident. The certified nursing assistant who is caring for
2085 the resident must complete this record by the end of his or her
2086 shift. This record must indicate assistance with activities of
2087 daily living, assistance with eating, and assistance with
2088 drinking, and must record each offering of nutrition and
2089 hydration for those residents whose plan of care or assessment
2090 indicates a risk for malnutrition or dehydration.
2091 (u)(22) Before November 30 of each year, subject to the
2092 availability of an adequate supply of the necessary vaccine,
2093 provide for immunizations against influenza viruses to all its
2094 consenting residents in accordance with the recommendations of
2095 the United States Centers for Disease Control and Prevention,
2096 subject to exemptions for medical contraindications and
2097 religious or personal beliefs. Subject to these exemptions, any
2098 consenting person who becomes a resident of the facility after
2099 November 30 but before March 31 of the following year must be
2100 immunized within 5 working days after becoming a resident.
2101 Immunization shall not be provided to any resident who provides
2102 documentation that he or she has been immunized as required by
2103 this paragraph subsection. This paragraph subsection does not
2104 prohibit a resident from receiving the immunization from his or
2105 her personal physician if he or she so chooses. A resident who
2106 chooses to receive the immunization from his or her personal
2107 physician shall provide proof of immunization to the facility.
2108 The agency may adopt and enforce any rules necessary to comply
2109 with or implement this subsection.
2110 (v)(23) Assess all residents for eligibility for
2111 pneumococcal polysaccharide vaccination (PPV) and vaccinate
2112 residents when indicated within 60 days after the effective date
2113 of this act in accordance with the recommendations of the United
2114 States Centers for Disease Control and Prevention, subject to
2115 exemptions for medical contraindications and religious or
2116 personal beliefs. Residents admitted after the effective date of
2117 this act shall be assessed within 5 working days of admission
2118 and, when indicated, vaccinated within 60 days in accordance
2119 with the recommendations of the United States Centers for
2120 Disease Control and Prevention, subject to exemptions for
2121 medical contraindications and religious or personal beliefs.
2122 Immunization shall not be provided to any resident who provides
2123 documentation that he or she has been immunized as required by
2124 this paragraph subsection. This paragraph subsection does not
2125 prohibit a resident from receiving the immunization from his or
2126 her personal physician if he or she so chooses. A resident who
2127 chooses to receive the immunization from his or her personal
2128 physician shall provide proof of immunization to the facility.
2129 The agency may adopt and enforce any rules necessary to comply
2130 with or implement this paragraph subsection.
2131 (w)(24) Annually encourage and promote to its employees the
2132 benefits associated with immunizations against influenza viruses
2133 in accordance with the recommendations of the United States
2134 Centers for Disease Control and Prevention. The agency may adopt
2135 and enforce any rules necessary to comply with or implement this
2136 paragraph subsection.
2137 (2) Facilities that have been awarded a Gold Seal under the
2138 program established in s. 400.235 may develop a plan to provide
2139 certified nursing assistant training as prescribed by federal
2140 regulations and state rules and may apply to the agency for
2141 approval of their program.
2142 Section 34. Subsections (5), (9), (10), (11), (12), (13),
2143 (14), and (15) of section 400.147, Florida Statutes, are amended
2144 to read:
2145 400.147 Internal risk management and quality assurance
2146 program.—
2147 (5) For purposes of reporting to the agency under this
2148 section, the term “adverse incident” means:
2149 (a) An event over which facility personnel could exercise
2150 control and which is associated in whole or in part with the
2151 facility’s intervention, rather than the condition for which
2152 such intervention occurred, and which results in one of the
2153 following:
2154 1. Death;
2155 2. Brain or spinal damage;
2156 3. Permanent disfigurement;
2157 4. Fracture or dislocation of bones or joints;
2158 5. A limitation of neurological, physical, or sensory
2159 function;
2160 6. Any condition that required medical attention to which
2161 the resident has not given his or her informed consent,
2162 including failure to honor advanced directives; or
2163 7. Any condition that required the transfer of the
2164 resident, within or outside the facility, to a unit providing a
2165 more acute level of care due to the adverse incident, rather
2166 than the resident’s condition prior to the adverse incident; or
2167 8. An event that is reported to law enforcement or its
2168 personnel for investigation; or
2169 (b) Abuse, neglect, or exploitation as defined in s.
2170 415.102;
2171 (c) Abuse, neglect and harm as defined in s. 39.01;
2172 (b)(d) Resident elopement, if the elopement places the
2173 resident at risk of harm or injury.; or
2174 (e) An event that is reported to law enforcement.
2175 (9) Abuse, neglect, or exploitation must be reported to the
2176 agency as required by 42 C.F.R. s. 483.13(c) and to the
2177 department as required by chapters 39 and 415.
2178 (10)(9) By the 10th of each month, each facility subject to
2179 this section shall report any notice received pursuant to s.
2180 400.0233(2) and each initial complaint that was filed with the
2181 clerk of the court and served on the facility during the
2182 previous month by a resident or a resident’s family member,
2183 guardian, conservator, or personal legal representative. The
2184 report must include the name of the resident, the resident’s
2185 date of birth and social security number, the Medicaid
2186 identification number for Medicaid-eligible persons, the date or
2187 dates of the incident leading to the claim or dates of
2188 residency, if applicable, and the type of injury or violation of
2189 rights alleged to have occurred. Each facility shall also submit
2190 a copy of the notices received pursuant to s. 400.0233(2) and
2191 complaints filed with the clerk of the court. This report is
2192 confidential as provided by law and is not discoverable or
2193 admissible in any civil or administrative action, except in such
2194 actions brought by the agency to enforce the provisions of this
2195 part.
2196 (11)(10) The agency shall review, as part of its licensure
2197 inspection process, the internal risk management and quality
2198 assurance program at each facility regulated by this section to
2199 determine whether the program meets standards established in
2200 statutory laws and rules, is being conducted in a manner
2201 designed to reduce adverse incidents, and is appropriately
2202 reporting incidents as required by this section.
2203 (12)(11) There is no monetary liability on the part of, and
2204 a cause of action for damages may not arise against, any risk
2205 manager for the implementation and oversight of the internal
2206 risk management and quality assurance program in a facility
2207 licensed under this part as required by this section, or for any
2208 act or proceeding undertaken or performed within the scope of
2209 the functions of such internal risk management and quality
2210 assurance program if the risk manager acts without intentional
2211 fraud.
2212 (13)(12) If the agency, through its receipt of the adverse
2213 incident reports prescribed in subsection (7), or through any
2214 investigation, has a reasonable belief that conduct by a staff
2215 member or employee of a facility is grounds for disciplinary
2216 action by the appropriate regulatory board, the agency shall
2217 report this fact to the regulatory board.
2218 (14)(13) The agency may adopt rules to administer this
2219 section.
2220 (14) The agency shall annually submit to the Legislature a
2221 report on nursing home adverse incidents. The report must
2222 include the following information arranged by county:
2223 (a) The total number of adverse incidents.
2224 (b) A listing, by category, of the types of adverse
2225 incidents, the number of incidents occurring within each
2226 category, and the type of staff involved.
2227 (c) A listing, by category, of the types of injury caused
2228 and the number of injuries occurring within each category.
2229 (d) Types of liability claims filed based on an adverse
2230 incident or reportable injury.
2231 (e) Disciplinary action taken against staff, categorized by
2232 type of staff involved.
2233 (15) Information gathered by a credentialing organization
2234 under a quality assurance program is not discoverable from the
2235 credentialing organization. This subsection does not limit
2236 discovery of, access to, or use of facility records, including
2237 those records from which the credentialing organization gathered
2238 its information.
2239 Section 35. Subsection (3) of section 400.162, Florida
2240 Statutes, is amended to read:
2241 400.162 Property and personal affairs of residents.—
2242 (3) A licensee shall provide for the safekeeping of
2243 personal effects, funds, and other property of the resident in
2244 the facility. Whenever necessary for the protection of
2245 valuables, or in order to avoid unreasonable responsibility
2246 therefor, the licensee may require that such valuables be
2247 excluded or removed from the facility and kept at some place not
2248 subject to the control of the licensee. At the request of a
2249 resident, the facility shall mark the resident’s personal
2250 property with the resident’s name or another type of
2251 identification, without defacing the property. Any theft or loss
2252 of a resident’s personal property shall be documented by the
2253 facility. The facility shall develop policies and procedures to
2254 minimize the risk of theft or loss of the personal property of
2255 residents. A copy of the policy shall be provided to every
2256 employee and to each resident and the resident’s representative
2257 if appropriate at admission and when revised. Facility policies
2258 must include provisions related to reporting theft or loss of a
2259 resident’s property to law enforcement and any facility waiver
2260 of liability for loss or theft. The facility shall post notice
2261 of these policies and procedures, and any revision thereof, in
2262 places accessible to residents.
