(1) “Agency” means the Agency for Health Care Administration.
(2) “Applicant” means an individual owner, corporation, partnership, firm, business, association, or other entity that owns or controls, directly or indirectly, 5 percent or more of an interest in the clinic and that applies for a clinic license.
(3) “Chief financial officer” means an individual who has at least a minimum of a bachelor’s degree from an accredited university in accounting or finance, or a related field, and who is the person responsible for the preparation of a clinic’s billing.
(4) “Clinic” means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services, including a mobile clinic and a portable equipment provider. As used in this part, the term does not include and the licensure requirements of this part do not apply to:
(a) Entities licensed or registered by the state under chapter 395; entities licensed or registered by the state and providing only health care services within the scope of services authorized under their respective licenses under ss. 383.30-383.332, chapter 390, chapter 394, chapter 397, this chapter except part X, chapter 429, chapter 463, chapter 465, chapter 466, chapter 478, chapter 484, or chapter 651; end-stage renal disease providers authorized under 42 C.F.R. part 494; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 485, subpart B, subpart H, or subpart J; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 486, subpart C; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 491, subpart A; providers certified by the Centers for Medicare and Medicaid services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder; or any entity that provides neonatal or pediatric hospital-based health care services or other health care services by licensed practitioners solely within a hospital licensed under chapter 395.
(b) Entities that own, directly or indirectly, entities licensed or registered by the state pursuant to chapter 395; entities that own, directly or indirectly, entities licensed or registered by the state and providing only health care services within the scope of services authorized pursuant to their respective licenses under ss. 383.30-383.332, chapter 390, chapter 394, chapter 397, this chapter except part X, chapter 429, chapter 463, chapter 465, chapter 466, chapter 478, chapter 484, or chapter 651; end-stage renal disease providers authorized under 42 C.F.R. part 494; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 485, subpart B, subpart H, or subpart J; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 486, subpart C; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 491, subpart A; providers certified by the Centers for Medicare and Medicaid services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder; or any entity that provides neonatal or pediatric hospital-based health care services by licensed practitioners solely within a hospital licensed under chapter 395.
(c) Entities that are owned, directly or indirectly, by an entity licensed or registered by the state pursuant to chapter 395; entities that are owned, directly or indirectly, by an entity licensed or registered by the state and providing only health care services within the scope of services authorized pursuant to their respective licenses under ss. 383.30-383.332, chapter 390, chapter 394, chapter 397, this chapter except part X, chapter 429, chapter 463, chapter 465, chapter 466, chapter 478, chapter 484, or chapter 651; end-stage renal disease providers authorized under 42 C.F.R. part 494; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 485, subpart B, subpart H, or subpart J; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 486, subpart C; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 491, subpart A; providers certified by the Centers for Medicare and Medicaid services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder; or any entity that provides neonatal or pediatric hospital-based health care services by licensed practitioners solely within a hospital under chapter 395.
(d) Entities that are under common ownership, directly or indirectly, with an entity licensed or registered by the state pursuant to chapter 395; entities that are under common ownership, directly or indirectly, with an entity licensed or registered by the state and providing only health care services within the scope of services authorized pursuant to their respective licenses under ss. 383.30-383.332, chapter 390, chapter 394, chapter 397, this chapter except part X, chapter 429, chapter 463, chapter 465, chapter 466, chapter 478, chapter 484, or chapter 651; end-stage renal disease providers authorized under 42 C.F.R. part 494; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 485, subpart B, subpart H, or subpart J; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 486, subpart C; providers certified and providing only health care services within the scope of services authorized under their respective certifications under 42 C.F.R. part 491, subpart A; providers certified by the Centers for Medicare and Medicaid services under the federal Clinical Laboratory Improvement Amendments and the federal rules adopted thereunder; or any entity that provides neonatal or pediatric hospital-based health care services by licensed practitioners solely within a hospital licensed under chapter 395.
(e) An entity that is exempt from federal taxation under 26 U.S.C. s. 501(c)(3) or (4), an employee stock ownership plan under 26 U.S.C. s. 409 that has a board of trustees at least two-thirds of which are Florida-licensed health care practitioners and provides only physical therapy services under physician orders, any community college or university clinic, and any entity owned or operated by the federal or state government, including agencies, subdivisions, or municipalities thereof.
(f) A sole proprietorship, group practice, partnership, or corporation that provides health care services by physicians covered by s. 627.419, that is directly supervised by one or more of such physicians, and that is wholly owned by one or more of those physicians or by a physician and the spouse, parent, child, or sibling of that physician.
