SF 372 (LSB 1109SV (2) 86)

SENATE FILE 372

BY  COMMITTEE ON STATE GOVERNMENT

(SUCCESSOR TO SSB 1172)

A BILL FOR

An Act relating to licensure of durable medical equipment providers, providing penalties, and including effective date and implementation provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 147.1, subsections 3 and 6, Code 2015, are amended to read as follows:
   3.  “Licensed” or “certified”, when applied to a physician and surgeon, podiatric physician, osteopathic physician and surgeon, physician assistant, psychologist, chiropractor, nurse, dentist, dental hygienist, dental assistant, optometrist, speech pathologist, audiologist, pharmacist, physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant, orthotist, prosthetist, pedorthist, respiratory care practitioner, practitioner of cosmetology arts and sciences, practitioner of barbering, funeral director, dietitian, marital and family therapist, mental health counselor, social worker, massage therapist, athletic trainer, acupuncturist, nursing home administrator, hearing aid dispenser, durable medical equipment provider, or sign language interpreter or transliterator means a person licensed under this subtitle.
   6.  “Profession” means medicine and surgery, podiatry, osteopathic medicine and surgery, practice as a physician assistant, psychology, chiropractic, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, pharmacy, physical therapy, physical therapist assisting, occupational therapy, occupational therapy assisting, respiratory care, cosmetology arts and sciences, barbering, mortuary science, marital and family therapy, mental health counseling, social work, dietetics, massage therapy, athletic training, acupuncture, nursing home administration, hearing aid dispensing, durable medical equipment providing, sign language interpreting or transliterating, orthotics, prosthetics, or pedorthics.
    Sec. 2.  Section 147.2, subsection 1, Code 2015, is amended to read as follows:
   1.  A person shall not engage in the practice of medicine and surgery, podiatry, osteopathic medicine and surgery, psychology, chiropractic, physical therapy, physical therapist assisting, nursing, dentistry, dental hygiene, dental assisting, optometry, speech pathology, audiology, occupational therapy, occupational therapy assisting, orthotics, prosthetics, pedorthics, respiratory care, pharmacy, cosmetology arts and sciences, barbering, social work, dietetics, marital and family therapy or mental health counseling, massage therapy, mortuary science, athletic training, acupuncture, nursing home administration, hearing aid dispensing, durable medical equipment providing, or sign language interpreting or transliterating, or shall not practice as a physician assistant, unless the person has obtained a license for that purpose from the board for the profession.
    Sec. 3.  Section 147.13, Code 2015, is amended by adding the following new subsection:
   NEW SUBSECTION.  25.  For durable medical equipment providers, the board of durable medical equipment providers.
    Sec. 4.  Section 147.14, subsection 1, Code 2015, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  x.  For durable medical equipment providers, seven licensed durable medical equipment providers.
    Sec. 5.  NEW SECTION.  154G.1  Definitions.

   For purposes of this chapter:

   1.  “Accrediting organization” means any organization recognized by the centers for Medicare and Medicaid services of the United States department of health and human services as an accreditation body for durable medical equipment providers.
   2.  “Affiliated person” means any person who directly or indirectly manages, controls, or oversees the operation of a corporation or other business entity that is a licensee, regardless of whether such person is a partner, shareholder, owner, officer, director, agent, or employee of the entity.
   3.  “Applicant” means an individual applicant in the case of a sole proprietorship or any officer, director, agent, managing employee, general manager, or affiliated person or any partner or shareholder having an ownership interest equal to five percent or greater in the corporation or other business entity.
   4.  “Board” means the board of durable medical equipment providers.
   5.  “Consumer” or “patient” means a person who uses durable medical equipment in the person’s residence.
   6.  “Durable medical equipment” means any product reimbursed under Medicare part B durable medical equipment benefits and any product as defined by the federal Food, Drug, and Cosmetic Act or reimbursable under Medicaid as provided by the board by rule. “Durable medical equipment” includes but is not limited to hospital beds, oxygen, walkers, continuous positive airway pressure machines, customized wheelchairs, and related seating and positioning devices, but does not include prosthetics or orthotics or any splints, braces, or aids custom-fit or custom-fabricated by a licensed health care practitioner or commercially available noncustomized splints, braces, or aids prescribed by a licensed health care practitioner.
   7.  “Durable medical equipment provider” means a person or entity that sells or rents, or offers to sell or rent, to or for a consumer any durable medical equipment or durable medical equipment services.
   8.  “Durable medical equipment provider personnel” means persons who are employed by or under contract with a durable medical equipment provider.
   9.  “Durable medical equipment services” means equipment management and consumer instruction, including selection, delivery, setup, and maintenance of equipment and other related services for the use of durable medical equipment in the consumer’s regular or temporary residence.
   10.  “General manager” means the individual who has the general administrative charge of the premises of a licensed durable medical equipment provider.
   11.  “Licensed health care practitioner” means a person licensed in this state engaging in a profession or occupation included in section 147.1, subsections 3 and 6.
   12.  “Licensee” means the person or entity to whom a license to operate as a durable medical equipment provider is issued by the board.
   13.  “Moratorium” means a mandated temporary cessation or suspension of the sale, rental, or offering of durable medical equipment, except that services related to durable medical equipment sold or rented prior to the moratorium shall be continued without interruption, unless ordered otherwise by the board.
   14.  “Premises” means those buildings and equipment which are located at the address of the licensed durable medical equipment provider for the provision of durable medical equipment services which are in such reasonable proximity as to appear to the public to be a single provider location.
   15.  “Residence” means a consumer’s home or place of residence, which may include a nursing home as defined in section 155.1, assisted living program as defined in section 231C.2, elder group home as defined in section 231B.1, transitional living facility, or other congregate residential facility.
   16.  “Retail sale” means a sale or rental of durable medical equipment directly to a consumer which does not require a prescription or billing of Medicare, Medicaid, or any other third-party insurance.
    Sec. 6.  NEW SECTION.  154G.2  License required —— exemptions.
   1.  A person shall not do any of the following without obtaining a license from the board under this chapter:
   a.  Hold oneself out to the public as providing durable medical equipment or durable medical equipment services or accept physician orders for durable medical equipment or durable medical equipment services.
   b.  Hold oneself out to the public as providing durable medical equipment that typically requires durable medical equipment services.
   c.  Provide durable medical equipment or durable medical equipment services to consumers in this state.
   2.  A separate license is required for all durable medical equipment providers operating on separate premises, even if the providers are operating under the same management. For each location a provider operates, an initial inspection by the board pursuant to section 154G.9 shall be required to obtain a license.
   3.  The following persons are exempt from durable medical equipment provider licensure unless the person operates a separate company, corporation, or division that is in the business of providing durable medical equipment and services for sale or rent to consumers at their regular or temporary place of residence pursuant to the provisions of this chapter:
   a.  Durable medical equipment providers operated by the federal government.
   b.  Nursing homes as defined in section 155.1.
   c.  Assisted living programs as defined in section 231C.2.
   d.  Home health agencies as defined in 42 C.F.R. pt. 484.
   e.  Hospice programs as defined in section 135J.1.
   f.  Intermediate care facilities for persons with intellectual disabilities or mental illnesses as defined in section 135C.1.
   g.  Homes for special services.
   h.  Transitional living facilities.
   i.  Hospitals licensed pursuant to chapter 135B.
   j.  Ambulatory surgical centers.
   k.  Manufacturers and wholesale distributors when not selling directly to consumers.
   l.  Licensed health care practitioners who utilize durable medical equipment in the course of their practice.
   m.  Pharmacies licensed pursuant to chapter 155A.
   n.  Any durable medical equipment provider who only provides items for retail sale.
   4.  A person shall not offer or advertise durable medical equipment or durable medical equipment services to the public unless such person has a valid license under this chapter or is exempted from licensure under subsection 3. A person holding a license issued under this chapter shall not advertise or indicate to the public that the person holds a durable medical equipment provider license other than the license the person has been issued.
    Sec. 7.  NEW SECTION.  154G.3  Principal place of business out of state.

   A durable medical equipment provider that provides durable medical equipment or durable medical equipment services to persons in this state and that has a principal place of business outside this state shall maintain an office or place of business within this state unless the principal place of business is located in a bordering state, is within fifty miles of a border with this state, and meets the other requirements of this chapter.
    Sec. 8.  NEW SECTION.  154G.4  Accreditation.

