House Bill hb1867e2
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HB 1867, Second Engrossed
1 A bill to be entitled
2 An act relating to health care; providing
3 legislative intent and findings with respect to
4 the Medical Quality Assurance Trust Fund and
5 function administered by the Department of
6 Health; requiring the Auditor General to do a
7 followup Medical Quality Assurance audit and
8 issue a report to the Legislature; requiring
9 the Department of Health to reimburse the
10 Agency for Health Care Administration for
11 certain costs; requiring the Office of Program
12 Policy Analysis and Government Accountability
13 to study the feasibility of maintaining the
14 Medical Quality Assurance function within a
15 single department and issue a report to the
16 Legislature; amending s. 456.004, F.S.;
17 providing requirements for rules relating to
18 biennial renewal of licenses; amending s.
19 456.025, F.S.; revising requirements relating
20 to the setting and use of fees for the
21 regulation of health care professions and
22 practitioners, including continuing education
23 fees; providing for an electronic continuing
24 education tracking system; repealing s.
25 458.31151, F.S.; repealing obsolete provisions;
26 amending s. 457.107, F.S.; for clarification of
27 acupuncture fees; amending s. 483.807, F.S.;
28 relating to clinical laboratory personnel fees;
29 amending s. 456.011, F.S.; requiring board
30 meetings to be conducted through
31 teleconferencing or other technological means
1
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HB 1867, Second Engrossed
1 except under certain circumstances; amending s.
2 456.013, F.S.; requiring the department to
3 charge initial license fees; amending s.
4 456.017, F.S.; providing for administration of
5 national examinations and termination of
6 state-administered written examinations;
7 providing for administration of
8 state-administered practical or clinical
9 examinations if paid for in advance by the
10 examination candidates; providing legislative
11 intent with respect to the use of national
12 examinations; providing for electronic access
13 to and posting of examination scores under
14 certain conditions; providing for the sharing
15 of examinations or examination item banks with
16 certain entities; clarifying circumstances
17 under which candidates may bring a challenge;
18 providing for electronic administration of
19 certain laws and rules examinations; amending
20 s. 456.035, F.S.; providing for electronic
21 notification of a licensee's current mailing
22 address and place of practice; amending s.
23 456.073, F.S.; authorizing a letter of guidance
24 in lieu of a finding of probable cause under
25 certain conditions; amending s. 456.081, F.S.;
26 providing for the posting of newsletters on the
27 department's website; amending s. 766.301,
28 F.S.; providing additional and clarifying
29 legislative intent with respect to expenses and
30 awards for birth-related neurologically injured
31 infants; providing applicability and purpose;
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HB 1867, Second Engrossed
1 amending s. 766.31, F.S.; revising requirements
2 as to what constitutes actual expenses for
3 which compensation for birth-related
4 neurological injury may be awarded; increasing
5 the cap on periodic payments; authorizing
6 certain compensation for funeral expenses;
7 providing applicability and purpose; amending
8 s. 766.302, F.S.; revising the definition of
9 "birth-related neurological injury"; providing
10 applicability; revising and providing grounds
11 for discipline of licensees; revising and
12 providing disciplinary actions; amending s.
13 456.079, F.S.; requiring mitigating or
14 aggravating circumstances to be in the final
15 order to be considered in the imposition of
16 penalties; amending ss. 457.109, 458.320,
17 458.331, 458.345, 458.347, 459.0085, 459.015,
18 459.022, 460.413, 461.013, 462.14, 463.016,
19 464.018, 465.008, 465.016, 466.028, 466.037,
20 467.203, 468.1295, 468.1755, 468.217, 468.365,
21 468.518, 468.719, 468.811, 478.52, 480.046,
22 483.825, 483.901, 484.014, 484.056, 486.125,
23 490.009, and 491.009, F.S.; revising and
24 conforming provisions relating to disciplinary
25 grounds and penalties; repealing s. 483.827,
26 F.S., relating to penalties applicable to
27 clinical laboratories; amending s. 456.065,
28 F.S.; requiring the unlicensed activity fee to
29 be in addition to all other fees collected from
30 each licensee; amending ss. 458.347 and
31 459.022, F.S.; allowing authorized physician
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HB 1867, Second Engrossed
1 assistants to prescribe any medication not
2 listed on a formulary established by the
3 Council on Physician Assistants; allowing
4 authorized physician assistants to dispense
5 drug samples pursuant to proper prescription;
6 eliminating the formulary committee and
7 revising provisions relating to creation and
8 amendment of the formulary, to conform;
9 amending s. 456.003, F.S.; providing a
10 limitation on the duties of certain boards;
11 providing for the Agency for Health Care
12 Administration to create the Organ Transplant
13 Task Force to study organ transplantation
14 programs; requiring the task force to study and
15 make recommendations on the necessity of the
16 issuance of certificates of need for such
17 programs and funding for organ transplantation;
18 providing a date for the task force to report
19 to the Governor and the Legislature; amending
20 409.9205, F.S.; transferring positions in the
21 Medicaid Fraud Control Unit of the Department
22 of Legal Affairs to Career Services; amending
23 s. 483.245, F.S.; prohibiting rebate or
24 split-fee arrangements with dialysis facilities
25 for patient referrals to clinical laboratories;
26 providing penalties; amending s. 232.435, F.S.;
27 providing training requirements for a first
28 responder and teacher athletic trainer;
29 amending s. 383.14, F.S.; amending screening
30 requirements for postnatal screening; amending
31 s. 395.0197, F.S.; revising provisions relating
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HB 1867, Second Engrossed
1 to hospital and ambulatory surgical center
2 internal risk management programs; modifying
3 requirements for risk management and prevention
4 education and training; restricting
5 participation of unlicensed persons in surgical
6 procedures; requiring ongoing evaluation of
7 surgical procedures and protocols; eliminating
8 an annual report summarizing facility incident
9 reports and disciplinary actions; requiring the
10 Agency for Health Care Administration to
11 publish website summaries of adverse incident
12 reports; requiring facility reporting of
13 allegations of sexual misconduct by health care
14 practitioners; providing certain civil
15 liability for licensed risk managers;
16 prohibiting intimidation of a risk manager;
17 providing a penalty; amending s. 395.10972,
18 F.S.; increasing membership on the Health Care
19 Risk Management Advisory Council; amending s.
20 395.701, F.S.; limiting the financial
21 information the agency may require to determine
22 the amount of hospital annual assessments;
23 amending s. 409.905, F.S.; providing that the
24 Agency for Health Care Administration may
25 restrict the provision of mandatory services by
26 mobile providers; amending s. 409.906, F.S.;
27 providing that the agency may restrict or
28 prohibit the provision of services by mobile
29 providers; providing that Medicaid will not
30 provide reimbursement for dental services
31 provided in mobile dental units, except for
5
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HB 1867, Second Engrossed
1 certain units; amending s. 456.013, F.S.;
2 providing a professional continuing education
3 requirement relating to prevention of medical
4 errors; amending s. 456.057, F.S.; providing
5 for appointment of a records custodian under
6 certain circumstances; amending s. 456.063,
7 F.S.; requiring licensed health care
8 practitioners to report to the Department of
9 Health any allegations of sexual misconduct;
10 amending s. 456.072, F.S.; providing additional
11 grounds for disciplinary actions; clarifying a
12 penalty involving restriction of professional
13 practice or license; providing additional
14 penalties; requiring assessment of costs
15 related to investigation and prosecution;
16 amending s. 456.073, F.S.; requiring the
17 Department of Health to notify the patient or
18 legal representative of the status of a
19 disciplinary case; requiring the department to
20 provide certain information to the complainant;
21 providing time limitations on the filing of
22 administrative complaints against licensees of
23 the department; amending s. 456.074, F.S.;
24 providing for an emergency order suspending the
25 license of a practitioner for fraud; amending
26 s. 456.077, F.S.; specifying violations for
27 which the Department of Health or a regulatory
28 board may issue citations; amending s. 456.081,
29 F.S.; requiring the Department of Health and
30 regulatory boards to maintain a website
31 containing specified information; creating s.
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HB 1867, Second Engrossed
1 458.3147, F.S.; providing automatic admission
2 to any medical school in the State University
3 System for military academy students or
4 graduates who qualify for the Medical Corps of
5 the United States military; amending s.
6 458.315, F.S.; providing requirements for the
7 Board of Medicine in issuing temporary
8 certificates; amending ss. 458.331 and 459.015,
9 F.S.; conforming language and cross references
10 to changes made by the act; amending s. 641.51,
11 F.S.; revising adverse determination
12 provisions; amending ss. 465.019 and 465.0196,
13 F.S.; requiring institutional pharmacies and
14 special pharmacy permittees that use pharmacy
15 technicians to have a written policy and
16 procedures manual; directing the Department of
17 Health and the Agency for Health Care
18 Administration to review health care
19 practitioner and facility reporting
20 requirements; requiring a report to the
21 Legislature; amending s. 468.1755, F.S.;
22 providing an additional ground for disciplinary
23 action against a nursing home administrator;
24 reenacting ss. 468.1695(3) and 468.1735, F.S.,
25 to incorporate said amendment in references;
26 reenacting s. 484.056(1)(a), F.S., relating to
27 disciplinary action against hearing aid
28 specialists, to incorporate the amendment to s.
29 456.072(1), in a reference; amending s.
30 766.101, F.S.; providing that a continuous
31 quality improvement committee of a licensed
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HB 1867, Second Engrossed
1 pharmacy is a medical review committee for
2 purposes of immunity from liability, and
3 reenacting ss. 440.105(1)(a) and 626.989(6),
4 F.S., to incorporate said amendment in
5 references; amending s. 766.1115, F.S.;
6 conforming language and cross references to
7 changes made by the act; amending s. 456.047,
8 F.S.; providing intent; revising and providing
9 definitions; revising duties of the Department
10 of Health relating to file maintenance;
11 providing that primary source data verified by
12 the department or its designee may be relied
13 upon to meet accreditation purposes; amending
14 s. 232.61, F.S.; requiring the Florida High
15 School Activities Association to adopt bylaws
16 which require students participating in
17 interscholastic athletic competition or who are
18 candidates for an interscholastic athletic team
19 to satisfactorily pass a medical evaluation
20 prior to participating in interscholastic
21 athletic competition or engaging in practice
22 with an interscholastic athletic team;
23 providing requirements with respect to such
24 evaluation; amending s. 240.4075, F.S.;
25 transferring the Nursing Student Loan
26 Forgiveness Program from the Department of
27 Education to the Department of Health;
28 including public schools, family practice
29 teaching hospitals, and specialty hospitals for
30 children as eligible facilities under the
31 program; exempting such facilities from the
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HB 1867, Second Engrossed
1 fund-matching requirements of the program;
2 amending s. 240.4076, F.S.; transferring the
3 nursing scholarship program from the Department
4 of Education to the Department of Health;
5 providing requirements under the program for
6 students seeking to qualify for a nursing
7 faculty position and receive credit for work in
8 such a position; including nursing homes,
9 hospitals, public schools, colleges of nursing,
10 and community college nursing programs as
11 eligible facilities under the program;
12 transferring powers, duties, functions, rules,
13 records, personnel, property, and
14 appropriations and other funds relating to the
15 Nursing Student Loan Forgiveness Program and
16 the nursing scholarship program from the
17 Department of Education to the Department of
18 Health; amending s. 464.005, F.S.; providing
19 for future relocation of the headquarters of
20 the Board of Nursing; amending s. 464.008,
21 F.S.; revising education requirements for
22 licensure by examination; amending s. 464.009,
23 F.S.; revising requirements for licensure by
24 endorsement; requiring submission of
25 fingerprints for a criminal history check and a
26 fee to cover the costs of such check; providing
27 for an electronic applicant notification
28 process; creating s. 464.0195, F.S.; creating
29 the Florida Center for Nursing and providing
30 its goals; creating s. 464.0196, F.S.;
31 providing for a board of directors; providing
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HB 1867, Second Engrossed
1 for appointment of board members; providing for
2 staggered terms; providing powers and duties;
3 authorizing per diem and travel expenses;
4 creating s. 464.0197, F.S.; declaring state
5 budget support for the center; prohibiting the
6 Board of Nursing from developing any rule
7 relating to faculty/student clinical ratios
8 until a specified time; requiring the Board of
9 Nursing and the Department of Education to
10 submit to the Legislature an implementation
11 plan detailing the impact and cost of any such
12 proposed rule change; amending s. 464.0205,
13 F.S.; deleting the application and processing
14 fee for applicants for a retired volunteer
15 nurse certificate; requiring study by Office of
16 Program Policy Analysis and Government
17 Accountability of the feasibility of
18 maintaining all of Medical Quality Assurance in
19 one state agency; creating s. 456.0375, F.S.;
20 requiring registration of certain clinics;
21 providing requirements, including fees;
22 providing rulemaking authority; requiring
23 medical directors or clinic directors for such
24 clinics and providing their duties and
25 responsibilities; providing an appropriation;
26 amending s. 456.031, F.S.; providing an
27 alternative by which licensees under ch. 466,
28 F.S., relating to dentistry, may comply with a
29 general requirement that they take
30 domestic-violence education courses; amending
31 s. 456.033, F.S.; providing an alternative by
10
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HB 1867, Second Engrossed
1 which such licensees may comply with a general
2 requirement that they take AIDS/HIV education
3 courses; amending s. 627.419, F.S.; providing
4 for appeals from certain adverse determinations
5 relating to dental service claims; providing
6 applicability; amending s. 468.302, F.S.;
7 revising a provision relating to exemption from
8 certification to use radiation on human beings;
9 amending ss. 468.352, 468.355, 468.357,
10 468.358, and 468.359, F.S.; revising
11 definitions and provisions relating to
12 licensure and use of titles and abbreviations
13 to correct and conform terminology with respect
14 to respiratory therapists and respiratory care
15 practitioners; amending ss. 468.1155 and
16 468.1215, F.S.; revising requirements for
17 licensure to practice speech-language pathology
18 or audiology and for certification of
19 speech-language pathology or audiology
20 assistants; amending s. 480.033, F.S.;
21 correcting terminology in the definition of
22 "massage"; amending s. 484.002, F.S.; amending
23 and creating definitions; amending ss. 484.002,
24 484.006, 484.012, F.S.; replacing references to
25 the term "medical doctor" with the term
26 "allopathic or osteopathic physician"; amending
27 s. 484.015, F.S.; revising inspection
28 authority; amending s. 484.0445, F.S.; removing
29 certain provisions relating to the training
30 program for hearing aid specialists; amending
31 s. 484.045, F.S.; revising requirements for
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HB 1867, Second Engrossed
1 licensure as a hearing aid specialist by
2 examination; amending s. 490.012, F.S.;
3 prohibiting the use of certain titles or
4 descriptions relating to the practice of
5 psychology or school psychology unless properly
6 licensed; providing penalties; amending s.
7 490.014, F.S.; revising exemptions from
8 regulation under ch. 490, F.S., relating to
9 psychology; correcting a cross reference;
10 amending s. 491.012, F.S.; revising
11 prohibitions against unlicensed practice of
12 clinical social work, marriage and family
13 therapy, and mental health counseling to
14 provide that practice by registered interns is
15 lawful; amending s. 491.014, F.S.; revising
16 exemptions from licensure under ch. 491, F.S.,
17 relating to clinical, counseling, and
18 psychotherapy services, to prohibit the use by
19 certain employees of titles, names, or
20 descriptions protected by the chapter; amending
21 ss. 458.319, 459.008, and 765.102, F.S.;
22 conforming terminology relating to palliative
23 care; amending s. 765.101, F.S.; redefining the
24 term "end-stage condition" with respect to
25 health care advance directives; creating s.
26 765.1025, F.S.; prescribing the content and
27 suitability of palliative care; amending s.
28 765.1103, F.S.; revising provisions relating to
29 compliance with requests for pain management
30 and palliative care; amending s. 765.205, F.S.;
31 prescribing the standards of decisionmaking to
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HB 1867, Second Engrossed
1 be used in certain circumstances by health care
2 surrogates, persons who have durable powers of
3 attorney for health care, and proxy
4 decisionmakers; amending s. 765.401, F.S.;
5 prescribing the standards of decisionmaking to
6 be used in certain circumstances by proxy
7 decisionmakers; requiring the Department of
8 Health to conduct an interim study on specialty
9 certification and provide a report to the
10 Legislature; amending s. 499.012, F.S.;
11 authorizing transfer of prescription drugs
12 between a retail pharmacy and a Modified Class
13 II institutional pharmacy under a retail
14 pharmacy wholesaler's permit; providing
15 legislative intent; amending ss. 395.3025,
16 400.1415, and 456.057, F.S.; prohibiting the
17 use of a patient's medical records for purposes
18 of solicitation and marketing absent a specific
19 written release or authorization; providing
20 penalties; creating s. 626.9651, F.S.;
21 requiring the Department of Insurance to adopt
22 rules governing the use of a consumer's
23 nonpublic personal financial and health
24 information; providing standards for the rules;
25 amending s. 400.141, F.S.; prescribing duties
26 of nursing homes with respect to influenza and
27 pneumococcal polysaccharide vaccinations;
28 providing rulemaking authority; establishing
29 the Office of Community Partners within the
30 Department of Health to provide for delivery of
31 social services through eligible private
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HB 1867, Second Engrossed
1 organizations and programs; providing procedure
2 for transfer of general revenue funds to match
3 federal funds received by the office; creating
4 s. 627.6474, F.S.; prohibiting health insurers
5 from requiring certain contracted health care
6 practitioners to accept the terms of other
7 health care contracts as a condition of
8 continuation or renewal; providing exceptions;
9 amending s. 627.662, F.S.; applying this
10 prohibition to group health insurance, blanket
11 health insurance, and franchise health
12 insurance; amending s. 641.315, F.S.; applying
13 this prohibition to health maintenance
14 organizations; providing effective dates.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1. (1) Subsection (3) is added to section
19 766.301, Florida Statutes, to read:
20 766.301 Legislative findings and intent.--
21 (3) In order to maintain the actuarial soundness of
22 the compensation scheme for birth-related neurological
23 injuries as established in ss. 766.301-766.316, the
24 Legislature hereby clarifies its original intent with respect
25 to the distinction between the payment of actual expenses for
26 medical necessities, which is authorized in s. 766.31(1)(a),
27 and the award of up to $125,000 for the parents or legal
28 guardians of neurologically injured infants, which is
29 authorized in s. 766.31(1)(b). It has always been the intent
30 of the Legislature that the term "actual expenses," as used in
31 s. 766.31(1)(a), means only out-of-pocket, monetary
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HB 1867, Second Engrossed
1 expenditures for the professionally rendered care of a
2 neurologically injured infant, as opposed to payments for the
3 time spent by a parent or other family member in providing
4 care to an eligible infant, and that s. 766.31(1)(b) has been
5 and remains the exclusive source of funds for parents or legal
6 guardians irrespective of the time, activities, and services
7 they devote to the care and welfare of an eligible
8 neurologically injured infant.
9 (2)(a) The addition of subsection (3) to section
10 766.301, Florida Statutes, by this section shall take effect
11 upon this act becoming a law and shall apply to all claims
12 under the Florida Birth-Related Neurological Injury
13 Compensation Plan which date from the effective date of
14 chapter 88-1, Laws of Florida.
15 (b) The purpose of the addition of subsection (3) to
16 section 766.301, Florida Statutes, by this section is to
17 clarify legislative intent with respect to the term "actual
18 expenses" as used in paragraph (a) of subsection (1) of
19 section 766.31, Florida Statutes, and the term "award" as used
20 in paragraph (b) of subsection (1) of section 766.31, Florida
21 Statutes.
22 Section 2. (1) Paragraphs (a) and (b) of subsection
23 (1) of section 766.31, Florida Statutes, are amended to read:
24 766.31 Administrative law judge awards for
25 birth-related neurological injuries; notice of award.--
26 (1) Upon determining that an infant has sustained a
27 birth-related neurological injury and that obstetrical
28 services were delivered by a participating physician at the
29 birth, the administrative law judge shall make an award
30 providing compensation for the following items relative to
31 such injury:
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HB 1867, Second Engrossed
1 (a) Actual expenses for medically necessary and
2 reasonable medical and hospital costs for, habilitative and
3 training, nonfamilial residential, and custodial care and
4 service, for medically necessary drugs, special equipment, and
5 facilities, and for related travel. However, such expenses
6 shall not include:
7 1. Expenses for items or services that the infant has
8 received, or is entitled to receive, under the laws of any
9 state or the Federal Government, except to the extent such
10 exclusion may be prohibited by federal law.
11 2. Expenses for items or services that the infant has
12 received, or is contractually entitled to receive, from any
13 prepaid health plan, health maintenance organization, or other
14 private insuring entity.
15 3. Expenses for which the infant has received
16 reimbursement, or for which the infant is entitled to receive
17 reimbursement, under the laws of any state or the Federal
18 Government, except to the extent such exclusion may be
19 prohibited by federal law.
20 4. Expenses for which the infant has received
21 reimbursement, or for which the infant is contractually
22 entitled to receive reimbursement, pursuant to the provisions
23 of any health or sickness insurance policy or other private
24 insurance program.
25 5. Compensation for the time, services, or activities
26 performed by the parents or legal guardians of the infant.
27
28 Expenses included under this paragraph shall be limited to
29 reasonable charges prevailing in the same community for
30 similar treatment of injured persons when such treatment is
31 paid for by the injured person.
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HB 1867, Second Engrossed
1 (b) Periodic payments of an award to the parents or
2 legal guardians of the infant found to have sustained a
3 birth-related neurological injury, which award shall not
4 exceed $125,000 $100,000. However, at the discretion of the
5 administrative law judge, such award may be made in a lump
6 sum. An award made under this paragraph shall be the exclusive
7 source of funds from the plan to the parents or legal
8 guardians of an eligible neurologically injured infant, and
9 compensation shall not be provided under any other provision
10 of the plan for the time, services, or activities performed by
11 the parents or legal guardians of the infant.
12 (2)(a) The amendment of paragraphs (a) and (b) of
13 subsection (1) of section 766.31, Florida Statutes, by this
14 section shall take effect upon this act becoming a law and
15 shall apply to all claims under the Florida Birth-Related
16 Neurological Injury Compensation Plan which date from the
17 effective date of chapter 88-1, Laws of Florida.
18 (b) The purpose of the amendment of paragraphs (a) and
19 (b) of subsection (1) of section 766.31, Florida Statutes, by
20 this section is to clarify legislative intent with respect to
21 the term "actual expenses" as used in paragraph (a) of
22 subsection (1) of section 766.31, Florida Statutes, and the
23 term "award" as used in paragraph (a) of subsection (1) of
24 section 766.31, Florida Statutes.
25 Section 3. (1) Subsection (2) of section 766.302,
26 Florida Statutes, is amended to read:
27 766.302 Definitions; ss. 766.301-766.316.--As used in
28 ss. 766.301-766.316, the term:
29 (2) "Birth-related neurological injury" means injury
30 to the brain or spinal cord of a live infant weighing at least
31 2,500 grams at birth, in the case of a single gestation, or a
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HB 1867, Second Engrossed
1 live infant weighing at least 2,000 grams at birth, in the
2 case of a multiple gestation, caused by oxygen deprivation or
3 mechanical injury occurring in the course of labor, delivery,
4 or resuscitation in the immediate postdelivery period in a
5 hospital, which renders the infant permanently and
6 substantially mentally and physically impaired. This
7 definition shall apply to live births only and shall not
8 include disability or death caused by genetic or congenital
9 abnormality.
10 (2) The amendment of subsection (2) of section
11 766.302, Florida Statutes, by this section shall take effect
12 July 1, 2001, and shall apply to all births occurring on or
13 after that date.
14 Section 4. (1) Paragraph (b) of subsection (1) of
15 section 766.31, Florida Statutes, as amended by this act, is
16 amended to read:
17 766.31 Administrative law judge awards for
18 birth-related neurological injuries; notice of award.--
19 (1) Upon determining that an infant has sustained a
20 birth-related neurological injury and that obstetrical
21 services were delivered by a participating physician at the
22 birth, the administrative law judge shall make an award
23 providing compensation for the following items relative to
24 such injury:
25 (b)1. Periodic payments of an award to the parents or
26 legal guardians of the infant found to have sustained a
27 birth-related neurological injury, which award shall not
28 exceed $125,000. However, at the discretion of the
29 administrative law judge, such award may be made in a lump
30 sum. An award made under this paragraph shall be the exclusive
31 source of funds from the plan to the parents or legal
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HB 1867, Second Engrossed
1 guardians of an eligible neurologically injured infant, and
2 compensation shall not be provided under any other provision
3 of the plan for the time, services, or activities performed by
4 the parents or legal guardians of the infant.
5 2. Payment for funeral expenses not to exceed $1,500.
6 (2) The amendment of paragraph (b) of subsection (1)
7 of section 766.31, Florida Statutes, by this section shall
8 take effect July 1, 2001, and shall apply to all births
9 occurring on or after that date.
10 Section 5. It is the intent of the Legislature that
11 the Medical Quality Assurance Trust Fund should be
12 administered in a fiscally responsible manner. It is also the
13 intent of the Legislature that the Department of Health reduce
14 expenses wherever possible to ensure that the cost of
15 regulation is reasonable and fair and does not serve as a
16 barrier to licensure in this state. The Legislature adopts
17 findings 1, 2, 4, 5, and 8 and the recommendations of the
18 Auditor General's Medical Quality Assurance Operational Audit
19 Report Number 01-063. In addition, the Legislature adopts
20 recommendations 1, 2, 4, 5, and 7 of the Florida Senate
21 Committee on Fiscal Policy Interim Project Report 2001-016.
22 Section 6. The Auditor General shall conduct a
23 followup audit to the Medical Quality Assurance Operational
24 Audit Report Number 01-063 to determine if the Department of
25 Health has implemented the recommendations of that report. The
26 Auditor General shall complete the followup audit and issue a
27 report to the President of the Senate and the Speaker of the
28 House of Representatives no later than January 31, 2002.
29 Section 7. The contract between the Department of
30 Health and the Agency for Health Care Administration pursuant
31 to section 20.43(3), Florida Statutes, is not subject to the
19
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HB 1867, Second Engrossed
1 provisions of section 216.346, Florida Statutes. The
2 Department of Health shall reimburse the Agency for Health
3 Care Administration for the agency's actual direct costs and
4 the agency's indirect costs incurred as a result of the
5 contract, subject to appropriated funds. The agency shall
6 provide to the department documentation, explanation, and
7 justification of all direct and indirect costs incurred, by
8 budget entity.
9 Section 8. The Office of Program Policy Analysis and
10 Government Accountability shall study the feasibility of
11 maintaining the entire Medical Quality Assurance function,
12 including enforcement, within a single department. The study
13 shall be completed and a report issued to the President of the
14 Senate and the Speaker of the House of Representatives no
15 later than November 30, 2001.
16 Section 9. Subsection (1) of section 456.004, Florida
17 Statutes, is amended, and subsection (10) is added to that
18 section, to read:
19 456.004 Department; powers and duties.--The
20 department, for the professions under its jurisdiction, shall:
21 (1) Adopt rules establishing a procedure for the
22 biennial renewal of licenses; however, the department may
23 issue up to a 4-year license to selected licensees
24 notwithstanding any other provisions of law to the contrary.
25 The rules shall specify the expiration dates of licenses and
26 the process for tracking compliance with continuing education
27 requirements, financial responsibility requirements, and any
28 other conditions of renewal set forth in statute or rule. Fees
29 for such renewal shall not exceed the fee caps for individual
30 professions on an annualized basis as authorized by law.
31
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HB 1867, Second Engrossed
1 (10) Set an examination fee that includes all costs to
2 develop, purchase, validate, administer, and defend the
3 examination and is an amount certain to cover all
4 administrative costs plus the actual per-applicant cost of the
5 examination.
6 Section 10. Section 456.025, Florida Statutes, is
7 amended to read:
8 456.025 Fees; receipts; disposition.--
9 (1) It is the intent of the Legislature that all costs
10 of regulating health care professions and practitioners shall
11 be borne solely by licensees and licensure applicants. It is
12 also the intent of the Legislature that fees should be
13 reasonable and not serve as a barrier to licensure. Moreover,
14 it is the intent of the Legislature that the department
15 operate as efficiently as possible and regularly report to the
16 Legislature additional methods to streamline operational
17 costs. Therefore, the boards in consultation with the
18 department, or the department if there is no board, shall, by
19 rule, set renewal fees which:
20 (a) Shall be based on revenue projections prepared
21 using generally accepted accounting procedures;
22 (b) Shall be adequate to cover all expenses relating
23 to that board identified in the department's long-range policy
24 plan, as required by s. 456.005;
25 (c) Shall be reasonable, fair, and not serve as a
26 barrier to licensure;
27 (d) Shall be based on potential earnings from working
28 under the scope of the license;
29 (e) Shall be similar to fees imposed on similar
30 licensure types;
31
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HB 1867, Second Engrossed
1 (f) Shall not be more than 10 percent greater than the
2 fee imposed for the previous biennium;
3 (g) Shall not be more than 10 percent greater than the
4 actual cost to regulate that profession for the previous
5 biennium; and
6 (h) Shall be subject to challenge pursuant to chapter
7 120.
8 (2) The chairpersons of the boards and councils listed
9 in s. 20.43(3)(g) shall meet annually at division headquarters
10 to review the long-range policy plan required by s. 456.005
11 and current and proposed fee schedules. The chairpersons
12 shall make recommendations for any necessary statutory changes
13 relating to fees and fee caps. Such recommendations shall be
14 compiled by the Department of Health and be included in the
15 annual report to the Legislature required by s. 456.026 as
16 well as be included in the long-range policy plan required by
17 s. 456.005.
18 (2)(1) Each board within the jurisdiction of the
19 department, or the department when there is no board, shall
20 determine by rule the amount of license fees for the
21 profession it regulates, based upon long-range estimates
22 prepared by the department of the revenue required to
23 implement laws relating to the regulation of professions by
24 the department and the board. Each board, or the department
25 if there is no board, shall ensure that license fees are
26 adequate to cover all anticipated costs and to maintain a
27 reasonable cash balance, as determined by rule of the agency,
28 with advice of the applicable board. If sufficient action is
29 not taken by a board within 1 year after notification by the
30 department that license fees are projected to be inadequate,
31 the department shall set license fees on behalf of the
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HB 1867, Second Engrossed
1 applicable board to cover anticipated costs and to maintain
2 the required cash balance. The department shall include
3 recommended fee cap increases in its annual report to the
4 Legislature. Further, it is the legislative intent that no
5 regulated profession operate with a negative cash balance. The
6 department may provide by rule for advancing sufficient funds
7 to any profession operating with a negative cash balance. The
8 advancement may be for a period not to exceed 2 consecutive
9 years, and the regulated profession must pay interest.
10 Interest shall be calculated at the current rate earned on
11 investments of a trust fund used by the department to
12 implement this chapter. Interest earned shall be allocated to
13 the various funds in accordance with the allocation of
14 investment earnings during the period of the advance.
15 (3)(2) Each board, or the department if there is no
16 board, may charge a fee not to exceed $25, as determined by
17 rule, for the issuance of a wall certificate pursuant to s.
18 456.013(2) requested by a licensee who was licensed prior to
19 July 1, 1998, or for the issuance of a duplicate wall
20 certificate requested by any licensee.
21 (4)(3) Each board, or the department if there is no
22 board, may, by rule, assess and collect a one-time fee from
23 each active status licensee and each inactive status licensee
24 in an amount necessary to eliminate a cash deficit or, if
25 there is not a cash deficit, in an amount sufficient to
26 maintain the financial integrity of the professions as
27 required in this section. Not more than one such assessment
28 may be made in any 4-year period without specific legislative
29 authorization.
30 (5) If the cash balance of the trust fund at the end
31 of any fiscal year exceeds the total appropriation provided
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HB 1867, Second Engrossed
1 for the regulation of the health care professions in the prior
2 fiscal year, the boards, in consultation with the department,
3 may lower the license renewal fees.
4 (6)(4) Each board authorized to approve continuing
5 education providers, or the department if there is no board,
6 shall may establish, by rule, a fee not to exceed $250 for
7 anyone seeking approval to provide continuing education
8 courses or programs and shall may establish by rule a biennial
9 renewal fee not to exceed $250 for the renewal of providership
10 of such courses. The fees collected from continuing education
11 providers shall be used for the purposes of reviewing course
12 provider applications, monitoring the integrity of the courses
13 provided, covering legal expenses incurred as a result of not
14 granting or renewing a providership, and developing and
15 maintaining an electronic continuing education tracking
16 system. The department shall implement an electronic
17 continuing education tracking system for each new biennial
18 renewal cycle for which electronic renewals are implemented
19 after the effective date of this act and shall integrate such
20 system into the licensure and renewal system. All approved
21 continuing education providers shall provide information on
22 course attendance to the department necessary to implement the
23 electronic tracking system. The department shall, by rule,
24 specify the form and procedures by which the information is to
25 be submitted. This subsection does not apply to continuing
26 education courses or providers approved by the board under
27 chapter 465.
28 (7)(5) All moneys collected by the department from
29 fees or fines or from costs awarded to the agency by a court
30 shall be paid into a trust fund used by the department to
31 implement this chapter. The Legislature shall appropriate
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HB 1867, Second Engrossed
1 funds from this trust fund sufficient to carry out this
2 chapter and the provisions of law with respect to professions
3 regulated by the Division of Medical Quality Assurance within
4 the department and the boards. The department may contract
5 with public and private entities to receive and deposit
6 revenue pursuant to this section. The department shall
7 maintain separate accounts in the trust fund used by the
8 department to implement this chapter for every profession
9 within the department. To the maximum extent possible, the
10 department shall directly charge all expenses to the account
11 of each regulated profession. For the purpose of this
12 subsection, direct charge expenses include, but are not
13 limited to, costs for investigations, examinations, and legal
14 services. For expenses that cannot be charged directly, the
15 department shall provide for the proportionate allocation
16 among the accounts of expenses incurred by the department in
17 the performance of its duties with respect to each regulated
18 profession. The regulation by the department of professions,
19 as defined in this chapter, shall be financed solely from
20 revenue collected by it from fees and other charges and
21 deposited in the Medical Quality Assurance Trust Fund, and all
22 such revenue is hereby appropriated to the department.
23 However, it is legislative intent that each profession shall
24 operate within its anticipated fees. The department may not
25 expend funds from the account of a profession to pay for the
26 expenses incurred on behalf of another profession, except that
27 the Board of Nursing must pay for any costs incurred in the
28 regulation of certified nursing assistants. The department
29 shall maintain adequate records to support its allocation of
30 agency expenses. The department shall provide any board with
31 reasonable access to these records upon request. On or before
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HB 1867, Second Engrossed
1 October 1 of each year, the department shall provide each
2 board an annual report of revenue and direct and allocated
3 expenses related to the operation of that profession. The
4 board shall use these reports and the department's adopted
5 long-range plan to determine the amount of license fees. A
6 condensed version of this information, with the department's
7 recommendations, shall be included in the annual report to the
8 Legislature prepared under s. 456.026.
9 (8)(6) The department shall provide a condensed
10 management report of budgets, finances, performance
11 statistics, and recommendations to each board at least once a
12 quarter. The department shall identify and include in such
13 presentations any changes, or projected changes, made to the
14 board's budget since the last presentation.
15 (9)(7) If a duplicate license is required or requested
16 by the licensee, the board or, if there is no board, the
17 department may charge a fee as determined by rule not to
18 exceed $25 before issuance of the duplicate license.
19 (10)(8) The department or the appropriate board shall
20 charge a fee not to exceed $25 for the certification of a
21 public record. The fee shall be determined by rule of the
22 department. The department or the appropriate board shall
23 assess a fee for duplicating a public record as provided in s.
24 119.07(1)(a) and (b).
25 Section 11. Subsection (1) of section 457.107, Florida
26 Statutes, is amended to read:
27 457.107 Renewal of licenses; continuing education.--
28 (1) The department shall renew a license upon receipt
29 of the renewal application and the required fee set by the
30 board by rule, not to exceed $500.
31
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HB 1867, Second Engrossed
1 Section 12. Section 458.31151, Florida Statutes, is
2 repealed.
3 Section 13. Subsection (1) of section 483.807, Florida
4 Statutes, is amended to read:
5 483.807 Fees; establishment; disposition.--
6 (1) The board, by rule, shall establish fees to be
7 paid for application, examination, reexamination, licensing
8 and renewal, registration, laboratory training program
9 application, reinstatement, and recordmaking and
10 recordkeeping. The board may also establish, by rule, a
11 delinquency fee. The board shall establish fees that are
12 adequate to ensure the continued operation of the board and to
13 fund the proportionate expenses incurred by the department in
14 carrying out its licensure and other related responsibilities
15 under this part. Fees shall be based on departmental estimates
16 of the revenue required to implement this part and the
17 provisions of law with respect to the regulation of clinical
18 laboratory personnel.
19 Section 14. Subsections (1), (3), and (4) of section
20 456.011, Florida Statutes, are amended to read:
21 456.011 Boards; organization; meetings; compensation
22 and travel expenses.--
23 (1) Each board within the department shall comply with
24 the provisions of this chapter section.
25 (3) The board shall meet at least once annually and
26 may meet as often as is necessary. Meetings shall be conducted
27 through teleconferencing or other technological means, unless
28 disciplinary hearings involving standard of care, sexual
29 misconduct, fraud, impairment, or felony convictions;
30 licensure denial hearings; or controversial rule hearings are
31 being conducted; or unless otherwise approved in advance of
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HB 1867, Second Engrossed
1 the meeting by the director of the Division of Medical Quality
2 Assurance. The chairperson or a quorum of the board shall have
3 the authority to call other meetings, except as provided above
4 relating to in-person meetings. A quorum shall be necessary
5 for the conduct of official business by the board or any
6 committee thereof. Unless otherwise provided by law, 51
7 percent or more of the appointed members of the board or any
8 committee, when applicable, shall constitute a quorum. The
9 membership of committees of the board, except as otherwise
10 authorized pursuant to this chapter or the applicable practice
11 act, shall be composed of currently appointed members of the
12 board. The vote of a majority of the members of the quorum
13 shall be necessary for any official action by the board or
14 committee. Three consecutive unexcused absences or absences
15 constituting 50 percent or more of the board's meetings within
16 any 12-month period shall cause the board membership of the
17 member in question to become void, and the position shall be
18 considered vacant. The board, or the department when there is
19 no board, shall, by rule, define unexcused absences.
20 (4) Unless otherwise provided by law, a board member
21 or former board member serving on a probable cause panel shall
22 be compensated $50 for each day in attendance at an official
23 meeting of the board and for each day of participation in any
24 other business involving the board. Each board shall adopt
25 rules defining the phrase "other business involving the
26 board," but the phrase may not routinely be defined to include
27 telephone conference calls that last less than 4 hours. A
28 board member also shall be entitled to reimbursement for
29 expenses pursuant to s. 112.061. Travel out of state shall
30 require the prior approval of the secretary.
