Florida Senate - 2009                                    SB 2620
       
       
       
       By Senator Altman
       
       
       
       
       24-01631-09                                           20092620__
    1                        A bill to be entitled                      
    2         An act relating to medical quality assurance; amending
    3         s. 395.0193, F.S.; requiring certain disciplinary
    4         actions to be reported to the Division of Medical
    5         Quality Assurance of the Department of Health rather
    6         than the Division of Health Quality Assurance of the
    7         Agency for Health Care Administration; amending s.
    8         395.0197, F.S.; requiring the agency to forward copies
    9         of adverse incident reports to the department;
   10         amending s. 395.3025, F.S.; authorizing disclosure of
   11         certain patient records to the department; requiring
   12         the administrator or records custodian of a facility
   13         to certify which records have been provided to the
   14         department; requiring the facility to charge a fee for
   15         copies of the records provided to the department;
   16         amending s. 400.145, F.S.; requiring the administrator
   17         or records custodian of a facility to certify which
   18         records have been provided to the department; amending
   19         s. 400.147, F.S.; authorizing the department to
   20         receive notification of adverse incidents for purposes
   21         of certain disciplinary proceedings; requiring the
   22         department to review certain adverse incident reports;
   23         requiring the agency to forward adverse incident
   24         reports to the department; amending s. 456.001, F.S.;
   25         providing a definition; amending s. 456.011, F.S.;
   26         providing additional requirements for the constitution
   27         of a quorum for meetings of certain committees and
   28         boards operating under ch. 456, F.S.; amending s.
   29         456.013, F.S.; requiring an application fee for
   30         licensure examinations; providing for extension of a
   31         temporary license; revising licensure requirements;
   32         authorizing the board or department to adopt rules
   33         requiring the display of a professional license;
   34         amending s. 456.025, F.S.; authorizing the increase of
   35         certain licensure fees; authorizing the imposition of
   36         reinspection fees; amending s. 456.036, F.S.;
   37         prohibiting the department from renewing the license
   38         of licensees owing outstanding fees, costs, or fines;
   39         providing for notice; providing for renewal of a
   40         license when requirements are met; amending s.
   41         456.037, F.S.; authorizing the board or department to
   42         require by rule the display of a business
   43         establishment license; amending s. 456.063, F.S.;
   44         authorizing the board or department to adopt rules
   45         relating to the reporting of sexual misconduct by
   46         licensed health care practitioners; amending s.
   47         456.072, F.S.; providing that failure to report
   48         disciplinary actions taken against a licensee’s
   49         license to practice is an additional ground under
   50         which the practitioner is subject to discipline by the
   51         department or the board having jurisdiction over the
   52         practitioner; providing penalties; amending ss.
   53         381.00593, 381.0303, 456.074, 456.41, 468.703,
   54         627.6474, 641.315, 766.1016, 766.1116, 768.13, and
   55         768.28, F.S.; conforming cross-references; providing
   56         an effective date.
   57  
   58  Be It Enacted by the Legislature of the State of Florida:
   59  
   60         Section 1. Subsection (4) of section 395.0193, Florida
   61  Statutes, is amended to read:
   62         395.0193 Licensed facilities; peer review; disciplinary
   63  powers; agency or partnership with physicians.—
   64         (4) Pursuant to ss. 458.337 and 459.016, any disciplinary
   65  actions taken under subsection (3) shall be reported in writing
   66  to the Division of Medical Health Quality Assurance of the
   67  Department of Health agency within 30 working days after its
   68  initial occurrence, regardless of the pendency of appeals to the
   69  governing board of the hospital. The notification shall identify
   70  the disciplined practitioner, the action taken, and the reason
   71  for such action. All final disciplinary actions taken under
   72  subsection (3), if different from those which were reported to
   73  the division agency within 30 days after the initial occurrence,
   74  shall be reported within 10 working days to the Division of
   75  Medical Health Quality Assurance of the department agency in
   76  writing and shall specify the disciplinary action taken and the
   77  specific grounds therefor. The division shall review each report
   78  and determine whether it potentially involved conduct by the
   79  licensee that is subject to disciplinary action, in which case
   80  s. 456.073 shall apply. The reports are not subject to
   81  inspection under s. 119.07(1) even if the division’s
   82  investigation results in a finding of probable cause.
