Florida Senate - 2015 SB 1146
By Senator Simmons
10-00698B-15 20151146__
1 A bill to be entitled
2 An act relating to agency relationships with
3 governmental health care contractors; amending s.
4 766.1115, F.S.; redefining terms; deleting an obsolete
5 date; extending sovereign immunity to employees or
6 agents of a health care provider that executes a
7 contract with a governmental contractor; authorizing
8 such health care provider to collect from a patient,
9 or the parent or guardian of a patient, a nominal fee
10 for administrative costs under certain circumstances;
11 limiting the nominal fee; clarifying that a receipt of
12 specified notice must be acknowledged by a patient or
13 the patient’s representative at the initial visit;
14 requiring the posting of notice that a specified
15 health care provider is an agent of a governmental
16 contractor; amending s. 768.28, F.S.; redefining the
17 term “officer, employee, or agent” to include
18 employees or agents of a health care provider;
19 providing an effective date.
20
21 Be It Enacted by the Legislature of the State of Florida:
22
23 Section 1. Paragraphs (a) and (d) of subsection (3) and
24 subsections (4) and (5) of section 766.1115, Florida Statutes,
25 are amended to read:
26 766.1115 Health care providers; creation of agency
27 relationship with governmental contractors.—
28 (3) DEFINITIONS.—As used in this section, the term:
29 (a) “Contract” means an agreement executed in compliance
30 with this section between a health care provider and a
31 governmental contractor which allows the health care provider,
32 or any employee or agent of the health care provider, to deliver
33 health care services to low-income recipients as an agent of the
34 governmental contractor. The contract must be for volunteer,
35 uncompensated services, except as provided in paragraph (4)(g).
36 For services to qualify as volunteer, uncompensated services
37 under this section, the health care provider must receive no
38 compensation from the governmental contractor for any services
39 provided under the contract and must not bill or accept
40 compensation from the recipient, or a public or private third
41 party payor, for the specific services provided to the low
42 income recipients covered by the contract, except as provided in
43 paragraphs(4)(g) and (h).
44 (d) “Health care provider” or “provider” means:
45 1. A birth center licensed under chapter 383.
46 2. An ambulatory surgical center licensed under chapter
47 395.
48 3. A hospital licensed under chapter 395.
49 4. A physician or physician assistant licensed under
50 chapter 458.
51 5. An osteopathic physician or osteopathic physician
52 assistant licensed under chapter 459.
53 6. A chiropractic physician licensed under chapter 460.
54 7. A podiatric physician licensed under chapter 461.
55 8. A registered nurse, nurse midwife, licensed practical
56 nurse, or advanced registered nurse practitioner licensed or
57 registered under part I of chapter 464 or any facility which
58 employs nurses licensed or registered under part I of chapter
59 464 to supply all or part of the care delivered under this
60 section.
61 9. A midwife licensed under chapter 467.
62 10. A health maintenance organization certificated under
63 part I of chapter 641.
64 11. A health care professional association and its
65 employees or a corporate medical group and its employees.
66 12. Any other medical facility the primary purpose of which
67 is to deliver human medical diagnostic services or which
68 delivers nonsurgical human medical treatment, and which includes
69 an office maintained by a provider.
70 13. A dentist or dental hygienist licensed under chapter
71 466.
72 14. A free clinic that delivers only medical diagnostic
73 services or nonsurgical medical treatment free of charge to all
74 low-income recipients, except as provided in paragraph (4)(h).
75 15. Any other health care professional, practitioner,
76 provider, or facility under contract with a governmental
77 contractor, including a student enrolled in an accredited
78 program that prepares the student for licensure as any one of
79 the professionals listed in subparagraphs 4.-9.
80
81 The term includes any nonprofit corporation qualified as exempt
82 from federal income taxation under s. 501(a) of the Internal
83 Revenue Code, and described in s. 501(c) of the Internal Revenue
84 Code, which delivers health care services provided by licensed
85 professionals listed in this paragraph, any federally funded
86 community health center, and any volunteer corporation or
87 volunteer health care provider that delivers health care
88 services.
89 (4) CONTRACT REQUIREMENTS.—A health care provider that
90 executes a contract with a governmental contractor to deliver
91 health care services on or after April 17, 1992, as an agent of
92 the governmental contractor, or any employee or agent of such
93 health care provider, is an agent for purposes of s. 768.28(9),
94 while acting within the scope of duties under the contract, if
95 the contract complies with the requirements of this section and
96 regardless of whether the individual treated is later found to
97 be ineligible. A health care provider, or any employee or agent
98 of the health care provider, shall continue to be an agent for
99 purposes of s. 768.28(9) for 30 days after a determination of
100 ineligibility to allow for treatment until the individual
101 transitions to treatment by another health care provider. A
102 health care provider under contract with the state, or any
103 employee or agent of such health care provider, may not be named
104 as a defendant in any action arising out of medical care or
105 treatment provided on or after April 17, 1992, under contracts
106 entered into under this section. The contract must provide that:
107 (a) The right of dismissal or termination of any health
108 care provider delivering services under the contract is retained
109 by the governmental contractor.
