Senate Bill 0994e1

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  1                      A bill to be entitled

  2         An act relating to physician licensure;

  3         amending ss. 458.347, 459.022, F.S.; providing

  4         for restricted or conditional licensure of

  5         physician assistants; creating s. 458.3135,

  6         F.S.; providing for the issuance of temporary

  7         certificates to foreign medical graduates

  8         studying at National Cancer

  9         Institute-designated cancer centers; requiring

10         a fee; amending s. 458.315, F.S.; waiving

11         application and licensure fees for physicians

12         obtaining a temporary certificate to practice

13         in areas of critical need when such practice is

14         limited to volunteer, uncompensated care for

15         low-income persons; amending ss. 458.345,

16         459.021, F.S.; providing for registration of

17         certain unlicensed physicians to practice at

18         teaching hospitals; providing rulemaking

19         authority; providing an effective date.

20

21  Be It Enacted by the Legislature of the State of Florida:

22

23         Section 1.  Section 458.3135, Florida Statutes, is

24  created to read:

25         (1)  The International Cancer Physician Visitor Program

26  is established at the National Cancer Institute-designated

27  cancer centers in the state for the purpose of providing

28  advanced education and training to internationally respected

29  and highly qualified international medical graduates on cancer

30  treatment techniques developed at the cancer center. Each

31  education and training course of study offered under this


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  1  section must be approved and certified to the board by a

  2  National Cancer Institute-designated cancer center.

  3         (2)  Physicians who wish to participate in the

  4  International Cancer Physician Visitor Program must obtain a

  5  temporary medical education certificate from the department.

  6  The department may annually issue 10 temporary medical

  7  education certificates to allow qualified international

  8  medical graduates to practice in conjunction with a course of

  9  study at each of the National Cancer Institute-designated

10  cancer centers in this state. The department shall issue a

11  temporary medical education certificate to an applicant that

12  the board certifies meets the following requirements:

13         (a)  Has been accepted by a National Cancer

14  Institute-designated cancer center to attend a course of study

15  certified to the board pursuant to subsection (1);

16         (b)  Pay an application fee of up to $300;

17         (c)  Possesses a valid and unencumbered license to

18  practice medicine in another country;

19         (d)  Is not under investigation for any act in this or

20  any other jurisdiction which would constitute the basis for

21  disciplining a physician under s. 458.331;

22         (e)  Has graduated from an accredited medical school or

23  its equivalent as provided in s. 458.311(1)(f) 1.a., or

24  graduated from a foreign medical school listed with the World

25  Health Organization; and

26         (f)  Meets the financial responsibility requirements of

27  s. 458.320.

28

29  An applicant may not be required to satisfy the practitioner

30  profile, background screening, and other requirements of ss.

31  455.565-455.5656. The temporary medical education certificate


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  1  permits a physician to practice medicine for the duration of a

  2  course of study certified to the board pursuant to subsection

  3  (1), but not exceeding 1 year. Such practice is limited to the

  4  facility owned or operated by the National Cancer

  5  Institute-designated cancer center and shall only be under the

  6  direct supervision of a Florida licensed physician who is a

  7  member of the National Cancer Institute-designated cancer

  8  center. A holder of a temporary medical education certificate

  9  is subject to discipline under chapters 455 and 458. Nothing

10  in this section is intended to enable a physician to qualify

11  for or otherwise engage in the practice of medicine in the

12  state, except as provided herein.

13         Section 2.  Paragraph (d) is added to subsection (9) of

14  section 458.347, Florida Statutes, to read:

15         458.347  Physician assistants.--

16         (9)  COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on

17  Physician Assistants is created within the department.

18         (d)  If the council finds that an applicant for

19  licensure has failed to meet each of the requirements for

20  licensure set forth in this section to the satisfaction of the

21  council, the council may enter an order to:

22         1.  Refuse to certify the applicant for licensure;

23         2.  Approve the applicant for licensure with

24  restrictions on the scope of practice or licensure; or

25         3.  Approve the applicant for conditional licensure.

26  Such conditions may include placement of the licensee on

27  probation for a period of time and conditions specified by the

28  council, including, but not limited to, requiring the licensee

29  to undergo treatment, to attend continuing education courses,

30  to work under the direct supervision of a physician licensed

31  in this state, or to take corrective action.


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  1         Section 3.  Paragraph (d) is added to subsection (9) of

  2  section 459.022, Florida Statutes, to read:

  3         459.022  Physician assistants.--

  4         (9)  COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on

  5  Physician Assistants is created within the department.

  6         (d)  If the council finds that an applicant for

  7  licensure has failed to meet each of the requirements for

  8  licensure set forth in this section to the satisfaction of the

  9  council, the council may enter an order to:

10         1.  Refuse to certify the applicant for licensure;

11         2.  Approve the applicant for licensure with

12  restrictions on the scope of practice or licensure; or

13         3.  Approve the applicant for conditional licensure.