   83         Section 2. Subsection (7) of section 395.0197, Florida
   84  Statutes, is amended to read:
   85         395.0197 Internal risk management program.—
   86         (7) Any of the following adverse incidents, whether
   87  occurring in the licensed facility or arising from health care
   88  prior to admission in the licensed facility, shall be reported
   89  by the facility to the agency within 15 calendar days after its
   90  occurrence:
   91         (a) The death of a patient;
   92         (b) Brain or spinal damage to a patient;
   93         (c) The performance of a surgical procedure on the wrong
   94  patient;
   95         (d) The performance of a wrong-site surgical procedure;
   96         (e) The performance of a wrong surgical procedure;
   97         (f) The performance of a surgical procedure that is
   98  medically unnecessary or otherwise unrelated to the patient’s
   99  diagnosis or medical condition;
  100         (g) The surgical repair of damage resulting to a patient
  101  from a planned surgical procedure, where the damage is not a
  102  recognized specific risk, as disclosed to the patient and
  103  documented through the informed-consent process; or
  104         (h) The performance of procedures to remove unplanned
  105  foreign objects remaining from a surgical procedure.
  106  
  107  The agency may grant extensions to this reporting requirement
  108  for more than 15 days upon justification submitted in writing by
  109  the facility administrator to the agency. The agency may require
  110  an additional, final report. These reports shall not be
  111  available to the public pursuant to s. 119.07(1) or any other
  112  law providing access to public records, nor be discoverable or
  113  admissible in any civil or administrative action, except in
  114  disciplinary proceedings by the agency or the appropriate
  115  regulatory board, nor shall they be available to the public as
  116  part of the record of investigation for and prosecution in
  117  disciplinary proceedings made available to the public by the
  118  agency or the appropriate regulatory board. However, the agency
  119  or the appropriate regulatory board shall make available, upon
  120  written request by a health care professional against whom
  121  probable cause has been found, any such records which form the
  122  basis of the determination of probable cause. The agency may
  123  investigate, as it deems appropriate, any such incident and
  124  prescribe measures that must or may be taken in response to the
  125  incident. The agency shall forward a copy of each incident
  126  report received from a facility to the Division of Medical
  127  Quality Assurance within the Department of Health review each
  128  incident and determine whether it potentially involved conduct
  129  by the health care professional who is subject to disciplinary
  130  action, in which case the provisions of s. 456.073 shall apply.
  131         Section 3. Paragraph (e) of subsection (4) of section
  132  395.3025, Florida Statutes, is amended to read:
  133         395.3025 Patient and personnel records; copies;
  134  examination.—
  135         (4) Patient records are confidential and must not be
  136  disclosed without the consent of the person to whom they
  137  pertain, but appropriate disclosure may be made without such
  138  consent to:
  139         (e) The Department of Health agency upon subpoena issued
  140  pursuant to s. 456.071, but the records obtained thereby must be
  141  used solely for the purpose of the department agency and the
  142  appropriate professional board in its investigation,
  143  prosecution, and appeal of disciplinary proceedings. The
  144  administrator or records custodian in a facility licensed under
  145  this chapter shall certify that true and complete copies of the
  146  records requested pursuant to a subpoena or a patient release
  147  have been provided to the department or otherwise identify those
  148  documents that have not been provided. If the department agency
  149  requests copies of the records, the facility shall charge a
  150  reasonable fee as determined by rule of the department no more
  151  than its actual copying costs, including reasonable staff time.
  152  The records must be sealed and must not be available to the
  153  public pursuant to s. 119.07(1) or any other statute providing
  154  access to records, nor may they be available to the public as
  155  part of the record of investigation for and prosecution in
  156  disciplinary proceedings made available to the public by the
  157  department agency or the appropriate regulatory board. However,
  158  the department agency must make available, upon written request
  159  by a practitioner against whom probable cause has been found,
  160  any such records that form the basis of the determination of
  161  probable cause.