(g) A sole proprietorship, group practice, partnership, or corporation that provides health care services by licensed health care practitioners under chapter 457, chapter 458, chapter 459, chapter 460, chapter 461, chapter 462, chapter 463, chapter 466, chapter 467, chapter 480, chapter 484, chapter 486, chapter 490, chapter 491, or part I, part III, part X, part XIII, or part XIV of chapter 468, or s. 464.012, and that is wholly owned by one or more licensed health care practitioners, or the licensed health care practitioners set forth in this paragraph and the spouse, parent, child, or sibling of a licensed health care practitioner if one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity’s compliance with all federal and state laws. However, a health care practitioner may not supervise services beyond the scope of the practitioner’s license, except that, for the purposes of this part, a clinic owned by a licensee in s. 456.053(3)(b) which provides only services authorized pursuant to s. 456.053(3)(b) may be supervised by a licensee specified in s. 456.053(3)(b).
(h) Clinical facilities affiliated with an accredited medical school at which training is provided for medical students, residents, or fellows.
(i) Entities that provide only oncology or radiation therapy services by physicians licensed under chapter 458 or chapter 459 or entities that provide oncology or radiation therapy services by physicians licensed under chapter 458 or chapter 459 which are owned by a corporation whose shares are publicly traded on a recognized stock exchange.
(j) Clinical facilities affiliated with a college of chiropractic accredited by the Council on Chiropractic Education at which training is provided for chiropractic students.
(k) Entities that provide licensed practitioners to staff emergency departments or to deliver anesthesia services in facilities licensed under chapter 395 and that derive at least 90 percent of their gross annual revenues from the provision of such services. Entities claiming an exemption from licensure under this paragraph must provide documentation demonstrating compliance.
(l) Orthotic, prosthetic, pediatric cardiology, or perinatology clinical facilities or anesthesia clinical facilities that are not otherwise exempt under paragraph (a) or paragraph (k) and that are a publicly traded corporation or are wholly owned, directly or indirectly, by a publicly traded corporation. As used in this paragraph, a publicly traded corporation is a corporation that issues securities traded on an exchange registered with the United States Securities and Exchange Commission as a national securities exchange.
(m) Entities that are owned by a corporation that has $250 million or more in total annual sales of health care services provided by licensed health care practitioners where one or more of the persons responsible for the operations of the entity is a health care practitioner who is licensed in this state and who is responsible for supervising the business activities of the entity and is responsible for the entity’s compliance with state law for purposes of this part.
(n) Entities that employ 50 or more licensed health care practitioners licensed under chapter 458 or chapter 459 where the billing for medical services is under a single tax identification number. The application for exemption under this subsection shall contain information that includes: the name, residence, and business address and phone number of the entity that owns the practice; a complete list of the names and contact information of all the officers and directors of the corporation; the name, residence address, business address, and medical license number of each licensed Florida health care practitioner employed by the entity; the corporate tax identification number of the entity seeking an exemption; a listing of health care services to be provided by the entity at the health care clinics owned or operated by the entity and a certified statement prepared by an independent certified public accountant which states that the entity and the health care clinics owned or operated by the entity have not received payment for health care services under personal injury protection insurance coverage for the preceding year. If the agency determines that an entity which is exempt under this subsection has received payments for medical services under personal injury protection insurance coverage, the agency may deny or revoke the exemption from licensure under this subsection.
(o) Entities that are, directly or indirectly, under the common ownership of or that are subject to common control by a mutual insurance holding company, as defined in s. 628.703, with an entity issued a certificate of authority under chapter 624 or chapter 641 which has $1 billion or more in total annual sales in this state.
(p) Entities that are owned by an entity that is a behavioral health care service provider in at least five other states; that, together with its affiliates, have $90 million or more in total annual revenues associated with the provision of behavioral health care services; and wherein one or more of the persons responsible for the operations of the entity is a health care practitioner who is licensed in this state, who is responsible for supervising the business activities of the entity, and who is responsible for the entity’s compliance with state law for purposes of this part.
(q) Medicaid providers.
Notwithstanding this subsection, an entity shall be deemed a clinic and must be licensed under this part in order to receive reimbursement under the Florida Motor Vehicle No-Fault Law, ss. 627.730-627.7405, unless exempted under s. 627.736(5)(h).
(5) “Medical director” means a physician who is employed or under contract with a clinic and who maintains a full and unencumbered physician license in accordance with chapter 458, chapter 459, chapter 460, or chapter 461. However, if the clinic does not provide services pursuant to the respective physician practices acts listed in this subsection, it may appoint a Florida-licensed health care practitioner who does not provide services pursuant to the respective physician practices acts listed in this subsection to serve as a clinic director who is responsible for the clinic’s activities. A health care practitioner may not serve as the clinic director if the services provided at the clinic are beyond the scope of that practitioner’s license, except that a licensee specified in s. 456.053(3)(b) who provides only services authorized pursuant to s. 456.053(3)(b) may serve as clinic director of an entity providing services as specified in s. 456.053(3)(b).
