Florida Senate - 2016                                     SB 848
       
       
        
       By Senator Sobel
       
       
       
       
       
       33-01100-16                                            2016848__
    1                        A bill to be entitled                      
    2         An act relating to the Health Care Clinic Act;
    3         amending s. 400.9905, F.S.; redefining the term
    4         “clinic”; amending s. 400.991, F.S.; redefining the
    5         term “applicant”; defining the term “convicted”;
    6         prohibiting applicants for clinic licensure from
    7         having an arrest awaiting final disposition for, or
    8         having been convicted of, a felony or crime punishable
    9         by a specified term of imprisonment; requiring the
   10         Agency for Health Care Administration to deny an
   11         application for a clinic license or license renewal
   12         from an applicant who has been found by a state or
   13         federal regulatory agency or court to have committed
   14         an act that resulted in the suspension or revocation
   15         of a clinic license; amending s. 400.995, F.S.;
   16         providing that a licensed clinic is subject to a
   17         specified administrative penalty if its medical
   18         director or clinic director fails to ensure that a
   19         practitioner providing health care services or
   20         supplies to a patient has a valid license; reenacting
   21         ss. 400.991(2), 400.9935(6), 480.0475(1)(a), and
   22         817.234(8)(c), F.S., to incorporate the amendment made
   23         to s. 400.9905, F.S., in references thereto; providing
   24         an effective date.
   25          
   26  Be It Enacted by the Legislature of the State of Florida:
   27  
   28         Section 1. Subsection (4) of section 400.9905, Florida
   29  Statutes, is amended to read:
   30         400.9905 Definitions.—
   31         (4) “Clinic” means an entity, including a mobile clinic and
   32  a portable equipment provider, which provides where health care
   33  services are provided to individuals and which receives
   34  remuneration tenders charges for reimbursement for the such
   35  services, including a mobile clinic and a portable equipment
   36  provider. As used in this part, the term does not include and
   37  the licensure requirements of this part do not apply to:
   38         (a) Entities licensed or registered by the state under
   39  chapter 395; entities licensed or registered by the state and
   40  providing only health care services within the scope of services
   41  authorized under their respective licenses under ss. 383.30
   42  383.335, chapter 390, chapter 394, chapter 397, this chapter
   43  except part X, chapter 429, chapter 463, chapter 465, chapter
   44  466, chapter 478, part I of chapter 483, chapter 484, or chapter
   45  651; end-stage renal disease providers authorized under 42
   46  C.F.R. part 405, subpart U; providers certified under 42 C.F.R.
   47  part 485, subpart B or subpart H; or an any entity that provides
   48  neonatal or pediatric hospital-based health care services or
   49  other health care services by licensed practitioners solely
   50  within a hospital licensed under chapter 395.
   51         (b) Entities that own, directly or indirectly, entities
   52  licensed or registered by the state pursuant to chapter 395;
   53  entities that own, directly or indirectly, entities licensed or
   54  registered by the state and providing only health care services
   55  within the scope of services authorized pursuant to their
   56  respective licenses under ss. 383.30-383.335, chapter 390,
   57  chapter 394, chapter 397, this chapter except part X, chapter
   58  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   59  of chapter 483, chapter 484, or chapter 651; end-stage renal
   60  disease providers authorized under 42 C.F.R. part 405, subpart
   61  U; providers certified under 42 C.F.R. part 485, subpart B or
   62  subpart H; or an any entity that provides neonatal or pediatric
   63  hospital-based health care services by licensed practitioners
   64  solely within a hospital licensed under chapter 395.
   65         (c) Entities that are owned, directly or indirectly, by an
   66  entity licensed or registered by the state pursuant to chapter
   67  395; entities that are owned, directly or indirectly, by an
   68  entity licensed or registered by the state and providing only
   69  health care services within the scope of services authorized
   70  pursuant to their respective licenses under ss. 383.30-383.335,
   71  chapter 390, chapter 394, chapter 397, this chapter except part
   72  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
   73  478, part I of chapter 483, chapter 484, or chapter 651; end
   74  stage renal disease providers authorized under 42 C.F.R. part
   75  405, subpart U; providers certified under 42 C.F.R. part 485,
   76  subpart B or subpart H; or an any entity that provides neonatal
   77  or pediatric hospital-based health care services by licensed
   78  practitioners solely within a hospital licensed under chapter
   79  395.
