Senate Bill sb1910c1

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    Florida Senate - 2001                           CS for SB 1910

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Garcia




    317-1822-01

  1                      A bill to be entitled

  2         An act relating to medical practice; creating

  3         s. 456.0375, F.S.; defining the term "clinic";

  4         imposing registration requirements for certain

  5         clinics; providing for medical directors;

  6         providing for enforcement; providing penalties;

  7         providing an effective date.

  8

  9  Be It Enacted by the Legislature of the State of Florida:

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11         Section 1.  Section 456.0375, Florida Statutes, is

12  created to read:

13         456.0375  Registration of certain clinics;

14  requirements; discipline; exemptions.--

15         (1)  As used in this section, the term "clinic" means a

16  business operating in a single structure or facility or group

17  of adjacent structures or facilities operating under the same

18  business name or management at which health care services are

19  provided to individuals and at which the clinic tenders

20  charges for reimbursement for such services, unless it is

21  otherwise licensed or registered by the state pursuant to

22  chapter 390, chapter 394, chapter 395, chapter 397, chapter

23  400, chapter 463, chapter 465, chapter 466, chapter 478,

24  chapter 480, or chapter 484 or is exempt from federal taxation

25  under 26 U.S.C. s. 501(c)(3). This section also does not apply

26  to a sole or group practice, partnership, or corporation that

27  provides health care services by licensed health care

28  practitioners as defined in s. 456.001(4), in accordance with

29  the applicable practice act, which is jointly owned by

30  licensed health care practitioners and the spouse, parent, or

31  child of a licensed health care practitioner, and at which the

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    Florida Senate - 2001                           CS for SB 1910
    317-1822-01




  1  licensed health care practitioners are legally responsible for

  2  the clinic's compliance with all federal and state laws.

  3         (2)(a)  A clinic in which an entity or individual other

  4  than those licensed under chapter 458, chapter 459, chapter

  5  460, or chapter 461 or certified under s. 464.012 possesses an

  6  ownership interest must register with the department. The

  7  clinic must at all times maintain a valid registration. Each

  8  clinic location must be registered separately even if operated

  9  under a common business name or management. For purposes of

10  determining registration requirements under this paragraph, a

11  clinic owned by a physician licensed under chapter 458,

12  chapter 459, chapter 460, or chapter 461 also includes any

13  clinic owned jointly by the physician and the physician's

14  spouse, parent, or child if the licensed physician supervises

15  the services performed in the clinic and is legally

16  responsible for the clinic's compliance with all federal and

17  state laws.

18         (b)  The department shall adopt rules necessary to

19  administer the registration program, including rules

20  establishing the specific registration procedures, forms, and

21  fees. Registration fees must be calculated to reasonably cover

22  the cost of registration and must be in such amount that the

23  total fees collected do not exceed the cost of administering

24  and enforcing compliance with this section. The registration

25  program must require:

26         1.  The clinic to file the registration form with the

27  department within 60 days after the effective date of this

28  section or prior to the inception of operation. The

29  registration expires automatically 2 years after its date of

30  issuance and must be renewed biennially thereafter.

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    Florida Senate - 2001                           CS for SB 1910
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  1         2.  The registration form to contain the name,

  2  residence, and business address, phone number, and license

  3  number of the medical director or clinical director for the

  4  clinic.

  5         3.  The clinic to display the registration certificate

  6  in a conspicuous location within the clinic which is readily

  7  visible to all patients.

  8         (3)(a)  Each clinic owned by an individual other than a

  9  fully licensed physician or owned by an entity other than a

10  professional corporation or limited liability company composed

11  only of fully licensed physicians must employ or contract with

12  a physician maintaining a full and unencumbered physician

13  license in accordance with chapter 458, chapter 459, chapter

14  460, or chapter 461 to serve as the medical director, or with

15  a licensed health care practitioner to serve as the clinical

16  director, who is responsible for activities in accordance with

17  her or his practice act.

18         (b)  A medical director or clinical director must agree

19  in writing to accept responsibility for the following

20  activities on behalf of the clinic. The medical director or

21  the clinical director shall:

22         1.  Have signs identifying the medical director or

23  clinical director posted in a conspicuous location within the

24  clinic which are readily visible to all patients.

25         2.  Ensure that all practitioners providing health care

26  services or supplies to patients maintain a current active and

27  unencumbered Florida license.

28         3.  Review any patient-referral contracts or agreements

29  executed by the clinic.

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    Florida Senate - 2001                           CS for SB 1910
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  1         4.  Ensure that all health care practitioners at the

  2  clinic have active appropriate certification or licensure for

  3  the level of care being provided.