  162         Section 4. Subsection (3) is added to section 400.145,
  163  Florida Statutes, to read:
  164         400.145 Records of care and treatment of resident; copies
  165  to be furnished.—
  166         (3) The administrator or records custodian in a facility
  167  licensed under this chapter shall certify that true and complete
  168  copies of records or documents subpoenaed pursuant to s. 456.057
  169  or s. 456.071 or requested by a patient release have been
  170  provided to the Department of Health or otherwise identify those
  171  documents that have not been provided.
  172         Section 5. Subsection (7) and paragraph (b) of subsection
  173  (8) of section 400.147, Florida Statutes, are amended to read:
  174         400.147 Internal risk management and quality assurance
  175  program.—
  176         (7) The facility shall initiate an investigation and shall
  177  notify the agency within 1 business day after the risk manager
  178  or his or her designee has received a report pursuant to
  179  paragraph (1)(d). The notification must be made in writing and
  180  be provided electronically, by facsimile device or overnight
  181  mail delivery. The notification must include information
  182  regarding the identity of the affected resident, the type of
  183  adverse incident, the initiation of an investigation by the
  184  facility, and whether the events causing or resulting in the
  185  adverse incident represent a potential risk to any other
  186  resident. The notification is confidential as provided by law
  187  and is not discoverable or admissible in any civil or
  188  administrative action, except in disciplinary proceedings by the
  189  Department of Health agency or the appropriate regulatory board.
  190  The agency may investigate, as it deems appropriate, any such
  191  incident and prescribe measures that must or may be taken in
  192  response to the incident. The Department of Health agency shall
  193  review each incident and determine whether it potentially
  194  involved conduct by the health care professional who is subject
  195  to disciplinary action, in which case the provisions of s.
  196  456.073 shall apply.
  197         (8)
  198         (b) A copy of the adverse incident report submitted The
  199  information reported to the agency pursuant to paragraph (a)
  200  which relates to health care practitioners as defined in s.
  201  456.001(4) shall be forwarded to the Division of Medical Quality
  202  Assurance within the Department of Health for review persons
  203  licensed under chapter 458, chapter 459, chapter 461, or chapter
  204  466 shall be reviewed by the agency. The agency shall determine
  205  whether any of the incidents potentially involved conduct by a
  206  health care professional who is subject to disciplinary action,
  207  in which case the provisions of s. 456.073 shall apply.
  208         Section 6. Subsections (1) through (7) of section 456.001,
  209  Florida Statutes, are renumbered as subsections (2) through (8),
  210  respectively, and a new subsection (1) is added to that section
  211  to read:
  212         456.001 Definitions.—As used in this chapter, the term:
  213         (1) “Application” means the documents required by the
  214  department to initiate the licensing process, including, but not
  215  limited to, the initial document filing and responses to
  216  requests from the department for additional data and
  217  information.
  218         Section 7. Subsection (3) of section 456.011, Florida
  219  Statutes, is amended to read:
  220         456.011 Boards; organization; meetings; compensation and
  221  travel expenses.—
  222         (3) The board shall meet at least once annually and may
  223  meet as often as is necessary. Meetings shall be conducted
  224  through teleconferencing or other technological means, unless
  225  disciplinary hearings involving standard of care, sexual
  226  misconduct, fraud, impairment, or felony convictions; licensure
  227  denial hearings; or controversial rule hearings are being
  228  conducted; or unless otherwise approved in advance of the
  229  meeting by the director of the Division of Medical Quality
  230  Assurance. The chairperson or a quorum of the board shall have
  231  the authority to call meetings, except as provided in this
  232  subsection above relating to in-person meetings. A quorum shall
  233  be necessary for the conduct of official business by the board
  234  or any committee thereof. Unless otherwise provided by law, 51
  235  percent or more of the appointed members of the board or any
  236  committee, when applicable, who have taken the oath of office
  237  pursuant to s. 5, Art. II of the State Constitution shall
  238  constitute a quorum. The membership of committees of the board,
  239  except as otherwise authorized pursuant to this chapter or the
  240  applicable practice act, shall be composed of currently
  241  appointed members of the board. The vote of a majority of the
  242  members of the quorum shall be necessary for any official action
  243  by the board or committee. Three consecutive unexcused absences
  244  or absences constituting 50 percent or more of the board’s
  245  meetings within any 12-month period shall cause the board
  246  membership of the member in question to become void, and the
  247  position shall be considered vacant. The board, or the
  248  department when there is no board, shall, by rule, define
  249  unexcused absences.
