House Bill 935
Lester J. Perling, Esq.
lperling@broadandcassel.com
Pariksith Singh, M.D.
psingh@accesshealthcarellc.com
Recordings of this webinar and additional materials can be found at:
http://www.gassmanresourcecenter.com/previously.recorded.webinars.html
Copyright © 2011
Alan S. Gassman, Esq.
agassman@gassmanpa.com
Summary
Gassman, Perling, and Singh
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Summary
 House Bill 935 was codified as Ch. 2011-122,
Laws of Florida.
 Approved by the Governor on June 2, 2011.
 Effective: July 1, 2011.
Gassman, Perling, and Singh
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Summary
 The major changes in this bill are:
 The bill provides physicians an incentive to post prices
in their respective practices.

The bill requires clinics and urgent care centers to post
their 50 most frequently used charges.

The bill requires a health care clinic licensed under
Florida Health Care Clinic Act (FHCCA) to ensure
compliance with the publishing and posting
requirements.
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Making Lemonade Out of Lemons:
The Bill’s Unanswered Questions
 What exactly is the difference between an Urgent Care
Center and any clinic that accepts walk-ins?
 Can a Primary Care Provider simultaneously be an Urgent
Care Center?
 Are there any exceptions for Primary Care Providers?
 The definition of Urgent Care Facility and other meanings
and definitions within the bill are extremely vague.
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Prior to HB 935
 The Patient’s Bill of Rights and
Responsibilities was established in 1991 and
codified in § 381.026, Florida Statutes.
 The statute established:

The right for patients to expect medical
providers to observe standards of care in
providing medical treatment and
communicating with their patients.
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Prior to HB 935

Upon request, the patients had a right to be
provided with a reasonable estimate of the
cost of medical treatment prior to treatment.

However, the reasonable estimate did not
preclude the health care provider or health
care facility from exceeding the estimate or
making additional charges.

There is no statutory requirement that a
physician post a schedule of his or her fees
for medical services.
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HB 935 Changes
Primary Care Providers
 HB 935 defines a Primary Care Provider (PCP) as
a health care provider who provides medical
services to patients which are commonly provided
without a referral from another health care provider.
(Example: pediatricians, family practice physicians,
and internists)
 A PCP may publish and post the schedule of
medical services that he or she provides and the
cost for each service.
 Note: Physicians are not required to post, but are
permitted to do so.
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Primary Care Providers
 If the PCP chooses to post the pricing schedule:
 The schedule must list, at least, the 50 most frequently performed
services provided by the PCP;
 The bill requires the posted charges to consist of those fees that would
be charged to an uninsured patient paying for medical services by
cash, check, credit card, or debit card;
 The schedule must be posted in a conspicuous location near the
reception area of the provider’s office in an area of at least 15 square
feet; and,
 The bill requires that an estimate of charges for medical treatment
provided to a patient be consistent with the posted schedule of
charges, if the PCP posts a schedule of charges pursuant to the bill.
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Primary Care Providers
 The bill provides PCP an incentive to post prices by
giving the following:
 Exemption from one period of license renewal
fees.

Exemption from the continuing medical education
requirements for a single 2-year period.
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Primary Care Providers
 If a PCP chooses to publish and post a
schedule of charges, the schedule must
remain posted as long as the PCP maintains
an active license in Florida and provides
medical services to patients.

If the schedule does not remain posted, the
PCP must pay the exemptions license fee
amount and make up any continuing medical
education credits that were waived.
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Urgent Care Centers
 The bill amends § 395.107, Florida Statutes, and
defines term “urgent care center” to include a facility
or clinic that provides immediate, but not emergent,
ambulatory medical services to patients with or
without an appointment.
 In other words, clinics that offer “immediate”
appointments may be considered an urgent care
center under this definition.

