Senate Bill sb2226c1

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    Florida Senate - 2002                           CS for SB 2226

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




    317-2233-02

  1                      A bill to be entitled

  2         An act relating to surgical first assistants;

  3         amending s. 395.002, F.S.; providing a

  4         definition; amending s. 395.0197, F.S.;

  5         revising a required component of internal risk

  6         management programs to include requirements for

  7         the use of surgical first assistants; creating

  8         ss. 627.64165, 627.6572, F.S.; requiring health

  9         insurance policies to provide coverage for the

10         medically necessary services of a surgical

11         first assistant selected by the primary surgeon

12         to assist in a covered surgical procedure;

13         amending s. 641.31, F.S.; requiring health

14         maintenance contracts to provide coverage for

15         the medically necessary services of a surgical

16         first assistant selected by a primary surgeon

17         contracted with the health maintenance

18         organization to assist in a covered surgical

19         procedure; providing applicability to new or

20         renewed policies and contracts; providing an

21         effective date.

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

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25         Section 1.  Present subsections (31), (32), and (33) of

26  section 395.002, Florida Statutes, are redesignated as

27  subsections (32), (33), and (34), respectively, and a new

28  subsection (31) is added to that section, to read:

29         395.002  Definitions.--As used in this chapter:

30         (31)  "Surgical first assistant" means the first

31  assistant to the surgeon during a surgical operation.

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    Florida Senate - 2002                           CS for SB 2226
    317-2233-02




  1         Section 2.  Paragraph (b) of subsection (1) of section

  2  395.0197, Florida Statutes, is amended to read:

  3         395.0197  Internal risk management program.--

  4         (1)  Every licensed facility shall, as a part of its

  5  administrative functions, establish an internal risk

  6  management program that includes all of the following

  7  components:

  8         (b)  The development of appropriate measures to

  9  minimize the risk of adverse incidents to patients, including,

10  but not limited to:

11         1.  Risk management and risk prevention education and

12  training of all nonphysician personnel as follows:

13         a.  Such education and training of all nonphysician

14  personnel as part of their initial orientation; and

15         b.  At least 1 hour of such education and training

16  annually for all personnel of the licensed facility working in

17  clinical areas and providing patient care, except those

18  persons licensed as health care practitioners who are required

19  to complete continuing education coursework pursuant to

20  chapter 456 or the respective practice act.

21         2.  A prohibition, except when emergency circumstances

22  require otherwise, against a staff member of the licensed

23  facility attending a patient in the recovery room, unless the

24  staff member is authorized to attend the patient in the

25  recovery room and is in the company of at least one other

26  person.  However, a licensed facility is exempt from the

27  two-person requirement if it has:

28         a.  Live visual observation;

29         b.  Electronic observation; or

30         c.  Any other reasonable measure taken to ensure

31  patient protection and privacy.

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    Florida Senate - 2002                           CS for SB 2226
    317-2233-02




  1         3.  A prohibition against an unlicensed person from

  2  assisting or participating in any surgical procedure unless

  3  the facility has authorized the person to do so following a

  4  competency assessment, and such assistance or participation is

  5  done under the direct and immediate supervision of a licensed

  6  physician and is not otherwise an activity that may only be

  7  performed by a licensed health care practitioner. Moreover,

  8  the primary operating surgeon may select a surgical first

  9  assistant from among available individuals who are approved or

10  credentialed by the facility.

11         4.  Development, implementation, and ongoing evaluation

12  of procedures, protocols, and systems to accurately identify

13  patients, planned procedures, and the correct site of the

14  planned procedure so as to minimize the performance of a

15  surgical procedure on the wrong patient, a wrong surgical

16  procedure, a wrong-site surgical procedure, or a surgical

17  procedure otherwise unrelated to the patient's diagnosis or

18  medical condition.

19         Section 3.  Section 627.64165, Florida Statutes, is

20  created to read:

21         627.64165  Surgical first assistants.--A health

22  insurance policy must provide coverage for the medically

23  necessary services provided by a surgical first assistant

24  selected by the primary surgeon to assist in a covered

25  surgical procedure. Nothing in this section may be construed

26  to require a health insurer to make additional, supplemental,

27  or duplicate payment to the hospital or provider solely

28  because of the use of a surgical first assistant.

29         Section 4.  Section 627.6572, Florida Statutes, is

30  created to read:

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    Florida Senate - 2002                           CS for SB 2226
    317-2233-02




  1         627.6572  Surgical first assistants.--A group, blanket,

  2  or franchise health insurance policy must provide coverage for

  3  the medically necessary services provided by a surgical first

  4  assistant selected by the primary surgeon to assist in a

  5  covered surgical procedure. Nothing in this section may be

  6  construed to require a health insurer to make additional,

  7  supplemental, or duplicate payment to the hospital or provider

  8  solely because of the use of a surgical first assistant.

  9         Section 5.  Subsection (40) is added to section 641.31,

10  Florida Statutes, to read:

11         641.31  Health maintenance contracts.--

12         (40)  A health maintenance organization must provide

13  coverage for the medically necessary services provided by a

14  surgical first assistant selected by a primary surgeon

15  contracted with the health maintenance organization to assist

16  in a covered surgical procedure. If the use of contracted

17  surgeons is mandated for a specific procedure, the health

18  maintenance organization may also require that the surgical

19  first assistant be a contracted provider with the health

20  maintenance organization. Payment to a hospital may not be

21  reduced by any portion of the payment to the surgical first

22  assistant. Nothing in this subsection may be construed to

23  require a health maintenance organization to make additional,

24  supplemental, or duplicate payment to the hospital or provider

25  solely because of the use of a surgical first assistant.

26         Section 6.  This act shall take effect July 1, 2002,

27  and shall apply to policies and contracts issued or renewed

28  after that date.

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    Florida Senate - 2002                           CS for SB 2226
    317-2233-02




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                             SB 2226

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  4  The Committee Substitute differs from SB 2226 in the following
    ways:
  5
    An amendment to s. 395.002, F.S., provides a definition of
  6  surgical first assistant.

  7  S. 627.64165, F.S., is created to require individual health
    insurance policies to provide coverage for the medically
  8  necessary services of a surgical first assistant.

  9  The medically necessary services will not be defined by the
    American College of Surgeons.
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