Florida Senate - 2021                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1786
       
       
       
       
       
       
                                Ì601382ÉÎ601382                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Appropriations (Farmer) recommended the
       following:
       
    1         Senate Amendment to Amendment (754030) (with directory and
    2  title amendments)
    3  
    4         Delete lines 114 - 292
    5  and insert:
    6  denied within 90 days after receipt of the request and must be
    7  accompanied by a written explanation of the determination.
    8  Failure to pay or deny the claim within 120 days after receipt
    9  of the request creates an uncontestable obligation to pay the
   10  expenses.
   11         (3)The award must require the association to conduct a
   12  periodic review of benefits provided to claimants to ensure that
   13  they are receiving the greatest benefit amount for which they
   14  are eligible.
   15         Section 2. Section 766.3145, Florida Statutes, is created
   16  to read:
   17         766.3145 Code of ethics.—
   18         (1)On or before July 1 of each year, employees of the
   19  association must sign and submit a statement attesting that they
   20  do not have a conflict of interest as defined in part III of
   21  chapter 112. As a condition of employment, all prospective
   22  employees must sign and submit to the association a conflict-of
   23  interest statement.
   24         (2)The executive director, the ombudsman, senior managers,
   25  and members of the board of directors are subject to part III of
   26  chapter 112, including, but not limited to, the code of ethics
   27  and the public disclosure and reporting of financial interests
   28  requirements of s. 112.3145. For purposes of applying part III
   29  of chapter 112 to activities of the executive director, senior
   30  managers, and members of the board of directors, those persons
   31  are considered public officers or employees and the association
   32  is considered their agency. Pursuant to s. 112.3143(2), a board
   33  member may not vote on any measure that would inure to his or
   34  her special private gain or loss; that he or she knows would
   35  inure to the special private gain or loss of any principal by
   36  whom he or she is retained or to the parent organization or
   37  subsidiary of a corporate principal by which he or she is
   38  retained, other than an agency as defined in s. 112.312; or that
   39  he or she knows would inure to the special private gain or loss
   40  of a relative or business associate of the public officer.
   41  Before the vote is taken, such member shall publicly state to
   42  the board the nature of his or her interest in the matter from
   43  which he or she is abstaining from voting and, within 15 days
   44  after the vote occurs, disclose the nature of his or her
   45  interest as a public record in a memorandum filed with the
   46  person responsible for recording the minutes of the meeting, who
   47  shall incorporate the memorandum in the minutes. The executive
   48  director, senior managers, and board members are also required
   49  to file such disclosures with the Commission on Ethics and the
   50  Office of Insurance Regulation. The executive director of the
   51  association or his or her designee shall notify each existing
   52  and newly appointed member of the board of directors and senior
   53  managers of his or her duty to comply with the reporting
   54  requirements of part III of chapter 112. At least quarterly, the
   55  executive director or his or her designee shall submit to the
   56  Commission on Ethics a list of names of the members of the board
   57  of directors and senior managers who are subject to the public
   58  disclosure requirements under s. 112.3145.
   59         (3) Notwithstanding s. 112.3148, s. 112.3149, or any other
   60  law, an employee or board member may not knowingly accept,
   61  directly or indirectly, any gift or expenditure from a person or
   62  entity, or an employee or representative of such person or
   63  entity, which has a contractual relationship with the
   64  association or which is under consideration for a contract.
   65         (4)An employee or board member who fails to comply with
   66  subsection (2) or (3) is subject to penalties provided under ss.
   67  112.317 and 112.3173.
   68         (5) Any senior manager or executive director of the
   69  association who is employed on or after January 1, 2022,
   70  regardless of the date of hire, who subsequently retires or
   71  terminates employment is prohibited from representing another
   72  person or entity before the association for 2 years after
   73  retirement or termination of employment from the association.
   74         Section 3. Paragraphs (a) and (c) of subsection (1),
   75  subsection (2), paragraph (i) of subsection (4), and paragraph
   76  (b) of subsection (5) of section 766.315, Florida Statutes, are
   77  amended, and subsection (6) is added to that section, to read:
   78         766.315 Florida Birth-Related Neurological Injury
   79  Compensation Association; board of directors.—
   80         (1)(a) The Florida Birth-Related Neurological Injury
   81  Compensation Plan shall be governed by a board of nine five
   82  directors which shall be known as the Florida Birth-Related
   83  Neurological Injury Compensation Association. The association is
   84  not a state agency, board, or commission. Notwithstanding the
   85  provision of s. 15.03, the association is authorized to use the
   86  state seal.
