Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol.32,No.12, March 24, 2006 issue of the Florida Administrative Weekly.

THE FULL TEXT OF PROPOSED RULE CHANGES:

59C-1.021 Certificate of Need Penalties.

(3)(a) Facilities failing to comply with any conditions or failing to provide the certificate of need office with a report on its compliance with conditions set forth on the cCertificate of nNeed or certificate of need exemption, will be assessed a fine, not to exceed $1,000 per failure per day. In assessing the penalty the agency shall take into account the degree of noncompliance. Fines for noncompliance with an indigent care condition may be assessed using the following formula unless the condition noncompliance is found to be willful under paragraph (3)(b). Fines for willful noncompliance may be assessed in an amount greater than the fine assessed using the following formula:

CAGP = the service condition agreed to by certificate of need or certificate of need exemption holder

ACTP = the actual percentage of service provided by the certificate of need or the certificate of need exemption holder during the reporting year

FAMT = dollar amount of the fine

FAMT = $365,000 x (CAGP – ACTP) / CAGP

Indigent care includes charity care and Medicaid. Charity care is defined, for purposes of condition compliance, as the portion of the facility charges reported to the Agency for Health Care Administration for which there is no compensation, other than restricted or unrestricted revenues provided to a facility by local governments or tax districts regardless of the method of payment, for care provided to a patient whose family income for the twelve months preceding the determination is less than or equal to 200 percent of the federal poverty level unless the amount of charges due from the patient exceed 25 percent of the annual family income. However, in no case shall the facility charges for a patient whose family income exceeds four times the federal poverty level for a family of four be considered charity. Medicaid patient days is defined, for purposes of condition compliance, as the patient days reimbursed by Medicaid.

(b) The existence of, but not limited to, one or more of the following circumstances may evidence willful condition noncompliance, allowing the agency to impose fines in excess of the calculated FAMT, but the total fine shall not exceed $365,000:

1. The CON or CON exemption holder fails to meet its indigent care condition when the condition is below the rate of indigent care provided by all other facilities in the planning area for the reporting period; or

2. The CON or CON exemption holder has been fined for condition noncompliance for any of the previous 3 years’ CON condition compliance reporting periods.

(3)(c) No change.