2263 Section 36. Paragraphs (a) and (b) of subsection (2) of
2264 section 400.191, Florida Statutes, are amended to read:
2265 400.191 Availability, distribution, and posting of reports
2266 and records.—
2267 (2) The agency shall publish the Nursing Home Guide
2268 annually in consumer-friendly printed form and quarterly in
2269 electronic form to assist consumers and their families in
2270 comparing and evaluating nursing home facilities.
2271 (a) The agency shall provide an Internet site which shall
2272 include at least the following information either directly or
2273 indirectly through a link to another established site or sites
2274 of the agency’s choosing:
2275 1. A section entitled “Have you considered programs that
2276 provide alternatives to nursing home care?” which shall be the
2277 first section of the Nursing Home Guide and which shall
2278 prominently display information about available alternatives to
2279 nursing homes and how to obtain additional information regarding
2280 these alternatives. The Nursing Home Guide shall explain that
2281 this state offers alternative programs that permit qualified
2282 elderly persons to stay in their homes instead of being placed
2283 in nursing homes and shall encourage interested persons to call
2284 the Comprehensive Assessment Review and Evaluation for Long-Term
2285 Care Services (CARES) Program to inquire if they qualify. The
2286 Nursing Home Guide shall list available home and community-based
2287 programs which shall clearly state the services that are
2288 provided and indicate whether nursing home services are included
2289 if needed.
2290 2. A list by name and address of all nursing home
2291 facilities in this state, including any prior name by which a
2292 facility was known during the previous 24-month period.
2293 3. Whether such nursing home facilities are proprietary or
2294 nonproprietary.
2295 4. The current owner of the facility’s license and the year
2296 that that entity became the owner of the license.
2297 5. The name of the owner or owners of each facility and
2298 whether the facility is affiliated with a company or other
2299 organization owning or managing more than one nursing facility
2300 in this state.
2301 6. The total number of beds in each facility and the most
2302 recently available occupancy levels.
2303 7. The number of private and semiprivate rooms in each
2304 facility.
2305 8. The religious affiliation, if any, of each facility.
2306 9. The languages spoken by the administrator and staff of
2307 each facility.
2308 10. Whether or not each facility accepts Medicare or
2309 Medicaid recipients or insurance, health maintenance
2310 organization, Veterans Administration, CHAMPUS program, or
2311 workers’ compensation coverage.
2312 11. Recreational and other programs available at each
2313 facility.
2314 12. Special care units or programs offered at each
2315 facility.
2316 13. Whether the facility is a part of a retirement
2317 community that offers other services pursuant to part III of
2318 this chapter or part I or part III of chapter 429.
2319 14. Survey and deficiency information, including all
2320 federal and state recertification, licensure, revisit, and
2321 complaint survey information, for each facility for the past 30
2322 months. For noncertified nursing homes, state survey and
2323 deficiency information, including licensure, revisit, and
2324 complaint survey information for the past 30 months shall be
2325 provided.
2326 15. A summary of the deficiency data for each facility over
2327 the past 30 months. The summary may include a score, rating, or
2328 comparison ranking with respect to other facilities based on the
2329 number of citations received by the facility on recertification,
2330 licensure, revisit, and complaint surveys; the severity and
2331 scope of the citations; and the number of recertification
2332 surveys the facility has had during the past 30 months. The
2333 score, rating, or comparison ranking may be presented in either
2334 numeric or symbolic form for the intended consumer audience.
2335 (b) The agency shall provide the following information in
2336 printed form:
2337 1. A section entitled “Have you considered programs that
2338 provide alternatives to nursing home care?” which shall be the
2339 first section of the Nursing Home Guide and which shall
2340 prominently display information about available alternatives to
2341 nursing homes and how to obtain additional information regarding
2342 these alternatives. The Nursing Home Guide shall explain that
2343 this state offers alternative programs that permit qualified
2344 elderly persons to stay in their homes instead of being placed
2345 in nursing homes and shall encourage interested persons to call
2346 the Comprehensive Assessment Review and Evaluation for Long-Term
2347 Care Services (CARES) Program to inquire if they qualify. The
2348 Nursing Home Guide shall list available home and community-based
2349 programs which shall clearly state the services that are
2350 provided and indicate whether nursing home services are included
2351 if needed.
2352 2. A list by name and address of all nursing home
2353 facilities in this state.
2354 3. Whether the nursing home facilities are proprietary or
2355 nonproprietary.
2356 4. The current owner or owners of the facility’s license
2357 and the year that entity became the owner of the license.
2358 5. The total number of beds, and of private and semiprivate
2359 rooms, in each facility.
2360 6. The religious affiliation, if any, of each facility.
2361 7. The name of the owner of each facility and whether the
2362 facility is affiliated with a company or other organization
2363 owning or managing more than one nursing facility in this state.
2364 8. The languages spoken by the administrator and staff of
2365 each facility.
2366 9. Whether or not each facility accepts Medicare or
2367 Medicaid recipients or insurance, health maintenance
2368 organization, Veterans Administration, CHAMPUS program, or
2369 workers’ compensation coverage.
2370 10. Recreational programs, special care units, and other
2371 programs available at each facility.
2372 11. The Internet address for the site where more detailed
2373 information can be seen.
2374 12. A statement advising consumers that each facility will
2375 have its own policies and procedures related to protecting
2376 resident property.
2377 13. A summary of the deficiency data for each facility over
2378 the past 30 months. The summary may include a score, rating, or
2379 comparison ranking with respect to other facilities based on the
2380 number of citations received by the facility on recertification,
2381 licensure, revisit, and complaint surveys; the severity and
2382 scope of the citations; the number of citations; and the number
2383 of recertification surveys the facility has had during the past
2384 30 months. The score, rating, or comparison ranking may be
2385 presented in either numeric or symbolic form for the intended
2386 consumer audience.
2387 Section 37. Paragraph (d) of subsection (1) of section
2388 400.195, Florida Statutes, is amended to read:
2389 400.195 Agency reporting requirements.—
2390 (1) For the period beginning June 30, 2001, and ending June
2391 30, 2005, the Agency for Health Care Administration shall
2392 provide a report to the Governor, the President of the Senate,
2393 and the Speaker of the House of Representatives with respect to
2394 nursing homes. The first report shall be submitted no later than
2395 December 30, 2002, and subsequent reports shall be submitted
2396 every 6 months thereafter. The report shall identify facilities
2397 based on their ownership characteristics, size, business
2398 structure, for-profit or not-for-profit status, and any other
2399 characteristics the agency determines useful in analyzing the
2400 varied segments of the nursing home industry and shall report:
2401 (d) Information regarding deficiencies cited, including
2402 information used to develop the Nursing Home Guide WATCH LIST
2403 pursuant to s. 400.191, and applicable rules, a summary of data
2404 generated on nursing homes by Centers for Medicare and Medicaid
2405 Services Nursing Home Quality Information Project, and
2406 information collected pursuant to s. 400.147(10) s. 400.147(9),
2407 relating to litigation.
2408 Section 38. Subsection (3) of section 400.23, Florida
2409 Statutes, is amended to read:
2410 400.23 Rules; evaluation and deficiencies; licensure
2411 status.—
2412 (3)(a)1. The agency shall adopt rules providing minimum
2413 staffing requirements for nursing homes. These requirements
2414 shall include, for each nursing home facility:
2415 a. A minimum certified nursing assistant staffing of 2.6
2416 hours of direct care per resident per day beginning January 1,
2417 2003, and increasing to 2.7 hours of direct care per resident
2418 per day beginning January 1, 2007. Beginning January 1, 2002, no
2419 facility shall staff below one certified nursing assistant per
2420 20 residents, and a minimum licensed nursing staffing of 1.0
2421 hour of direct care per resident per day but never below one
2422 licensed nurse per 40 residents.
2423 b. Beginning January 1, 2007, a minimum weekly average
2424 certified nursing assistant staffing of 2.9 hours of direct care
2425 per resident per day. For the purpose of this sub-subparagraph,
2426 a week is defined as Sunday through Saturday.
2427 2. Nursing assistants employed under s. 400.211(2) may be
2428 included in computing the staffing ratio for certified nursing
2429 assistants only if their job responsibilities include only
2430 nursing-assistant-related duties.
2431 3. Each nursing home must document compliance with staffing
2432 standards as required under this paragraph and post daily the
2433 names of staff on duty for the benefit of facility residents and
2434 the public.
