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HB 349 2026
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hb349-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to cardiac services providers; 2
amending s. 395.1055, F.S.; revising requirements for 3
licensure of Level I and Level II adult cardiovascular 4
programs; requiring the Agency for Health Care 5
Administration to update specified rules as new 6
applicable industry standards and guidelines are 7
published; providing an effective date. 8
9
Be It Enacted by the Legislature of the State of Florida: 10
11
Section 1. Subsections (18) and (19) of section 395.1055, 12
Florida Statutes, are amended to read: 13
395.1055 Rules and enforcement.— 14
(18)(a) In establishing rules for adult cardiovascular 15
services, The agency shall grant licensure include provisions 16
that allow for: 17
(a) the establishment of two hospital program licensure 18
levels, a Level I program that authorizes the performance of 19
adult percutaneous cardiac intervention without onsite cardiac 20
surgery, including rotational or other atherectomy devices, 21
electrophysiology, and treatment of chronic total occlusions, 22
and a Level II program that authorizes the performance of 23
percutaneous cardiac intervention with onsite cardiac surgery. 24
(b)1. For A hospital seeking licensure as a Level I 25
HB 349 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
program must:, demonstration that, for the most recent 12-month 26
period as reported to the agency, the hospital has provided a 27
minimum of 300 adult inpatient and outpatient diagnostic cardiac 28
catheterizations or, for the most recent 12-month period, has 29
discharged or transferred at least 300 patients with the 30
principal diagnosis of ischemic heart disease and that it has 31
1. Have a formalized, written transfer agreement with a 32
hospital that has a Level II program, including written 33
transport protocols to ensure safe and efficient transfer of a 34
patient within 60 minutes. 35
2.a. A hospital located more than 100 road miles from the 36
closest Level II adult cardiovascular services program is not 37
required to meet the diagnostic cardiac catheterization volume 38
and ischemic heart disease diagnosis volume requirements in 39
subparagraph 1. if the hospital demonstrates that it has, for 40
the most recent 12-month period as reported to the agency, 41
provided a minimum of 100 adult inpatient and outpatient 42
diagnostic cardiac catheterizations or that, for the most recent 43
12-month period, it has discharged or transferred at least 300 44
patients with the principal diagnosis of ischemic heart disease. 45
b. For a hospital located more than 100 road miles from 46
the closest Level II adult cardiovascular services program, have 47
does not need to meet the 60-minute transfer time protocol 48
requirement in subparagraph 1. if the hospital demonstrates that 49
it has a formalized, written transfer agreement with a hospital 50
HB 349 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
that has a Level II program. The agreement must include written 51
transport protocols to ensure the safe and efficient transfer of 52
a patient, taking into consideration the patient's clinical and 53
physical characteristics, road and weather conditions, and 54
viability of ground and air ambulance service to transfer the 55
patient. 56
3. At a minimum, the rules for adult cardiovascular 57
services must require nursing and technical staff to have 58
demonstrated experience in handling acutely ill patients 59
requiring intervention, based on the staff member's previous 60
experience in dedicated cardiac interventional laboratories or 61
surgical centers. If a staff member's previous experience is in 62
a dedicated cardiac interventional laboratory at a hospital that 63
does not have an approved adult open heart surgery program, the 64
staff member's previous experience qualifies only if, at the 65
time the staff member acquired his or her experience, the 66
dedicated cardiac interventional laboratory: 67
a. Had an annual volume of 500 or more percutaneous 68
cardiac intervention procedures. 69
b. Achieved a demonstrated success rate of 95 percent or 70
greater for percutaneous cardiac intervention procedures. 71
c. Experienced a complication rate of less than 5 percent 72
for percutaneous cardiac intervention procedures. 73
d. Performed diverse cardiac procedures, including, but 74
not limited to, balloon angioplasty and stenting, rotational 75
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atherectomy, cutting balloon atheroma remodeling, and procedures 76
relating to left ventricular support capability. 77
(c) For A hospital seeking licensure as a Level II program 78
must demonstrate, demonstration that, for the most recent 12-79
month period as reported to the agency, the hospital has 80
performed a minimum of 1,100 adult inpatient and outpatient 81
cardiac catheterizations, of which at least 400 must be 82
therapeutic catheterizations, or, for the most recent 12-month 83
period, has discharged at least 800 patients with the principal 84
diagnosis of ischemic heart disease. 85
(d) As a condition of licensure as a Level I or Level II 86
program, a hospital must demonstrate all of the following: 87
1. Compliance with the most recent guidelines of the 88
American College of Cardiology, and the American Heart 89
Association, the Society for Cardiovascular Angiography and 90
Interventions, and, for hospitals providing electrophysiology 91
services, the Heart Rhythm Society guidelines for staffing, 92
physician training and experience, operating procedures, 93
equipment, physical plant, and patient selection criteria, to 94
ensure patient quality and safety. 95
2.(e) The establishment of appropriate hours of operation 96
and protocols to ensure availability and timely referral in the 97
event of emergencies. 98
3.(f) The demonstration of A plan to provide services to 99
Medicaid and charity care patients. 100
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4.(g) For a hospital licensed as a for adult diagnostic 101
cardiac catheterization that provides Level I or Level II 102
program for adult cardiovascular services, demonstration that 103
the hospital is participating in the American College of 104
Cardiology's National Cardiovascular Data Registry or the 105
American Heart Association's Get with the Guidelines–Coronary 106
Artery Disease registry and documentation of an ongoing quality 107
improvement plan ensuring that the licensed cardiac program 108
meets or exceeds national quality and outcome benchmarks 109
reported by the registry in which the hospital participates. A 110
hospital licensed for Level II adult cardiovascular services 111
must also participate in the clinical outcome reporting systems 112
operated by the Society for Thoracic Surgeons. 113
(19) The agency may adopt rules to administer the 114
requirements of part II of chapter 408 and shall update such 115
rules as new applicable industry standards and guidelines are 116
published. 117
Section 2. This act shall take effect October 1, 2026. 118