Florida Senate - 2021 COMMITTEE AMENDMENT
Bill No. CS for SB 1786
Ì790104qÎ790104
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 or denied within 90 days after receipt of the request and must
7 be 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 (4) The award must require the reimbursement of expenses
16 for private nursing staff or attendant care to be provided at a
17 rate at least equal to the state or federal minimum wage,
18 whichever is greater.
19 Section 2. Section 766.3145, Florida Statutes, is created
20 to read:
21 766.3145 Code of ethics.—
22 (1) On or before July 1 of each year, employees of the
23 association must sign and submit a statement attesting that they
24 do not have a conflict of interest as defined in part III of
25 chapter 112. As a condition of employment, all prospective
26 employees must sign and submit to the association a conflict-of
27 interest statement.
28 (2) The executive director, the ombudsman, senior managers,
29 and members of the board of directors are subject to part III of
30 chapter 112, including, but not limited to, the code of ethics
31 and the public disclosure and reporting of financial interests
32 requirements of s. 112.3145. For purposes of applying part III
33 of chapter 112 to activities of the executive director, senior
34 managers, and members of the board of directors, those persons
35 are considered public officers or employees and the association
36 is considered their agency. Pursuant to s. 112.3143(2), a board
37 member may not vote on any measure that would inure to his or
38 her special private gain or loss; that he or she knows would
39 inure to the special private gain or loss of any principal by
40 whom he or she is retained or to the parent organization or
41 subsidiary of a corporate principal by which he or she is
42 retained, other than an agency as defined in s. 112.312; or that
43 he or she knows would inure to the special private gain or loss
44 of a relative or business associate of the public officer.
45 Before the vote is taken, such member shall publicly state to
46 the board the nature of his or her interest in the matter from
47 which he or she is abstaining from voting and, within 15 days
48 after the vote occurs, disclose the nature of his or her
49 interest as a public record in a memorandum filed with the
50 person responsible for recording the minutes of the meeting, who
51 shall incorporate the memorandum in the minutes. The executive
52 director, senior managers, and board members are also required
53 to file such disclosures with the Commission on Ethics and the
54 Office of Insurance Regulation. The executive director of the
55 association or his or her designee shall notify each existing
56 and newly appointed member of the board of directors and senior
57 managers of his or her duty to comply with the reporting
58 requirements of part III of chapter 112. At least quarterly, the
59 executive director or his or her designee shall submit to the
60 Commission on Ethics a list of names of the members of the board
61 of directors and senior managers who are subject to the public
62 disclosure requirements under s. 112.3145.
63 (3) Notwithstanding s. 112.3148, s. 112.3149, or any other
64 law, an employee or board member may not knowingly accept,
65 directly or indirectly, any gift or expenditure from a person or
66 entity, or an employee or representative of such person or
67 entity, which has a contractual relationship with the
68 association or which is under consideration for a contract.
69 (4) An employee or board member who fails to comply with
70 subsection (2) or (3) is subject to penalties provided under ss.
71 112.317 and 112.3173.
72 (5) Any senior manager or executive director of the
73 association who is employed on or after January 1, 2022,
74 regardless of the date of hire, who subsequently retires or
75 terminates employment is prohibited from representing another
76 person or entity before the association for 2 years after
77 retirement or termination of employment from the association.
78 Section 3. Paragraphs (a) and (c) of subsection (1),
79 subsection (2), paragraph (i) of subsection (4), and paragraph
80 (b) of subsection (5) of section 766.315, Florida Statutes, are
81 amended, and subsection (6) is added to that section, to read:
82 766.315 Florida Birth-Related Neurological Injury
83 Compensation Association; board of directors.—
84 (1)(a) The Florida Birth-Related Neurological Injury
85 Compensation Plan shall be governed by a board of nine five
86 directors which shall be known as the Florida Birth-Related
87 Neurological Injury Compensation Association. The association is
88 not a state agency, board, or commission. Notwithstanding the
89 provision of s. 15.03, the association is authorized to use the
90 state seal.