   87         (c) The directors shall be appointed by the Chief Financial
   88  Officer, ensuring that the board represents the gender diversity
   89  of this state, as follows:
   90         1. One citizen representative.
   91         2. One representative of participating physicians.
   92         3. One representative of hospitals.
   93         4. One representative of casualty insurers.
   94         5. One representative of physicians other than
   95  participating physicians.
   96         6.One parent or legal guardian representative of an
   97  injured infant under the plan.
   98         7.One representative of an advocacy organization for
   99  children with disabilities.
  100         8.One representative who is a financial management expert
  101  with a fiduciary duty to clients.
  102         9.One member in good standing of The Florida Bar who is
  103  not affiliated with any of the groups identified in
  104  subparagraphs 2.-8. and who has experience representing cases on
  105  behalf of children who have been injured in a health care
  106  setting. This director must not have represented anyone in legal
  107  matters against the association within the 2-year period
  108  immediately preceding appointment to the board and may not
  109  handle any legal matters against the association while serving
  110  as a director or within 2 years after leaving the board.
  111         (2)(a) The Chief Financial Officer may select the
  112  representative of the participating physicians from a list of at
  113  least three names recommended by the American Congress of
  114  Obstetricians and Gynecologists, District XII; the
  115  representative of hospitals from a list of at least three names
  116  recommended by the Florida Hospital Association; the
  117  representative of casualty insurers from a list of at least
  118  three names, one of which is recommended by the American
  119  Insurance Association, one of which is recommended by the
  120  Florida Insurance Council, and one of which is recommended by
  121  the Property Casualty Insurers Association of America; and the
  122  representative of physicians, other than participating
  123  physicians, from a list of three names recommended by the
  124  Florida Medical Association and a list of three names
  125  recommended by the Florida Osteopathic Medical Association; the
  126  parent or guardian of a child from a list of three names
  127  recommended by the Governor; the financial management expert
  128  from a list of three names recommended by the Governor; and the
  129  member of The Florida Bar from a list of three names recommended
  130  by the President of The Florida Bar. However, the Chief
  131  Financial Officer is not required to make an appointment from
  132  among the nominees of the respective associations. A
  133  participating physician who is named in a pending petition for a
  134  claim may not be appointed to the board. An appointed director
  135  who is a participating physician may not vote on any board
  136  matter relating to a claim accepted for an award for
  137  compensation if the physician was named in the petition for the
  138  claim.
  139         (b) The Chief Financial Officer shall promptly notify the
  140  appropriate medical association or person identified in
  141  paragraph (a) who makes recommendations upon the occurrence of
  142  any vacancy, and like nominations may be made for the filling of
  143  the vacancy.
  144         (c) The Governor, the President of the Senate, the Speaker
  145  of the House of Representatives, or the Chief Financial Officer
  146  may remove a director from office for misconduct, malfeasance,
  147  misfeasance, or neglect of duty in office. Any vacancy so
  148  created shall be filled as provided in paragraph (a).
  149         (4) The board of directors shall have the power to:
  150         (i) Employ or retain such persons as are necessary to
  151  perform the administrative and financial transactions and
  152  responsibilities of the plan and to perform other necessary and
  153  proper functions not prohibited by law.
  154         1.The board of directors shall employ an ombudsman who
  155  will serve at the pleasure of, and must report directly to, the
  156  board and who will act as an advocate for the parents and legal
  157  guardians of plan participants.
  158         2.The ombudsman shall do all of the following:
  159         a.Provide information and assistance, outreach, and
  160  education to parents and legal guardians of plan participants
  161  regarding plan benefits and community, state, and federal
  162  government resources.
  163         b.Investigate complaints of parents or legal guardians of
  164  plan participants regarding the operation of the plan.
  165         c.Provide an annual report to the board regarding the
  166  ombudsman’s activities, the disposition of complaints, and any
  167  recommendations to improve the operations of the plan and the
  168  delivery of benefits to participants.