31
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HB 1867, Second Engrossed
1 Section 15. Subsection (2) of section 456.013, Florida
2 Statutes, is amended to read:
3 456.013 Department; general licensing provisions.--
4 (2) Before the issuance of any license, the department
5 shall may charge an initial license fee as determined by rule
6 of the applicable board or, if no such board exists, by rule
7 of the department. Upon receipt of the appropriate license
8 fee, the department shall issue a license to any person
9 certified by the appropriate board, or its designee, as having
10 met the licensure requirements imposed by law or rule. The
11 license shall consist of a wallet-size identification card and
12 a wall card measuring 6 1/2 inches by 5 inches. In addition
13 to the two-part license, the department, at the time of
14 initial licensure, shall issue a wall certificate suitable for
15 conspicuous display, which shall be no smaller than 8 1/2
16 inches by 14 inches. The licensee shall surrender to the
17 department the wallet-size identification card, the wall card,
18 and the wall certificate, if one has been issued by the
19 department, if the licensee's license is revoked.
20 Section 16. Section 456.017, Florida Statutes, is
21 amended to read:
22 456.017 Department of Health; examinations.--
23 (1)(a) The department shall provide, contract, or
24 approve services for the development, preparation,
25 administration, scoring, score reporting, and evaluation of
26 all examinations, in consultation with the appropriate board.
27 The department shall certify that examinations developed and
28 approved by the department adequately and reliably measure an
29 applicant's ability to practice the profession regulated by
30 the department. After an examination developed or approved by
31 the department has been administered, the board, or the
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HB 1867, Second Engrossed
1 department when there is no board, may reject any question
2 which does not reliably measure the general areas of
3 competency specified in the rules of the board. The department
4 may contract for the preparation, administration, scoring,
5 score reporting, and evaluation of examinations, when such
6 services are available and approved by the board.
7 (b) For each examination developed by the department
8 or contracted vendor, to the extent not otherwise specified by
9 statute, the board, or the department when there is no board,
10 shall by rule specify the general areas of competency to be
11 covered by each examination, the relative weight to be
12 assigned in grading each area tested, and the score necessary
13 to achieve a passing grade. The department shall assess, and
14 fees, where applicable, to cover the actual cost for any
15 purchase, development, validation, and administration, and
16 defense of required examinations. This subsection does not
17 apply to national examinations approved and administered
18 pursuant to paragraph (c). If a practical examination is
19 deemed to be necessary, the rules shall specify the criteria
20 by which examiners are to be selected, the grading criteria to
21 be used by the examiner, the relative weight to be assigned in
22 grading each criterion, and the score necessary to achieve a
23 passing grade. When a mandatory standardization exercise for a
24 practical examination is required by law, the board, or the
25 department when there is no board, may conduct such exercise.
26 Therefore, board members, or employees of the department when
27 there is no board, may serve as examiners at a practical
28 examination with the consent of the board or department, as
29 appropriate.
30 (c)1. The board, or the department when there is no
31 board, shall may approve by rule the use of one or more any
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HB 1867, Second Engrossed
1 national examinations examination which the department has
2 certified as meeting requirements of national examinations and
3 generally accepted testing standards pursuant to department
4 rules. Providers of examinations seeking certification by the
5 department shall pay the actual costs incurred by the
6 department in making a determination regarding the
7 certification. The name and number of a candidate may be
8 provided to a national contractor for the limited purpose of
9 preparing the grade tape and information to be returned to the
10 board or department; or, to the extent otherwise specified by
11 rule, the candidate may apply directly to the vendor of the
12 national examination and supply test score information to the
13 department. The department may delegate to the board the duty
14 to provide and administer the examination. Any national
15 examination approved by a board, or the department when there
16 is no board, prior to October 1, 1997, is deemed certified
17 under this paragraph.
18 2. The board, or the department when there is no
19 board, shall approve and begin administering a national
20 examination no later than December 31, 2001. Neither the board
21 nor the department may administer a state-developed written
22 examination after December 31, 2001, notwithstanding any other
23 provision of law. The examination may be administered
24 electronically if adequate security measures are used, as
25 determined by rule of the department.
26 3. The board, or the department when there is no
27 board, may administer a state-developed practical or clinical
28 examination, as required by the applicable practice act, if
29 all costs of development, purchase, validation,
30 administration, review, and defense are paid by the
31 examination candidate prior to the administration of the
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HB 1867, Second Engrossed
1 examination. If a national practical or clinical examination
2 is available and certified by the department pursuant to this
3 section, the board, or the department when there is no board,
4 may administer the national examination.
5 4. It is the intent of the Legislature to reduce the
6 costs associated with state examinations and to encourage the
7 use of national examinations whenever possible.
8 (d) Each board, or the department when there is no
9 board, shall adopt rules regarding the security and monitoring
10 of examinations. The department shall implement those rules
11 adopted by the respective boards. In order to maintain the
12 security of examinations, the department may employ the
13 procedures set forth in s. 456.065 to seek fines and
14 injunctive relief against an examinee who violates the
15 provisions of s. 456.018 or the rules adopted pursuant to this
16 paragraph. The department, or any agent thereof, may, for the
17 purposes of investigation, confiscate any written,
18 photographic, or recording material or device in the
19 possession of the examinee at the examination site which the
20 department deems necessary to enforce such provisions or
21 rules. The scores of candidates who have taken state-developed
22 examinations shall be provided to the candidates
23 electronically using a candidate identification number, and
24 the department shall post the aggregate scores on the
25 department's website without identifying the names of the
26 candidates.
27 (e) If the professional board with jurisdiction over
28 an examination concurs, the department may, for a fee, share
29 with any other state's licensing authority or a national
30 testing entity an examination or examination item bank
31 developed by or for the department unless prohibited by a
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HB 1867, Second Engrossed
1 contract entered into by the department for development or
2 purchase of the examination. The department, with the
3 concurrence of the appropriate board, shall establish
4 guidelines that ensure security of a shared exam and shall
5 require that any other state's licensing authority comply with
6 those guidelines. Those guidelines shall be approved by the
7 appropriate professional board. All fees paid by the user
8 shall be applied to the department's examination and
9 development program for professions regulated by this chapter.
10 (f) The department may adopt rules necessary to
11 administer this subsection.
12 (2) For each examination developed by the department
13 or a contracted vendor, the board, or the department when
14 there is no board, shall adopt rules providing for
15 reexamination of any applicants who failed an examination
16 developed by the department or a contracted vendor. If both a
17 written and a practical examination are given, an applicant
18 shall be required to retake only the portion of the
19 examination on which the applicant failed to achieve a passing
20 grade, if the applicant successfully passes that portion
21 within a reasonable time, as determined by rule of the board,
22 or the department when there is no board, of passing the other
23 portion. Except for national examinations approved and
24 administered pursuant to this section, the department shall
25 provide procedures for applicants who fail an examination
26 developed by the department or a contracted vendor to review
27 their examination questions, answers, papers, grades, and
28 grading key for the questions the candidate answered
29 incorrectly or, if not feasible, the parts of the examination
30 failed. Applicants shall bear the actual cost for the
31 department to provide examination review pursuant to this
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HB 1867, Second Engrossed
1 subsection. An applicant may waive in writing the
2 confidentiality of the applicant's examination grades.
3 Notwithstanding any other provision of law, only candidates
4 who fail an examination by less than 10 percent shall be
5 entitled to challenge the validity of the examination at
6 hearing.
7 (3) For each examination developed or administered by
8 the department or a contracted vendor, an accurate record of
9 each applicant's examination questions, answers, papers,
10 grades, and grading key shall be kept for a period of not less
11 than 2 years immediately following the examination, and such
12 record shall thereafter be maintained or destroyed as provided
13 in chapters 119 and 257. This subsection does not apply to
14 national examinations approved and administered pursuant to
15 this section.
16 (4) Meetings of any member of the department or of any
17 board within the department held for the exclusive purpose of
18 creating or reviewing licensure examination questions or
19 proposed examination questions are exempt from the provisions
20 of s. 286.011 and s. 24(b), Art. I of the State Constitution.
21 Any public records, such as tape recordings, minutes, or
22 notes, generated during or as a result of such meetings are
23 confidential and exempt from the provisions of s. 119.07(1)
24 and s. 24(a), Art. I of the State Constitution. However, these
25 exemptions shall not affect the right of any person to review
26 an examination as provided in subsection (2).
27 (5) For examinations developed by the department or a
28 contracted vendor, each board, or the department when there is
29 no board, may provide licensure examinations in an applicant's
30 native language. Notwithstanding any other provision of law,
31 applicants for examination or reexamination pursuant to this
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HB 1867, Second Engrossed
1 subsection shall bear the full cost for the department's
2 development, preparation, validation, administration, grading,
3 and evaluation of any examination in a language other than
4 English prior to the examination being administered. Requests
5 for translated examinations must be on file in the board
6 office at least 6 months prior to the scheduled examination.
7 When determining whether it is in the public interest to allow
8 the examination to be translated into a language other than
9 English, the board shall consider the percentage of the
10 population who speak the applicant's native language.
11 Applicants must apply for translation to the applicable board
12 at least 6 months prior to the scheduled examination.
13 (6) In addition to meeting any other requirements for
14 licensure by examination or by endorsement, and
15 notwithstanding the provisions in paragraph (1)(c), an
16 applicant may be required by a board, or the department when
17 there is no board, to certify competency in state laws and
18 rules relating to the applicable practice act. Beginning
19 October 1, 2001, all laws and rules examinations shall be
20 administered electronically unless the laws and rules
21 examination is administered concurrently with another written
22 examination for that profession or unless the electronic
23 administration would be substantially more expensive.
24 Section 17. Subsection (1) of section 456.035, Florida
25 Statutes, is amended to read:
26 456.035 Address of record.--
27 (1) Each licensee of the department is solely
28 responsible for notifying the department in writing of the
29 licensee's current mailing address and place of practice, as
30 defined by rule of the board or the department if there is no
31 board. Electronic notification shall be allowed by the
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HB 1867, Second Engrossed
1 department; however, it shall be the responsibility of the
2 licensee to ensure that the electronic notification was
3 received by the department. A licensee's failure to notify the
4 department of a change of address constitutes a violation of
5 this section, and the licensee may be disciplined by the board
6 or the department if there is no board.
7 Section 18. Subsections (2), (4), and (10) of section
8 456.073, Florida Statutes, are amended to read:
9 456.073 Disciplinary proceedings.--Disciplinary
10 proceedings for each board shall be within the jurisdiction of
11 the department.
12 (2) The department shall allocate sufficient and
13 adequately trained staff to expeditiously and thoroughly
14 determine legal sufficiency and investigate all legally
15 sufficient complaints. For purposes of this section, it is the
16 intent of the Legislature that the term "expeditiously" means
17 that the department complete the report of its initial
18 investigative findings and recommendations concerning the
19 existence of probable cause within 6 months after its receipt
20 of the complaint. The failure of the department, for
21 disciplinary cases under its jurisdiction, to comply with the
22 time limits of this section while investigating a complaint
23 against a licensee constitutes harmless error in any
24 subsequent disciplinary action unless a court finds that
25 either the fairness of the proceeding or the correctness of
26 the action may have been impaired by a material error in
27 procedure or a failure to follow prescribed procedure. When
28 its investigation is complete and legally sufficient, the
29 department shall prepare and submit to the probable cause
30 panel of the appropriate regulatory board the investigative
31 report of the department. The report shall contain the
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HB 1867, Second Engrossed
1 investigative findings and the recommendations of the
2 department concerning the existence of probable cause. The
3 department shall not recommend a letter of guidance in lieu of
4 finding probable cause if the subject has already been issued
5 a letter of guidance for a related offense. At any time after
6 legal sufficiency is found, the department may dismiss any
7 case, or any part thereof, if the department determines that
8 there is insufficient evidence to support the prosecution of
9 allegations contained therein. The department shall provide a
10 detailed report to the appropriate probable cause panel prior
11 to dismissal of any case or part thereof, and to the subject
12 of the complaint after dismissal of any case or part thereof,
13 under this section. For cases dismissed prior to a finding of
14 probable cause, such report is confidential and exempt from s.
15 119.07(1). The probable cause panel shall have access, upon
16 request, to the investigative files pertaining to a case prior
17 to dismissal of such case. If the department dismisses a case,
18 the probable cause panel may retain independent legal counsel,
19 employ investigators, and continue the investigation and
20 prosecution of the case as it deems necessary.
21 (4) The determination as to whether probable cause
22 exists shall be made by majority vote of a probable cause
23 panel of the board, or by the department, as appropriate. Each
24 regulatory board shall provide by rule that the determination
25 of probable cause shall be made by a panel of its members or
26 by the department. Each board may provide by rule for multiple
27 probable cause panels composed of at least two members. Each
28 board may provide by rule that one or more members of the
29 panel or panels may be a former board member. The length of
30 term or repetition of service of any such former board member
31 on a probable cause panel may vary according to the direction
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HB 1867, Second Engrossed
1 of the board when authorized by board rule. Any probable cause
2 panel must include one of the board's former or present
3 consumer members, if one is available, is willing to serve,
4 and is authorized to do so by the board chair. Any probable
5 cause panel must include a present board member. Any probable
6 cause panel must include a former or present professional
7 board member. However, any former professional board member
8 serving on the probable cause panel must hold an active valid
9 license for that profession. All proceedings of the panel are
10 exempt from s. 286.011 until 10 days after probable cause has
11 been found to exist by the panel or until the subject of the
12 investigation waives his or her privilege of confidentiality.
13 The probable cause panel may make a reasonable request, and
14 upon such request the department shall provide such additional
15 investigative information as is necessary to the determination
16 of probable cause. A request for additional investigative
17 information shall be made within 15 days from the date of
18 receipt by the probable cause panel of the investigative
19 report of the department or the agency. The probable cause
20 panel or the department, as may be appropriate, shall make its
21 determination of probable cause within 30 days after receipt
22 by it of the final investigative report of the department. The
23 secretary may grant extensions of the 15-day and the 30-day
24 time limits. In lieu of a finding of probable cause, the
25 probable cause panel, or the department if there is no board,
26 may issue a letter of guidance to the subject. If, within the
27 30-day time limit, as may be extended, the probable cause
28 panel does not make a determination regarding the existence of
29 probable cause or does not issue a letter of guidance in lieu
30 of a finding of probable cause, the department must make a
31 determination regarding the existence of probable cause within
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1 10 days after the expiration of the time limit. If the
2 probable cause panel finds that probable cause exists, it
3 shall direct the department to file a formal complaint against
4 the licensee. The department shall follow the directions of
5 the probable cause panel regarding the filing of a formal
6 complaint. If directed to do so, the department shall file a
7 formal complaint against the subject of the investigation and
8 prosecute that complaint pursuant to chapter 120. However, the
9 department may decide not to prosecute the complaint if it
10 finds that probable cause has been improvidently found by the
11 panel. In such cases, the department shall refer the matter to
12 the board. The board may then file a formal complaint and
13 prosecute the complaint pursuant to chapter 120. The
14 department shall also refer to the board any investigation or
15 disciplinary proceeding not before the Division of
16 Administrative Hearings pursuant to chapter 120 or otherwise
17 completed by the department within 1 year after the filing of
18 a complaint. The department, for disciplinary cases under its
19 jurisdiction, must establish a uniform reporting system to
20 quarterly refer to each board the status of any investigation
21 or disciplinary proceeding that is not before the Division of
22 Administrative Hearings or otherwise completed by the
23 department within 1 year after the filing of the complaint.
24 Annually, the department, in consultation with the applicable
25 probable cause panel, if there is no board, or each board must
26 establish a plan to expedite reduce or otherwise close any
27 investigation or disciplinary proceeding that is not before
28 the Division of Administrative Hearings or otherwise completed
29 by the department within 1 year after the filing of the
30 complaint. A probable cause panel or a board may retain
31 independent legal counsel, employ investigators, and continue
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HB 1867, Second Engrossed
1 the investigation as it deems necessary; all costs thereof
2 shall be paid from a trust fund used by the department to
3 implement this chapter. All proceedings of the probable cause
4 panel are exempt from s. 120.525.
5 (10) The complaint and all information obtained
6 pursuant to the investigation by the department are
7 confidential and exempt from s. 119.07(1) until 10 days after
8 probable cause has been found to exist by the probable cause
9 panel or by the department, or until the regulated
10 professional or subject of the investigation waives his or her
11 privilege of confidentiality, whichever occurs first. Upon
12 completion of the investigation and a recommendation by the
13 department to find probable cause, and pursuant to a written
14 request by the subject or the subject's attorney, the
15 department shall provide the subject an opportunity to inspect
16 the investigative file or, at the subject's expense, forward
17 to the subject a copy of the investigative file.
18 Notwithstanding s. 456.057, the subject may inspect or receive
19 a copy of any expert witness report or patient record
20 connected with the investigation if the subject agrees in
21 writing to maintain the confidentiality of any information
22 received under this subsection until 10 days after probable
23 cause is found and to maintain the confidentiality of patient
24 records pursuant to s. 456.057. The subject may file a written
25 response to the information contained in the investigative
26 file. Such response must be filed within 20 days of mailing by
27 the department, unless an extension of time has been granted
28 by the department. This subsection does not prohibit the
29 department from providing such information to any law
30 enforcement agency or to any other regulatory agency.
31
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HB 1867, Second Engrossed
1 Section 19. Section 456.081, Florida Statutes, is
2 amended to read:
3 456.081 Publication of information.--The department
4 and the boards shall have the authority to advise licensees
5 periodically, through the publication of a newsletter on the
6 department's website, about information that the department or
7 the board determines is of interest to the industry. Unless
8 otherwise prohibited by law, the department and the boards
9 shall publish a summary of final orders resulting in
10 disciplinary action fines, suspensions, or revocations, and
11 any other information the department or the board determines
12 is of interest to the public.
13 Section 20. Subsection (3) of section 456.079, Florida
14 Statutes, is amended to read:
15 456.079 Disciplinary guidelines.--
16 (3) A specific finding in the final order of
17 mitigating or aggravating circumstances shall allow the board
18 to impose a penalty other than that provided for in such
19 guidelines. If applicable, the board, or the department if
20 there is no board, shall adopt by rule disciplinary guidelines
21 to designate possible mitigating and aggravating circumstances
22 and the variation and range of penalties permitted for such
23 circumstances.
24 Section 21. Subsections (1) and (2) of section
25 457.109, Florida Statutes, are amended to read:
26 457.109 Disciplinary actions; grounds; action by the
27 board.--
28 (1) The following acts shall constitute grounds for
29 denial of a license or disciplinary action, as specified in s.
30 456.072(2) which the disciplinary actions specified in
31 subsection (2) may be taken:
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1 (a) Attempting to obtain, obtaining, or renewing a
2 license to practice acupuncture by bribery, by fraudulent
3 misrepresentations, or through an error of the department.
4 (b) Having a license to practice acupuncture revoked,
5 suspended, or otherwise acted against, including the denial of
6 licensure, by the licensing authority of another state,
7 territory, or country.
8 (c) Being convicted or found guilty, regardless of
9 adjudication, in any jurisdiction of a crime which directly
10 relates to the practice of acupuncture or to the ability to
11 practice acupuncture. Any plea of nolo contendere shall be
12 considered a conviction for purposes of this chapter.
13 (d) False, deceptive, or misleading advertising or
14 advertising which claims that acupuncture is useful in curing
15 any disease.
16 (e) Advertising, practicing, or attempting to practice
17 under a name other than one's own.
18 (f) Failing to report to the department any person who
19 the licensee knows is in violation of this chapter or of the
20 rules of the department.
21 (g) Aiding, assisting, procuring, employing, or
22 advising any unlicensed person to practice acupuncture
23 contrary to this chapter or to a rule of the department.
24 (h) Failing to perform any statutory or legal
25 obligation placed upon a licensed acupuncturist.
26 (i) Making or filing a report which the licensee knows
27 to be false, intentionally or negligently failing to file a
28 report or record required by state or federal law, willfully
29 impeding or obstructing such filing or inducing another person
30 to do so. Such reports or records shall include only those
31 which are signed in the capacity as a licensed acupuncturist.
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HB 1867, Second Engrossed
1 (j) Exercising influence within a
2 patient-acupuncturist relationship for purposes of engaging a
3 patient in sexual activity. A patient shall be presumed to be
4 incapable of giving free, full, and informed consent to sexual
5 activity with his or her acupuncturist.
6 (k) Making deceptive, untrue, or fraudulent
7 representations in the practice of acupuncture or employing a
8 trick or scheme in the practice of acupuncture when such
9 scheme or trick fails to conform to the generally prevailing
10 standards of treatment in the community.
11 (l) Soliciting patients, either personally or through
12 an agent, through the use of fraud, intimidation, undue
13 influence, or a form of overreaching or vexatious conduct. A
14 solicitation is any communication which directly or implicitly
15 requests an immediate oral response from the recipient.
16 (m) Failing to keep written medical records justifying
17 the course of treatment of the patient.
18 (n) Exercising influence on the patient to exploit the
19 patient for the financial gain of the licensee or of a third
20 party.
21 (o) Being unable to practice acupuncture with
22 reasonable skill and safety to patients by reason of illness
23 or use of alcohol, drugs, narcotics, chemicals, or any other
24 type of material or as a result of any mental or physical
25 condition. In enforcing this paragraph, upon a finding of the
26 secretary or the secretary's designee that probable cause
27 exists to believe that the licensee is unable to serve as an
28 acupuncturist due to the reasons stated in this paragraph, the
29 department shall have the authority to issue an order to
30 compel the licensee to submit to a mental or physical
31 examination by a physician designated by the department. If
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HB 1867, Second Engrossed
1 the licensee refuses to comply with such order, the
2 department's order directing such examination may be enforced
3 by filing a petition for enforcement in the circuit court
4 where the licensee resides or serves as an acupuncturist. The
5 licensee against whom the petition is filed shall not be named
6 or identified by initials in any public court record or
7 document, and the proceedings shall be closed to the public.
8 The department shall be entitled to the summary procedure
9 provided in s. 51.011. An acupuncturist affected under this
10 paragraph shall at reasonable intervals be afforded an
11 opportunity to demonstrate that he or she can resume the
12 competent practice of acupuncture with reasonable skill and
13 safety to patients. In any proceeding under this paragraph,
14 neither the record of proceedings nor the orders entered by
15 the department shall be used against an acupuncturist in any
16 other proceeding.
17 (p) Gross or repeated malpractice or the failure to
18 practice acupuncture with that level of care, skill, and
19 treatment which is recognized by a reasonably prudent similar
20 acupuncturist as being acceptable under similar conditions and
21 circumstances.
22 (q) Practicing or offering to practice beyond the
23 scope permitted by law or accepting and performing
24 professional responsibilities which the licensee knows or has
25 reason to know that he or she is not competent to perform.
26 (r) Delegating professional responsibilities to a
27 person when the licensee delegating such responsibilities
28 knows or has reason to know that such person is not qualified
29 by training, experience, or licensure to perform them.
30 (s) Violating any provision of this chapter, a rule of
31 the department, or a lawful order of the board department
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HB 1867, Second Engrossed
1 previously entered in a disciplinary hearing or failing to
2 comply with a lawfully issued subpoena of the department.
3 (t) Conspiring with another to commit an act, or
4 committing an act, which would tend to coerce, intimidate, or
5 preclude another licensee from lawfully advertising his or her
6 services.
7 (u) Fraud or deceit or gross negligence, incompetence,
8 or misconduct in the operation of a course of study.
9 (v) Failing to comply with state, county, or municipal
10 regulations or reporting requirements relating to public
11 health and the control of contagious and infectious diseases.
12 (w) Failing to comply with any rule of the board
13 relating to health and safety, including, but not limited to,
14 the sterilization of needles and equipment and the disposal of
15 potentially infectious materials.
16 (x) Violating any provision of this chapter or chapter
17 456, or any rules adopted pursuant thereto.
18 (2) The board may enter an order denying licensure or
19 imposing any of the penalties in s. 456.072(2) against any
20 applicant for licensure or licensee who is found guilty of
21 violating any provision of subsection (1) of this section or
22 who is found guilty of violating any provision of s.
23 456.072(1). When the board finds any person guilty of any of
24 the acts set forth in subsection (1), it may enter an order
25 imposing one or more of the following penalties:
26 (a) Refusal to certify to the department an
27 application for licensure.
28 (b) Revocation or suspension of a license.
29 (c) Restriction of practice.
30 (d) Imposition of an administrative fine not to exceed
31 $1,000 for each count or separate offense.
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HB 1867, Second Engrossed
1 (e) Issuance of a reprimand.
2 (f) Placement of the acupuncturist on probation for a
3 period of time and subject to such conditions as the board may
4 specify.
5 Section 22. Subsection (6) of section 458.320, Florida
6 Statutes, is amended to read:
7 458.320 Financial responsibility.--
8 (6) Any deceptive, untrue, or fraudulent
9 representation by the licensee with respect to any provision
10 of this section shall result in permanent disqualification
11 from any exemption to mandated financial responsibility as
12 provided in this section and shall constitute grounds for
13 disciplinary action under as specified in s. 458.331.
14 Section 23. Subsections (1) and (2) of section
15 458.331, Florida Statutes, are amended to read:
16 458.331 Grounds for disciplinary action; action by the
17 board and department.--
18 (1) The following acts shall constitute grounds for
19 denial of a license or disciplinary action, as specified in s.
20 456.072(2) which the disciplinary actions specified in
21 subsection (2) may be taken:
22 (a) Attempting to obtain, obtaining, or renewing a
23 license to practice medicine by bribery, by fraudulent
24 misrepresentations, or through an error of the department or
25 the board.
26 (b) Having a license or the authority to practice
27 medicine revoked, suspended, or otherwise acted against,
28 including the denial of licensure, by the licensing authority
29 of any jurisdiction, including its agencies or subdivisions.
30 The licensing authority's acceptance of a physician's
31 relinquishment of a license, stipulation, consent order, or
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HB 1867, Second Engrossed
1 other settlement, offered in response to or in anticipation of
2 the filing of administrative charges against the physician's
3 license, shall be construed as action against the physician's
4 license.
5 (c) Being convicted or found guilty of, or entering a
6 plea of nolo contendere to, regardless of adjudication, a
7 crime in any jurisdiction which directly relates to the
8 practice of medicine or to the ability to practice medicine.
9 (d) False, deceptive, or misleading advertising.
10 (e) Failing to report to the department any person who
11 the licensee knows is in violation of this chapter or of the
12 rules of the department or the board. A treatment provider
13 approved pursuant to s. 456.076 shall provide the department
14 or consultant with information in accordance with the
15 requirements of s. 456.076(3), (4), (5), and (6).
16 (f) Aiding, assisting, procuring, or advising any
17 unlicensed person to practice medicine contrary to this
18 chapter or to a rule of the department or the board.
19 (g) Failing to perform any statutory or legal
20 obligation placed upon a licensed physician.
21 (h) Making or filing a report which the licensee knows
22 to be false, intentionally or negligently failing to file a
23 report or record required by state or federal law, willfully
24 impeding or obstructing such filing or inducing another person
25 to do so. Such reports or records shall include only those
26 which are signed in the capacity as a licensed physician.
27 (i) Paying or receiving any commission, bonus,
28 kickback, or rebate, or engaging in any split-fee arrangement
29 in any form whatsoever with a physician, organization, agency,
30 or person, either directly or indirectly, for patients
31 referred to providers of health care goods and services,
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HB 1867, Second Engrossed
1 including, but not limited to, hospitals, nursing homes,
2 clinical laboratories, ambulatory surgical centers, or
3 pharmacies. The provisions of this paragraph shall not be
4 construed to prevent a physician from receiving a fee for
5 professional consultation services.
6 (j) Exercising influence within a patient-physician
7 relationship for purposes of engaging a patient in sexual
8 activity. A patient shall be presumed to be incapable of
9 giving free, full, and informed consent to sexual activity
10 with his or her physician.
11 (k) Making deceptive, untrue, or fraudulent
12 representations in or related to the practice of medicine or
13 employing a trick or scheme in the practice of medicine.
14 (l) Soliciting patients, either personally or through
15 an agent, through the use of fraud, intimidation, undue
16 influence, or a form of overreaching or vexatious conduct. A
17 solicitation is any communication which directly or implicitly
18 requests an immediate oral response from the recipient.
19 (m) Failing to keep legible, as defined by department
20 rule in consultation with the board, medical records that
21 identify the licensed physician or the physician extender and
22 supervising physician by name and professional title who is or
23 are responsible for rendering, ordering, supervising, or
24 billing for each diagnostic or treatment procedure and that
25 justify the course of treatment of the patient, including, but
26 not limited to, patient histories; examination results; test
27 results; records of drugs prescribed, dispensed, or
28 administered; and reports of consultations and
29 hospitalizations.
30 (n) Exercising influence on the patient or client in
31 such a manner as to exploit the patient or client for
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HB 1867, Second Engrossed
1 financial gain of the licensee or of a third party, which
2 shall include, but not be limited to, the promoting or selling
3 of services, goods, appliances, or drugs.
4 (o) Promoting or advertising on any prescription form
5 of a community pharmacy unless the form shall also state "This
6 prescription may be filled at any pharmacy of your choice."
7 (p) Performing professional services which have not
8 been duly authorized by the patient or client, or his or her
9 legal representative, except as provided in s. 743.064, s.
10 766.103, or s. 768.13.
11 (q) Prescribing, dispensing, administering, mixing, or
12 otherwise preparing a legend drug, including any controlled
13 substance, other than in the course of the physician's
14 professional practice. For the purposes of this paragraph, it
15 shall be legally presumed that prescribing, dispensing,
16 administering, mixing, or otherwise preparing legend drugs,
17 including all controlled substances, inappropriately or in
18 excessive or inappropriate quantities is not in the best
19 interest of the patient and is not in the course of the
20 physician's professional practice, without regard to his or
21 her intent.
22 (r) Prescribing, dispensing, or administering any
23 medicinal drug appearing on any schedule set forth in chapter
24 893 by the physician to himself or herself, except one
25 prescribed, dispensed, or administered to the physician by
26 another practitioner authorized to prescribe, dispense, or
27 administer medicinal drugs.
28 (s) Being unable to practice medicine with reasonable
29 skill and safety to patients by reason of illness or use of
30 alcohol, drugs, narcotics, chemicals, or any other type of
31 material or as a result of any mental or physical condition.
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HB 1867, Second Engrossed
1 In enforcing this paragraph, the department shall have, upon a
2 finding of the secretary or the secretary's designee that
3 probable cause exists to believe that the licensee is unable
4 to practice medicine because of the reasons stated in this
5 paragraph, the authority to issue an order to compel a
6 licensee to submit to a mental or physical examination by
7 physicians designated by the department. If the licensee
8 refuses to comply with such order, the department's order
9 directing such examination may be enforced by filing a
10 petition for enforcement in the circuit court where the
11 licensee resides or does business. The licensee against whom
12 the petition is filed may not be named or identified by
13 initials in any public court records or documents, and the
14 proceedings shall be closed to the public. The department
15 shall be entitled to the summary procedure provided in s.
16 51.011. A licensee or certificateholder affected under this
17 paragraph shall at reasonable intervals be afforded an
18 opportunity to demonstrate that he or she can resume the
19 competent practice of medicine with reasonable skill and
20 safety to patients.
21 (t) Gross or repeated malpractice or the failure to
22 practice medicine with that level of care, skill, and
23 treatment which is recognized by a reasonably prudent similar
24 physician as being acceptable under similar conditions and
25 circumstances. The board shall give great weight to the
26 provisions of s. 766.102 when enforcing this paragraph. As
27 used in this paragraph, "repeated malpractice" includes, but
28 is not limited to, three or more claims for medical
29 malpractice within the previous 5-year period resulting in
30 indemnities being paid in excess of $25,000 each to the
31 claimant in a judgment or settlement and which incidents
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HB 1867, Second Engrossed
1 involved negligent conduct by the physician. As used in this
2 paragraph, "gross malpractice" or "the failure to practice
3 medicine with that level of care, skill, and treatment which
4 is recognized by a reasonably prudent similar physician as
5 being acceptable under similar conditions and circumstances,"
6 shall not be construed so as to require more than one
7 instance, event, or act. Nothing in this paragraph shall be
8 construed to require that a physician be incompetent to
9 practice medicine in order to be disciplined pursuant to this
10 paragraph.
11 (u) Performing any procedure or prescribing any
12 therapy which, by the prevailing standards of medical practice
13 in the community, would constitute experimentation on a human
14 subject, without first obtaining full, informed, and written
15 consent.
16 (v) Practicing or offering to practice beyond the
17 scope permitted by law or accepting and performing
18 professional responsibilities which the licensee knows or has
19 reason to know that he or she is not competent to perform. The
20 board may establish by rule standards of practice and
21 standards of care for particular practice settings, including,
22 but not limited to, education and training, equipment and
23 supplies, medications including anesthetics, assistance of and
24 delegation to other personnel, transfer agreements,
25 sterilization, records, performance of complex or multiple
26 procedures, informed consent, and policy and procedure
27 manuals.
28 (w) Delegating professional responsibilities to a
29 person when the licensee delegating such responsibilities
30 knows or has reason to know that such person is not qualified
31 by training, experience, or licensure to perform them.
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HB 1867, Second Engrossed
1 (x) Violating any provision of this chapter, a rule of
2 the board or department, or a lawful order of the board or
3 department previously entered in a disciplinary hearing or
4 failing to comply with a lawfully issued subpoena of the
5 department.
6 (y) Conspiring with another licensee or with any other
7 person to commit an act, or committing an act, which would
8 tend to coerce, intimidate, or preclude another licensee from
9 lawfully advertising his or her services.
10 (z) Procuring, or aiding or abetting in the procuring
11 of, an unlawful termination of pregnancy.
12 (aa) Presigning blank prescription forms.
13 (bb) Prescribing any medicinal drug appearing on
14 Schedule II in chapter 893 by the physician for office use.
15 (cc) Prescribing, ordering, dispensing, administering,
16 supplying, selling, or giving any drug which is a Schedule II
17 amphetamine or a Schedule II sympathomimetic amine drug or any
18 compound thereof, pursuant to chapter 893, to or for any
19 person except for:
20 1. The treatment of narcolepsy; hyperkinesis;
21 behavioral syndrome characterized by the developmentally
22 inappropriate symptoms of moderate to severe distractability,
23 short attention span, hyperactivity, emotional lability, and
24 impulsivity; or drug-induced brain dysfunction;
25 2. The differential diagnostic psychiatric evaluation
26 of depression or the treatment of depression shown to be
27 refractory to other therapeutic modalities; or
28 3. The clinical investigation of the effects of such
29 drugs or compounds when an investigative protocol therefor is
30 submitted to, reviewed, and approved by the board before such
31 investigation is begun.
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HB 1867, Second Engrossed
1 (dd) Failing to supervise adequately the activities of
2 those physician assistants, paramedics, emergency medical
3 technicians, or advanced registered nurse practitioners acting
4 under the supervision of the physician.
5 (ee) Prescribing, ordering, dispensing, administering,
6 supplying, selling, or giving growth hormones, testosterone or
7 its analogs, human chorionic gonadotropin (HCG), or other
8 hormones for the purpose of muscle building or to enhance
9 athletic performance. For the purposes of this subsection, the
10 term "muscle building" does not include the treatment of
11 injured muscle. A prescription written for the drug products
12 listed above may be dispensed by the pharmacist with the
13 presumption that the prescription is for legitimate medical
14 use.
15 (ff) Prescribing, ordering, dispensing, administering,
16 supplying, selling, or giving amygdalin (laetrile) to any
17 person.
18 (gg) Misrepresenting or concealing a material fact at
19 any time during any phase of a licensing or disciplinary
20 process or procedure.
21 (hh) Improperly interfering with an investigation or
22 with any disciplinary proceeding.
23 (ii) Failing to report to the department any licensee
24 under this chapter or under chapter 459 who the physician or
25 physician assistant knows has violated the grounds for
26 disciplinary action set out in the law under which that person
27 is licensed and who provides health care services in a
28 facility licensed under chapter 395, or a health maintenance
29 organization certificated under part I of chapter 641, in
30 which the physician or physician assistant also provides
31 services.
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HB 1867, Second Engrossed
1 (jj) Being found by any court in this state to have
2 provided corroborating written medical expert opinion attached
3 to any statutorily required notice of claim or intent or to
4 any statutorily required response rejecting a claim, without
5 reasonable investigation.
6 (kk) Failing to report to the board, in writing,
7 within 30 days if action as defined in paragraph (b) has been
8 taken against one's license to practice medicine in another
9 state, territory, or country.
10 (ll) Advertising or holding oneself out as a
11 board-certified specialist, if not qualified under s.
12 458.3312, in violation of this chapter.
13 (mm) Failing to comply with the requirements of ss.
14 381.026 and 381.0261 to provide patients with information
15 about their patient rights and how to file a patient
16 complaint.
17 (nn) Violating any provision of this chapter or
18 chapter 456, or any rules adopted pursuant thereto.
19 (2) The board may enter an order denying licensure or
20 imposing any of the penalties in s. 456.072(2) against any
21 applicant for licensure or licensee who is found guilty of
22 violating any provision of subsection (1) of this section or
23 who is found guilty of violating any provision of s.
24 456.072(1). When the board finds any person guilty of any of
25 the grounds set forth in subsection (1), including conduct
26 that would constitute a substantial violation of subsection
27 (1) which occurred prior to licensure, it may enter an order
28 imposing one or more of the following penalties:
29 (a) Refusal to certify, or certification with
30 restrictions, to the department an application for licensure,
31 certification, or registration.
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HB 1867, Second Engrossed
1 (b) Revocation or suspension of a license.
2 (c) Restriction of practice.
3 (d) Imposition of an administrative fine not to exceed
4 $10,000 for each count or separate offense.
5 (e) Issuance of a reprimand.
6 (f) Placement of the physician on probation for a
7 period of time and subject to such conditions as the board may
8 specify, including, but not limited to, requiring the
9 physician to submit to treatment, to attend continuing
10 education courses, to submit to reexamination, or to work
11 under the supervision of another physician.
12 (g) Issuance of a letter of concern.
13 (h) Corrective action.
14 (i) Refund of fees billed to and collected from the
15 patient.
16 (j) Imposition of an administrative fine in accordance
17 with s. 381.0261 for violations regarding patient rights.
18
19 In determining what action is appropriate, the board must
20 first consider what sanctions are necessary to protect the
21 public or to compensate the patient. Only after those
22 sanctions have been imposed may the disciplining authority
23 consider and include in the order requirements designed to
24 rehabilitate the physician. All costs associated with
25 compliance with orders issued under this subsection are the
26 obligation of the physician.