  250         Section 8. Subsections (3) through (12) of section 456.013,
  251  Florida Statutes, are renumbered as subsections (4) through
  252  (13), respectively, subsection (1) is amended, present
  253  subsection (2) is renumbered as subsection (3) and amended, and
  254  a new subsection (2) is added to that section, to read:
  255         456.013 Department; general licensing provisions.—
  256         (1)(a) Any person desiring to be licensed in a profession
  257  within the jurisdiction of the department shall apply to the
  258  department in writing to take the licensure examination. The
  259  application shall be made on a form prepared and furnished by
  260  the department. The application form must be available on the
  261  World Wide Web and the department may accept electronically
  262  submitted applications beginning July 1, 2001. A nonrefundable
  263  application fee established by the board, or the department when
  264  there is no board, shall be submitted with the application in an
  265  amount established by rule by the board, or the department when
  266  there is no board, to comply with s. 456.025. The application
  267  shall require the social security number of the applicant,
  268  except as provided in paragraph (b). The form shall be
  269  supplemented as needed to reflect any material change in any
  270  circumstance or condition stated in the application which takes
  271  place between the initial filing of the application and the
  272  final grant or denial of the license and which might affect the
  273  decision of the department. If an application is submitted
  274  electronically, the department may require supplemental
  275  materials, including an original signature of the applicant and
  276  verification of credentials, to be submitted in a nonelectronic
  277  format. An incomplete application shall expire 1 year after
  278  initial filing. In order to further the economic development
  279  goals of the state, and notwithstanding any law to the contrary,
  280  the department may enter into an agreement with the county tax
  281  collector for the purpose of appointing the county tax collector
  282  as the department’s agent to accept applications for licenses
  283  and applications for renewals of licenses. The agreement must
  284  specify the time within which the tax collector must forward any
  285  applications and accompanying application fees to the
  286  department.
  287         (b) If an applicant has not been issued a social security
  288  number by the Federal Government at the time of application
  289  because the applicant is not a citizen or resident of this
  290  country, the department may process the application using a
  291  unique personal identification number. If such an applicant is
  292  otherwise eligible for licensure, the board, or the department
  293  when there is no board, may issue to the applicant a temporary
  294  license, as established by rule of the board, or the department
  295  when there is no board to the applicant, which shall expire 90
  296  30 days after issuance unless a social security number is
  297  obtained and submitted in writing to the department. Upon
  298  receipt of the applicant’s social security number, the
  299  department shall issue a new license, which shall expire at the
  300  end of the current biennium.
  301         (c) The license shall be issued in the legal name of the
  302  applicant as reflected on the applicant’s birth certificate or
  303  United States passport. A request to change or issue a license
  304  under any other name must be supported by either a certified
  305  copy of a marriage license, a certified copy of an order of a
  306  United States federal or state court, or the applicant’s
  307  original naturalization certificate.
  308         (2) The board, or the department when there is no board,
  309  may adopt a rule allowing an applicant for licensure to complete
  310  the coursework requirements for licensure by successfully
  311  completing the required coursework as a student or by teaching
  312  the required coursework as an instructor or professor in an
  313  accredited institution.