(6) “Mobile clinic” means a movable or detached self-contained health care unit within or from which direct health care services are provided to individuals and which otherwise meets the definition of a clinic in subsection (4).
(7) “Portable equipment provider” means an entity that contracts with or employs persons to provide portable equipment to multiple locations performing treatment or diagnostic testing of individuals, that bills third-party payors for those services, and that otherwise meets the definition of a clinic in subsection (4).
...linics
operating in Florida be licensed by the State unless they fall within a statutory
exemption. See Fla. Stat. § 400.991. One of the exemptions is for clinics that are
“wholly owned by one or more licensed health care practitioners.” Id. §
400.9905(4)(g)....
Cited 4 times | Published | District Court, S.D. Florida
...§ 817.234(1)(a)(2). A statement includes but is not limited to, any notice, statement, proof of loss, invoice, account, bill for services or other *1300 evidence of loss, injury or expense. Id. § 817.234(6). E. The Health Care Clinic Act, Fla. Stat. § 400.9905 (4), § 400.9935(3) (2012) The Health Care Clinic Act ("HCCA") requires health care clinics to be licensed by the Agency for Health Care Administration ("AHCA") unless they qualify for an exemption....
...§ 400.991 (2012) ; State Farm Fire & Cas. Co. v. Silver Star Health & Rehab , 739 F.3d 579 , 582 (11th Cir. 2013). " 'Clinic' means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services." Fla. Stat. § 400.9905 (4). The term clinic does not include entities that fall within one of the enumerated exemptions in sections 400.9905(4)(a)-(n) of the Florida statutes....
...ld, or sibling of a licensed health care practitioner if one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity's compliance with all federal and state laws . Id. § 400.9905(4)(g) (emphasis added)....
...are noncompensable and unenforceable. a. Did Calhoun Qualify as a Clinic? Under the HCCA, " '[c]linic' means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services." Fla. Stat. § 400.9905 (4)....
...sibling of a licensed health care practitioner if one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity's compliance with all federal and state laws . Fla. Stat. § 400.9905 (4)(g) (emphasis added)....
...The Parties do not dispute that Calhoun was wholly owned by licensed practitioners-the owners were all licensed chiropractors. The dispute here hinges on the interpretation of the HCCA's requirement pertaining to supervision. State Farm argues that Section 400.9905(4)(g) imposes a requirement of supervision upon wholly owned clinics....
...29, 2016) ("If the health care practitioner fails to supervise the clinic's business activities or does not remain responsible for legal compliance, then the clinic does not lawfully qualify for the exemption."). Thus, Calhoun qualifies for an exemption under Section 400.9905(4)(g) if one of the owners, a licensed health care practitioner, supervised the business activities and was legally responsible for Calhoun's compliance with federal and state laws....
...lorida Department of Health, the trial court’s order granting summary judgment in favor of State Farm and denying the clinic’s motion for summary judgment is affirmed. Affirmed. . The section was repealed effective March 1, 2004, and replaced by section 400.9905, Florida Statutes (Supp.2004), which permits no exemptions to the licensing requirement.
...§ 400.991 (2009). One such exemption applies if the clinic is “wholly owned” by a licensed health care practitioner who supervises the business activities and is legally responsible for the entity’s compliance with all federal and state laws. See Fla. Stat. § 400.9905 (4)(g)....
...Stat. § 400.9935 (3). The HCCA allows for certain exemptions from mandatory licensure. One such exemption provides that a clinic is not required to be licensed if it is “wholly owned by one or more licensed health care practitioners.” Fla Stat. § 400.9905(4)(g)....
...at *4 (internal quotations omitted); Fla. Stat. § 627.736 (5)(d). For the purposes of ruling on a motion to dismiss, the Altamonte Springs court held that the insurer’s allegations of secret ownership of the medical practice in violation of Florida Statute Section 400.9905(4)(g) — exempting health care clinics owned by licensed health care practitioners from more stringent and expensive licensing requirements- — coupled with an accounting of bills submitted from clinic to insurer satisfied the Rule 9(b) pleading requirements: Altamonte Springs, 2011 WL 6450769 at **3-4....
...ptance and retention of a benefit “that it is not legally entitled to receive in the first placet.]” Silver Star, 739 F.3d at 584 (affirming insurer’s claim for unjust enrichment against medical clinic operating in violation of Florida Statute Section 400.9905(4)(g)); see also Altamonte Springs, 2011 WL 6450769 at *5 (holding that insurer did not bargain for unlawfully rendered medical services, and provider’s retention of payments for these services was sufficient to support cause of action for unjust enrichment)....