   80         (d) Entities that are under common ownership, directly or
   81  indirectly, with an entity licensed or registered by the state
   82  pursuant to chapter 395; entities that are under common
   83  ownership, directly or indirectly, with an entity licensed or
   84  registered by the state and providing only health care services
   85  within the scope of services authorized pursuant to their
   86  respective licenses under ss. 383.30-383.335, chapter 390,
   87  chapter 394, chapter 397, this chapter except part X, chapter
   88  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   89  of chapter 483, chapter 484, or chapter 651; end-stage renal
   90  disease providers authorized under 42 C.F.R. part 405, subpart
   91  U; providers certified under 42 C.F.R. part 485, subpart B or
   92  subpart H; or an any entity that provides neonatal or pediatric
   93  hospital-based health care services by licensed practitioners
   94  solely within a hospital licensed under chapter 395.
   95         (e) An entity that is exempt from federal taxation under 26
   96  U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan
   97  under 26 U.S.C. s. 409 that has a board of trustees at least
   98  two-thirds of which are Florida-licensed health care
   99  practitioners and provides only physical therapy services under
  100  physician orders, a any community college or university clinic,
  101  and an any entity owned or operated by the federal or state
  102  government, including agencies, subdivisions, or municipalities
  103  thereof.
  104         (f) A sole proprietorship, group practice, partnership, or
  105  corporation that provides health care services by physicians
  106  covered by s. 627.419, that is directly supervised by one or
  107  more of such physicians, and that is wholly owned by one or more
  108  of those physicians or by a physician and the spouse, parent,
  109  child, or sibling of that physician.
  110         (g) A sole proprietorship, group practice, partnership, or
  111  corporation that provides health care services by licensed
  112  health care practitioners under chapter 457, chapter 458,
  113  chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
  114  chapter 466, chapter 467, chapter 480, chapter 484, chapter 486,
  115  chapter 490, chapter 491, or part I, part III, part X, part
  116  XIII, or part XIV of chapter 468, or s. 464.012, and that is
  117  wholly owned by one or more licensed health care practitioners,
  118  or the licensed health care practitioners set forth in this
  119  paragraph and the spouse, parent, child, or sibling of a
  120  licensed health care practitioner if one of the owners who is a
  121  licensed health care practitioner is supervising the business
  122  activities and is legally responsible for the entity’s
  123  compliance with all federal and state laws. However, a health
  124  care practitioner may not supervise services beyond the scope of
  125  the practitioner’s license, except that, for the purposes of
  126  this part, a clinic owned by a licensee in s. 456.053(3)(b)
  127  which provides only services authorized pursuant to s.
  128  456.053(3)(b) may be supervised by a licensee specified in s.
  129  456.053(3)(b).
  130         (h) Clinical facilities affiliated with an accredited
  131  medical school at which training is provided for medical
  132  students, residents, or fellows.
  133         (i) Entities that provide only oncology or radiation
  134  therapy services by physicians licensed under chapter 458 or
  135  chapter 459 or entities that provide oncology or radiation
  136  therapy services by physicians licensed under chapter 458 or
  137  chapter 459 which are owned by a corporation whose shares are
  138  publicly traded on a recognized stock exchange.
  139         (j) Clinical facilities affiliated with a college of
  140  chiropractic accredited by the Council on Chiropractic Education
  141  at which training is provided for chiropractic students.
  142         (k) Entities that provide licensed practitioners to staff
  143  emergency departments or to deliver anesthesia services in
  144  facilities licensed under chapter 395 and that derive at least
  145  90 percent of their gross annual revenues from the provision of
  146  such services. Entities claiming an exemption from licensure
  147  under this paragraph must provide documentation demonstrating
  148  compliance.
  149         (l) Orthotic, prosthetic, pediatric cardiology, or
  150  perinatology clinical facilities or anesthesia clinical
  151  facilities that are not otherwise exempt under paragraph (a) or
  152  paragraph (k) and that are a publicly traded corporation or are
  153  wholly owned, directly or indirectly, by a publicly traded
  154  corporation. As used in this paragraph, a publicly traded
  155  corporation is a corporation that issues securities traded on an
  156  exchange registered with the United States Securities and
  157  Exchange Commission as a national securities exchange.
  158         (m) Entities that are owned by a corporation that has $250
  159  million or more in total annual sales of health care services
  160  provided by licensed health care practitioners where one or more
