SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2910
Amendment No. ___ Barcode 803424
CHAMBER ACTION
Senate House
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04/26/2004 04:50 PM .
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11 Senator Peaden moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 123, between lines 11 and 12,
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16 insert:
17 Section 38. Section 641.31097, Florida Statutes, is
18 created to read:
19 641.31097 Decreasing inappropriate utilization of
20 emergency care.--
21 (1) The Legislature finds and declares it to be of
22 vital importance that emergency services and care be provided
23 by hospitals and physicians to every person in need of such
24 care, but with the double-digit increases in health insurance
25 premiums, health care providers and insurers should encourage
26 patients and the insured to assume responsibility for their
27 treatment, including emergency care. The Legislature finds
28 that inappropriate utilization of emergency department
29 services increases the overall cost of providing health care
30 and these costs are ultimately borne by the hospital, by the
31 insured patients, and, many times, by the taxpayers of this
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SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2910
Amendment No. ___ Barcode 803424
1 state. Finally, the Legislature declares that the providers
2 and insurers must share the responsibility of providing
3 alternative treatment options to urgent care patients outside
4 of the emergency department. Therefore, it is the intent of
5 the Legislature to place the obligation for educating
6 consumers and creating mechanisms for delivery of care that
7 will decrease the overutilization of emergency service on
8 health maintenance organizations and providers.
9 (2) Health maintenance organizations shall provide on
10 their Internet websites information regarding appropriate
11 utilization of emergency care services, which shall include,
12 but not be limited to, a list of alternative urgent care
13 contracted providers, the types of services offered by these
14 providers, and what to do in the event of a true emergency.
15 (3) Health maintenance organizations shall develop
16 community emergency department diversion programs. Such
17 programs may include at the discretion of the health
18 maintenance organization, but not be limited to, enlisting
19 providers to be on call to subscribers after hours,
20 coordinating care through local community resources, and
21 providing incentives to providers for case management.
22 (4) As a disincentive for subscribers to
23 inappropriately use emergency department services for
24 nonemergency care, health maintenance organizations may
25 require higher copayments for urgent care or primary care
26 provided in an emergency department and higher copayments for
27 use of out-of-network emergency departments. Higher copayments
28 may not be charged for the utilization of the emergency
29 department for emergency care. For the purposes of this
30 section, the term "emergency care" has the same meaning as
31 provided in s. 395.002 and shall include services provided to
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SENATE AMENDMENT
Bill No. CS for CS for CS for SB 2910
Amendment No. ___ Barcode 803424
1 rule out an emergency medical condition.
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3 (Redesignate subsequent sections.)
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6 ================ T I T L E A M E N D M E N T ===============
7 And the title is amended as follows:
8 On page 11, line 20, after the semicolon,
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10 and insert:
11 creating s. 641.31097, F.S.; providing for
12 decreasing inappropriate use of emergency care;
13 providing legislative findings and intent;
14 requiring health maintenance organizations and
15 providers to provide certain information
16 electronically and develop community emergency
17 department diversion programs; authorizing
18 health maintenance organizations to require
19 higher copayments for certain uses of emergency
20 departments;
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