HB 935

1	A bill to be entitled
2	An act relating to health care price transparency;
3	amending s. 381.026, F.S.; providing a definition;
4	requiring primary care providers to publish and post a
5	schedule of certain charges for medical services offered
6	to patients; requiring a primary care provider's estimates
7	of charges for medical services to be consistent with the
8	posted schedule; amending ss. 458.331, 459.015, and
9	461.013, F.S.; providing additional acts that constitute
10	grounds for denial of a license or disciplinary action
11	against certain physicians, osteopathic physicians, or
12	podiatric physicians, to which penalties apply; providing
13	construction with respect to the doctrine of incorporation
14	by reference; providing an effective date.
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1.  Subsection (2) and paragraph (c) of subsection
19	(4) of section 381.026, Florida Statutes, are amended to read:
20	381.026  Florida Patient's Bill of Rights and
21	Responsibilities.-
22	(2)  DEFINITIONS.-As used in this section and s. 381.0261,
23	the term:
24	(a)  "Department" means the Department of Health.
25	(b)  "Health care facility" means a facility licensed under
26	chapter 395.
27	(c)  "Health care provider" means a physician licensed
28	under chapter 458, an osteopathic physician licensed under
29	chapter 459, or a podiatric physician licensed under chapter
30	461.
31	(d)  "Primary care provider" means a health care provider
32	who provides medical services to patients which are commonly
33	provided without referral from another health care provider,
34	including family and general practice, general pediatrics,
35	obstetrics and gynecology, and general internal medicine.
36	(e)(d)  "Responsible provider" means a health care provider
37	who is primarily responsible for patient care in a health care
38	facility or provider's office.
39	(4)  RIGHTS OF PATIENTS.-Each health care facility or
40	provider shall observe the following standards:
41	(c)  Financial information and disclosure.-
42	1.  A patient has the right to be given, upon request, by
43	the responsible provider, his or her designee, or a
44	representative of the health care facility full information and
45	necessary counseling on the availability of known financial
46	resources for the patient's health care.
47	2.  A health care provider or a health care facility shall,
48	upon request, disclose to each patient who is eligible for
49	Medicare, before in advance of treatment, whether the health
50	care provider or the health care facility in which the patient
51	is receiving medical services accepts assignment under Medicare
52	reimbursement as payment in full for medical services and
53	treatment rendered in the health care provider's office or
54	health care facility.
55	3.  A primary care provider shall publish a schedule of
56	charges for the medical services that the provider offers to
57	patients. The schedule must include the prices charged to an
58	uninsured person paying for such services by cash, check, credit
59	card, or debit card. The schedule must be posted in a
60	conspicuous place in the reception area of the provider's
61	office.
62	4.3.  A health care provider or a health care facility
63	shall, upon request, furnish a person, before the prior to
64	provision of medical services, a reasonable estimate of charges
65	for such services. The health care provider or the health care
66	facility shall provide an uninsured person, before prior to the
67	provision of a planned nonemergency medical service, a
68	reasonable estimate of charges for such service and information
69	regarding the provider's or facility's discount or charity
70	policies for which the uninsured person may be eligible. Such
71	estimates by a primary care provider must be consistent with the
72	schedule posted under subparagraph 3. Estimates shall, to the
73	extent possible, be written in a language comprehensible to an
74	ordinary layperson. Such reasonable estimate does shall not
75	preclude the health care provider or health care facility from
76	exceeding the estimate or making additional charges based on
77	changes in the patient's condition or treatment needs.
78	5.4.  Each licensed facility not operated by the state
79	shall make available to the public on its Internet website or by
80	other electronic means a description of and a link to the
81	performance outcome and financial data that is published by the
82	agency pursuant to s. 408.05(3)(k). The facility shall place a
83	notice in the reception area that such information is available
84	electronically and the website address. The licensed facility
85	may indicate that the pricing information is based on a
86	compilation of charges for the average patient and that each
87	patient's bill may vary from the average depending upon the
88	severity of illness and individual resources consumed. The
89	licensed facility may also indicate that the price of service is
90	negotiable for eligible patients based upon the patient's
91	ability to pay.
92	6.5.  A patient has the right to receive a copy of an
93	itemized bill upon request. A patient has a right to be given an
94	explanation of charges upon request.
95	Section 2.  Paragraph (rr) is added to subsection (1) of
96	section 458.331, Florida Statutes, and subsection (11) is added
97	to that section, to read:
98	458.331  Grounds for disciplinary action; action by the
99	board and department.-
100	(1)  The following acts constitute grounds for denial of a
101	license or disciplinary action, as specified in s. 456.072(2):
102	(rr)  Failing to publish or post a schedule of charges for
103	the medical services offered to patients as required in s.
104	381.026(4)(c)3. This paragraph applies only to a physician who
105	is a "primary care provider" as defined in s. 381.026(2).
106	(11)  The purpose of this section is to facilitate uniform
107	discipline for those acts made punishable under this section
108	and, to this end, a reference to this section constitutes a
109	general reference under the doctrine of incorporation by
110	reference.
111	Section 3.  Paragraph (tt) is added to subsection (1) of
112	section 459.015, Florida Statutes, and subsection (11) is added
113	to that section, to read:
114	459.015  Grounds for disciplinary action; action by the
115	board and department.-
116	(1)  The following acts constitute grounds for denial of a
117	license or disciplinary action, as specified in s. 456.072(2):
118	(tt)  Failing to publish or post a schedule of charges for
119	the medical services offered to patients as required in s.
120	381.026(4)(c)3. This paragraph applies only to an osteopathic
121	physician who is a "primary care provider" as defined in s.
122	381.026(2).
123	(11)  The purpose of this section is to facilitate uniform
124	discipline for those acts made punishable under this section
125	and, to this end, a reference to this section constitutes a
126	general reference under the doctrine of incorporation by
127	reference.
128	Section 4.  Paragraph (dd) is added to subsection (1) of
129	section 461.013, Florida Statutes, and subsection (7) is added
130	to that section, to read:
131	461.013  Grounds for disciplinary action; action by the
132	board; investigations by department.-
133	(1)  The following acts constitute grounds for denial of a
134	license or disciplinary action, as specified in s. 456.072(2):
135	(dd)  Failing to publish or post a schedule of charges for
136	the medical services offered to patients as required in s.
137	381.026(4)(c)3. This paragraph applies only to a podiatric
138	physician who is a "primary care provider" as defined in s.
139	381.026(2).
140	(7)  The purpose of this section is to facilitate uniform
141	discipline for those acts made punishable under this section
142	and, to this end, a reference to this section constitutes a
143	general reference under the doctrine of incorporation by
144	reference.
145	Section 5.  This act shall take effect July 1, 2011.

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