2435 4. The agency shall recognize the use of licensed nurses
2436 for compliance with minimum staffing requirements for certified
2437 nursing assistants, provided that the facility otherwise meets
2438 the minimum staffing requirements for licensed nurses and that
2439 the licensed nurses are performing the duties of a certified
2440 nursing assistant. Unless otherwise approved by the agency,
2441 licensed nurses counted toward the minimum staffing requirements
2442 for certified nursing assistants must exclusively perform the
2443 duties of a certified nursing assistant for the entire shift and
2444 not also be counted toward the minimum staffing requirements for
2445 licensed nurses. If the agency approved a facility’s request to
2446 use a licensed nurse to perform both licensed nursing and
2447 certified nursing assistant duties, the facility must allocate
2448 the amount of staff time specifically spent on certified nursing
2449 assistant duties for the purpose of documenting compliance with
2450 minimum staffing requirements for certified and licensed nursing
2451 staff. In no event may the hours of a licensed nurse with dual
2452 job responsibilities be counted twice.
2453 (b) The agency shall adopt rules to allow properly trained
2454 staff of a nursing facility, in addition to certified nursing
2455 assistants and licensed nurses, to assist residents with eating.
2456 The rules shall specify the minimum training requirements and
2457 shall specify the physiological conditions or disorders of
2458 residents which would necessitate that the eating assistance be
2459 provided by nursing personnel of the facility. Nonnursing staff
2460 providing eating assistance to residents under the provisions of
2461 this subsection shall not count toward compliance with minimum
2462 staffing standards.
2463 (c) Licensed practical nurses licensed under chapter 464
2464 who are providing nursing services in nursing home facilities
2465 under this part may supervise the activities of other licensed
2466 practical nurses, certified nursing assistants, and other
2467 unlicensed personnel providing services in such facilities in
2468 accordance with rules adopted by the Board of Nursing.
2469 Section 39. Paragraph (a) of subsection (7) of section
2470 400.9935, Florida Statutes, is amended to read:
2471 400.9935 Clinic responsibilities.—
2472 (7)(a) Each clinic engaged in magnetic resonance imaging
2473 services must be accredited by the Joint Commission on
2474 Accreditation of Healthcare Organizations, the American College
2475 of Radiology, or the Accreditation Association for Ambulatory
2476 Health Care, within 1 year after licensure. A clinic that is
2477 accredited by the American College of Radiology or is within the
2478 original 1-year period after licensure and replaces its core
2479 magnetic resonance imaging equipment shall be given 1 year after
2480 the date on which the equipment is replaced to attain
2481 accreditation. However, a clinic may request a single, 6-month
2482 extension if it provides evidence to the agency establishing
2483 that, for good cause shown, such clinic cannot can not be
2484 accredited within 1 year after licensure, and that such
2485 accreditation will be completed within the 6-month extension.
2486 After obtaining accreditation as required by this subsection,
2487 each such clinic must maintain accreditation as a condition of
2488 renewal of its license. A clinic that files a change of
2489 ownership application must comply with the original
2490 accreditation timeframe requirements of the transferor. The
2491 agency shall deny a change of ownership application if the
2492 clinic is not in compliance with the accreditation requirements.
2493 When a clinic adds, replaces, or modifies magnetic resonance
2494 imaging equipment and the accreditation agency requires new
2495 accreditation, the clinic must be accredited within 1 year after
2496 the date of the addition, replacement, or modification but may
2497 request a single, 6-month extension if the clinic provides
2498 evidence of good cause to the agency.
2499 Section 40. Subsection (6) of section 400.995, Florida
2500 Statutes, is amended to read:
2501 400.995 Agency administrative penalties.—
2502 (6) During an inspection, the agency, as an alternative to
2503 or in conjunction with an administrative action against a clinic
2504 for violations of this part and adopted rules, shall make a
2505 reasonable attempt to discuss each violation and recommended
2506 corrective action with the owner, medical director, or clinic
2507 director of the clinic, prior to written notification. The
2508 agency, instead of fixing a period within which the clinic shall
2509 enter into compliance with standards, may request a plan of
2510 corrective action from the clinic which demonstrates a good
2511 faith effort to remedy each violation by a specific date,
2512 subject to the approval of the agency.
2513 Section 41. Subsections (5), (9), and (13) of section
2514 408.803, Florida Statutes, are amended to read:
2515 408.803 Definitions.—As used in this part, the term:
2516 (5) “Change of ownership” means:
2517 (a) An event in which the licensee sells or otherwise
2518 transfers its ownership changes to a different individual or
2519 legal entity as evidenced by a change in federal employer
2520 identification number or taxpayer identification number; or
2521 (b) An event in which 51 45 percent or more of the
2522 ownership, voting shares, membership, or controlling interest of
2523 a licensee is in any manner transferred or otherwise assigned.
2524 This paragraph does not apply to a licensee that is publicly
2525 traded on a recognized stock exchange in a corporation whose
2526 shares are not publicly traded on a recognized stock exchange is
2527 transferred or assigned, including the final transfer or
2528 assignment of multiple transfers or assignments over a 2-year
2529 period that cumulatively total 45 percent or greater.
2530
2531 A change solely in the management company or board of directors
2532 is not a change of ownership.
2533 (9) “Licensee” means an individual, corporation,
2534 partnership, firm, association, or governmental entity, or other
2535 entity that is issued a permit, registration, certificate, or
2536 license by the agency. The licensee is legally responsible for
2537 all aspects of the provider operation.
2538 (13) “Voluntary board member” means a board member or
2539 officer of a not-for-profit corporation or organization who
2540 serves solely in a voluntary capacity, does not receive any
2541 remuneration for his or her services on the board of directors,
2542 and has no financial interest in the corporation or
2543 organization. The agency shall recognize a person as a voluntary
2544 board member following submission of a statement to the agency
2545 by the board member and the not-for-profit corporation or
2546 organization that affirms that the board member conforms to this
2547 definition. The statement affirming the status of the board
2548 member must be submitted to the agency on a form provided by the
2549 agency.
2550 Section 42. Paragraph (a) of subsection (1), subsection
2551 (2), paragraph (c) of subsection (7), and subsection (8) of
2552 section 408.806, Florida Statutes, are amended to read:
2553 408.806 License application process.—
2554 (1) An application for licensure must be made to the agency
2555 on forms furnished by the agency, submitted under oath, and
2556 accompanied by the appropriate fee in order to be accepted and
2557 considered timely. The application must contain information
2558 required by authorizing statutes and applicable rules and must
2559 include:
2560 (a) The name, address, and social security number of:
2561 1. The applicant;
2562 2. The administrator or a similarly titled person who is
2563 responsible for the day-to-day operation of the provider;
2564 3. The financial officer or similarly titled person who is
2565 responsible for the financial operation of the licensee or
2566 provider; and
2567 4. Each controlling interest if the applicant or
2568 controlling interest is an individual.
2569 (2)(a) The applicant for a renewal license must submit an
2570 application that must be received by the agency at least 60 days
2571 but no more than 120 days before prior to the expiration of the
2572 current license. An application received more than 120 days
2573 before the expiration of the current license shall be returned
2574 to the applicant. If the renewal application and fee are
2575 received prior to the license expiration date, the license shall
2576 not be deemed to have expired if the license expiration date
2577 occurs during the agency’s review of the renewal application.
2578 (b) The applicant for initial licensure due to a change of
2579 ownership must submit an application that must be received by
2580 the agency at least 60 days prior to the date of change of
2581 ownership.
2582 (c) For any other application or request, the applicant
2583 must submit an application or request that must be received by
2584 the agency at least 60 days but no more than 120 days before
2585 prior to the requested effective date, unless otherwise
2586 specified in authorizing statutes or applicable rules. An
2587 application received more than 120 days before the requested
2588 effective date shall be returned to the applicant.
2589 (d) The agency shall notify the licensee by mail or
2590 electronically at least 90 days before prior to the expiration
2591 of a license that a renewal license is necessary to continue
2592 operation. The failure to timely submit a renewal application
2593 and license fee shall result in a $50 per day late fee charged
2594 to the licensee by the agency; however, the aggregate amount of
2595 the late fee may not exceed 50 percent of the licensure fee or
2596 $500, whichever is less. If an application is received after the
2597 required filing date and exhibits a hand-canceled postmark
2598 obtained from a United States post office dated on or before the
2599 required filing date, no fine will be levied.
2600 (7)
2601 (c) If an inspection is required by the authorizing statute
2602 for a license application other than an initial application, the
2603 inspection must be unannounced. This paragraph does not apply to
2604 inspections required pursuant to ss. 383.324, 395.0161(4),
2605 429.67(6), and 483.061(2).
2606 (8) The agency may establish procedures for the electronic
2607 notification and submission of required information, including,
2608 but not limited to:
2609 (a) Licensure applications.
2610 (b) Required signatures.
2611 (c) Payment of fees.
2612 (d) Notarization of applications.
