2002 Florida Legislative Review

By: Douglas Mannheimer

(Mr. Mannheimer is a partner in the Tallahassee office of Broad and Cassel. He heads the firm's legislative practice and has represented health care providers before the Legislature for the past 15 years. He is a former chairman of the Florida Commission on Integrated Health Care Delivery Systems, was a co-chair of the Florida Health Care Association's Legislative Tort Reform Committee, and has an extensive regulatory practice representing health care providers.)

Health care issues were again very important topics before the 2002 Florida Legislature. More than 100 bills were introduced regarding health care. A very brief summary of some of the bills which passed the Legislature is provided below. This report does not summarize every piece of legislation enacted, nor is it meant to provide a detailed analysis of those bills. The complete version of bills can be found under the Legislature's web site, http://www.leg.state.fl.us/Welcome/index.cfm, looking for the "enrolled" (ER) version of a bill.

• HB 615 - A program was created to provide financial assistance to federally qualified health centers under the Department of Health. [Effective 7/1/02, Chapter 2002-289]
  
  
• CS/SB 1262 - The Department of Health was authorized to take actions regarding vaccination or quarantine under newly defined "public health emergencies" Authority was given to the State Health Officer regarding the compounding of bulk prescription drugs and ordering vaccination or quarantine regarding certain communicable diseases. [Effective 5/23/02, Chapter 2002-269]
  
  
• CS/SB 1766 - Certain providers of maternity an newborn services will be required to provide the parents of the newborn with written information concerning the dangers of shaking infants and young children. The Department of Health will assist with public information regarding the subject. [Effective 4/24/02, Chapter 2002-174]
  
  
• CS/CS/CS/HB 519 - In an attempt to address the current nursing shortage, this bill eases some restrictions regarding the licensing of nurses from other states and territories. Assistance is provided in the repayment of loans for participating nurses. Certain provisions of the nursing scholarship program expanded. A program is provided for encouraging exploration of the nursing profession for middle and high school students. Incentives are provided for health care practitioners to provide services in public schools as volunteers. [Effective 5/3/02, Chapter 2002-230]
  
  
• CS/SB 2048 - Florida Medicaid will be required to pay for medically necessary lung transplant services for recipients, subject to funding and other limitations. [Effective 7/1/02, Chapter 2002-35]
  
  
• CS/SB 1276 - The bill authorizes the planning and development for implementation of a statewide Florida 211 network to provide for a statewide information and referral system by telephone. AHCA and the Department of Elder Affairs are to create a model system of managed and integrated comprehensive service of all statewide services funded to the elderly. Entities will be allowed to contract with the state to provide health care and social services on a prepaid or fixed sum basis to elderly recipients. Consumer-directed care for long term care services is encouraged, along with individual monthly budgets for allowances to pay for home and community-based long term care services. Long-term care consumers may be allowed to receive payments for providers which may include neighbors, friends, spouses, or relatives. The bill encourages home and community-based long term care and urges a reduction in the number of nursing home bed days purchased by the state Medicaid program. AHCA will be allowed to contract with entities on a risk-sharing basis to provide in-home physician services through enhanced home-based medical care for disabled persons. New requirements for nursing home facility preadmission screening were enacted to ensure that Medicaid will provide long term care services in the most appropriate setting. Nursing homes and ALFs were exempt from certain cosmetology salon requirements when a licensed cosmetologist provides services exclusively for facility residents. [Effective 5/1/02, Chapter 2002-223]
  
  
• SB 1378 - Nursing home employees may not participate in any activities relating to union organizing during the time that is counted toward minimum staffing requirements, and salaries paid by providers to employees for union organizing are not an allowable cost for Medicaid cost reporting. Likewise, expenses incurred for activities related to influencing employees with regards to unionization will not be allowable Medicaid costs. [Effective 5/3/02, Chapter 2002-231]
  
  
• SB 264 - The bill requires construction contractors, electrical contractors, and alarm system contractors who perform construction work under certain state contracts to implement drug-free workplace programs. [Effective 10/1/02, Chapter 2002-14]
  
  
• SB 604 - The bill creates a mechanism for Florida licensed pharmacies that have the same owner, or that have a written contract specifying the services to be performed, to share pharmacy duties. Definitions and rules are authorized for "centralized prescription filling." [Effective 7/1/02, Chapter 2002-182]
  
  
• CS/CS/SB 640 - A representative of the Department of Health may voluntarily appear in criminal proceedings regarding licensed health care professionals to make recommendations regarding conditions of probation and to provide other assistance to the court. Criminal penalties are increased with regard to the prescribing of controlled substances and obtaining controlled substances through fraud, trick or scheme. Evidence of medical necessity may be considered in determining whether a practitioner knowingly assisted the patient in wrongfully obtaining controlled substances. [Effective 7/1/02, Chapter 2002-81]
  
  
• HB 1405 - The Department of Health will take new actions towards immediate suspension of health care practitioners' licenses based on defaulted student loans or loans guaranteed by the state or federal government. Health care practitioners' licenses may be suspended until new payment terms are agreed upon or the payment obligation is resumed. [Effective 5/13/02, Chapter 2002-254]
  
  
• SB 46-E - A pilot program was created to provide health care coverage for low-income persons. The "health-flex" plans would be exempt from certain current requirements under the insurance code, and the plans may be authorized to limit or exclude mandated benefits, cap the total claims paid per year per enrollee, and limit the number of enrollees. The new plans may be piloted in AHCA District 1, Broward County, Indian River County, and Dade County. A Florida Alzheimer's Center and Research Institute was established at the University of South Florida. Requirements and procedures for the payment of claims by health insurers and HMO's were substantially revised. Time periods for payment denial or to contest claims was standardized to 20 days for electronically submitted claims and 40 days for non-electronically submitted claims. Failure to pay or deny a claim within 120 days for electronic or 140 days for non-electronic claims will create an "uncontestable obligation" for the insurer or the HMO to pay the claim. Procedures and time-frames for "overpayment" claims by insurers are provided, and the interest rate penalties for "overdue" payments of claims were increased from 10 to 12 percent per year. New sanctions are provided for health plans which fail to comply with time-frames and "patterns of non-compliance" by health plans or providers as to claims payments may result in reporting to licensure and certification entities. HMOs will still be responsible for violations of claims payments, treatment authorization and adverse determination provisions, even if obligations to pay are transferred to another entity. The bill deletes the requirement that an HMO, in addition to the primary care physician, must determine that a subscriber requires an examination by an ophthalmologist for medically necessary, contractually covered services, in order for the subscriber to be referred to a contracted ophthalmologist.

The bill attempts to remove certain referrals for diagnostic clinical laboratory services related to renal dialysis from the list of those orders, recommendations, or plans of care that are excluded from the definition of referral for purposes of the prohibitions contained in the "Patient Self-Referral Act of 1992."

For insurance rating purposes, the experience of small employer groups of less than 2 employees are separated from the rating experience of larger groups. [Effective 10/1/02, Chapter 2002-389]

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