  169         (5)
  170         (b) All meetings of the board of directors are subject to
  171  the requirements of s. 286.011, and all books, records, and
  172  audits of the plan are open to the public for reasonable
  173  inspection to the general public, except that a claim file in
  174  the possession of the association or its representative is
  175  confidential and exempt from the provisions of s. 119.07(1) and
  176  s. 24(a), Art. I of the State Constitution until termination of
  177  litigation or settlement of the claim, although medical records
  178  and other portions of the claim file may remain confidential and
  179  exempt as otherwise provided by law. Any book, record, document,
  180  audit, or asset acquired by, prepared for, or paid for by the
  181  association is subject to the authority of the board of
  182  directors, which is responsible therefor.
  183         (6)On or before January 31, 2022, and by each January 31
  184  thereafter, the association shall submit an annual report to the
  185  Governor, the President of the Senate, and the Speaker of the
  186  House of Representatives. The report must include:
  187         (a)The number of petitions filed for compensation with the
  188  division, the number of claimants awarded compensation, the
  189  number of claimants denied compensation, and the reasons for the
  190  denial of compensation.
  191         (b)The number and dollar amount of paid and denied
  192  compensation for expenses by category and the reasons for any
  193  denied compensation for expenses by category.
  194         (c)The average turnaround time for paying or denying
  195  compensation for expenses.
  196         (d)Legislative recommendations to improve the program.
  197         (e)A summary of any pending or resolved litigation during
  198  the year which affects the plan.
  199         (f)For the initial report due on or before January 31,
  200  2022, an actuarial report conducted by an independent actuary
  201  that provides an analysis of the estimated costs of implementing
  202  the following changes to the plan:
  203         1.Reducing the minimum birth weight eligibility for a
  204  participant in the plan from 2,500 grams to 2,000 grams.
  205         2.Revising the eligibility of participation in the plan by
  206  providing that an infant must be permanently and substantially
  207  mentally or physically impaired, rather than permanently and
  208  substantially mentally and physically impaired.
  209         3.Increasing the annual special benefit or quality of life
  210  benefit from $500 to $2,500 per calendar year.
  211         Section 4. The Auditor General shall conduct an annual
  212  performance audit of the association and the plan to evaluate
  213  management’s performance in administering the laws, policies,
  214  and procedures governing the operations of the association and
  215  the plan in an efficient and effective manner.
  216         (1)The audit must include evaluations of all of the
  217  following:
  218         (a)The protocols used for the payment of expenses,
  219  including standards for determining medical necessity and
  220  reasonableness of requests for medical care, services, or other
  221  benefits provided under the plan and the timeliness of the
  222  payment of expenses.
  223         (b)The effectiveness of the association’s outreach to
  224  inform parents and legal guardians of participants of available
  225  benefits and any changes in benefits and processes to resolve
  226  disputes regarding the payment of expenses internally.
  227         (c)The efficacy of the current processes for the
  228  procurement of goods and services.
  229         (d)The internal controls of the plan and association.
  230         (2)The Auditor General shall release the audit and publish
  231  it on its website by January 15 of each year, beginning on
  232  January 15, 2022.
  233  
  234  ====== D I R E C T O R Y  C L A U S E  A M E N D M E N T ======
  235  And the directory clause is amended as follows:
  236         Delete lines 5 - 6
  237  and insert:
  238         Section 5. Present subsection (3) of section 766.31, is
  239  redesignated as subsection (4), a new subsection (3) is added to
  240  that section, and subsections (1) and (2) are amended, to read:
  241  
  242  ================= T I T L E  A M E N D M E N T ================
  243  And the title is amended as follows:
  244         Delete lines 355 - 366
  245  and insert:
  246         of directors; authorizing the Governor, the
  247         Legislature, or the Chief Financial Officer to remove
  248         a director for specified conduct; requiring the board
  249         of directors to employ an ombudsman for a specified
  250         purpose; providing duties of the ombudsman; providing
  251         that meetings of the board of directors are subject to
  252         public meeting requirements; requiring the association
  253         to submit an annual report to the Governor and the
  254         Legislature by a specified date; providing
  255         requirements for the report; requiring the first
  256         report to include a certain actuarial report;
  257         providing requirements for the actuarial report;
  258         requiring the Auditor General to conduct an annual
  259         performance audit of the association and plan;
  260         providing requirements for the audit; requiring the
  261         Auditor General to release the audit and publish it on
  262         its website by a specified date each year;