...which is wholly owned by one or more licensed health care practitioners ... so long as one of the owners who is a licensed health care practitioner is supervising the business activities and is legally responsible for the entity’s compliance with all federal and state laws. [ Fla. Stat. § 400.9905 (4)(g) ]....
...y that wishes to receive PIP reimbursements , even if generally excluded from the definition of a "Clinic," will be deemed a "Clinic," and therefore must be a licensed "Clinic" under the Clinic Act in order to receive PIP reimbursements . Fla. Stat. § 400.9905 (4) ("[A]n entity shall be deemed a clinic and must be licensed under this part in order to receive reimbursement under the Florida Motor Vehicle No-Fault Law, ss....
...lative intent." E.A.R. v. State , 4 So.3d 614 , 629 (Fla. 2009) (citation omitted). Indeed, the PIP Statute and the Clinic Act are in pari materia as they refer to each other expressly and both have provisions concerning PIP benefits. See Fla. Stat. § 400.9905 (4) ; Fla....
...nsistent with the PIP Statute as the Clinic Act and the PIP Statute each proscribe separate yet consistent requirements that must be met in order for an entity to receive PIP reimbursements. 3 Compare *1298 Fla. Stat. § 400.9935 (3), and Fla. Stat. § 400.9905 (4), with Fla....
...reimbursements [ECF No. 39 at 11]. Rather, the Florida Legislature has determined that clinics can fall out of compliance with the Clinic Act and lose their ability to receive PIP reimbursements. See Fla. Stat. § 400.9935 (3) ; see also Fla. Stat. § 400.9905 (4)....
...roader concerns the Clinic Act was designed to address. Notably, the limited exemptions found within Fla. Stat. § 627.736 (5)(h) are consistent in nature with the exclusions from the definition of a "Clinic" under the Clinic Act. Compare Fla. Stat. § 400.9905 (4), with Fla....
Published | Court of Appeals for the Eleventh Circuit
Argued: Mar 5, 2025
...more licensed health care practitioners . . . if one of the owners
who is a licensed health care practitioner is supervising the business
activities and is legally responsible for the entity’s compliance with
all federal and state laws.” Id. § 400.9905(4)(g)....
...n an owner; on their interpreta-
tion of the exemption, a clinic owner is simply monetarily liable for
any violations of law by his clinics. This appeal thus turns on the
meaning of the phrase “legally responsible” within §
400.9905(4)(g), Florida Statutes.
The Florida Supreme Court, which is the final arbiter of
Florida law, has not published a decision interpreting the statutory
language at issue....
...ose clinics] and is legally respon-
sible for [their] compliance with all federal and state laws.”
LaRocca’s clinics subsequently received formal certificates of ex-
emption from ACHA, affirming their exempt status under §
400.9905(4)(g) for a two-year period beginning on September 11,
2019.
On October 29, 2021, State Farm sued LaRocca, five of the
chiropractic clinics he owns and operates, and several of his co-
owners...
...4th DCA 2023)
(“[C]ourts are instructed to presume that the Legislature knows
how to say what it means and that the differentiation in the lan-
guage is intentional.” (internal quotations omitted))).
In sum, the district court reasoned, the purpose of
§ 400.9905(4)(g) “is to identify who must own the entity in order to
qualify for a wholly owned exemption and to delineate the
owner/licensed health care practitioner’s role as supervising the
business activities and bein...
...motion for reconsideration. Despite its decision not to proceed
with its direct-kickback and patient-brokering theory of liability at
trial, State Farm now asks us to adopt its definition of “legally re-
sponsible” under § 400.9905(4)(g), under which an owner of a clinic
violates the wholly owned exemption if he does not “assume[ ] a
legal duty” to “ensure” that his clinics are complying (or at least
“substantially” complying) with all federal and state laws....
...ughly ‘subject to some kind
of liability,’” Am. Fam. Mut. Ins. Co. v. Williams, 832 F.3d 645, 648 (7th
Cir. 2016), without any requirement of control or direction, we find
that the term “legally responsible” within § 400.9905(4)(g) is suffi-
ciently open to interpretation such that the Florida Supreme Court
is best suited to tell us what the term means....
...Therefore, we certify to the Florida Supreme Court the fol-
lowing question: 6
Under Florida law, what does it mean to be “legally
responsible” within the meaning of Fla. Stat.
§ 400.9905(4)(g)?
5 Erie R.R....
This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. Attorney Syfert regularly works with Chapter 400 in the context of nursing home negligence and represents clients throughout Northeast Florida. For legal consultation, call 904-383-7448.
