HB 1125

CS

CHAMBER ACTION

1	The Health & Families Council recommends the following:
2
3	Council/Committee Substitute
4	A bill to be entitled
5	An act relating to studies on health care; creating a
6	commission to study the effect of the 2004 hurricane
7	season on certain hospitals and identify hospitals unable
8	to comply with the Florida Building Code or located in
9	flood-prone areas; providing for membership,
10	reimbursement, and duties of the study commission;
11	requiring the Department of Community Affairs to provide
12	staff for the study commission; requiring the commission
13	to submit a report and recommendations to the Governor and
14	the Legislature; creating a health insurance plan study
15	group; specifying membership; requiring the Agency for
16	Health Care Administration and the Office of Insurance
17	Regulation to provide staff support; requiring the study
18	group to investigate certain issues relating to health
19	insurance plans; requiring the group to meet and submit
20	recommendations to the Governor and the Legislature;
21	directing the Office of Program Policy Analysis and
22	Government Accountability to conduct a study to evaluate
23	whether the State of Florida should join the Nurse
24	Licensure Compact and to submit a report to the
25	Legislature; providing that a licensee that failed to
26	renew its ambulatory surgical center license may meet the
27	requirements of the Florida Building Code under certain
28	specified circumstances; providing an effective date.
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30	WHEREAS, the State of Florida experienced four major
31	hurricanes during 2004, and
32	WHEREAS, the state recognizes the importance of maintaining
33	a system of hospitals throughout the state to ensure that the
34	underserved population has access to hospitals when the need
35	arises and acknowledges that these hospitals serve a critical
36	state purpose in providing this care, and
37	WHEREAS, it is an important state interest to ensure that
38	these hospitals continue to provide health care services to the
39	state's underserved populations, and
40	WHEREAS, many hospitals and health care facilities
41	sustained significant structural damage to their facilities in
42	2004, and
43	WHEREAS, hospitals that provide the majority of safety net
44	care for indigent and charity cases were forced to operate in
45	facilities that were not structurally sound, and
46	WHEREAS, these hospitals do not have the ability to care
47	for patients at alternative sites during natural disasters, and
48	WHEREAS, these hospitals do not have the capital needed to
49	invest in the significant infrastructure costs associated with
50	hurricane damage, and
51	WHEREAS, these hospitals have been in existence for many
52	years and have become geographically place-bound, with little
53	opportunity to expand beyond their current property lines, NOW,
54	THEREFORE,
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56	Be It Enacted by the Legislature of the State of Florida:
57
58	Section 1.  (1)  STUDY COMMISSION.--There is created a
59	study commission to address critical issues relating to
60	hospitals serving indigent populations and licensed under
61	chapter 395, Florida Statutes, which sustained significant
62	damage to their facilities during the 2004 hurricane season.
63	(2)  SUBJECT OF STUDY.--
64	(a)  The commission shall identify:
65	1.  All hospitals that are currently not able to comply
66	with the provisions of the Florida Building Code as defined in
67	chapter 553, Florida Statutes, and any associated administrative
68	rules;
69	2.  Hospitals that are located within 10 miles of the
70	coastline; and
71	3.  Hospitals that are located in a designated flood zone.
72	(b)  The study commission shall make recommendations for
73	allowing these hospitals to find alternative methods of
74	renovating their existing facility in order to meet the
75	requirements of the Florida Building Code. The commission shall
76	review all alternatives that could be made available to those
77	hospitals when renovation is not financially practicable or
78	structurally feasible. The commission shall review existing laws
79	and agency rules and recommend needed changes to address these
80	issues.
81	(3)  REPORT.--The commission shall meet by September 1,
82	2005, and shall submit recommendations, including
83	recommendations for statutory changes, to the Governor, the
84	President of the Senate, and the Speaker of the House of
85	Representatives by January 1, 2006. Such recommendations shall
86	also include an evaluation of whether grant funds should be made
87	available to assist hospitals with the cost of reconstructing
88	existing facilities.
89	(4)  MEMBERSHIP.--The study commission shall be staffed by
90	the Department of Community Affairs and shall include:
91	(a)  The Secretary of Community Affairs, or his or her
92	designee.
93	(b)  The director of the Division of Emergency Management,
94	or his or her designee.
95	(c)  The Secretary of Health Care Administration, or his or
96	her designee.
97	(d)  Four representatives of hospitals from regions of the
98	state where hospitals experienced significant hurricane damage
99	during 2004, with two members appointed by the President of the
100	Senate and two members appointed by the Speaker of the House of
