HB 1121

1	A bill to be entitled
2	An act relating to health care providers; amending s. 766.1115,
3	F.S.; revising definitions; providing qualifications for
4	volunteer, uncompensated services; extending protection of
5	sovereign immunity to free clinics as health care providers;
6	requiring the Department of Health to adopt certain rules to
7	specify methods for determination and approval of patient
8	eligibility; providing requirements for such rules; defining the
9	term "health care practitioner"; providing for waiver of
10	biennial license renewal fees and fulfillment of a portion of
11	continuing education hours for specified health care
12	practitioners who provide services, without compensation, to
13	low-income recipients as agents of governmental contractors;
14	amending s. 381.00593, F.S.; providing that for purposes of the
15	public school volunteer health care practitioner program, a
16	licensed dietitian/nutritionist is a health care practitioner;
17	providing an effective date.
18
19	Be It Enacted by the Legislature of the State of Florida:
20
21	Section 1.  Paragraphs (a) and (d) of subsection (3),
22	subsection (4), and subsection (10) of section 766.1115, Florida
23	Statutes, are amended to read:
24	766.1115  Health care providers; creation of agency
25	relationship with governmental contractors.--
26	(3)  DEFINITIONS.--As used in this section, the term:
27	(a)  "Contract" means an agreement executed in compliance
28	with this section between a health care provider and a
29	governmental contractor. This contract shall allow the health
30	care provider to deliver health care services to low-income
31	recipients as an agent of the governmental contractor. The
32	contract must be for volunteer, uncompensated services. For
33	services to qualify as volunteer, uncompensated services under
34	this section, the health care provider must receive no
35	compensation from the governmental contractor for any services
36	provided under the contract and must not bill or accept
37	compensation from the recipient, or any public or private third-
38	party payor, for the specific services provided to the low-
39	income recipients covered by the contract.
40	(d)  "Health care provider" or "provider" means:
41	1.  A birth center licensed under chapter 383.
42	2.  An ambulatory surgical center licensed under chapter
43	395.
44	3.  A hospital licensed under chapter 395.
45	4.  A physician or physician assistant licensed under
46	chapter 458.
47	5.  An osteopathic physician or osteopathic physician
48	assistant licensed under chapter 459.
49	6.  A chiropractic physician licensed under chapter 460.
50	7.  A podiatric physician licensed under chapter 461.
51	8.  A registered nurse, nurse midwife, licensed practical
52	nurse, or advanced registered nurse practitioner licensed or
53	registered under part I of chapter 464 or any facility which
54	employs nurses licensed or registered under part I of chapter
55	464 to supply all or part of the care delivered under this
56	section.
57	9.  A midwife licensed under chapter 467.
58	10.  A health maintenance organization certificated under
59	part I of chapter 641.
60	11.  A health care professional association and its
61	employees or a corporate medical group and its employees.
62	12.  Any other medical facility the primary purpose of
63	which is to deliver human medical diagnostic services or which
64	delivers nonsurgical human medical treatment, and which includes
65	an office maintained by a provider.
66	13.  A dentist or dental hygienist licensed under chapter
67	466.
68	14.  A free clinic that delivers only medical diagnostic
69	services or nonsurgical medical treatment free of charge to all
70	low-income recipients.
71	15.14.  Any other health care professional, practitioner,
72	provider, or facility under contract with a governmental
73	contractor, including a student enrolled in an accredited
74	program that prepares the student for licensure as any one of
75	the professionals listed in subparagraphs 4.-9.
76
77	The term includes any nonprofit corporation qualified as exempt
78	from federal income taxation under s. 501(a) of the Internal
79	Revenue Code, and described in s. 501(c) of the Internal Revenue
80	Code, which delivers health care services provided by licensed
81	professionals listed in this paragraph, any federally funded
82	community health center, and any volunteer corporation or
83	volunteer health care provider that delivers health care
84	services.
