Florida Senate - 2013                                     SB 594
       
       
       
       By Senator Bean
       
       
       
       
       4-00277A-13                                            2013594__
    1                        A bill to be entitled                      
    2         An act relating to nursing homes and related health
    3         care facilities; amending s. 400.9905, F.S.;
    4         clarifying provisions to exempt certain clinics that
    5         receive reimbursement under the Florida Motor Vehicle
    6         No-Fault Law from licensure requirements in this state
    7         if they hold specific federal certification; extending
    8         the exemption to clinics that are owned by certain
    9         entities; providing an effective date.
   10  
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Subsection (4) of section 400.9905, Florida
   14  Statutes, is amended to read:
   15         400.9905 Definitions.—
   16         (4) “Clinic” means an entity in which where health care
   17  services are provided to individuals and which tenders charges
   18  for reimbursement for such services, including a mobile clinic
   19  and a portable equipment provider. As used in this part, the
   20  term does not include and the licensure requirements of this
   21  part do not apply to:
   22         (a) Entities licensed or registered by the state under
   23  chapter 395; entities licensed or registered by the state and
   24  providing only health care services within the scope of services
   25  authorized under their respective licenses under ss. 383.30
   26  383.335, chapter 390, chapter 394, chapter 397, this chapter
   27  except part X, chapter 429, chapter 463, chapter 465, chapter
   28  466, chapter 478, part I of chapter 483, chapter 484, or chapter
   29  651; end-stage renal disease providers authorized under 42
   30  C.F.R. part 405, subpart U; providers certified under 42 C.F.R.
   31  part 485, subpart B or subpart H; or any entity that provides
   32  neonatal or pediatric hospital-based health care services or
   33  other health care services by licensed practitioners solely
   34  within a hospital licensed under chapter 395.
   35         (b) Entities that own, directly or indirectly, entities
   36  licensed or registered by the state pursuant to chapter 395;
   37  entities that own, directly or indirectly, entities licensed or
   38  registered by the state and providing only health care services
   39  within the scope of services authorized pursuant to their
   40  respective licenses under ss. 383.30-383.335, chapter 390,
   41  chapter 394, chapter 397, this chapter except part X, chapter
   42  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   43  of chapter 483, chapter 484, or chapter 651; end-stage renal
   44  disease providers authorized under 42 C.F.R. part 405, subpart
   45  U; providers certified under 42 C.F.R. part 485, subpart B or
   46  subpart H; or any entity that provides neonatal or pediatric
   47  hospital-based health care services by licensed practitioners
   48  solely within a hospital licensed under chapter 395.
   49         (c) Entities that are owned, directly or indirectly, by an
   50  entity licensed or registered by the state pursuant to chapter
   51  395; entities that are owned, directly or indirectly, by an
   52  entity licensed or registered by the state and providing only
   53  health care services within the scope of services authorized
   54  pursuant to their respective licenses under ss. 383.30-383.335,
   55  chapter 390, chapter 394, chapter 397, this chapter except part
   56  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
   57  478, part I of chapter 483, chapter 484, or chapter 651; end
   58  stage renal disease providers authorized under 42 C.F.R. part
   59  405, subpart U; providers certified under 42 C.F.R. part 485,
   60  subpart B or subpart H; or any entity that provides neonatal or
   61  pediatric hospital-based health care services by licensed
   62  practitioners solely within a hospital under chapter 395.
   63         (d) Entities that are under common ownership, directly or
   64  indirectly, with an entity licensed or registered by the state
   65  pursuant to chapter 395; entities that are under common
   66  ownership, directly or indirectly, with an entity licensed or
   67  registered by the state and providing only health care services
   68  within the scope of services authorized pursuant to their
   69  respective licenses under ss. 383.30-383.335, chapter 390,
   70  chapter 394, chapter 397, this chapter except part X, chapter
   71  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   72  of chapter 483, chapter 484, or chapter 651; end-stage renal
   73  disease providers authorized under 42 C.F.R. part 405, subpart
   74  U; providers certified under 42 C.F.R. part 485, subpart B or
   75  subpart H; or any entity that provides neonatal or pediatric
   76  hospital-based health care services by licensed practitioners
   77  solely within a hospital licensed under chapter 395.
   78         (e) An entity that is exempt from federal taxation under 26
   79  U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan
   80  under 26 U.S.C. s. 409 that has a board of trustees at least
   81  two-thirds of which are Florida-licensed health care
   82  practitioners and provides only physical therapy services under
   83  physician orders, any community college or university clinic,
   84  and any entity owned or operated by the federal or state
   85  government, including agencies, subdivisions, or municipalities
   86  thereof.
   87         (f) A sole proprietorship, group practice, partnership, or
   88  corporation that provides health care services by physicians
   89  covered by s. 627.419, that is directly supervised by one or