27 Section 24. Subsection (2) of section 458.345, Florida
28 Statutes, is amended to read:
29 458.345 Registration of resident physicians, interns,
30 and fellows; list of hospital employees; prescribing of
31 medicinal drugs; penalty.--
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HB 1867, Second Engrossed
1 (2) The board shall not certify to the department for
2 registration any applicant who is under investigation in any
3 state or jurisdiction for an act which would constitute
4 grounds the basis for imposing a disciplinary action under
5 penalty specified in s. 458.331(2)(b) until such time as the
6 investigation is completed, at which time the provisions of s.
7 458.331 shall apply.
8 Section 25. Paragraph (g) of subsection (7) of section
9 458.347, Florida Statutes, is amended to read:
10 458.347 Physician assistants.--
11 (7) PHYSICIAN ASSISTANT LICENSURE.--
12 (g) The Board of Medicine may impose any of the
13 penalties authorized under specified in ss. 456.072 and
14 458.331(2) upon a physician assistant if the physician
15 assistant or the supervising physician has been found guilty
16 of or is being investigated for any act that constitutes a
17 violation of this chapter or chapter 456.
18 Section 26. Subsection (6) of section 459.0085,
19 Florida Statutes, is amended to read:
20 459.0085 Financial responsibility.--
21 (6) Any deceptive, untrue, or fraudulent
22 representation by the licensee with respect to any provision
23 of this section shall result in permanent disqualification
24 from any exemption to mandated financial responsibility as
25 provided in this section and shall constitute grounds for
26 disciplinary action under as specified in s. 459.015.
27 Section 27. Subsections (1) and (2) of section
28 459.015, Florida Statutes, are amended to read:
29 459.015 Grounds for disciplinary action; action by the
30 board and department.--
31
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HB 1867, Second Engrossed
1 (1) The following acts shall constitute grounds for
2 denial of a license or disciplinary action, as specified in s.
3 456.072(2) which the disciplinary actions specified in
4 subsection (2) may be taken:
5 (a) Attempting to obtain, obtaining, or renewing a
6 license to practice osteopathic medicine or a certificate
7 issued under this chapter by bribery, by fraudulent
8 misrepresentations, or through an error of the department or
9 the board.
10 (b) Having a license or the authority to practice
11 osteopathic medicine revoked, suspended, or otherwise acted
12 against, including the denial of licensure, by the licensing
13 authority of any jurisdiction, including its agencies or
14 subdivisions. The licensing authority's acceptance of a
15 physician's relinquishment of license, stipulation, consent
16 order, or other settlement offered in response to or in
17 anticipation of the filing of administrative charges against
18 the physician shall be construed as action against the
19 physician's license.
20 (c) Being convicted or found guilty, regardless of
21 adjudication, of a crime in any jurisdiction which directly
22 relates to the practice of osteopathic medicine or to the
23 ability to practice osteopathic medicine. A plea of nolo
24 contendere shall create a rebuttable presumption of guilt to
25 the underlying criminal charges.
26 (d) False, deceptive, or misleading advertising.
27 (e) Failing to report to the department or the
28 department's impaired professional consultant any person who
29 the licensee or certificateholder knows is in violation of
30 this chapter or of the rules of the department or the board.
31 A treatment provider, approved pursuant to s. 456.076, shall
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1 provide the department or consultant with information in
2 accordance with the requirements of s. 456.076(3), (4), (5),
3 and (6).
4 (f) Aiding, assisting, procuring, or advising any
5 unlicensed person to practice osteopathic medicine contrary to
6 this chapter or to a rule of the department or the board.
7 (g) Failing to perform any statutory or legal
8 obligation placed upon a licensed osteopathic physician.
9 (h) Giving false testimony in the course of any legal
10 or administrative proceedings relating to the practice of
11 medicine or the delivery of health care services.
12 (i) Making or filing a report which the licensee knows
13 to be false, intentionally or negligently failing to file a
14 report or record required by state or federal law, willfully
15 impeding or obstructing such filing, or inducing another
16 person to do so. Such reports or records shall include only
17 those which are signed in the capacity as a licensed
18 osteopathic physician.
19 (j) Paying or receiving any commission, bonus,
20 kickback, or rebate, or engaging in any split-fee arrangement
21 in any form whatsoever with a physician, organization, agency,
22 person, partnership, firm, corporation, or other business
23 entity, for patients referred to providers of health care
24 goods and services, including, but not limited to, hospitals,
25 nursing homes, clinical laboratories, ambulatory surgical
26 centers, or pharmacies. The provisions of this paragraph
27 shall not be construed to prevent an osteopathic physician
28 from receiving a fee for professional consultation services.
29 (k) Refusing to provide health care based on a
30 patient's participation in pending or past litigation or
31 participation in any disciplinary action conducted pursuant to
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1 this chapter, unless such litigation or disciplinary action
2 directly involves the osteopathic physician requested to
3 provide services.
4 (l) Exercising influence within a patient-physician
5 relationship for purposes of engaging a patient in sexual
6 activity. A patient shall be presumed to be incapable of
7 giving free, full, and informed consent to sexual activity
8 with his or her physician.
9 (m) Making deceptive, untrue, or fraudulent
10 representations in or related to the practice of osteopathic
11 medicine or employing a trick or scheme in the practice of
12 osteopathic medicine.
13 (n) Soliciting patients, either personally or through
14 an agent, through the use of fraud, intimidation, undue
15 influence, or forms of overreaching or vexatious conduct. A
16 solicitation is any communication which directly or implicitly
17 requests an immediate oral response from the recipient.
18 (o) Failing to keep legible, as defined by department
19 rule in consultation with the board, medical records that
20 identify the licensed osteopathic physician or the osteopathic
21 physician extender and supervising osteopathic physician by
22 name and professional title who is or are responsible for
23 rendering, ordering, supervising, or billing for each
24 diagnostic or treatment procedure and that justify the course
25 of treatment of the patient, including, but not limited to,
26 patient histories; examination results; test results; records
27 of drugs prescribed, dispensed, or administered; and reports
28 of consultations and hospitalizations.
29 (p) Fraudulently altering or destroying records
30 relating to patient care or treatment, including, but not
31
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1 limited to, patient histories, examination results, and test
2 results.
3 (q) Exercising influence on the patient or client in
4 such a manner as to exploit the patient or client for
5 financial gain of the licensee or of a third party which shall
6 include, but not be limited to, the promotion or sale of
7 services, goods, appliances, or drugs.
8 (r) Promoting or advertising on any prescription form
9 of a community pharmacy, unless the form shall also state
10 "This prescription may be filled at any pharmacy of your
11 choice."
12 (s) Performing professional services which have not
13 been duly authorized by the patient or client or his or her
14 legal representative except as provided in s. 743.064, s.
15 766.103, or s. 768.13.
16 (t) Prescribing, dispensing, administering, supplying,
17 selling, giving, mixing, or otherwise preparing a legend drug,
18 including all controlled substances, other than in the course
19 of the osteopathic physician's professional practice. For the
20 purposes of this paragraph, it shall be legally presumed that
21 prescribing, dispensing, administering, supplying, selling,
22 giving, mixing, or otherwise preparing legend drugs, including
23 all controlled substances, inappropriately or in excessive or
24 inappropriate quantities is not in the best interest of the
25 patient and is not in the course of the osteopathic
26 physician's professional practice, without regard to his or
27 her intent.
28 (u) Prescribing or dispensing any medicinal drug
29 appearing on any schedule set forth in chapter 893 by the
30 osteopathic physician for himself or herself or administering
31 any such drug by the osteopathic physician to himself or
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1 herself unless such drug is prescribed for the osteopathic
2 physician by another practitioner authorized to prescribe
3 medicinal drugs.
4 (v) Prescribing, ordering, dispensing, administering,
5 supplying, selling, or giving amygdalin (laetrile) to any
6 person.
7 (w) Being unable to practice osteopathic medicine with
8 reasonable skill and safety to patients by reason of illness
9 or use of alcohol, drugs, narcotics, chemicals, or any other
10 type of material or as a result of any mental or physical
11 condition. In enforcing this paragraph, the department shall,
12 upon a finding of the secretary or the secretary's designee
13 that probable cause exists to believe that the licensee is
14 unable to practice medicine because of the reasons stated in
15 this paragraph, have the authority to issue an order to compel
16 a licensee to submit to a mental or physical examination by
17 physicians designated by the department. If the licensee
18 refuses to comply with such order, the department's order
19 directing such examination may be enforced by filing a
20 petition for enforcement in the circuit court where the
21 licensee resides or does business. The licensee against whom
22 the petition is filed shall not be named or identified by
23 initials in any public court records or documents, and the
24 proceedings shall be closed to the public. The department
25 shall be entitled to the summary procedure provided in s.
26 51.011. A licensee or certificateholder affected under this
27 paragraph shall at reasonable intervals be afforded an
28 opportunity to demonstrate that he or she can resume the
29 competent practice of medicine with reasonable skill and
30 safety to patients.
31
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1 (x) Gross or repeated malpractice or the failure to
2 practice osteopathic medicine with that level of care, skill,
3 and treatment which is recognized by a reasonably prudent
4 similar osteopathic physician as being acceptable under
5 similar conditions and circumstances. The board shall give
6 great weight to the provisions of s. 766.102 when enforcing
7 this paragraph. As used in this paragraph, "repeated
8 malpractice" includes, but is not limited to, three or more
9 claims for medical malpractice within the previous 5-year
10 period resulting in indemnities being paid in excess of
11 $25,000 each to the claimant in a judgment or settlement and
12 which incidents involved negligent conduct by the osteopathic
13 physician. As used in this paragraph, "gross malpractice" or
14 "the failure to practice osteopathic medicine with that level
15 of care, skill, and treatment which is recognized by a
16 reasonably prudent similar osteopathic physician as being
17 acceptable under similar conditions and circumstances" shall
18 not be construed so as to require more than one instance,
19 event, or act. Nothing in this paragraph shall be construed to
20 require that an osteopathic physician be incompetent to
21 practice osteopathic medicine in order to be disciplined
22 pursuant to this paragraph. A recommended order by an
23 administrative law judge or a final order of the board finding
24 a violation under this paragraph shall specify whether the
25 licensee was found to have committed "gross malpractice,"
26 "repeated malpractice," or "failure to practice osteopathic
27 medicine with that level of care, skill, and treatment which
28 is recognized as being acceptable under similar conditions and
29 circumstances," or any combination thereof, and any
30 publication by the board shall so specify.
31
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1 (y) Performing any procedure or prescribing any
2 therapy which, by the prevailing standards of medical practice
3 in the community, would constitute experimentation on human
4 subjects, without first obtaining full, informed, and written
5 consent.
6 (z) Practicing or offering to practice beyond the
7 scope permitted by law or accepting and performing
8 professional responsibilities which the licensee knows or has
9 reason to know that he or she is not competent to perform. The
10 board may establish by rule standards of practice and
11 standards of care for particular practice settings, including,
12 but not limited to, education and training, equipment and
13 supplies, medications including anesthetics, assistance of and
14 delegation to other personnel, transfer agreements,
15 sterilization, records, performance of complex or multiple
16 procedures, informed consent, and policy and procedure
17 manuals.
18 (aa) Delegating professional responsibilities to a
19 person when the licensee delegating such responsibilities
20 knows or has reason to know that such person is not qualified
21 by training, experience, or licensure to perform them.
22 (bb) Violating any provision of this chapter, a rule
23 of the board or department, or a lawful order of the board or
24 department previously entered in a disciplinary hearing or
25 failing to comply with a lawfully issued subpoena of the board
26 or department.
27 (cc) Conspiring with another licensee or with any
28 other person to commit an act, or committing an act, which
29 would tend to coerce, intimidate, or preclude another licensee
30 from lawfully advertising his or her services.
31
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1 (dd) Procuring, or aiding or abetting in the procuring
2 of, an unlawful termination of pregnancy.
3 (ee) Presigning blank prescription forms.
4 (ff) Prescribing any medicinal drug appearing on
5 Schedule II in chapter 893 by the osteopathic physician for
6 office use.
7 (gg) Prescribing, ordering, dispensing, administering,
8 supplying, selling, or giving any drug which is a Schedule II
9 amphetamine or Schedule II sympathomimetic amine drug or any
10 compound thereof, pursuant to chapter 893, to or for any
11 person except for:
12 1. The treatment of narcolepsy; hyperkinesis;
13 behavioral syndrome characterized by the developmentally
14 inappropriate symptoms of moderate to severe distractability,
15 short attention span, hyperactivity, emotional lability, and
16 impulsivity; or drug-induced brain dysfunction;
17 2. The differential diagnostic psychiatric evaluation
18 of depression or the treatment of depression shown to be
19 refractory to other therapeutic modalities; or
20 3. The clinical investigation of the effects of such
21 drugs or compounds when an investigative protocol therefor is
22 submitted to, reviewed, and approved by the board before such
23 investigation is begun.
24 (hh) Failing to supervise adequately the activities of
25 those physician assistants, paramedics, emergency medical
26 technicians, advanced registered nurse practitioners, or other
27 persons acting under the supervision of the osteopathic
28 physician.
29 (ii) Prescribing, ordering, dispensing, administering,
30 supplying, selling, or giving growth hormones, testosterone or
31 its analogs, human chorionic gonadotropin (HCG), or other
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1 hormones for the purpose of muscle building or to enhance
2 athletic performance. For the purposes of this subsection, the
3 term "muscle building" does not include the treatment of
4 injured muscle. A prescription written for the drug products
5 listed above may be dispensed by the pharmacist with the
6 presumption that the prescription is for legitimate medical
7 use.
8 (jj) Misrepresenting or concealing a material fact at
9 any time during any phase of a licensing or disciplinary
10 process or procedure.
11 (kk) Improperly interfering with an investigation or
12 with any disciplinary proceeding.
13 (ll) Failing to report to the department any licensee
14 under chapter 458 or under this chapter who the osteopathic
15 physician or physician assistant knows has violated the
16 grounds for disciplinary action set out in the law under which
17 that person is licensed and who provides health care services
18 in a facility licensed under chapter 395, or a health
19 maintenance organization certificated under part I of chapter
20 641, in which the osteopathic physician or physician assistant
21 also provides services.
22 (mm) Being found by any court in this state to have
23 provided corroborating written medical expert opinion attached
24 to any statutorily required notice of claim or intent or to
25 any statutorily required response rejecting a claim, without
26 reasonable investigation.
27 (nn) Advertising or holding oneself out as a
28 board-certified specialist in violation of this chapter.
29 (oo) Failing to comply with the requirements of ss.
30 381.026 and 381.0261 to provide patients with information
31
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HB 1867, Second Engrossed
1 about their patient rights and how to file a patient
2 complaint.
3 (pp) Violating any provision of this chapter or
4 chapter 456, or any rules adopted pursuant thereto.
5 (2) The board may enter an order denying licensure or
6 imposing any of the penalties in s. 456.072(2) against any
7 applicant for licensure or licensee who is found guilty of
8 violating any provision of subsection (1) of this section or
9 who is found guilty of violating any provision of s.
10 456.072(1). When the board finds any person guilty of any of
11 the grounds set forth in subsection (1), it may enter an order
12 imposing one or more of the following penalties:
13 (a) Refusal to certify, or certify with restrictions,
14 to the department an application for certification, licensure,
15 renewal, or reactivation.
16 (b) Revocation or suspension of a license or
17 certificate.
18 (c) Restriction of practice.
19 (d) Imposition of an administrative fine not to exceed
20 $10,000 for each count or separate offense.
21 (e) Issuance of a reprimand.
22 (f) Issuance of a letter of concern.
23 (g) Placement of the osteopathic physician on
24 probation for a period of time and subject to such conditions
25 as the board may specify, including, but not limited to,
26 requiring the osteopathic physician to submit to treatment,
27 attend continuing education courses, submit to reexamination,
28 or work under the supervision of another osteopathic
29 physician.
30 (h) Corrective action.
31
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HB 1867, Second Engrossed
1 (i) Refund of fees billed to and collected from the
2 patient.
3 (j) Imposition of an administrative fine in accordance
4 with s. 381.0261 for violations regarding patient rights.
5
6 In determining what action is appropriate, the board must
7 first consider what sanctions are necessary to protect the
8 public or to compensate the patient. Only after those
9 sanctions have been imposed may the disciplining authority
10 consider and include in the order requirements designed to
11 rehabilitate the physician. All costs associated with
12 compliance with orders issued under this subsection are the
13 obligation of the physician.
14 Section 28. Paragraph (f) of subsection (7) of section
15 459.022, Florida Statutes, is amended to read:
16 459.022 Physician assistants.--
17 (7) PHYSICIAN ASSISTANT LICENSURE.--
18 (f) The Board of Osteopathic Medicine may impose any
19 of the penalties authorized under specified in ss. 456.072 and
20 459.015(2) upon a physician assistant if the physician
21 assistant or the supervising physician has been found guilty
22 of or is being investigated for any act that constitutes a
23 violation of this chapter or chapter 456.
24 Section 29. Subsections (1) and (2) of section
25 460.413, Florida Statutes, are amended to read:
26 460.413 Grounds for disciplinary action; action by
27 board or department.--
28 (1) The following acts shall constitute grounds for
29 denial of a license or disciplinary action, as specified in s.
30 456.072(2) which the disciplinary actions specified in
31 subsection (2) may be taken:
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1 (a) Attempting to obtain, obtaining, or renewing a
2 license to practice chiropractic medicine by bribery, by
3 fraudulent misrepresentations, or through an error of the
4 department or the board.
5 (b) Having a license to practice chiropractic medicine
6 revoked, suspended, or otherwise acted against, including the
7 denial of licensure, by the licensing authority of another
8 state, territory, or country.
9 (c) Being convicted or found guilty, regardless of
10 adjudication, of a crime in any jurisdiction which directly
11 relates to the practice of chiropractic medicine or to the
12 ability to practice chiropractic medicine. Any plea of nolo
13 contendere shall be considered a conviction for purposes of
14 this chapter.
15 (d) False, deceptive, or misleading advertising.
16 (e) Causing to be advertised, by any means whatsoever,
17 any advertisement which does not contain an assertion or
18 statement which would identify herself or himself as a
19 chiropractic physician or identify such chiropractic clinic or
20 related institution in which she or he practices or in which
21 she or he is owner, in whole or in part, as a chiropractic
22 institution.
23 (f) Advertising, practicing, or attempting to practice
24 under a name other than one's own.
25 (g) Failing to report to the department any person who
26 the licensee knows is in violation of this chapter or of the
27 rules of the department or the board.
28 (h) Aiding, assisting, procuring, or advising any
29 unlicensed person to practice chiropractic medicine contrary
30 to this chapter or to a rule of the department or the board.
31
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1 (i) Failing to perform any statutory or legal
2 obligation placed upon a licensed chiropractic physician.
3 (j) Making or filing a report which the licensee knows
4 to be false, intentionally or negligently failing to file a
5 report or record required by state or federal law, willfully
6 impeding or obstructing such filing or inducing another person
7 to do so. Such reports or records shall include only those
8 which are signed in the capacity of a licensed chiropractic
9 physician.
10 (k) Making misleading, deceptive, untrue, or
11 fraudulent representations in the practice of chiropractic
12 medicine or employing a trick or scheme in the practice of
13 chiropractic medicine when such trick or scheme fails to
14 conform to the generally prevailing standards of treatment in
15 the chiropractic medical community.
16 (l) Soliciting patients either personally or through
17 an agent, unless such solicitation falls into a category of
18 solicitations approved by rule of the board.
19 (m) Failing to keep legibly written chiropractic
20 medical records that identify clearly by name and credentials
21 the licensed chiropractic physician rendering, ordering,
22 supervising, or billing for each examination or treatment
23 procedure and that justify the course of treatment of the
24 patient, including, but not limited to, patient histories,
25 examination results, test results, X rays, and diagnosis of a
26 disease, condition, or injury. X rays need not be retained
27 for more than 4 years.
28 (n) Exercising influence on the patient or client in
29 such a manner as to exploit the patient or client for
30 financial gain of the licensee or of a third party which shall
31
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1 include, but not be limited to, the promotion or sale of
2 services, goods or appliances, or drugs.
3 (o) Performing professional services which have not
4 been duly authorized by the patient or client or her or his
5 legal representative except as provided in ss. 743.064,
6 766.103, and 768.13.
7 (p) Prescribing, dispensing, or administering any
8 medicinal drug except as authorized by s. 460.403(9)(c)2.,
9 performing any surgery, or practicing obstetrics.
10 (q) Being unable to practice chiropractic medicine
11 with reasonable skill and safety to patients by reason of
12 illness or use of alcohol, drugs, narcotics, chemicals, or any
13 other type of material or as a result of any mental or
14 physical condition. In enforcing this paragraph, upon a
15 finding by the secretary of the department, or his or her
16 designee, or the probable cause panel of the board that
17 probable cause exists to believe that the licensee is unable
18 to practice the profession because of reasons stated in this
19 paragraph, the department shall have the authority to compel a
20 licensee to submit to a mental or physical examination by a
21 physician designated by the department. If the licensee
22 refuses to comply with the department's order, the department
23 may file a petition for enforcement in the circuit court of
24 the circuit in which the licensee resides or does business.
25 The department shall be entitled to the summary procedure
26 provided in s. 51.011. The record of proceedings to obtain a
27 compelled mental or physical examination shall not be used
28 against a licensee in any other proceedings. A chiropractic
29 physician affected under this paragraph shall at reasonable
30 intervals be afforded an opportunity to demonstrate that she
31
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1 or he can resume the competent practice of chiropractic
2 medicine with reasonable skill and safety to patients.
3 (r) Gross or repeated malpractice or the failure to
4 practice chiropractic medicine at a level of care, skill, and
5 treatment which is recognized by a reasonably prudent
6 chiropractic physician as being acceptable under similar
7 conditions and circumstances. The board shall give great
8 weight to the standards for malpractice in s. 766.102 in
9 interpreting this provision. A recommended order by an
10 administrative law judge, or a final order of the board
11 finding a violation under this section shall specify whether
12 the licensee was found to have committed "gross malpractice,"
13 "repeated malpractice," or "failure to practice chiropractic
14 medicine with that level of care, skill, and treatment which
15 is recognized as being acceptable under similar conditions and
16 circumstances" or any combination thereof, and any publication
17 by the board shall so specify.
18 (s) Performing any procedure or prescribing any
19 therapy which, by the prevailing standards of chiropractic
20 medical practice in the community, would constitute
21 experimentation on human subjects, without first obtaining
22 full, informed, and written consent.
23 (t) Practicing or offering to practice beyond the
24 scope permitted by law or accepting and performing
25 professional responsibilities which the licensee knows or has
26 reason to know that she or he is not competent to perform.
27 (u) Delegating professional responsibilities to a
28 person when the licensee delegating such responsibilities
29 knows or has reason to know that such person is not qualified
30 by training, experience, or licensure to perform them.
31
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1 (v) Violating any provision of this chapter, any rule
2 of the board or department, or a lawful order of the board or
3 department previously entered in a disciplinary hearing or
4 failing to comply with a lawfully issued subpoena of the
5 department.
6 (w) Conspiring with another licensee or with any other
7 person to commit an act, or committing an act, which would
8 tend to coerce, intimidate, or preclude another licensee from
9 lawfully advertising her or his services.
10 (x) Submitting to any third-party payor a claim for a
11 service or treatment which was not actually provided to a
12 patient.
13 (y) Failing to preserve identity of funds and property
14 of a patient. As provided by rule of the board, money or other
15 property entrusted to a chiropractic physician for a specific
16 purpose, including advances for costs and expenses of
17 examination or treatment, is to be held in trust and must be
18 applied only to that purpose. Money and other property of
19 patients coming into the hands of a chiropractic physician are
20 not subject to counterclaim or setoff for chiropractic
21 physician's fees, and a refusal to account for and deliver
22 over such money and property upon demand shall be deemed a
23 conversion. This is not to preclude the retention of money or
24 other property upon which the chiropractic physician has a
25 valid lien for services or to preclude the payment of agreed
26 fees from the proceeds of transactions for examinations or
27 treatments. Controversies as to the amount of the fees are
28 not grounds for disciplinary proceedings unless the amount
29 demanded is clearly excessive or extortionate, or the demand
30 is fraudulent. All funds of patients paid to a chiropractic
31 physician, other than advances for costs and expenses, shall
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1 be deposited in one or more identifiable bank accounts
2 maintained in the state in which the chiropractic physician's
3 office is situated, and no funds belonging to the chiropractic
4 physician shall be deposited therein except as follows:
5 1. Funds reasonably sufficient to pay bank charges may
6 be deposited therein.
7 2. Funds belonging in part to a patient and in part
8 presently or potentially to the physician must be deposited
9 therein, but the portion belonging to the physician may be
10 withdrawn when due unless the right of the physician to
11 receive it is disputed by the patient, in which event the
12 disputed portion shall not be withdrawn until the dispute is
13 finally resolved.
14
15 Every chiropractic physician shall maintain complete records
16 of all funds, securities, and other properties of a patient
17 coming into the possession of the physician and render
18 appropriate accounts to the patient regarding them. In
19 addition, every chiropractic physician shall promptly pay or
20 deliver to the patient, as requested by the patient, the
21 funds, securities, or other properties in the possession of
22 the physician which the patient is entitled to receive.
23 (z) Offering to accept or accepting payment for
24 services rendered by assignment from any third-party payor
25 after offering to accept or accepting whatever the third-party
26 payor covers as payment in full, if the effect of the offering
27 or acceptance is to eliminate or give the impression of
28 eliminating the need for payment by an insured of any required
29 deductions applicable in the policy of the insured.
30
31
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1 (aa) Failing to provide, upon request of the insured,
2 a copy of a claim submitted to any third-party payor for
3 service or treatment of the insured.
4 (bb) Advertising a fee or charge for a service or
5 treatment which is different from the fee or charge the
6 licensee submits to third-party payors for that service or
7 treatment.
8 (cc) Advertising any reduced or discounted fees for
9 services or treatments, or advertising any free services or
10 treatments, without prominently stating in the advertisement
11 the usual fee of the licensee for the service or treatment
12 which is the subject of the discount, rebate, or free
13 offering.
14 (dd) Using acupuncture without being certified
15 pursuant to s. 460.403(9)(f).
16 (ee) Failing to report to the department any licensee
17 under chapter 458 or under chapter 459 who the chiropractic
18 physician or chiropractic physician's assistant knows has
19 violated the grounds for disciplinary action set out in the
20 law under which that person is licensed and who provides
21 health care services in a facility licensed under chapter 395,
22 or a health maintenance organization certificated under part I
23 of chapter 641, in which the chiropractic physician or
24 chiropractic physician's assistant also provides services.
25 (ff) Violating any provision of this chapter or
26 chapter 456, or any rules adopted pursuant thereto.
27 (2) The board may enter an order denying licensure or
28 imposing any of the penalties in s. 456.072(2) against any
29 applicant for licensure or licensee who is found guilty of
30 violating any provision of subsection (1) of this section or
31 who is found guilty of violating any provision of s.
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HB 1867, Second Engrossed
1 456.072(1). When the board finds any person guilty of any of
2 the grounds set forth in subsection (1), it may enter an order
3 imposing one or more of the following penalties:
4 (a) Refusal to certify to the department an
5 application for licensure.
6 (b) Revocation or suspension of a license.
7 (c) Restriction of practice.
8 (d) Imposition of an administrative fine not to exceed
9 $10,000 for each count or separate offense.
10 (e) Issuance of a reprimand.
11 (f) Placement of the chiropractic physician on
12 probation for a period of time and subject to such conditions
13 as the board may specify, including requiring the chiropractic
14 physician to submit to treatment, to attend continuing
15 education courses, to submit to reexamination, or to work
16 under the supervision of another chiropractic physician.
17 (g) Imposition of costs of the investigation and
18 prosecution.
19 (h) Requirement that the chiropractic physician
20 undergo remedial education.
21 (i) Issuance of a letter of concern.
22 (j) Corrective action.
23 (k) Refund of fees billed to and collected from the
24 patient or a third party.
25
26 In determining what action is appropriate, the board must
27 first consider what sanctions are necessary to protect the
28 public or to compensate the patient. Only after those
29 sanctions have been imposed may the disciplining authority
30 consider and include in the order requirements designed to
31 rehabilitate the chiropractic physician. All costs associated
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1 with compliance with orders issued under this subsection are
2 the obligation of the chiropractic physician.
3 Section 30. Subsections (1) and (2) of section
4 461.013, Florida Statutes, are amended to read:
5 461.013 Grounds for disciplinary action; action by the
6 board; investigations by department.--
7 (1) The following acts shall constitute grounds for
8 denial of a license or disciplinary action, as specified in s.
9 456.072(2) which the disciplinary actions specified in
10 subsection (2) may be taken:
11 (a) Attempting to obtain, obtaining, or renewing a
12 license to practice podiatric medicine by bribery, by
13 fraudulent misrepresentations, or through an error of the
14 department or the board.
15 (b) Having a license to practice podiatric medicine
16 revoked, suspended, or otherwise acted against, including the
17 denial of licensure, by the licensing authority of another
18 state, territory, or country.
19 (c) Being convicted or found guilty, regardless of
20 adjudication, of a crime in any jurisdiction which directly
21 relates to the practice of podiatric medicine or to the
22 ability to practice podiatric medicine. Any plea of nolo
23 contendere shall be considered a conviction for purposes of
24 this chapter.
25 (d) False, deceptive, or misleading advertising.
26 (e) Advertising, practicing, or attempting to practice
27 under a name other than one's own.
28 (f) Failing to report to the department any person who
29 the licensee knows is in violation of this chapter or of the
30 rules of the department or the board.
31
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1 (g) Aiding, assisting, procuring, permitting, or
2 advising any unlicensed person to practice podiatric medicine
3 contrary to this chapter or to rule of the department or the
4 board.
5 (h) Failing to perform any statutory or legal
6 obligation placed upon a licensed podiatric physician.
7 (i) Making or filing a report which the licensee knows
8 to be false, intentionally or negligently failing to file a
9 report or record required by state or federal law, willfully
10 impeding or obstructing such filing or inducing another person
11 to do so. Such report or records shall include only those
12 which are signed in the capacity of a licensed podiatric
13 physician.
14 (j) Making misleading, deceptive, untrue, or
15 fraudulent representations in the practice of podiatric
16 medicine or employing a trick or scheme in the practice of
17 podiatric medicine when such scheme or trick fails to conform
18 to the generally prevailing standards of treatment in the
19 podiatric community.
20 (k) Soliciting patients either personally or through
21 an agent, unless such solicitation falls into a category of
22 solicitations approved by rule of the board.
23 (l) Failing to keep written medical records justifying
24 the course of treatment of the patient, including, but not
25 limited to, patient histories, examination results, and test
26 results.
27 (m) Exercising influence on the patient or client in
28 such a manner as to exploit the patient or client for
29 financial gain of the licensee or of a third party which shall
30 include, but not be limited to, the promotion or sale of
31 services, goods, appliances, or drugs and the promoting or
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1 advertising on any prescription form of a community pharmacy
2 unless the form shall also state "This prescription may be
3 filled at any pharmacy of your choice."
4 (n) Performing professional services which have not
5 been duly authorized by the patient or client or her or his
6 legal representative except as provided in ss. 743.064,
7 766.103, and 768.13.
8 (o) Prescribing, dispensing, administering, mixing, or
9 otherwise preparing a legend drug, including all controlled
10 substances, other than in the course of the podiatric
11 physician's professional practice. For the purposes of this
12 paragraph, it shall be legally presumed that prescribing,
13 dispensing, administering, mixing, or otherwise preparing
14 legend drugs, including all controlled substances,
15 inappropriately or in excessive or inappropriate quantities is
16 not in the best interest of the patient and is not in the
17 course of the podiatric physician's professional practice,
18 without regard to her or his intent.
19 (p) Prescribing, dispensing, or administering any
20 medicinal drug appearing on any schedule set forth in chapter
21 893 by the podiatric physician to herself or himself except
22 those prescribed, dispensed, or administered to the podiatric
23 physician by another practitioner authorized to prescribe,
24 dispense, or administer them.
25 (q) Prescribing, ordering, dispensing, administering,
26 supplying, selling, or giving any amphetamine or
27 sympathomimetic amine drug or compound designated as a
28 Schedule II controlled substance pursuant to chapter 893.
29 (r) Being unable to practice podiatric medicine with
30 reasonable skill and safety to patients by reason of illness
31 or use of alcohol, drugs, narcotics, chemicals, or any other
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1 type of material or as a result of any mental or physical
2 condition. In enforcing this paragraph the department shall,
3 upon probable cause, have authority to compel a podiatric
4 physician to submit to a mental or physical examination by
5 physicians designated by the department. Failure of a
6 podiatric physician to submit to such examination when
7 directed shall constitute an admission of the allegations
8 against her or him, unless the failure was due to
9 circumstances beyond her or his control, consequent upon which
10 a default and final order may be entered without the taking of
11 testimony or presentation of evidence. A podiatric physician
12 affected under this paragraph shall at reasonable intervals be
13 afforded an opportunity to demonstrate that she or he can
14 resume the competent practice of podiatric medicine with
15 reasonable skill and safety to patients.
16 (s) Gross or repeated malpractice or the failure to
17 practice podiatric medicine at a level of care, skill, and
18 treatment which is recognized by a reasonably prudent
19 podiatric physician as being acceptable under similar
20 conditions and circumstances. The board shall give great
21 weight to the standards for malpractice in s. 766.102 in
22 interpreting this section. As used in this paragraph,
23 "repeated malpractice" includes, but is not limited to, three
24 or more claims for medical malpractice within the previous
25 5-year period resulting in indemnities being paid in excess of
26 $10,000 each to the claimant in a judgment or settlement and
27 which incidents involved negligent conduct by the podiatric
28 physicians. As used in this paragraph, "gross malpractice" or
29 "the failure to practice podiatric medicine with the level of
30 care, skill, and treatment which is recognized by a reasonably
31 prudent similar podiatric physician as being acceptable under
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1 similar conditions and circumstances" shall not be construed
2 so as to require more than one instance, event, or act.
3 (t) Performing any procedure or prescribing any
4 therapy which, by the prevailing standards of podiatric
5 medical practice in the community, would constitute
6 experimentation on human subjects without first obtaining
7 full, informed, and written consent.
8 (u) Practicing or offering to practice beyond the
9 scope permitted by law or accepting and performing
10 professional responsibilities which the licensee knows or has
11 reason to know that she or he is not competent to perform.
12 (v) Delegating professional responsibilities to a
13 person when the licensee delegating such responsibilities
14 knows or has reason to know that such person is not qualified
15 by training, experience, or licensure to perform them.
16 (w) Violating any provision of this chapter or chapter
17 456, any rule of the board or department, or a lawful order of
18 the board or department previously entered in a disciplinary
19 hearing or failing to comply with a lawfully issued subpoena
20 of the board or department.
21 (x) Conspiring with another licensee or with any other
22 person to commit an act, or committing an act, which would
23 tend to coerce, intimidate, or preclude another licensee from
24 lawfully advertising her or his services.
25 (y) Prescribing, ordering, dispensing, administering,
26 supplying, selling, or giving growth hormones, testosterone or
27 its analogs, human chorionic gonadotropin (HCG), or other
28 hormones for the purpose of muscle building or to enhance
29 athletic performance. For the purposes of this subsection, the
30 term "muscle building" does not include the treatment of
31 injured muscle. A prescription written for any of the drug
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1 products listed above may be dispensed by the pharmacist with
2 the presumption that the prescription is for legitimate
3 medical use.
4 (z) Fraud, deceit, or misconduct in the practice of
5 podiatric medicine.
6 (aa) Failing to report to the department any licensee
7 under chapter 458 or chapter 459 who the podiatric physician
8 knows has violated the grounds for disciplinary action set out
9 in the law under which that person is licensed and who
10 provides health care services in a facility licensed under
11 chapter 395, or a health maintenance organization certificated
12 under part I of chapter 641, in which the podiatric physician
13 also provides services.
14 (bb) Failing to comply with the requirements of ss.
15 381.026 and 381.0261 to provide patients with information
16 about their patient rights and how to file a patient
17 complaint.
18 (cc) Violating any provision of this chapter or
19 chapter 456, or any rules adopted pursuant thereto.
20 (2) The board may enter an order denying licensure or
21 imposing any of the penalties in s. 456.072(2) against any
22 applicant for licensure or licensee who is found guilty of
23 violating any provision of subsection (1) of this section or
24 who is found guilty of violating any provision of s.
25 456.072(1). When the board finds any person guilty of any of
26 the grounds set forth in subsection (1), it may enter an order
27 imposing one or more of the following penalties:
28 (a) Refusal to certify to the department an
29 application for licensure.
30 (b) Revocation or suspension of a license.
31 (c) Restriction of practice.
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1 (d) Imposition of an administrative fine not to exceed
2 $10,000 for each count or separate offense.
3 (e) Issuance of a reprimand.
4 (f) Placing the podiatric physician on probation for a
5 period of time and subject to such conditions as the board may
6 specify, including requiring the podiatric physician to submit
7 to treatment, to attend continuing education courses, to
8 submit to reexamination, and to work under the supervision of
9 another podiatric physician.
10 (g) Imposition of an administrative fine in accordance
11 with s. 381.0261 for violations regarding patient rights.
12 Section 31. Subsections (1) and (2) of section 462.14,
13 Florida Statutes, are amended to read:
14 462.14 Grounds for disciplinary action; action by the
15 department.--
16 (1) The following acts constitute grounds for denial
17 of a license or disciplinary action, as specified in s.
18 456.072(2) which the disciplinary actions specified in
19 subsection (2) may be taken:
20 (a) Attempting to obtain, obtaining, or renewing a
21 license to practice naturopathic medicine by bribery, by
22 fraudulent misrepresentation, or through an error of the
23 department.
24 (b) Having a license to practice naturopathic medicine
25 revoked, suspended, or otherwise acted against, including the
26 denial of licensure, by the licensing authority of another
27 state, territory, or country.
28 (c) Being convicted or found guilty, regardless of
29 adjudication, of a crime in any jurisdiction which directly
30 relates to the practice of naturopathic medicine or to the
31 ability to practice naturopathic medicine. Any plea of nolo
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1 contendere shall be considered a conviction for purposes of
2 this chapter.
3 (d) False, deceptive, or misleading advertising.
4 (e) Advertising, practicing, or attempting to practice
5 under a name other than one's own.
6 (f) Failing to report to the department any person who
7 the licensee knows is in violation of this chapter or of the
8 rules of the department.
9 (g) Aiding, assisting, procuring, or advising any
10 unlicensed person to practice naturopathic medicine contrary
11 to this chapter or to a rule of the department.
12 (h) Failing to perform any statutory or legal
13 obligation placed upon a licensed naturopathic physician.
