Florida Senate - 2022 SB 998



By Senator Rodriguez





39-00782B-22 2022998__
1 A bill to be entitled
2 An act relating to enhancing patient care continuums;
3 amending s. 381.026, F.S.; defining the term “patient
4 care continuum”; revising the purpose of the patient’s
5 bill of rights; providing that patients have a right
6 to expect their health care records to be shared
7 between their health care providers; conforming
8 provisions to changes made by the act; amending s.
9 381.0405, F.S.; revising the purpose and functions of
10 the Office of Rural Health; amending s. 381.0406,
11 F.S.; revising legislative findings; revising the
12 definition of the term “health care provider”;
13 defining the term “patient care continuum”; requiring
14 rural health networks to use health information
15 exchange systems for specified purposes; amending s.
16 381.04065, F.S.; revising criteria for Department of
17 Health approval of certain cooperative agreements in
18 certified rural health networks; amending s. 395.1052,
19 F.S.; requiring hospitals to use health information
20 exchange systems to provide certain notification to a
21 patient’s primary care provider, if any; requiring
22 hospitals to inform each patient of the right to
23 request the hospital’s treating physician consult with
24 any provider within the patient’s care continuum,
25 rather than only the primary care provider or a
26 specialist provider, when developing the patient’s
27 plan of care; requiring the treating physician to make
28 a reasonable effort to consult with such provider, if
29 requested; amending s. 395.3015, F.S.; requiring
30 certain hospitals to require use of an electronic
31 system for patient medical records; amending s.
32 408.05, F.S.; revising membership requirements for the
33 State Consumer Health Information and Policy Advisory
34 Council; amending s. 408.051, F.S.; defining and
35 revising terms; requiring health care facilities to
36 use health information exchange systems to exchange
37 electronic health records; providing requirements for
38 the exchange of electronic health records and minimum
39 requirements for such records; prohibiting vendors of
40 certified electronic health record technologies from
41 charging health care facilities and health care
42 practitioners more than a specified amount for
43 building an interface with a health information
44 exchange system; requiring such vendors to provide
45 system upgrades and software updates free of charge to
46 health care facilities and health care practitioners
47 who purchase the technology; amending s. 408.0611,
48 F.S.; requiring the Agency for Health Care
49 Administration to provide health information exchange
50 systems with access to the electronic prescribing
51 clearinghouse for a specified purpose; amending s.
52 456.057, F.S.; requiring certain records owners to use
53 a health information exchange system to provide
54 patient records to health care practitioners and
55 providers; amending ss. 381.4018 and 456.42, F.S.;
56 conforming cross-references; providing an effective
57 date.
58
59 WHEREAS, laws and rules should allow health care
60 practitioners to practice to the full extent of their
61 professional training and expertise throughout a patient’s care
62 continuum through the secure electronic exchange of the
63 patient’s health records between private, local, and state
64 health information exchange systems, and
65 WHEREAS, laws and rules should allow health care providers
66 to deliver primary, acute, tertiary, quaternary, long-term, and
67 palliative health care services based on real-time data created
68 by health care providers throughout a patient’s care continuum
69 to improve patient outcomes and quality of life, and
70 WHEREAS, all types of health care providers who create or
71 own a patient’s health records should be free to share such
72 health information without the constraints of costly interfaces
73 imposed by certified electronic health record technology
74 vendors, and
75 WHEREAS, patients have a right to expect robust
76 communication between all of the health care providers within
77 their care continuums, and
78 WHEREAS, laws and rules should not allow or create
79 mechanisms that block the owner of health records from sharing
80 or exchanging such records with health care providers in a
81 patient’s care continuum, and
82 WHEREAS, laws and rules should not add burdens or barriers
83 beyond what is required by state and federal health information
84 privacy laws, focusing only on those policies that prevent
85 patient harm rather than policies that are overly prescriptive
86 and unnecessarily restrict communication between a patient’s
87 health care providers, and
88 WHEREAS, laws and rules should allow Medicaid and other
89 public health programs to share a defined set of patient health
90 information to support the care continuum throughout the life of
91 a patient, NOW, THEREFORE,
92
93 Be It Enacted by the Legislature of the State of Florida:
94
95 Section 1. Present paragraphs (d) and (e) of subsection (2)
96 of section 381.026, Florida Statutes, are redesignated as
97 paragraphs (e) and (f), respectively, a new paragraph (d) is
98 added to that subsection, and subsection (3), paragraph (b) of
99 subsection (4), and subsection (6) of that section are amended,
100 to read:
101 381.026 Florida Patient’s Bill of Rights and
102 Responsibilities.—
103 (2) DEFINITIONS.—As used in this section and s. 381.0261,
104 the term:
105 (d) “Patient care continuum” means an integrated system of
106 health care which follows a patient through time or through a
107 range of services and requires health care providers and other
108 providers to document care more thoroughly over time and to
109 share patient data across specialties, offering a more unified
110 patient care approach and facilitating the seamless transition
111 of the patient’s care between specialists and other providers.
