Florida Senate - 2016 SB 1144 By Senator Gaetz 1-00103B-16 20161144__ 1 A bill to be entitled 2 An act relating to certificates of need for health 3 care-related projects; amending s. 408.036, F.S.; 4 providing an exemption from certificate of need review 5 for certain health care-related projects; specifying 6 conditions and requirements for the exemption; 7 requiring a certain agreement between the project 8 applicant and the Agency for Health Care 9 Administration; providing penalties for failure to 10 comply with certain requirements for an exemption to a 11 certificate of need review; providing an effective 12 date. 13 14 Be It Enacted by the Legislature of the State of Florida: 15 16 Section 1. Present paragraphs (a) through (t) of subsection 17 (3) of section 408.036, Florida Statutes, are redesignated as 18 paragraphs (b) through (u), respectively, a new paragraph (a) is 19 added to that subsection, present subsections (4) and (5) of 20 that section are redesignated as subsections (5) and (6), 21 respectively, and a new subsection (4) is added to that section, 22 to read: 23 408.036 Projects subject to review; exemptions.— 24 (3) EXEMPTIONS.—Upon request, the following projects are 25 subject to exemption from the provisions of subsection (1): 26 (a) Any project conditioned upon a significant, active, and 27 continuing commitment to improved access to care for uninsured 28 and low-income residents of the applicable service district. 29 Such commitment is demonstrated by compliance with the following 30 conditions and requirements which the project applicant must 31 accept in a signed agreement with the agency: 32 1. The project licensee must contribute, once the project 33 is operational and at the end of each of the first four calendar 34 quarters of the project’s operations, an amount equal to 1.5 35 percent of the gross revenues earned by the exempt project. 36 Contributions shall be made to the agency and deposited in the 37 Public Medical Assistance Trust Fund. 38 2.a. Beginning in the fifth calendar quarter of the exempt 39 project’s operations, the licensee must provide charity care in 40 an amount equal to or greater than the applicable district 41 average among licensed providers of similar services. For 42 purposes of this section, the term “charity care” means 43 uncompensated care delivered to uninsured patients having 44 incomes at or below 200 percent of the federal poverty level 45 when such services are preauthorized by the licensee and not 46 subject to collection procedures. The valuation of charity care 47 must be based on Medicaid reimbursement rates. 48 b. Alternatively, if the licensee provides less charity 49 care than is required by sub-subparagraph a., the licensee must 50 donate: 51 (I) Pursuant to a written agreement with a charity care 52 provider in the service district, payments for charity care 53 provided to residents of the service district in total amounts 54 equal to or greater than the difference between the value of the 55 charity care provided in sub-subparagraph a. and the applicable 56 district average among licensed providers of similar services; 57 or 58 (II) Payments to Florida Health Choices for health care 59 coverage financial assistance in total amounts equal to or 60 greater than the difference between the value of the charity 61 care provided in sub-subparagraph a. and the applicable district 62 average among licensed providers of similar services. The 63 payments for financial assistance must be made in increments 64 sufficient to purchase silver-level health care coverage for an 65 individual for at least 1 year. The individual receiving this 66 assistance must have been uninsured during the previous 12 67 months. The licensee and Florida Health Choices shall cooperate 68 to identify individuals from the service district who are 69 qualified to receive the available assistance. 70 c. The agreement between the agency and the applicant for 71 an exemption must require the licensee to submit reports and 72 data necessary to monitor compliance with the charity care 73 threshold. 74 (4) PENALTIES.—A facility licensed based on the exemption 75 established in subsection (3)(a) is subject to the following 76 penalties for noncompliance with its specific commitment to 77 improve access to care for uninsured and low-income persons in 78 the service district: 79 (a) For the first quarter in which the value of services, 80 donations, and financial assistance falls below the specified 81 threshold, the fine is equal to twice the amount of the 82 shortfall. The fine is doubled in each subsequent quarter of 83 noncompliance up to a maximum of four quarters. 84 (b) Following a fifth quarter of noncompliance, the exempt 85 license shall be suspended until the licensee implements a 86 corrective action plan that the agency has approved. 87 (c) Failure by the facility to maintain compliance 88 following the implementation of a corrective action plan shall 89 result in revocation of the exempt license. 90 Section 2. This act shall take effect July 1, 2016.