  314         (3)(2) Before the issuance of any license, the department
  315  shall charge an initial license fee as determined by the
  316  applicable board or, if there is no board, by rule of the
  317  department. Upon receipt of the appropriate license fee, the
  318  department shall issue a license to any person certified by the
  319  appropriate board, or its designee, as having met the licensure
  320  requirements imposed by law or rule. The license shall consist
  321  of a wallet-size identification card and a wall card measuring 6
  322  1/2 inches by 5 inches. The licensee shall surrender to the
  323  department the wallet-size identification card and the wall card
  324  if the licensee’s license is issued in error or is revoked. The
  325  board, or the department when there is no board, may by rule
  326  require the display of a license.
  327         Section 9. Subsections (2) through (11) of section 456.025,
  328  Florida Statutes, are renumbered as subsections (3) through
  329  (12), respectively, present subsection (4) is amended, and new
  330  subsections (2) and (13) are added to that section, to read:
  331         456.025 Fees; receipts; disposition.—
  332         (2) Notwithstanding any other provision of law, when a
  333  profession is in a deficit, the board, or the department if
  334  there is no board, shall increase fees to satisfy the
  335  requirements of subsection (1).
  336         (5)(4) Each board, or the department if there is no board,
  337  may charge a fee not to exceed $25, as determined by rule, for
  338  the issuance of a wall certificate pursuant to s. 456.013(3)(2)
  339  requested by a licensee who was licensed prior to July 1, 1998,
  340  or for the issuance of a duplicate wall certificate requested by
  341  any licensee.
  342         (13) Each board, or the department if there is no board,
  343  may charge a fee as determined by rule for the reinspection of a
  344  business establishment prior to its licensure.
  345         Section 10. Subsections (14) and (15) of section 456.036,
  346  Florida Statutes, are renumbered as subsections (15) and (16),
  347  respectively, and a new subsection (14) is added to that section
  348  to read:
  349         456.036 Licenses; active and inactive status; delinquency.—
  350         (14) The department may not renew the license of a
  351  licensee, as defined in s. 456.001, who owes outstanding fees,
  352  costs, or fines to the department. The department shall notify
  353  each licensee who has failed to pay outstanding fees, costs, or
  354  fines at the licensee’s last known address of record with the
  355  department when issuing the license renewal notice required by
  356  s. 456.038. The department shall renew the license of any
  357  licensee when the outstanding fees, costs, or fines are paid if
  358  all other requirements for renewal are met.
  359         Section 11. Subsections (4) and (5) of section 456.037,
  360  Florida Statutes, are renumbered as subsections (5) and (6),
  361  respectively, and a new subsection (4) is added to that section
  362  to read:
  363         456.037 Business establishments; requirements for active
  364  status licenses; delinquency; discipline; applicability.—
  365         (4) The board, or the department if there is no board, may
  366  by rule require the display of a business establishment license.
  367         Section 12. Subsection (3) of section 456.063, Florida
  368  Statutes, is amended to read:
  369         456.063 Sexual misconduct; disqualification for license,
  370  certificate, or registration.—
  371         (3) Licensed health care practitioners shall report
  372  allegations of sexual misconduct to the department, regardless
  373  of the practice setting in which the alleged sexual misconduct
  374  occurred. Each board, or the department if there is no board,
  375  may adopt rules pursuant to ss. 120.536(1) and 120.54 to
  376  implement this subsection.
  377         Section 13. Paragraph (ii) is added to subsection (1) of
  378  section 456.072, Florida Statutes, to read:
  379         456.072 Grounds for discipline; penalties; enforcement.—
  380         (1) The following acts shall constitute grounds for which
  381  the disciplinary actions specified in subsection (2) may be
  382  taken:
  383         (ii) Failing to report to the board, or the department if
  384  there is no board, in writing, within 30 days after an action as
  385  provided in subsection (2) has been taken against a licensee’s
  386  license to practice any profession in this state or another
  387  state, territory, or jurisdiction.
  388         (2) When the board, or the department when there is no
  389  board, finds any person guilty of the grounds set forth in
  390  subsection (1) or of any grounds set forth in the applicable
  391  practice act, including conduct constituting a substantial
  392  violation of subsection (1) or a violation of the applicable
  393  practice act which occurred prior to obtaining a license, it may
  394  enter an order imposing one or more of the following penalties:
  395         (a) Refusal to certify, or to certify with restrictions, an
  396  application for a license.