   A durable medical equipment provider accredited by an accrediting organization may submit documents to the board evidencing current accreditation and shall be presumed to comply with the licensing requirements of this chapter. Licensing of a durable medical equipment provider that has been accredited by an accrediting organization shall become effective upon written notification from the board that the accreditation meets the standards set out in rules adopted by the board.
    Sec. 9.  NEW SECTION.  154G.5  License application —— renewal —— duplicates —— fees.
   1.  An application for an initial license or for renewal of an existing license shall be made under oath to the board on forms furnished by the board and must be accompanied by the appropriate license fee as established by the board by rule.
   2.  The applicant shall file with the application information demonstrating that the applicant is in compliance with this chapter and applicable rules. Such information shall include the following:
   a.  A report specifying by category the durable medical equipment to be provided and indicating the durable medical equipment offered either directly by the applicant or through contractual arrangements with existing durable medical equipment providers. Categories of equipment include but are not limited to the following:
   (1)  Respiratory modalities.
   (2)  Ambulation aids.
   (3)  Mobility aids.
   (4)  Sickroom setup.
   (5)  Disposables.
   b.  A report specifying by category the durable medical equipment services to be provided and indicating those offered either directly by the applicant or through contractual arrangements with existing providers. Categories of services include but are not limited to the following:
   (1)  Intake.
   (2)  Equipment selection.
   (3)  Delivery.
   (4)  Setup and installation.
   (5)  Patient training.
   (6)  Ongoing service and maintenance.
   (7)  Retrieval.
   c.  A list of those persons with whom the applicant contracts to provide durable medical equipment or durable medical equipment services to its consumers and those persons for whom the applicant provides durable medical equipment or durable medical equipment services.
   d.  A description and explanation of any exclusions, permanent suspensions, or terminations of the applicant from the Medicare or medical assistance program. Proof of compliance with the disclosure of ownership and control interest requirements of the Medicare or medical assistance program shall be accepted in lieu of this submission.
   e.  A description and explanation of any felony committed by a member of the board of directors of the applicant, its officers, or any individual owning five percent or more of the applicant. This requirement does not apply to a director of a not-for-profit corporation or organization if the director serves solely in a voluntary capacity for the corporation or organization, does not regularly take part in the day-to-day operational decisions of the corporation or organization, receives no remuneration for such director’s services on the corporation’s or organization’s board of directors, and has no financial interest and no family members with a financial interest in the corporation or organization, provided that the director and the not-for-profit corporation or organization include in the application a statement affirming that the director’s relationship to the corporation satisfies the requirements of this paragraph.
   3.  An applicant for initial licensure shall demonstrate financial ability to operate, which may be accomplished by the submission of a surety bond in the amount of fifty thousand dollars to the board. An existing surety bond for Medicare credentialing held by the applicant shall be sufficient in lieu of an additional bond.
   4.  An applicant for license renewal who has demonstrated financial inability to operate shall demonstrate financial ability to operate before the board may renew the applicant’s license.
   5.  The board shall initiate a criminal background check of the applicant upon receipt of a completed, signed, and dated application. As used in this subsection, “applicant” means the general manager and the financial officer or similarly titled individual who is responsible for the financial operation of the durable medical equipment provider.
   a.  The applicant shall supply fingerprint samples or submit to a criminal history records check to be conducted by the division of criminal investigation of the department of public safety. Any costs incurred by the division of criminal investigation of the department of public safety in conducting such investigation of an applicant shall be paid by the potential licensee.
   b.  The board may require a criminal background check for a member of the board of directors of the potential licensee or an officer or an individual owning five percent or more of the potential licensee if the board has probable cause to believe that such individual has been convicted of a felony.
   6.  The board shall not issue a license to an applicant if the applicant or an administrator or financial officer of the durable medical equipment provider has been found guilty of or has entered a plea of nolo contendere or guilty to any felony.
   7.  Proof of professional and commercial liability insurance shall be submitted with the application. The board shall set the required amounts of liability insurance by rule, but the required amount shall not be less than two hundred fifty thousand dollars per claim. In the case of contracted services, the contractor shall have liability insurance of not less than two hundred fifty thousand dollars per claim.
   8.  Ninety days before the expiration date of a license, the durable medical equipment provider shall submit an application for license renewal to the board under oath on forms furnished by the board. The license shall be renewed if the applicant has met the requirements established under this chapter and applicable rules. The durable medical equipment provider must file with the application satisfactory proof that it is in compliance with this chapter and applicable rules. The durable medical equipment provider must submit satisfactory proof of its financial ability to comply with the requirements of this chapter.
   9.  When a duplicate license is issued, a fee shall be assessed not exceeding the actual cost of duplicating and mailing the duplicate license.
   10.  The license must be displayed in a conspicuous place in the administrative office of the durable medical equipment provider and is valid only while in the possession of the person or entity to which it is issued. The license may not be sold, assigned, or otherwise transferred, voluntarily or involuntarily, and is valid only for the durable medical equipment provider and location for which originally issued.
   11.  All license fees required of a durable medical equipment provider are nonrefundable. The board shall set license renewal fees by rule sufficient to cover its costs in carrying out its responsibilities.
   12.  State, county, or municipal governments applying for licenses under this chapter are exempt from the payment of license fees.
   13.  An applicant for initial licensure, or following a change of ownership as described in section 154G.6, shall pay a license processing fee not to exceed three hundred dollars and an inspection fee not to exceed four hundred dollars to be paid by all applicants except those not subject to licensure inspection by the board.
    Sec. 10.  NEW SECTION.  154G.6  Provisional licenses —— change of ownership.
   1.  A provisional license shall be issued by the board to an approved applicant for initial licensure for a period of ninety days. During that time, the board shall conduct an investigation to determine substantial compliance, as determined by the board, with the requirements of section 154G.5, including any determination to be made by the board pending the outcome of the criminal background check performed pursuant to section 154G.5, subsection 5. If substantial compliance is demonstrated, a license shall be issued, to expire two years after the effective date of the provisional license.
   2.  A durable medical equipment provider against whom a proceeding by the board for revocation or suspension or for denial of a renewal application is pending may be issued a provisional license effective until final disposition of such proceedings. If judicial relief is sought from the final disposition, the court that has jurisdiction may direct the board to issue a provisional license for the duration of the judicial proceeding.
   3.  a.  When a change of ownership of a durable medical equipment provider occurs, the prospective owner shall submit an initial application for a license to the board at least fifteen days before the effective date of the change of ownership. An application for change of ownership of a license is required when ownership, a majority of the ownership, or controlling interest of a licensed durable medical equipment provider is transferred or assigned and when the prospective owner agrees to undertake or provide services to the extent that legal liability for operation of the durable medical equipment provider rests with the prospective owner.
   b.  A provisional license shall be issued to the new owner for a period of ninety days during which time all required documentation must be submitted and an investigation must be conducted demonstrating substantial compliance with this section. If substantial compliance is demonstrated a license shall be issued, to expire two years after the issuance of the provisional license.
   4.  a.  When a change of the general manager of a durable medical equipment provider occurs, the licensee shall notify the board of the change within forty-five days and shall provide evidence of compliance with the background check requirements in section 154G.5, subsection 5.
   b.  A general manager who has met the standards for the abuse registry background check and the criminal background check, but for whom background screening results from the division of criminal investigation of the department of public safety have not yet been received, may be employed pending receipt of the division of criminal investigation of the department of public safety background screening report.
   5.  When a change is reported which requires issuance of a license, the board shall assess a fee. The fee must be based on the actual cost of processing and issuing the license.
    Sec. 11.  NEW SECTION.  154G.7  Standards.

