Florida Senate - 2016                              CS for SB 108
       By the Committee on Health Policy; and Senator Grimsley
       588-01306-16                                           2016108c1
    1                        A bill to be entitled                      
    2         An act relating to financial arrangements between
    3         referring health care providers and providers of
    4         health care services; amending s. 456.053, F.S.;
    5         exempting clinical laboratory services incidental to
    6         renal dialysis from the definition of “designated
    7         health services”; providing that the definition of
    8         “investment interest” does not include investment
    9         interests in an entity that is the sole provider of
   10         clinical laboratory services incidental to renal
   11         dialysis in a rural area; excluding orders,
   12         recommendations, or plans of care by a nephrologist
   13         for clinical laboratory services incidental to renal
   14         dialysis from the definition of “referral”; providing
   15         an effective date.
   17  Be It Enacted by the Legislature of the State of Florida:
   19         Section 1. Paragraphs (c), (k), and (o) of subsection (3)
   20  of section 456.053, Florida Statutes, are amended to read:
   21         456.053 Financial arrangements between referring health
   22  care providers and providers of health care services.—
   23         (3) DEFINITIONS.—For the purpose of this section, the word,
   24  phrase, or term:
   25         (c) “Designated health services” means, for purposes of
   26  this section, clinical laboratory services, other than clinical
   27  laboratory services incidental to renal dialysis, physical
   28  therapy services, comprehensive rehabilitative services,
   29  diagnostic-imaging services, and radiation therapy services.
   30         (k) “Investment interest” means equities an equity or debt
   31  securities security issued by an entity, including, without
   32  limitation, shares of stock in a corporation, units or other
   33  interests in a partnership, bonds, debentures, notes, or other
   34  equity interests or debt instruments. The following investment
   35  interests are shall be excepted from this definition:
   36         1. An investment interest in an entity that is the sole
   37  provider of designated health services or clinical laboratory
   38  services incidental to renal dialysis in a rural area.;
   39         2. An investment interest in notes, bonds, debentures, or
   40  other debt instruments issued by an entity that which provides
   41  designated health services, as an integral part of a plan by the
   42  such entity to acquire such investor’s equity investment
   43  interest in the entity, provided that the interest rate is
   44  consistent with fair market value, and that the maturity date of
   45  the notes, bonds, debentures, or other debt instruments issued
   46  by the entity to the investor is not later than October 1, 1996.
   47         3. An investment interest in real property which results
   48  resulting in a landlord-tenant relationship between the health
   49  care provider and the entity in which the equity interest is
   50  held, unless the rent is determined, in whole or in part, by the
   51  business volume or profitability of the tenant or exceeds fair
   52  market value.; or
   53         4. An investment interest in an entity that which owns or
   54  leases and operates a hospital licensed under chapter 395 or a
   55  nursing home facility licensed under chapter 400.
   56         (o) “Referral” means any referral of a patient by a health
   57  care provider for health care services, including, without
   58  limitation:
   59         1. The forwarding of a patient by a health care provider to
   60  another health care provider or to an entity which provides or
   61  supplies designated health services or any other health care
   62  item or service; or
   63         2. The request or establishment of a plan of care by a
   64  health care provider, which includes the provision of designated
   65  health services or other health care item or service.
   66         3. The following orders, recommendations, or plans of care
   67  shall not constitute a referral by a health care provider:
   68         a. By a radiologist for diagnostic-imaging services.
   69         b. By a physician specializing in the provision of
   70  radiation therapy services for such services.
   71         c. By a medical oncologist for drugs and solutions to be
   72  prepared and administered intravenously to such oncologist’s
   73  patient, as well as for the supplies and equipment used in
   74  connection therewith to treat such patient for cancer and the
   75  complications thereof.
   76         d. By a cardiologist for cardiac catheterization services.
   77         e. By a pathologist for diagnostic clinical laboratory
   78  tests and pathological examination services, if furnished by or
   79  under the supervision of such pathologist pursuant to a
   80  consultation requested by another physician.
   81         f. By a health care provider who is the sole provider or
   82  member of a group practice for designated health services or
   83  other health care items or services that are prescribed or
   84  provided solely for such referring health care provider’s or
   85  group practice’s own patients, and that are provided or
   86  performed by or under the direct supervision of such referring
   87  health care provider or group practice; provided, however, that
   88  effective July 1, 1999, a physician licensed pursuant to chapter
   89  458, chapter 459, chapter 460, or chapter 461 may refer a
   90  patient to a sole provider or group practice for diagnostic
   91  imaging services, excluding radiation therapy services, for
   92  which the sole provider or group practice billed both the
   93  technical and the professional fee for or on behalf of the
   94  patient, if the referring physician has no investment interest
   95  in the practice. The diagnostic imaging service referred to a
   96  group practice or sole provider must be a diagnostic imaging
   97  service normally provided within the scope of practice to the
   98  patients of the group practice or sole provider. The group
   99  practice or sole provider may accept no more than 15 percent of
  100  their patients receiving diagnostic imaging services from
  101  outside referrals, excluding radiation therapy services.
  102         g. By a health care provider for services provided by an
  103  ambulatory surgical center licensed under chapter 395.
  104         h. By a urologist for lithotripsy services.
  105         i. By a dentist for dental services performed by an
  106  employee of or health care provider who is an independent
  107  contractor with the dentist or group practice of which the
  108  dentist is a member.
  109         j. By a physician for infusion therapy services to a
  110  patient of that physician or a member of that physician’s group
  111  practice.
  112         k. By a nephrologist for renal dialysis services, and
  113  supplies, or clinical laboratory services incidental to renal
  114  dialysis except laboratory services.
  115         l. By a health care provider whose principal professional
  116  practice consists of treating patients in their private
  117  residences for services to be rendered in such private
  118  residences, except for services rendered by a home health agency
  119  licensed under chapter 400. For purposes of this sub
  120  subparagraph, the term “private residences” includes patients’
  121  private homes, independent living centers, and assisted living
  122  facilities, but does not include skilled nursing facilities.
  123         m. By a health care provider for sleep-related testing.
  124         Section 2. This act shall take effect July 1, 2016.