14 (i) Making or filing a report which the licensee knows
15 to be false, intentionally or negligently failing to file a
16 report or record required by state or federal law, willfully
17 impeding or obstructing such filing or inducing another person
18 to do so. Such reports or records shall include only those
19 which are signed in the capacity as a licensed naturopathic
20 physician.
21 (j) Paying or receiving any commission, bonus,
22 kickback, or rebate, or engaging in any split-fee arrangement
23 in any form whatsoever with a physician, organization, agency,
24 or person, either directly or indirectly, for patients
25 referred to providers of health care goods and services,
26 including, but not limited to, hospitals, nursing homes,
27 clinical laboratories, ambulatory surgical centers, or
28 pharmacies. The provisions of this paragraph shall not be
29 construed to prevent a naturopathic physician from receiving a
30 fee for professional consultation services.
31
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1 (k) Exercising influence within a patient-physician
2 relationship for purposes of engaging a patient in sexual
3 activity. A patient shall be presumed to be incapable of
4 giving free, full, and informed consent to sexual activity
5 with her or his physician.
6 (l) Making deceptive, untrue, or fraudulent
7 representations in the practice of naturopathic medicine or
8 employing a trick or scheme in the practice of naturopathic
9 medicine when such scheme or trick fails to conform to the
10 generally prevailing standards of treatment in the medical
11 community.
12 (m) Soliciting patients, either personally or through
13 an agent, through the use of fraud, intimidation, undue
14 influence, or a form of overreaching or vexatious conduct. A
15 "solicitation" is any communication which directly or
16 implicitly requests an immediate oral response from the
17 recipient.
18 (n) Failing to keep written medical records justifying
19 the course of treatment of the patient, including, but not
20 limited to, patient histories, examination results, test
21 results, X rays, and records of the prescribing, dispensing
22 and administering of drugs.
23 (o) Exercising influence on the patient or client in
24 such a manner as to exploit the patient or client for the
25 financial gain of the licensee or of a third party, which
26 shall include, but not be limited to, the promoting or selling
27 of services, goods, appliances, or drugs and the promoting or
28 advertising on any prescription form of a community pharmacy
29 unless the form also states "This prescription may be filled
30 at any pharmacy of your choice."
31
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1 (p) Performing professional services which have not
2 been duly authorized by the patient or client, or her or his
3 legal representative, except as provided in s. 743.064, s.
4 766.103, or s. 768.13.
5 (q) Prescribing, dispensing, administering, mixing, or
6 otherwise preparing a legend drug, including any controlled
7 substance, other than in the course of the naturopathic
8 physician's professional practice. For the purposes of this
9 paragraph, it shall be legally presumed that prescribing,
10 dispensing, administering, mixing, or otherwise preparing
11 legend drugs, including all controlled substances,
12 inappropriately or in excessive or inappropriate quantities is
13 not in the best interest of the patient and is not in the
14 course of the naturopathic physician's professional practice,
15 without regard to her or his intent.
16 (r) Prescribing, dispensing, or administering any
17 medicinal drug appearing on any schedule set forth in chapter
18 893 by the naturopathic physician to herself or himself,
19 except one prescribed, dispensed, or administered to the
20 naturopathic physician by another practitioner authorized to
21 prescribe, dispense, or administer medicinal drugs.
22 (s) Being unable to practice naturopathic medicine
23 with reasonable skill and safety to patients by reason of
24 illness or use of alcohol, drugs, narcotics, chemicals, or any
25 other type of material or as a result of any mental or
26 physical condition. In enforcing this paragraph, the
27 department shall have, upon probable cause, authority to
28 compel a naturopathic physician to submit to a mental or
29 physical examination by physicians designated by the
30 department. The failure of a naturopathic physician to submit
31 to such an examination when so directed shall constitute an
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1 admission of the allegations against her or him upon which a
2 default and final order may be entered without the taking of
3 testimony or presentation of evidence, unless the failure was
4 due to circumstances beyond the naturopathic physician's
5 control. A naturopathic physician affected under this
6 paragraph shall at reasonable intervals be afforded an
7 opportunity to demonstrate that she or he can resume the
8 competent practice of naturopathic medicine with reasonable
9 skill and safety to patients. In any proceeding under this
10 paragraph, neither the record of proceedings nor the orders
11 entered by the department may be used against a naturopathic
12 physician in any other proceeding.
13 (t) Gross or repeated malpractice or the failure to
14 practice naturopathic medicine with that level of care, skill,
15 and treatment which is recognized by a reasonably prudent
16 similar physician as being acceptable under similar conditions
17 and circumstances. The department shall give great weight to
18 the provisions of s. 766.102 when enforcing this paragraph.
19 (u) Performing any procedure or prescribing any
20 therapy which, by the prevailing standards of medical practice
21 in the community, constitutes experimentation on a human
22 subject, without first obtaining full, informed, and written
23 consent.
24 (v) Practicing or offering to practice beyond the
25 scope permitted by law or accepting and performing
26 professional responsibilities which the licensee knows or has
27 reason to know that she or he is not competent to perform.
28 (w) Delegating professional responsibilities to a
29 person when the licensee delegating such responsibilities
30 knows or has reason to know that such person is not qualified
31 by training, experience, or licensure to perform them.
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1 (x) Violating any provision of this chapter, any rule
2 of the department, or a lawful order of the department
3 previously entered in a disciplinary hearing or failing to
4 comply with a lawfully issued subpoena of the department.
5 (y) Conspiring with another licensee or with any other
6 person to commit an act, or committing an act, which would
7 tend to coerce, intimidate, or preclude another licensee from
8 lawfully advertising her or his services.
9 (z) Procuring, or aiding or abetting in the procuring
10 of, an unlawful termination of pregnancy.
11 (aa) Presigning blank prescription forms.
12 (bb) Prescribing by the naturopathic physician for
13 office use any medicinal drug appearing on Schedule II in
14 chapter 893.
15 (cc) Prescribing, ordering, dispensing, administering,
16 supplying, selling, or giving any drug which is an amphetamine
17 or sympathomimetic amine drug, or a compound designated
18 pursuant to chapter 893 as a Schedule II controlled substance
19 to or for any person except for:
20 1. The treatment of narcolepsy; hyperkinesis;
21 behavioral syndrome in children characterized by the
22 developmentally inappropriate symptoms of moderate to severe
23 distractability, short attention span, hyperactivity,
24 emotional lability, and impulsivity; or drug-induced brain
25 dysfunction.
26 2. The differential diagnostic psychiatric evaluation
27 of depression or the treatment of depression shown to be
28 refractory to other therapeutic modalities.
29 3. The clinical investigation of the effects of such
30 drugs or compounds when an investigative protocol therefor is
31
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1 submitted to, reviewed, and approved by the department before
2 such investigation is begun.
3 (dd) Prescribing, ordering, dispensing, administering,
4 supplying, selling, or giving growth hormones, testosterone or
5 its analogs, human chorionic gonadotropin (HCG), or other
6 hormones for the purpose of muscle building or to enhance
7 athletic performance. For the purposes of this subsection, the
8 term "muscle building" does not include the treatment of
9 injured muscle. A prescription written for the drug products
10 listed above may be dispensed by the pharmacist with the
11 presumption that the prescription is for legitimate medical
12 use.
13 (ee) Violating any provision of this chapter or
14 chapter 456, or any rules adopted pursuant thereto.
15 (2) The department may enter an order denying
16 licensure or imposing any of the penalties in s. 456.072(2)
17 against any applicant for licensure or licensee who is found
18 guilty of violating any provision of subsection (1) of this
19 section or who is found guilty of violating any provision of
20 s. 456.072(1). When the department finds any person guilty of
21 any of the grounds set forth in subsection (1), it may enter
22 an order imposing one or more of the following penalties:
23 (a) Refusal to certify to the department an
24 application for licensure.
25 (b) Revocation or suspension of a license.
26 (c) Restriction of practice.
27 (d) Imposition of an administrative fine not to exceed
28 $1,000 for each count or separate offense.
29 (e) Issuance of a reprimand.
30 (f) Placement of the naturopathic physician on
31 probation for a period of time and subject to such conditions
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1 as the department may specify, including, but not limited to,
2 requiring the naturopathic physician to submit to treatment,
3 to attend continuing education courses, to submit to
4 reexamination, or to work under the supervision of another
5 naturopathic physician.
6 Section 32. Subsections (1) and (2) of section
7 463.016, Florida Statutes, are amended to read:
8 463.016 Grounds for disciplinary action; action by the
9 board.--
10 (1) The following acts shall constitute grounds for
11 denial of a license or disciplinary action, as specified in s.
12 456.072(2) which the disciplinary actions specified in
13 subsection (2) may be taken:
14 (a) Procuring or attempting to procure a license to
15 practice optometry by bribery, by fraudulent
16 misrepresentations, or through an error of the department or
17 board.
18 (b) Procuring or attempting to procure a license for
19 any other person by making or causing to be made any false
20 representation.
21 (c) Having a license to practice optometry revoked,
22 suspended, or otherwise acted against, including the denial of
23 licensure, by the licensing authority of another jurisdiction.
24 (d) Being convicted or found guilty, regardless of
25 adjudication, of a crime in any jurisdiction which directly
26 relates to the practice of optometry or to the ability to
27 practice optometry. Any plea of nolo contendere shall be
28 considered a conviction for the purposes of this chapter.
29 (e) Making or filing a report or record which the
30 licensee knows to be false, intentionally or negligently
31 failing to file a report or record required by state or
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1 federal law, willfully impeding or obstructing such filing, or
2 inducing another person to do so. Such reports or records
3 shall include only those which are signed by the licensee in
4 her or his capacity as a licensed practitioner.
5 (f) Advertising goods or services in a manner which is
6 fraudulent, false, deceptive, or misleading in form or
7 content.
8 (g) Fraud or deceit, negligence or incompetency, or
9 misconduct in the practice of optometry.
10 (h) A violation or repeated violations of provisions
11 of this chapter, or of chapter 456, and any rules promulgated
12 pursuant thereto.
13 (i) Conspiring with another licensee or with any
14 person to commit an act, or committing an act, which would
15 coerce, intimidate, or preclude another licensee from lawfully
16 advertising her or his services.
17 (j) Willfully submitting to any third-party payor a
18 claim for services which were not provided to a patient.
19 (k) Failing to keep written optometric records about
20 the examinations, treatments, and prescriptions for patients.
21 (l) Willfully failing to report any person who the
22 licensee knows is in violation of this chapter or of rules of
23 the department or the board.
24 (m) Gross or repeated malpractice.
25 (n) Practicing with a revoked, suspended, inactive, or
26 delinquent license.
27 (o) Being unable to practice optometry with reasonable
28 skill and safety to patients by reason of illness or use of
29 alcohol, drugs, narcotics, chemicals, or any other type of
30 material or as a result of any mental or physical condition.
31 A licensed practitioner affected under this paragraph shall at
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1 reasonable intervals be afforded an opportunity to demonstrate
2 that she or he can resume the competent practice of optometry
3 with reasonable skill and safety to patients.
4 (p) Having been disciplined by a regulatory agency in
5 another state for any offense that would constitute a
6 violation of Florida laws or rules regulating optometry.
7 (q) Violating any provision of s. 463.014 or s.
8 463.015.
9 (r) Violating any lawful order of the board or
10 department, previously entered in a disciplinary hearing, or
11 failing to comply with a lawfully issued subpoena of the board
12 or department.
13 (s) Practicing or offering to practice beyond the
14 scope permitted by law or accepting and performing
15 professional responsibilities which the licensed practitioner
16 knows or has reason to know she or he is not competent to
17 perform.
18 (t) Violating any provision of this chapter or chapter
19 456, or any rules adopted pursuant thereto.
20 (2) The department may enter an order imposing any of
21 the penalties in s. 456.072(2) against any licensee who is
22 found guilty of violating any provision of subsection (1) of
23 this section or who is found guilty of violating any provision
24 of s. 456.072(1). When the board finds any person guilty of
25 any of the grounds set forth in subsection (1), it may enter
26 an order imposing one or more of the following penalties:
27 (a) Refusal to certify to the department an
28 application for licensure.
29 (b) Revocation or suspension of a license.
30 (c) Imposition of an administrative fine not to exceed
31 $5,000 for each count or separate offense.
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1 (d) Issuance of a reprimand.
2 (e) Placement of the licensed practitioner on
3 probation for a period of time and subject to such conditions
4 as the board may specify, including requiring the licensed
5 practitioner to submit to treatment, to attend continuing
6 education courses, or to work under the supervision of another
7 licensed practitioner.
8 Section 33. Subsections (1) and (2) of section
9 464.018, Florida Statutes, are amended to read:
10 464.018 Disciplinary actions.--
11 (1) The following acts constitute shall be grounds for
12 denial of a license or disciplinary action, as specified in s.
13 456.072(2) disciplinary action set forth in this section:
14 (a) Procuring, attempting to procure, or renewing a
15 license to practice nursing by bribery, by knowing
16 misrepresentations, or through an error of the department or
17 the board.
18 (b) Having a license to practice nursing revoked,
19 suspended, or otherwise acted against, including the denial of
20 licensure, by the licensing authority of another state,
21 territory, or country.
22 (c) Being convicted or found guilty of, or entering a
23 plea of nolo contendere to, regardless of adjudication, a
24 crime in any jurisdiction which directly relates to the
25 practice of nursing or to the ability to practice nursing.
26 (d) Being found guilty, regardless of adjudication, of
27 any of the following offenses:
28 1. A forcible felony as defined in chapter 776.
29 2. A violation of chapter 812, relating to theft,
30 robbery, and related crimes.
31
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1 3. A violation of chapter 817, relating to fraudulent
2 practices.
3 4. A violation of chapter 800, relating to lewdness
4 and indecent exposure.
5 5. A violation of chapter 784, relating to assault,
6 battery, and culpable negligence.
7 6. A violation of chapter 827, relating to child
8 abuse.
9 7. A violation of chapter 415, relating to protection
10 from abuse, neglect, and exploitation.
11 8. A violation of chapter 39, relating to child abuse,
12 abandonment, and neglect.
13 (e) Having been found guilty of, regardless of
14 adjudication, or entered a plea of nolo contendere or guilty
15 to, any offense prohibited under s. 435.03 or under any
16 similar statute of another jurisdiction; or having committed
17 an act which constitutes domestic violence as defined in s.
18 741.28.
19 (f) Making or filing a false report or record, which
20 the licensee knows to be false, intentionally or negligently
21 failing to file a report or record required by state or
22 federal law, willfully impeding or obstructing such filing or
23 inducing another person to do so. Such reports or records
24 shall include only those which are signed in the nurse's
25 capacity as a licensed nurse.
26 (g) False, misleading, or deceptive advertising.
27 (h) Unprofessional conduct, which shall include, but
28 not be limited to, any departure from, or the failure to
29 conform to, the minimal standards of acceptable and prevailing
30 nursing practice, in which case actual injury need not be
31 established.
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1 (i) Engaging or attempting to engage in the
2 possession, sale, or distribution of controlled substances as
3 set forth in chapter 893, for any other than legitimate
4 purposes authorized by this part.
5 (j) Being unable to practice nursing with reasonable
6 skill and safety to patients by reason of illness or use of
7 alcohol, drugs, narcotics, or chemicals or any other type of
8 material or as a result of any mental or physical condition.
9 In enforcing this paragraph, the department shall have, upon a
10 finding of the secretary or the secretary's designee that
11 probable cause exists to believe that the licensee is unable
12 to practice nursing because of the reasons stated in this
13 paragraph, the authority to issue an order to compel a
14 licensee to submit to a mental or physical examination by
15 physicians designated by the department. If the licensee
16 refuses to comply with such order, the department's order
17 directing such examination may be enforced by filing a
18 petition for enforcement in the circuit court where the
19 licensee resides or does business. The licensee against whom
20 the petition is filed shall not be named or identified by
21 initials in any public court records or documents, and the
22 proceedings shall be closed to the public. The department
23 shall be entitled to the summary procedure provided in s.
24 51.011. A nurse affected by the provisions of this paragraph
25 shall at reasonable intervals be afforded an opportunity to
26 demonstrate that she or he can resume the competent practice
27 of nursing with reasonable skill and safety to patients.
28 (k) Failing to report to the department any person who
29 the licensee knows is in violation of this part or of the
30 rules of the department or the board; however, if the licensee
31 verifies that such person is actively participating in a
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1 board-approved program for the treatment of a physical or
2 mental condition, the licensee is required to report such
3 person only to an impaired professionals consultant.
4 (l) Knowingly violating any provision of this part, a
5 rule of the board or the department, or a lawful order of the
6 board or department previously entered in a disciplinary
7 proceeding or failing to comply with a lawfully issued
8 subpoena of the department.
9 (m) Failing to report to the department any licensee
10 under chapter 458 or under chapter 459 who the nurse knows has
11 violated the grounds for disciplinary action set out in the
12 law under which that person is licensed and who provides
13 health care services in a facility licensed under chapter 395,
14 or a health maintenance organization certificated under part I
15 of chapter 641, in which the nurse also provides services.
16 (n) Violating any provision of this chapter or chapter
17 456, or any rules adopted pursuant thereto.
18 (2) The board may enter an order denying licensure or
19 imposing any of the penalties in s. 456.072(2) against any
20 applicant for licensure or licensee who is found guilty of
21 violating any provision of subsection (1) of this section or
22 who is found guilty of violating any provision of s.
23 456.072(1). When the board finds any person guilty of any of
24 the grounds set forth in subsection (1), it may enter an order
25 imposing one or more of the following penalties:
26 (a) Refusal to certify to the department an
27 application for licensure.
28 (b) Revocation or suspension of a license with
29 reinstatement subject to the provisions of subsection (3).
30 (c) Permanent revocation of a license.
31 (d) Restriction of practice.
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1 (e) Imposition of an administrative fine not to exceed
2 $1,000 for each count or separate offense.
3 (f) Issuance of a reprimand.
4 (g) Placement of the nurse on probation for a period
5 of time and subject to such conditions as the board may
6 specify, including requiring the nurse to submit to treatment,
7 to attend continuing education courses, to take an
8 examination, or to work under the supervision of another
9 nurse.
10 Section 34. Subsections (3) and (4) of section
11 465.008, Florida Statutes, are amended to read:
12 465.008 Renewal of license.--
13 (3) Sixty days prior to the end of the biennium the
14 department shall mail a notice of renewal to the last known
15 address of the licensee.
16 (3)(4) Any person licensed under this chapter for 50
17 years or more is exempt from the payment of the renewal or
18 delinquent fee, and the department shall issue a lifetime
19 license to such a person.
20 Section 35. Subsections (1) and (2) of section
21 465.016, Florida Statutes, are amended to read:
22 465.016 Disciplinary actions.--
23 (1) The following acts constitute shall be grounds for
24 denial of a license or disciplinary action, as specified in s.
25 456.072(2) disciplinary action set forth in this section:
26 (a) Obtaining a license by misrepresentation or fraud
27 or through an error of the department or the board.
28 (b) Procuring or attempting to procure a license for
29 any other person by making or causing to be made any false
30 representation.
31
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1 (c) Permitting any person not licensed as a pharmacist
2 in this state or not registered as an intern in this state, or
3 permitting a registered intern who is not acting under the
4 direct and immediate personal supervision of a licensed
5 pharmacist, to fill, compound, or dispense any prescriptions
6 in a pharmacy owned and operated by such pharmacist or in a
7 pharmacy where such pharmacist is employed or on duty.
8 (d) Being unfit or incompetent to practice pharmacy by
9 reason of:
10 1. Habitual intoxication.
11 2. The misuse or abuse of any medicinal drug appearing
12 in any schedule set forth in chapter 893.
13 3. Any abnormal physical or mental condition which
14 threatens the safety of persons to whom she or he might sell
15 or dispense prescriptions, drugs, or medical supplies or for
16 whom she or he might manufacture, prepare, or package, or
17 supervise the manufacturing, preparation, or packaging of,
18 prescriptions, drugs, or medical supplies.
19 (e) Violating any of the requirements of this chapter;
20 or if licensed as a practitioner in this or any other state,
21 violating any of the requirements of their respective practice
22 act or violating chapter 499; 21 U.S.C. ss. 301-392, known as
23 the Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et
24 seq., known as the Comprehensive Drug Abuse Prevention and
25 Control Act; or chapter 893.
26 (f) Having been convicted or found guilty, regardless
27 of adjudication, in a court of this state or other
28 jurisdiction, of a crime which directly relates to the ability
29 to practice pharmacy or to the practice of pharmacy. A plea
30 of nolo contendere constitutes a conviction for purposes of
31 this provision.
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1 (g) Using in the compounding of a prescription, or
2 furnishing upon prescription, an ingredient or article
3 different in any manner from the ingredient or article
4 prescribed, except as authorized in s. 465.019(6) or s.
5 465.025.
6 (h) Having been disciplined by a regulatory agency in
7 another state for any offense that would constitute a
8 violation of this chapter.
9 (i) Compounding, dispensing, or distributing a legend
10 drug, including any controlled substance, other than in the
11 course of the professional practice of pharmacy. For purposes
12 of this paragraph, it shall be legally presumed that the
13 compounding, dispensing, or distributing of legend drugs in
14 excessive or inappropriate quantities is not in the best
15 interests of the patient and is not in the course of the
16 professional practice of pharmacy.
17 (j) Making or filing a report or record which the
18 licensee knows to be false, intentionally or negligently
19 failing to file a report or record required by federal or
20 state law, willfully impeding or obstructing such filing, or
21 inducing another person to do so. Such reports or records
22 include only those which the licensee is required to make or
23 file in her or his capacity as a licensed pharmacist.
24 (k) Failing to make prescription fee or price
25 information readily available by failing to provide such
26 information upon request and upon the presentation of a
27 prescription for pricing or dispensing. Nothing in this
28 section shall be construed to prohibit the quotation of price
29 information on a prescription drug to a potential consumer by
30 telephone.
31
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1 (l) Placing in the stock of any pharmacy any part of
2 any prescription compounded or dispensed which is returned by
3 a patient; however, in a hospital, nursing home, correctional
4 facility, or extended care facility in which unit-dose
5 medication is dispensed to inpatients, each dose being
6 individually sealed and the individual unit dose or unit-dose
7 system labeled with the name of the drug, dosage strength,
8 manufacturer's control number, and expiration date, if any,
9 the unused unit dose of medication may be returned to the
10 pharmacy for redispensing. Each pharmacist shall maintain
11 appropriate records for any unused or returned medicinal
12 drugs.
13 (m) Being unable to practice pharmacy with reasonable
14 skill and safety by reason of illness, use of drugs,
15 narcotics, chemicals, or any other type of material or as a
16 result of any mental or physical condition. A pharmacist
17 affected under this paragraph shall at reasonable intervals be
18 afforded an opportunity to demonstrate that she or he can
19 resume the competent practice of pharmacy with reasonable
20 skill and safety to her or his customers.
21 (n) Violating a rule of the board or department or
22 violating an order of the board or department previously
23 entered in a disciplinary hearing.
24 (o) Failing to report to the department any licensee
25 under chapter 458 or under chapter 459 who the pharmacist
26 knows has violated the grounds for disciplinary action set out
27 in the law under which that person is licensed and who
28 provides health care services in a facility licensed under
29 chapter 395, or a health maintenance organization certificated
30 under part I of chapter 641, in which the pharmacist also
31 provides services.
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1 (p) Failing to notify the Board of Pharmacy in writing
2 within 20 days of the commencement or cessation of the
3 practice of the profession of pharmacy in Florida when such
4 commencement or cessation of the practice of the profession of
5 pharmacy in Florida was a result of a pending or completed
6 disciplinary action or investigation in another jurisdiction.
7 (q) Using or releasing a patient's records except as
8 authorized by this chapter and chapter 456.
9 (r) Violating any provision of this chapter or chapter
10 456, or any rules adopted pursuant thereto.
11 (2) The board may enter an order denying licensure or
12 imposing any of the penalties in s. 456.072(2) against any
13 applicant for licensure or licensee who is found guilty of
14 violating any provision of subsection (1) of this section or
15 who is found guilty of violating any provision of s.
16 456.072(1). When the board finds any person guilty of any of
17 the grounds set forth in subsection (1), it may enter an order
18 imposing one or more of the following penalties:
19 (a) Refusal to certify to the department an
20 application for licensure.
21 (b) Revocation or suspension of a license.
22 (c) Imposition of an administrative fine not to exceed
23 $5,000 for each count or separate offense.
24 (d) Issuance of a reprimand.
25 (e) Placement of the pharmacist on probation for a
26 period of time and subject to such conditions as the board may
27 specify, including, but not limited to, requiring the
28 pharmacist to submit to treatment, to attend continuing
29 education courses, to submit to reexamination, or to work
30 under the supervision of another pharmacist.
31
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1 Section 36. Subsections (1) and (2) of section
2 466.028, Florida Statutes, are amended to read:
3 466.028 Grounds for disciplinary action; action by the
4 board.--
5 (1) The following acts shall constitute grounds for
6 denial of a license or disciplinary action, as specified in s.
7 456.072(2) which the disciplinary actions specified in
8 subsection (2) may be taken:
9 (a) Attempting to obtain, obtaining, or renewing a
10 license under this chapter by bribery, fraudulent
11 misrepresentations, or through an error of the department or
12 the board.
13 (b) Having a license to practice dentistry or dental
14 hygiene revoked, suspended, or otherwise acted against,
15 including the denial of licensure, by the licensing authority
16 of another state, territory, or country.
17 (c) Being convicted or found guilty of or entering a
18 plea of nolo contendere to, regardless of adjudication, a
19 crime in any jurisdiction which relates to the practice of
20 dentistry or dental hygiene. A plea of nolo contendere shall
21 create a rebuttable presumption of guilt to the underlying
22 criminal charges.
23 (d) Advertising goods or services in a manner which is
24 fraudulent, false, deceptive, or misleading in form or content
25 contrary to s. 466.019 or rules of the board adopted pursuant
26 thereto.
27 (e) Advertising, practicing, or attempting to practice
28 under a name other than one's own.
29 (f) Failing to report to the department any person who
30 the licensee knows, or has reason to believe, is clearly in
31
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1 violation of this chapter or of the rules of the department or
2 the board.
3 (g) Aiding, assisting, procuring, or advising any
4 unlicensed person to practice dentistry or dental hygiene
5 contrary to this chapter or to a rule of the department or the
6 board.
7 (h) Being employed by any corporation, organization,
8 group, or person other than a dentist or a professional
9 corporation or limited liability company composed of dentists
10 to practice dentistry.
11 (i) Failing to perform any statutory or legal
12 obligation placed upon a licensee.
13 (j) Making or filing a report which the licensee knows
14 to be false, failing to file a report or record required by
15 state or federal law, knowingly impeding or obstructing such
16 filing or inducing another person to do so. Such reports or
17 records shall include only those which are signed in the
18 capacity as a licensee.
19 (k) Committing any act which would constitute sexual
20 battery, as defined in chapter 794, upon a patient or
21 intentionally touching the sexual organ of a patient.
22 (l) Making deceptive, untrue, or fraudulent
23 representations in or related to the practice of dentistry.
24 (m) Failing to keep written dental records and medical
25 history records justifying the course of treatment of the
26 patient including, but not limited to, patient histories,
27 examination results, test results, and X rays, if taken.
28 (n) Failing to make available to a patient or client,
29 or to her or his legal representative or to the department if
30 authorized in writing by the patient, copies of documents in
31
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1 the possession or under control of the licensee which relate
2 to the patient or client.
3 (o) Performing professional services which have not
4 been duly authorized by the patient or client, or her or his
5 legal representative, except as provided in ss. 766.103 and
6 768.13.
7 (p) Prescribing, procuring, dispensing, administering,
8 mixing, or otherwise preparing a legend drug, including any
9 controlled substance, other than in the course of the
10 professional practice of the dentist. For the purposes of
11 this paragraph, it shall be legally presumed that prescribing,
12 procuring, dispensing, administering, mixing, or otherwise
13 preparing legend drugs, including all controlled substances,
14 in excessive or inappropriate quantities is not in the best
15 interest of the patient and is not in the course of the
16 professional practice of the dentist, without regard to her or
17 his intent.
18 (q) Prescribing, procuring, dispensing, or
19 administering any medicinal drug appearing on any schedule set
20 forth in chapter 893, by a dentist to herself or himself,
21 except those prescribed, dispensed, or administered to the
22 dentist by another practitioner authorized to prescribe them.
23 (r) Prescribing, procuring, ordering, dispensing,
24 administering, supplying, selling, or giving any drug which is
25 a Schedule II amphetamine or a Schedule II sympathomimetic
26 amine drug or a compound thereof, pursuant to chapter 893, to
27 or for any person except for the clinical investigation of the
28 effects of such drugs or compounds when an investigative
29 protocol therefor is submitted to, and reviewed and approved
30 by, the board before such investigation is begun.
31
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1 (s) Being unable to practice her or his profession
2 with reasonable skill and safety to patients by reason of
3 illness or use of alcohol, drugs, narcotics, chemicals, or any
4 other type of material or as a result of any mental or
5 physical condition. In enforcing this paragraph, the
6 department shall have, upon a finding of the secretary or her
7 or his designee that probable cause exists to believe that the
8 licensee is unable to practice dentistry or dental hygiene
9 because of the reasons stated in this paragraph, the authority
10 to issue an order to compel a licensee to submit to a mental
11 or physical examination by physicians designated by the
12 department. If the licensee refuses to comply with such
13 order, the department's order directing such examination may
14 be enforced by filing a petition for enforcement in the
15 circuit court where the licensee resides or does business.
16 The licensee against whom the petition is filed shall not be
17 named or identified by initials in any public court records or
18 documents, and the proceedings shall be closed to the public.
19 The department shall be entitled to the summary procedure
20 provided in s. 51.011. A licensee affected under this
21 paragraph shall at reasonable intervals be afforded an
22 opportunity to demonstrate that she or he can resume the
23 competent practice of her or his profession with reasonable
24 skill and safety to patients.
25 (t) Fraud, deceit, or misconduct in the practice of
26 dentistry or dental hygiene.
27 (u) Failure to provide and maintain reasonable
28 sanitary facilities and conditions.
29 (v) Failure to provide adequate radiation safeguards.
30 (w) Performing any procedure or prescribing any
31 therapy which, by the prevailing standards of dental practice
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1 in the community, would constitute experimentation on human
2 subjects, without first obtaining full, informed, and written
3 consent.
4 (x) Being guilty of incompetence or negligence by
5 failing to meet the minimum standards of performance in
6 diagnosis and treatment when measured against generally
7 prevailing peer performance, including, but not limited to,
8 the undertaking of diagnosis and treatment for which the
9 dentist is not qualified by training or experience or being
10 guilty of dental malpractice. For purposes of this paragraph,
11 it shall be legally presumed that a dentist is not guilty of
12 incompetence or negligence by declining to treat an individual
13 if, in the dentist's professional judgment, the dentist or a
14 member of her or his clinical staff is not qualified by
15 training and experience, or the dentist's treatment facility
16 is not clinically satisfactory or properly equipped to treat
17 the unique characteristics and health status of the dental
18 patient, provided the dentist refers the patient to a
19 qualified dentist or facility for appropriate treatment. As
20 used in this paragraph, "dental malpractice" includes, but is
21 not limited to, three or more claims within the previous
22 5-year period which resulted in indemnity being paid, or any
23 single indemnity paid in excess of $5,000 in a judgment or
24 settlement, as a result of negligent conduct on the part of
25 the dentist.
26 (y) Practicing or offering to practice beyond the
27 scope permitted by law or accepting and performing
28 professional responsibilities which the licensee knows or has
29 reason to know that she or he is not competent to perform.
30
31
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1 (z) Delegating professional responsibilities to a
2 person who is not qualified by training, experience, or
3 licensure to perform them.
4 (aa) The violation or the repeated violation of this
5 chapter, chapter 456, or any rule promulgated pursuant to
6 chapter 456 or this chapter; the violation of a lawful order
7 of the board or department previously entered in a
8 disciplinary hearing; or failure to comply with a lawfully
9 issued subpoena of the board or department.
10 (bb) Conspiring with another licensee or with any
11 person to commit an act, or committing an act, which would
12 tend to coerce, intimidate, or preclude another licensee from
13 lawfully advertising her or his services.
14 (cc) Being adjudged mentally incompetent in this or
15 any other state, the discipline for which shall last only so
16 long as the adjudication.
17 (dd) Presigning blank prescription or laboratory work
18 order forms.
19 (ee) Prescribing, ordering, dispensing, administering,
20 supplying, selling, or giving growth hormones, testosterone or
21 its analogs, human chorionic gonadotropin (HCG), or other
22 hormones for the purpose of muscle building or to enhance
23 athletic performance. For the purposes of this subsection, the
24 term "muscle building" does not include the treatment of
25 injured muscle. A prescription written for the drug products
26 listed above may be dispensed by the pharmacist with the
27 presumption that the prescription is for legitimate medical
28 use.
29 (ff) Operating or causing to be operated a dental
30 office in such a manner as to result in dental treatment that
31 is below minimum acceptable standards of performance for the
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1 community. This includes, but is not limited to, the use of
2 substandard materials or equipment, the imposition of time
3 limitations within which dental procedures are to be
4 performed, or the failure to maintain patient records as
5 required by this chapter.
6 (gg) Administering anesthesia in a manner which
7 violates rules of the board adopted pursuant to s. 466.017.
8 (hh) Failing to report to the department any licensee
9 under chapter 458 or chapter 459 who the dentist knows has
10 violated the grounds for disciplinary action set out in the
11 law under which that person is licensed and who provides
12 health care services in a facility licensed under chapter 395,
13 or a health maintenance organization certificated under part I
14 of chapter 641, in which the dentist also provides services.
15 (ii) Failing to report to the board, in writing,
16 within 30 days if action has been taken against one's license
17 to practice dentistry in another state, territory, or country.
18 (jj) Advertising specialty services in violation of
19 this chapter.
20 (kk) Allowing any person other than another dentist or
21 a professional corporation or limited liability company
22 composed of dentists to direct, control, or interfere with a
23 dentist's clinical judgment; however, this paragraph may not
24 be construed to limit a patient's right of informed consent.
25 To direct, control, or interfere with a dentist's clinical
26 judgment may not be interpreted to mean dental services
27 contractually excluded, the application of alternative
28 benefits that may be appropriate given the dentist's
29 prescribed course of treatment, or the application of
30 contractual provisions and scope of coverage determinations in
31 comparison with a dentist's prescribed treatment on behalf of
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1 a covered person by an insurer, health maintenance
2 organization, or a prepaid limited health service
3 organization.
4 (ll) Violating any provision of this chapter or
5 chapter 456, or any rules adopted pursuant thereto.
6 (2) The board may enter an order denying licensure or
7 imposing any of the penalties in s. 456.072(2) against any
8 applicant for licensure or licensee who is found guilty of
9 violating any provision of subsection (1) of this section or
10 who is found guilty of violating any provision of s.
11 456.072(1). When the board finds any applicant or licensee
12 guilty of any of the grounds set forth in subsection (1), it
13 may enter an order imposing one or more of the following
14 penalties:
15 (a) Denial of an application for licensure.
16 (b) Revocation or suspension of a license.
17 (c) Imposition of an administrative fine not to exceed
18 $3,000 for each count or separate offense.
19 (d) Issuance of a reprimand.
20 (e) Placement of the licensee on probation for a
21 period of time and subject to such conditions as the board may
22 specify, including requiring the licensee to attend continuing
23 education courses or demonstrate competency through a written
24 or practical examination or to work under the supervision of
25 another licensee.
26 (f) Restricting the authorized scope of practice.
27 Section 37. Section 466.037, Florida Statutes, is
28 amended to read:
29 466.037 Suspension and revocation; administrative
30 fine.--The department may suspend or revoke the certificate of
31 any dental laboratory registered under s. 466.032, for failing
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1 to comply with the provisions of this chapter or rules adopted
2 by the department under this chapter. The department may
3 impose an administrative fine not to exceed $500 for each
4 count or separate offense.
5 Section 38. Subsections (1) and (2) of section
6 467.203, Florida Statutes, are amended to read:
7 467.203 Disciplinary actions; penalties.--
8 (1) The following acts constitute shall be grounds for
9 denial of a license or disciplinary action, as specified in s.
10 456.072(2) disciplinary action as set forth in this section:
11 (a) Procuring, attempting to procure, or renewing a
12 license to practice midwifery by bribery, by fraudulent
13 misrepresentation, or through an error of the department.
14 (b) Having a license to practice midwifery revoked,
15 suspended, or otherwise acted against, including being denied
16 licensure, by the licensing authority of another state,
17 territory, or country.
18 (c) Being convicted or found guilty, regardless of
19 adjudication, in any jurisdiction of a crime which directly
20 relates to the practice of midwifery or to the ability to
21 practice midwifery. A plea of nolo contendere shall be
22 considered a conviction for purposes of this provision.
23 (d) Making or filing a false report or record, which
24 the licensee knows to be false; intentionally or negligently
25 failing to file a report or record required by state or
26 federal law; or willfully impeding or obstructing such filing
27 or inducing another to do so. Such reports or records shall
28 include only those which are signed in the midwife's capacity
29 as a licensed midwife.
30 (e) Advertising falsely, misleadingly, or deceptively.
31
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1 (f) Engaging in unprofessional conduct, which
2 includes, but is not limited to, any departure from, or the
3 failure to conform to, the standards of practice of midwifery
4 as established by the department, in which case actual injury
5 need not be established.
6 (g) Being unable to practice midwifery with reasonable
7 skill and safety to patients by reason of illness;
8 drunkenness; or use of drugs, narcotics, chemicals, or other
9 materials or as a result of any mental or physical condition.
10 A midwife affected under this paragraph shall, at reasonable
11 intervals, be afforded an opportunity to demonstrate that he
12 or she can resume the competent practice of midwifery with
13 reasonable skill and safety.
14 (h) Failing to report to the department any person who
15 the licensee knows is in violation of this chapter or of the
16 rules of the department.
17 (i) Willfully or repeatedly Violating any provision of
18 this chapter, any rule of the department, or any lawful order
19 of the department previously entered in a disciplinary
20 proceeding or failing to comply with a lawfully issued
21 subpoena of the department.
22 (j) Violating any provision of this chapter or chapter
23 456, or any rules adopted pursuant thereto.
24 (2) The department may enter an order denying
25 licensure or imposing any of the penalties in s. 456.072(2)
26 against any applicant for licensure or licensee who is found
27 guilty of violating any provision of subsection (1) of this
28 section or who is found guilty of violating any provision of
29 s. 456.072(1). When the department finds any person guilty of
30 any of the grounds set forth in subsection (1), it may enter
31 an order imposing one or more of the following penalties:
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1 (a) Refusal to approve an application for licensure.
2 (b) Revocation or suspension of a license.
3 (c) Imposition of an administrative fine not to exceed
4 $1,000 for each count or separate offense.
