Florida Senate - 2014                CS for CS for CS for SB 746
       
       
        
       By the Committees on Community Affairs; Criminal Justice; and
       Health Policy; and Senator Sobel
       
       
       
       
       578-04053-14                                           2014746c3
    1                        A bill to be entitled                      
    2         An act relating to the Health Care Clinic Act;
    3         amending s. 400.9905, F.S.; redefining the term
    4         “clinic”; exempting certain federally certified
    5         clinics from licensure under the act; amending s.
    6         400.995, F.S.; providing that a clinic is subject to
    7         penalties if it engages physicians whose licenses have
    8         been suspended or revoked; providing an effective
    9         date.
   10          
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Subsection (4) of section 400.9905, Florida
   14  Statutes, is amended to read:
   15         400.9905 Definitions.—
   16         (4) “Clinic” means an entity that provides where health
   17  care services are provided to individuals and that receives
   18  remuneration which tenders charges for reimbursement for such
   19  services, including a mobile clinic and a portable equipment
   20  provider. As used in this part, the term does not include and
   21  the licensure requirements of this part do not apply to:
   22         (a) Entities licensed or registered by the state under
   23  chapter 395; entities licensed or registered by the state and
   24  providing only health care services within the scope of services
   25  authorized under their respective licenses under ss. 383.30
   26  383.335, chapter 390, chapter 394, chapter 397, this chapter
   27  except part X, chapter 429, chapter 463, chapter 465, chapter
   28  466, chapter 478, part I of chapter 483, chapter 484, or chapter
   29  651; end-stage renal disease providers authorized under 42
   30  C.F.R. part 405, subpart U; providers certified under 42 C.F.R.
   31  part 485, subpart B or subpart H; or an any entity that provides
   32  neonatal or pediatric hospital-based health care services or
   33  other health care services by licensed practitioners solely
   34  within a hospital licensed under chapter 395.
   35         (b) Entities that own, directly or indirectly, entities
   36  licensed or registered by the state pursuant to chapter 395;
   37  entities that own, directly or indirectly, entities licensed or
   38  registered by the state and providing only health care services
   39  within the scope of services authorized pursuant to their
   40  respective licenses under ss. 383.30-383.335, chapter 390,
   41  chapter 394, chapter 397, this chapter except part X, chapter
   42  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   43  of chapter 483, chapter 484, or chapter 651; end-stage renal
   44  disease providers authorized under 42 C.F.R. part 405, subpart
   45  U; providers certified under 42 C.F.R. part 485, subpart B or
   46  subpart H; or an any entity that provides neonatal or pediatric
   47  hospital-based health care services by licensed practitioners
   48  solely within a hospital licensed under chapter 395.
   49         (c) Entities that are owned, directly or indirectly, by an
   50  entity licensed or registered by the state pursuant to chapter
   51  395; entities that are owned, directly or indirectly, by an
   52  entity licensed or registered by the state and providing only
   53  health care services within the scope of services authorized
   54  pursuant to their respective licenses under ss. 383.30-383.335,
   55  chapter 390, chapter 394, chapter 397, this chapter except part
   56  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
   57  478, part I of chapter 483, chapter 484, or chapter 651; end
   58  stage renal disease providers authorized under 42 C.F.R. part
   59  405, subpart U; providers certified under 42 C.F.R. part 485,
   60  subpart B or subpart H; or an any entity that provides neonatal
   61  or pediatric hospital-based health care services by licensed
   62  practitioners solely within a hospital under chapter 395.
   63         (d) Entities that are under common ownership, directly or
   64  indirectly, with an entity licensed or registered by the state
   65  pursuant to chapter 395; entities that are under common
   66  ownership, directly or indirectly, with an entity licensed or
   67  registered by the state and providing only health care services
   68  within the scope of services authorized pursuant to their
   69  respective licenses under ss. 383.30-383.335, chapter 390,
   70  chapter 394, chapter 397, this chapter except part X, chapter
   71  429, chapter 463, chapter 465, chapter 466, chapter 478, part I
   72  of chapter 483, chapter 484, or chapter 651; end-stage renal
   73  disease providers authorized under 42 C.F.R. part 405, subpart
   74  U; providers certified under 42 C.F.R. part 485, subpart B or
   75  subpart H; or an any entity that provides neonatal or pediatric
   76  hospital-based health care services by licensed practitioners
   77  solely within a hospital licensed under chapter 395.
   78         (e) An entity that is exempt from federal taxation under 26
   79  U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan
   80  under 26 U.S.C. s. 409 that has a board of trustees at least
   81  two-thirds of which are Florida-licensed health care
   82  practitioners and provides only physical therapy services under
   83  physician orders, a any community college or university clinic,
   84  and an any entity owned or operated by the federal or state
   85  government, including agencies, subdivisions, or municipalities
   86  thereof.
   87         (f) A sole proprietorship, group practice, partnership, or
   88  corporation that provides health care services by physicians
   89  covered by s. 627.419, that is directly supervised by one or
   90  more of such physicians, and that is wholly owned by one or more
   91  of those physicians or by a physician and the spouse, parent,
   92  child, or sibling of that physician.
   93         (g) A sole proprietorship, group practice, partnership, or
   94  corporation that provides health care services by licensed
   95  health care practitioners under chapter 457, chapter 458,
   96  chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