85	(4)  CONTRACT REQUIREMENTS.--A health care provider that
86	executes a contract with a governmental contractor to deliver
87	health care services on or after April 17, 1992, as an agent of
88	the governmental contractor is an agent for purposes of s.
89	768.28(9), while acting within the scope of duties under
90	pursuant to the contract, if the contract complies with the
91	requirements of this section and regardless of whether the
92	individual treated is later found to be ineligible. A health
93	care provider under contract with the state may not be named as
94	a defendant in any action arising out of the medical care or
95	treatment provided on or after April 17, 1992, under pursuant to
96	contracts entered into under this section. The contract must
97	provide that:
98	(a)  The right of dismissal or termination of any health
99	care provider delivering services under pursuant to the contract
100	is retained by the governmental contractor.
101	(b)  The governmental contractor has access to the patient
102	records of any health care provider delivering services under
103	pursuant to the contract.
104	(c)  Adverse incidents and information on treatment
105	outcomes must be reported by any health care provider to the
106	governmental contractor if the such incidents and information
107	pertain to a patient treated under pursuant to the contract. The
108	health care provider shall submit the reports required by s.
109	395.0197. If an incident involves a professional licensed by the
110	Department of Health or a facility licensed by the Agency for
111	Health Care Administration, the governmental contractor shall
112	submit such incident reports to the appropriate department or
113	agency, which shall review each incident and determine whether
114	it involves conduct by the licensee that is subject to
115	disciplinary action. All patient medical records and any
116	identifying information contained in adverse incident reports
117	and treatment outcomes which are obtained by governmental
118	entities under pursuant to this paragraph are confidential and
119	exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
120	of the State Constitution.
121	(d)  Patient selection and initial referral must be made
122	solely by the governmental contractor, and the provider must
123	accept all referred patients. However, the number of patients
124	that must be accepted may be limited by the contract, and
125	patients may not be transferred to the provider based on a
126	violation of the antidumping provisions of the Omnibus Budget
127	Reconciliation Act of 1989, the Omnibus Budget Reconciliation
128	Act of 1990, or chapter 395.
129	(e)  If emergency care is required, the patient need not be
130	referred before receiving treatment, but must be referred within
131	48 hours after treatment is commenced or within 48 hours after
132	the patient has the mental capacity to consent to treatment,
133	whichever occurs later.
134	(f)  Patient care, including any followup or hospital care,
135	is subject to approval by the governmental contractor.
136	(g)  The provider is subject to supervision and regular
137	inspection by the governmental contractor.
138
139	A governmental contractor that is also a health care provider is
140	not required to enter into a contract under this section with
141	respect to the health care services delivered by its employees.
142	(10)  RULES.--The department shall adopt rules to
143	administer this section in a manner consistent with its purpose
144	to provide and facilitate access to appropriate, safe, and cost-
145	effective health care services and to maintain health care
146	quality. The rules may include services to be provided and
147	authorized procedures. Notwithstanding the requirements of
148	paragraph (4)(d), the department shall adopt rules that specify
149	required methods for determination and approval of patient
150	eligibility and referral and the contractual conditions under
151	which a health care provider may perform the patient eligibility
152	and referral process on behalf of the department. These rules
153	shall include, but not be limited to, the following
154	requirements:
155	(a)  The provider must accept all patients referred by the
156	department. However, the number of patients that must be
157	accepted may be limited by the contract.
158	(b)  The provider shall comply with departmental rules
159	regarding the determination and approval of patient eligibility
160	and referral.
161	(c)  The provider shall complete training conducted by the
162	department regarding compliance with the approved methods for
163	determination and approval of patient eligibility and referral.
164	(d)  The department shall retain review and oversight
165	authority of the patient eligibility and referral determination.