2613
2614 Requirements for electronic submission of any documents required
2615 by this part or authorizing statutes may be established by rule.
2616 As an alternative to sending documents as required by
2617 authorizing statutes, the agency may provide electronic access
2618 to information or documents.
2619 Section 43. Subsection (2) of section 408.808, Florida
2620 Statutes, is amended to read:
2621 408.808 License categories.—
2622 (2) PROVISIONAL LICENSE.—A provisional license may be
2623 issued to an applicant pursuant to s. 408.809(3). An applicant
2624 against whom a proceeding denying or revoking a license is
2625 pending at the time of license renewal may be issued a
2626 provisional license effective until final action not subject to
2627 further appeal. A provisional license may also be issued to an
2628 applicant applying for a change of ownership. A provisional
2629 license shall be limited in duration to a specific period of
2630 time, not to exceed 12 months, as determined by the agency.
2631 Section 44. Subsection (5) of section 408.809, Florida
2632 Statutes, is amended, and subsection (6) is added to that
2633 section, to read:
2634 408.809 Background screening; prohibited offenses.—
2635 (5) Effective October 1, 2009, in addition to the offenses
2636 listed in ss. 435.03 and 435.04, all persons required to undergo
2637 background screening pursuant to this part or authorizing
2638 statutes must not have been found guilty of, regardless of
2639 adjudication, or entered a plea of nolo contendere or guilty to,
2640 any of the following offenses or any similar offense of another
2641 jurisdiction:
2642 (a) Any authorizing statutes, if the offense was a felony.
2643 (b) This chapter, if the offense was a felony.
2644 (c) Section 409.920, relating to Medicaid provider fraud,
2645 if the offense was a felony.
2646 (d) Section 409.9201, relating to Medicaid fraud, if the
2647 offense was a felony.
2648 (e) Section 741.28, relating to domestic violence.
2649 (f) Chapter 784, relating to assault, battery, and culpable
2650 negligence, if the offense was a felony.
2651 (g) Section 810.02, relating to burglary.
2652 (h) Section 817.034, relating to fraudulent acts through
2653 mail, wire, radio, electromagnetic, photoelectronic, or
2654 photooptical systems.
2655 (i) Section 817.234, relating to false and fraudulent
2656 insurance claims.
2657 (j) Section 817.505, relating to patient brokering.
2658 (k) Section 817.568, relating to criminal use of personal
2659 identification information.
2660 (l) Section 817.60, relating to obtaining a credit card
2661 through fraudulent means.
2662 (m) Section 817.61, relating to fraudulent use of credit
2663 cards, if the offense was a felony.
2664 (n) Section 831.01, relating to forgery.
2665 (o) Section 831.02, relating to uttering forged
2666 instruments.
2667 (p) Section 831.07, relating to forging bank bills, checks,
2668 drafts, or promissory notes.
2669 (q) Section 831.09, relating to uttering forged bank bills,
2670 checks, drafts, or promissory notes.
2671 (r) Section 831.30, relating to fraud in obtaining
2672 medicinal drugs.
2673 (s) Section 831.31, relating to the sale, manufacture,
2674 delivery, or possession with the intent to sell, manufacture, or
2675 deliver any counterfeit controlled substance, if the offense was
2676 a felony.
2677
2678 A person who serves as a controlling interest of or is employed
2679 by a licensee on September 30, 2009, is not required by law to
2680 submit to rescreening if that licensee has in its possession
2681 written evidence that the person has been screened and qualified
2682 according to the standards specified in s. 435.03 or s. 435.04.
2683 However, if such person has a disqualifying offense listed in
2684 this section, he or she may apply for an exemption from the
2685 appropriate licensing agency before September 30, 2009, and if
2686 agreed to by the employer, may continue to perform his or her
2687 duties until the licensing agency renders a decision on the
2688 application for exemption for offenses listed in this section.
2689 Exemptions from disqualification may be granted pursuant to s.
2690 435.07. Background screening is not required to obtain a
2691 certificate of exemption issued under s. 483.106.
2692 (6) The attestations required under ss. 435.04(5) and
2693 435.05(3) must be submitted at the time of license renewal,
2694 notwithstanding the provisions of ss. 435.04(5) and 435.05(3)
2695 which require annual submission of an affidavit of compliance
2696 with background screening requirements.
2697 Section 45. Section 408.811, Florida Statutes, is amended
2698 to read:
2699 408.811 Right of inspection; copies; inspection reports;
2700 plan for correction of deficiencies.—
2701 (1) An authorized officer or employee of the agency may
2702 make or cause to be made any inspection or investigation deemed
2703 necessary by the agency to determine the state of compliance
2704 with this part, authorizing statutes, and applicable rules. The
2705 right of inspection extends to any business that the agency has
2706 reason to believe is being operated as a provider without a
2707 license, but inspection of any business suspected of being
2708 operated without the appropriate license may not be made without
2709 the permission of the owner or person in charge unless a warrant
2710 is first obtained from a circuit court. Any application for a
2711 license issued under this part, authorizing statutes, or
2712 applicable rules constitutes permission for an appropriate
2713 inspection to verify the information submitted on or in
2714 connection with the application.
2715 (a) All inspections shall be unannounced, except as
2716 specified in s. 408.806.
2717 (b) Inspections for relicensure shall be conducted
2718 biennially unless otherwise specified by authorizing statutes or
2719 applicable rules.
2720 (2) Inspections conducted in conjunction with
2721 certification, comparable licensure requirements, or a
2722 recognized or approved accreditation organization may be
2723 accepted in lieu of a complete licensure inspection. However, a
2724 licensure inspection may also be conducted to review any
2725 licensure requirements that are not also requirements for
2726 certification.
2727 (3) The agency shall have access to and the licensee shall
2728 provide, or if requested send, copies of all provider records
2729 required during an inspection or other review at no cost to the
2730 agency, including records requested during an offsite review.
2731 (4) A deficiency must be corrected within 30 calendar days
2732 after the provider is notified of inspection results unless an
2733 alternative timeframe is required or approved by the agency.
2734 (5) The agency may require an applicant or licensee to
2735 submit a plan of correction for deficiencies. If required, the
2736 plan of correction must be filed with the agency within 10
2737 calendar days after notification unless an alternative timeframe
2738 is required.
2739 (6)(a)(4)(a) Each licensee shall maintain as public
2740 information, available upon request, records of all inspection
2741 reports pertaining to that provider that have been filed by the
2742 agency unless those reports are exempt from or contain
2743 information that is exempt from s. 119.07(1) and s. 24(a), Art.
2744 I of the State Constitution or is otherwise made confidential by
2745 law. Effective October 1, 2006, copies of such reports shall be
2746 retained in the records of the provider for at least 3 years
2747 following the date the reports are filed and issued, regardless
2748 of a change of ownership.
2749 (b) A licensee shall, upon the request of any person who
2750 has completed a written application with intent to be admitted
2751 by such provider, any person who is a client of such provider,
2752 or any relative, spouse, or guardian of any such person, furnish
2753 to the requester a copy of the last inspection report pertaining
2754 to the licensed provider that was issued by the agency or by an
2755 accrediting organization if such report is used in lieu of a
2756 licensure inspection.
2757 Section 46. Section 408.813, Florida Statutes, is amended
2758 to read:
2759 408.813 Administrative fines; violations.—As a penalty for
2760 any violation of this part, authorizing statutes, or applicable
2761 rules, the agency may impose an administrative fine.
2762 (1) Unless the amount or aggregate limitation of the fine
2763 is prescribed by authorizing statutes or applicable rules, the
2764 agency may establish criteria by rule for the amount or
2765 aggregate limitation of administrative fines applicable to this
2766 part, authorizing statutes, and applicable rules. Each day of
2767 violation constitutes a separate violation and is subject to a
2768 separate fine. For fines imposed by final order of the agency
2769 and not subject to further appeal, the violator shall pay the
2770 fine plus interest at the rate specified in s. 55.03 for each
2771 day beyond the date set by the agency for payment of the fine.
2772 (2) Violations of this part, authorizing statutes, or
2773 applicable rules shall be classified according to the nature of
2774 the violation and the gravity of its probable effect on clients.
