CS for SB 1146 First Engrossed
20151146e1
1 A bill to be entitled
2 An act relating to agency relationships with
3 governmental health care contractors; amending s.
4 766.1115, F.S.; redefining terms; deleting an obsolete
5 date; extending sovereign immunity to employees or
6 agents of a health care provider that executes a
7 contract with a governmental contractor; clarifying
8 that a receipt of specified notice must be
9 acknowledged by a patient or the patient’s
10 representative at the initial visit; requiring the
11 posting of notice that a specified health care
12 provider is an agent of a governmental contractor;
13 amending s. 768.28, F.S.; redefining the term
14 “officer, employee, or agent” to include employees or
15 agents of a health care provider; providing an
16 effective date.
17
18 Be It Enacted by the Legislature of the State of Florida:
19
20 Section 1. Paragraphs (a) and (d) of subsection (3) and
21 subsections (4) and (5) of section 766.1115, Florida Statutes,
22 are amended to read:
23 766.1115 Health care providers; creation of agency
24 relationship with governmental contractors.—
25 (3) DEFINITIONS.—As used in this section, the term:
26 (a) “Contract” means an agreement executed in compliance
27 with this section between a health care provider and a
28 governmental contractor which allows the health care provider,
29 or any employee or agent of the health care provider, to deliver
30 health care services to low-income recipients as an agent of the
31 governmental contractor. The contract must be for volunteer,
32 uncompensated services, except as provided in paragraph (4)(g).
33 For services to qualify as volunteer, uncompensated services
34 under this section, the health care provider must receive no
35 compensation from the governmental contractor for any services
36 provided under the contract and must not bill or accept
37 compensation from the recipient, or a public or private third
38 party payor, for the specific services provided to the low
39 income recipients covered by the contract, except as provided in
40 paragraph (4)(g). A free clinic as described in subparagraph
41 (3)(d)14. may receive a legislative appropriation, a grant
42 through a legislative appropriation, or a grant from a
43 governmental entity or nonprofit corporation to support the
44 delivery of such contracted services by volunteer health care
45 providers, including the employment of health care providers to
46 supplement, coordinate, or support the delivery of services by
47 volunteer health care providers. Such an appropriation or grant
48 does not constitute compensation under this paragraph from the
49 governmental contractor for services provided under the
50 contract, nor does receipt and use of the appropriation or grant
51 constitute the acceptance of compensation under this paragraph
52 for the specific services provided to the low-income recipients
53 covered by the contract.
54 (d) “Health care provider” or “provider” means:
55 1. A birth center licensed under chapter 383.
56 2. An ambulatory surgical center licensed under chapter
57 395.
58 3. A hospital licensed under chapter 395.
59 4. A physician or physician assistant licensed under
60 chapter 458.
61 5. An osteopathic physician or osteopathic physician
62 assistant licensed under chapter 459.
63 6. A chiropractic physician licensed under chapter 460.
64 7. A podiatric physician licensed under chapter 461.
65 8. A registered nurse, nurse midwife, licensed practical
66 nurse, or advanced registered nurse practitioner licensed or
67 registered under part I of chapter 464 or any facility which
68 employs nurses licensed or registered under part I of chapter
69 464 to supply all or part of the care delivered under this
70 section.
71 9. A midwife licensed under chapter 467.
72 10. A health maintenance organization certificated under
73 part I of chapter 641.
74 11. A health care professional association and its
75 employees or a corporate medical group and its employees.
76 12. Any other medical facility the primary purpose of which
77 is to deliver human medical diagnostic services or which
78 delivers nonsurgical human medical treatment, and which includes
79 an office maintained by a provider.
80 13. A dentist or dental hygienist licensed under chapter
81 466.
82 14. A free clinic that delivers only medical diagnostic
83 services or nonsurgical medical treatment free of charge to all
84 low-income recipients.
85 15. Any other health care professional, practitioner,
86 provider, or facility under contract with a governmental
87 contractor, including a student enrolled in an accredited
88 program that prepares the student for licensure as any one of
89 the professionals listed in subparagraphs 4.-9.
90
91 The term includes any nonprofit corporation qualified as exempt
92 from federal income taxation under s. 501(a) of the Internal
93 Revenue Code, and described in s. 501(c) of the Internal Revenue
94 Code, which delivers health care services provided by licensed
95 professionals listed in this paragraph, any federally funded
96 community health center, and any volunteer corporation or
97 volunteer health care provider that delivers health care
98 services.