  161  of the persons responsible for the operations of the entity is a
  162  health care practitioner who is licensed in this state and who
  163  is responsible for supervising the business activities of the
  164  entity and is responsible for the entity’s compliance with state
  165  law for purposes of this part.
  166         (n) Entities that employ 50 or more licensed health care
  167  practitioners licensed under chapter 458 or chapter 459 where
  168  the billing for medical services is under a single tax
  169  identification number. The application for exemption under this
  170  subsection must shall contain information that includes: the
  171  name, residence, and business address and phone number of the
  172  entity that owns the practice; a complete list of the names and
  173  contact information of all the officers and directors of the
  174  corporation; the name, residence address, business address, and
  175  medical license number of each licensed Florida health care
  176  practitioner employed by the entity; the corporate tax
  177  identification number of the entity seeking an exemption; a
  178  listing of health care services to be provided by the entity at
  179  the health care clinics owned or operated by the entity and a
  180  certified statement prepared by an independent certified public
  181  accountant which states that the entity and the health care
  182  clinics owned or operated by the entity have not received
  183  payment for health care services under personal injury
  184  protection insurance coverage for the preceding year. If the
  185  agency determines that an entity which is exempt under this
  186  subsection has received payments for medical services under
  187  personal injury protection insurance coverage, the agency may
  188  deny or revoke the exemption from licensure under this
  189  subsection.
  190  
  191  Notwithstanding this subsection, an entity shall be deemed a
  192  clinic and must be licensed under this part in order to receive
  193  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  194  627.730-627.7405, unless exempted under s. 627.736(5)(h).
  195         Section 2. Paragraphs (a) and (b) of subsection (5) of
  196  section 400.991, Florida Statutes, are amended, present
  197  subsection (6) of that section is redesignated as subsection
  198  (7), and a new subsection (6) is added to that section, to read:
  199         400.991 License requirements; background screenings;
  200  prohibitions.—
  201         (5)(a) As used in this subsection and subsection (6), the
  202  term:
  203         1. “Applicant” means an individual who owns or controls
  204  individuals owning or controlling, directly or indirectly, any 5
  205  percent or more of an interest in a clinic; the medical or
  206  clinic director, or a similarly titled individual person who is
  207  responsible for the day-to-day operation of the licensed clinic;
  208  the financial officer or similarly titled individual who is
  209  responsible for the financial operation of the clinic; and a
  210  licensed health care practitioner practitioners at the clinic.
  211         2.“Convicted” means a finding of guilt, regardless of
  212  adjudication, the acceptance of a plea of nolo contendere or
  213  guilty by a court, or an adjudication of delinquency if the
  214  record has not been sealed or expunged.
  215         (b) The agency shall require level 2 background screening
  216  for applicants and personnel as required in s. 408.809(1)(e)
  217  pursuant to chapter 435 and s. 408.809. In addition to the
  218  disqualifying offenses listed in ss. 408.809 and 435.04, an
  219  applicant may not have an arrest awaiting final disposition for,
  220  or have been convicted of, a felony or a crime punishable by
  221  imprisonment of 1 year or more under state or federal law or the
  222  law of any other country.
  223         (6) The agency shall deny the application for a health care
  224  clinic license or license renewal by an applicant who has been
  225  previously found by a state or federal regulatory agency or
  226  court to have committed an act that resulted in the suspension
  227  or revocation of a health care clinic license or its equivalent.
  228         Section 3. Subsection (4) of section 400.995, Florida
  229  Statutes, is amended to read:
  230         400.995 Agency administrative penalties.—
  231         (4) A Any licensed clinic shall be subject to an
  232  administrative fine of $5,000 per day if its:
  233         (a)whose Owner, medical director, or clinic director
  234  concurrently operates an unlicensed clinic shall be subject to
  235  an administrative fine of $5,000 per day.
  236         (b) Medical director or clinic director violates s.
  237  400.9935(1)(b).
  238         Section 4. Subsection (2) of s. 400.991, subsection (6) of
  239  s. 400.9935, paragraph (a) of subsection (1) of s. 480.0475, and
  240  paragraph (c) of subsection (8) of s. 817.234, Florida Statutes,
  241  are reenacted for the purpose of incorporating the amendment
  242  made by this act to s. 400.9905, Florida Statutes, in references
  243  thereto.
  244         Section 5. This act shall take effect July 1, 2016.