2775 The scope of a violation may be cited as an isolated, patterned,
2776 or widespread deficiency. An isolated deficiency is a deficiency
2777 affecting one or a very limited number of clients, or involving
2778 one or a very limited number of staff, or a situation that
2779 occurred only occasionally or in a very limited number of
2780 locations. A patterned deficiency is a deficiency in which more
2781 than a very limited number of clients are affected, or more than
2782 a very limited number of staff are involved, or the situation
2783 has occurred in several locations, or the same client or clients
2784 have been affected by repeated occurrences of the same deficient
2785 practice but the effect of the deficient practice is not found
2786 to be pervasive throughout the provider. A widespread deficiency
2787 is a deficiency in which the problems causing the deficiency are
2788 pervasive in the provider or represent systemic failure that has
2789 affected or has the potential to affect a large portion of the
2790 provider’s clients. This subsection does not affect the
2791 legislative determination of the amount of a fine imposed under
2792 authorizing statutes. Violations shall be classified on the
2793 written notice as follows:
2794 (a) Class “I” violations are those conditions or
2795 occurrences related to the operation and maintenance of a
2796 provider or to the care of clients which the agency determines
2797 present an imminent danger to the clients of the provider or a
2798 substantial probability that death or serious physical or
2799 emotional harm would result therefrom. The condition or practice
2800 constituting a class I violation shall be abated or eliminated
2801 within 24 hours, unless a fixed period, as determined by the
2802 agency, is required for correction. The agency shall impose an
2803 administrative fine as provided by law for a cited class I
2804 violation. A fine shall be levied notwithstanding the correction
2805 of the violation.
2806 (b) Class “II” violations are those conditions or
2807 occurrences related to the operation and maintenance of a
2808 provider or to the care of clients which the agency determines
2809 directly threaten the physical or emotional health, safety, or
2810 security of the clients, other than class I violations. The
2811 agency shall impose an administrative fine as provided by law
2812 for a cited class II violation. A fine shall be levied
2813 notwithstanding the correction of the violation.
2814 (c) Class “III” violations are those conditions or
2815 occurrences related to the operation and maintenance of a
2816 provider or to the care of clients which the agency determines
2817 indirectly or potentially threaten the physical or emotional
2818 health, safety, or security of clients, other than class I or
2819 class II violations. The agency shall impose an administrative
2820 fine as provided in this section for a cited class III
2821 violation. A citation for a class III violation must specify the
2822 time within which the violation is required to be corrected. If
2823 a class III violation is corrected within the time specified, a
2824 fine may not be imposed.
2825 (d) Class “IV” violations are those conditions or
2826 occurrences related to the operation and maintenance of a
2827 provider or to required reports, forms, or documents that do not
2828 have the potential of negatively affecting clients. These
2829 violations are of a type that the agency determines do not
2830 threaten the health, safety, or security of clients. The agency
2831 shall impose an administrative fine as provided in this section
2832 for a cited class IV violation. A citation for a class IV
2833 violation must specify the time within which the violation is
2834 required to be corrected. If a class IV violation is corrected
2835 within the time specified, a fine may not be imposed.
2836 Section 47. Subsections (11), (12), (13), (14), (15), (16),
2837 (17), (18), (19), (20), (21), (22), (23), (24), (25), (26),
2838 (27), (28), and (29) of section 408.820, Florida Statutes, are
2839 amended to read:
2840 408.820 Exemptions.—Except as prescribed in authorizing
2841 statutes, the following exemptions shall apply to specified
2842 requirements of this part:
2843 (11) Private review agents, as provided under part I of
2844 chapter 395, are exempt from ss. 408.806(7), 408.810, and
2845 408.811.
2846 (11)(12) Health care risk managers, as provided under part
2847 I of chapter 395, are exempt from ss. 408.806(7), 408.810(4)
2848 (10) 408.810, and 408.811.
2849 (12)(13) Nursing homes, as provided under part II of
2850 chapter 400, are exempt from ss. 408.810(7) and 408.813(2) s.
2851 408.810(7).
2852 (13)(14) Assisted living facilities, as provided under part
2853 I of chapter 429, are exempt from s. 408.810(10).
2854 (14)(15) Home health agencies, as provided under part III
2855 of chapter 400, are exempt from s. 408.810(10).
2856 (15)(16) Nurse registries, as provided under part III of
2857 chapter 400, are exempt from s. 408.810(6) and (10).
2858 (16)(17) Companion services or homemaker services
2859 providers, as provided under part III of chapter 400, are exempt
2860 from s. 408.810(6)-(10).
2861 (17)(18) Adult day care centers, as provided under part III
2862 of chapter 429, are exempt from s. 408.810(10).
2863 (18)(19) Adult family-care homes, as provided under part II
2864 of chapter 429, are exempt from s. 408.810(7)-(10).
2865 (18)(20) Homes for special services, as provided under part
2866 V of chapter 400, are exempt from s. 408.810(7)-(10).
2867 (20)(21) Transitional living facilities, as provided under
2868 part V of chapter 400, are exempt from s. 408.810(10) s.
2869 408.810(7)-(10).
2870 (21)(22) Prescribed pediatric extended care centers, as
2871 provided under part VI of chapter 400, are exempt from s.
2872 408.810(10).
2873 (22)(23) Home medical equipment providers, as provided
2874 under part VII of chapter 400, are exempt from s. 408.810(10).
2875 (23)(24) Intermediate care facilities for persons with
2876 developmental disabilities, as provided under part VIII of
2877 chapter 400, are exempt from s. 408.810(7).
2878 (24)(25) Health care services pools, as provided under part
2879 IX of chapter 400, are exempt from s. 408.810(6)-(10).
2880 (25)(26) Health care clinics, as provided under part X of
2881 chapter 400, are exempt from s. 408.810(6), (7), (10) ss.
2882 408.809 and 408.810(1), (6), (7), and (10).
2883 (26)(27) Clinical laboratories, as provided under part I of
2884 chapter 483, are exempt from s. 408.810(5)-(10).
2885 (27)(28) Multiphasic health testing centers, as provided
2886 under part II of chapter 483, are exempt from s. 408.810(5)
2887 (10).
2888 (28)(29) Organ and tissue procurement agencies, as provided
2889 under chapter 765, are exempt from s. 408.810(5)-(10).
2890 Section 48. Section 408.821, Florida Statutes, is created
2891 to read:
2892 408.821 Emergency management planning; emergency
2893 operations; inactive license.—
2894 (1) A licensee required by authorizing statutes to have an
2895 emergency operations plan must designate a safety liaison to
2896 serve as the primary contact for emergency operations.
2897 (2) An entity subject to this part may temporarily exceed
2898 its licensed capacity to act as a receiving provider in
2899 accordance with an approved emergency operations plan for up to
2900 15 days. While in an overcapacity status, each provider must
2901 furnish or arrange for appropriate care and services to all
2902 clients. In addition, the agency may approve requests for
2903 overcapacity in excess of 15 days, which approvals may be based
2904 upon satisfactory justification and need as provided by the
2905 receiving and sending providers.
2906 (3)(a) An inactive license may be issued to a licensee
2907 subject to this section when the provider is located in a
2908 geographic area in which a state of emergency was declared by
2909 the Governor if the provider:
2910 1. Suffered damage to its operation during the state of
2911 emergency.
2912 2. Is currently licensed.
2913 3. Does not have a provisional license.
2914 4. Will be temporarily unable to provide services but is
2915 reasonably expected to resume services within 12 months.
2916 (b) An inactive license may be issued for a period not to
2917 exceed 12 months but may be renewed by the agency for up to 12
2918 additional months upon demonstration to the agency of progress
2919 toward reopening. A request by a licensee for an inactive
2920 license or to extend the previously approved inactive period
2921 must be submitted in writing to the agency, accompanied by
2922 written justification for the inactive license, which states the
2923 beginning and ending dates of inactivity and includes a plan for
2924 the transfer of any clients to other providers and appropriate
2925 licensure fees. Upon agency approval, the licensee shall notify
2926 clients of any necessary discharge or transfer as required by
2927 authorizing statutes or applicable rules. The beginning of the
2928 inactive licensure period shall be the date the provider ceases
2929 operations. The end of the inactive period shall become the
2930 license expiration date, and all licensure fees must be current,
2931 must be paid in full, and may be prorated. Reactivation of an
2932 inactive license requires the prior approval by the agency of a
2933 renewal application, including payment of licensure fees and
2934 agency inspections indicating compliance with all requirements
2935 of this part and applicable rules and statutes.
2936 (4) The agency may adopt rules relating to emergency
2937 management planning, communications, and operations. Licensees
2938 providing residential or inpatient services must utilize an
2939 online database approved by the agency to report information to
2940 the agency regarding the provider’s emergency status, planning,
2941 or operations.
2942 Section 49. Section 408.831, Florida Statutes, is amended
2943 to read:
2944 408.831 Denial, suspension, or revocation of a license,
2945 registration, certificate, or application.—
2946 (1) In addition to any other remedies provided by law, the
2947 agency may deny each application or suspend or revoke each
2948 license, registration, or certificate of entities regulated or
2949 licensed by it:
2950 (a) If the applicant, licensee, or a licensee subject to
2951 this part which shares a common controlling interest with the
2952 applicant has failed to pay all outstanding fines, liens, or
2953 overpayments assessed by final order of the agency or final
2954 order of the Centers for Medicare and Medicaid Services, not
2955 subject to further appeal, unless a repayment plan is approved
2956 by the agency; or
2957 (b) For failure to comply with any repayment plan.
