Florida Senate - 2009 COMMITTEE AMENDMENT
Bill No. CS for CS for SB 1986
Barcode 500958
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
04/15/2009 .
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The Committee on Health and Human Services Appropriations
(Gaetz) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 277 - 464
4 and insert:
5 interest has been administratively sanctioned by the agency
6 since the last licensure renewal application for one or more of
7 the following acts:
8 (a) An intentional or negligent act that materially affects
9 the health or safety of a client of the provider;
10 (b) Knowingly providing home health services in an
11 unlicensed assisted living facility or unlicensed adult family
12 care home, unless the home health agency or employee reports the
13 unlicensed facility or home to the agency within 72 hours after
14 providing the services;
15 (c) Preparing or maintaining fraudulent patient records,
16 such as, but not limited to, charting ahead, recording vital
17 signs or symptoms which were not personally obtained or observed
18 by the home health agency’s staff at the time indicated,
19 borrowing patients or patient records from other home health
20 agencies to pass a survey or inspection, or falsifying
21 signatures;
22 (d) Failing to provide at least one service directly to a
23 patient for a period of 60 days;
24 (e) Demonstrating a pattern of falsifying documents
25 relating to the training of home health aides or certified
26 nursing assistants or demonstrating a pattern of falsifying
27 health statements for staff who provide direct care to patients.
28 A pattern may be demonstrated by a showing of at least three
29 fraudulent entries or documents;
30 (f) Demonstrating a pattern of billing any payor for
31 services not provided. A pattern may be demonstrated by a
32 showing of at least three billings for services not provided
33 within a 12-month period;
34 (g) Demonstrating a pattern of failing to provide a service
35 specified in the home health agency’s written agreement with a
36 patient or the patient’s legal representative, or the plan of
37 care for that patient, unless a reduction in service is mandated
38 by Medicare, Medicaid, or a state program or as provided in s.
39 400.492(3). A pattern may be demonstrated by a showing of at
40 least three incidents, regardless of the patient or service, in
41 which the home health agency did not provide a service specified
42 in a written agreement or plan of care during a 3-month period;
43 (h) Giving remuneration to a case manager, discharge
44 planner, facility-based staff member, or third-party vendor who
45 is involved in the discharge planning process of a facility
46 licensed under chapter 395, chapter 429, or this chapter from
47 whom the home health agency receives referrals or gives
48 remuneration as prohibited in s. 400.474(6)(a);
49 (i) Giving cash, or its equivalent, to a Medicare or
50 Medicaid beneficiary;
51 (j) Demonstrating a pattern of billing the Medicaid program
52 for services to Medicaid recipients which are medically
53 unnecessary. A pattern may be demonstrated by a showing of at
54 least two fraudulent entries or documents;
55 (k) Providing services to residents in an assisted living
56 facility for which the home health agency does not receive fair
57 market value remuneration; or
58 (l) Providing staffing to an assisted living facility for
59 which the home health agency does not receive fair market value
60 remuneration.
61 Section 5. Paragraph (e) is amended, and Paragraph (l) is
62 added to subsection (6) of section 400.474, Florida Statutes, to
63 read:
64 400.474 Administrative penalties.—
65 (6) The agency may deny, revoke, or suspend the license of
66 a home health agency and shall impose a fine of $5,000 against a
67 home health agency that:
68 (e) Gives remuneration to a case manager, discharge
69 planner, facility-based staff member, or third-party vendor who
70 is involved in the discharge planning process of a facility
71 licensed under chapter 395, chapter 429, or this chapter from
72 whom the home health agency receives referrals.
73 (l) Demonstrates a pattern of billing the Medicaid program
74 for services to Medicaid recipients that are medically
75 unnecessary. A pattern may be demonstrated by a showing of at
76 least two medically unnecessary services.
77 Section 6. Paragraph (a) of subsection (15) of section
78 400.506, Florida Statutes, is amended to read:
79 400.506 Licensure of nurse registries; requirements;
80 penalties.—
81 (15)(a) The agency may deny, suspend, or revoke the license
82 of a nurse registry and shall impose a fine of $5,000 against a
83 nurse registry that:
84 1. Provides services to residents in an assisted living
85 facility for which the nurse registry does not receive fair
86 market value remuneration.
87 2. Provides staffing to an assisted living facility for
88 which the nurse registry does not receive fair market value
89 remuneration.
90 3. Fails to provide the agency, upon request, with copies
91 of all contracts with assisted living facilities which were
92 executed within the last 5 years.
93 4. Gives remuneration to a case manager, discharge planner,
94 facility-based staff member, or third-party vendor who is
95 involved in the discharge planning process of a facility
96 licensed under chapter 395 or this chapter and from whom the
97 nurse registry receives referrals. However, this subparagraph
98 does not prohibit a nurse registry from providing promotional
99 items or promotional products, food, or beverages. The
100 cumulative value of these items may not exceed $50 for a single
101 event. The cumulative value of these items may not exceed $100
102 in a calendar year for all persons specified in this
103 subparagraph who are affiliated with a facility.
