456.053 Financial arrangements between referring health care providers and providers of health care services.—
(1) SHORT TITLE.—This section may be cited as the “Patient Self-Referral Act of 1992.”
(2) LEGISLATIVE INTENT.—It is recognized by the Legislature that the referral of a patient by a health care provider to a provider of health care services in which the referring health care provider has an investment interest represents a potential conflict of interest. The Legislature finds these referral practices may limit or eliminate competitive alternatives in the health care services market, may result in overutilization of health care services, may increase costs to the health care system, and may adversely affect the quality of health care. The Legislature also recognizes, however, that it may be appropriate for providers to own entities providing health care services, and to refer patients to such entities, as long as certain safeguards are present in the arrangement. It is the intent of the Legislature to provide guidance to health care providers regarding prohibited patient referrals between health care providers and entities providing health care services and to protect the people of Florida from unnecessary and costly health care expenditures.
(3) DEFINITIONS.—For the purpose of this section, the word, phrase, or term:
(a) “Board” means any of the following boards relating to the respective professions: the Board of Medicine as created in s. 458.307; the Board of Osteopathic Medicine as created in s. 459.004; the Board of Chiropractic Medicine as created in s. 460.404; the Board of Podiatric Medicine as created in s. 461.004; the Board of Optometry as created in s. 463.003; the Board of Nursing as created in s. 464.004; the Board of Pharmacy as created in s. 465.004; and the Board of Dentistry as created in s. 466.004.
(b) “Comprehensive rehabilitation services” means services that are provided by health care professionals licensed under part I or part III of chapter 468 or chapter 486 to provide speech, occupational, or physical therapy services on an outpatient or ambulatory basis.
(c) “Designated health services” means, for purposes of this section, clinical laboratory services, physical therapy services, comprehensive rehabilitative services, diagnostic-imaging services, and radiation therapy services.
(d) “Diagnostic imaging services” means magnetic resonance imaging, nuclear medicine, angiography, arteriography, computed tomography, positron emission tomography, digital vascular imaging, bronchography, lymphangiography, splenography, ultrasound, EEG, EKG, nerve conduction studies, and evoked potentials.
(e) “Entity” means any individual, partnership, firm, corporation, or other business entity.
(f) “Fair market value” means value in arms length transactions, consistent with the general market value, and, with respect to rentals or leases, the value of rental property for general commercial purposes, not taking into account its intended use, and, in the case of a lease of space, not adjusted to reflect the additional value the prospective lessee or lessor would attribute to the proximity or convenience to the lessor where the lessor is a potential source of patient referrals to the lessee.
(g) “Group practice” means a group of two or more health care providers legally organized as a partnership, professional corporation, or similar association:
1. In which each health care provider who is a member of the group provides substantially the full range of services which the health care provider routinely provides, including medical care, consultation, diagnosis, or treatment, through the joint use of shared office space, facilities, equipment, and personnel;
2. For which substantially all of the services of the health care providers who are members of the group are provided through the group and are billed in the name of the group and amounts so received are treated as receipts of the group; and
3. In which the overhead expenses of and the income from the practice are distributed in accordance with methods previously determined by members of the group.
(h) “Health care provider” means a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461; an advanced practice registered nurse registered under s. 464.0123; or any health care provider licensed under chapter 463 or chapter 466.
(i) “Immediate family member” means a health care provider’s spouse, child, child’s spouse, grandchild, grandchild’s spouse, parent, parent-in-law, or sibling.
(j) “Investment interest” means an equity or debt security issued by an entity, including, without limitation, shares of stock in a corporation, units or other interests in a partnership, bonds, debentures, notes, or other equity interests or debt instruments. The following investment interests shall be excepted from this definition:
1. An investment interest in an entity that is the sole provider of designated health services in a rural area;
2. An investment interest in notes, bonds, debentures, or other debt instruments issued by an entity which provides designated health services, as an integral part of a plan by such entity to acquire such investor’s equity investment interest in the entity, provided that the interest rate is consistent with fair market value, and that the maturity date of the notes, bonds, debentures, or other debt instruments issued by the entity to the investor is not later than October 1, 1996.
3. An investment interest in real property resulting in a landlord-tenant relationship between the health care provider and the entity in which the equity interest is held, unless the rent is determined, in whole or in part, by the business volume or profitability of the tenant or exceeds fair market value; or
4. An investment interest in an entity which owns or leases and operates a hospital licensed under chapter 395 or a nursing home facility licensed under chapter 400.