   90  more of such physicians, and that is wholly owned by one or more
   91  of those physicians or by a physician and the spouse, parent,
   92  child, or sibling of that physician.
   93         (g) A sole proprietorship, group practice, partnership, or
   94  corporation that provides health care services by licensed
   95  health care practitioners under chapter 457, chapter 458,
   96  chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
   97  chapter 466, chapter 467, chapter 480, chapter 484, chapter 486,
   98  chapter 490, chapter 491, or part I, part III, part X, part
   99  XIII, or part XIV of chapter 468, or s. 464.012, and that is
  100  wholly owned by one or more licensed health care practitioners,
  101  or the licensed health care practitioners set forth in this
  102  paragraph and the spouse, parent, child, or sibling of a
  103  licensed health care practitioner if one of the owners who is a
  104  licensed health care practitioner is supervising the business
  105  activities and is legally responsible for the entity’s
  106  compliance with all federal and state laws. However, a health
  107  care practitioner may not supervise services beyond the scope of
  108  the practitioner’s license, except that, for the purposes of
  109  this part, a clinic owned by a licensee in s. 456.053(3)(b)
  110  which provides only services authorized pursuant to s.
  111  456.053(3)(b) may be supervised by a licensee specified in s.
  112  456.053(3)(b).
  113         (h) Clinical facilities affiliated with an accredited
  114  medical school at which training is provided for medical
  115  students, residents, or fellows.
  116         (i) Entities that provide only oncology or radiation
  117  therapy services by physicians licensed under chapter 458 or
  118  chapter 459 or entities that provide oncology or radiation
  119  therapy services by physicians licensed under chapter 458 or
  120  chapter 459 which are owned by a corporation whose shares are
  121  publicly traded on a recognized stock exchange.
  122         (j) Clinical facilities affiliated with a college of
  123  chiropractic accredited by the Council on Chiropractic Education
  124  at which training is provided for chiropractic students.
  125         (k) Entities that provide licensed practitioners to staff
  126  emergency departments or to deliver anesthesia services in
  127  facilities licensed under chapter 395 and that derive at least
  128  90 percent of their gross annual revenues from the provision of
  129  such services. Entities claiming an exemption from licensure
  130  under this paragraph must provide documentation demonstrating
  131  compliance.
  132         (l) Orthotic or prosthetic clinical facilities that are a
  133  publicly traded corporation or that are wholly owned, directly
  134  or indirectly, by a publicly traded corporation. As used in this
  135  paragraph, a publicly traded corporation is a corporation that
  136  issues securities traded on an exchange registered with the
  137  United States Securities and Exchange Commission as a national
  138  securities exchange.
  139         (m) Entities that are owned by a corporation that has $250
  140  million or more in total annual sales of health care services
  141  provided by licensed health care practitioners where one or more
  142  of the owners is a health care practitioner who is licensed in
  143  this state and who is responsible for supervising the business
  144  activities of the entity and is legally responsible for the
  145  entity’s compliance with state law for purposes of this part.
  146         (n) Entities that employ 50 or more licensed health care
  147  practitioners licensed under chapter 458 or chapter 459 where
  148  the billing for medical services is under a single tax
  149  identification number. The application for exemption under this
  150  subsection shall contain information that includes: the name,
  151  residence, and business address and phone number of the entity
  152  that owns the practice; a complete list of the names and contact
  153  information of all the officers and directors of the
  154  corporation; the name, residence address, business address, and
  155  medical license number of each licensed Florida health care
  156  practitioner employed by the entity; the corporate tax
  157  identification number of the entity seeking an exemption; a
  158  listing of health care services to be provided by the entity at
  159  the health care clinics owned or operated by the entity and a
  160  certified statement prepared by an independent certified public
  161  accountant which states that the entity and the health care
  162  clinics owned or operated by the entity have not received
  163  payment for health care services under personal injury
  164  protection insurance coverage for the preceding year. If the
  165  agency determines that an entity which is exempt under this
  166  subsection has received payments for medical services under
  167  personal injury protection insurance coverage, the agency may
  168  deny or revoke the exemption from licensure under this
  169  subsection.
  170  
  171  Notwithstanding this subsection, an entity shall be deemed a
  172  clinic and must be licensed under this part in order to receive
  173  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  174  627.730-627.7405, unless exempted under s. 627.736(5)(h) or
  175  under this subsection as a provider certified under 42 C.F.R.
  176  part 485, subpart H, before June 30, 2014. However, if a single
  177  legal entity owns clinics certified under 42 C.F.R. part 485,
  178  subpart H, which are exempted under this provision, the
  179  exemption extends after June 30, 2014, to other clinics
  180  certified under 42 C.F.R. part 485, subpart H, which are owned
  181  by that entity.
  182         Section 2. This act shall take effect July 1, 2013.