   The following standards shall govern the manner in which a licensed durable medical equipment provider operates:

   1.  A licensed durable medical equipment provider must be in compliance with all applicable federal and state licensure and regulatory requirements.
   2.  A licensed durable medical equipment provider must honor all warranties under applicable law.
   3.  A licensed durable medical equipment provider must maintain a physical facility on an appropriate site and must maintain a visible sign with posted hours of operation. The location must be accessible to the public and staffed during posted hours of business. The location must be at least two hundred square feet and contain space for storing records.
   4.  A licensed durable medical equipment provider must maintain a primary business telephone number listed under the name of the business in a local directory or a toll-free telephone number available through directory assistance. The exclusive use of a beeper, answering machine, answering service, or cell phone during posted business hours is prohibited.
   5.  A licensed durable medical equipment provider shall furnish the board any information required under state law.
   6.  A licensed durable medical equipment provider must notify the accrediting organization for the durable medical equipment provider when a new location is opened.
   7.  All durable medical equipment provider locations, whether owned or subcontracted, must adhere to the standards established pursuant to this section and be separately accredited in order to comply with licensure requirements.
   8.  A licensed durable medical equipment provider must disclose to the board upon application for a license all products and services, including the addition of new product lines for which the durable medical equipment provider is seeking accreditation.
   9.  A licensed durable medical equipment provider must remain open to the public for at least thirty hours per week.
    Sec. 12.  NEW SECTION.  154G.8  Duties.