(k) “Investor” means a person or entity owning a legal or beneficial ownership or investment interest, directly or indirectly, including, without limitation, through an immediate family member, trust, or another entity related to the investor within the meaning of 42 C.F.R. s. 413.17, in an entity.
(l) “Outside referral for diagnostic imaging services” means a referral of a patient to a group practice or sole provider for diagnostic imaging services by a physician who is not a member of the group practice or of the sole provider’s practice and who does not have an investment interest in the group practice or sole provider’s practice, for which the group practice or sole provider billed for both the technical and the professional fee for the patient, and the patient did not become a patient of the group practice or sole provider’s practice.
(m) “Patient of a group practice” or “patient of a sole provider” means a patient who receives a physical examination, evaluation, diagnosis, and development of a treatment plan if medically necessary by a physician who is a member of the group practice or the sole provider’s practice.
(n) “Referral” means any referral of a patient by a health care provider for health care services, including, without limitation:
1. The forwarding of a patient by a health care provider to another health care provider or to an entity which provides or supplies designated health services or any other health care item or service; or
2. The request or establishment of a plan of care by a health care provider, which includes the provision of designated health services or other health care item or service.
3. The following orders, recommendations, or plans of care shall not constitute a referral by a health care provider:
a. By a radiologist for diagnostic-imaging services.
b. By a physician specializing in the provision of radiation therapy services for such services.
c. By a medical oncologist for drugs and solutions to be prepared and administered intravenously to such oncologist’s patient, as well as for the supplies and equipment used in connection therewith to treat such patient for cancer and the complications thereof.
d. By a cardiologist for cardiac catheterization services.
e. By a pathologist for diagnostic clinical laboratory tests and pathological examination services, if furnished by or under the supervision of such pathologist pursuant to a consultation requested by another physician.
f. By a health care provider who is the sole provider or member of a group practice for designated health services or other health care items or services that are prescribed or provided solely for such referring health care provider’s or group practice’s own patients, and that are provided or performed by or under the supervision of such referring health care provider or group practice if such supervision complies with all applicable Medicare payment and coverage rules for services; provided, however, a physician licensed pursuant to chapter 458, chapter 459, chapter 460, or chapter 461 or an advanced practice registered nurse registered under s. 464.0123 may refer a patient to a sole provider or group practice for diagnostic imaging services, excluding radiation therapy services, for which the sole provider or group practice billed both the technical and the professional fee for or on behalf of the patient, if the referring physician or advanced practice registered nurse registered under s. 464.0123 has no investment interest in the practice. The diagnostic imaging service referred to a group practice or sole provider must be a diagnostic imaging service normally provided within the scope of practice to the patients of the group practice or sole provider. The group practice or sole provider may accept no more than 15 percent of their patients receiving diagnostic imaging services from outside referrals, excluding radiation therapy services. However, the 15 percent limitation of this sub-subparagraph and the requirements of subparagraph (4)(a)2. do not apply to a group practice entity that owns an accountable care organization or an entity operating under an advanced alternative payment model according to federal regulations if such entity provides diagnostic imaging services and has more than 30,000 patients enrolled per year.
g. By a health care provider for services provided by an ambulatory surgical center licensed under chapter 395.
h. By a urologist for lithotripsy services.
i. By a dentist for dental services performed by an employee of or health care provider who is an independent contractor with the dentist or group practice of which the dentist is a member.
j. By a physician for infusion therapy services to a patient of that physician or a member of that physician’s group practice.
k. By a nephrologist for renal dialysis services and supplies, except laboratory services.
l. By a health care provider whose principal professional practice consists of treating patients in their private residences for services to be rendered in such private residences, except for services rendered by a home health agency licensed under chapter 400. For purposes of this sub-subparagraph, the term “private residences” includes patients’ private homes, independent living centers, and assisted living facilities, but does not include skilled nursing facilities.
m. By a health care provider for sleep-related testing.
(o) “Rural area” means a county with a population density of no greater than 100 persons per square mile, as defined by the United States Census.
(p) “Sole provider” means one health care provider licensed under chapter 458, chapter 459, chapter 460, or chapter 461, or registered under s. 464.0123, who maintains a separate medical office and a medical practice separate from any other health care provider and who bills for his or her services separately from the services provided by any other health care provider. A sole provider shall not share overhead expenses or professional income with any other person or group practice.