  4         5.  Serve as the clinic records owner as defined in s.

  5  456.057.

  6         6.  Ensure compliance with the medical recordkeeping,

  7  office-surgery, and adverse-incident-reporting requirements of

  8  chapter 456, the respective practice acts, and the rules

  9  adopted thereunder.

10         7.  Conduct systematic reviews of clinic billings to

11  ensure that the billings are not fraudulent or unlawful. Upon

12  discovery of an unlawful charge, the medical director or

13  clinical director must take immediate corrective action.

14         (c)  Any contract to serve as a medical director or

15  clinical director entered into or renewed by a physician or

16  licensed health care practitioner in violation of this section

17  is void as contrary to public policy. This section applies to

18  contracts entered into or renewed on or after October 1, 2001.

19         (d)  The department, in consultation with the boards,

20  shall adopt rules specifying limitations on the number of

21  registered clinics and licensees for which a medical director

22  or clinical director may assume responsibility for purposes of

23  this section. In determining the quality of supervision a

24  medical director or clinical director can provide, the

25  department shall consider the number of clinic employees, the

26  clinic location, and the services provided by the clinic.

27         (4)(a)  All charges or reimbursement claims made by or

28  on behalf of a clinic that is required to be registered under

29  this section but that is not so registered are unlawful

30  charges and therefore are noncompensable and unenforceable.

31  Any person knowingly operating or managing an unregistered

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    Florida Senate - 2001                           CS for SB 1910
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  1  clinic otherwise required to be registered under this section

  2  commits a felony of the third degree, punishable as provided

  3  in s. 775.082, s. 775.083, or s. 775.084.

  4         (b)  Any licensed health care practitioner who violates

  5  this section is subject to discipline in accordance with

  6  chapter 456 and the respective practice act.

  7         (c)  The department shall revoke the registration of

  8  any clinic registered under this section for operating in

  9  violation of the requirements of this section.

10         Section 2.  This act shall take effect October 1, 2001.

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    Florida Senate - 2001                           CS for SB 1910
    317-1822-01




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 1910

  3

  4  The bill requires individuals or entities who are not
    Florida-licensed allopathic or osteopathic physicians,
  5  chiropractic physicians, podiatric physicians, physician
    assistants, or advanced registered nurse practitioners, who
  6  possess an ownership interest in a clinic to register with the
    Department of Health within 60 days after October 1, 2001.
  7  Clinics that are not exempt must comply with the bill's
    requirements to employ or contract with a medical director who
  8  is a Florida-licensed physician or with a clinical director
    who is a Florida-licensed health care practitioner.
  9
    A clinic licensed or registered under chapter 390 (abortion),
10  394 (mental health), 395 (hospitals), 397 (substance abuse
    services), 400 (nursing homes), 463 (optometry), 465
11  (pharmacy), 466 (dental), 478 (electrolysis), 480 (massage),
    or 484 (optical/hearing aid specialist), Florida Statutes, or
12  that is exempt from federal taxation under the Tax Code is
    exempt from the bill's requirements. The bill exempts a sole
13  or group practice, partnership, or corporation that provides
    health care services by licensed health care practitioners as
14  defined in s. 456.001(4), F.S., in accordance with their
    practice act, only if the following conditions are met: the
15  clinic must be jointly owned by licensed health care
    practitioners and the spouse, parent, or child of a licensed
16  health care practitioner, and the licensed health care
    practitioners are legally responsible for the clinic's
17  compliance with all federal and state laws.

18  The bill requires all clinics that are not otherwise exempt to
    register with the Department of Health. The Department of
19  Health must adopt rules to implement a registration program,
    including rules prescribing registration fees. The fees must
20  not exceed an amount that will provide sufficient revenue to
    administer the registration program.
21
    The bill requires a medical director or clinical director to
22  be responsible for activities on behalf of the clinic and
    specifies the duties of the medical director or clinical
23  director of such clinic.

24  Any person knowingly operating or managing an unregistered
    clinic commits a third degree felony. A third degree felony
25  carries a maximum prison sentence of 5 years and a maximum
    fine of $5,000. The Department of Health must revoke the
26  registration of clinics found to be in violation of the bill.
    Also, a violation of the bill by a licensed health care
27  practitioner would be grounds for discipline under ch. 456,
    F.S., and the practice act of that practitioner. All charges
28  or any reimbursement claims made by or on behalf of
    unregistered clinics would be considered to be unlawful
29  charges and therefore be noncompensable and unenforceable. The
    bill makes any contract to serve as a medical director or
30  clinical director entered into or renewed by a physician or
    licensed health care practitioner after October 1, 2001, that
31  violates the provisions of the bill void.

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