Florida Senate - 2017                                     SB 232
       By Senator Grimsley
       26-00118-17                                            2017232__
    1                        A bill to be entitled                      
    2         An act relating to health care facilities; amending s.
    3         395.003, F.S.; requiring that, as a condition of
    4         initial licensure and license renewal, ambulatory
    5         surgical centers provide at least the same amount of
    6         services to Medicare and Medicaid patients and
    7         patients who qualify for charity care as certain other
    8         licensed providers; requiring ambulatory surgical
    9         centers to report certain data; defining a term for
   10         purposes of a subsection; requiring ambulatory
   11         surgical centers to comply with certain building and
   12         lifesafety codes in certain circumstances; amending s.
   13         395.6025, F.S.; revising the circumstances under which
   14         statutory rural hospitals and operators of rural
   15         hospitals are not required to obtain a certificate of
   16         need for the construction of a replacement rural
   17         hospital; providing an effective date.
   19  Be It Enacted by the Legislature of the State of Florida:
   21         Section 1. Present subsections (6) through (10) of section
   22  395.003, Florida Statutes, are redesignated as subsections (7)
   23  through (11), respectively, a new subsection (6) is added to
   24  that section, and present subsections (9) and (10) of that
   25  section are amended, to read:
   26         395.003 Licensure; denial, suspension, and revocation.—
   27         (6)As a condition of initial licensure and license
   28  renewal, an ambulatory surgical center must provide services to
   29  Medicare patients, Medicaid patients, and patients who qualify
   30  for charity care in an amount equal to or greater than the
   31  applicable district average among licensed providers of similar
   32  services. Ambulatory surgical centers shall report the same data
   33  required to be reported to the agency by hospitals under s.
   34  408.061 or otherwise published for hospitals by the agency. For
   35  purposes of this subsection, the term “charity care” means
   36  uncompensated care delivered to uninsured patients with incomes
   37  at or below 200 percent of the federal poverty level when such
   38  services are preauthorized by the licensed providers and are not
   39  subject to collection procedures. An ambulatory surgical center
   40  that does not discharge a patient until after midnight of the
   41  day of the patient’s procedure shall comply with the same
   42  building codes and lifesafety codes that apply to a hospital.
   43         (10)(9) A hospital licensed as of June 1, 2004, shall be
   44  exempt from subsection (9) (8) as long as the hospital maintains
   45  the same ownership, facility street address, and range of
   46  services that were in existence on June 1, 2004. Any transfer of
   47  beds, or other agreements that result in the establishment of a
   48  hospital or hospital services within the intent of this section,
   49  shall be subject to subsection (9) (8). Unless the hospital is
   50  otherwise exempt under subsection (9) (8), the agency shall deny
   51  or revoke the license of a hospital that violates any of the
   52  criteria set forth in that subsection.
   53         (11)(10) The agency may adopt rules implementing the
   54  licensure requirements set forth in subsection (9) (8). Within
   55  14 days after rendering its decision on a license application or
   56  revocation, the agency shall publish its proposed decision in
   57  the Florida Administrative Register. Within 21 days after
   58  publication of the agency’s decision, any authorized person may
   59  file a request for an administrative hearing. In administrative
   60  proceedings challenging the approval, denial, or revocation of a
   61  license pursuant to subsection (9) (8), the hearing must be
   62  based on the facts and law existing at the time of the agency’s
   63  proposed agency action. Existing hospitals may initiate or
   64  intervene in an administrative hearing to approve, deny, or
   65  revoke licensure under subsection (9) (8) based upon a showing
   66  that an established program will be substantially affected by
   67  the issuance or renewal of a license to a hospital within the
   68  same district or service area.
   69         Section 2. Section 395.6025, Florida Statutes, is amended
   70  to read:
   71         395.6025 Rural hospital replacement facilities.
   72  Notwithstanding s. 408.036, a hospital defined as a statutory
   73  rural hospital in accordance with s. 395.602, or an a not-for
   74  profit operator of rural hospitals, is not required to obtain a
   75  certificate of need for the construction of a replacement new
   76  hospital located in a county with a population of at least
   77  15,000 but no more than 18,000 and a density of fewer than 100
   78  30 persons per square mile, or a replacement facility, provided
   79  that the replacement, or new, facility is not located within 15
   80  10 miles of the site of a the currently licensed rural hospital
   81  in an adjacent county and within the current primary service
   82  area. As used in this section, the term “service area” means the
   83  fewest number of zip codes that account for 75 percent of the
   84  hospital’s discharges for the most recent 5-year period, based
   85  on information available from the hospital inpatient discharge
   86  database in the Florida Center for Health Information and
   87  Transparency at the Agency for Health Care Administration.
   88         Section 3. This act shall take effect July 1, 2017.