5 (d) Issuance of a reprimand.
6 (e) Placement of the midwife on probation for such
7 period of time and subject to such conditions as the
8 department may specify, including requiring the midwife to
9 submit to treatment; undertake further relevant education or
10 training; take an examination; or work under the supervision
11 of another licensed midwife, a physician, or a nurse midwife
12 licensed under part I of chapter 464.
13 Section 39. Subsections (1) and (2) of section
14 468.1295, Florida Statutes, are amended to read:
15 468.1295 Disciplinary proceedings.--
16 (1) The following acts constitute grounds for denial
17 of a license or disciplinary action, as specified in s.
18 456.072(2) both disciplinary actions as set forth in
19 subsection (2) and cease and desist or other related actions
20 by the department as set forth in s. 456.065:
21 (a) Procuring or attempting to procure a license by
22 bribery, by fraudulent misrepresentation, or through an error
23 of the department or the board.
24 (b) Having a license revoked, suspended, or otherwise
25 acted against, including denial of licensure, by the licensing
26 authority of another state, territory, or country.
27 (c) Being convicted or found guilty of, or entering a
28 plea of nolo contendere to, regardless of adjudication, a
29 crime in any jurisdiction which directly relates to the
30 practice of speech-language pathology or audiology.
31
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1 (d) Making or filing a report or record which the
2 licensee knows to be false, intentionally or negligently
3 failing to file a report or records required by state or
4 federal law, willfully impeding or obstructing such filing, or
5 inducing another person to impede or obstruct such filing.
6 Such report or record shall include only those reports or
7 records which are signed in one's capacity as a licensed
8 speech-language pathologist or audiologist.
9 (e) Advertising goods or services in a manner which is
10 fraudulent, false, deceptive, or misleading in form or
11 content.
12 (f) Being proven guilty of fraud or deceit or of
13 negligence, incompetency, or misconduct in the practice of
14 speech-language pathology or audiology.
15 (g) Violating a lawful order of the board or
16 department previously entered in a disciplinary hearing, or
17 failing to comply with a lawfully issued subpoena of the board
18 or department.
19 (h) Practicing with a revoked, suspended, inactive, or
20 delinquent license.
21 (i) Using, or causing or promoting the use of, any
22 advertising matter, promotional literature, testimonial,
23 guarantee, warranty, label, brand, insignia, or other
24 representation, however disseminated or published, which is
25 misleading, deceiving, or untruthful.
26 (j) Showing or demonstrating or, in the event of sale,
27 delivery of a product unusable or impractical for the purpose
28 represented or implied by such action.
29 (k) Failing to submit to the board on an annual basis,
30 or such other basis as may be provided by rule, certification
31
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1 of testing and calibration of such equipment as designated by
2 the board and on the form approved by the board.
3 (l) Aiding, assisting, procuring, employing, or
4 advising any licensee or business entity to practice
5 speech-language pathology or audiology contrary to this part,
6 chapter 456, or any rule adopted pursuant thereto.
7 (m) Violating any provision of this part or chapter
8 456 or any rule adopted pursuant thereto.
9 (m)(n) Misrepresenting the professional services
10 available in the fitting, sale, adjustment, service, or repair
11 of a hearing aid, or using any other term or title which might
12 connote the availability of professional services when such
13 use is not accurate.
14 (n)(o) Representing, advertising, or implying that a
15 hearing aid or its repair is guaranteed without providing full
16 disclosure of the identity of the guarantor; the nature,
17 extent, and duration of the guarantee; and the existence of
18 conditions or limitations imposed upon the guarantee.
19 (o)(p) Representing, directly or by implication, that
20 a hearing aid utilizing bone conduction has certain specified
21 features, such as the absence of anything in the ear or
22 leading to the ear, or the like, without disclosing clearly
23 and conspicuously that the instrument operates on the bone
24 conduction principle and that in many cases of hearing loss
25 this type of instrument may not be suitable.
26 (p)(q) Stating or implying that the use of any hearing
27 aid will improve or preserve hearing or prevent or retard the
28 progression of a hearing impairment or that it will have any
29 similar or opposite effect.
30 (q)(r) Making any statement regarding the cure of the
31 cause of a hearing impairment by the use of a hearing aid.
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1 (r)(s) Representing or implying that a hearing aid is
2 or will be "custom-made," "made to order," or
3 "prescription-made," or in any other sense specially
4 fabricated for an individual, when such is not the case.
5 (s)(t) Canvassing from house to house or by telephone,
6 either in person or by an agent, for the purpose of selling a
7 hearing aid, except that contacting persons who have evidenced
8 an interest in hearing aids, or have been referred as in need
9 of hearing aids, shall not be considered canvassing.
10 (t)(u) Failing to notify the department in writing of
11 a change in current mailing and place-of-practice address
12 within 30 days after such change.
13 (u)(v) Failing to provide all information as described
14 in ss. 468.1225(5)(b), 468.1245(1), and 468.1246.
15 (v)(w) Exercising influence on a client in such a
16 manner as to exploit the client for financial gain of the
17 licensee or of a third party.
18 (w)(x) Practicing or offering to practice beyond the
19 scope permitted by law or accepting and performing
20 professional responsibilities the licensee or
21 certificateholder knows, or has reason to know, the licensee
22 or certificateholder is not competent to perform.
23 (x)(y) Aiding, assisting, procuring, or employing any
24 unlicensed person to practice speech-language pathology or
25 audiology.
26 (y)(z) Delegating or contracting for the performance
27 of professional responsibilities by a person when the licensee
28 delegating or contracting for performance of such
29 responsibilities knows, or has reason to know, such person is
30 not qualified by training, experience, and authorization to
31 perform them.
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1 (z)(aa) Committing any act upon a patient or client
2 which would constitute sexual battery or which would
3 constitute sexual misconduct as defined pursuant to s.
4 468.1296.
5 (aa)(bb) Being unable to practice the profession for
6 which he or she is licensed or certified under this chapter
7 with reasonable skill or competence as a result of any mental
8 or physical condition or by reason of illness, drunkenness, or
9 use of drugs, narcotics, chemicals, or any other substance. In
10 enforcing this paragraph, upon a finding by the secretary, his
11 or her designee, or the board that probable cause exists to
12 believe that the licensee or certificateholder is unable to
13 practice the profession because of the reasons stated in this
14 paragraph, the department shall have the authority to compel a
15 licensee or certificateholder to submit to a mental or
16 physical examination by a physician, psychologist, clinical
17 social worker, marriage and family therapist, or mental health
18 counselor designated by the department or board. If the
19 licensee or certificateholder refuses to comply with the
20 department's order directing the examination, such order may
21 be enforced by filing a petition for enforcement in the
22 circuit court in the circuit in which the licensee or
23 certificateholder resides or does business. The department
24 shall be entitled to the summary procedure provided in s.
25 51.011. A licensee or certificateholder affected under this
26 paragraph shall at reasonable intervals be afforded an
27 opportunity to demonstrate that he or she can resume the
28 competent practice for which he or she is licensed or
29 certified with reasonable skill and safety to patients.
30 (bb) Violating any provision of this chapter or
31 chapter 456, or any rules adopted pursuant thereto.
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1 (2) The board may enter an order denying licensure or
2 imposing any of the penalties in s. 456.072(2) against any
3 applicant for licensure or licensee who is found guilty of
4 violating any provision of subsection (1) of this section or
5 who is found guilty of violating any provision of s.
6 456.072(1). When the board finds any person guilty of any of
7 the acts set forth in subsection (1), it may issue an order
8 imposing one or more of the following penalties:
9 (a) Refusal to certify, or to certify with
10 restrictions, an application for licensure.
11 (b) Suspension or permanent revocation of a license.
12 (c) Issuance of a reprimand.
13 (d) Restriction of the authorized scope of practice.
14 (e) Imposition of an administrative fine not to exceed
15 $1,000 for each count or separate offense.
16 (f) Placement of the licensee or certificateholder on
17 probation for a period of time and subject to such conditions
18 as the board may specify. Those conditions may include, but
19 are not limited to, requiring the licensee or
20 certificateholder to undergo treatment, attend continuing
21 education courses, submit to be reexamined, work under the
22 supervision of another licensee, or satisfy any terms which
23 are reasonably tailored to the violation found.
24 (g) Corrective action.
25 Section 40. Subsections (1) and (2) of section
26 468.1755, Florida Statutes, are amended to read:
27 468.1755 Disciplinary proceedings.--
28 (1) The following acts shall constitute grounds for
29 denial of a license or disciplinary action, as specified in s.
30 456.072(2) which the disciplinary actions in subsection (2)
31 may be taken:
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1 (a) Violation of any provision of s. 456.072(1) or s.
2 468.1745(1).
3 (b) Attempting to procure a license to practice
4 nursing home administration by bribery, by fraudulent
5 misrepresentation, or through an error of the department or
6 the board.
7 (c) Having a license to practice nursing home
8 administration revoked, suspended, or otherwise acted against,
9 including the denial of licensure, by the licensing authority
10 of another state, territory, or country.
11 (d) Being convicted or found guilty, regardless of
12 adjudication, of a crime in any jurisdiction which relates to
13 the practice of nursing home administration or the ability to
14 practice nursing home administration. Any plea of nolo
15 contendere shall be considered a conviction for purposes of
16 this part.
17 (e) Making or filing a report or record which the
18 licensee knows to be false, intentionally failing to file a
19 report or record required by state or federal law, willfully
20 impeding or obstructing such filing, or inducing another
21 person to impede or obstruct such filing. Such reports or
22 records shall include only those which are signed in the
23 capacity of a licensed nursing home administrator.
24 (f) Authorizing the discharge or transfer of a
25 resident for a reason other than those provided in ss. 400.022
26 and 400.0255.
27 (g) Advertising goods or services in a manner which is
28 fraudulent, false, deceptive, or misleading in form or
29 content.
30 (h) Fraud or deceit, negligence, incompetence, or
31 misconduct in the practice of nursing home administration.
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1 (i) A violation or repeated violations of this part,
2 chapter 456, or any rules promulgated pursuant thereto.
3 (i)(j) Violation of a lawful order of the board or
4 department previously entered in a disciplinary hearing or
5 failing to comply with a lawfully issued subpoena of the board
6 or department.
7 (j)(k) Practicing with a revoked, suspended, inactive,
8 or delinquent license.
9 (k)(l) Repeatedly acting in a manner inconsistent with
10 the health, safety, or welfare of the patients of the facility
11 in which he or she is the administrator.
12 (l)(m) Being unable to practice nursing home
13 administration with reasonable skill and safety to patients by
14 reason of illness, drunkenness, use of drugs, narcotics,
15 chemicals, or any other material or substance or as a result
16 of any mental or physical condition. In enforcing this
17 paragraph, upon a finding of the secretary or his or her
18 designee that probable cause exists to believe that the
19 licensee is unable to serve as a nursing home administrator
20 due to the reasons stated in this paragraph, the department
21 shall have the authority to issue an order to compel the
22 licensee to submit to a mental or physical examination by a
23 physician designated by the department. If the licensee
24 refuses to comply with such order, the department's order
25 directing such examination may be enforced by filing a
26 petition for enforcement in the circuit court where the
27 licensee resides or serves as a nursing home administrator.
28 The licensee against whom the petition is filed shall not be
29 named or identified by initials in any public court records or
30 documents, and the proceedings shall be closed to the public.
31 The department shall be entitled to the summary procedure
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1 provided in s. 51.011. A licensee affected under this
2 paragraph shall have the opportunity, at reasonable intervals,
3 to demonstrate that he or she can resume the competent
4 practice of nursing home administration with reasonable skill
5 and safety to patients.
6 (m)(n) Willfully or repeatedly violating any of the
7 provisions of the law, code, or rules of the licensing or
8 supervising authority or agency of the state or political
9 subdivision thereof having jurisdiction of the operation and
10 licensing of nursing homes.
11 (n)(o) Paying, giving, causing to be paid or given, or
12 offering to pay or to give to any person a commission or other
13 valuable consideration for the solicitation or procurement,
14 either directly or indirectly, of nursing home usage.
15 (o)(p) Willfully permitting unauthorized disclosure of
16 information relating to a patient or his or her records.
17 (p)(q) Discriminating with respect to patients,
18 employees, or staff on account of race, religion, color, sex,
19 or national origin.
20 (q) Violating any provision of this chapter or chapter
21 456, or any rules adopted pursuant thereto.
22 (2) The board may enter an order denying licensure or
23 imposing any of the penalties in s. 456.072(2) against any
24 applicant for licensure or licensee who is found guilty of
25 violating any provision of subsection (1) of this section or
26 who is found guilty of violating any provision of s.
27 456.072(1). When the board finds any nursing home
28 administrator guilty of any of the grounds set forth in
29 subsection (1), it may enter an order imposing one or more of
30 the following penalties:
31 (a) Denial of an application for licensure.
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1 (b) Revocation or suspension of a license.
2 (c) Imposition of an administrative fine not to exceed
3 $1,000 for each count or separate offense.
4 (d) Issuance of a reprimand.
5 (e) Placement of the licensee on probation for a
6 period of time and subject to such conditions as the board may
7 specify, including requiring the licensee to attend continuing
8 education courses or to work under the supervision of another
9 licensee.
10 (f) Restriction of the authorized scope of practice.
11 Section 41. Section 468.217, Florida Statutes, is
12 amended to read:
13 468.217 Denial of or refusal to renew license;
14 suspension and revocation of license and other disciplinary
15 measures.--
16 (1) The following acts constitute grounds for denial
17 of a license or disciplinary action, as specified in s.
18 456.072(2) The board may deny or refuse to renew a license,
19 suspend or revoke a license, issue a reprimand, impose a fine,
20 or impose probationary conditions upon a licensee, when the
21 licensee or applicant for license has been guilty of
22 unprofessional conduct which has endangered, or is likely to
23 endanger, the health, welfare, or safety of the public. Such
24 unprofessional conduct includes:
25 (a) Attempting to obtain, obtaining, or renewing a
26 license to practice occupational therapy by bribery, by
27 fraudulent misrepresentation, or through an error of the
28 department or the board.
29 (b) Having a license to practice occupational therapy
30 revoked, suspended, or otherwise acted against, including the
31
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1 denial of licensure, by the licensing authority of another
2 state, territory, or country.
3 (c) Being convicted or found guilty, regardless of
4 adjudication, of a crime in any jurisdiction which directly
5 relates to the practice of occupational therapy or to the
6 ability to practice occupational therapy. A plea of nolo
7 contendere shall be considered a conviction for the purposes
8 of this part.
9 (d) False, deceptive, or misleading advertising.
10 (e) Advertising, practicing, or attempting to practice
11 under a name other than one's own name.
12 (f) Failing to report to the department any person who
13 the licensee knows is in violation of this part or of the
14 rules of the department or of the board.
15 (g) Aiding, assisting, procuring, or advising any
16 unlicensed person to practice occupational therapy contrary to
17 this part or to a rule of the department or the board.
18 (h) Failing to perform any statutory or legal
19 obligation placed upon a licensed occupational therapist or
20 occupational therapy assistant.
21 (i) Making or filing a report which the licensee knows
22 to be false, intentionally or negligently failing to file a
23 report or record required by state or federal law, willfully
24 impeding or obstructing such filing or inducing another person
25 to do so. Such reports or records include only those which
26 are signed in the capacity as a licensed occupational
27 therapist or occupational therapy assistant.
28 (j) Paying or receiving any commission, bonus,
29 kickback, or rebate to or from, or engaging in any split-fee
30 arrangement in any form whatsoever with, a physician,
31 organization, agency, or person, either directly or
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1 indirectly, for patients referred to providers of health care
2 goods and services, including, but not limited to, hospitals,
3 nursing homes, clinical laboratories, ambulatory surgical
4 centers, or pharmacies. The provisions of this paragraph
5 shall not be construed to prevent an occupational therapist or
6 occupational therapy assistant from receiving a fee for
7 professional consultation services.
8 (k) Exercising influence within a patient-therapist
9 relationship for purposes of engaging a patient in sexual
10 activity. A patient is presumed to be incapable of giving
11 free, full, and informed consent to sexual activity with the
12 patient's occupational therapist or occupational therapy
13 assistant.
14 (l) Making deceptive, untrue, or fraudulent
15 representations in the practice of occupational therapy or
16 employing a trick or scheme in the practice of occupational
17 therapy if such scheme or trick fails to conform to the
18 generally prevailing standards of treatment in the
19 occupational therapy community.
20 (m) Soliciting patients, either personally or through
21 an agent, through the use of fraud, intimidation, undue
22 influence, or a form of overreaching or vexatious conduct. A
23 "solicitation" is any communication which directly or
24 implicitly requests an immediate oral response from the
25 recipient.
26 (n) Failing to keep written records justifying the
27 course of treatment of the patient, including, but not limited
28 to, patient histories, examination results, and test results.
29 (o) Exercising influence on the patient or client in
30 such a manner as to exploit the patient or client for
31 financial gain of the licensee or of a third party which
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1 includes, but is not limited to, the promoting or selling of
2 services, goods, appliances, or drugs.
3 (p) Performing professional services which have not
4 been duly authorized by the patient or client, or his or her
5 legal representative, except as provided in s. 768.13.
6 (q) Gross or repeated malpractice or the failure to
7 practice occupational therapy with that level of care, skill,
8 and treatment which is recognized by a reasonably prudent
9 similar occupational therapist or occupational therapy
10 assistant as being acceptable under similar conditions and
11 circumstances.
12 (r) Performing any procedure which, by the prevailing
13 standards of occupational therapy practice in the community,
14 would constitute experimentation on a human subject without
15 first obtaining full, informed, and written consent.
16 (s) Practicing or offering to practice beyond the
17 scope permitted by law or accepting and performing
18 professional responsibilities which the licensee knows or has
19 reason to know that he or she is not competent to perform.
20 (t) Being unable to practice occupational therapy with
21 reasonable skill and safety to patients by reason of illness
22 or use of alcohol, drugs, narcotics, chemicals, or any other
23 type of material or as a result of any mental or physical
24 condition. In enforcing this paragraph, the department shall
25 have, upon probable cause, authority to compel an occupational
26 therapist or occupational therapy assistant to submit to a
27 mental or physical examination by physicians designated by the
28 department. The failure of an occupational therapist or
29 occupational therapy assistant to submit to such examination
30 when so directed constitutes an admission of the allegations
31 against him or her, upon which a default and final order may
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1 be entered without the taking of testimony or presentation of
2 evidence, unless the failure was due to circumstances beyond
3 his or her control. An occupational therapist or occupational
4 therapy assistant affected under this paragraph shall at
5 reasonable intervals be afforded an opportunity to demonstrate
6 that he or she can resume the competent practice of
7 occupational therapy with reasonable skill and safety to
8 patients. In any proceeding under this paragraph, neither the
9 record of proceedings nor the orders entered by the board
10 shall be used against an occupational therapist or
11 occupational therapy assistant in any other proceeding.
12 (u) Delegating professional responsibilities to a
13 person when the licensee who is delegating such
14 responsibilities knows or has reason to know that such person
15 is not qualified by training, experience, or licensure to
16 perform them.
17 (v) Violating any provision of this part, a rule of
18 the board or department, or a lawful order of the board or
19 department previously entered in a disciplinary hearing or
20 failing to comply with a lawfully issued subpoena of the
21 department.
22 (w) Conspiring with another licensee or with any other
23 person to commit an act, or committing an act, which would
24 tend to coerce, intimidate, or preclude another licensee from
25 lawfully advertising his or her services.
26 (x) Violating any provision of this chapter or chapter
27 456, or any rules adopted pursuant thereto.
28 (2) The board may enter an order denying licensure or
29 imposing any of the penalties in s. 456.072(2) against any
30 applicant for licensure or licensee who is found guilty of
31 violating any provision of subsection (1) of this section or
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1 who is found guilty of violating any provision of s.
2 456.072(1).
3 (3)(2) The board may not reinstate the license of an
4 occupational therapist or occupational therapy assistant, or
5 cause a license to be issued to a person it has deemed
6 unqualified, until such time as the board is satisfied that
7 such person has complied with all the terms and conditions set
8 forth in the final order and is capable of safely engaging in
9 the practice of occupational therapy.
10 Section 42. Subsections (1) and (2) of section
11 468.365, Florida Statutes, are amended to read:
12 468.365 Disciplinary grounds and actions.--
13 (1) The following acts constitute grounds for denial
14 of a license or disciplinary action, as specified in s.
15 456.072(2) which the disciplinary actions in subsection (2)
16 may be taken:
17 (a) Procuring, attempting to procure, or renewing a
18 license as provided by this part by bribery, by fraudulent
19 misrepresentation, or through an error of the department or
20 the board.
21 (b) Having licensure, certification, registration, or
22 other authority, by whatever name known, to deliver
23 respiratory care services revoked, suspended, or otherwise
24 acted against, including the denial of licensure,
25 certification, registration, or other authority to deliver
26 respiratory care services by the licensing authority of
27 another state, territory, or country.
28 (c) Being convicted or found guilty of, or entering a
29 plea of nolo contendere to, regardless of adjudication, a
30 crime in any jurisdiction which directly relates to
31
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1 respiratory care services or to the ability to deliver such
2 services.
3 (d) Willfully making or filing a false report or
4 record, willfully failing to file a report or record required
5 by state or federal law, or willfully impeding or obstructing
6 such filing or inducing another person to do so. Such reports
7 or records include only those reports or records which require
8 the signature of a respiratory care practitioner or
9 respiratory therapist licensed pursuant to this part.
10 (e) Circulating false, misleading, or deceptive
11 advertising.
12 (f) Unprofessional conduct, which includes, but is not
13 limited to, any departure from, or failure to conform to,
14 acceptable standards related to the delivery of respiratory
15 care services, as set forth by the board in rules adopted
16 pursuant to this part.
17 (g) Engaging or attempting to engage in the
18 possession, sale, or distribution of controlled substances, as
19 set forth by law, for any purpose other than a legitimate
20 purpose.
21 (h) Willfully failing to report any violation of this
22 part.
23 (i) Willfully or repeatedly Violating a rule of the
24 board or the department or a lawful order of the board or
25 department previously entered in a disciplinary hearing.
26 (j) Violation of any rule adopted pursuant to this
27 part or chapter 456.
28 (j)(k) Engaging in the delivery of respiratory care
29 services with a revoked, suspended, or inactive license.
30 (k)(l) Permitting, aiding, assisting, procuring, or
31 advising any person who is not licensed pursuant to this part,
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1 contrary to this part or to any rule of the department or the
2 board.
3 (l)(m) Failing to perform any statutory or legal
4 obligation placed upon a respiratory care practitioner or
5 respiratory therapist licensed pursuant to this part.
6 (m)(n) Accepting and performing professional
7 responsibilities which the licensee knows, or has reason to
8 know, she or he is not competent to perform.
9 (n)(o) Delegating professional responsibilities to a
10 person when the licensee delegating such responsibilities
11 knows, or has reason to know, that such person is not
12 qualified by training, experience, or licensure to perform
13 them.
14 (o)(p) Gross or repeated malpractice or the failure to
15 deliver respiratory care services with that level of care,
16 skill, and treatment which is recognized by a reasonably
17 prudent respiratory care practitioner or respiratory therapist
18 with similar professional training as being acceptable under
19 similar conditions and circumstances.
20 (p)(q) Paying or receiving any commission, bonus,
21 kickback, or rebate to or from, or engaging in any split-fee
22 arrangement in any form whatsoever with, a person,
23 organization, or agency, either directly or indirectly, for
24 goods or services rendered to patients referred by or to
25 providers of health care goods and services, including, but
26 not limited to, hospitals, nursing homes, clinical
27 laboratories, ambulatory surgical centers, or pharmacies. The
28 provisions of this paragraph shall not be construed to prevent
29 the licensee from receiving a fee for professional
30 consultation services.
31
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1 (q)(r) Exercising influence within a respiratory care
2 relationship for the purpose of engaging a patient in sexual
3 activity. A patient is presumed to be incapable of giving
4 free, full, and informed consent to sexual activity with the
5 patient's respiratory care practitioner or respiratory
6 therapist.
7 (r)(s) Making deceptive, untrue, or fraudulent
8 representations in the delivery of respiratory care services
9 or employing a trick or scheme in the delivery of respiratory
10 care services if such a scheme or trick fails to conform to
11 the generally prevailing standards of other licensees within
12 the community.
13 (s)(t) Soliciting patients, either personally or
14 through an agent, through the use of fraud, deception, or
15 otherwise misleading statements or through the exercise of
16 intimidation or undue influence.
17 (t)(u) Failing to keep written respiratory care
18 records justifying the reason for the action taken by the
19 licensee.
20 (u)(v) Exercising influence on the patient in such a
21 manner as to exploit the patient for the financial gain of the
22 licensee or a third party, which includes, but is not limited
23 to, the promoting or selling of services, goods, appliances,
24 or drugs.
25 (v)(w) Performing professional services which have not
26 been duly ordered by a physician licensed pursuant to chapter
27 458 or chapter 459 and which are not in accordance with
28 protocols established by the hospital, other health care
29 provider, or the board, except as provided in ss. 743.064,
30 766.103, and 768.13.
31
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1 (w)(x) Being unable to deliver respiratory care
2 services with reasonable skill and safety to patients by
3 reason of illness or use of alcohol, drugs, narcotics,
4 chemicals, or any other type of material as a result of any
5 mental or physical condition. In enforcing this paragraph,
6 the department shall, upon probable cause, have authority to
7 compel a respiratory care practitioner or respiratory
8 therapist to submit to a mental or physical examination by
9 physicians designated by the department. The cost of
10 examination shall be borne by the licensee being examined.
11 The failure of a respiratory care practitioner or respiratory
12 therapist to submit to such an examination when so directed
13 constitutes an admission of the allegations against her or
14 him, upon which a default and a final order may be entered
15 without the taking of testimony or presentation of evidence,
16 unless the failure was due to circumstances beyond her or his
17 control. A respiratory care practitioner or respiratory
18 therapist affected under this paragraph shall at reasonable
19 intervals be afforded an opportunity to demonstrate that she
20 or he can resume the competent delivery of respiratory care
21 services with reasonable skill and safety to her or his
22 patients. In any proceeding under this paragraph, neither the
23 record of proceedings nor the orders entered by the board
24 shall be used against a respiratory care practitioner or
25 respiratory therapist in any other proceeding.
26 (x) Violating any provision of this chapter or chapter
27 456, or any rules adopted pursuant thereto.
28 (2) The board may enter an order denying licensure or
29 imposing any of the penalties in s. 456.072(2) against any
30 applicant for licensure or licensee who is found guilty of
31 violating any provision of subsection (1) of this section or
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1 who is found guilty of violating any provision of s.
2 456.072(1). If the board finds any person guilty of any of the
3 grounds set forth in subsection (1), it may enter an order
4 imposing one or more of the following penalties:
5 (a) Denial of an application for licensure.
6 (b) Revocation or suspension of licensure.
7 (c) Imposition of an administrative fine not to exceed
8 $1,000 for each count or separate offense.
9 (d) Placement of the respiratory care practitioner or
10 respiratory therapist on probation for such period of time and
11 subject to such conditions as the board may specify,
12 including, but not limited to, requiring the respiratory care
13 practitioner or respiratory therapist to submit to treatment,
14 to attend continuing education courses, or to work under the
15 supervision of another respiratory care practitioner or
16 respiratory therapist.
17 (e) Issuance of a reprimand.
18 Section 43. Subsections (1) and (2) of section
19 468.518, Florida Statutes, are amended to read:
20 468.518 Grounds for disciplinary action.--
21 (1) The following acts constitute grounds for denial
22 of a license or disciplinary action, as specified in s.
23 456.072(2) which the disciplinary actions in subsection (2)
24 may be taken:
25 (a) Violating any provision of this part, any board or
26 agency rule adopted pursuant thereto, or any lawful order of
27 the board or agency previously entered in a disciplinary
28 hearing held pursuant to this part, or failing to comply with
29 a lawfully issued subpoena of the agency. The provisions of
30 this paragraph also apply to any order or subpoena previously
31
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1 issued by the Department of Health during its period of
2 regulatory control over this part.
3 (b) Being unable to engage in dietetics and nutrition
4 practice or nutrition counseling with reasonable skill and
5 safety to patients by reason of illness or use of alcohol,
6 drugs, narcotics, chemicals, or any other type of material or
7 as a result of any mental or physical condition.
8 1. A licensee whose license is suspended or revoked
9 pursuant to this paragraph shall, at reasonable intervals, be
10 given an opportunity to demonstrate that he or she can resume
11 the competent practice of dietetics and nutrition or nutrition
12 counseling with reasonable skill and safety to patients.
13 2. Neither the record of the proceeding nor the orders
14 entered by the board in any proceeding under this paragraph
15 may be used against a licensee in any other proceeding.
16 (c) Attempting to procure or procuring a license to
17 practice dietetics and nutrition or nutrition counseling by
18 fraud or material misrepresentation of material fact.
19 (d) Having a license to practice dietetics and
20 nutrition or nutrition counseling revoked, suspended, or
21 otherwise acted against, including the denial of licensure by
22 the licensing authority of another state, district, territory,
23 or country.
24 (e) Being convicted or found guilty of, or entering a
25 plea of nolo contendere to, regardless of adjudication, a
26 crime in any jurisdiction which directly relates to the
27 practice of dietetics and nutrition or nutrition counseling or
28 the ability to practice dietetics and nutrition or nutrition
29 counseling.
30 (f) Making or filing a report or record that the
31 licensee knows to be false, willfully failing to file a report
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1 or record required by state or federal law, willfully impeding
2 or obstructing such filing, or inducing another person to
3 impede or obstruct such filing. Such reports or records
4 include only those that are signed in the capacity of a
5 licensed dietitian/nutritionist or licensed nutrition
6 counselor.
7 (g) Advertising goods or services in a manner that is
8 fraudulent, false, deceptive, or misleading in form or
9 content.
10 (h) Committing an act of fraud or deceit, or of
11 negligence, incompetency, or misconduct in the practice of
12 dietetics and nutrition or nutrition counseling.
13 (i) Practicing with a revoked, suspended, inactive, or
14 delinquent license.
15 (j) Treating or undertaking to treat human ailments by
16 means other than by dietetics and nutrition practice or
17 nutrition counseling.
18 (k) Failing to maintain acceptable standards of
19 practice as set forth by the board and the council in rules
20 adopted pursuant to this part.
21 (l) Engaging directly or indirectly in the dividing,
22 transferring, assigning, rebating, or refunding of fees
23 received for professional services, or profiting by means of a
24 credit or other valuable consideration, such as an unearned
25 commission, discount, or gratuity, with any person referring a
26 patient or with any relative or business associate of the
27 referring person. Nothing in this part prohibits the members
28 of any regularly and properly organized business entity that
29 is composed of licensees under this part and recognized under
30 the laws of this state from making any division of their total
31 fees among themselves as they determine necessary.
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1 (m) Advertising, by or on behalf of a licensee under
2 this part, any method of assessment or treatment which is
3 experimental or without generally accepted scientific
4 validation.
5 (n) Violating any provision of this chapter or chapter
6 456, or any rules adopted pursuant thereto.
7 (2) The board may enter an order denying licensure or
8 imposing any of the penalties in s. 456.072(2) against any
9 applicant for licensure or licensee who is found guilty of
10 violating any provision of subsection (1) of this section or
11 who is found guilty of violating any provision of s.
12 456.072(1). When the board finds any licensee guilty of any of
13 the grounds set forth in subsection (1), it may enter an order
14 imposing one or more of the following penalties:
15 (a) Denial of an application for licensure;
16 (b) Revocation or suspension of a license;
17 (c) Imposition of an administrative fine not to exceed
18 $1,000 for each violation;
19 (d) Issuance of a reprimand or letter of guidance;
20 (e) Placement of the licensee on probation for a
21 period of time and subject to such conditions as the board may
22 specify, including requiring the licensee to attend continuing
23 education courses or to work under the supervision of a
24 licensed dietitian/nutritionist or licensed nutrition
25 counselor; or
26 (f) Restriction of the authorized scope of practice of
27 the licensee.
28 Section 44. Section 468.719, Florida Statutes, is
29 amended to read:
30 468.719 Disciplinary actions.--
31
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1 (1) The following acts constitute shall be grounds for
2 denial of a license or disciplinary action, as specified in s.
3 456.072(2) disciplinary actions provided for in subsection
4 (2):
5 (a) A violation of any law relating to the practice of
6 athletic training, including, but not limited to, any
7 violation of this part, s. 456.072, or any rule adopted
8 pursuant thereto.
9 (a)(b) Failing to include the athletic trainer's name
10 and license number in any advertising, including, but not
11 limited to, business cards and letterhead, related to the
12 practice of athletic training. Advertising shall not include
13 clothing or other novelty items.
14 (b)(c) Committing incompetency or misconduct in the
15 practice of athletic training.
16 (c)(d) Committing fraud or deceit in the practice of
17 athletic training.
18 (d)(e) Committing negligence, gross negligence, or
19 repeated negligence in the practice of athletic training.
20 (e)(f) While practicing athletic training, being
21 unable to practice athletic training with reasonable skill and
22 safety to athletes by reason of illness or use of alcohol or
23 drugs or as a result of any mental or physical condition.
24 (f) Violating any provision of this chapter or chapter
25 456, or any rules adopted pursuant thereto.
26 (2) The board may enter an order denying licensure or
27 imposing any of the penalties in s. 456.072(2) against any
28 applicant for licensure or licensee who is found guilty of
29 violating any provision of subsection (1) of this section or
30 who is found guilty of violating any provision of s.
31 456.072(1). When the board finds any person guilty of any of
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1 the acts set forth in subsection (1), the board may enter an
2 order imposing one or more of the penalties provided in s.
3 456.072.
4 Section 45. Section 468.811, Florida Statutes, is
5 amended to read:
6 468.811 Disciplinary proceedings.--
7 (1) The following acts constitute are grounds for
8 denial of a license or disciplinary action, as specified in s.
9 456.072(2): disciplinary action against a licensee and the
10 issuance of cease and desist orders or other related action by
11 the department, pursuant to s. 456.072, against any person who
12 engages in or aids in a violation.
13 (a) Attempting to procure a license by fraudulent
14 misrepresentation.
15 (b) Having a license to practice orthotics,
16 prosthetics, or pedorthics revoked, suspended, or otherwise
17 acted against, including the denial of licensure in another
18 jurisdiction.
19 (c) Being convicted or found guilty of or pleading
20 nolo contendere to, regardless of adjudication, in any
21 jurisdiction, a crime that directly relates to the practice of
22 orthotics, prosthetics, or pedorthics, including violations of
23 federal laws or regulations regarding orthotics, prosthetics,
24 or pedorthics.
25 (d) Filing a report or record that the licensee knows
26 is false, intentionally or negligently failing to file a
27 report or record required by state or federal law, willfully
28 impeding or obstructing such filing, or inducing another
29 person to impede or obstruct such filing. Such reports or
30 records include only reports or records that are signed in a
31 person's capacity as a licensee under this act.
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1 (e) Advertising goods or services in a fraudulent,
2 false, deceptive, or misleading manner.
3 (f) Violation of this act or chapter 456, or any rules
4 adopted thereunder.
5 (f)(g) Violation of an order of the board, agency, or
6 department previously entered in a disciplinary hearing or
7 failure to comply with a subpoena issued by the board, agency,
8 or department.
9 (g)(h) Practicing with a revoked, suspended, or
10 inactive license.
11 (h)(i) Gross or repeated malpractice or the failure to
12 deliver orthotic, prosthetic, or pedorthic services with that
13 level of care and skill which is recognized by a reasonably
14 prudent licensed practitioner with similar professional
15 training as being acceptable under similar conditions and
16 circumstances.
17 (i)(j) Failing to provide written notice of any
18 applicable warranty for an orthosis, prosthesis, or pedorthic
19 device that is provided to a patient.
20 (j) Violating any provision of this chapter or chapter
21 456, or any rules adopted pursuant thereto.
22 (2) The board may enter an order denying licensure or
23 imposing any of the penalties in s. 456.072(2) against any
24 applicant for licensure or licensee who is found guilty of
25 violating any provision of subsection (1) of this section or
26 who is found guilty of violating any provision of s.
27 456.072(1). The board may enter an order imposing one or more
28 of the penalties in s. 456.072(2) against any person who
29 violates any provision of subsection (1).
30 Section 46. Subsections (1) and (2) of section 478.52,
31 Florida Statutes, are amended to read:
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1 478.52 Disciplinary proceedings.--
2 (1) The following acts constitute are grounds for
3 denial of a license or disciplinary action, as specified in s.
4 456.072(2) which the disciplinary actions in subsection (2)
5 may be taken:
6 (a) Obtaining or attempting to obtain a license by
7 bribery, fraud, or knowing misrepresentation.
8 (b) Having a license or other authority to deliver
9 electrolysis services revoked, suspended, or otherwise acted
10 against, including denial of licensure, in another
11 jurisdiction.
12 (c) Being convicted or found guilty of, or entering a
13 plea of nolo contendere to, regardless of adjudication, a
14 crime, in any jurisdiction, which directly relates to the
15 practice of electrology.
16 (d) Willfully making or filing a false report or
17 record, willfully failing to file a report or record required
18 for electrologists, or willfully impeding or obstructing the
19 filing of a report or record required by this act or inducing
20 another person to do so.
21 (e) Circulating false, misleading, or deceptive
22 advertising.
23 (f) Unprofessional conduct, including any departure
24 from, or failure to conform to, acceptable standards related
25 to the delivery of electrolysis services.
26 (g) Engaging or attempting to engage in the illegal
27 possession, sale, or distribution of any illegal or controlled
28 substance.
29 (h) Willfully failing to report any known violation of
30 this chapter.
31
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1 (i) Willfully or repeatedly violating a rule adopted
2 under this chapter, or an order of the board or department
3 previously entered in a disciplinary hearing.
4 (j) Engaging in the delivery of electrolysis services
5 without an active license.
6 (k) Employing an unlicensed person to practice
7 electrology.
8 (l) Failing to perform any statutory or legal
9 obligation placed upon an electrologist.
10 (m) Accepting and performing professional
11 responsibilities which the licensee knows, or has reason to
12 know, she or he is not competent to perform.
13 (n) Delegating professional responsibilities to a
14 person the licensee knows, or has reason to know, is
15 unqualified by training, experience, or licensure to perform.
16 (o) Gross or repeated malpractice or the inability to
17 practice electrology with reasonable skill and safety.
18 (p) Judicially determined mental incompetency.
19 (q) Practicing or attempting to practice electrology
20 under a name other than her or his own.
21 (r) Being unable to practice electrology with
22 reasonable skill and safety because of a mental or physical
23 condition or illness, or the use of alcohol, controlled
24 substances, or any other substance which impairs one's ability
25 to practice.