14  Such conditions may include placement of the licensee on

15  probation for a period of time and conditions specified by the

16  council, including, but not limited to, requiring the licensee

17  to undergo treatment, to attend continuing education courses,

18  to work under the direct supervision of a physician licensed

19  in this state, or to take corrective action.

20         Section 4.  Subsection (5) is added to section 458.315,

21  Florida Statutes, to read:

22         458.315  Temporary certificate for practice in areas of

23  critical need.--Any physician who is licensed to practice in

24  any other state, whose license is currently valid, and who

25  pays an application fee of $300 may be issued a temporary

26  certificate to practice in communities of Florida where there

27  is a critical need for physicians.  A certificate may be

28  issued to a physician who will be employed by a county health

29  department, correctional facility, community health center

30  funded by s. 329, s. 330, or s. 340 of the United States

31  Public Health Services Act, or other entity that provides


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  1  health care to indigents and that is approved by the State

  2  Health Officer.  The Board of Medicine may issue this

  3  temporary certificate with the following restrictions:

  4         (5)  The application fee and all licensure fees,

  5  including neurological injury compensation assessments, shall

  6  be waived for those persons obtaining a temporary certificate

  7  to practice in areas of critical need for the purpose of

  8  providing volunteer, uncompensated care for low-income

  9  Floridians. The applicant must submit an affidavit from the

10  employing agency or institution stating that the physician

11  will not receive any compensation for any service involving

12  the practice of medicine.

13         Section 5.  Section 458.345, Florida Statutes, is

14  amended to read:

15         458.345  Registration of resident physicians, interns,

16  and fellows; list of hospital employees; prescribing of

17  medicinal drugs; penalty.--

18         (1)  Any person desiring to practice as a resident

19  physician, assistant resident physician, house physician,

20  intern, or fellow in fellowship training which leads to

21  subspecialty board certification in this state, or any person

22  desiring to practice as a resident physician, assistant

23  resident physician, house physician, intern, or fellow in

24  fellowship training in a teaching hospital as defined in s.

25  408.07(44) or s. 395.805(2), who does not hold a valid, active

26  license issued under this chapter shall apply to the

27  department to be registered and shall remit a fee not to

28  exceed $300 as set by the board.  The department shall

29  register any applicant the board certifies has met the

30  following requirements:

31         (a)  Is at least 21 years of age.


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  1         (b)  Has not committed any act or offense within or

  2  without the state which would constitute the basis for refusal

  3  to certify an application for licensure pursuant to s.

  4  458.331.

  5         (c)  Is a graduate of a medical school or college as

  6  specified in s. 458.311(1)(f).

  7         (2)  The board shall not certify to the department for

  8  registration any applicant who is under investigation in any

  9  state or jurisdiction for an act which would constitute the

10  basis for imposing a disciplinary penalty specified in s.

11  458.331(2)(b) until such time as the investigation is

12  completed, at which time the provisions of s. 458.331 shall

13  apply.

14         (3)  Every hospital or teaching hospital employing or

15  utilizing the services of a resident physician, assistant

16  resident physician, house physician, intern, or fellow in

17  fellowship training registered under this section which leads

18  to subspecialty board certification shall designate a person

19  who shall, on dates designated by the board, in consultation

20  with the department, furnish the department with a list of

21  such the hospital's employees and such other information as

22  the board may direct.  The chief executive officer of each

23  such hospital shall provide the executive director of the

24  board with the name, title, and address of the person

25  responsible for furnishing such reports.

26         (4)  Registration under this section shall

27  automatically expire after 2 years without further action by

28  the board or the department unless an application for renewal

29  is approved by the board.  No person registered under this

30  section may be employed or utilized as a house physician or

31  act as a resident physician, an assistant resident physician,


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  1  an intern, or a fellow in fellowship training which leads to a

  2  subspecialty board certification in a hospital or teaching

  3  hospital of this state for more than 2 years without a valid,

  4  active license or renewal of registration under this section.

  5  Requirements for renewal of registration shall be established

  6  by rule of the board.  An application fee not to exceed $300

  7  as set by the board shall accompany the application for

  8  renewal, except that resident physicians, assistant resident

  9  physicians, interns, and fellows in fellowship training

10  registered under this section are which leads to subspecialty

11  board certification shall be exempt from payment of any

12  renewal fees.

13         (5)  Notwithstanding any provision of this section or

14  s. 120.52 to the contrary, any person who is registered under

15  this section is subject to the provisions of s. 458.331.