   A licensed durable medical equipment provider shall do all of the following:

   1.  Offer and provide durable medical equipment to consumers and offer and provide durable medical equipment services, as necessary, to consumers who purchase or rent equipment that requires such services.
   2.  Provide at least one category of durable medical equipment directly by filling orders from its own inventory.
   3.  Respond to orders received for durable medical equipment by filling those orders from its own inventory or inventory from other companies with which it has contracted to fill such orders, or customizing or fitting items for sale from supplies purchased under contract.
   4.  Maintain trained durable medical equipment provider personnel to coordinate order fulfillment and schedule timely durable medical equipment and durable medical equipment service delivery.
   5.  As necessary in relation to the sophistication of the durable medical equipment and durable medical equipment services being provided:
   a.  Ensure that delivery personnel are appropriately trained to conduct an environment and equipment compatibility assessment.
   b.  Appropriately and safely set up the durable medical equipment.
   c.  Instruct patients and caregivers in the safe operation and client maintenance of the durable medical equipment.
   d.  Recognize when additional education or follow-up patient compliance monitoring is appropriate.
    Sec. 13.  NEW SECTION.  154G.9  Inspections.
   1.  The board shall make or cause to be made such inspections and investigations of a durable medical equipment provider as it considers necessary, including:
   a.  Licensure inspections.
   b.  Inspections directed by the centers for Medicare and Medicaid services of the United States department of health and human services.
   c.  Licensure complaint investigations, including full licensure investigations with a review of all licensure standards as outlined in rules adopted by the board. Complaints received by the board from individuals, organizations, or other sources are subject to review and investigation by the board.
   2.  The board shall accept, in lieu of its own periodic inspections for licensure, submission of a survey or inspection of an accrediting organization, provided the accreditation of the licensed durable medical equipment provider is not provisional and provided the licensed durable medical equipment provider authorizes release of, and the board receives the report of, the accrediting organization.
    Sec. 14.  NEW SECTION.  154G.10  License denial, revocation, or suspension.
   1.  The board may deny, revoke, or suspend a license, or impose a civil penalty not to exceed five thousand dollars per violation per day in accordance with this section.
   2.  Either of the following actions by a durable medical equipment provider or any of its employees is grounds for administrative action or imposition of civil penalties by the board:
   a.  Violation of this chapter or rules adopted pursuant to this chapter.
   b.  An intentional, reckless, or negligent act that materially affects the health or safety of a patient.
   3.  The board may deny licensure to an applicant or revoke the license of a licensee who does any of the following:
   a.  Makes or previously made a false representation or omission of any material fact in an application, including the submission of an application that conceals the applicant’s controlling or ownership interest, or any officer, director, agent, managing employee, affiliated person, partner, or shareholder who may not be eligible to participate.
   b.  Has been previously found by any board created under chapter 147 to have violated the standards or conditions relating to licensure or certification or the quality of services provided.
   c.  Has been or is currently excluded, suspended, or terminated from, or has involuntarily withdrawn from, participation in any state Medicaid program, the Medicare program, or any other governmental or private health care or health insurance program.
   4.  The board may issue an emergency order immediately suspending or revoking a license when it determines that any condition within the responsibility of the durable medical equipment provider presents a clear and present danger to public health and safety.
   5.  The board may impose an immediate moratorium on the license of a licensed durable medical equipment provider when the board determines that any condition within the responsibility of the durable medical equipment provider presents a threat to public health or safety.
    Sec. 15.  NEW SECTION.  154G.11  Penalties.
   1.  The following penalties shall be imposed for operating as a durable medical equipment provider without a license under this chapter:
   a.  A person who operates as a durable medical equipment provider without a license under this chapter commits a class “D” felony.
   b.  For any person who has received government reimbursement for services provided by an unlicensed durable medical equipment provider, the board shall make a fraud referral to the appropriate government reimbursement program.
   2.  If the board discovers that a licensee is concurrently operating licensed and unlicensed provider locations, the board may impose a civil penalty of not more than five hundred dollars per violation or suspend any of the licensee’s existing licenses.
   3.  A durable medical equipment provider found to be operating without a license may apply for licensure but shall cease operations until a license is issued by the board.