112 The term includes, but is not limited to, an interdisciplinary
113 or case management team involving health care providers and
114 nonmedical administrators who collaborate to document the
115 patient’s progression of care and assist in day-to-day health
116 care provider decisions to ensure that the patient receives the
117 highest possible quality of care.
118 (3) PURPOSE.—It is the purpose of this section to promote
119 the interests and well-being of the patients of health care
120 providers and health care facilities and to promote better
121 communication between the patient and the patient’s health care
122 providers throughout the patient’s care continuum provider. It
123 is the intent of the Legislature that health care providers
124 understand their responsibility to give their patients a general
125 understanding of the procedures to be performed on them; and to
126 provide information pertaining to their health care so that they
127 may make decisions in an informed manner after considering the
128 information relating to their condition, the available treatment
129 alternatives, and substantial risks and hazards inherent in the
130 treatments; and to provide the necessary follow-up care and
131 information after the procedures are performed on them. It is
132 the intent of the Legislature that patients have a general
133 understanding of their responsibilities toward health care
134 providers and health care facilities. It is the intent of the
135 Legislature that the provision of such information to a patient
136 eliminate potential misunderstandings between patients and
137 health care providers. It is a public policy of the state that
138 the interests of patients be recognized in a patient’s bill of
139 rights and responsibilities and that a health care facility or
140 health care provider may not require a patient to waive his or
141 her rights as a condition of treatment. This section may shall
142 not be used for any purpose in any civil or administrative
143 action and neither expands nor limits any rights or remedies
144 provided under any other law.
145 (4) RIGHTS OF PATIENTS.—Each health care facility or
146 provider shall observe the following standards:
147 (b) Information.—
148 1. A patient has the right to know the name, function, and
149 qualifications of each health care provider who is providing
150 medical services to the patient. A patient may request such
151 information from his or her responsible provider or the health
152 care facility in which he or she is receiving medical services.
153 2. A patient in a health care facility has the right to
154 know what patient support services are available in the
155 facility.
156 3. A patient has the right to be given by his or her health
157 care provider information concerning diagnosis, planned course
158 of treatment, alternatives, risks, and prognosis, unless it is
159 medically inadvisable or impossible to give this information to
160 the patient, in which case the information must be given to the
161 patient’s guardian or a person designated as the patient’s
162 representative. A patient has the right to refuse this
163 information.
164 4. A patient has the right to expect his or her health care
165 records to be shared, in accordance with any applicable state
166 and federal privacy regulations, among health care providers and
167 other providers involved in the patient’s care continuum for the
168 purpose of facilitating a seamless transition of the patient’s
169 care between specialists and other providers.
170 5. A patient has the right to refuse any treatment based on
171 information required by this paragraph, except as otherwise
172 provided by law. The responsible provider shall document any
173 such refusal.
174 6.5. A patient in a health care facility has the right to
175 know what facility rules and regulations apply to patient
176 conduct.
177 7.6. A patient has the right to express grievances to a
178 health care provider, a health care facility, or the appropriate
179 state licensing agency regarding alleged violations of patients’
180 rights. A patient has the right to know the health care
181 provider’s or health care facility’s procedures for expressing a
182 grievance.
183 8.7. A patient in a health care facility who does not speak
184 English has the right to be provided an interpreter when
185 receiving medical services if the facility has a person readily
186 available who can interpret on behalf of the patient.
