Florida Senate - 2015                              CS for SB 768
       By the Committee on Health Policy; and Senator Gaetz
       588-02133-15                                           2015768c1
    1                        A bill to be entitled                      
    2         An act relating to patient observation status
    3         notification; amending s. 395.301, F.S.; requiring a
    4         licensed facility to document observation services in
    5         a patient’s discharge papers when the facility places
    6         the patient on observation status; requiring a
    7         licensed facility to notify a patient or patient’s
    8         proxy of observation status through discharge papers;
    9         authorizing a licensed facility to notify a patient or
   10         patient’s proxy of observation status through other
   11         forms of communication; providing an effective date.
   13  Be It Enacted by the Legislature of the State of Florida:
   15         Section 1. Section 395.301, Florida Statutes, is amended,
   16  to read:
   17         395.301 Itemized patient bill; form and content prescribed
   18  by the agency; patient observation status notification.—
   19         (1) A licensed facility not operated by the state shall
   20  notify each patient during admission and at discharge of his or
   21  her right to receive an itemized bill upon request. Within 7
   22  days following the patient’s discharge or release from a
   23  licensed facility not operated by the state, the licensed
   24  facility providing the service shall, upon request, submit to
   25  the patient, or to the patient’s survivor or legal guardian as
   26  may be appropriate, an itemized statement detailing in language
   27  comprehensible to an ordinary layperson the specific nature of
   28  charges or expenses incurred by the patient, which in the
   29  initial billing shall contain a statement of specific services
   30  received and expenses incurred for such items of service,
   31  enumerating in detail the constituent components of the services
   32  received within each department of the licensed facility and
   33  including unit price data on rates charged by the licensed
   34  facility, as prescribed by the agency.
   35         (2)(a) Each such statement submitted pursuant to this
   36  section:
   37         1. May not include charges of hospital-based physicians if
   38  billed separately.
   39         2. May not include any generalized category of expenses
   40  such as “other” or “miscellaneous” or similar categories.
   41         3. Shall list drugs by brand or generic name and not refer
   42  to drug code numbers when referring to drugs of any sort.
   43         4. Shall specifically identify therapy treatment as to the
   44  date, type, and length of treatment when therapy treatment is a
   45  part of the statement.
   46         (b) Any person receiving a statement pursuant to this
   47  section shall be fully and accurately informed as to each charge
   48  and service provided by the institution preparing the statement.
   49         (3) On each itemized statement submitted pursuant to
   50  subsection (1) there shall appear the words “A FOR-PROFIT (or
   53  similar words sufficient to identify clearly and plainly the
   54  ownership status of the licensed facility. Each itemized
   55  statement must prominently display the phone number of the
   56  medical facility’s patient liaison who is responsible for
   57  expediting the resolution of any billing dispute between the
   58  patient, or his or her representative, and the billing
   59  department.
   60         (4) An itemized bill shall be provided once to the
   61  patient’s physician at the physician’s request, at no charge.
   62         (5) In any billing for services subsequent to the initial
   63  billing for such services, the patient, or the patient’s
   64  survivor or legal guardian, may elect, at his or her option, to
   65  receive a copy of the detailed statement of specific services
   66  received and expenses incurred for each such item of service as
   67  provided in subsection (1).
   68         (6) No physician, dentist, podiatric physician, or licensed
   69  facility may add to the price charged by any third party except
   70  for a service or handling charge representing a cost actually
   71  incurred as an item of expense; however, the physician, dentist,
   72  podiatric physician, or licensed facility is entitled to fair
   73  compensation for all professional services rendered. The amount
   74  of the service or handling charge, if any, shall be set forth
   75  clearly in the bill to the patient.
   76         (7) Each licensed facility not operated by the state shall
   77  provide, prior to provision of any nonemergency medical
   78  services, a written good faith estimate of reasonably
   79  anticipated charges for the facility to treat the patient’s
   80  condition upon written request of a prospective patient. The
   81  estimate shall be provided to the prospective patient within 7
   82  business days after the receipt of the request. The estimate may
   83  be the average charges for that diagnosis related group or the
   84  average charges for that procedure. Upon request, the facility
   85  shall notify the patient of any revision to the good faith
   86  estimate. Such estimate shall not preclude the actual charges
   87  from exceeding the estimate. The facility shall place a notice
   88  in the reception area that such information is available.
   89  Failure to provide the estimate within the provisions
   90  established pursuant to this section shall result in a fine of
   91  $500 for each instance of the facility’s failure to provide the
   92  requested information.
   93         (8) Each licensed facility that is not operated by the
   94  state shall provide any uninsured person seeking planned
   95  nonemergency elective admission a written good faith estimate of
   96  reasonably anticipated charges for the facility to treat such
   97  person. The estimate must be provided to the uninsured person
   98  within 7 business days after the person notifies the facility
   99  and the facility confirms that the person is uninsured. The
  100  estimate may be the average charges for that diagnosis-related
  101  group or the average charges for that procedure. Upon request,
  102  the facility shall notify the person of any revision to the good
  103  faith estimate. Such estimate does not preclude the actual
  104  charges from exceeding the estimate. The facility shall also
  105  provide to the uninsured person a copy of any facility discount
  106  and charity care discount policies for which the uninsured
  107  person may be eligible. The facility shall place a notice in the
  108  reception area where such information is available. Failure to
  109  provide the estimate as required by this subsection shall result
  110  in a fine of $500 for each instance of the facility’s failure to
  111  provide the requested information.
  112         (9) If a licensed facility places a patient on observation
  113  rather than inpatient status, observation services shall be
  114  documented in the patient’s discharge papers. The patient or
  115  patient’s proxy shall be notified of observation services
  116  through discharge papers and also may be notified through
  117  brochures, signage, or other forms of communication for this
  118  purpose.
  119         (10)(9) A licensed facility shall make available to a
  120  patient all records necessary for verification of the accuracy
  121  of the patient’s bill within 30 business days after the request
  122  for such records. The verification information must be made
  123  available in the facility’s offices. Such records shall be
  124  available to the patient prior to and after payment of the bill
  125  or claim. The facility may not charge the patient for making
  126  such verification records available; however, the facility may
  127  charge its usual fee for providing copies of records as
  128  specified in s. 395.3025.
  129         (11)(10) Each facility shall establish a method for
  130  reviewing and responding to questions from patients concerning
  131  the patient’s itemized bill. Such response shall be provided
  132  within 30 days after the date a question is received. If the
  133  patient is not satisfied with the response, the facility must
  134  provide the patient with the address of the agency to which the
  135  issue may be sent for review.
  136         (12)(11) Each licensed facility shall make available on its
  137  Internet website a link to the performance outcome and financial
  138  data that is published by the Agency for Health Care
  139  Administration pursuant to s. 408.05(3)(k). The facility shall
  140  place a notice in the reception area that the information is
  141  available electronically and the facility’s Internet website
  142  address.
  143         Section 2. This act shall take effect July 1, 2015.