The definition does not include the emergency
department of a hospital.
 Making an appointment on short notice for an existing
problem related to a current course of treatment
would most likely not fall under “urgent care center.”
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Urgent Care Centers
 Specific requirements for urgent care centers are:
 They must publish a schedule of charges for the
medical services offered to patients;
 They must include the prices charged to an uninsured
person paying for such services by cash, check, credit
card, or debit card;
 The schedule must be posted in a conspicuous place
in the reception area of the urgent care center;
 It must include the 50 services most frequently
provided by the urgent care center;
 It may group services by three price levels, listing
services in each price level; and
 The posting must be at least 15 square feet in size.
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Urgent Care Centers
 The bill imposes a fine of not more than
$1,000, per day, upon an urgent care center
for each day that the schedule of charges is
not published and posted as required by the
bill.
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Health Care Clinics
 HB 935 amends § 400.9935, Florida Statutes,
to require a medical director or clinic director
of a health care clinic licensed under FHCCA,
to ensure compliance with the publishing and
posting requirements.
 If an applicant for health care clinic licensure
meets the definition of “urgent care center" it
must post and publish many of its charges so
patients can see them.
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Health Care Clinics
 Specific requirements for posting are:

Post in a conspicuous place in the reception area of
the facility.

Must include prices charged to uninsured patients
paying at the time of service.

The sign must be at least 15 square feet in size and
provide prices for at least the top 50 most frequently
provided services. The clinic is not limited to listing just
50 services.