101	Representatives.
102	(e)  The Secretary of Health, or his or her designee.
103	(f)  A director of county emergency management, selected by
104	the Florida Emergency Preparedness Association.
105	(5)  REIMBURSEMENT.--Members of the study commission shall
106	serve without remuneration, but are entitled to reimbursement in
107	accordance with section 112.061, Florida Statutes, for per diem
108	and travel expenses incurred in performing their duties in
109	accordance with this section.
110	Section 2.  (1)  A 13-member health insurance plan study
111	group is created, to be composed of:
112	(a)  Three representatives of employers offering high
113	deductible health plans to their employees, one each who will be
114	appointed by the Florida Chamber of Commerce, the National
115	Federation of Independent Business, and Associated Industries of
116	Florida. Of these representatives, one shall be a small employer
117	as defined in s. 627.6699, Florida Statutes.
118	(b)  Three representatives of commercial health plans, to
119	be appointed by America's Health Insurance Plans and the Florida
120	Insurance Council.
121	(c)  Three representatives of hospitals, to be appointed by
122	the Florida Hospital Association.
123	(d)  Two physician representatives, one to be appointed by
124	the Florida Medical Association and one to be appointed by the
125	Florida Osteopathic Medical Association.
126	(e)  The Secretary of Health Care Administration, who shall
127	serve as co-chair.
128	(f)  The Director of the Office of Insurance Regulation,
129	who shall serve as co-chair.
130	(2)  Staff support for the study group shall be provided
131	jointly by the Agency for Health Care Administration and the
132	Office of Insurance Regulation.
133	(3)  The study group shall study the following issues
134	related to high deductible health insurance plans, health
135	savings accounts, and health reimbursement arrangements as they
136	relate to:
137	(a)  The impact of high deductibles on access to health
138	care services and pharmaceutical benefits.
139	(b)  The impact of high deductibles on utilization of
140	health care services and overutilization of health care
141	services.
142	(c)  The impact on hospitals' and physicians' inability to
143	collect deductibles and copayments.
144	(d)  The ability of hospitals, physicians, and insureds to
145	determine, prior to service delivery, the level of deductible
146	and copayment required of the insureds.
147	(e)  The methods to assist hospitals, physicians, and
148	insureds to determine, prior to service delivery, the status of
149	the insureds in meeting annual deductible requirements and any
150	subsequent copayments.
151	(f)  The methods to assist hospitals and physicians in the
152	collection of deductibles and copayments, including electric
153	payments.
154	(g)  Alternative approaches to the collection of
155	deductibles and copayments when either the amounts of patient
156	financial responsibility are unknown in advance or there are no
157	funds electronically available from the patient to pay for the
158	deductible and any associated copayment.
159	(4)  The study group shall also study the following issues
160	in addition to those specified in subsection (3):
161	(a)  The assignment of benefits attestations and contract
162	provisions which nullify the attestations of insureds.
163	(b)  The standardization of insured or subscriber
164	identifications cards.
165	(c)  The standardization of claim edits or assurance that
166	claim edits comply with nationally recognized editing
167	guidelines.
168	(d)  The provision of comparative cost information to
169	insureds and subscribers.
170	(5)  The study group shall meet by August 1, 2005, and
171	shall submit recommendations to the Governor, the President of
172	the Senate, and the Speaker of the House of Representatives by
173	January 1, 2006.
174	Section 3.  The Office of Program Policy Analysis and
175	Government Accountability (OPPAGA) shall conduct a study to
176	evaluate whether the State of Florida should join the Nurse
177	Licensure Compact. The study's scope shall include, but not be
178	limited to, identifying the potential impact on the state's
179	nursing shortage, benefits to the state, implementation
180	barriers, and any fiscal impact. OPPAGA shall submit a report to
181	the President of the Senate and the Speaker of the House of
182	Representatives by February 1, 2006.
183	Section 4.  A licensee that failed to renew its ambulatory
184	surgical center license may meet requirements of the Florida
185	Building Code that were in effect at the time of original
186	licensure for the purpose of an initial application if:
187	(1)  The license expired between July 1, 2004, and December
188	31, 2004.
189	(2)  The initial license application was filed within 30
190	days after the license expired.
191	(3)  The ambulatory surgical center is in compliance with
192	regulatory requirements based upon agency inspection.
193
194	This section only applies to the initial application for
195	licensure and does not circumvent any requirements to meet
196	current Florida Building Code requirements or other
197	modifications.
198	Section 5.  This act shall take effect upon becoming a law.

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