  397         (b) Suspension or permanent revocation of a license.
  398         (c) Restriction of practice or license, including, but not
  399  limited to, restricting the licensee from practicing in certain
  400  settings, restricting the licensee to work only under designated
  401  conditions or in certain settings, restricting the licensee from
  402  performing or providing designated clinical and administrative
  403  services, restricting the licensee from practicing more than a
  404  designated number of hours, or any other restriction found to be
  405  necessary for the protection of the public health, safety, and
  406  welfare.
  407         (d) Imposition of an administrative fine not to exceed
  408  $10,000 for each count or separate offense. If the violation is
  409  for fraud or making a false or fraudulent representation, the
  410  board, or the department if there is no board, must impose a
  411  fine of $10,000 per count or offense.
  412         (e) Issuance of a reprimand or letter of concern.
  413         (f) Placement of the licensee on probation for a period of
  414  time and subject to such conditions as the board, or the
  415  department when there is no board, may specify. Those conditions
  416  may include, but are not limited to, requiring the licensee to
  417  undergo treatment, attend continuing education courses, submit
  418  to be reexamined, work under the supervision of another
  419  licensee, or satisfy any terms which are reasonably tailored to
  420  the violations found.
  421         (g) Corrective action.
  422         (h) Imposition of an administrative fine in accordance with
  423  s. 381.0261 for violations regarding patient rights.
  424         (i) Refund of fees billed and collected from the patient or
  425  a third party on behalf of the patient.
  426         (j) Requirement that the practitioner undergo remedial
  427  education.
  428  
  429  In determining what action is appropriate, the board, or
  430  department when there is no board, must first consider what
  431  sanctions are necessary to protect the public or to compensate
  432  the patient. Only after those sanctions have been imposed may
  433  the disciplining authority consider and include in the order
  434  requirements designed to rehabilitate the practitioner. All
  435  costs associated with compliance with orders issued under this
  436  subsection are the obligation of the practitioner.
  437         Section 14. Paragraph (a) of subsection (4) of section
  438  381.00593, Florida Statutes, is amended to read:
  439         381.00593 Public school volunteer health care practitioner
  440  program.—
  441         (4)(a) Notwithstanding any provision of chapter 458,
  442  chapter 459, chapter 460, chapter 461, chapter 463, part I of
  443  chapter 464, chapter 465, chapter 466, chapter 467, parts I and
  444  X of chapter 468, or chapter 486 to the contrary, any health
  445  care practitioner who participates in the program established in
  446  this section and thereby agrees to provide his or her services,
  447  without compensation, in a public school for at least 80 hours a
  448  year for each school year during the biennial licensure period,
  449  or, if the health care practitioner is retired, for at least 400
  450  hours a year for each school year during the licensure period,
  451  upon providing sufficient proof from the applicable school
  452  district that the health care practitioner has completed such
  453  hours at the time of license renewal under procedures specified
  454  by the Department of Health, shall be eligible for the
  455  following:
  456         1. Waiver of the biennial license renewal fee for an active
  457  license; and
  458         2. Fulfillment of a maximum of 25 percent of the continuing
  459  education hours required for license renewal under s.
  460  456.013(10)(9).
  461  
  462  The school district may establish a schedule for health care
  463  practitioners who participate in the program.
  464         Section 15. Subsection (1) of section 381.0303, Florida
  465  Statutes, is amended to read:
  466         381.0303 Special needs shelters.—
  467         (1) PURPOSE.—The purpose of this section is to provide for
  468  the operation and closure of special needs shelters and to
  469  designate the Department of Health, through its county health
  470  departments, as the lead agency for coordination of the
  471  recruitment of health care practitioners, as defined in s.
  472  456.001(5)(4), to staff special needs shelters in times of
  473  emergency or disaster and to provide resources to the department
  474  to carry out this responsibility. However, nothing in this
  475  section prohibits a county health department from entering into
  476  an agreement with a local emergency management agency to assume
  477  the lead responsibility for recruiting health care
  478  practitioners.