2958 (2) In reviewing any application requesting a change of
2959 ownership or change of the licensee, registrant, or
2960 certificateholder, the transferor shall, prior to agency
2961 approval of the change, repay or make arrangements to repay any
2962 amounts owed to the agency. Should the transferor fail to repay
2963 or make arrangements to repay the amounts owed to the agency,
2964 the issuance of a license, registration, or certificate to the
2965 transferee shall be delayed until repayment or until
2966 arrangements for repayment are made.
2967 (3) An entity subject to this section may exceed its
2968 licensed capacity to act as a receiving facility in accordance
2969 with an emergency operations plan for clients of evacuating
2970 providers from a geographic area where an evacuation order has
2971 been issued by a local authority having jurisdiction. While in
2972 an overcapacity status, each provider must furnish or arrange
2973 for appropriate care and services to all clients. In addition,
2974 the agency may approve requests for overcapacity beyond 15 days,
2975 which approvals may be based upon satisfactory justification and
2976 need as provided by the receiving and sending facilities.
2977 (4)(a) An inactive license may be issued to a licensee
2978 subject to this section when the provider is located in a
2979 geographic area where a state of emergency was declared by the
2980 Governor if the provider:
2981 1. Suffered damage to its operation during that state of
2982 emergency.
2983 2. Is currently licensed.
2984 3. Does not have a provisional license.
2985 4. Will be temporarily unable to provide services but is
2986 reasonably expected to resume services within 12 months.
2987 (b) An inactive license may be issued for a period not to
2988 exceed 12 months but may be renewed by the agency for up to 12
2989 additional months upon demonstration to the agency of progress
2990 toward reopening. A request by a licensee for an inactive
2991 license or to extend the previously approved inactive period
2992 must be submitted in writing to the agency, accompanied by
2993 written justification for the inactive license, which states the
2994 beginning and ending dates of inactivity and includes a plan for
2995 the transfer of any clients to other providers and appropriate
2996 licensure fees. Upon agency approval, the licensee shall notify
2997 clients of any necessary discharge or transfer as required by
2998 authorizing statutes or applicable rules. The beginning of the
2999 inactive licensure period shall be the date the provider ceases
3000 operations. The end of the inactive period shall become the
3001 licensee expiration date, and all licensure fees must be
3002 current, paid in full, and may be prorated. Reactivation of an
3003 inactive license requires the prior approval by the agency of a
3004 renewal application, including payment of licensure fees and
3005 agency inspections indicating compliance with all requirements
3006 of this part and applicable rules and statutes.
3007 (3)(5) This section provides standards of enforcement
3008 applicable to all entities licensed or regulated by the Agency
3009 for Health Care Administration. This section controls over any
3010 conflicting provisions of chapters 39, 383, 390, 391, 394, 395,
3011 400, 408, 429, 468, 483, and 765 or rules adopted pursuant to
3012 those chapters.
3013 Section 50. Subsection (2) of section 408.918, Florida
3014 Statutes, is amended, and subsection (3) is added to that
3015 section, to read:
3016 408.918 Florida 211 Network; uniform certification
3017 requirements.—
3018 (2) In order to participate in the Florida 211 Network, a
3019 211 provider must be fully accredited by the National certified
3020 by the Agency for Health Care Administration. The agency shall
3021 develop criteria for certification, as recommended by the
3022 Florida Alliance of Information and Referral Services or have
3023 received approval to operate, pending accreditation, from its
3024 affiliate, the Florida Alliance of Information and Referral
3025 Services, and shall adopt the criteria as administrative rules.
3026 (a) If any provider of information and referral services or
3027 other entity leases a 211 number from a local exchange company
3028 and is not authorized as described in this section, certified by
3029 the agency, the agency shall, after consultation with the local
3030 exchange company and the Public Service Commission shall,
3031 request that the Federal Communications Commission direct the
3032 local exchange company to revoke the use of the 211 number.
3033 (b) The agency shall seek the assistance and guidance of
3034 the Public Service Commission and the Federal Communications
3035 Commission in resolving any disputes arising over jurisdiction
3036 related to 211 numbers.
3037 (3) The Florida Alliance of Information and Referral
3038 Services is the 211 collaborative organization for the state
3039 which is responsible for studying, designing, implementing,
3040 supporting, and coordinating the Florida 211 Network and for
3041 receiving federal grants.
3042 Section 51. Paragraph (e) of subsection (4) of section
3043 409.221, Florida Statutes, is amended to read:
3044 409.221 Consumer-directed care program.—
3045 (4) CONSUMER-DIRECTED CARE.—
3046 (e) Services.—Consumers shall use the budget allowance only
3047 to pay for home and community-based services that meet the
3048 consumer’s long-term care needs and are a cost-efficient use of
3049 funds. Such services may include, but are not limited to, the
3050 following:
3051 1. Personal care.
3052 2. Homemaking and chores, including housework, meals,
3053 shopping, and transportation.
3054 3. Home modifications and assistive devices which may
3055 increase the consumer’s independence or make it possible to
3056 avoid institutional placement.
3057 4. Assistance in taking self-administered medication.
3058 5. Day care and respite care services, including those
3059 provided by nursing home facilities pursuant to s. 400.141(1)(f)
3060 s. 400.141(6) or by adult day care facilities licensed pursuant
3061 to s. 429.907.
3062 6. Personal care and support services provided in an
3063 assisted living facility.
3064 Section 52. Subsection (5) of section 409.901, Florida
3065 Statutes, is amended to read:
3066 409.901 Definitions; ss. 409.901-409.920.—As used in ss.
3067 409.901-409.920, except as otherwise specifically provided, the
3068 term:
3069 (5) “Change of ownership” means:
3070 (a) An event in which the provider ownership changes to a
3071 different individual legal entity as evidenced by a change in
3072 federal employer identification number or taxpayer
3073 identification number; or
3074 (b) An event in which 51 45 percent or more of the
3075 ownership, voting shares, membership, or controlling interest of
3076 a provider is in any manner transferred or otherwise assigned.
3077 This paragraph does not apply to a licensee that is publicly
3078 traded on a recognized stock exchange; or
3079 (c) When the provider is licensed or registered by the
3080 agency, an event considered a change of ownership for licensure
3081 as defined in s. 408.803 in a corporation whose shares are not
3082 publicly traded on a recognized stock exchange is transferred or
3083 assigned, including the final transfer or assignment of multiple
3084 transfers or assignments over a 2-year period that cumulatively
3085 total 45 percent or more.
3086
3087 A change solely in the management company or board of directors
3088 is not a change of ownership.
3089 Section 53. Section 429.071, Florida Statutes, is repealed.
3090 Section 54. Paragraph (e) of subsection (1) and subsections
3091 (2) and (3) of section 429.08, Florida Statutes, are amended to
3092 read:
3093 429.08 Unlicensed facilities; referral of person for
3094 residency to unlicensed facility; penalties; verification of
3095 licensure status.—
3096 (1)
3097 (e) The agency shall publish provide to the department’s
3098 elder information and referral providers a list, by county, of
3099 licensed assisted living facilities, to assist persons who are
3100 considering an assisted living facility placement in locating a
3101 licensed facility. This information may be provided
3102 electronically or through the agency’s Internet site.
3103 (2) Each field office of the Agency for Health Care
3104 Administration shall establish a local coordinating workgroup
3105 which includes representatives of local law enforcement
3106 agencies, state attorneys, the Medicaid Fraud Control Unit of
3107 the Department of Legal Affairs, local fire authorities, the
3108 Department of Children and Family Services, the district long
3109 term care ombudsman council, and the district human rights
3110 advocacy committee to assist in identifying the operation of
3111 unlicensed facilities and to develop and implement a plan to
3112 ensure effective enforcement of state laws relating to such
3113 facilities. The workgroup shall report its findings, actions,
3114 and recommendations semiannually to the Director of Health
3115 Quality Assurance of the agency.
3116 (2)(3) It is unlawful to knowingly refer a person for
3117 residency to an unlicensed assisted living facility; to an
3118 assisted living facility the license of which is under denial or
3119 has been suspended or revoked; or to an assisted living facility
3120 that has a moratorium pursuant to part II of chapter 408. Any
3121 person who violates this subsection commits a noncriminal
3122 violation, punishable by a fine not exceeding $500 as provided
3123 in s. 775.083.
3124 (a) Any health care practitioner, as defined in s. 456.001,
3125 who is aware of the operation of an unlicensed facility shall
3126 report that facility to the agency. Failure to report a facility
3127 that the practitioner knows or has reasonable cause to suspect
3128 is unlicensed shall be reported to the practitioner’s licensing
3129 board.