110 (b) The governmental contractor has access to the patient
111 records of any health care provider delivering services under
112 the contract.
113 (c) Adverse incidents and information on treatment outcomes
114 must be reported by any health care provider to the governmental
115 contractor if the incidents and information pertain to a patient
116 treated under the contract. The health care provider shall
117 submit the reports required by s. 395.0197. If an incident
118 involves a professional licensed by the Department of Health or
119 a facility licensed by the Agency for Health Care
120 Administration, the governmental contractor shall submit such
121 incident reports to the appropriate department or agency, which
122 shall review each incident and determine whether it involves
123 conduct by the licensee that is subject to disciplinary action.
124 All patient medical records and any identifying information
125 contained in adverse incident reports and treatment outcomes
126 which are obtained by governmental entities under this paragraph
127 are confidential and exempt from the provisions of s. 119.07(1)
128 and s. 24(a), Art. I of the State Constitution.
129 (d) Patient selection and initial referral must be made by
130 the governmental contractor or the provider. Patients may not be
131 transferred to the provider based on a violation of the
132 antidumping provisions of the Omnibus Budget Reconciliation Act
133 of 1989, the Omnibus Budget Reconciliation Act of 1990, or
134 chapter 395.
135 (e) If emergency care is required, the patient need not be
136 referred before receiving treatment, but must be referred within
137 48 hours after treatment is commenced or within 48 hours after
138 the patient has the mental capacity to consent to treatment,
139 whichever occurs later.
140 (f) The provider is subject to supervision and regular
141 inspection by the governmental contractor.
142 (g) As an agent of the governmental contractor for purposes
143 of s. 768.28(9), while acting within the scope of duties under
144 the contract, A health care provider licensed under chapter 466,
145 as an agent of the governmental contractor for purposes of s.
146 768.28(9), may allow a patient, or a parent or guardian of the
147 patient, to voluntarily contribute a monetary amount to cover
148 costs of dental laboratory work related to the services provided
149 to the patient within the scope of duties under the contract.
150 This contribution may not exceed the actual cost of the dental
151 laboratory charges.
152 (h) A health care provider, as an agent of the governmental
153 contractor for purposes of s. 768.28(9), may collect from a
154 patient, or a parent or guardian of the patient, a nominal fee
155 for administrative costs related to the services provided to the
156 patient under the contract. For purposes of this paragraph, a
157 nominal fee may not exceed $10.
158
159 A governmental contractor that is also a health care provider is
160 not required to enter into a contract under this section with
161 respect to the health care services delivered by its employees.
162 (5) NOTICE OF AGENCY RELATIONSHIP.—The governmental
163 contractor must provide written notice to each patient, or the
164 patient’s legal representative, receipt of which must be
165 acknowledged in writing at the initial visit, that the provider
166 is an agent of the governmental contractor and that the
167 exclusive remedy for injury or damage suffered as the result of
168 any act or omission of the provider or of any employee or agent
169 thereof acting within the scope of duties pursuant to the
170 contract is by commencement of an action pursuant to the
171 provisions of s. 768.28. Thereafter, and with respect to any
172 federally funded community health center, the notice
173 requirements may be met by posting in a place conspicuous to all
174 persons a notice that the health care provider federally funded
175 community health center is an agent of the governmental
176 contractor and that the exclusive remedy for injury or damage
177 suffered as the result of any act or omission of the provider or
178 of any employee or agent thereof acting within the scope of
179 duties pursuant to the contract is by commencement of an action
180 pursuant to the provisions of s. 768.28.
181 Section 2. Paragraph (b) of subsection (9) of section
182 768.28, Florida Statutes, is amended to read:
183 768.28 Waiver of sovereign immunity in tort actions;
184 recovery limits; limitation on attorney fees; statute of
185 limitations; exclusions; indemnification; risk management
186 programs.—
187 (9)
188 (b) As used in this subsection, the term:
189 1. “Employee” includes any volunteer firefighter.
190 2. “Officer, employee, or agent” includes, but is not
191 limited to, any health care provider, and its employees or
192 agents, when providing services pursuant to s. 766.1115; any
193 nonprofit independent college or university located and
194 chartered in this state which owns or operates an accredited
195 medical school, and its employees or agents, when providing
196 patient services pursuant to paragraph (10)(f); and any public
197 defender or her or his employee or agent, including, among
198 others, an assistant public defender and an investigator.
199 Section 3. This act shall take effect July 1, 2015.