    Sec. 16.  Section 272C.1, subsection 6, Code 2015, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  ag.  The board of durable medical equipment providers created pursuant to chapter 147.
    Sec. 17.  INITIAL APPOINTMENTS.  Notwithstanding any provision to the contrary in this Act, the initial appointees to the board of durable medical equipment providers established pursuant to this Act shall hold accreditation from an accrediting organization, as defined in section 154G.1, as enacted in this Act.
    Sec. 18.  EFFECTIVE UPON ENACTMENT.  The following provision or provisions of this Act, being deemed of immediate importance, take effect upon enactment:
   1.  The sections of this Act amending sections 147.13, 147.14, and 272C.1, and the section relating to initial appointments to the board of durable medical equipment providers.
    Sec. 19.  EFFECTIVE DATE AND IMPLEMENTATION.  The following provision or provisions of this Act take effect January 1, 2016, except that the board of durable medical equipment providers may begin implementation prior to January 1, 2016, to the extent necessary to transition to full implementation of these provisions of this Act:
   1.  The sections of this Act amending sections 147.1 and 147.2, and enacting sections 154G.1 through 154G.11.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill establishes a licensing procedure and standards of practice for durable medical equipment providers.
   The bill creates a new licensing board, the board of durable medical equipment providers. The board shall be responsible for administering the licensing procedure and regulating durable medical equipment providers. The bill makes Code chapters 147 and 272C, including penalty and other regulatory provisions, applicable to the practice of durable medical equipment providing.
   Under the bill, persons or entities who hold themselves out to the public as providers of durable medical equipment must have a license issued by the board. To operate as a durable medical equipment provider, a person or entity must have a place of business open to the public at least 30 hours per week. If the person or entity has multiple locations, it must have a license for each location. If the person or entity’s principal place of business is located out of state but within 50 miles of the state and does business in the state, it need not maintain a location in Iowa.
   If a durable medical equipment provider is accredited by an organization recognized by the centers for Medicare and Medicaid services of the United States department of health and human services and provides proof of such accreditation to the board, the board shall grant the provider a license. Licenses shall be issued for two years. An inspection is required before a license can be issued. The board shall establish the fees for new licenses and for renewals. The bill enumerates a list of groups who are not required to meet the licensure requirements.
   Any person operating as a durable medical equipment provider without a license commits a class “D” felony and shall cease operation until a license is issued by the board.
   An applicant for a durable medical equipment provider license must complete the form made available by the board. The applicant must also provide a report specifying by category the equipment and services to be provided and indicating those offered either directly by the applicant or through contractual arrangements with existing providers. An applicant must provide a list of entities with whom it contracts for the provision of equipment and services. An initial applicant must provide proof of professional and commercial liability insurance as well as financial stability in the form of a $50,000 surety bond or an existing surety bond for Medicare credentialing.
   An applicant’s general manager and senior financial officer must submit to and pay for the costs of a criminal background check conducted by the division of criminal investigation of the department of public safety. The board may require background checks of any board of director members or of owners who hold at least a 5 percent stake in an applicant entity. The applicant must disclose information regarding felonies committed by a member of the board of directors, its officers, or any individual owning 5 percent or more of the applicant entity.
   The board may deny, revoke, or suspend a license, or impose a civil penalty not to exceed $5,000 per violation per day if a durable medical equipment provider or any of its employees violates the bill or rules or commits an intentional, reckless, or negligent act that materially affects the health or safety of a patient. The board may deny or revoke the license of any applicant that made a false representation or omission of any material fact on its application, has been previously found by any professional licensing, certifying, or standards board or agency to have violated its standards or conditions, or has been excluded, suspended, or terminated or has involuntarily withdrawn from participation in any governmental or private health care or health insurance program.
   The board may investigate or inspect an applicant or licensee as it considers necessary. The board shall accept a survey or inspection of an accrediting organization if the accreditation of the licensed durable medical equipment provider is not provisional and the provider authorizes the release of the organization’s report, which is received by the board.
   The provisions of the bill that create the board, allow for initial board appointments, and grant the board rulemaking authority shall be effective upon enactment. The remaining provisions shall take effect on January 1, 2016.