  479         Section 16. Subsection (3) of section 456.074, Florida
  480  Statutes, is amended to read:
  481         456.074 Certain health care practitioners; immediate
  482  suspension of license.—
  483         (3) The department may issue an emergency order suspending
  484  or restricting the license of any health care practitioner as
  485  defined in s. 456.001(5)(4) who tests positive for any drug on
  486  any government or private sector preemployment or employer
  487  ordered confirmed drug test, as defined in s. 112.0455, when the
  488  practitioner does not have a lawful prescription and legitimate
  489  medical reason for using such drug. The practitioner shall be
  490  given 48 hours from the time of notification to the practitioner
  491  of the confirmed test result to produce a lawful prescription
  492  for the drug before an emergency order is issued.
  493         Section 17. Paragraph (b) of subsection (2) of section
  494  456.41, Florida Statutes, is amended to read:
  495         456.41 Complementary or alternative health care
  496  treatments.—
  497         (2) DEFINITIONS.—As used in this section, the term:
  498         (b) “Health care practitioner” means any health care
  499  practitioner as defined in s. 456.001(5)(4).
  500         Section 18. Subsection (2) of section 468.703, Florida
  501  Statutes, is amended to read:
  502         468.703 Board of Athletic Training.—
  503         (2) Five members of the board must be licensed athletic
  504  trainers. One member of the board must be a physician licensed
  505  under chapter 458 or chapter 459. One member of the board must
  506  be a physician licensed under chapter 460. Two members of the
  507  board shall be consumer members, each of whom must be a resident
  508  of this state who has never worked as an athletic trainer, who
  509  has no financial interest in the practice of athletic training,
  510  and who has never been a licensed health care practitioner as
  511  defined in s. 456.001(5)(4).
  512         Section 19. Section 627.6474, Florida Statutes, is amended
  513  to read:
  514         627.6474 Provider contracts.—A health insurer shall not
  515  require a contracted health care practitioner as defined in s.
  516  456.001(5)(4) to accept the terms of other health care
  517  practitioner contracts with the insurer or any other insurer, or
  518  health maintenance organization, under common management and
  519  control with the insurer, including Medicare and Medicaid
  520  practitioner contracts and those authorized by s. 627.6471, s.
  521  627.6472, or s. 641.315, except for a practitioner in a group
  522  practice as defined in s. 456.053 who must accept the terms of a
  523  contract negotiated for the practitioner by the group, as a
  524  condition of continuation or renewal of the contract. Any
  525  contract provision that violates this section is void. A
  526  violation of this section is not subject to the criminal penalty
  527  specified in s. 624.15.
  528         Section 20. Subsection (10) of section 641.315, Florida
  529  Statutes, is amended to read:
  530         641.315 Provider contracts.—
  531         (10) A health maintenance organization shall not require a
  532  contracted health care practitioner as defined in s.
  533  456.001(5)(4) to accept the terms of other health care
  534  practitioner contracts with the health maintenance organization
  535  or any insurer, or other health maintenance organization, under
  536  common management and control with the health maintenance
  537  organization, including Medicare and Medicaid practitioner
  538  contracts and those authorized by s. 627.6471, s. 627.6472, or
  539  s. 641.315, except for a practitioner in a group practice as
  540  defined in s. 456.053 who must accept the terms of a contract
  541  negotiated for the practitioner by the group, as a condition of
  542  continuation or renewal of the contract. Any contract provision
  543  that violates this section is void. A violation of this section
  544  is not subject to the criminal penalty specified in s. 624.15.
  545         Section 21. Paragraph (a) of subsection (1) and subsection
  546  (4) of section 766.1016, Florida Statutes, are amended to read:
  547         766.1016 Patient safety data privilege.—
  548         (1) As used in this section, the term:
  549         (a) “Patient safety data” means reports made to patient
  550  safety organizations, including all health care data,
  551  interviews, memoranda, analyses, root cause analyses, products
  552  of quality assurance or quality improvement processes,
  553  corrective action plans, or information collected or created by
  554  a health care facility licensed under chapter 395, or a health
  555  care practitioner as defined in s. 456.001(5)(4), as a result of
  556  an occurrence related to the provision of health care services
  557  which exacerbates an existing medical condition or could result
  558  in injury, illness, or death.