   97  chapter 466, chapter 467, chapter 480, chapter 484, chapter 486,
   98  chapter 490, chapter 491, or part I, part III, part X, part
   99  XIII, or part XIV of chapter 468, or s. 464.012, and that is
  100  wholly owned by one or more licensed health care practitioners,
  101  or the licensed health care practitioners set forth in this
  102  paragraph and the spouse, parent, child, or sibling of a
  103  licensed health care practitioner if one of the owners who is a
  104  licensed health care practitioner is supervising the business
  105  activities and is legally responsible for the entity’s
  106  compliance with all federal and state laws. However, a health
  107  care practitioner may not supervise services beyond the scope of
  108  the practitioner’s license, except that, for the purposes of
  109  this part, a clinic owned by a licensee in s. 456.053(3)(b)
  110  which provides only services authorized pursuant to s.
  111  456.053(3)(b) may be supervised by a licensee specified in s.
  112  456.053(3)(b).
  113         (h) Clinical facilities affiliated with an accredited
  114  medical school at which training is provided for medical
  115  students, residents, or fellows.
  116         (i) Entities that provide only oncology or radiation
  117  therapy services by physicians licensed under chapter 458 or
  118  chapter 459 or entities that provide oncology or radiation
  119  therapy services by physicians licensed under chapter 458 or
  120  chapter 459 which are owned by a corporation whose shares are
  121  publicly traded on a recognized stock exchange.
  122         (j) Clinical facilities affiliated with a college of
  123  chiropractic accredited by the Council on Chiropractic Education
  124  at which training is provided for chiropractic students.
  125         (k) Entities that provide licensed practitioners to staff
  126  emergency departments or to deliver anesthesia services in
  127  facilities licensed under chapter 395 and that derive at least
  128  90 percent of their gross annual revenues from the provision of
  129  such services. Entities claiming an exemption from licensure
  130  under this paragraph must provide documentation demonstrating
  131  compliance.
  132         (l) Orthotic, prosthetic, pediatric cardiology, or
  133  perinatology clinical facilities or anesthesia clinical
  134  facilities that are not otherwise exempt under paragraph (a) or
  135  paragraph (k) and that are a publicly traded corporation or are
  136  wholly owned, directly or indirectly, by a publicly traded
  137  corporation. As used in this paragraph, a publicly traded
  138  corporation is a corporation that issues securities traded on an
  139  exchange registered with the United States Securities and
  140  Exchange Commission as a national securities exchange.
  141         (m) Entities that are owned by a corporation that has $250
  142  million or more in total annual sales of health care services
  143  provided by licensed health care practitioners where one or more
  144  of the persons responsible for the operations of the entity is a
  145  health care practitioner who is licensed in this state and who
  146  is responsible for supervising the business activities of the
  147  entity and is responsible for the entity’s compliance with state
  148  law for purposes of this part.
  149         (n) Entities that employ 50 or more licensed health care
  150  practitioners licensed under chapter 458 or chapter 459 where
  151  the billing for medical services is under a single tax
  152  identification number. The application for exemption under this
  153  subsection must shall contain information that includes: the
  154  name, residence, and business address and phone number of the
  155  entity that owns the practice; a complete list of the names and
  156  contact information of all the officers and directors of the
  157  corporation; the name, residence address, business address, and
  158  medical license number of each licensed Florida health care
  159  practitioner employed by the entity; the corporate tax
  160  identification number of the entity seeking an exemption; a
  161  listing of health care services to be provided by the entity at
  162  the health care clinics owned or operated by the entity and a
  163  certified statement prepared by an independent certified public
  164  accountant which states that the entity and the health care
  165  clinics owned or operated by the entity have not received
  166  payment for health care services under personal injury
  167  protection insurance coverage for the preceding year. If the
  168  agency determines that an entity which is exempt under this
  169  subsection has received payments for medical services under
  170  personal injury protection insurance coverage, the agency may
  171  deny or revoke the exemption from licensure under this
  172  subsection.
  173  
  174  Notwithstanding this subsection, an entity shall be deemed a
  175  clinic and must be licensed under this part in order to receive
  176  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  177  627.730-627.7405, unless exempted under s. 627.736(5)(h) or, as
  178  a provider certified pursuant to 42 C.F.R. part 485, subpart H,
  179  exempted under this subsection before July 1, 2014. However, if
  180  a single legal entity owned a clinic that is exempt under this
  181  subsection before July 1, 2014, the exemption extends beyond
  182  that date to other clinics owned by that entity which are
  183  certified under 42 C.F.R. part 485, subpart H.
  184         Section 2. Present subsection (6) of section 400.995,
  185  Florida Statutes, is renumbered as subsection (7), and a new
  186  subsection (6) is added to that section, to read:
  187         400.995 Agency administrative penalties.—
  188         (6) A clinic is subject to additional inspections,
  189  administrative penalties, licensure suspension or revocation,
  190  applicable criminal penalties, or any combination of the above
  191  if:
  192         (a) An inspection or investigation reveals that the clinic
  193  hired or continues to directly or contractually engage a
  194  physician whose license is suspended or revoked; or
  195         (b) The licenses of two or more physicians have been
  196  suspended or revoked as a consequence of the physicians’ actions
  197  while engaged by the clinic.
  198         Section 3. This act shall take effect July 1, 2014.