166	Section 2.  (1)  As used in this section, the term "health
167	care practitioner" means a physician or physician assistant
168	licensed under chapter 458, Florida Statutes; an osteopathic
169	physician or physician assistant licensed under chapter 459,
170	Florida Statutes; a chiropractic physician licensed under
171	chapter 460, Florida Statutes; a podiatric physician licensed
172	under chapter 461, Florida Statutes; an advanced registered
173	nurse practitioner, registered nurse, or licensed practical
174	nurse licensed under part I of chapter 464, Florida Statutes; a
175	dentist or dental hygienist licensed under chapter 466, Florida
176	Statutes; or a midwife licensed under chapter 467, Florida
177	Statutes, who participates as a health care provider under s.
178	766.1115, Florida Statutes.
179	(2)  Notwithstanding any provision of chapter 458, chapter
180	459, chapter 460, chapter 461, part I of chapter 464, chapter
181	466, or chapter 467, Florida Statutes, to the contrary, any
182	health care practitioner who participates as a health care
183	provider under s. 766.1115, Florida Statutes, and thereby agrees
184	with a governmental contractor to provide his or her services
185	without compensation and as an agent of the governmental
186	contractor to low-income recipients in accordance with s.
187	766.1115, Florida Statutes, for at least 80 hours a year for
188	each year during the biennial licensure period, or, if the
189	health care practitioner is retired, for at least 400 hours a
190	year for each year during the licensure period, upon providing
191	sufficient proof from the applicable governmental contractor
192	that the health care practitioner has completed the hours at the
193	time of license renewal under procedures specified by the
194	Department of Health, shall be eligible for:
195	(a)  Waiver of the biennial license renewal fee for an
196	active license; and
197	(b)  Fulfillment of a maximum of 25 percent of the
198	continuing education hours required for license renewal under s.
199	456.013(9), Florida Statutes.
200	Section 3.  Subsections (3) and (4) of section 381.00593,
201	Florida Statutes, are amended to read:
202	381.00593  Public school volunteer health care practitioner
203	program.--
204	(3)  For purposes of this section, the term "health care
205	practitioner" means a physician licensed under chapter 458; an
206	osteopathic physician licensed under chapter 459; a chiropractic
207	physician licensed under chapter 460; a podiatric physician
208	licensed under chapter 461; an optometrist licensed under
209	chapter 463; an advanced registered nurse practitioner,
210	registered nurse, or licensed practical nurse licensed under
211	part I of chapter 464; a pharmacist licensed under chapter 465;
212	a dentist or dental hygienist licensed under chapter 466; a
213	midwife licensed under chapter 467; a speech-language
214	pathologist or audiologist licensed under part I of chapter 468;
215	a dietitian/nutritionist licensed under part X of chapter 468;
216	or a physical therapist licensed under chapter 486.
217	(4)(a)  Notwithstanding any provision of chapter 458,
218	chapter 459, chapter 460, chapter 461, chapter 463, part I of
219	chapter 464, chapter 465, chapter 466, chapter 467, parts part I
220	and X of chapter 468, or chapter 486 to the contrary, any health
221	care practitioner who participates in the program established in
222	this section and thereby agrees to provide his or her services,
223	without compensation, in a public school for at least 80 hours a
224	year for each school year during the biennial licensure period,
225	or, if the health care practitioner is retired, for at least 400
226	hours a year for each school year during the licensure period,
227	upon providing sufficient proof from the applicable school
228	district that the health care practitioner has completed such
229	hours at the time of license renewal under procedures specified
230	by the Department of Health, shall be eligible for the
231	following:
232	1.  Waiver of the biennial license renewal fee for an
233	active license; and
234	2.  Fulfillment of a maximum of 25 percent of the
235	continuing education hours required for license renewal under,
236	pursuant to s. 456.013(9).
237
238	The school district may establish a schedule for health care
239	practitioners who participate in the program.
240	(b)  A health care practitioner must complete all forms and
241	procedures for participation in the program prior to the
242	applicable license renewal date.
243	Section 4.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.