16         (6)  A person registered as a resident physician under

17  this section may in the normal course of his or her employment

18  prescribe medicinal drugs described in schedules set out in

19  chapter 893 when:

20         (a)  The person prescribes such medicinal drugs through

21  use of a Drug Enforcement Administration number issued to the

22  hospital or teaching hospital by which the person is employed

23  or at which the person's services are used;

24         (b)  The person is identified by a discrete suffix to

25  the identification number issued to such the hospital; and

26         (c)  The use of the institutional identification number

27  and individual suffixes conforms to the requirements of the

28  federal Drug Enforcement Administration.

29         (7)  Any person willfully violating this section

30  commits a misdemeanor of the first degree, punishable as

31  provided in s. 775.082 or s. 775.083.


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  1         (8)  The board shall adopt rules to implement this

  2  section.

  3         Section 6.  Section 459.021, Florida Statutes, is

  4  amended to read:

  5         459.021  Registration of resident physicians, interns,

  6  and fellows; list of hospital employees; penalty.--

  7         (1)  Any person who holds a degree of Doctor of

  8  Osteopathic Medicine from a college of osteopathic medicine

  9  recognized and approved by the American Osteopathic

10  Association who desires to practice as a resident physician,

11  assistant resident physician, house physician, intern, or

12  fellow in fellowship training which leads to subspecialty

13  board certification in this state, or any person desiring to

14  practice as a resident physician, assistant resident

15  physician, house physician, intern, or fellow in fellowship

16  training in a teaching hospital in this state as defined in s.

17  408.07(44) or s. 395.805(2), who does not hold an active

18  license issued under this chapter shall apply to the

19  department to be registered, on an application provided by the

20  department, within 30 days of commencing such a training

21  program and shall remit a fee not to exceed $300 as set by the

22  board.

23         (2)  Any person required to be registered under this

24  section shall renew such registration annually.  Such

25  registration shall be terminated upon the registrant's receipt

26  of an active license issued under this chapter.  No person

27  shall be registered under this section for an aggregate of

28  more than 5 years, unless additional years are approved by the

29  board.

30         (3)  Every hospital or teaching hospital having

31  employed or contracted with or utilized the services of a


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  1  person who holds a degree of Doctor of Osteopathic Medicine

  2  from a college of osteopathic medicine recognized and approved

  3  by the American Osteopathic Association as a resident

  4  physician, assistant resident physician, house physician,

  5  intern, or fellow in fellowship training under this section

  6  which leads to subspecialty board certification shall

  7  designate a person who shall furnish, on dates designated by

  8  the board, in consultation with the department, to the

  9  department a list of all such persons who have served in such

10  the hospital during the preceding 6-month period. The chief

11  executive officer of each such hospital shall provide the

12  executive director of the board with the name, title, and

13  address of the person responsible for filing such reports.

14         (4)  The registration may be revoked or the department

15  may refuse to issue any registration for any cause which would

16  be a ground for its revocation or refusal to issue a license

17  to practice osteopathic medicine, as well as on the following

18  grounds:

19         (a)  Omission of the name of an intern, resident

20  physician, assistant resident physician, house physician, or

21  fellow in fellowship training from the list of employees

22  required by subsection (3) to be furnished to the department

23  by the hospital or teaching hospital served by the employee.

24         (b)  Practicing osteopathic medicine outside of a bona

25  fide hospital training program.

26         (5)  It is a misdemeanor of the second degree,

27  punishable as provided in s. 775.082 or s. 775.083 for any

28  hospital or teaching hospital, and also for the

29  superintendent, administrator, and other person or persons

30  having administrative authority in such a hospital:

31


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  1         (a)  To employ the services in such the hospital of any

  2  person listed in subsection (3), unless such person is

  3  registered with the department under the law or the holder of

  4  a license to practice osteopathic medicine under this chapter.

  5         (b)  To fail to furnish to the department the list and

  6  information required by subsection (3).

  7         (6)  Any person desiring registration pursuant to this

  8  section shall meet all the requirements of s. 459.0055.

  9         (7)  The board shall promulgate rules pursuant to ss.

10  120.536(1) and 120.54 as necessary to implement this section.

11         (8)  Notwithstanding any provision of this section or

12  s. 120.52 to the contrary, any person who is registered under

13  this section is subject to the provisions of s. 459.015.

14         (9)  A person registered as a resident physician under

15  this section may in the normal course of his or her employment

16  prescribe medicinal drugs described in schedules set out in

17  chapter 893 when:

18         (a)  The person prescribes such medicinal drugs through

19  use of a Drug Enforcement Administration number issued to the

20  hospital or teaching hospital by which the person is employed

21  or at which the person's services are used;

22         (b)  The person is identified by a discrete suffix to

23  the identification number issued to such the hospital; and

24         (c)  The use of the institutional identification number

25  and individual suffixes conforms to the requirements of the

26  federal Drug Enforcement Administration.

27         Section 7.  This act shall take effect upon becoming a

28  law.

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30

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