26 1. The department may, upon probable cause, compel a
27 licensee to submit to a mental or physical examination by
28 physicians designated by the department. The cost of an
29 examination shall be borne by the licensee, and her or his
30 failure to submit to such an examination constitutes an
31 admission of the allegations against her or him, consequent
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1 upon which a default and a final order may be entered without
2 the taking of testimony or presentation of evidence, unless
3 the failure was due to circumstances beyond her or his
4 control.
5 2. A licensee who is disciplined under this paragraph
6 shall, at reasonable intervals, be afforded an opportunity to
7 demonstrate that she or he can resume the practice of
8 electrology with reasonable skill and safety.
9 3. In any proceeding under this paragraph, the record
10 of proceedings or the orders entered by the board may not be
11 used against a licensee in any other proceeding.
12 (s) Disclosing the identity of or information about a
13 patient without written permission, except for information
14 which does not identify a patient and which is used for
15 training purposes in an approved electrolysis training
16 program.
17 (t) Practicing or attempting to practice any permanent
18 hair removal except as described in s. 478.42(5).
19 (u) Operating any electrolysis facility unless it has
20 been duly licensed as provided in this chapter.
21 (v) Violating any provision of this chapter or chapter
22 456, or any rules adopted pursuant thereto.
23 (2) The board may enter an order denying licensure or
24 imposing any of the penalties in s. 456.072(2) against any
25 applicant for licensure or licensee who is found guilty of
26 violating any provision of subsection (1) of this section or
27 who is found guilty of violating any provision of s.
28 456.072(1). When the board finds any person guilty of any of
29 the grounds set forth in subsection (1), including conduct
30 that would constitute a substantial violation of subsection
31
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1 (1) which occurred prior to licensure, it may enter an order
2 imposing one or more of the following penalties:
3 (a) Deny the application for licensure.
4 (b) Revoke or suspend the license.
5 (c) Impose an administrative fine not to exceed $5,000
6 for each count or separate offense.
7 (d) Place the licensee on probation for a specified
8 time and subject the licensee to such conditions as the board
9 determines necessary, including, but not limited to, requiring
10 treatment, continuing education courses, reexamination, or
11 working under the supervision of another licensee.
12 (e) Issue a reprimand to the licensee.
13 (f) Restriction of a licensee's practice.
14 Section 47. Subsections (1) and (2) of section
15 480.046, Florida Statutes, are amended to read:
16 480.046 Grounds for disciplinary action by the
17 board.--
18 (1) The following acts shall constitute grounds for
19 denial of a license or disciplinary action, as specified in s.
20 456.072(2) which disciplinary actions specified in subsection
21 (2) may be taken against a massage therapist or massage
22 establishment licensed under this act:
23 (a) Attempting to procure a license to practice
24 massage by bribery or fraudulent misrepresentation.
25 (b) Having a license to practice massage revoked,
26 suspended, or otherwise acted against, including the denial of
27 licensure, by the licensing authority of another state,
28 territory, or country.
29 (c) Being convicted or found guilty, regardless of
30 adjudication, of a crime in any jurisdiction which directly
31 relates to the practice of massage or to the ability to
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1 practice massage. Any plea of nolo contendere shall be
2 considered a conviction for purposes of this chapter.
3 (d) False, deceptive, or misleading advertising.
4 (e) Aiding, assisting, procuring, or advising any
5 unlicensed person to practice massage contrary to the
6 provisions of this chapter or to a rule of the department or
7 the board.
8 (f) Making deceptive, untrue, or fraudulent
9 representations in the practice of massage.
10 (g) Being unable to practice massage with reasonable
11 skill and safety by reason of illness or use of alcohol,
12 drugs, narcotics, chemicals, or any other type of material or
13 as a result of any mental or physical condition. In enforcing
14 this paragraph, the department shall have, upon probable
15 cause, authority to compel a massage therapist to submit to a
16 mental or physical examination by physicians designated by the
17 department. Failure of a massage therapist to submit to such
18 examination when so directed, unless the failure was due to
19 circumstances beyond her or his control, shall constitute an
20 admission of the allegations against her or him, consequent
21 upon which a default and final order may be entered without
22 the taking of testimony or presentation of evidence. A
23 massage therapist affected under this paragraph shall at
24 reasonable intervals be afforded an opportunity to demonstrate
25 that she or he can resume the competent practice of massage
26 with reasonable skill and safety to clients.
27 (h) Gross or repeated malpractice or the failure to
28 practice massage with that level of care, skill, and treatment
29 which is recognized by a reasonably prudent massage therapist
30 as being acceptable under similar conditions and
31 circumstances.
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1 (i) Practicing or offering to practice beyond the
2 scope permitted by law or accepting and performing
3 professional responsibilities which the licensee knows or has
4 reason to know that she or he is not competent to perform.
5 (j) Delegating professional responsibilities to a
6 person when the licensee delegating such responsibilities
7 knows or has reason to know that such person is not qualified
8 by training, experience, or licensure to perform.
9 (k) Violating any provision of this chapter, a rule of
10 the board or department, or a lawful order of the board or
11 department previously entered in a disciplinary hearing, or
12 failing to comply with a lawfully issued subpoena of the
13 department.
14 (l) Refusing to permit the department to inspect the
15 business premises of the licensee during regular business
16 hours.
17 (m) Failing to keep the equipment and premises of the
18 massage establishment in a clean and sanitary condition.
19 (n) Practicing massage at a site, location, or place
20 which is not duly licensed as a massage establishment, except
21 that a massage therapist, as provided by rules adopted by the
22 board, may provide massage services, excluding colonic
23 irrigation, at the residence of a client, at the office of the
24 client, at a sports event, at a convention, or at a trade
25 show.
26 (o) Violating any provision of this chapter or chapter
27 456, or any rules adopted pursuant thereto.
28 (2) The board may enter an order denying licensure or
29 imposing any of the penalties in s. 456.072(2) against any
30 applicant for licensure or licensee who is found guilty of
31 violating any provision of subsection (1) of this section or
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1 who is found guilty of violating any provision of s.
2 456.072(1). When the board finds any person guilty of any of
3 the grounds set forth in subsection (1), it may enter an order
4 imposing one or more of the following penalties:
5 (a) Refusal to license an applicant.
6 (b) Revocation or suspension of a license.
7 (c) Issuance of a reprimand or censure.
8 (d) Imposition of an administrative fine not to exceed
9 $1,000 for each count or separate offense.
10 Section 48. Section 483.825, Florida Statutes, is
11 amended to read:
12 483.825 Grounds for disciplinary action.--
13 (1) The following acts constitute grounds for denial
14 of a license or disciplinary action, as specified in s.
15 456.072(2) which disciplinary actions specified in s. 483.827
16 may be taken against applicants, registrants, and licensees
17 under this part:
18 (a)(1) Attempting to obtain, obtaining, or renewing a
19 license or registration under this part by bribery, by
20 fraudulent misrepresentation, or through an error of the
21 department or the board.
22 (b)(2) Engaging in or attempting to engage in, or
23 representing herself or himself as entitled to perform, any
24 clinical laboratory procedure or category of procedures not
25 authorized pursuant to her or his license.
26 (c)(3) Demonstrating incompetence or making consistent
27 errors in the performance of clinical laboratory examinations
28 or procedures or erroneous reporting.
29 (d)(4) Performing a test and rendering a report
30 thereon to a person not authorized by law to receive such
31 services.
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1 (e)(5) Has been convicted or found guilty of, or
2 entered a plea of nolo contendere to, regardless of
3 adjudication, a crime in any jurisdiction which directly
4 relates to the activities of clinical laboratory personnel or
5 involves moral turpitude or fraudulent or dishonest dealing.
6 The record of a conviction certified or authenticated in such
7 form as to be admissible in evidence under the laws of the
8 state shall be admissible as prima facie evidence of such
9 guilt.
10 (f)(6) Having been adjudged mentally or physically
11 incompetent.
12 (g)(7) Violating or Aiding and abetting in the
13 violation of any provision of this part or the rules adopted
14 hereunder.
15 (h)(8) Reporting a test result when no laboratory test
16 was performed on a clinical specimen.
17 (i)(9) Knowingly advertising false services or
18 credentials.
19 (j)(10) Having a license revoked, suspended, or
20 otherwise acted against, including the denial of licensure, by
21 the licensing authority of another jurisdiction. The licensing
22 authority's acceptance of a relinquishment of a license,
23 stipulation, consent order, or other settlement, offered in
24 response to or in anticipation of the filing of administrative
25 charges against the licensee, shall be construed as action
26 against the licensee.
27 (k)(11) Failing to report to the board, in writing,
28 within 30 days that an action under subsection (5), subsection
29 (6), or subsection (10) has been taken against the licensee or
30 one's license to practice as clinical laboratory personnel in
31 another state, territory, country, or other jurisdiction.
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1 (l)(12) Being unable to perform or report clinical
2 laboratory examinations with reasonable skill and safety to
3 patients by reason of illness or use of alcohol, drugs,
4 narcotics, chemicals, or any other type of material or as a
5 result of any mental or physical condition. In enforcing this
6 subsection, the department shall have, upon a finding of the
7 secretary or his or her designee that probable cause exists to
8 believe that the licensee is unable to practice because of the
9 reasons stated in this subsection, the authority to issue an
10 order to compel a licensee to submit to a mental or physical
11 examination by physicians designated by the department. If
12 the licensee refuses to comply with such order, the
13 department's order directing such examination may be enforced
14 by filing a petition for enforcement in the circuit court
15 where the licensee resides or does business. The department
16 shall be entitled to the summary procedure provided in s.
17 51.011. A licensee affected under this subsection shall at
18 reasonable intervals be afforded an opportunity to demonstrate
19 that he or she can resume competent practice with reasonable
20 skill and safety to patients.
21 (m)(13) Delegating professional responsibilities to a
22 person when the licensee delegating such responsibilities
23 knows, or has reason to know, that such person is not
24 qualified by training, experience, or licensure to perform
25 them.
26 (n)(14) Violating a previous order of the board
27 entered in a disciplinary proceeding.
28 (o)(15) Failing to report to the department a person
29 or other licensee who the licensee knows is in violation of
30 this chapter or the rules of the department or board adopted
31 hereunder.
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1 (p)(16) Making or filing a report which the licensee
2 knows to be false, intentionally or negligently failing to
3 file a report or record required by state or federal law,
4 willfully impeding or obstructing such filing or inducing
5 another person to do so, including, but not limited to,
6 impeding an agent of the state from obtaining a report or
7 record for investigative purposes. Such reports or records
8 shall include only those generated in the capacity as a
9 licensed clinical laboratory personnel.
10 (q)(17) Paying or receiving any commission, bonus,
11 kickback, or rebate, or engaging in any split-fee arrangement
12 in any form whatsoever with a physician, organization, agency,
13 or person, either directly or indirectly for patients referred
14 to providers of health care goods and services including, but
15 not limited to, hospitals, nursing homes, clinical
16 laboratories, ambulatory surgical centers, or pharmacies. The
17 provisions of this subsection shall not be construed to
18 prevent a clinical laboratory professional from receiving a
19 fee for professional consultation services.
20 (r)(18) Exercising influence on a patient or client in
21 such a manner as to exploit the patient or client for the
22 financial gain of the licensee or other third party, which
23 shall include, but not be limited to, the promoting, selling,
24 or withholding of services, goods, appliances, referrals, or
25 drugs.
26 (s)(19) Practicing or offering to practice beyond the
27 scope permitted by law or rule, or accepting or performing
28 professional services or responsibilities which the licensee
29 knows or has reason to know that he or she is not competent to
30 perform.
31
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1 (t)(20) Misrepresenting or concealing a material fact
2 at any time during any phase of the licensing, investigative,
3 or disciplinary process, procedure, or proceeding.
4 (u)(21) Improperly interfering with an investigation
5 or any disciplinary proceeding.
6 (v)(22) Engaging in or attempting to engage in sexual
7 misconduct, causing undue embarrassment or using disparaging
8 language or language of a sexual nature towards a patient,
9 exploiting superior/subordinate, professional/patient,
10 instructor/student relationships for personal gain, sexual
11 gratification, or advantage.
12 (w) Violating any provision of this chapter or chapter
13 456, or any rules adopted pursuant thereto.
14 (2) The board may enter an order denying licensure or
15 imposing any of the penalties in s. 456.072(2) against any
16 applicant for licensure or licensee who is found guilty of
17 violating any provision of subsection (1) of this section or
18 who is found guilty of violating any provision of s.
19 456.072(1).
20 (3) In determining the amount of the fine to be levied
21 for a violation, as provided in subsection (1), the following
22 factors shall be considered:
23 (a) The severity of the violation, including the
24 probability that death or serious harm to the health or safety
25 of any person will result or has resulted, the severity of the
26 actual or potential harm, and the extent to which the
27 provisions of this part were violated.
28 (b) Actions taken by the licensee to correct the
29 violation or to remedy complaints.
30 (c) Any previous violation by the licensee.
31
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1 (d) The financial benefit to the licensee of
2 committing or continuing the violation.
3 Section 49. Section 483.827, Florida Statutes, is
4 repealed.
5 Section 50. Subsection (6) of section 483.901, Florida
6 Statutes, is amended to read:
7 483.901 Medical physicists; definitions; licensure.--
8 (6) LICENSE REQUIRED.--An individual may not engage in
9 the practice of medical physics, including the specialties of
10 diagnostic radiological physics, therapeutic radiological
11 physics, medical nuclear radiological physics, or medical
12 health physics, without a license issued by the department for
13 the appropriate specialty.
14 (a) The department shall adopt rules to administer
15 this section which specify license application and renewal
16 fees, continuing education requirements, and standards for
17 practicing medical physics. The council shall recommend to
18 the department continuing education requirements that shall be
19 a condition of license renewal. The department shall require
20 a minimum of 24 hours per biennium of continuing education
21 offered by an organization recommended by the council and
22 approved by the department. The department, upon
23 recommendation of the council, may adopt rules to specify
24 continuing education requirements for persons who hold a
25 license in more than one specialty.
26 (b) In order to apply for a medical physicist license
27 in one or more specialties, a person must file an individual
28 application for each specialty with the department. The
29 application must be on a form prescribed by the department and
30 must be accompanied by a nonrefundable application fee for
31 each specialty.
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1 (c) The department may issue a license to an eligible
2 applicant if the applicant meets all license requirements. At
3 any time before the department issues a license, the applicant
4 may request in writing that the application be withdrawn. To
5 reapply, the applicant must submit a new application and an
6 additional nonrefundable application fee and must meet all
7 current licensure requirements.
8 (d) The department shall review each completed
9 application for a license which the department receives.
10 (e) On receipt of an application and fee as specified
11 in this section, the department may issue a license to
12 practice medical physics in this state on or after October 1,
13 1997, to a person who is board certified in the medical
14 physics specialty in which the applicant applies to practice
15 by the American Board of Radiology for diagnostic radiological
16 physics, therapeutic radiological physics, or medical nuclear
17 radiological physics; by the American Board of Medical Physics
18 for diagnostic radiological physics, therapeutic radiological
19 physics, or medical nuclear radiological physics; or by the
20 American Board of Health Physics or an equivalent certifying
21 body approved by the department.
22 (f) A licensee shall:
23 1. Display the license in a place accessible to the
24 public; and
25 2. Report immediately any change in the licensee's
26 address or name to the department.
27 (g) The following acts constitute are grounds for
28 denial of a license or disciplinary action, as specified in s.
29 456.072(2) which the disciplinary actions in paragraph (h) may
30 be taken:
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1 1. Obtaining or attempting to obtain a license by
2 bribery, fraud, knowing misrepresentation, or concealment of
3 material fact or through an error of the department.
4 2. Having a license denied, revoked, suspended, or
5 otherwise acted against in another jurisdiction.
6 3. Being convicted or found guilty of, or entering a
7 plea of nolo contendere to, regardless of adjudication, a
8 crime in any jurisdiction which relates to the practice of, or
9 the ability to practice, the profession of medical physics.
10 4. Willfully failing to file a report or record
11 required for medical physics or willfully impeding or
12 obstructing the filing of a report or record required by this
13 section or inducing another person to do so.
14 5. Making misleading, deceptive, or fraudulent
15 representations in or related to the practice of medical
16 physics.
17 6. Willfully failing to report any known violation of
18 this section or any rule adopted thereunder.
19 7. Willfully or repeatedly violating a rule adopted
20 under this section or an order of the department.
21 7.8. Failing to perform any statutory or legal
22 obligation placed upon a licensee.
23 8.9. Aiding, assisting, procuring, employing, or
24 advising any unlicensed person to practice medical physics
25 contrary to this section or any rule adopted thereunder.
26 9.10. Delegating or contracting for the performance of
27 professional responsibilities by a person when the licensee
28 delegating or contracting such responsibilities knows, or has
29 reason to know, such person is not qualified by training,
30 experience, and authorization to perform them.
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1 10.11. Practicing or offering to practice beyond the
2 scope permitted by law or accepting and performing
3 professional responsibilities the licensee knows, or has
4 reason to know, the licensee is not competent to perform.
5 11.12. Gross or repeated malpractice or the inability
6 to practice medical physics with reasonable skill and safety.
7 12.13. Judicially determined mental incompetency.
8 13.14. Being unable to practice medical physics with
9 reasonable skill and safety because of a mental or physical
10 condition or illness or the use of alcohol, controlled
11 substances, or any other substance which impairs one's ability
12 to practice.
13 a. The department may, upon probable cause, compel a
14 licensee to submit to a mental or physical examination by
15 physicians designated by the department. The cost of an
16 examination shall be borne by the licensee, and the licensee's
17 failure to submit to such an examination constitutes an
18 admission of the allegations against the licensee, consequent
19 upon which a default and a final order may be entered without
20 the taking of testimony or presentation of evidence, unless
21 the failure was due to circumstances beyond the licensee's
22 control.
23 b. A licensee who is disciplined under this
24 subparagraph shall, at reasonable intervals, be afforded an
25 opportunity to demonstrate that the licensee can resume the
26 practice of medical physics with reasonable skill and safety.
27 c. With respect to any proceeding under this
28 subparagraph, the record of proceedings or the orders entered
29 by the department may not be used against a licensee in any
30 other proceeding.
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1 14. Violating any provision of this chapter or chapter
2 456, or any rules adopted pursuant thereto.
3 (h) The board may enter an order denying licensure or
4 imposing any of the penalties in s. 456.072(2) against any
5 applicant for licensure or licensee who is found guilty of
6 violating any provision of subsection (1) of this section or
7 who is found guilty of violating any provision of s.
8 456.072(1). When the department finds any person guilty of any
9 of the grounds set forth in paragraph (g), including conduct
10 that would constitute a substantial violation of paragraph (g)
11 which occurred prior to licensure, it may enter an order
12 imposing one or more of the following penalties:
13 1. Deny the application for licensure.
14 2. Revoke or suspend the license.
15 3. Impose an administrative fine for each count or
16 separate offense.
17 4. Place the licensee on probation for a specified
18 time and subject the licensee to such conditions as the
19 department determines necessary, including requiring
20 treatment, continuing education courses, or working under the
21 monitoring or supervision of another licensee.
22 5. Restrict a licensee's practice.
23 6. Issue a reprimand to the licensee.
24 (i) The department may not issue or reinstate a
25 license to a person it has deemed unqualified until it is
26 satisfied that such person has complied with the terms and
27 conditions of the final order and that the licensee can safely
28 practice medical physics.
29 (j) Upon receipt of a complete application and the fee
30 set forth by rule, the department may issue a
31 physicist-in-training certificate to a person qualified to
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1 practice medical physics under direct supervision. The
2 department may establish by rule requirements for initial
3 certification and renewal of a physicist-in-training
4 certificate.
5 Section 51. Subsections (1) and (2) of section
6 484.014, Florida Statutes, are amended to read:
7 484.014 Disciplinary actions.--
8 (1) The following acts constitute relating to the
9 practice of opticianry shall be grounds for denial of a
10 license or disciplinary action, as specified in s. 456.072(2)
11 both disciplinary action against an optician as set forth in
12 this section and cease and desist or other related action by
13 the department as set forth in s. 456.065 against any person
14 operating an optical establishment who engages in, aids, or
15 abets any such violation:
16 (a) Procuring or attempting to procure a license by
17 misrepresentation, bribery, or fraud or through an error of
18 the department or the board.
19 (b) Procuring or attempting to procure a license for
20 any other person by making or causing to be made any false
21 representation.
22 (c) Making or filing a report or record which the
23 licensee knows to be false, intentionally or negligently
24 failing to file a report or record required by federal or
25 state law, willfully impeding or obstructing such filing, or
26 inducing another person to do so. Such reports or records
27 shall include only those which the person is required to make
28 or file as an optician.
29 (d) Failing to make fee or price information readily
30 available by providing such information upon request or upon
31 the presentation of a prescription.
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1 (e) Advertising goods or services in a manner which is
2 fraudulent, false, deceptive, or misleading in form or
3 content.
4 (f) Fraud or deceit, or negligence, incompetency, or
5 misconduct, in the authorized practice of opticianry.
6 (g) Violation or repeated violation of this part or of
7 chapter 456 or any rules promulgated pursuant thereto.
8 (g)(h) Practicing with a revoked, suspended, inactive,
9 or delinquent license.
10 (h)(i) Violation of a lawful order of the board or
11 department previously entered in a disciplinary hearing or
12 failing to comply with a lawfully issued subpoena of the
13 department.
14 (i)(j) Violation of any provision of s. 484.012.
15 (j)(k) Conspiring with another licensee or with any
16 person to commit an act, or committing an act, which would
17 coerce, intimidate, or preclude another licensee from lawfully
18 advertising her or his services.
19 (k)(l) Willfully submitting to any third-party payor a
20 claim for services which were not provided to a patient.
21 (l)(m) Failing to keep written prescription files.
22 (m)(n) Willfully failing to report any person who the
23 licensee knows is in violation of this part or of rules of the
24 department or the board.
25 (n)(o) Exercising influence on a client in such a
26 manner as to exploit the client for financial gain of the
27 licensee or of a third party.
28 (o)(p) Gross or repeated malpractice.
29 (p)(q) Permitting any person not licensed as an
30 optician in this state to fit or dispense any lenses,
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1 spectacles, eyeglasses, or other optical devices which are
2 part of the practice of opticianry.
3 (q)(r) Being convicted or found guilty of, or entering
4 a plea of nolo contendere to, regardless of adjudication, in a
5 court of this state or other jurisdiction, a crime which
6 relates to the ability to practice opticianry or to the
7 practice of opticianry.
8 (r)(s) Having been disciplined by a regulatory agency
9 in another state for any offense that would constitute a
10 violation of Florida law or rules regulating opticianry.
11 (s)(t) Being unable to practice opticianry with
12 reasonable skill and safety by reason of illness or use of
13 drugs, narcotics, chemicals, or any other type of material or
14 as a result of any mental or physical condition. An optician
15 affected under this paragraph shall at reasonable intervals be
16 afforded an opportunity to demonstrate that she or he can
17 resume the competent practice of opticianry with reasonable
18 skill and safety to her or his customers.
19 (t) Violating any provision of this chapter or chapter
20 456, or any rules adopted pursuant thereto.
21 (2) The board may enter an order denying licensure or
22 imposing any of the penalties in s. 456.072(2) against any
23 applicant for licensure or licensee who is found guilty of
24 violating any provision of subsection (1) of this section or
25 who is found guilty of violating any provision of s.
26 456.072(1). When the board finds any person guilty of any of
27 the grounds set forth in subsection (1), it may enter an order
28 imposing one or more of the following penalties:
29 (a) Refusal to certify to the department an
30 application for licensure.
31 (b) Revocation or suspension of a license.
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1 (c) Imposition of an administrative fine not to exceed
2 $1,000 for each count or separate offense.
3 (d) Issuance of a reprimand.
4 (e) Placement of the optician on probation for a
5 period of time and subject to such conditions as the board may
6 specify, including requiring the optician to submit to
7 treatment or to work under the supervision of another
8 optician.
9 Section 52. Subsections (1) and (2) of section
10 484.056, Florida Statutes, are amended to read:
11 484.056 Disciplinary proceedings.--
12 (1) The following acts constitute relating to the
13 practice of dispensing hearing aids shall be grounds for
14 denial of a license or disciplinary action, as specified in s.
15 456.072(2) both disciplinary action against a hearing aid
16 specialist as set forth in this section and cease and desist
17 or other related action by the department as set forth in s.
18 456.065 against any person owning or operating a hearing aid
19 establishment who engages in, aids, or abets any such
20 violation:
21 (a) Violation of any provision of s. 456.072(1), s.
22 484.0512, or s. 484.053.
23 (b) Attempting to procure a license to dispense
24 hearing aids by bribery, by fraudulent misrepresentations, or
25 through an error of the department or the board.
26 (c) Having a license to dispense hearing aids revoked,
27 suspended, or otherwise acted against, including the denial of
28 licensure, by the licensing authority of another state,
29 territory, or country.
30 (d) Being convicted or found guilty of, or entering a
31 plea of nolo contendere to, regardless of adjudication, a
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1 crime in any jurisdiction which directly relates to the
2 practice of dispensing hearing aids or the ability to practice
3 dispensing hearing aids, including violations of any federal
4 laws or regulations regarding hearing aids.
5 (e) Making or filing a report or record which the
6 licensee knows to be false, intentionally or negligently
7 failing to file a report or record required by state or
8 federal law, willfully impeding or obstructing such filing, or
9 inducing another person to impede or obstruct such filing.
10 Such reports or records shall include only those reports or
11 records which are signed in one's capacity as a licensed
12 hearing aid specialist.
13 (f) Advertising goods or services in a manner which is
14 fraudulent, false, deceptive, or misleading in form or
15 content.
16 (g) Proof that the licensee is guilty of fraud or
17 deceit or of negligence, incompetency, or misconduct in the
18 practice of dispensing hearing aids.
19 (h) Violation or repeated violation of this part or of
20 chapter 456, or any rules promulgated pursuant thereto.
21 (h)(i) Violation of a lawful order of the board or
22 department previously entered in a disciplinary hearing or
23 failure to comply with a lawfully issued subpoena of the board
24 or department.
25 (i)(j) Practicing with a revoked, suspended, inactive,
26 or delinquent license.
27 (j)(k) Using, or causing or promoting the use of, any
28 advertising matter, promotional literature, testimonial,
29 guarantee, warranty, label, brand, insignia, or other
30 representation, however disseminated or published, which is
31 misleading, deceiving, or untruthful.
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1 (k)(l) Showing or demonstrating, or, in the event of
2 sale, delivery of, a product unusable or impractical for the
3 purpose represented or implied by such action.
4 (l)(m) Misrepresentation of professional services
5 available in the fitting, sale, adjustment, service, or repair
6 of a hearing aid, or use of the terms "doctor," "clinic,"
7 "clinical," "medical audiologist," "clinical audiologist,"
8 "research audiologist," or "audiologic" or any other term or
9 title which might connote the availability of professional
10 services when such use is not accurate.
11 (m)(n) Representation, advertisement, or implication
12 that a hearing aid or its repair is guaranteed without
13 providing full disclosure of the identity of the guarantor;
14 the nature, extent, and duration of the guarantee; and the
15 existence of conditions or limitations imposed upon the
16 guarantee.
17 (n)(o) Representing, directly or by implication, that
18 a hearing aid utilizing bone conduction has certain specified
19 features, such as the absence of anything in the ear or
20 leading to the ear, or the like, without disclosing clearly
21 and conspicuously that the instrument operates on the bone
22 conduction principle and that in many cases of hearing loss
23 this type of instrument may not be suitable.
24 (o)(p) Making any predictions or prognostications as
25 to the future course of a hearing impairment, either in
26 general terms or with reference to an individual person.
27 (p)(q) Stating or implying that the use of any hearing
28 aid will improve or preserve hearing or prevent or retard the
29 progression of a hearing impairment or that it will have any
30 similar or opposite effect.
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1 (q)(r) Making any statement regarding the cure of the
2 cause of a hearing impairment by the use of a hearing aid.
3 (r)(s) Representing or implying that a hearing aid is
4 or will be "custom-made," "made to order," or
5 "prescription-made" or in any other sense specially fabricated
6 for an individual person when such is not the case.
7 (s)(t) Canvassing from house to house or by telephone
8 either in person or by an agent for the purpose of selling a
9 hearing aid, except that contacting persons who have evidenced
10 an interest in hearing aids, or have been referred as in need
11 of hearing aids, shall not be considered canvassing.
12 (t)(u) Failure to submit to the board on an annual
13 basis, or such other basis as may be provided by rule,
14 certification of testing and calibration of audiometric
15 testing equipment on the form approved by the board.
16 (u)(v) Failing to provide all information as described
17 in s. 484.051(1).
18 (v)(w) Exercising influence on a client in such a
19 manner as to exploit the client for financial gain of the
20 licensee or of a third party.
21 (w) Violating any provision of this chapter or chapter
22 456, or any rules adopted pursuant thereto.
23 (2)(a) The board may enter an order denying licensure
24 or imposing any of the penalties in s. 456.072(2) against any
25 applicant for licensure or licensee who is found guilty of
26 violating any provision of subsection (1) of this section or
27 who is found guilty of violating any provision of s.
28 456.072(1). Except as provided in paragraph (b), when the
29 board finds any hearing aid specialist to be guilty of any of
30 the grounds set forth in subsection (1), it may enter an order
31 imposing one or more of the following penalties:
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1 1. Denial of an application for licensure.
2 2. Revocation or suspension of a license.
3 3. Imposition of an administrative fine not to exceed
4 $1,000 for each count or separate offense.
5 4. Issuance of a reprimand.
6 5. Placing the hearing aid specialist on probation for
7 a period of time and subject to such conditions as the board
8 may specify, including requiring the hearing aid specialist to
9 attend continuing education courses or to work under the
10 supervision of another hearing aid specialist.
11 6. Restricting the authorized scope of practice.
12 (b) The board shall revoke the license of any hearing
13 aid specialist found guilty of canvassing as described in this
14 section.
15 Section 53. Subsections (1) and (2) of section
16 486.125, Florida Statutes, are amended to read:
17 486.125 Refusal, revocation, or suspension of license;
18 administrative fines and other disciplinary measures.--
19 (1) The following acts shall constitute grounds for
20 denial of a license or disciplinary action, as specified in s.
21 456.072(2) which the disciplinary actions specified in
22 subsection (2) may be taken:
23 (a) Being unable to practice physical therapy with
24 reasonable skill and safety to patients by reason of illness
25 or use of alcohol, drugs, narcotics, chemicals, or any other
26 type of material or as a result of any mental or physical
27 condition.
28 1. In enforcing this paragraph, upon a finding of the
29 secretary or the secretary's designee that probable cause
30 exists to believe that the licensee is unable to practice
31 physical therapy due to the reasons stated in this paragraph,
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1 the department shall have the authority to compel a physical
2 therapist or physical therapist assistant to submit to a
3 mental or physical examination by a physician designated by
4 the department. If the licensee refuses to comply with such
5 order, the department's order directing such examination may
6 be enforced by filing a petition for enforcement in the
7 circuit court where the licensee resides or serves as a
8 physical therapy practitioner. The licensee against whom the
9 petition is filed shall not be named or identified by initials
10 in any public court records or documents, and the proceedings
11 shall be closed to the public. The department shall be
12 entitled to the summary procedure provided in s. 51.011.
13 2. A physical therapist or physical therapist
14 assistant whose license is suspended or revoked pursuant to
15 this subsection shall, at reasonable intervals, be given an
16 opportunity to demonstrate that she or he can resume the
17 competent practice of physical therapy with reasonable skill
18 and safety to patients.
19 3. Neither the record of proceeding nor the orders
20 entered by the board in any proceeding under this subsection
21 may be used against a physical therapist or physical therapist
22 assistant in any other proceeding.
23 (b) Having committed fraud in the practice of physical
24 therapy or deceit in obtaining a license as a physical
25 therapist or as a physical therapist assistant.
26 (c) Being convicted or found guilty regardless of
27 adjudication, of a crime in any jurisdiction which directly
28 relates to the practice of physical therapy or to the ability
29 to practice physical therapy. The entry of any plea of nolo
30 contendere shall be considered a conviction for purpose of
31 this chapter.
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1 (d) Having treated or undertaken to treat human
2 ailments by means other than by physical therapy, as defined
3 in this chapter.
4 (e) Failing to maintain acceptable standards of
5 physical therapy practice as set forth by the board in rules
6 adopted pursuant to this chapter.
7 (f) Engaging directly or indirectly in the dividing,
8 transferring, assigning, rebating, or refunding of fees
9 received for professional services, or having been found to
10 profit by means of a credit or other valuable consideration,
11 such as an unearned commission, discount, or gratuity, with
12 any person referring a patient or with any relative or
13 business associate of the referring person. Nothing in this
14 chapter shall be construed to prohibit the members of any
15 regularly and properly organized business entity which is
16 comprised of physical therapists and which is recognized under
17 the laws of this state from making any division of their total
18 fees among themselves as they determine necessary.
19 (g) Having a license revoked or suspended; having had
20 other disciplinary action taken against her or him; or having
21 had her or his application for a license refused, revoked, or
22 suspended by the licensing authority of another state,
23 territory, or country.
24 (h) Violating any provision of this chapter, a rule of
25 the board or department, or a lawful order of the board or
26 department previously entered in a disciplinary hearing.
27 (i) Making or filing a report or record which the
28 licensee knows to be false. Such reports or records shall
29 include only those which are signed in the capacity of a
30 physical therapist.
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1 (j) Practicing or offering to practice beyond the
2 scope permitted by law or accepting and performing
3 professional responsibilities which the licensee knows or has
4 reason to know that she or he is not competent to perform,
5 including, but not limited to, specific spinal manipulation.
6 (k) Violating any provision of this chapter or chapter
7 456, or any rules adopted pursuant thereto.
8 (2) The board may enter an order denying licensure or
9 imposing any of the penalties in s. 456.072(2) against any
10 applicant for licensure or licensee who is found guilty of
11 violating any provision of subsection (1) of this section or
12 who is found guilty of violating any provision of s.
13 456.072(1). When the board finds any person guilty of any of
14 the grounds set forth in subsection (1), it may enter an order
15 imposing one or more of the following penalties:
16 (a) Refusal to certify to the department an
17 application for licensure.
18 (b) Revocation or suspension of a license.
19 (c) Restriction of practice.
20 (d) Imposition of an administrative fine not to exceed
21 $1,000 for each count or separate offense.
22 (e) Issuance of a reprimand.
23 (f) Placement of the physical therapist or physical
24 therapist assistant on probation for a period of time and
25 subject to such conditions as the board may specify,
26 including, but not limited to, requiring the physical
27 therapist or physical therapist assistant to submit to
28 treatment, to attend continuing education courses, to submit
29 to reexamination, or to work under the supervision of another
30 physical therapist.
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1 (g) Recovery of actual costs of investigation and
2 prosecution.
3 Section 54. Section 490.009, Florida Statutes, is
4 amended to read:
5 490.009 Discipline.--
6 (1) When the department or, in the case of
7 psychologists, the board finds that an applicant, provisional
8 licensee, or licensee whom it regulates under this chapter has
9 committed any of the acts set forth in subsection (2), it may
10 issue an order imposing one or more of the following
11 penalties:
12 (a) Denial of an application for licensure, either
13 temporarily or permanently.
14 (b) Revocation of an application for licensure, either
15 temporarily or permanently.
16 (c) Suspension for a period of up to 5 years or
17 revocation of a license, after hearing.
18 (d) Immediate suspension of a license pursuant to s.
19 120.60(6).
20 (e) Imposition of an administrative fine not to exceed
21 $5,000 for each count or separate offense.
22 (f) Issuance of a public reprimand.
23 (g) Placement of an applicant or licensee on probation
24 for a period of time and subject to conditions specified by
25 the department or, in the case of psychologists, by the board,
26 including, but not limited to, requiring the applicant or
27 licensee to submit to treatment, to attend continuing
28 education courses, to submit to reexamination, or to work
29 under the supervision of a designated licensee.
30 (h) Restriction of practice.
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1 (1)(2) The following acts constitute of a licensee,
2 provisional licensee, or applicant are grounds for denial of a
3 license or disciplinary action, as specified in s. 456.072(2)
4 which the disciplinary actions listed in subsection (1) may be
5 taken:
6 (a) Attempting to obtain, obtaining, or renewing a
7 license under this chapter by bribery or fraudulent
8 misrepresentation or through an error of the board or
9 department.
10 (b) Having a license to practice a comparable
11 profession revoked, suspended, or otherwise acted against,
12 including the denial of certification or licensure by another
13 state, territory, or country.
14 (c) Being convicted or found guilty, regardless of
15 adjudication, of a crime in any jurisdiction which directly
16 relates to the practice of his or her profession or the
17 ability to practice his or her profession. A plea of nolo
18 contendere creates a rebuttable presumption of guilt of the
19 underlying criminal charges. However, the board shall allow
20 the person who is the subject of the disciplinary proceeding
21 to present any evidence relevant to the underlying charges and
22 circumstances surrounding the plea.
23 (d) False, deceptive, or misleading advertising or
24 obtaining a fee or other thing of value on the representation
25 that beneficial results from any treatment will be guaranteed.
26 (e) Advertising, practicing, or attempting to practice
27 under a name other than one's own.
28 (f) Maintaining a professional association with any
29 person who the applicant or licensee knows, or has reason to
30 believe, is in violation of this chapter or of a rule of the
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1 department or, in the case of psychologists, of the department
2 or the board.
3 (g) Knowingly aiding, assisting, procuring, or
4 advising any nonlicensed person to hold himself or herself out
5 as licensed under this chapter.
6 (h) Failing to perform any statutory or legal
7 obligation placed upon a person licensed under this chapter.
8 (i) Willfully making or filing a false report or
9 record; failing to file a report or record required by state
10 or federal law; willfully impeding or obstructing the filing
11 of a report or record; or inducing another person to make or
12 file a false report or record or to impede or obstruct the
13 filing of a report or record. Such report or record includes
14 only a report or record which requires the signature of a
15 person licensed under this chapter.
16 (j) Paying a kickback, rebate, bonus, or other
17 remuneration for receiving a patient or client, or receiving a
18 kickback, rebate, bonus, or other remuneration for referring a
19 patient or client to another provider of mental health care
20 services or to a provider of health care services or goods;
21 referring a patient or client to oneself for services on a
22 fee-paid basis when those services are already being paid for
23 by some other public or private entity; or entering into a
24 reciprocal referral agreement.
25 (k) Committing any act upon a patient or client which
26 would constitute sexual battery or which would constitute
27 sexual misconduct as defined in s. 490.0111.
28 (l) Making misleading, deceptive, untrue, or
29 fraudulent representations in the practice of any profession
30 licensed under this chapter.
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1 (m) Soliciting patients or clients personally, or
2 through an agent, through the use of fraud, intimidation,
3 undue influence, or a form of overreaching or vexatious
4 conduct.
