Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 1712
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Health Policy (Harrell) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete lines 59 - 94
    4  and insert:
    5         (8)Applicable only to a hospital that is, or will be,
    6  newly licensed on or after July 1, 2019; that has not been
    7  issued a certificate of need by the agency; and that is not
    8  replacing a currently operating hospital located within 1 mile
    9  of the newly licensed hospital:
   10         (a)When proposing a new hospital project subject to this
   11  subsection and before filing for approval of plans and
   12  specifications under s. 395.0163, each prospective applicant for
   13  licensure must submit a notice to the agency of its intent to
   14  establish a newly licensed hospital which includes the location
   15  for the proposed hospital, the number and types of beds to be
   16  licensed, and the services that the hospital will offer.
   17         (b) The agency may not license a new general hospital
   18  subject to this subsection unless:
   19         1. The hospital has at least 80 beds and has intensive
   20  care, progressive care, and medical-surgical beds. This
   21  requirement does not apply if the hospital is a rural hospital,
   22  as defined in s. 395.602, or is located in a medically
   23  underserved area; and
   24         2. The hospital has an onsite emergency department that
   25  will operate 24 hours per day, 7 days per week.
   26         (c) Each such hospital must participate in the state
   27  Medicaid program and the Medicare program.
   28         (d) Except as provided in paragraph (e), each such hospital
   29  must provide charity care in an amount equal to or greater than
   30  the district average for hospitals in the applicable district.
   31  The agency shall adopt by rule a method for calculating the
   32  district average for charity care for each district. For
   33  purposes of this subsection, the term “charity care” means
   34  uncompensated care delivered to uninsured patients having an
   35  income at or below 200 percent of the federal poverty level when
   36  such services are preauthorized by the licensee and not subject
   37  to collection procedures, and “district” has the same meaning as
   38  in s. 408.032(5). The valuation of charity care must be based on
   39  Medicaid reimbursement rates.
   40         (e) If such a hospital is located in a medically
   41  underserved area, the amount of charity care required to be
   42  provided by the hospital under paragraph (d) is equivalent in
   43  percentage to the medically underserved area’s Index of Medical
   44  Underservice score as calculated by the federal Health Resources
   45  and Services Administration within the Department of Health and
   46  Human Services.
   47         (f) In lieu of providing charity care under paragraph (d)
   48  or paragraph (e), each such hospital may donate an amount
   49  determined by the agency to be functionally equivalent to the
   50  amounts required under those paragraphs to the agency’s Grants
   51  and Donations Trust Fund.
   52         (g) Each such hospital shall annually report to the agency
   53  its compliance with paragraphs (c)-(f). Failure to report
   54  compliance constitutes noncompliance. The agency shall assess an
   55  administrative fine on a hospital that fails to comply with this
   56  subsection in the amount of 1 percent of its net revenue for
   57  each 0.5 percent of the required amount of charity care not
   58  provided pursuant to paragraph (d) or paragraph (e) or the
   59  required amount as determined by the agency pursuant to
   60  paragraph (f).
   61         (h) The agency shall adopt rules to implement this
   62  subsection.
   64  ================= T I T L E  A M E N D M E N T ================
   65  And the title is amended as follows:
   66         Delete lines 4 - 15
   67  and insert:
   68         providing applicability; requiring certain hospitals
   69         licensed after a specified date to submit a notice to
   70         the Agency for Health Care Administration which
   71         contains specified information before filing for
   72         approval of plans and specifications to establish a
   73         newly licensed hospital; prohibiting the agency from
   74         licensing a new general hospital unless certain
   75         criteria are met; requiring certain hospitals to
   76         participate in the Medicaid program as a provider of
   77         medical assistance and to provide a certain amount of
   78         charity care; defining the terms “charity care” and
   79         “district”; providing a separate calculation of
   80         required charity care for such hospitals located in a
   81         medically underserved area; authorizing such hospitals
   82         to provide a certain donation the agency’s Grants and
   83         Donations Trust Fund in lieu of providing the required
   84         charity care; requiring such hospitals to annually
   85         report compliance to the agency; requiring the agency
   86         to impose a specified administrative fine for
   87         noncompliance; requiring the agency to adopt rules;