3130 (b) Any provider as defined in s. 408.803 hospital or
3131 community mental health center licensed under chapter 395 or
3132 chapter 394 which knowingly discharges a patient or client to an
3133 unlicensed facility is subject to sanction by the agency.
3134 (c) Any employee of the agency or department, or the
3135 Department of Children and Family Services, who knowingly refers
3136 a person for residency to an unlicensed facility; to a facility
3137 the license of which is under denial or has been suspended or
3138 revoked; or to a facility that has a moratorium pursuant to part
3139 II of chapter 408 is subject to disciplinary action by the
3140 agency or department, or the Department of Children and Family
3141 Services.
3142 (d) The employer of any person who is under contract with
3143 the agency or department, or the Department of Children and
3144 Family Services, and who knowingly refers a person for residency
3145 to an unlicensed facility; to a facility the license of which is
3146 under denial or has been suspended or revoked; or to a facility
3147 that has a moratorium pursuant to part II of chapter 408 shall
3148 be fined and required to prepare a corrective action plan
3149 designed to prevent such referrals.
3150 (e) The agency shall provide the department and the
3151 Department of Children and Family Services with a list of
3152 licensed facilities within each county and shall update the list
3153 at least quarterly.
3154 (f) At least annually, the agency shall notify, in
3155 appropriate trade publications, physicians licensed under
3156 chapter 458 or chapter 459, hospitals licensed under chapter
3157 395, nursing home facilities licensed under part II of chapter
3158 400, and employees of the agency or the department, or the
3159 Department of Children and Family Services, who are responsible
3160 for referring persons for residency, that it is unlawful to
3161 knowingly refer a person for residency to an unlicensed assisted
3162 living facility and shall notify them of the penalty for
3163 violating such prohibition. The department and the Department of
3164 Children and Family Services shall, in turn, notify service
3165 providers under contract to the respective departments who have
3166 responsibility for resident referrals to facilities. Further,
3167 the notice must direct each noticed facility and individual to
3168 contact the appropriate agency office in order to verify the
3169 licensure status of any facility prior to referring any person
3170 for residency. Each notice must include the name, telephone
3171 number, and mailing address of the appropriate office to
3172 contact.
3173 Section 55. Paragraph (e) of subsection (1) of section
3174 429.14, Florida Statutes, is amended to read:
3175 429.14 Administrative penalties.—
3176 (1) In addition to the requirements of part II of chapter
3177 408, the agency may deny, revoke, and suspend any license issued
3178 under this part and impose an administrative fine in the manner
3179 provided in chapter 120 against a licensee of an assisted living
3180 facility for a violation of any provision of this part, part II
3181 of chapter 408, or applicable rules, or for any of the following
3182 actions by a licensee of an assisted living facility, for the
3183 actions of any person subject to level 2 background screening
3184 under s. 408.809, or for the actions of any facility employee:
3185 (e) A citation of any of the following deficiencies as
3186 specified defined in s. 429.19:
3187 1. One or more cited class I deficiencies.
3188 2. Three or more cited class II deficiencies.
3189 3. Five or more cited class III deficiencies that have been
3190 cited on a single survey and have not been corrected within the
3191 times specified.
3192 Section 56. Section 429.19, Florida Statutes, is amended to
3193 read:
3194 429.19 Violations; imposition of administrative fines;
3195 grounds.—
3196 (1) In addition to the requirements of part II of chapter
3197 408, the agency shall impose an administrative fine in the
3198 manner provided in chapter 120 for the violation of any
3199 provision of this part, part II of chapter 408, and applicable
3200 rules by an assisted living facility, for the actions of any
3201 person subject to level 2 background screening under s. 408.809,
3202 for the actions of any facility employee, or for an intentional
3203 or negligent act seriously affecting the health, safety, or
3204 welfare of a resident of the facility.
3205 (2) Each violation of this part and adopted rules shall be
3206 classified according to the nature of the violation and the
3207 gravity of its probable effect on facility residents. The agency
3208 shall indicate the classification on the written notice of the
3209 violation as follows:
3210 (a) Class “I” violations are defined in s. 408.813 those
3211 conditions or occurrences related to the operation and
3212 maintenance of a facility or to the personal care of residents
3213 which the agency determines present an imminent danger to the
3214 residents or guests of the facility or a substantial probability
3215 that death or serious physical or emotional harm would result
3216 therefrom. The condition or practice constituting a class I
3217 violation shall be abated or eliminated within 24 hours, unless
3218 a fixed period, as determined by the agency, is required for
3219 correction. The agency shall impose an administrative fine for a
3220 cited class I violation in an amount not less than $5,000 and
3221 not exceeding $10,000 for each violation. A fine may be levied
3222 notwithstanding the correction of the violation.
3223 (b) Class “II” violations are defined in s. 408.813 those
3224 conditions or occurrences related to the operation and
3225 maintenance of a facility or to the personal care of residents
3226 which the agency determines directly threaten the physical or
3227 emotional health, safety, or security of the facility residents,
3228 other than class I violations. The agency shall impose an
3229 administrative fine for a cited class II violation in an amount
3230 not less than $1,000 and not exceeding $5,000 for each
3231 violation. A fine shall be levied notwithstanding the correction
3232 of the violation.
3233 (c) Class “III” violations are defined in s. 408.813 those
3234 conditions or occurrences related to the operation and
3235 maintenance of a facility or to the personal care of residents
3236 which the agency determines indirectly or potentially threaten
3237 the physical or emotional health, safety, or security of
3238 facility residents, other than class I or class II violations.
3239 The agency shall impose an administrative fine for a cited class
3240 III violation in an amount not less than $500 and not exceeding
3241 $1,000 for each violation. A citation for a class III violation
3242 must specify the time within which the violation is required to
3243 be corrected. If a class III violation is corrected within the
3244 time specified, no fine may be imposed, unless it is a repeated
3245 offense.
3246 (d) Class “IV” violations are defined in s. 408.813 those
3247 conditions or occurrences related to the operation and
3248 maintenance of a building or to required reports, forms, or
3249 documents that do not have the potential of negatively affecting
3250 residents. These violations are of a type that the agency
3251 determines do not threaten the health, safety, or security of
3252 residents of the facility. The agency shall impose an
3253 administrative fine for a cited class IV violation in an amount
3254 not less than $100 and not exceeding $200 for each violation. A
3255 citation for a class IV violation must specify the time within
3256 which the violation is required to be corrected. If a class IV
3257 violation is corrected within the time specified, no fine shall
3258 be imposed. Any class IV violation that is corrected during the
3259 time an agency survey is being conducted will be identified as
3260 an agency finding and not as a violation.
3261 (3) For purposes of this section, in determining if a
3262 penalty is to be imposed and in fixing the amount of the fine,
3263 the agency shall consider the following factors:
3264 (a) The gravity of the violation, including the probability
3265 that death or serious physical or emotional harm to a resident
3266 will result or has resulted, the severity of the action or
3267 potential harm, and the extent to which the provisions of the
3268 applicable laws or rules were violated.
3269 (b) Actions taken by the owner or administrator to correct
3270 violations.
3271 (c) Any previous violations.
3272 (d) The financial benefit to the facility of committing or
3273 continuing the violation.
3274 (e) The licensed capacity of the facility.
3275 (4) Each day of continuing violation after the date fixed
3276 for termination of the violation, as ordered by the agency,
3277 constitutes an additional, separate, and distinct violation.
3278 (5) Any action taken to correct a violation shall be
3279 documented in writing by the owner or administrator of the
3280 facility and verified through followup visits by agency
3281 personnel. The agency may impose a fine and, in the case of an
3282 owner-operated facility, revoke or deny a facility’s license
3283 when a facility administrator fraudulently misrepresents action
3284 taken to correct a violation.
3285 (6) Any facility whose owner fails to apply for a change
3286 of-ownership license in accordance with part II of chapter 408
3287 and operates the facility under the new ownership is subject to
3288 a fine of $5,000.
3289 (7) In addition to any administrative fines imposed, the
3290 agency may assess a survey fee, equal to the lesser of one half
3291 of the facility’s biennial license and bed fee or $500, to cover
3292 the cost of conducting initial complaint investigations that
3293 result in the finding of a violation that was the subject of the
3294 complaint or monitoring visits conducted under s. 429.28(3)(c)
3295 to verify the correction of the violations.
3296 (8) During an inspection, the agency, as an alternative to
3297 or in conjunction with an administrative action against a
3298 facility for violations of this part and adopted rules, shall
3299 make a reasonable attempt to discuss each violation and
3300 recommended corrective action with the owner or administrator of
3301 the facility, prior to written notification. The agency, instead
3302 of fixing a period within which the facility shall enter into
3303 compliance with standards, may request a plan of corrective
3304 action from the facility which demonstrates a good faith effort
3305 to remedy each violation by a specific date, subject to the
3306 approval of the agency.