5 (n) Failing to make available to a patient or client,
6 upon written request, copies of test results, reports, or
7 documents in the possession or under the control of the
8 licensee which have been prepared for and paid for by the
9 patient or client.
10 (o) Failing to respond within 30 days to a written
11 communication from the department concerning any investigation
12 by the department or to make available any relevant records
13 with respect to any investigation about the licensee's conduct
14 or background.
15 (p) Being unable to practice the profession for which
16 he or she is licensed under this chapter with reasonable skill
17 or competence as a result of any mental or physical condition
18 or by reason of illness; drunkenness; or excessive use of
19 drugs, narcotics, chemicals, or any other substance. In
20 enforcing this paragraph, upon a finding by the secretary, the
21 secretary's designee, or the board that probable cause exists
22 to believe that the licensee is unable to practice the
23 profession because of the reasons stated in this paragraph,
24 the department shall have the authority to compel a licensee
25 to submit to a mental or physical examination by psychologists
26 or physicians designated by the department or board. If the
27 licensee refuses to comply with the department's order, the
28 department may file a petition for enforcement in the circuit
29 court of the circuit in which the licensee resides or does
30 business. The licensee shall not be named or identified by
31 initials in the petition or in any other public court records
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1 or documents, and the enforcement proceedings shall be closed
2 to the public. The department shall be entitled to the
3 summary procedure provided in s. 51.011. A licensee affected
4 under this paragraph shall be afforded an opportunity at
5 reasonable intervals to demonstrate that he or she can resume
6 the competent practice for which he or she is licensed with
7 reasonable skill and safety to patients.
8 (q) Violating provisions of this chapter, or of
9 chapter 456, or any rules adopted pursuant thereto.
10 (q)(r) Performing any treatment or prescribing any
11 therapy which, by the prevailing standards of the mental
12 health professions in the community, would constitute
13 experimentation on human subjects, without first obtaining
14 full, informed, and written consent.
15 (r)(s) Failing to meet the minimum standards of
16 performance in professional activities when measured against
17 generally prevailing peer performance, including the
18 undertaking of activities for which the licensee is not
19 qualified by training or experience.
20 (s)(t) Delegating professional responsibilities to a
21 person whom the licensee knows or has reason to know is not
22 qualified by training or experience to perform such
23 responsibilities.
24 (t)(u) Violating a rule relating to the regulation of
25 the profession or a lawful order of the department previously
26 entered in a disciplinary hearing.
27 (u)(v) Failing to maintain in confidence a
28 communication made by a patient or client in the context of
29 such services, except as provided in s. 490.0147.
30
31
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1 (v)(w) Making public statements which are derived from
2 test data, client contacts, or behavioral research and which
3 identify or damage research subjects or clients.
4 (w) Violating any provision of this chapter or chapter
5 456, or any rules adopted pursuant thereto.
6 (2) The department, or in the case of psychologists,
7 the board, may enter an order denying licensure or imposing
8 any of the penalties in s. 456.072(2) against any applicant
9 for licensure or licensee who is found guilty of violating any
10 provision of subsection (1) of this section or who is found
11 guilty of violating any provision of s. 456.072(1).
12 Section 55. Section 491.009, Florida Statutes, is
13 amended to read:
14 491.009 Discipline.--
15 (1) When the department or the board finds that an
16 applicant, licensee, provisional licensee, registered intern,
17 or certificateholder whom it regulates under this chapter has
18 committed any of the acts set forth in subsection (2), it may
19 issue an order imposing one or more of the following
20 penalties:
21 (a) Denial of an application for licensure,
22 registration, or certification, either temporarily or
23 permanently.
24 (b) Revocation of an application for licensure,
25 registration, or certification, either temporarily or
26 permanently.
27 (c) Suspension for a period of up to 5 years or
28 revocation of a license, registration, or certificate, after
29 hearing.
30 (d) Immediate suspension of a license, registration,
31 or certificate pursuant to s. 120.60(6).
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1 (e) Imposition of an administrative fine not to exceed
2 $1,000 for each count or separate offense.
3 (f) Issuance of a public reprimand.
4 (g) Placement of an applicant, licensee, registered
5 intern, or certificateholder on probation for a period of time
6 and subject to such conditions as the board may specify,
7 including, but not limited to, requiring the applicant,
8 licensee, registered intern, or certificateholder to submit to
9 treatment, to attend continuing education courses, to submit
10 to reexamination, or to work under the supervision of a
11 designated licensee or certificateholder.
12 (h) Restriction of practice.
13 (1)(2) The following acts constitute of a licensee,
14 provisional licensee, registered intern, certificateholder, or
15 applicant are grounds for denial of a license or disciplinary
16 action, as specified in s. 456.072(2) which the disciplinary
17 actions listed in subsection (1) may be taken:
18 (a) Attempting to obtain, obtaining, or renewing a
19 license, registration, or certificate under this chapter by
20 bribery or fraudulent misrepresentation or through an error of
21 the board or the department.
22 (b) Having a license, registration, or certificate to
23 practice a comparable profession revoked, suspended, or
24 otherwise acted against, including the denial of certification
25 or licensure by another state, territory, or country.
26 (c) Being convicted or found guilty of, regardless of
27 adjudication, or having entered a plea of nolo contendere to,
28 a crime in any jurisdiction which directly relates to the
29 practice of his or her profession or the ability to practice
30 his or her profession. However, in the case of a plea of nolo
31 contendere, the board shall allow the person who is the
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1 subject of the disciplinary proceeding to present evidence in
2 mitigation relevant to the underlying charges and
3 circumstances surrounding the plea.
4 (d) False, deceptive, or misleading advertising or
5 obtaining a fee or other thing of value on the representation
6 that beneficial results from any treatment will be guaranteed.
7 (e) Advertising, practicing, or attempting to practice
8 under a name other than one's own.
9 (f) Maintaining a professional association with any
10 person who the applicant, licensee, registered intern, or
11 certificateholder knows, or has reason to believe, is in
12 violation of this chapter or of a rule of the department or
13 the board.
14 (g) Knowingly aiding, assisting, procuring, or
15 advising any nonlicensed, nonregistered, or noncertified
16 person to hold himself or herself out as licensed, registered,
17 or certified under this chapter.
18 (h) Failing to perform any statutory or legal
19 obligation placed upon a person licensed, registered, or
20 certified under this chapter.
21 (i) Willfully making or filing a false report or
22 record; failing to file a report or record required by state
23 or federal law; willfully impeding or obstructing the filing
24 of a report or record; or inducing another person to make or
25 file a false report or record or to impede or obstruct the
26 filing of a report or record. Such report or record includes
27 only a report or record which requires the signature of a
28 person licensed, registered, or certified under this chapter.
29 (j) Paying a kickback, rebate, bonus, or other
30 remuneration for receiving a patient or client, or receiving a
31 kickback, rebate, bonus, or other remuneration for referring a
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1 patient or client to another provider of mental health care
2 services or to a provider of health care services or goods;
3 referring a patient or client to oneself for services on a
4 fee-paid basis when those services are already being paid for
5 by some other public or private entity; or entering into a
6 reciprocal referral agreement.
7 (k) Committing any act upon a patient or client which
8 would constitute sexual battery or which would constitute
9 sexual misconduct as defined pursuant to s. 491.0111.
10 (l) Making misleading, deceptive, untrue, or
11 fraudulent representations in the practice of any profession
12 licensed, registered, or certified under this chapter.
13 (m) Soliciting patients or clients personally, or
14 through an agent, through the use of fraud, intimidation,
15 undue influence, or a form of overreaching or vexatious
16 conduct.
17 (n) Failing to make available to a patient or client,
18 upon written request, copies of tests, reports, or documents
19 in the possession or under the control of the licensee,
20 registered intern, or certificateholder which have been
21 prepared for and paid for by the patient or client.
22 (o) Failing to respond within 30 days to a written
23 communication from the department or the board concerning any
24 investigation by the department or the board, or failing to
25 make available any relevant records with respect to any
26 investigation about the licensee's, registered intern's, or
27 certificateholder's conduct or background.
28 (p) Being unable to practice the profession for which
29 he or she is licensed, registered, or certified under this
30 chapter with reasonable skill or competence as a result of any
31 mental or physical condition or by reason of illness;
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1 drunkenness; or excessive use of drugs, narcotics, chemicals,
2 or any other substance. In enforcing this paragraph, upon a
3 finding by the secretary, the secretary's designee, or the
4 board that probable cause exists to believe that the licensee,
5 registered intern, or certificateholder is unable to practice
6 the profession because of the reasons stated in this
7 paragraph, the department shall have the authority to compel a
8 licensee, registered intern, or certificateholder to submit to
9 a mental or physical examination by psychologists, physicians,
10 or other licensees under this chapter, designated by the
11 department or board. If the licensee, registered intern, or
12 certificateholder refuses to comply with such order, the
13 department's order directing the examination may be enforced
14 by filing a petition for enforcement in the circuit court in
15 the circuit in which the licensee, registered intern, or
16 certificateholder resides or does business. The licensee,
17 registered intern, or certificateholder against whom the
18 petition is filed shall not be named or identified by initials
19 in any public court records or documents, and the proceedings
20 shall be closed to the public. The department shall be
21 entitled to the summary procedure provided in s. 51.011. A
22 licensee, registered intern, or certificateholder affected
23 under this paragraph shall at reasonable intervals be afforded
24 an opportunity to demonstrate that he or she can resume the
25 competent practice for which he or she is licensed,
26 registered, or certified with reasonable skill and safety to
27 patients.
28 (q) Violating provisions of this chapter, or of
29 chapter 456, or any rules adopted pursuant thereto.
30 (q)(r) Performing any treatment or prescribing any
31 therapy which, by the prevailing standards of the mental
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1 health professions in the community, would constitute
2 experimentation on human subjects, without first obtaining
3 full, informed, and written consent.
4 (r)(s) Failing to meet the minimum standards of
5 performance in professional activities when measured against
6 generally prevailing peer performance, including the
7 undertaking of activities for which the licensee, registered
8 intern, or certificateholder is not qualified by training or
9 experience.
10 (s)(t) Delegating professional responsibilities to a
11 person whom the licensee, registered intern, or
12 certificateholder knows or has reason to know is not qualified
13 by training or experience to perform such responsibilities.
14 (t)(u) Violating a rule relating to the regulation of
15 the profession or a lawful order of the department or the
16 board previously entered in a disciplinary hearing.
17 (u)(v) Failure of the licensee, registered intern, or
18 certificateholder to maintain in confidence a communication
19 made by a patient or client in the context of such services,
20 except as provided in s. 491.0147.
21 (v)(w) Making public statements which are derived from
22 test data, client contacts, or behavioral research and which
23 identify or damage research subjects or clients.
24 (w) Violating any provision of this chapter or chapter
25 456, or any rules adopted pursuant thereto.
26 (2) The department, or in the case of psychologists,
27 the board, may enter an order denying licensure or imposing
28 any of the penalties in s. 456.072(2) against any applicant
29 for licensure or licensee who is found guilty of violating any
30 provision of subsection (1) of this section or who is found
31 guilty of violating any provision of s. 456.072(1).
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1 Section 56. Subsection (3) of section 456.065, Florida
2 Statutes, is amended to read:
3 456.065 Unlicensed practice of a health care
4 profession; intent; cease and desist notice; penalties;
5 enforcement; citations; fees; allocation and disposition of
6 moneys collected.--
7 (3) Because all enforcement costs should be covered by
8 professions regulated by the department, the department shall
9 impose, upon initial licensure and each licensure renewal, a
10 special fee of $5 per licensee to fund efforts to combat
11 unlicensed activity. Such fee shall be in addition to all
12 other fees collected from each licensee. The board, with
13 concurrence of the department, or the department when there is
14 no board, may earmark $5 of the current licensure fee for this
15 purpose, if such board, or profession regulated by the
16 department, is not in a deficit and has a reasonable cash
17 balance. The department shall make direct charges to the
18 Medical Quality Assurance Trust Fund by profession. The
19 department shall seek board advice regarding enforcement
20 methods and strategies. The department shall directly credit
21 the Medical Quality Assurance Trust Fund, by profession, with
22 the revenues received from the department's efforts to enforce
23 licensure provisions. The department shall include all
24 financial and statistical data resulting from unlicensed
25 activity enforcement as a separate category in the quarterly
26 management report provided for in s. 456.025. For an
27 unlicensed activity account, a balance which remains at the
28 end of a renewal cycle may, with concurrence of the applicable
29 board and the department, be transferred to the operating fund
30 account of that profession. The department shall also use
31
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1 these funds to inform and educate consumers generally on the
2 importance of using licensed health care practitioners.
3 Section 57. Effective October 1, 2001, paragraphs (e)
4 and (f) of subsection (4) of section 458.347, Florida
5 Statutes, are amended to read:
6 458.347 Physician assistants.--
7 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
8 (e) A supervisory physician may delegate to a fully
9 licensed physician assistant the authority to prescribe any
10 medication used in the supervisory physician's practice unless
11 if such medication is listed on the formulary created pursuant
12 to paragraph (f). A fully licensed physician assistant may
13 only prescribe such medication under the following
14 circumstances:
15 1. A physician assistant must clearly identify to the
16 patient that he or she is a physician assistant. Furthermore,
17 the physician assistant must inform the patient that the
18 patient has the right to see the physician prior to any
19 prescription being prescribed by the physician assistant.
20 2. The supervisory physician must notify the
21 department of his or her intent to delegate, on a
22 department-approved form, before delegating such authority and
23 notify the department of any change in prescriptive privileges
24 of the physician assistant.
25 3. The physician assistant must file with the
26 department, before commencing to prescribe, evidence that he
27 or she has completed a continuing medical education course of
28 at least 3 classroom hours in prescriptive practice, conducted
29 by an accredited program approved by the boards, which course
30 covers the limitations, responsibilities, and privileges
31 involved in prescribing medicinal drugs, or evidence that he
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1 or she has received education comparable to the continuing
2 education course as part of an accredited physician assistant
3 training program.
4 4. The physician assistant must file with the
5 department, before commencing to prescribe, evidence that the
6 physician assistant has a minimum of 3 months of clinical
7 experience in the specialty area of the supervising physician.
8 5. The physician assistant must file with the
9 department a signed affidavit that he or she has completed a
10 minimum of 10 continuing medical education hours in the
11 specialty practice in which the physician assistant has
12 prescriptive privileges with each licensure renewal
13 application.
14 6. The department shall issue a license and a
15 prescriber number to the physician assistant granting
16 authority for the prescribing of medicinal drugs authorized
17 within this paragraph upon completion of the foregoing
18 requirements.
19 7. The prescription must be written in a form that
20 complies with chapter 499 and must contain, in addition to the
21 supervisory physician's name, address, and telephone number,
22 the physician assistant's prescriber number. Unless it is a
23 drug sample dispensed by the physician assistant, the
24 prescription must be filled in a pharmacy permitted under
25 chapter 465 and must be dispensed in that pharmacy by a
26 pharmacist licensed under chapter 465. The appearance of the
27 prescriber number creates a presumption that the physician
28 assistant is authorized to prescribe the medicinal drug and
29 the prescription is valid.
30 8. The physician assistant must note the prescription
31 in the appropriate medical record, and the supervisory
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1 physician must review and sign each notation. For dispensing
2 purposes only, the failure of the supervisory physician to
3 comply with these requirements does not affect the validity of
4 the prescription.
5 9. This paragraph does not prohibit a supervisory
6 physician from delegating to a physician assistant the
7 authority to order medication for a hospitalized patient of
8 the supervisory physician.
9
10 This paragraph does not apply to facilities licensed pursuant
11 to chapter 395.
12 (f)1. There is created a five-member committee
13 appointed by the Secretary of Health. The committee must be
14 composed of one fully licensed physician assistant licensed
15 pursuant to this section or s. 459.022, two physicians
16 licensed pursuant to this chapter, one of whom supervises a
17 fully licensed physician assistant, one osteopathic physician
18 licensed pursuant to chapter 459, and one pharmacist licensed
19 pursuant to chapter 465 who is not licensed pursuant to this
20 chapter or chapter 459. The council committee shall establish
21 a formulary of medicinal drugs that for which a fully licensed
22 physician assistant, licensed under this section or s.
23 459.022, may not prescribe. The formulary must may not include
24 controlled substances as defined in chapter 893,
25 antineoplastics, antipsychotics, radiopharmaceuticals, general
26 anesthetics and or radiographic contrast materials, and all or
27 any parenteral preparations except insulin and epinephrine.
28 2. In establishing the formulary, the council shall
29 consult with a pharmacist licensed under chapter 465, but not
30 licensed under this chapter or chapter 459, who shall be
31 selected by the Secretary of Health.
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1 3.2. Only the council committee shall add to, delete
2 from, or modify the formulary. Any person who requests an
3 addition, deletion, or modification of a medicinal drug listed
4 on such formulary has the burden of proof to show cause why
5 such addition, deletion, or modification should be made.
6 4.3. The boards shall adopt the formulary required by
7 this paragraph, and each addition, deletion, or modification
8 to the formulary, by rule. Notwithstanding any provision of
9 chapter 120 to the contrary, the formulary rule shall be
10 effective 60 days after the date it is filed with the
11 Secretary of State. Upon adoption of the formulary, the
12 department shall mail a copy of such formulary to each fully
13 licensed physician assistant, licensed under this section or
14 s. 459.022, and to each pharmacy licensed by the state. The
15 boards shall establish, by rule, a fee not to exceed $200 to
16 fund the provisions of this paragraph and paragraph (e).
17 Section 58. Effective October 1, 2001, subsection (4)
18 and paragraph (c) of subsection (9) of section 459.022,
19 Florida Statutes, are amended to read:
20 459.022 Physician assistants.--
21 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
22 (a) The boards shall adopt, by rule, the general
23 principles that supervising physicians must use in developing
24 the scope of practice of a physician assistant under direct
25 supervision and under indirect supervision. These principles
26 shall recognize the diversity of both specialty and practice
27 settings in which physician assistants are used.
28 (b) This chapter does not prevent third-party payors
29 from reimbursing employers of physician assistants for covered
30 services rendered by licensed physician assistants.
31
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1 (c) Licensed physician assistants may not be denied
2 clinical hospital privileges, except for cause, so long as the
3 supervising physician is a staff member in good standing.
4 (d) A supervisory physician may delegate to a licensed
5 physician assistant, pursuant to a written protocol, the
6 authority to act according to s. 154.04(1)(c). Such delegated
7 authority is limited to the supervising physician's practice
8 in connection with a county health department as defined and
9 established pursuant to chapter 154. The boards shall adopt
10 rules governing the supervision of physician assistants by
11 physicians in county health departments.
12 (e) A supervisory physician may delegate to a fully
13 licensed physician assistant the authority to prescribe any
14 medication used in the supervisory physician's practice unless
15 if such medication is listed on the formulary created pursuant
16 to s. 458.347. A fully licensed physician assistant may only
17 prescribe such medication under the following circumstances:
18 1. A physician assistant must clearly identify to the
19 patient that she or he is a physician assistant. Furthermore,
20 the physician assistant must inform the patient that the
21 patient has the right to see the physician prior to any
22 prescription being prescribed by the physician assistant.
23 2. The supervisory physician must notify the
24 department of her or his intent to delegate, on a
25 department-approved form, before delegating such authority and
26 notify the department of any change in prescriptive privileges
27 of the physician assistant.
28 3. The physician assistant must file with the
29 department, before commencing to prescribe, evidence that she
30 or he has completed a continuing medical education course of
31 at least 3 classroom hours in prescriptive practice, conducted
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1 by an accredited program approved by the boards, which course
2 covers the limitations, responsibilities, and privileges
3 involved in prescribing medicinal drugs, or evidence that she
4 or he has received education comparable to the continuing
5 education course as part of an accredited physician assistant
6 training program.
7 4. The physician assistant must file with the
8 department, before commencing to prescribe, evidence that the
9 physician assistant has a minimum of 3 months of clinical
10 experience in the specialty area of the supervising physician.
11 5. The physician assistant must file with the
12 department a signed affidavit that she or he has completed a
13 minimum of 10 continuing medical education hours in the
14 specialty practice in which the physician assistant has
15 prescriptive privileges with each licensure renewal
16 application.
17 6. The department shall issue a license and a
18 prescriber number to the physician assistant granting
19 authority for the prescribing of medicinal drugs authorized
20 within this paragraph upon completion of the foregoing
21 requirements.
22 7. The prescription must be written in a form that
23 complies with chapter 499 and must contain, in addition to the
24 supervisory physician's name, address, and telephone number,
25 the physician assistant's prescriber number. Unless it is a
26 drug sample dispensed by the physician assistant, the
27 prescription must be filled in a pharmacy permitted under
28 chapter 465, and must be dispensed in that pharmacy by a
29 pharmacist licensed under chapter 465. The appearance of the
30 prescriber number creates a presumption that the physician
31
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1 assistant is authorized to prescribe the medicinal drug and
2 the prescription is valid.
3 8. The physician assistant must note the prescription
4 in the appropriate medical record, and the supervisory
5 physician must review and sign each notation. For dispensing
6 purposes only, the failure of the supervisory physician to
7 comply with these requirements does not affect the validity of
8 the prescription.
9 9. This paragraph does not prohibit a supervisory
10 physician from delegating to a physician assistant the
11 authority to order medication for a hospitalized patient of
12 the supervisory physician.
13
14 This paragraph does not apply to facilities licensed pursuant
15 to chapter 395.
16 (f)1. There is created a five-member committee
17 appointed by the Secretary of Health. The committee must be
18 composed of one fully licensed physician assistant licensed
19 pursuant to this section or s. 458.347, two physicians
20 licensed pursuant to chapter 458, one of whom supervises a
21 fully licensed physician assistant, one osteopathic physician
22 licensed pursuant to this chapter, and one pharmacist licensed
23 pursuant to chapter 465 who is not licensed pursuant to this
24 chapter or chapter 458. The committee shall establish a
25 formulary of medicinal drugs for which a fully licensed
26 physician assistant may prescribe. The formulary may not
27 include controlled substances as defined in chapter 893,
28 antineoplastics, antipsychotics, radiopharmaceuticals, general
29 anesthetics or radiographic contrast materials, or any
30 parenteral preparations except insulin and epinephrine.
31
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1 2. Only the committee shall add to, delete from, or
2 modify the formulary. Any person who requests an addition,
3 deletion, or modification of a medicinal drug listed on such
4 formulary has the burden of proof to show cause why such
5 addition, deletion, or modification should be made.
6 3. The boards shall adopt the formulary required by
7 this paragraph, and each addition, deletion, or modification
8 to the formulary, by rule. Notwithstanding any provision of
9 chapter 120 to the contrary, the formulary rule shall be
10 effective 60 days after the date it is filed with the
11 Secretary of State. Upon adoption of the formulary, the
12 department shall mail a copy of such formulary to each fully
13 licensed physician assistant and to each pharmacy licensed by
14 the state. The boards shall establish, by rule, a fee not to
15 exceed $200 to fund the provisions of this paragraph and
16 paragraph (e).
17 (9) COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on
18 Physician Assistants is created within the department.
19 (c) The council shall:
20 1. Recommend to the department the licensure of
21 physician assistants.
22 2. Develop all rules regulating the use of physician
23 assistants by physicians under chapter 458 and this chapter,
24 except for rules relating to the formulary developed under s.
25 458.347(4)(f). The council shall also develop rules to ensure
26 that the continuity of supervision is maintained in each
27 practice setting. The boards shall consider adopting a
28 proposed rule developed by the council at the regularly
29 scheduled meeting immediately following the submission of the
30 proposed rule by the council. A proposed rule submitted by
31 the council may not be adopted by either board unless both
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1 boards have accepted and approved the identical language
2 contained in the proposed rule. The language of all proposed
3 rules submitted by the council must be approved by both boards
4 pursuant to each respective board's guidelines and standards
5 regarding the adoption of proposed rules. If either board
6 rejects the council's proposed rule, that board must specify
7 its objection to the council with particularity and include
8 any recommendations it may have for the modification of the
9 proposed rule.
10 3. Make recommendations to the boards regarding all
11 matters relating to physician assistants.
12 4. Address concerns and problems of practicing
13 physician assistants in order to improve safety in the
14 clinical practices of licensed physician assistants.
15 Section 59. Subsection (6) is added to section
16 456.003, Florida Statutes, to read:
17 456.003 Legislative intent; requirements.--
18 (6) Unless expressly and specifically granted in
19 statute, the duties conferred on the boards do not include the
20 enlargement, modification, or contravention of the lawful
21 scope of practice of the profession regulated by the boards.
22 This subsection shall not prohibit the boards, or the
23 department when there is no board, from taking disciplinary
24 action or issuing a declaratory statement.
25 Section 60. (1)(a) The Agency for Health Care
26 Administration shall create an Organ Transplant Task Force
27 within the Agency for Health Care Administration, which task
28 force must be funded by existing agency funds.
29 (b) Task force participants shall be responsible for
30 only the expenses that they generate individually through
31
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1 participation. The agency shall be responsible for expenses
2 incidental to the production of any required data or reports.
3 (2) The task force shall consist of up to 15 members.
4 The task force chairperson shall be selected by majority vote
5 of a quorum present. Eight members shall constitute a quorum.
6 The membership shall include, but not be limited to, a balance
7 of members representing the Agency for Health Care
8 Administration, health care facilities that have existing
9 organ transplantation programs, individual organ transplant
10 health care practitioners, pediatric organ transplantation
11 programs, organ procurement agencies, and organ transplant
12 recipients or family members.
13 (3) The task force shall meet for the purpose of
14 studying and making recommendations regarding current and
15 future supply of organs in relation to the number of existing
16 organ transplantation programs and the future necessity of the
17 issuance of a certificate of need for proposed organ
18 transplantation programs. At a minimum, the task force shall
19 submit a report to the Legislature which includes a summary of
20 the methods of allocation and distribution of organs; a list
21 of facilities performing multiple organ transplants and the
22 number being performed; the number of Medicaid and charity
23 care patients who have received organ transplants by existing
24 organ transplant programs; suggested mechanisms for funding
25 organ transplants, which shall include, but need not be
26 limited to, an organ transplant trust fund for the treatment
27 of Medicaid and charity patients; the impact of trends in
28 health care delivery and financing on organ transplantation;
29 and the number of certificates of need applications reviewed
30 by the Agency for Health Care Administration in the last 5
31
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1 years, including the number approved or denied and the number
2 litigated.
3 (4) The task force shall meet at the call of the
4 chairperson. The task force shall submit a report to the
5 Governor, the President of the Senate, and the Speaker of the
6 House of Representatives by January 15, 2002. The task force
7 is abolished effective December 31, 2002.
8 Section 61. Section 409.9205, Florida Statutes, is
9 amended to read:
10 409.9205 Medicaid Fraud Control Unit; law enforcement
11 officers.--
12 (1) Except as provided in s. 110.205, all positions in
13 the Medicaid Fraud Control Unit of the Department of Legal
14 Affairs are hereby transferred to the Career Service System.
15 (2) All investigators employed by the Medicaid Fraud
16 Control Unit who have been certified under s. 943.1395 are law
17 enforcement officers of the state. Such investigators have
18 the authority to conduct criminal investigations, bear arms,
19 make arrests, and apply for, serve, and execute search
20 warrants, arrest warrants, capias, and other process
21 throughout the state pertaining to Medicaid fraud as described
22 in this chapter. The Attorney General shall provide
23 reasonable notice of criminal investigations conducted by the
24 Medicaid Fraud Control Unit to, and coordinate those
25 investigations with, the sheriffs of the respective counties.
26 Investigators employed by the Medicaid Fraud Control Unit are
27 not eligible for membership in the Special Risk Class of the
28 Florida Retirement System under s. 121.0515.
29 Section 62. Subsection (1) of section 483.245, Florida
30 Statutes, is amended to read:
31 483.245 Rebates prohibited; penalties.--
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1 (1) It is unlawful for any person to pay or receive
2 any commission, bonus, kickback, or rebate or engage in any
3 split-fee arrangement in any form whatsoever with any dialysis
4 facility, physician, surgeon, organization, agency, or person,
5 either directly or indirectly, for patients referred to a
6 clinical laboratory licensed under this part.
7 Section 63. Subsection (3) of section 232.435, Florida
8 Statutes, is amended to read:
9 232.435 Extracurricular athletic activities; athletic
10 trainers.--
11 (3)(a) To the extent practicable, a school district
12 program should include the following employment classification
13 and advancement scheme:
14 1. First responder - To qualify as a first responder,
15 a person must possess a professional, temporary, part-time,
16 adjunct, or substitute certificate pursuant to s. 231.17, be
17 certified in cardiopulmonary resuscitation, first aid, and
18 have 15 semester hours in courses such as care and prevention
19 of athletic injuries, anatomy, physiology, nutrition,
20 counseling, and other similar courses approved by the
21 Commissioner of Education. This person may only administer
22 first aid and similar care.
23 1. Teacher apprentice trainer I.--To qualify as a
24 teacher apprentice trainer I, a person must possess a
25 professional, temporary, part-time, adjunct, or substitute
26 certificate pursuant to s. 231.17, be certified in first aid
27 and cardiopulmonary resuscitation, and have earned a minimum
28 of 6 semester hours or the equivalent number of inservice
29 education points in the basic prevention and care of athletic
30 injuries.
31
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1 2. Teacher apprentice trainer II.--To qualify as a
2 teacher apprentice trainer II, a person must meet the
3 requirements of teacher apprentice trainer I and also have
4 earned a minimum of 15 additional semester hours or the
5 equivalent number of inservice education points in such
6 courses as anatomy, physiology, use of modalities, nutrition,
7 counseling, and other courses approved by the Commissioner of
8 Education.
9 2.3. Teacher athletic trainer.--To qualify as a
10 teacher athletic trainer, a person must possess a
11 professional, temporary, part-time, adjunct, or substitute
12 certificate pursuant to s. 232.17, and be licensed as required
13 by part XIII of chapter 468 meet the requirements of teacher
14 apprentice trainer II, be certified by the Department of
15 Education or a nationally recognized athletic trainer
16 association, and perform one or more of the following
17 functions: preventing athletic injuries; recognizing,
18 evaluating, managing, treating, and rehabilitating athletic
19 injuries; administering an athletic training program; and
20 educating and counseling athletes.
21 (b) If a school district uses the services of an
22 athletic trainer who is not a teacher athletic trainer or a
23 teacher apprentice trainer within the requirements of this
24 section, such athletic trainer must be licensed as required by
25 part XIII of chapter 468.
26 Section 64. Paragraph (b) of subsection (1) of section
27 383.14, Florida Statutes, is amended to read:
28 383.14 Screening for metabolic disorders, other
29 hereditary and congenital disorders, and environmental risk
30 factors.--
31
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1 (1) SCREENING REQUIREMENTS.--To help ensure access to
2 the maternal and child health care system, the Department of
3 Health shall promote the screening of all infants born in
4 Florida for phenylketonuria and other metabolic, hereditary,
5 and congenital disorders known to result in significant
6 impairment of health or intellect, as screening programs
7 accepted by current medical practice become available and
8 practical in the judgment of the department. The department
9 shall also promote the identification and screening of all
10 infants born in this state and their families for
11 environmental risk factors such as low income, poor education,
12 maternal and family stress, emotional instability, substance
13 abuse, and other high-risk conditions associated with
14 increased risk of infant mortality and morbidity to provide
15 early intervention, remediation, and prevention services,
16 including, but not limited to, parent support and training
17 programs, home visitation, and case management.
18 Identification, perinatal screening, and intervention efforts
19 shall begin prior to and immediately following the birth of
20 the child by the attending health care provider. Such efforts
21 shall be conducted in hospitals, perinatal centers, county
22 health departments, school health programs that provide
23 prenatal care, and birthing centers, and reported to the
24 Office of Vital Statistics.
25 (b) Postnatal screening.--A risk factor analysis using
26 the department's designated risk assessment instrument shall
27 also be conducted as part of the medical screening process
28 upon the birth of a child and submitted to the department's
29 Office of Vital Statistics for recording and other purposes
30 provided for in this chapter. The department's screening
31 process for risk assessment shall include a scoring mechanism
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1 and procedures that establish thresholds for notification,
2 further assessment, referral, and eligibility for services by
3 professionals or paraprofessionals consistent with the level
4 of risk. Procedures for developing and using the screening
5 instrument, notification, referral, and care coordination
6 services, reporting requirements, management information, and
7 maintenance of a computer-driven registry in the Office of
8 Vital Statistics which ensures privacy safeguards must be
9 consistent with the provisions and plans established under
10 chapter 411, Pub. L. No. 99-457, and this chapter. Procedures
11 established for reporting information and maintaining a
12 confidential registry must include a mechanism for a
13 centralized information depository at the state and county
14 levels. The department shall coordinate with existing risk
15 assessment systems and information registries. The department
16 must ensure, to the maximum extent possible, that the
17 screening information registry is integrated with the
18 department's automated data systems, including the Florida
19 On-line Recipient Integrated Data Access (FLORIDA) system.
20 Tests and screenings must be performed by the State Public
21 Health Laboratory, in coordination with Children's Medical
22 Services, at such times and in such manner as is prescribed by
23 the department after consultation with the Genetics and Infant
24 Screening Advisory Council and the State Coordinating Council
25 for School Readiness Programs.
26 Section 65. Section 395.0197, Florida Statutes, is
27 amended to read:
28 395.0197 Internal risk management program.--
29 (1) Every licensed facility shall, as a part of its
30 administrative functions, establish an internal risk
31
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1 management program that includes all of the following
2 components:
3 (a) The investigation and analysis of the frequency
4 and causes of general categories and specific types of adverse
5 incidents to patients.
6 (b) The development of appropriate measures to
7 minimize the risk of adverse incidents to patients, including,
8 but not limited to:
9 1. Risk management and risk prevention education and
10 training of all nonphysician personnel as follows:
11 a. Such education and training of all nonphysician
12 personnel as part of their initial orientation; and
13 b. At least 1 hour of such education and training
14 annually for all nonphysician personnel of the licensed
15 facility working in clinical areas and providing patient care,
16 except those persons licensed as health care practitioners who
17 are required to complete continuing education coursework
18 pursuant to chapter 456 or the respective practice act.
19 2. A prohibition, except when emergency circumstances
20 require otherwise, against a staff member of the licensed
21 facility attending a patient in the recovery room, unless the
22 staff member is authorized to attend the patient in the
23 recovery room and is in the company of at least one other
24 person. However, a licensed facility is exempt from the
25 two-person requirement if it has:
26 a. Live visual observation;
27 b. Electronic observation; or
28 c. Any other reasonable measure taken to ensure
29 patient protection and privacy.
30 3. A prohibition against an unlicensed person from
31 assisting or participating in any surgical procedure unless
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1 the facility has authorized the person to do so following a
2 competency assessment, and such assistance or participation is
3 done under the direct and immediate supervision of a licensed
4 physician and is not otherwise an activity that may only be
5 performed by a licensed health care practitioner.
6 4. Development, implementation, and ongoing evaluation
7 of procedures, protocols, and systems to accurately identify
8 patients, planned procedures, and the correct site of the
9 planned procedure so as to minimize the performance of a
10 surgical procedure on the wrong patient, a wrong surgical
11 procedure, a wrong-site surgical procedure, or a surgical
12 procedure otherwise unrelated to the patient's diagnosis or
13 medical condition.
14 (c) The analysis of patient grievances that relate to
15 patient care and the quality of medical services.
16 (d) The development and implementation of an incident
17 reporting system based upon the affirmative duty of all health
18 care providers and all agents and employees of the licensed
19 health care facility to report adverse incidents to the risk
20 manager, or to his or her designee, within 3 business days
21 after their occurrence.
22 (2) The internal risk management program is the
23 responsibility of the governing board of the health care
24 facility. Each licensed facility shall hire a risk manager,
25 licensed under s. 395.10974 part IX of chapter 626, who is
26 responsible for implementation and oversight of such
27 facility's internal risk management program as required by
28 this section. A risk manager must not be made responsible for
29 more than four internal risk management programs in separate
30 licensed facilities, unless the facilities are under one
31
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1 corporate ownership or the risk management programs are in
2 rural hospitals.
3 (3) In addition to the programs mandated by this
4 section, other innovative approaches intended to reduce the
5 frequency and severity of medical malpractice and patient
6 injury claims shall be encouraged and their implementation and
7 operation facilitated. Such additional approaches may include
8 extending internal risk management programs to health care
9 providers' offices and the assuming of provider liability by a
10 licensed health care facility for acts or omissions occurring
11 within the licensed facility.
12 (4) The agency shall, after consulting with the
13 Department of Insurance, adopt rules governing the
14 establishment of internal risk management programs to meet the
15 needs of individual licensed facilities. Each internal risk
16 management program shall include the use of incident reports
17 to be filed with an individual of responsibility who is
18 competent in risk management techniques in the employ of each
19 licensed facility, such as an insurance coordinator, or who is
20 retained by the licensed facility as a consultant. The
21 individual responsible for the risk management program shall
22 have free access to all medical records of the licensed
23 facility. The incident reports are part of the workpapers of
24 the attorney defending the licensed facility in litigation
25 relating to the licensed facility and are subject to
26 discovery, but are not admissible as evidence in court. A
27 person filing an incident report is not subject to civil suit
28 by virtue of such incident report. As a part of each internal
29 risk management program, the incident reports shall be used to
30 develop categories of incidents which identify problem areas.
31
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1 Once identified, procedures shall be adjusted to correct the
2 problem areas.
3 (5) For purposes of reporting to the agency pursuant
4 to this section, the term "adverse incident" means an event
5 over which health care personnel could exercise control and
6 which is associated in whole or in part with medical
7 intervention, rather than the condition for which such
8 intervention occurred, and which:
9 (a) Results in one of the following injuries:
10 1. Death;
11 2. Brain or spinal damage;
12 3. Permanent disfigurement;
13 4. Fracture or dislocation of bones or joints;
14 5. A resulting limitation of neurological, physical,
15 or sensory function which continues after discharge from the
16 facility;
17 6. Any condition that required specialized medical
18 attention or surgical intervention resulting from nonemergency
19 medical intervention, other than an emergency medical
20 condition, to which the patient has not given his or her
21 informed consent; or
22 7. Any condition that required the transfer of the
23 patient, within or outside the facility, to a unit providing a
24 more acute level of care due to the adverse incident, rather
25 than the patient's condition prior to the adverse incident;
26 (b) Was the performance of a surgical procedure on the
27 wrong patient, a wrong surgical procedure, a wrong-site
28 surgical procedure, or a surgical procedure otherwise
29 unrelated to the patient's diagnosis or medical condition;
30 (c) Required the surgical repair of damage resulting
31 to a patient from a planned surgical procedure, where the
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1 damage was not a recognized specific risk, as disclosed to the
2 patient and documented through the informed-consent process;
3 or
4 (d) Was a procedure to remove unplanned foreign
5 objects remaining from a surgical procedure.