  559         (4) The exchange of patient safety data among health care
  560  facilities licensed under chapter 395, or health care
  561  practitioners as defined in s. 456.001(5)(4), or patient safety
  562  organizations which does not identify any patient shall not
  563  constitute a waiver of any privilege established in this
  564  section.
  565         Section 22. Paragraph (b) of subsection (2) of section
  566  766.1116, Florida Statutes, is amended to read:
  567         766.1116 Health care practitioner; waiver of license
  568  renewal fees and continuing education requirements.—
  569         (2) Notwithstanding any provision of chapter 458, chapter
  570  459, chapter 460, chapter 461, part I of chapter 464, chapter
  571  466, or chapter 467 to the contrary, any health care
  572  practitioner who participates as a health care provider under s.
  573  766.1115 and thereby agrees with a governmental contractor to
  574  provide his or her services without compensation and as an agent
  575  of the governmental contractor to low-income recipients in
  576  accordance with s. 766.1115 for at least 80 hours a year for
  577  each year during the biennial licensure period, or, if the
  578  health care practitioner is retired, for at least 400 hours a
  579  year for each year during the licensure period, upon providing
  580  sufficient proof from the applicable governmental contractor
  581  that the health care practitioner has completed the hours at the
  582  time of license renewal under procedures specified by the
  583  Department of Health, shall be eligible for:
  584         (b) Fulfillment of a maximum of 25 percent of the
  585  continuing education hours required for license renewal under s.
  586  456.013(10)(9).
  587         Section 23. Paragraph (c) of subsection (2) of section
  588  768.13, Florida Statutes, is amended to read:
  589         768.13 Good Samaritan Act; immunity from civil liability.—
  590         (2)
  591         (c)1. Any health care practitioner as defined in s.
  592  456.001(5)(4) who is in a hospital attending to a patient of his
  593  or her practice or for business or personal reasons unrelated to
  594  direct patient care, and who voluntarily responds to provide
  595  care or treatment to a patient with whom at that time the
  596  practitioner does not have a then-existing health care patient
  597  practitioner relationship, and when such care or treatment is
  598  necessitated by a sudden or unexpected situation or by an
  599  occurrence that demands immediate medical attention, shall not
  600  be held liable for any civil damages as a result of any act or
  601  omission relative to that care or treatment, unless that care or
  602  treatment is proven to amount to conduct that is willful and
  603  wanton and would likely result in injury so as to affect the
  604  life or health of another.
  605         2. The immunity provided by this paragraph does not apply
  606  to damages as a result of any act or omission of providing
  607  medical care or treatment unrelated to the original situation
  608  that demanded immediate medical attention.
  609         3. For purposes of this paragraph, the Legislature’s intent
  610  is to encourage health care practitioners to provide necessary
  611  emergency care to all persons without fear of litigation as
  612  described in this paragraph.
  613         Section 24. Paragraph (a) of subsection (12) of section
  614  768.28, Florida Statutes, is amended to read:
  615         768.28 Waiver of sovereign immunity in tort actions;
  616  recovery limits; limitation on attorney fees; statute of
  617  limitations; exclusions; indemnification; risk management
  618  programs.—
  619         (12)(a) A health care practitioner, as defined in s.
  620  456.001(5)(4), who has contractually agreed to act as an agent
  621  of a state university board of trustees to provide medical
  622  services to a student athlete for participation in or as a
  623  result of intercollegiate athletics, to include team practices,
  624  training, and competitions, shall be considered an agent of the
  625  respective state university board of trustees, for the purposes
  626  of this section, while acting within the scope of and pursuant
  627  to guidelines established in that contract. The contracts shall
  628  provide for the indemnification of the state by the agent for
  629  any liabilities incurred up to the limits set out in this
  630  chapter.
  631         Section 25. This act shall take effect July 1, 2009.