THE BILL ITSELF
CS/HB 1207
Ambulatory Surgical Centers
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A bill to be entitled
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An act relating to ambulatory surgical centers;
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amending s. 395.301, F.S.; providing a penalty for
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failure by an ambulatory surgical center to timely
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provide a good faith estimate; requiring the Agency
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for Health Care Administration to notify the Division
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of Law Revision upon the adoption of certain federal
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rules; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraph (c) of subsection (1) of section
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395.301, Florida Statutes, is amended to read:
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395.301 Price transparency; itemized patient statement or
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bill; patient admission status notification.—
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(1) A facility licensed under this chapter shall provide
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timely and accurate financial information and quality of service
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measures to patients and prospective patients of the facility,
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or to patients' survivors or legal guardians, as appropriate.
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Such information shall be provided in accordance with this
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section and rules adopted by the agency pursuant to this chapter
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and s. 408.05. Licensed facilities operating exclusively as
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state facilities are exempt from this subsection.
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(c)1. Before providing any nonemergency medical services,
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each licensed facility shall provide in writing or by electronic
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means a good faith estimate of reasonably anticipated charges by
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the facility for the treatment of a patient's or prospective
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patient's specific condition. The facility is not required to
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adjust the estimate for any potential insurance coverage. The
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facility must provide the estimate to the patient's health
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insurer, as defined in s. 627.446(1), and the patient at least 3
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business days before the date such service is to be provided,
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but no later than 1 business day after the date such service is
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scheduled or, in the case of a service scheduled at least 10
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business days in advance, no later than 3 business days after
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the date the service is scheduled. The facility must provide the
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estimate to the patient no later than 3 business days after the
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date the patient requests an estimate. The estimate may be based
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on the descriptive service bundles developed by the agency under
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s. 408.05(3)(c) unless the patient or prospective patient
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requests a more personalized and specific estimate that accounts
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for the specific condition and characteristics of the patient or
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prospective patient. The facility shall inform the patient or
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prospective patient that he or she may contact his or her health
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insurer for additional information concerning cost-sharing
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responsibilities.
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2. In the estimate, the facility shall provide to the
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patient or prospective patient information on the facility's
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financial assistance policy, including the application process,
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payment plans, and discounts and the facility's charity care
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policy and collection procedures.
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3. The estimate shall clearly identify any facility fees
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and, if applicable, include a statement notifying the patient or
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prospective patient that a facility fee is included in the
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estimate, the purpose of the fee, and that the patient may pay
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less for the procedure or service at another facility or in
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another health care setting.
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4. The facility shall notify the patient or prospective
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patient of any revision to the estimate.
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5. In the estimate, the facility must notify the patient
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or prospective patient that services may be provided in the
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health care facility by the facility as well as by other health
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care providers that may separately bill the patient, if
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applicable.
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6. Failure to timely provide the estimate pursuant to this
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paragraph by a hospital shall result in a daily fine of $1,000
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until the estimate is provided to the patient or prospective
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patient and the health insurer. The total fine per patient
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estimate may not exceed $10,000.
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7. Failure to timely provide the estimate pursuant to this
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paragraph by an ambulatory surgical center shall result in a
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daily fine of $250 until the estimate is provided to the patient
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or prospective patient and the health insurer. The total fine
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per patient estimate may not exceed $2,500.
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Section 2. The changes made by this act to s. 395.301,
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Florida Statutes, are not effective until the United States
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Department of Health and Human Services, the United States
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Department of Labor, and the United States Department of the
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Treasury issue a final rule pertaining to good faith estimates
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required by section 2799B-6 of the Public Health Services Act.
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The Agency for Health Care Administration shall notify the
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Division of Law Revision upon the adoption of the final rule.
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Section 3. This act shall take effect upon becoming a law.