187 9.8. A health care provider or health care facility shall
188 respect a patient’s right to privacy and should refrain from
189 making a written inquiry or asking questions concerning the
190 ownership of a firearm or ammunition by the patient or by a
191 family member of the patient, or the presence of a firearm in a
192 private home or other domicile of the patient or a family member
193 of the patient. Notwithstanding this provision, a health care
194 provider or health care facility that in good faith believes
195 that this information is relevant to the patient’s medical care
196 or safety, or safety of others, may make such a verbal or
197 written inquiry.
198 10.9. A patient may decline to answer or provide any
199 information regarding ownership of a firearm by the patient or a
200 family member of the patient, or the presence of a firearm in
201 the domicile of the patient or a family member of the patient. A
202 patient’s decision not to answer a question relating to the
203 presence or ownership of a firearm does not alter existing law
204 regarding a physician’s authorization to choose his or her
205 patients.
206 11.10. A health care provider or health care facility may
207 not discriminate against a patient based solely upon the
208 patient’s exercise of the constitutional right to own and
209 possess firearms or ammunition.
210 12.11. A health care provider or health care facility shall
211 respect a patient’s legal right to own or possess a firearm and
212 should refrain from unnecessarily harassing a patient about
213 firearm ownership during an examination.
214 (6) SUMMARY OF RIGHTS AND RESPONSIBILITIES.—Any health care
215 practitioner as defined in s. 456.001 provider who treats a
216 patient in an office or any health care facility licensed under
217 chapter 395 that provides emergency services and care or
218 outpatient services and care to a patient, or admits and treats
219 a patient, shall adopt and make available to the patient, in
220 writing, a statement of the rights and responsibilities of
221 patients, including the following:
222
223 SUMMARY OF THE FLORIDA PATIENT’S BILL
224 OF RIGHTS AND RESPONSIBILITIES
225
226 Florida law requires that your health care provider or
227 health care facility recognize your rights while you are
228 receiving medical care and that you respect the health care
229 provider’s or health care facility’s right to expect certain
230 behavior on the part of patients. You may request a copy of the
231 full text of this law from your health care provider or health
232 care facility. A summary of your rights and responsibilities
233 follows:
234 A patient has the right to be treated with courtesy and
235 respect, with appreciation of his or her individual dignity, and
236 with protection of his or her need for privacy.
237 A patient has the right to a prompt and reasonable response
238 to questions and requests.
239 A patient has the right to know who is providing medical
240 services and who is responsible for his or her care.
241 A patient has the right to know what patient support
242 services are available, including whether an interpreter is
243 available if he or she does not speak English.
244 A patient has the right to bring any person of his or her
245 choosing to the patient-accessible areas of the health care
246 facility or provider’s office to accompany the patient while the
247 patient is receiving inpatient or outpatient treatment or is
248 consulting with his or her health care provider, unless doing so
249 would risk the safety or health of the patient, other patients,
250 or staff of the facility or office or cannot be reasonably
251 accommodated by the facility or provider.
252 A patient has the right to know what rules and regulations
253 apply to his or her conduct.
254 A patient has the right to be given by the health care
255 provider information concerning diagnosis, planned course of
256 treatment, alternatives, risks, and prognosis.
257 A patient has the right to expect communication between
258 health care providers involved in the patient’s care continuum.
259 A patient has the right to refuse any treatment, except as
260 otherwise provided by law.
261 A patient has the right to be given, upon request, full
262 information and necessary counseling on the availability of
263 known financial resources for his or her care.
264 A patient who is eligible for Medicare has the right to
265 know, upon request and in advance of treatment, whether the
266 health care provider or health care facility accepts the
267 Medicare assignment rate.
268 A patient has the right to receive, upon request, before
269 prior to treatment, a reasonable estimate of charges for medical
270 care.
271 A patient has the right to receive a copy of a reasonably
272 clear and understandable, itemized bill and, upon request, to
273 have the charges explained.
274 A patient has the right to impartial access to medical
275 treatment or accommodations, regardless of race, national
276 origin, religion, handicap, or source of payment.
277 A patient has the right to treatment for any emergency
278 medical condition that will deteriorate from failure to provide
279 treatment.
280 A patient has the right to know if medical treatment is for
281 purposes of experimental research and to give his or her consent
282 or refusal to participate in such experimental research.
283 A patient has the right to express grievances regarding any
284 violation of his or her rights, as stated in Florida law,
285 through the grievance procedure of the health care provider or
286 health care facility which served him or her and to