91 (c) The President of the Senate and the Speaker of the
92 House of Representatives, alternating appointments as vacancies
93 occur, shall appoint the directors, ensuring that the board
94 represents the gender diversity of this state, shall be
95 appointed by the Chief Financial Officer as follows:
96 1. One citizen representative.
97 2. One representative of participating physicians.
98 3. One representative of hospitals.
99 4. One representative of casualty insurers.
100 5. One representative of physicians other than
101 participating physicians.
102 6. One parent or legal guardian representative of an
103 injured infant under the plan.
104 7. One representative of an advocacy organization for
105 children with disabilities.
106 8. One representative who is a financial management expert
107 with a fiduciary duty to clients.
108 9. One member in good standing of The Florida Bar who is
109 not affiliated with any of the groups identified in
110 subparagraphs 2.-8. and who has experience representing cases on
111 behalf of children who have been injured in a health care
112 setting. This director must not have represented anyone in legal
113 matters against the association within the 2-year period
114 immediately preceding appointment to the board and may not
115 handle any legal matters against the association while serving
116 as a director or within 2 years after leaving the board.
117 (2)(a) The President of the Senate or the Speaker of the
118 House of Representatives, as applicable, Chief Financial Officer
119 may select the representative of the participating physicians
120 from a list of at least three names recommended by the American
121 Congress of Obstetricians and Gynecologists, District XII; the
122 representative of hospitals from a list of at least three names
123 recommended by the Florida Hospital Association; the
124 representative of casualty insurers from a list of at least
125 three names, one of which is recommended by the American
126 Insurance Association, one of which is recommended by the
127 Florida Insurance Council, and one of which is recommended by
128 the Property Casualty Insurers Association of America; and the
129 representative of physicians, other than participating
130 physicians, from a list of three names recommended by the
131 Florida Medical Association and a list of three names
132 recommended by the Florida Osteopathic Medical Association; the
133 parent or guardian of a child from a list of three names
134 recommended by the Governor; the financial management expert
135 from a list of three names recommended by the Governor; and the
136 member of The Florida Bar from a list of three names recommended
137 by the President of The Florida Bar. However, the President of
138 the Senate or the Speaker of the House of Representatives, as
139 applicable, Chief Financial Officer is not required to make an
140 appointment from among the nominees of the respective
141 associations. A participating physician who is named in a
142 pending petition for a claim may not be appointed to the board.
143 An appointed director who is a participating physician may not
144 vote on any board matter relating to a claim accepted for an
145 award for compensation if the physician was named in the
146 petition for the claim.
147 (b) The President of the Senate or the Speaker of the House
148 of Representatives, as applicable, Chief Financial Officer shall
149 promptly notify the appropriate medical association or person
150 identified in paragraph (a) who makes recommendations upon the
151 occurrence of any vacancy, and like nominations may be made for
152 the filling of the vacancy.
153 (c) The Governor, the President of the Senate, or the
154 Speaker of the House of Representatives may remove a director
155 from office for misconduct, malfeasance, misfeasance, or neglect
156 of duty in office. Any vacancy so created shall be filled as
157 provided in paragraph (a).
158 (4) The board of directors shall have the power to:
159 (i) Employ or retain such persons as are necessary to
160 perform the administrative and financial transactions and
161 responsibilities of the plan and to perform other necessary and
162 proper functions not prohibited by law.
163 1. The board of directors shall employ an ombudsman who
164 will serve at the pleasure of, and must report directly to, the
165 board and who will act as an advocate for the parents and legal
166 guardians of plan participants.
167 2. The ombudsman shall do all of the following:
168 a. Provide information and assistance, outreach, and
169 education to parents and legal guardians of plan participants
170 regarding plan benefits and community, state, and federal
171 government resources.
172 b. Investigate complaints of parents or legal guardians of
173 plan participants regarding the operation of the plan.
174 c. Provide an annual report to the board regarding the
175 ombudsman’s activities, the disposition of complaints, and any
176 recommendations to improve the operations of the plan and the
177 delivery of benefits to participants.