(4) REQUIREMENTS FOR ACCEPTING OUTSIDE REFERRALS FOR DIAGNOSTIC IMAGING.—
(a) A group practice or sole provider accepting outside referrals for diagnostic imaging services is required to comply with the following conditions:
1. Diagnostic imaging services must be provided exclusively by a group practice physician or by a full-time or part-time employee of the group practice or of the sole provider’s practice.
2. All equity in the group practice or sole provider’s practice accepting outside referrals for diagnostic imaging must be held by the physicians comprising the group practice or the sole provider’s practice, each of whom must provide at least 75 percent of his or her professional services to the group. Alternatively, the group must be incorporated under chapter 617 and must be exempt under the provisions of s. 501(c)(3) of the Internal Revenue Code and be part of a foundation in existence prior to January 1, 1999, that is created for the purpose of patient care, medical education, and research.
3. A group practice or sole provider may not enter into, extend or renew any contract with a practice management company that provides any financial incentives, directly or indirectly, based on an increase in outside referrals for diagnostic imaging services from any group or sole provider managed by the same practice management company.
4. The group practice or sole provider accepting outside referrals for diagnostic imaging services must bill for both the professional and technical component of the service on behalf of the patient, and no portion of the payment, or any type of consideration, either directly or indirectly, may be shared with the referring physician.
5. Group practices or sole providers that have a Medicaid provider agreement with the Agency for Health Care Administration must furnish diagnostic imaging services to their Medicaid patients and may not refer a Medicaid recipient to a hospital for outpatient diagnostic imaging services unless the physician furnishes the hospital with documentation demonstrating the medical necessity for such a referral. If necessary, the Agency for Health Care Administration may apply for a federal waiver to implement this subparagraph.
6. All group practices and sole providers accepting outside referrals for diagnostic imaging shall report annually to the Agency for Health Care Administration providing the number of outside referrals accepted for diagnostic imaging services and the total number of all patients receiving diagnostic imaging services.
(b) If a group practice or sole provider accepts an outside referral for diagnostic imaging services in violation of this subsection or if a group practice or sole provider accepts outside referrals for diagnostic imaging services in excess of the percentage limitation established in subparagraph (a)2., the group practice or the sole provider shall be subject to the penalties in subsection (5).
(c) Each managing physician member of a group practice and each sole provider who accepts outside referrals for diagnostic imaging services shall submit an annual attestation signed under oath to the Agency for Health Care Administration which shall include the annual report required under subparagraph (a)6. and which shall further confirm that each group practice or sole provider is in compliance with the percentage limitations for accepting outside referrals and the requirements for accepting outside referrals listed in paragraph (a). The agency may verify the report submitted by group practices and sole providers.
(5) PROHIBITED REFERRALS AND CLAIMS FOR PAYMENT.—Except as provided in this section:
(a) A health care provider may not refer a patient for the provision of designated health services to an entity in which the health care provider is an investor or has an investment interest.
(b) A health care provider may not refer a patient for the provision of any other health care item or service to an entity in which the health care provider is an investor unless:
1. The provider’s investment interest is in registered securities purchased on a national exchange or over-the-counter market and issued by a publicly held corporation:
a. Whose shares are traded on a national exchange or on the over-the-counter market; and
b. Whose total assets at the end of the corporation’s most recent fiscal quarter exceeded $50 million; or
2. With respect to an entity other than a publicly held corporation described in subparagraph 1., and a referring provider’s investment interest in such entity, each of the following requirements are met:
a. No more than 50 percent of the value of the investment interests are held by investors who are in a position to make referrals to the entity.
b. The terms under which an investment interest is offered to an investor who is in a position to make referrals to the entity are no different from the terms offered to investors who are not in a position to make such referrals.
c. The terms under which an investment interest is offered to an investor who is in a position to make referrals to the entity are not related to the previous or expected volume of referrals from that investor to the entity.
d. There is no requirement that an investor make referrals or be in a position to make referrals to the entity as a condition for becoming or remaining an investor.
3. With respect to either such entity or publicly held corporation:
a. The entity or corporation does not loan funds to or guarantee a loan for an investor who is in a position to make referrals to the entity or corporation if the investor uses any part of such loan to obtain the investment interest.
b. The amount distributed to an investor representing a return on the investment interest is directly proportional to the amount of the capital investment, including the fair market value of any preoperational services rendered, invested in the entity or corporation by that investor.
4. Each board and, in the case of hospitals, the Agency for Health Care Administration, shall encourage the use by licensees of the declaratory statement procedure to determine the applicability of this section or any rule adopted pursuant to this section as it applies solely to the licensee. Boards shall submit to the Agency for Health Care Administration the name of any entity in which a provider investment interest has been approved pursuant to this section.