104 5. Gives remuneration to a physician, a member of the
105 physician’s office staff, or an immediate family member of the
106 physician, and the nurse registry received a patient referral in
107 the last 12 months from that physician or the physician’s office
108 staff. However, this subparagraph does not prohibit a nurse
109 registry from providing promotional items or promotional
110 products, food, or beverages. The cumulative value of these
111 items may not exceed $50 for a single event. The cumulative
112 value of these items may not exceed $100 in a calendar year for
113 all persons specified in this subparagraph who are affiliated
114 with a physician’s office.
115 Section 7. Section 408.8065, Florida Statutes, is created
116 to read:
117 408.8065 Additional licensure requirements for home health
118 agencies, home medical equipment providers, and health care
119 clinics.—
120 (1) An applicant for initial licensure, or initial
121 licensure due to a change of ownership, as a home health agency,
122 home medical equipment provider, or health care clinic shall:
123 (a) Demonstrate financial ability to operate, as required
124 under s. 408.810(8).
125 (b) Submit pro forma financial statements, including a
126 balance sheet, income and expense statement, and a statement of
127 cash flows for the first two years of operation which provide
128 evidence that the applicant has sufficient assets, credit, and
129 projected revenues to cover liabilities and expenses.
130 (c) Submit a statement of the applicant’s estimated startup
131 costs and sources of funds through the break-even point in
132 operations demonstrating that the applicant has the ability to
133 fund all startup costs, working capital, and contingency
134 financing. The statement must show that the applicant has at a
135 minimum 3 months of average projected expenses to cover startup
136 costs, working capital, and contingency financing. The minimum
137 amount for contingency funding shall not be less than one month
138 of average projected expenses.
139 (d) An applicant will have demonstrated the financial
140 ability to operate if the applicant’s assets, credit, and
141 projected revenues meet or exceed projected liabilities and
142 expenses; and the applicant has provided independent evidence
143 that the funds necessary for startup costs, working capital, and
144 contingency financing exist and will be available as needed.
145
146 All documents required under this subsection must be
147 prepared in accordance with generally accepted accounting
148 principles and may be in a compilation form. The financial
149 statements must be signed by a certified public accountant.
150 (2) In addition to the penalties provided in s. 408.812,
151 any person offering services requiring licensure under part III,
152 part VII, or part X of chapter 400, who knowingly files a false
153 or misleading license or license renewal application or who
154 submits false or misleading information related to such
155 application; and any person who violates or conspires to violate
156 this section commits a felony of the third degree, punishable as
157 provided in s. 775.082, s. 775.083, or s. 775.084.
158 Section 8. Subsection (3), and paragraph (a) of subsection
159 (5), of section 408.810, Florida Statutes, is amended to read:
160 408.810 Minimum licensure requirements.—In addition to the
161 licensure requirements specified in this part, authorizing
162 statutes, and applicable rules, each applicant and licensee must
163 comply with the requirements of this section in order to obtain
164 and maintain a license.
165 (3) Unless otherwise specified in this part, authorizing
166 statutes, or applicable rules, any information required to be
167 reported to the agency must be submitted within 21 calendar days
168 after the report period or effective date of the information,
169 whichever is earlier, including, but not limited to, any change
170 of:
171 (a) Information contained in the most recent application
172 for licensure.
173 (b) Required insurance or bonds.
174 (5)(a) On or before the first day services are provided to
175 a client, a licensee must inform the client and his or her
176 immediate family or representative, if appropriate, of the right
177 to report:
178 1. Complaints. The statewide toll-free telephone number for
179 reporting complaints to the agency must be provided to clients
180 in a manner that is clearly legible and must include the words:
181 “To report a complaint regarding the services you receive,
182 please call toll-free (phone number).”
183 2. Abusive, neglectful, or exploitative practices. The
184 statewide toll-free telephone number for the central abuse
185 hotline must be provided to clients in a manner that is clearly
186 legible and must include the words: “To report abuse, neglect,
187 or exploitation, please call toll-free (phone number).”
188 3. Medicaid fraud. An agency written description of
189 Medicaid fraud and the statewide toll-free telephone number
190
191 ================= T I T L E A M E N D M E N T ================
192 And the title is amended as follows:
193 Delete lines 17 - 34
194 and insert:
195 authorizing the Agency for Health Care Administration to deny,
196 revoke, or suspend the license of or fine a home health agency
197 that provides remuneration to certain facilities or bills the
198 Medicaid program for medically unnecessary services; amending s.
199 400.506, F.S.; exempting certain items from a prohibition
200 against providing remuneration to certain persons by a nurse
201 registry; creating s. 408.8065, F.S.; providing additional
202 licensure requirements for home health agencies, home medical
203 equipment providers, and health care clinics; imposing criminal
204 penalties on a person who knowingly submits misleading
205 information to the Agency for Health Care Administration in
206 connection with applications for certain licenses; amending s.
207 408.810, F.S.; revising provisions relating to information
208 required for licensure; requiring certain licensees