3307 (9) The agency shall develop and disseminate an annual list
3308 of all facilities sanctioned or fined $5,000 or more for
3309 violations of state standards, the number and class of
3310 violations involved, the penalties imposed, and the current
3311 status of cases. The list shall be disseminated, at no charge,
3312 to the Department of Elderly Affairs, the Department of Health,
3313 the Department of Children and Family Services, the Agency for
3314 Persons with Disabilities, the area agencies on aging, the
3315 Florida Statewide Advocacy Council, and the state and local
3316 ombudsman councils. The Department of Children and Family
3317 Services shall disseminate the list to service providers under
3318 contract to the department who are responsible for referring
3319 persons to a facility for residency. The agency may charge a fee
3320 commensurate with the cost of printing and postage to other
3321 interested parties requesting a copy of this list. This
3322 information may be provided electronically or through the
3323 agency’s Internet site.
3324 Section 57. Subsections (2) and (6) of section 429.23,
3325 Florida Statutes, are amended to read:
3326 429.23 Internal risk management and quality assurance
3327 program; adverse incidents and reporting requirements.—
3328 (2) Every facility licensed under this part is required to
3329 maintain adverse incident reports. For purposes of this section,
3330 the term, “adverse incident” means:
3331 (a) An event over which facility personnel could exercise
3332 control rather than as a result of the resident’s condition and
3333 results in:
3334 1. Death;
3335 2. Brain or spinal damage;
3336 3. Permanent disfigurement;
3337 4. Fracture or dislocation of bones or joints;
3338 5. Any condition that required medical attention to which
3339 the resident has not given his or her consent, including failure
3340 to honor advanced directives;
3341 6. Any condition that requires the transfer of the resident
3342 from the facility to a unit providing more acute care due to the
3343 incident rather than the resident’s condition before the
3344 incident; or.
3345 7. An event that is reported to law enforcement or its
3346 personnel for investigation; or
3347 (b) Abuse, neglect, or exploitation as defined in s.
3348 415.102;
3349 (c) Events reported to law enforcement; or
3350 (b)(d) Resident elopement, if the elopement places the
3351 resident at risk of harm or injury.
3352 (6) Abuse, neglect, or exploitation must be reported to the
3353 Department of Children and Family Services as required under
3354 chapter 415 The agency shall annually submit to the Legislature
3355 a report on assisted living facility adverse incident reports.
3356 The report must include the following information arranged by
3357 county:
3358 (a) A total number of adverse incidents;
3359 (b) A listing, by category, of the type of adverse
3360 incidents occurring within each category and the type of staff
3361 involved;
3362 (c) A listing, by category, of the types of injuries, if
3363 any, and the number of injuries occurring within each category;
3364 (d) Types of liability claims filed based on an adverse
3365 incident report or reportable injury; and
3366 (e) Disciplinary action taken against staff, categorized by
3367 the type of staff involved.
3368 Section 58. Subsection (9) of section 429.26, Florida
3369 Statutes, is repealed.
3370 Section 59. Subsection (3) of section 430.80, Florida
3371 Statutes, is amended to read:
3372 430.80 Implementation of a teaching nursing home pilot
3373 project.—
3374 (3) To be designated as a teaching nursing home, a nursing
3375 home licensee must, at a minimum:
3376 (a) Provide a comprehensive program of integrated senior
3377 services that include institutional services and community-based
3378 services;
3379 (b) Participate in a nationally recognized accreditation
3380 program and hold a valid accreditation, such as the
3381 accreditation awarded by the Joint Commission on Accreditation
3382 of Healthcare Organizations;
3383 (c) Have been in business in this state for a minimum of 10
3384 consecutive years;
3385 (d) Demonstrate an active program in multidisciplinary
3386 education and research that relates to gerontology;
3387 (e) Have a formalized contractual relationship with at
3388 least one accredited health profession education program located
3389 in this state;
3390 (f) Have a formalized contractual relationship with an
3391 accredited hospital that is designated by law as a teaching
3392 hospital; and
3393 (g) Have senior staff members who hold formal faculty
3394 appointments at universities, which must include at least one
3395 accredited health profession education program.
3396 (h) Maintain insurance coverage pursuant to s.
3397 400.141(1)(s) s. 400.141(20) or proof of financial
3398 responsibility in a minimum amount of $750,000. Such proof of
3399 financial responsibility may include:
3400 1. Maintaining an escrow account consisting of cash or
3401 assets eligible for deposit in accordance with s. 625.52; or
3402 2. Obtaining and maintaining pursuant to chapter 675 an
3403 unexpired, irrevocable, nontransferable and nonassignable letter
3404 of credit issued by any bank or savings association organized
3405 and existing under the laws of this state or any bank or savings
3406 association organized under the laws of the United States that
3407 has its principal place of business in this state or has a
3408 branch office which is authorized to receive deposits in this
3409 state. The letter of credit shall be used to satisfy the
3410 obligation of the facility to the claimant upon presentment of a
3411 final judgment indicating liability and awarding damages to be
3412 paid by the facility or upon presentment of a settlement
3413 agreement signed by all parties to the agreement when such final
3414 judgment or settlement is a result of a liability claim against
3415 the facility.
3416 Section 60. Subsection (5) of section 435.04, Florida
3417 Statutes, is amended to read:
3418 435.04 Level 2 screening standards.—
3419 (5) Under penalty of perjury, all employees in such
3420 positions of trust or responsibility shall attest to meeting the
3421 requirements for qualifying for employment and agreeing to
3422 inform the employer immediately if convicted of any of the
3423 disqualifying offenses while employed by the employer. Each
3424 employer of employees in such positions of trust or
3425 responsibilities which is licensed or registered by a state
3426 agency shall submit to the licensing agency annually or at the
3427 time of license renewal, under penalty of perjury, an affidavit
3428 of compliance with the provisions of this section.
3429 Section 61. Subsection (3) of section 435.05, Florida
3430 Statutes, is amended to read:
3431 435.05 Requirements for covered employees.—Except as
3432 otherwise provided by law, the following requirements shall
3433 apply to covered employees:
3434 (3) Each employer required to conduct level 2 background
3435 screening must sign an affidavit annually or at the time of
3436 license renewal, under penalty of perjury, stating that all
3437 covered employees have been screened or are newly hired and are
3438 awaiting the results of the required screening checks.
3439 Section 62. Subsection (2) of section 483.031, Florida
3440 Statutes, is amended to read:
3441 483.031 Application of part; exemptions.—This part applies
3442 to all clinical laboratories within this state, except:
3443 (2) A clinical laboratory that performs only waived tests
3444 and has received a certificate of exemption from the agency
3445 under s. 483.106.
3446 Section 63. Subsection (10) of section 483.041, Florida
3447 Statutes, is amended to read:
3448 483.041 Definitions.—As used in this part, the term:
3449 (10) “Waived test” means a test that the federal Centers
3450 for Medicare and Medicaid Services Health Care Financing
3451 Administration has determined qualifies for a certificate of
3452 waiver under the federal Clinical Laboratory Improvement
3453 Amendments of 1988, and the federal rules adopted thereunder.
3454 Section 64. Section 483.106, Florida Statutes, is repealed.
3455 Section 65. Subsection (3) of section 483.172, Florida
3456 Statutes, is amended to read:
3457 483.172 License fees.—
3458 (3) The agency shall assess a biennial fee of $100 for a
3459 certificate of exemption and a $100 biennial license fee under
3460 this section for facilities surveyed by an approved accrediting
3461 organization.
3462 Section 66. Paragraph (b) of subsection (1) of section
3463 627.4239, Florida Statutes, is amended to read:
3464 627.4239 Coverage for use of drugs in treatment of cancer.—
3465 (1) DEFINITIONS.—As used in this section, the term:
3466 (b) “Standard reference compendium” means authoritative
3467 compendia identified by the Secretary of the United States
3468 Department of Health and Human Services and recognized by the
3469 federal Centers for Medicare and Medicaid Services:
3470 1. The United States Pharmacopeia Drug Information;
3471 2. The American Medical Association Drug Evaluations; or
3472 3. The American Hospital Formulary Service Drug
3473 Information.
3474 Section 67. Subsection (13) of section 651.118, Florida
3475 Statutes, is amended to read:
3476 651.118 Agency for Health Care Administration; certificates
3477 of need; sheltered beds; community beds.—
3478 (13) Residents, as defined in this chapter, are not
3479 considered new admissions for the purpose of s. 400.141
3480 (1)(o)1.d. s. 400.141(15)(d).
3481 Section 68. This act shall take effect July 1, 2009.