99 (4) CONTRACT REQUIREMENTS.—A health care provider that
100 executes a contract with a governmental contractor to deliver
101 health care services on or after April 17, 1992, as an agent of
102 the governmental contractor, or any employee or agent of such
103 health care provider, is an agent for purposes of s. 768.28(9),
104 while acting within the scope of duties under the contract, if
105 the contract complies with the requirements of this section and
106 regardless of whether the individual treated is later found to
107 be ineligible. A health care provider, or any employee or agent
108 of the health care provider, shall continue to be an agent for
109 purposes of s. 768.28(9) for 30 days after a determination of
110 ineligibility to allow for treatment until the individual
111 transitions to treatment by another health care provider. A
112 health care provider under contract with the state, or any
113 employee or agent of such health care provider, may not be named
114 as a defendant in any action arising out of medical care or
115 treatment provided on or after April 17, 1992, under contracts
116 entered into under this section. The contract must provide that:
117 (a) The right of dismissal or termination of any health
118 care provider delivering services under the contract is retained
119 by the governmental contractor.
120 (b) The governmental contractor has access to the patient
121 records of any health care provider delivering services under
122 the contract.
123 (c) Adverse incidents and information on treatment outcomes
124 must be reported by any health care provider to the governmental
125 contractor if the incidents and information pertain to a patient
126 treated under the contract. The health care provider shall
127 submit the reports required by s. 395.0197. If an incident
128 involves a professional licensed by the Department of Health or
129 a facility licensed by the Agency for Health Care
130 Administration, the governmental contractor shall submit such
131 incident reports to the appropriate department or agency, which
132 shall review each incident and determine whether it involves
133 conduct by the licensee that is subject to disciplinary action.
134 All patient medical records and any identifying information
135 contained in adverse incident reports and treatment outcomes
136 which are obtained by governmental entities under this paragraph
137 are confidential and exempt from the provisions of s. 119.07(1)
138 and s. 24(a), Art. I of the State Constitution.
139 (d) Patient selection and initial referral must be made by
140 the governmental contractor or the provider. Patients may not be
141 transferred to the provider based on a violation of the
142 antidumping provisions of the Omnibus Budget Reconciliation Act
143 of 1989, the Omnibus Budget Reconciliation Act of 1990, or
144 chapter 395.
145 (e) If emergency care is required, the patient need not be
146 referred before receiving treatment, but must be referred within
147 48 hours after treatment is commenced or within 48 hours after
148 the patient has the mental capacity to consent to treatment,
149 whichever occurs later.
150 (f) The provider is subject to supervision and regular
151 inspection by the governmental contractor.
152 (g) As an agent of the governmental contractor for purposes
153 of s. 768.28(9), while acting within the scope of duties under
154 the contract, A health care provider licensed under chapter 466,
155 as an agent of the governmental contractor for purposes of s.
156 768.28(9), may allow a patient, or a parent or guardian of the
157 patient, to voluntarily contribute a monetary amount to cover
158 costs of dental laboratory work related to the services provided
159 to the patient within the scope of duties under the contract.
160 This contribution may not exceed the actual cost of the dental
161 laboratory charges.
162
163 A governmental contractor that is also a health care provider is
164 not required to enter into a contract under this section with
165 respect to the health care services delivered by its employees.
166 (5) NOTICE OF AGENCY RELATIONSHIP.—The governmental
167 contractor must provide written notice to each patient, or the
168 patient’s legal representative, receipt of which must be
169 acknowledged in writing at the initial visit, that the provider
170 is an agent of the governmental contractor and that the
171 exclusive remedy for injury or damage suffered as the result of
172 any act or omission of the provider or of any employee or agent
173 thereof acting within the scope of duties pursuant to the
174 contract is by commencement of an action pursuant to the
175 provisions of s. 768.28. Thereafter, and with respect to any
176 federally funded community health center, the notice
177 requirements may be met by posting in a place conspicuous to all
178 persons a notice that the health care provider federally funded
179 community health center is an agent of the governmental
180 contractor and that the exclusive remedy for injury or damage
181 suffered as the result of any act or omission of the provider or
182 of any employee or agent thereof acting within the scope of
183 duties pursuant to the contract is by commencement of an action
184 pursuant to the provisions of s. 768.28.
185 Section 2. Paragraph (b) of subsection (9) of section
186 768.28, Florida Statutes, is amended to read:
187 768.28 Waiver of sovereign immunity in tort actions;
188 recovery limits; limitation on attorney fees; statute of
189 limitations; exclusions; indemnification; risk management
190 programs.—
191 (9)
192 (b) As used in this subsection, the term:
193 1. “Employee” includes any volunteer firefighter.
194 2. “Officer, employee, or agent” includes, but is not
195 limited to, any health care provider, and its employees or
196 agents, when providing services pursuant to s. 766.1115; any
197 nonprofit independent college or university located and
198 chartered in this state which owns or operates an accredited
199 medical school, and its employees or agents, when providing
200 patient services pursuant to paragraph (10)(f); and any public
201 defender or her or his employee or agent, including, among
202 others, an assistant public defender and an investigator.
203 Section 3. This act shall take effect July 1, 2015.