The pricing can have up to 3 price levels.
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Recommendations/
Potential Issues
 If a physician-owned clinic applies for a
certificate of exemption from AHCA in the
future, it may have to comply with the new
posting requirements, even if it does not meet
the law’s definition of “urgent care center.”
 Florida law does not require clinics that are
exempt from clinic licensure obtain a
certificate of exemption, but many health care
plans, Medicare and Medicaid, may require
one for credentialing.
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Recommendations/
Potential Issues
 While the new law may make health care
pricing more transparent across the board, it
also might dissuade patients from initially
seeking medical care.
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Recommendations/
Potential Issues
 Along with the recent bill to limit the prescribing and
dispensing of controlled substances in an
uncontrolled manner, physicians are now forced to be
more compliant and forthright with patients and the
government.
 It is recommend that all primary care clinics that offer
any kind of walk-in or immediate appointment service
follow the requirements of the law and establish a list
of the 50 most common procedures offered at that
location along with the cost involved for any self-pay
patient.
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Recommendations/
Potential Issues
 Such bills always create work for a practice at
the outset, but by raising the bar, practices
become more compliant and consumer
friendly.
 Some procedures may not be easy to price.
In that case, one may wish to list the price
range of the procedure and note the limitation
of such price range.
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Further Resources
 The text of the Bill is available at:
http://www.flsenate.gov/Session/Bill/2011/0935/BillText/er/PDF
 An Article, a sample Schedule of Charges as
shown on Slide 22, and the chart found on
Slide 2 is available from Gassman Law
Associates, P.A.
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Questions?
Lester Perling, Esq.
lperling@broadandcassel.com
(954) 745-5261
Dr. Pariksith Singh
psingh@accesshealthcarellc.net
(352) 688-2883
Alan S. Gassman, Esq.
agassman@gassmanpa.com
(727) 442-1200
Gassman, Perling, and Singh
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Sample Schedule of Charges
2011 SELF-PAY PRICING
OFFICE VISITS AND PHYSICALS
CODE
99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99391
99392
99393
99394
99395
99396
99397
99WRK
99SCH
99DOT
CODE
NEW PATIENT
LEVEL 1 OFFICE VISIT
NEW PATIENT
LEVEL 2 OFFICE VISIT
NEW PATIENT
LEVEL 3 OFFICE VISIT
NEW PATIENT
LEVEL 4 OFFICE VISIT
NEW PATIENT
LEVEL 5 OFFICE VISIT
RETURNING PATIENT
LEVEL 1 OFFICE VISIT
RETURNING PATIENT
LEVEL 2 OFFICE VISIT
RETURNING PATIENT
LEVEL 3 OFFICE VISIT
RETURNING PATIENT
LEVEL 4 OFFICE VISIT
RETURNING PATIENT
LEVEL 5 OFFICE VISIT
PREVENTATIVE CARE/PHYSICAL < 1
YEAR OF AGE
PREVENTATIVE CARE/PHYSICAL 1 TO 4 YEARS OF AGE
PREVENTATIVE CARE/PHYSICAL 5 TO 11 YEARS OF AGE
PREVENTATIVE CARE/PHYSICAL 12 TO 17 YEARS OF AGE
PREVENTATIVE CARE/PHYSICAL 18 TO 39 YEARS OF AGE
PREVENTATIVE CARE/PHYSICAL 40 TO 64 YEARS OF AGE
PREVENTATIVE CARE/PHYSICAL 65 OR > YEARS OF AGE
WORK PHYSICAL
SCHOOL PHYSICAL
DEPARTMENT OF TRANSPORTATION PHYSICAL
OTHER PROCEDURES
PRICE
20550
20610
69210
TRIGGER POINT INJECTION
JOINT ASPIRATE/INJECT
EAR LAVAGE (PROVIDER)
$ 61.00
$ 84.00
$ 84.00
80100
81002
81025
82270
82962
85610
86580
87880
93000
97388
DRUG SCREEN
URINALYSIS
URINE PREGNANCY TEST
OCCULT BLOOD
BLOOD SUGAR BY BGM
PT/INR
PPD/TB TEST
STREP TEST
EKG
BP MONITOR
SUTURE REMOVAL (OTHER
$ 21.00
+ LAB
$ 4.00
$ 9.00
$ 23.00
$ 10.00
$ 6.00
$ 9.00
$ 25.00
$ 22.00
$ 13.00
G0101
Q0091
94760
PELVIC EXAM
PAP TEST
PULSE OXIMETRY
$ 44.00
$ 39.00
$ 46.00
$ 6.00
94640
94799
36415
96372
90471
NEBULIZER TREATMENT
PEAK FLOW TESTING
BLOOD DRAW
THERAPEUTIC INJECTION
IMMUNIZATION INJ OTHER
$17.00
+ MED
N/C
$ 10.00
$ 25.00
$ 23.00
MD)
CODE
PRICE
NEW
NEW
NEW
NEW
NEW
NEW
NEW
$ 90.00
$ 96.00
$ 98.00
$105.00
$105.00
$125.00
$135.00
INJECTIONS W/O OV
$ 44.00
$ 76.00
$111.00
$170.00
$211.00
$ 21.00
$ 44.00
$ 73.00
$109.00
$146.00
$ 76.00
$ 84.00
$ 85.00
$ 93.00
$ 93.00
$101.00
$115.00
$ 40.00
$ 25.00
$ 50.00
PRICE
$ 11.00
$ 13.00
$ 24.00
$ 25.00
$ 25.00
$100.00
$ 60.00
$150.00X3
$ 50.00
$185.00
$ 28.00
95115
95117
J3420
J1100
90658
90636
90746
90649
90732
90736
90703
SINGLE ALLERGY SHOT
MULT ALLERGY SHOTS
B-12 SHOT
DECADRON SHOT
FLU SHOT
HEP A&B PREVENTATIVE SHOT
HEP B SHOT
HPV/GUARDASIL SHOT
PNEUMONIA SHOT
SHINGLES/ZOSTAVAX SHOT
TETANUS SHOT
J1885
TORADOL 15 MG SHOT
$
4.00
J1956
J2920
J2930
J2950
J3301
96360
96361
96365
96366
96523
LEVAQUIN IV
SOLUMEDROL <40 MG
SOLUMEDROL <40 MG TO 125MG
PHERGAN 50 MG
KENALOG/CORTISONE 10 MG
IV FOR 1 HR (EA HYDRATION)
IV TO 8 HRS (EA HYDRATION)
IV 1 HOUR (DIAGNOSIS/DRUG)
IV TO 8 HOURS (EA/DIAGNOSIS)
PORT FLUSH
$
$
$
$
$
$
$
$
$
$
22.50
5.00
5.50
4.00
3.00
61.00
17.00
75.00
13.00
27.00
INJECTIONS & IVS WITH OV
Gassman, Perling, and Singh
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