Florida Senate - 2016 CS for SB 108
By the Committee on Health Policy; and Senator Grimsley
1 A bill to be entitled
2 An act relating to financial arrangements between
3 referring health care providers and providers of
4 health care services; amending s. 456.053, F.S.;
5 exempting clinical laboratory services incidental to
6 renal dialysis from the definition of “designated
7 health services”; providing that the definition of
8 “investment interest” does not include investment
9 interests in an entity that is the sole provider of
10 clinical laboratory services incidental to renal
11 dialysis in a rural area; excluding orders,
12 recommendations, or plans of care by a nephrologist
13 for clinical laboratory services incidental to renal
14 dialysis from the definition of “referral”; providing
15 an effective date.
17 Be It Enacted by the Legislature of the State of Florida:
19 Section 1. Paragraphs (c), (k), and (o) of subsection (3)
20 of section 456.053, Florida Statutes, are amended to read:
21 456.053 Financial arrangements between referring health
22 care providers and providers of health care services.—
23 (3) DEFINITIONS.—For the purpose of this section, the word,
24 phrase, or term:
25 (c) “Designated health services” means
, for purposes of
26 this section, clinical laboratory services, other than clinical
27 laboratory services incidental to renal dialysis, physical
28 therapy services, comprehensive rehabilitative services,
29 diagnostic-imaging services, and radiation therapy services.
30 (k) “Investment interest” means equities an equity or debt
31 securities security issued by an entity, including, without
32 limitation, shares of stock in a corporation, units or other
33 interests in a partnership, bonds, debentures, notes, or other
34 equity interests or debt instruments. The following investment
35 interests are shall be excepted from this definition:
36 1. An investment interest in an entity that is the sole
37 provider of designated health services or clinical laboratory
38 services incidental to renal dialysis in a rural area. ;
39 2. An investment interest in notes, bonds, debentures, or
40 other debt instruments issued by an entity that which provides
41 designated health services, as an integral part of a plan by the
42 such entity to acquire such investor’s equity investment
43 interest in the entity, provided that the interest rate is
44 consistent with fair market value, and that the maturity date of
45 the notes, bonds, debentures, or other debt instruments issued
46 by the entity to the investor is not later than October 1, 1996.
47 3. An investment interest in real property which results
48 resulting in a landlord-tenant relationship between the health
49 care provider and the entity in which the equity interest is
50 held, unless the rent is determined, in whole or in part, by the
51 business volume or profitability of the tenant or exceeds fair
52 market value. ; or
53 4. An investment interest in an entity that which owns or
54 leases and operates a hospital licensed under chapter 395 or a
55 nursing home facility licensed under chapter 400.
56 (o) “Referral” means any referral of a patient by a health
57 care provider for health care services, including, without
59 1. The forwarding of a patient by a health care provider to
60 another health care provider or to an entity which provides or
61 supplies designated health services or any other health care
62 item or service; or
63 2. The request or establishment of a plan of care by a
64 health care provider, which includes the provision of designated
65 health services or other health care item or service.
66 3. The following orders, recommendations, or plans of care
67 shall not constitute a referral by a health care provider:
68 a. By a radiologist for diagnostic-imaging services.
69 b. By a physician specializing in the provision of
70 radiation therapy services for such services.
71 c. By a medical oncologist for drugs and solutions to be
72 prepared and administered intravenously to such oncologist’s
73 patient, as well as for the supplies and equipment used in
74 connection therewith to treat such patient for cancer and the
75 complications thereof.
76 d. By a cardiologist for cardiac catheterization services.
77 e. By a pathologist for diagnostic clinical laboratory
78 tests and pathological examination services, if furnished by or
79 under the supervision of such pathologist pursuant to a
80 consultation requested by another physician.
81 f. By a health care provider who is the sole provider or
82 member of a group practice for designated health services or
83 other health care items or services that are prescribed or
84 provided solely for such referring health care provider’s or
85 group practice’s own patients, and that are provided or
86 performed by or under the direct supervision of such referring
87 health care provider or group practice; provided, however, that
88 effective July 1, 1999, a physician licensed pursuant to chapter
89 458, chapter 459, chapter 460, or chapter 461 may refer a
90 patient to a sole provider or group practice for diagnostic
91 imaging services, excluding radiation therapy services, for
92 which the sole provider or group practice billed both the
93 technical and the professional fee for or on behalf of the
94 patient, if the referring physician has no investment interest
95 in the practice. The diagnostic imaging service referred to a
96 group practice or sole provider must be a diagnostic imaging
97 service normally provided within the scope of practice to the
98 patients of the group practice or sole provider. The group
99 practice or sole provider may accept no more than 15 percent of
100 their patients receiving diagnostic imaging services from
101 outside referrals, excluding radiation therapy services.
102 g. By a health care provider for services provided by an
103 ambulatory surgical center licensed under chapter 395.
104 h. By a urologist for lithotripsy services.
105 i. By a dentist for dental services performed by an
106 employee of or health care provider who is an independent
107 contractor with the dentist or group practice of which the
108 dentist is a member.
109 j. By a physician for infusion therapy services to a
110 patient of that physician or a member of that physician’s group
112 k. By a nephrologist for renal dialysis services, and
113 supplies, or clinical laboratory services incidental to renal
114 dialysis except laboratory services.
115 l. By a health care provider whose principal professional
116 practice consists of treating patients in their private
117 residences for services to be rendered in such private
118 residences, except for services rendered by a home health agency
119 licensed under chapter 400. For purposes of this sub
120 subparagraph, the term “private residences” includes patients’
121 private homes, independent living centers, and assisted living
122 facilities, but does not include skilled nursing facilities.
123 m. By a health care provider for sleep-related testing.
124 Section 2. This act shall take effect July 1, 2016.