(c) No claim for payment may be presented by an entity to any individual, third-party payor, or other entity for a service furnished pursuant to a referral prohibited under this section.
(d) If an entity collects any amount that was billed in violation of this section, the entity shall refund such amount on a timely basis to the payor or individual, whichever is applicable.
(e) Any person that presents or causes to be presented a bill or a claim for service that such person knows or should know is for a service for which payment may not be made under paragraph (c), or for which a refund has not been made under paragraph (d), shall be subject to a civil penalty of not more than $15,000 for each such service to be imposed and collected by the appropriate board.
(f) Any health care provider or other entity that enters into an arrangement or scheme, such as a cross-referral arrangement, which the physician or entity knows or should know has a principal purpose of assuring referrals by the physician to a particular entity which, if the physician directly made referrals to such entity, would be in violation of this section, shall be subject to a civil penalty of not more than $100,000 for each such circumvention arrangement or scheme to be imposed and collected by the appropriate board.
(g) A violation of this section by a health care provider shall constitute grounds for disciplinary action to be taken by the applicable board pursuant to s. 458.331(2), s. 459.015(2), s. 460.413(2), s. 461.013(2), s. 463.016(2), s. 464.018, or s. 466.028(2). Any hospital licensed under chapter 395 found in violation of this section shall be subject to s. 395.0185(2).
(h) Any hospital licensed under chapter 395 that discriminates against or otherwise penalizes a health care provider for compliance with this act.
(i) The provision of paragraph (a) shall not apply to referrals to the offices of radiation therapy centers managed by an entity or subsidiary or general partner thereof, which performed radiation therapy services at those same offices prior to April 1, 1991, and shall not apply also to referrals for radiation therapy to be performed at no more than one additional office of any entity qualifying for the foregoing exception which, prior to February 1, 1992, had a binding purchase contract on and a nonrefundable deposit paid for a linear accelerator to be used at the additional office. The physical site of the radiation treatment centers affected by this provision may be relocated as a result of the following factors: acts of God; fire; strike; accident; war; eminent domain actions by any governmental body; or refusal by the lessor to renew a lease. A relocation for the foregoing reasons is limited to relocation of an existing facility to a replacement location within the county of the existing facility upon written notification to the Office of Licensure and Certification.
(j) A health care provider who meets the requirements of paragraphs (b) and (i) must disclose his or her investment interest to his or her patients as provided in s. 456.052.
Cited 25 times | Published | Florida 4th District Court of Appeal | 2001 WL 608969
...Chapter 92-178, Laws of Florida, created the "Patient Self-Referral Act of 1992," repealing certain provisions relating to a physician's business dealings in relation to his or her patients, and codifying an act to specifically address this issue. This Act is now codified in section 456.053, Florida Statutes (2000)....
...Accordingly, we affirm the trial court's ruling that, as a matter of law, the subject contract is void as violative of Florida law and public policy and, thus, confers no enforceable rights on appellants based upon it. AFFIRMED. DELL and STEVENSON, JJ., concur. NOTES [1] This statute was renumbered as section 456.053, Florida Statutes....
Cited 4 times | Published | Florida 3rd District Court of Appeal | 2007 WL 911845
...Count I seeks a declaratory judgment against VitalMD that VitalMD's failure to require MEP LLC to compensate Dr. Perez pursuant to the oral employment agreement violated 42 U.S.C. § 1395nn (the "Stark Law") and Florida's Patient Self-Referral Act (the "Self-Referral Act"), section 456.053, Florida Statutes (2002)....
...patient of’ the interest, the identity of the entity in which the provider has an interest, the patient’s rights to alternative services, and the identities of at least two alternative sources of the services. § 456.052(1), Fla. Stat. However, section 456.053(3)(o )3.f., Florida Statutes, contains an exemption for referrals: f....
DUBINA, Chief Judge: This case involves a constitutional challenge to Florida’s “Patient Self-Referral Act of 1992” (the “Florida Act”), Fla. Stat. § 456.053 , which prohibits Florida physicians from referring their patients for services to business entities in which the referring physicians have a financial interest....
...y limit or eliminate competitive alternatives in the health care services market, may result in overutilization of health care services, may increase costs to the health care system, and may adversely affect the quality of health care.” Fla. Stat. § 456.053 (2)....