178 (5)
179 (b) All meetings of the board of directors are subject to
180 the requirements of s. 286.011, and all books, records, and
181 audits of the plan are open to the public for reasonable
182 inspection to the general public, except that a claim file in
183 the possession of the association or its representative is
184 confidential and exempt from the provisions of s. 119.07(1) and
185 s. 24(a), Art. I of the State Constitution until termination of
186 litigation or settlement of the claim, although medical records
187 and other portions of the claim file may remain confidential and
188 exempt as otherwise provided by law. Any book, record, document,
189 audit, or asset acquired by, prepared for, or paid for by the
190 association is subject to the authority of the board of
191 directors, which is responsible therefor.
192 (6) On or before January 31, 2022, and by each January 31
193 thereafter, the association shall submit an annual report to the
194 Governor, the President of the Senate, and the Speaker of the
195 House of Representatives. The report must include:
196 (a) The number of petitions filed for compensation with the
197 division, the number of claimants awarded compensation, the
198 number of claimants denied compensation, and the reasons for the
199 denial of compensation.
200 (b) The number and dollar amount of paid and denied
201 compensation for expenses by category and the reasons for any
202 denied compensation for expenses by category.
203 (c) The average turnaround time for paying or denying
204 compensation for expenses.
205 (d) Legislative recommendations to improve the program.
206 (e) A summary of any pending or resolved litigation during
207 the year which affects the plan.
208 (f) For the initial report due on or before January 31,
209 2022, an actuarial report conducted by an independent actuary
210 that provides an analysis of the estimated costs of implementing
211 the following changes to the plan:
212 1. Reducing the minimum birth weight eligibility for a
213 participant in the plan from 2,500 grams to 2,000 grams.
214 2. Revising the eligibility of participation in the plan by
215 providing that an infant must be permanently and substantially
216 mentally or physically impaired, rather than permanently and
217 substantially mentally and physically impaired.
218 3. Increasing the annual special benefit or quality of life
219 benefit from $500 to $2,500 per calendar year.
220 Section 4. The Auditor General shall conduct an annual
221 performance audit of the association and plan to evaluate
222 management’s performance in administering the laws, policies,
223 and procedures governing the operations of the association and
224 plan in an efficient and effective manner.
225 (1) The audit must include evaluations of all of the
226 following:
227 (a) The protocols used for the payment of expenses,
228 including standards for determining medical necessity and
229 reasonableness of requests for medical care, services, or other
230 benefits provided under the plan and the timeliness of the
231 payment of expenses.
232 (b) The effectiveness of the association’s outreach to
233 inform parents and legal guardians of participants of available
234 benefits and any changes in benefits and processes to resolve
235 disputes regarding the payment of expenses internally.
236 (c) The efficacy of the current processes for the
237 procurement of goods and services.
238 (d) The internal controls of the plan and association.
239 (2) The Auditor General shall release the audit and publish
240 it on its website by January 15 of each year, beginning on
241 January 15, 2022.
242
243 ====== D I R E C T O R Y C L A U S E A M E N D M E N T ======
244 And the directory clause is amended as follows:
245 Delete lines 5 - 6
246 and insert:
247 Section 5. Present subsection (3) of section 766.31,
248 Florida Statutes, is redesignated as subsection (5), a new
249 subsection (3) and subsection (4) are added to that section, and
250 subsections (1) and (2) are amended, to read:
251
252 ================= T I T L E A M E N D M E N T ================
253 And the title is amended as follows:
254 Delete lines 355 - 366
255 and insert:
256 of directors; authorizing the Governor, the President
257 of the Senate, or the Speaker of the House of
258 Representatives to remove a director for specified
259 conduct; requiring the board of directors to employ an
260 ombudsman for a specified purpose; providing duties of
261 the ombudsman; providing that meetings of the board of
262 directors are subject to public meeting requirements;
263 requiring the association to submit an annual report
264 to the Governor and the Legislature by a specified
265 date; providing requirements for the report; requiring
266 the first report to include a certain actuarial
267 report; providing requirements for the actuarial
268 report; requiring the Auditor General to conduct an
269 annual performance audit of the association and plan;
270 providing requirements for the audit; requiring the
271 Auditor General to release the audit and publish it on
272 its website by a specified date each year;