...The Florida Act makes unlawful (1) a physician’s referral of a patient to a clinical laboratory service provider in which the physician has an ownership or other financial interest or (2) any presentation of a claim for payment for health care services rendered in violation of the Act. Id. § 456.053(5)(a), (c). The statute provides that violators are subject to disciplinary action by the State of Florida and a civil penalty of not more than $15,000 for knowing violations. Id. § 456.053(5)(e), (g)....
...We agree with the district court that the Florida Act passes rational basis-scrutiny because, no matter how ineffective the law might actually be, it was not irrational for the Florida Legislature to conclude that the amendments to the law would accomplish the legislative objectives identified in Fla. Stat. § 456.053 (2)....
Cited 1 times | Published | Florida 1st District Court of Appeal | 2007 WL 1238640
...r in central Florida (the "Oncology Group" or "Group"). Because of the proposed business structure and ownership arrangement of the Oncology Group, Appellant determined there was a substantial risk, under Florida's Patient Self-Referral Act of 1992, section 456.053, Florida Statutes (2005), that it would be statutorily prohibited from billing for radiation therapy services furnished to certain patients of the Group. Thus, Appellant filed a petition for declaratory statement [1] requesting that AHCA address the ability of the proposed Oncology Group to bill for medical services under section 456.053....
..." and Appellant was not substantially affected. [3] *1177 AHCA argues for the first time on appeal that the Department of Health is the only governmental agency with the authority to enter a binding declaratory statement regarding the application of section 456.053. However, section 456.053(5)(b)4, states: Each board and, in the case of hospitals, the Agency for Health Care Administration, shall encourage the use by licensees of the declaratory statement procedure to determine the applicability of this section or any rule adopted pursuant to this section as it applies solely to the licensee....
...Boards shall submit to the Agency for Health Care Administration the name of any entity in which a provider investment interest has been approved pursuant to this section, and the Agency for Health Care Administration shall adopt rules providing for periodic quality assurance and utilization review of such entities. § 456.053(5)(b)4, Fla....
...(2005) (emphasis added). Appellant contends, and AHCA does not dispute, that Appellant is a licensee under chapter 395, which concerns the regulation of hospitals and other licensed facilities by AHCA. See generally Chapter 395, Fla. Stat. (2005). Section 456.053(5)(b)4 specifically states that in the case of "hospitals," AHCA shall encourage the use of declaratory statements regarding the applicability of section 456.053....
...uthority to regulate Appellant. Further, AHCA has a number of responsibilities under the Florida Patient Self-Referral Act, indicating that AHCA has the authority to interpret that Act and issue declaratory statements regarding the Act. See, e.g., §§ 456.053(4)(a)6, (4)(c), (4)(a)5, (5)(g), Fla....
...Accordingly, summary judgment will be granted in favor of Defendant. Background Plaintiffs are foreign corporations providing renal dialysis services in Florida, either directly or through separate subsidiary corporate entities. They are challenging provisions of Section 456.053, Florida Statutes (“the Florida referral statute”), which regulates physician referrals of patients. The provision of the Florida referral statute at issue makes it unlawful for a physician to refer a patient to clinical laboratory services at an entity in which the physician has ownership or owns stock or debt securities. § 456.053(5)(a), Fla....
...Under the current provisions of the referral statute, a physician may not refer a patient for renal dialysis services at an entity in which the physician has a financial interest. A physician who violates the Florida referral statute is subject to disciplinary action by the medical board. § 456.053(5)(f), Fla. Stat. The Florida referral statute also provides a civil penalty of up to $15,000 for each violation if a person who knows, or has reason to know, that a referral is unlawful presents a bill or claim for payment of such service. § 456.053(5)(e), Fla....
...ts of the physicians. The express legislative intent for the statute is to limit potential conflicts of interests, limit overutilization of health care services, encourage competition, reduce costs, and protect the quality of health care. Fla. Stat. § 456.053 (2)....
...d State Farm of responsibility for the costs of these services under Florida Statute Section 627.736(5)(b)(l)(b), based on Defendants’ alleged violations of the Patient Brokering Act (Fla.Stat. § 817.505), the Patient Self-Referral Act (Fla.Stat. § 456.053), the Anti-Kickback Statute (Fla.Stat....
...1-3-l^f) But the issues raised in State Farm’s complaint do not implicate the regulation of such referral services. Counts I-IV rely on alleged violations of state statutes and rules that govern referral and advertising practices of medical and chiropractic care providers ( Fla. Stat. §§ 817.505 , 456.053, 456.054, and 460.413(d), (f), and (Z)); Fla....
...for a service furnished pursuant to a referral prohibited under this section.... If an entity collects any amount that was billed in violation of this section, the entity shall refund such amount on a timely basis to the payor or individual, whichever is applicable.” Fla. Stat. § 456.053 (5)(c)-(d)....
...es a right, there, although in express terms it has not given a remedy, the remedy which by law is properly applicable to that right follows as an incident.” Smith v. Piezo Tech. & Prof'l Adm’r, 427 So.2d 182, 184 (Fla.1983). The language of Section 456.053(5)(d) clearly establishes a payor’s right to a refund, and the provision cannot rightfully be considered as a tool to ensure the public’s safety or welfare....
...regard for the extent of that attorney’s actual participation in the case.
Compliance with Rule 4-1.5(g) prevents “participation fees” from
becoming “kickbacks.” As such, it operates similarly to Florida’s Patient
Self-Referral Act, section 456.053, Florida Statutes, which governs referral
of a patient by a health care provider to another provider in which the
referring provider has a financial interest. Such referrals are not totally
prohibited, “as long as certain safeguards are present in the arrangement.”
§ 456.053 (2), Fla....
Published | Court of Appeals for the Eleventh Circuit
...ry 10, 2013)
Before DUBINA, Chief Judge, CARNES and GILMAN, ∗ Circuit Judges.
DUBINA, Chief Judge:
This case involves a constitutional challenge to Florida’s “Patient Self-
Referral Act of 1992” (the “Florida Act”), FLA. STAT. § 456.053, which prohibits
Florida physicians from referring their patients for services to business entities in
which the referring physicians have a financial interest....
...self-referral practices “may limit or eliminate competitive alternatives in the health
care services market, may result in overutilization of health care services, may
increase costs to the health care system, and may adversely affect the quality of
health care.” FLA. STAT. § 456.053(2)....
...The Florida Act
makes unlawful (1) a physician’s referral of a patient to a clinical laboratory
service provider in which the physician has an ownership or other financial interest
or (2) any presentation of a claim for payment for health care services rendered in
violation of the Act. Id. § 456.053(5)(a), (c). The statute provides that violators
are subject to disciplinary action by the State of Florida and a civil penalty of not
more than $15,000 for knowing violations. Id. § 456.053(5)(e), (g)....
...We agree with the district court that the Florida Act passes
rational basis-scrutiny because, no matter how ineffective the law might actually
be, it was not irrational for the Florida Legislature to conclude that the
amendments to the law would accomplish the legislative objectives identified in
FLA. STAT. § 456.053(2).
In their brief, Appellants assert that the Florida Legislature’s refusal to
acknowledge the findings of the 2001 House committee report shows that it was
irrational to amend the Florida Act in 2002 to remove the ESRD exempti...
Published | Court of Appeals for the Eleventh Circuit
...ry 10, 2013)
Before DUBINA, Chief Judge, CARNES and GILMAN, ∗ Circuit Judges.
DUBINA, Chief Judge:
This case involves a constitutional challenge to Florida’s “Patient Self-
Referral Act of 1992” (the “Florida Act”), FLA. STAT. § 456.053, which prohibits
Florida physicians from referring their patients for services to business entities in
which the referring physicians have a financial interest....
...self-referral practices “may limit or eliminate competitive alternatives in the health
care services market, may result in overutilization of health care services, may
increase costs to the health care system, and may adversely affect the quality of
health care.” FLA. STAT. § 456.053(2)....
...The Florida Act
makes unlawful (1) a physician’s referral of a patient to a clinical laboratory
service provider in which the physician has an ownership or other financial interest
or (2) any presentation of a claim for payment for health care services rendered in
violation of the Act. Id. § 456.053(5)(a), (c). The statute provides that violators
are subject to disciplinary action by the State of Florida and a civil penalty of not
more than $15,000 for knowing violations. Id. § 456.053(5)(e), (g)....
...We agree with the district court that the Florida Act passes
rational basis-scrutiny because, no matter how ineffective the law might actually
be, it was not irrational for the Florida Legislature to conclude that the
amendments to the law would accomplish the legislative objectives identified in
FLA. STAT. § 456.053(2).
In their brief, Appellants assert that the Florida Legislature’s refusal to
acknowledge the findings of the 2001 House committee report shows that it was
irrational to amend the Florida Act in 2002 to remove the ESRD exempti...
This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. For legal consultation, call 904-383-7448.