6 (6)(a) Each licensed facility subject to this section
7 shall submit an annual report to the agency summarizing the
8 incident reports that have been filed in the facility for that
9 year. The report shall include:
10 1. The total number of adverse incidents.
11 2. A listing, by category, of the types of operations,
12 diagnostic or treatment procedures, or other actions causing
13 the injuries, and the number of incidents occurring within
14 each category.
15 3. A listing, by category, of the types of injuries
16 caused and the number of incidents occurring within each
17 category.
18 4. A code number using the health care professional's
19 licensure number and a separate code number identifying all
20 other individuals directly involved in adverse incidents to
21 patients, the relationship of the individual to the licensed
22 facility, and the number of incidents in which each individual
23 has been directly involved. Each licensed facility shall
24 maintain names of the health care professionals and
25 individuals identified by code numbers for purposes of this
26 section.
27 5. A description of all malpractice claims filed
28 against the licensed facility, including the total number of
29 pending and closed claims and the nature of the incident which
30 led to, the persons involved in, and the status and
31
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1 disposition of each claim. Each report shall update status and
2 disposition for all prior reports.
3 (b) The information reported to the agency pursuant to
4 paragraph (a) which relates to persons licensed under chapter
5 458, chapter 459, chapter 461, or chapter 466 shall be
6 reviewed by the agency. The agency shall determine whether
7 any of the incidents potentially involved conduct by a health
8 care professional who is subject to disciplinary action, in
9 which case the provisions of s. 456.073 shall apply.
10 (c) The report submitted to the agency shall also
11 contain the name and license number of the risk manager of the
12 licensed facility, a copy of its policy and procedures which
13 govern the measures taken by the facility and its risk manager
14 to reduce the risk of injuries and adverse incidents, and the
15 results of such measures. The annual report is confidential
16 and is not available to the public pursuant to s. 119.07(1) or
17 any other law providing access to public records. The annual
18 report is not discoverable or admissible in any civil or
19 administrative action, except in disciplinary proceedings by
20 the agency or the appropriate regulatory board. The annual
21 report is not available to the public as part of the record of
22 investigation for and prosecution in disciplinary proceedings
23 made available to the public by the agency or the appropriate
24 regulatory board. However, the agency or the appropriate
25 regulatory board shall make available, upon written request by
26 a health care professional against whom probable cause has
27 been found, any such records which form the basis of the
28 determination of probable cause.
29 (7) The licensed facility shall notify the agency no
30 later than 1 business day after the risk manager or his or her
31 designee has received a report pursuant to paragraph (1)(d)
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1 and can determine within 1 business day that any of the
2 following adverse incidents has occurred, whether occurring in
3 the licensed facility or arising from health care prior to
4 admission in the licensed facility:
5 (a) The death of a patient;
6 (b) Brain or spinal damage to a patient;
7 (c) The performance of a surgical procedure on the
8 wrong patient;
9 (d) The performance of a wrong-site surgical
10 procedure; or
11 (e) The performance of a wrong surgical procedure.
12
13 The notification must be made in writing and be provided by
14 facsimile device or overnight mail delivery. The notification
15 must include information regarding the identity of the
16 affected patient, the type of adverse incident, the initiation
17 of an investigation by the facility, and whether the events
18 causing or resulting in the adverse incident represent a
19 potential risk to other patients.
20 (8) Any of the following adverse incidents, whether
21 occurring in the licensed facility or arising from health care
22 prior to admission in the licensed facility, shall be reported
23 by the facility to the agency within 15 calendar days after
24 its occurrence:
25 (a) The death of a patient;
26 (b) Brain or spinal damage to a patient;
27 (c) The performance of a surgical procedure on the
28 wrong patient;
29 (d) The performance of a wrong-site surgical
30 procedure;
31 (e) The performance of a wrong surgical procedure;
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1 (f) The performance of a surgical procedure that is
2 medically unnecessary or otherwise unrelated to the patient's
3 diagnosis or medical condition;
4 (g) The surgical repair of damage resulting to a
5 patient from a planned surgical procedure, where the damage is
6 not a recognized specific risk, as disclosed to the patient
7 and documented through the informed-consent process; or
8 (h) The performance of procedures to remove unplanned
9 foreign objects remaining from a surgical procedure.
10
11 The agency may grant extensions to this reporting requirement
12 for more than 15 days upon justification submitted in writing
13 by the facility administrator to the agency. The agency may
14 require an additional, final report. These reports shall not
15 be available to the public pursuant to s. 119.07(1) or any
16 other law providing access to public records, nor be
17 discoverable or admissible in any civil or administrative
18 action, except in disciplinary proceedings by the agency or
19 the appropriate regulatory board, nor shall they be available
20 to the public as part of the record of investigation for and
21 prosecution in disciplinary proceedings made available to the
22 public by the agency or the appropriate regulatory board.
23 However, the agency or the appropriate regulatory board shall
24 make available, upon written request by a health care
25 professional against whom probable cause has been found, any
26 such records which form the basis of the determination of
27 probable cause. The agency may investigate, as it deems
28 appropriate, any such incident and prescribe measures that
29 must or may be taken in response to the incident. The agency
30 shall review each incident and determine whether it
31 potentially involved conduct by the health care professional
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1 who is subject to disciplinary action, in which case the
2 provisions of s. 456.073 shall apply.
3 (9) The agency shall publish on the agency's website,
4 no less than quarterly, a summary and trend analysis of
5 adverse incident reports received pursuant to this section,
6 which shall not include information that would identify the
7 patient, the reporting facility, or the health care
8 practitioners involved. The agency shall publish on the
9 agency's website an annual summary and trend analysis of all
10 adverse incident reports and malpractice claims information
11 provided by facilities in their annual reports, which shall
12 not include information that would identify the patient, the
13 reporting facility, or the practitioners involved. The
14 purpose of the publication of the summary and trend analysis
15 is to promote the rapid dissemination of information relating
16 to adverse incidents and malpractice claims to assist in
17 avoidance of similar incidents and reduce morbidity and
18 mortality.
19 (10)(9) The internal risk manager of each licensed
20 facility shall:
21 (a) Investigate every allegation of sexual misconduct
22 which is made against a member of the facility's personnel who
23 has direct patient contact, when the allegation is that the
24 sexual misconduct occurred at the facility or on the grounds
25 of the facility.; and
26 (b) Report every allegation of sexual misconduct to
27 the administrator of the licensed facility.
28 (c) Notify the family or guardian of the victim, if a
29 minor, that an allegation of sexual misconduct has been made
30 and that an investigation is being conducted.;
31
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1 (d) Report to the Department of Health every
2 allegation of sexual misconduct, as defined in chapter 456 and
3 the respective practice act, by a licensed health care
4 practitioner that involves a patient.
5 (11)(10) Any witness who witnessed or who possesses
6 actual knowledge of the act that is the basis of an allegation
7 of sexual abuse shall:
8 (a) Notify the local police; and
9 (b) Notify the hospital risk manager and the
10 administrator.
11
12 For purposes of this subsection, "sexual abuse" means acts of
13 a sexual nature committed for the sexual gratification of
14 anyone upon, or in the presence of, a vulnerable adult,
15 without the vulnerable adult's informed consent, or a minor.
16 "Sexual abuse" includes, but is not limited to, the acts
17 defined in s. 794.011(1)(h), fondling, exposure of a
18 vulnerable adult's or minor's sexual organs, or the use of the
19 vulnerable adult or minor to solicit for or engage in
20 prostitution or sexual performance. "Sexual abuse" does not
21 include any act intended for a valid medical purpose or any
22 act which may reasonably be construed to be a normal
23 caregiving action.
24 (12)(11) A person who, with malice or with intent to
25 discredit or harm a licensed facility or any person, makes a
26 false allegation of sexual misconduct against a member of a
27 licensed facility's personnel is guilty of a misdemeanor of
28 the second degree, punishable as provided in s. 775.082 or s.
29 775.083.
30 (13)(12) In addition to any penalty imposed pursuant
31 to this section, the agency shall require a written plan of
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1 correction from the facility. For a single incident or series
2 of isolated incidents that are nonwillful violations of the
3 reporting requirements of this section, the agency shall first
4 seek to obtain corrective action by the facility. If the
5 correction is not demonstrated within the timeframe
6 established by the agency or if there is a pattern of
7 nonwillful violations of this section, the agency may impose
8 an administrative fine, not to exceed $5,000 for any violation
9 of the reporting requirements of this section. The
10 administrative fine for repeated nonwillful violations shall
11 not exceed $10,000 for any violation. The administrative fine
12 for each intentional and willful violation may not exceed
13 $25,000 per violation, per day. The fine for an intentional
14 and willful violation of this section may not exceed $250,000.
15 In determining the amount of fine to be levied, the agency
16 shall be guided by s. 395.1065(2)(b). This subsection does not
17 apply to the notice requirements under subsection (7).
18 (14)(13) The agency shall have access to all licensed
19 facility records necessary to carry out the provisions of this
20 section. The records obtained by the agency under subsection
21 (6), subsection (8), or subsection (10) (9) are not available
22 to the public under s. 119.07(1), nor shall they be
23 discoverable or admissible in any civil or administrative
24 action, except in disciplinary proceedings by the agency or
25 the appropriate regulatory board, nor shall records obtained
26 pursuant to s. 456.071 be available to the public as part of
27 the record of investigation for and prosecution in
28 disciplinary proceedings made available to the public by the
29 agency or the appropriate regulatory board. However, the
30 agency or the appropriate regulatory board shall make
31 available, upon written request by a health care professional
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1 against whom probable cause has been found, any such records
2 which form the basis of the determination of probable cause,
3 except that, with respect to medical review committee records,
4 s. 766.101 controls.
5 (15)(14) The meetings of the committees and governing
6 board of a licensed facility held solely for the purpose of
7 achieving the objectives of risk management as provided by
8 this section shall not be open to the public under the
9 provisions of chapter 286. The records of such meetings are
10 confidential and exempt from s. 119.07(1), except as provided
11 in subsection (14) (13).
12 (16)(15) The agency shall review, as part of its
13 licensure inspection process, the internal risk management
14 program at each licensed facility regulated by this section to
15 determine whether the program meets standards established in
16 statutes and rules, whether the program is being conducted in
17 a manner designed to reduce adverse incidents, and whether the
18 program is appropriately reporting incidents under this
19 section subsections (5), (6), (7), and (8).
20 (17)(16) There shall be no monetary liability on the
21 part of, and no cause of action for damages shall arise
22 against, any risk manager, licensed under s. 395.10974 part IX
23 of chapter 626, for the implementation and oversight of the
24 internal risk management program in a facility licensed under
25 this chapter or chapter 390 as required by this section, for
26 any act or proceeding undertaken or performed within the scope
27 of the functions of such internal risk management program if
28 the risk manager acts without intentional fraud.
29 (18) A privilege against civil liability is hereby
30 granted to any licensed risk manager or licensed facility with
31 regard to information furnished pursuant to this chapter,
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1 unless the licensed risk manager or facility acted in bad
2 faith or with malice in providing such information.
3 (19)(17) If the agency, through its receipt of any
4 reports required under this section the annual reports
5 prescribed in subsection (6) or through any investigation, has
6 a reasonable belief that conduct by a staff member or employee
7 of a licensed facility is grounds for disciplinary action by
8 the appropriate regulatory board, the agency shall report this
9 fact to such regulatory board.
10 (18) The agency shall annually publish a report
11 summarizing the information contained in the annual incident
12 reports submitted by licensed facilities pursuant to
13 subsection (6) and disciplinary actions reported to the agency
14 pursuant to s. 395.0193. The report must, at a minimum,
15 summarize:
16 (a) Adverse incidents, by category of reported
17 incident, and by type of professional involved.
18 (b) Types of malpractice claims filed, by type of
19 professional involved.
20 (c) Disciplinary actions taken against professionals,
21 by type of professional involved.
22 (20) It shall be unlawful for any person to coerce,
23 intimidate, or preclude a risk manager from lawfully executing
24 his or her reporting obligations pursuant to this chapter.
25 Such unlawful action shall be subject to civil monetary
26 penalties not to exceed $10,000 per violation.
27 Section 66. Section 395.10972, Florida Statutes, is
28 amended to read:
29 395.10972 Health Care Risk Manager Advisory
30 Council.--The Secretary of Health Care Administration may
31 appoint a seven-member five-member advisory council to advise
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1 the agency on matters pertaining to health care risk managers.
2 The members of the council shall serve at the pleasure of the
3 secretary. The council shall designate a chair. The council
4 shall meet at the call of the secretary or at those times as
5 may be required by rule of the agency. The members of the
6 advisory council shall receive no compensation for their
7 services, but shall be reimbursed for travel expenses as
8 provided in s. 112.061. The council shall consist of
9 individuals representing the following areas:
10 (1) Two shall be active health care risk managers,
11 including one risk manager who is recommended by and a member
12 of the Florida Society of Healthcare Risk Management.
13 (2) One shall be an active hospital administrator.
14 (3) One shall be an employee of an insurer or
15 self-insurer of medical malpractice coverage.
16 (4) One shall be a representative of the
17 health-care-consuming public.
18 (5) Two shall be licensed health care practitioners,
19 one of whom shall be licensed as a physician under chapter 458
20 or chapter 459.
21 Section 67. Paragraph (b) of subsection (2) of section
22 395.701, Florida Statutes, is amended to read:
23 395.701 Annual assessments on net operating revenues
24 for inpatient and outpatient services to fund public medical
25 assistance; administrative fines for failure to pay
26 assessments when due; exemption.--
27 (2)
28 (b) There is imposed upon each hospital an assessment
29 in an amount equal to 1 percent of the annual net operating
30 revenue for outpatient services for each hospital, such
31 revenue to be determined by the agency, based on the actual
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1 experience of the hospital as reported to the agency. While
2 prior year report worksheets may be reconciled to the
3 hospital's audited financial statements, no additional audited
4 financial components may be required for the purposes of
5 determining the amount of the assessment imposed pursuant to
6 this section other than those in effect on July 1, 2000.
7 Within 6 months after the end of each hospital fiscal year,
8 the agency shall certify the amount of the assessment for each
9 hospital. The assessment shall be payable to and collected by
10 the agency in equal quarterly amounts, on or before the first
11 day of each calendar quarter, beginning with the first full
12 calendar quarter that occurs after the agency certifies the
13 amount of the assessment for each hospital. All moneys
14 collected pursuant to this subsection shall be deposited into
15 the Public Medical Assistance Trust Fund.
16 Section 68. Section 409.905, Florida Statutes, is
17 amended to read:
18 409.905 Mandatory Medicaid services.--The agency may
19 make payments for the following services, which are required
20 of the state by Title XIX of the Social Security Act,
21 furnished by Medicaid providers to recipients who are
22 determined to be eligible on the dates on which the services
23 were provided. Any service under this section shall be
24 provided only when medically necessary and in accordance with
25 state and federal law. Mandatory services rendered by
26 providers in mobile units to Medicaid recipients may be
27 restricted by the agency. Nothing in this section shall be
28 construed to prevent or limit the agency from adjusting fees,
29 reimbursement rates, lengths of stay, number of visits, number
30 of services, or any other adjustments necessary to comply with
31
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1 the availability of moneys and any limitations or directions
2 provided for in the General Appropriations Act or chapter 216.
3 (1) ADVANCED REGISTERED NURSE PRACTITIONER
4 SERVICES.--The agency shall pay for services provided to a
5 recipient by a licensed advanced registered nurse practitioner
6 who has a valid collaboration agreement with a licensed
7 physician on file with the Department of Health or who
8 provides anesthesia services in accordance with established
9 protocol required by state law and approved by the medical
10 staff of the facility in which the anesthetic service is
11 performed. Reimbursement for such services must be provided in
12 an amount that equals not less than 80 percent of the
13 reimbursement to a physician who provides the same services,
14 unless otherwise provided for in the General Appropriations
15 Act.
16 (2) EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND
17 TREATMENT SERVICES.--The agency shall pay for early and
18 periodic screening and diagnosis of a recipient under age 21
19 to ascertain physical and mental problems and conditions and
20 provide treatment to correct or ameliorate these problems and
21 conditions. These services include all services determined by
22 the agency to be medically necessary for the treatment,
23 correction, or amelioration of these problems, including
24 personal care, private duty nursing, durable medical
25 equipment, physical therapy, occupational therapy, speech
26 therapy, respiratory therapy, and immunizations.
27 (3) FAMILY PLANNING SERVICES.--The agency shall pay
28 for services necessary to enable a recipient voluntarily to
29 plan family size or to space children. These services include
30 information; education; counseling regarding the availability,
31 benefits, and risks of each method of pregnancy prevention;
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1 drugs and supplies; and necessary medical care and followup.
2 Each recipient participating in the family planning portion of
3 the Medicaid program must be provided freedom to choose any
4 alternative method of family planning, as required by federal
5 law.
6 (4) HOME HEALTH CARE SERVICES.--The agency shall pay
7 for nursing and home health aide services, supplies,
8 appliances, and durable medical equipment, necessary to assist
9 a recipient living at home. An entity that provides services
10 pursuant to this subsection shall be licensed under part IV of
11 chapter 400 or part II of chapter 499, if appropriate. These
12 services, equipment, and supplies, or reimbursement therefor,
13 may be limited as provided in the General Appropriations Act
14 and do not include services, equipment, or supplies provided
15 to a person residing in a hospital or nursing facility. In
16 providing home health care services, the agency may require
17 prior authorization of care based on diagnosis.
18 (5) HOSPITAL INPATIENT SERVICES.--The agency shall pay
19 for all covered services provided for the medical care and
20 treatment of a recipient who is admitted as an inpatient by a
21 licensed physician or dentist to a hospital licensed under
22 part I of chapter 395. However, the agency shall limit the
23 payment for inpatient hospital services for a Medicaid
24 recipient 21 years of age or older to 45 days or the number of
25 days necessary to comply with the General Appropriations Act.
26 (a) The agency is authorized to implement
27 reimbursement and utilization management reforms in order to
28 comply with any limitations or directions in the General
29 Appropriations Act, which may include, but are not limited to:
30 prior authorization for inpatient psychiatric days; enhanced
31 utilization and concurrent review programs for highly utilized
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1 services; reduction or elimination of covered days of service;
2 adjusting reimbursement ceilings for variable costs; adjusting
3 reimbursement ceilings for fixed and property costs; and
4 implementing target rates of increase.
5 (b) A licensed hospital maintained primarily for the
6 care and treatment of patients having mental disorders or
7 mental diseases is not eligible to participate in the hospital
8 inpatient portion of the Medicaid program except as provided
9 in federal law. However, the department shall apply for a
10 waiver, within 9 months after June 5, 1991, designed to
11 provide hospitalization services for mental health reasons to
12 children and adults in the most cost-effective and lowest cost
13 setting possible. Such waiver shall include a request for the
14 opportunity to pay for care in hospitals known under federal
15 law as "institutions for mental disease" or "IMD's." The
16 waiver proposal shall propose no additional aggregate cost to
17 the state or Federal Government, and shall be conducted in
18 Hillsborough County, Highlands County, Hardee County, Manatee
19 County, and Polk County. The waiver proposal may incorporate
20 competitive bidding for hospital services, comprehensive
21 brokering, prepaid capitated arrangements, or other mechanisms
22 deemed by the department to show promise in reducing the cost
23 of acute care and increasing the effectiveness of preventive
24 care. When developing the waiver proposal, the department
25 shall take into account price, quality, accessibility,
26 linkages of the hospital to community services and family
27 support programs, plans of the hospital to ensure the earliest
28 discharge possible, and the comprehensiveness of the mental
29 health and other health care services offered by participating
30 providers.
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1 (c) Agency for Health Care Administration shall adjust
2 a hospital's current inpatient per diem rate to reflect the
3 cost of serving the Medicaid population at that institution
4 if:
5 1. The hospital experiences an increase in Medicaid
6 caseload by more than 25 percent in any year, primarily
7 resulting from the closure of a hospital in the same service
8 area occurring after July 1, 1995; or
9 2. The hospital's Medicaid per diem rate is at least
10 25 percent below the Medicaid per patient cost for that year.
11
12 No later than November 1, 2000, the agency must provide
13 estimated costs for any adjustment in a hospital inpatient per
14 diem pursuant to this paragraph to the Executive Office of the
15 Governor, the House of Representatives General Appropriations
16 Committee, and the Senate Budget Committee. Before the agency
17 implements a change in a hospital's inpatient per diem rate
18 pursuant to this paragraph, the Legislature must have
19 specifically appropriated sufficient funds in the 2001-2002
20 General Appropriations Act to support the increase in cost as
21 estimated by the agency. This paragraph is repealed on July 1,
22 2001.
23 (6) HOSPITAL OUTPATIENT SERVICES.--The agency shall
24 pay for preventive, diagnostic, therapeutic, or palliative
25 care and other services provided to a recipient in the
26 outpatient portion of a hospital licensed under part I of
27 chapter 395, and provided under the direction of a licensed
28 physician or licensed dentist, except that payment for such
29 care and services is limited to $1,500 per state fiscal year
30 per recipient, unless an exception has been made by the
31 agency, and with the exception of a Medicaid recipient under
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1 age 21, in which case the only limitation is medical
2 necessity.
3 (7) INDEPENDENT LABORATORY SERVICES.--The agency shall
4 pay for medically necessary diagnostic laboratory procedures
5 ordered by a licensed physician or other licensed practitioner
6 of the healing arts which are provided for a recipient in a
7 laboratory that meets the requirements for Medicare
8 participation and is licensed under chapter 483, if required.
9 (8) NURSING FACILITY SERVICES.--The agency shall pay
10 for 24-hour-a-day nursing and rehabilitative services for a
11 recipient in a nursing facility licensed under part II of
12 chapter 400 or in a rural hospital, as defined in s. 395.602,
13 or in a Medicare certified skilled nursing facility operated
14 by a hospital, as defined by s. 395.002(11), that is licensed
15 under part I of chapter 395, and in accordance with provisions
16 set forth in s. 409.908(2)(a), which services are ordered by
17 and provided under the direction of a licensed physician.
18 However, if a nursing facility has been destroyed or otherwise
19 made uninhabitable by natural disaster or other emergency and
20 another nursing facility is not available, the agency must pay
21 for similar services temporarily in a hospital licensed under
22 part I of chapter 395 provided federal funding is approved and
23 available.
24 (9) PHYSICIAN SERVICES.--The agency shall pay for
25 covered services and procedures rendered to a recipient by, or
26 under the personal supervision of, a person licensed under
27 state law to practice medicine or osteopathic medicine. These
28 services may be furnished in the physician's office, the
29 Medicaid recipient's home, a hospital, a nursing facility, or
30 elsewhere, but shall be medically necessary for the treatment
31 of an injury, illness, or disease within the scope of the
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1 practice of medicine or osteopathic medicine as defined by
2 state law. The agency shall not pay for services that are
3 clinically unproven, experimental, or for purely cosmetic
4 purposes.
5 (10) PORTABLE X-RAY SERVICES.--The agency shall pay
6 for professional and technical portable radiological services
7 ordered by a licensed physician or other licensed practitioner
8 of the healing arts which are provided by a licensed
9 professional in a setting other than a hospital, clinic, or
10 office of a physician or practitioner of the healing arts, on
11 behalf of a recipient.
12 (11) RURAL HEALTH CLINIC SERVICES.--The agency shall
13 pay for outpatient primary health care services for a
14 recipient provided by a clinic certified by and participating
15 in the Medicare program which is located in a federally
16 designated, rural, medically underserved area and has on its
17 staff one or more licensed primary care nurse practitioners or
18 physician assistants, and a licensed staff supervising
19 physician or a consulting supervising physician.
20 (12) TRANSPORTATION SERVICES.--The agency shall ensure
21 that appropriate transportation services are available for a
22 Medicaid recipient in need of transport to a qualified
23 Medicaid provider for medically necessary and
24 Medicaid-compensable services, provided a client's ability to
25 choose a specific transportation provider shall be limited to
26 those options resulting from policies established by the
27 agency to meet the fiscal limitations of the General
28 Appropriations Act. The agency may pay for transportation and
29 other related travel expenses as necessary only if these
30 services are not otherwise available.
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1 Section 69. Section 409.906, Florida Statutes, is
2 amended to read:
3 409.906 Optional Medicaid services.--Subject to
4 specific appropriations, the agency may make payments for
5 services which are optional to the state under Title XIX of
6 the Social Security Act and are furnished by Medicaid
7 providers to recipients who are determined to be eligible on
8 the dates on which the services were provided. Any optional
9 service that is provided shall be provided only when medically
10 necessary and in accordance with state and federal law.
11 Optional services rendered by providers in mobile units to
12 Medicaid recipients may be restricted or prohibited by the
13 agency. Nothing in this section shall be construed to prevent
14 or limit the agency from adjusting fees, reimbursement rates,
15 lengths of stay, number of visits, or number of services, or
16 making any other adjustments necessary to comply with the
17 availability of moneys and any limitations or directions
18 provided for in the General Appropriations Act or chapter 216.
19 If necessary to safeguard the state's systems of providing
20 services to elderly and disabled persons and subject to the
21 notice and review provisions of s. 216.177, the Governor may
22 direct the Agency for Health Care Administration to amend the
23 Medicaid state plan to delete the optional Medicaid service
24 known as "Intermediate Care Facilities for the Developmentally
25 Disabled." Optional services may include:
26 (1) ADULT DENTURE SERVICES.--The agency may pay for
27 dentures, the procedures required to seat dentures, and the
28 repair and reline of dentures, provided by or under the
29 direction of a licensed dentist, for a recipient who is age 21
30 or older. However, Medicaid will not provide reimbursement for
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1 dental services provided in a mobile dental unit, except for a
2 mobile dental unit:
3 (a) Owned by, operated by, or having a contractual
4 agreement with the Department of Health and complying with
5 Medicaid's county health department clinic services program
6 specifications as a county health department clinic services
7 provider.
8 (b) Owned by, operated by, or having a contractual
9 arrangement with a federally qualified health center and
10 complying with Medicaid's federally qualified health center
11 specifications as a federally qualified health center
12 provider.
13 (c) Rendering dental services to Medicaid recipients,
14 21 years of age and older, at nursing facilities.
15 (d) Owned by, operated by, or having a contractual
16 agreement with a state-approved dental educational
17 institution.
18 (2) ADULT HEALTH SCREENING SERVICES.--The agency may
19 pay for an annual routine physical examination, conducted by
20 or under the direction of a licensed physician, for a
21 recipient age 21 or older, without regard to medical
22 necessity, in order to detect and prevent disease, disability,
23 or other health condition or its progression.
24 (3) AMBULATORY SURGICAL CENTER SERVICES.--The agency
25 may pay for services provided to a recipient in an ambulatory
26 surgical center licensed under part I of chapter 395, by or
27 under the direction of a licensed physician or dentist.
28 (4) BIRTH CENTER SERVICES.--The agency may pay for
29 examinations and delivery, recovery, and newborn assessment,
30 and related services, provided in a licensed birth center
31 staffed with licensed physicians, certified nurse midwives,
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1 and midwives licensed in accordance with chapter 467, to a
2 recipient expected to experience a low-risk pregnancy and
3 delivery.
4 (5) CASE MANAGEMENT SERVICES.--The agency may pay for
5 primary care case management services rendered to a recipient
6 pursuant to a federally approved waiver, and targeted case
7 management services for specific groups of targeted
8 recipients, for which funding has been provided and which are
9 rendered pursuant to federal guidelines. The agency is
10 authorized to limit reimbursement for targeted case management
11 services in order to comply with any limitations or directions
12 provided for in the General Appropriations Act.
13 Notwithstanding s. 216.292, the Department of Children and
14 Family Services may transfer general funds to the Agency for
15 Health Care Administration to fund state match requirements
16 exceeding the amount specified in the General Appropriations
17 Act for targeted case management services.
18 (6) CHILDREN'S DENTAL SERVICES.--The agency may pay
19 for diagnostic, preventive, or corrective procedures,
20 including orthodontia in severe cases, provided to a recipient
21 under age 21, by or under the supervision of a licensed
22 dentist. Services provided under this program include
23 treatment of the teeth and associated structures of the oral
24 cavity, as well as treatment of disease, injury, or impairment
25 that may affect the oral or general health of the individual.
26 However, Medicaid will not provide reimbursement for dental
27 services provided in a mobile dental unit, except for a mobile
28 dental unit:
29 (a) Owned by, operated by, or having a contractual
30 agreement with the Department of Health and complying with
31 Medicaid's county health department clinic services program
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HB 1867, Second Engrossed
1 specifications as a county health department clinic services
2 provider.
3 (b) Owned by, operated by, or having a contractual
4 arrangement with a federally qualified health center and
5 complying with Medicaid's federally qualified health center
6 specifications as a federally qualified health center
7 provider.
8 (c) Rendering dental services to Medicaid recipients,
9 21 years of age and older, at nursing facilities.
10 (d) Owned by, operated by, or having a contractual
11 agreement with a state-approved dental educational
12 institution.
13 (7) CHIROPRACTIC SERVICES.--The agency may pay for
14 manual manipulation of the spine and initial services,
15 screening, and X rays provided to a recipient by a licensed
16 chiropractic physician.
17 (8) COMMUNITY MENTAL HEALTH SERVICES.--The agency may
18 pay for rehabilitative services provided to a recipient by a
19 mental health or substance abuse provider licensed by the
20 agency and under contract with the agency or the Department of
21 Children and Family Services to provide such services. Those
22 services which are psychiatric in nature shall be rendered or
23 recommended by a psychiatrist, and those services which are
24 medical in nature shall be rendered or recommended by a
25 physician or psychiatrist. The agency must develop a provider
26 enrollment process for community mental health providers which
27 bases provider enrollment on an assessment of service need.
28 The provider enrollment process shall be designed to control
29 costs, prevent fraud and abuse, consider provider expertise
30 and capacity, and assess provider success in managing
31 utilization of care and measuring treatment outcomes.
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1 Providers will be selected through a competitive procurement
2 or selective contracting process. In addition to other
3 community mental health providers, the agency shall consider
4 for enrollment mental health programs licensed under chapter
5 395 and group practices licensed under chapter 458, chapter
6 459, chapter 490, or chapter 491. The agency is also
7 authorized to continue operation of its behavioral health
8 utilization management program and may develop new services if
9 these actions are necessary to ensure savings from the
10 implementation of the utilization management system. The
11 agency shall coordinate the implementation of this enrollment
12 process with the Department of Children and Family Services
13 and the Department of Juvenile Justice. The agency is
14 authorized to utilize diagnostic criteria in setting
15 reimbursement rates, to preauthorize certain high-cost or
16 highly utilized services, to limit or eliminate coverage for
17 certain services, or to make any other adjustments necessary
18 to comply with any limitations or directions provided for in
19 the General Appropriations Act.
20 (9) DIALYSIS FACILITY SERVICES.--Subject to specific
21 appropriations being provided for this purpose, the agency may
22 pay a dialysis facility that is approved as a dialysis
23 facility in accordance with Title XVIII of the Social Security
24 Act, for dialysis services that are provided to a Medicaid
25 recipient under the direction of a physician licensed to
26 practice medicine or osteopathic medicine in this state,
27 including dialysis services provided in the recipient's home
28 by a hospital-based or freestanding dialysis facility.
29 (10) DURABLE MEDICAL EQUIPMENT.--The agency may
30 authorize and pay for certain durable medical equipment and
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1 supplies provided to a Medicaid recipient as medically
2 necessary.
3 (11) HEALTHY START SERVICES.--The agency may pay for a
4 continuum of risk-appropriate medical and psychosocial
5 services for the Healthy Start program in accordance with a
6 federal waiver. The agency may not implement the federal
7 waiver unless the waiver permits the state to limit enrollment
8 or the amount, duration, and scope of services to ensure that
9 expenditures will not exceed funds appropriated by the
10 Legislature or available from local sources. If the Health
11 Care Financing Administration does not approve a federal
12 waiver for Healthy Start services, the agency, in consultation
13 with the Department of Health and the Florida Association of
14 Healthy Start Coalitions, is authorized to establish a
15 Medicaid certified-match program for Healthy Start services.
16 Participation in the Healthy Start certified-match program
17 shall be voluntary, and reimbursement shall be limited to the
18 federal Medicaid share to Medicaid-enrolled Healthy Start
19 coalitions for services provided to Medicaid recipients. The
20 agency shall take no action to implement a certified-match
21 program without ensuring that the amendment and review
22 requirements of ss. 216.177 and 216.181 have been met.
23 (12) HEARING SERVICES.--The agency may pay for hearing
24 and related services, including hearing evaluations, hearing
25 aid devices, dispensing of the hearing aid, and related
26 repairs, if provided to a recipient by a licensed hearing aid
27 specialist, otolaryngologist, otologist, audiologist, or
28 physician.
29 (13) HOME AND COMMUNITY-BASED SERVICES.--The agency
30 may pay for home-based or community-based services that are
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HB 1867, Second Engrossed
1 rendered to a recipient in accordance with a federally
2 approved waiver program.
3 (14) HOSPICE CARE SERVICES.--The agency may pay for
4 all reasonable and necessary services for the palliation or
5 management of a recipient's terminal illness, if the services
6 are provided by a hospice that is licensed under part VI of
7 chapter 400 and meets Medicare certification requirements.
8 (15) INTERMEDIATE CARE FACILITY FOR THE
9 DEVELOPMENTALLY DISABLED SERVICES.--The agency may pay for
10 health-related care and services provided on a 24-hour-a-day
11 basis by a facility licensed and certified as a Medicaid
12 Intermediate Care Facility for the Developmentally Disabled,
13 for a recipient who needs such care because of a developmental
14 disability.
15 (16) INTERMEDIATE CARE SERVICES.--The agency may pay
16 for 24-hour-a-day intermediate care nursing and rehabilitation
17 services rendered to a recipient in a nursing facility
18 licensed under part II of chapter 400, if the services are
19 ordered by and provided under the direction of a physician.
20 (17) OPTOMETRIC SERVICES.--The agency may pay for
21 services provided to a recipient, including examination,
22 diagnosis, treatment, and management, related to ocular
23 pathology, if the services are provided by a licensed
24 optometrist or physician.
25 (18) PHYSICIAN ASSISTANT SERVICES.--The agency may pay
26 for all services provided to a recipient by a physician
27 assistant licensed under s. 458.347 or s. 459.022.
28 Reimbursement for such services must be not less than 80
29 percent of the reimbursement that would be paid to a physician
30 who provided the same services.
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1 (19) PODIATRIC SERVICES.--The agency may pay for
2 services, including diagnosis and medical, surgical,
3 palliative, and mechanical treatment, related to ailments of
4 the human foot and lower leg, if provided to a recipient by a
5 podiatric physician licensed under state law.
6 (20) PRESCRIBED DRUG SERVICES.--The agency may pay for
7 medications that are prescribed for a recipient by a physician
8 or other licensed practitioner of the healing arts authorized
9 to prescribe medications and that are dispensed to the
10 recipient by a licensed pharmacist or physician in accordance
11 with applicable state and federal law.
12 (21) REGISTERED NURSE FIRST ASSISTANT SERVICES.--The
13 agency may pay for all services provided to a recipient by a
14 registered nurse first assistant as described in s. 464.027.
15 Reimbursement for such services may not be less than 80
16 percent of the reimbursement that would be paid to a physician
17 providing the same services.
18 (22) STATE HOSPITAL SERVICES.--The agency may pay for
19 all-inclusive psychiatric inpatient hospital care provided to
20 a recipient age 65 or older in a state mental hospital.
21 (23) VISUAL SERVICES.--The agency may pay for visual
22 examinations, eyeglasses, and eyeglass repairs for a
23 recipient, if they are prescribed by a licensed physician
24 specializing in diseases of the eye or by a licensed
25 optometrist.
26 (24) CHILD-WELFARE-TARGETED CASE MANAGEMENT.--The
27 Agency for Health Care Administration, in consultation with
28 the Department of Children and Family Services, may establish
29 a targeted case-management pilot project in those counties
30 identified by the Department of Children and Family Services
31 and for the community-based child welfare project in Sarasota
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HB 1867, Second Engrossed
1 and Manatee counties, as authorized under s. 409.1671. These
2 projects shall be established for the purpose of determining
3 the impact of targeted case management on the child welfare
4 program and the earnings from the child welfare program.
5 Results of the pilot projects shall be reported to the Child
6 Welfare Estimating Conference and the Social Services
7 Estimating Conference established under s. 216.136. The number
8 of projects may not be increased until requested by the
9 Department of Children and Family Services, recommended by the
10 Child Welfare Estimating Conference and the Social Services
11 Estimating Conference, and approved by the Legislature. The
12 covered group of individuals who are eligible to receive
13 targeted case management include children who are eligible for
14 Medicaid; who are between the ages of birth through 21; and
15 who are under protective supervision or postplacement
16 supervision, under foster-care supervision, or in shelter care
17 or foster care. The number of individuals who are eligible to
18 receive targeted case management shall be limited to the
19 number for whom the Department of Children and Family Services
20 has available matching funds to cover the costs. The general
21 revenue funds required to match the funds for services
22 provided by the community-based child welfare projects are
23 limited to funds available for services described under s.
24 409.1671. The Department of Children and Family Services may
25 transfer the general revenue matching funds as billed by the
26 Agency for Health Care Administration.
27 Section 70. Subsections (7) through (11) of section
28 456.013, Florida Statutes, are renumbered as subsections (8)
29 through (12), respectively, and a new subsection (7) is added
30 to said section to read:
31 456.013 Department; general licensing provisions.--
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HB 1867, Second Engrossed
1 (7) The boards, or the department when there is no
2 board, shall require the completion of a 2-hour course
3 relating to prevention of medical errors as part of the
4 licensure and renewal process. The 2-hour course shall count
5 towards the total number of continuing education hours
6 required for the profession. The course shall be approved by
7 the board or department, as appropriate, and shall include a
8 study of root-cause analysis, error reduction and prevention,
9 and patient safety. If the course is being offered by a
10 facility licensed pursuant to chapter 395 for its employees,
11 the board may approve up to 1 hour of the 2-hour course to be
12 specifically related to error reduction and prevention methods
13 used in that facility.
14 Section 71. Subsection (19) is added to section
15 456.057, Florida Statutes, to read:
16 456.057 Ownership and control of patient records;
17 report or copies of records to be furnished.--
18 (19) The board, or department when there is no board,
19 may temporarily or permanently appoint a person or entity as a
20 custodian of medical records in the event of the death of a
21 practitioner, the mental or physical incapacitation of the
22 practitioner, or the abandonment of medical records by a
23 practitioner. The custodian appointed shall comply with all
24 provisions of this section, including the release of patient
25 records.
26 Section 72. Subsection (3) is added to section
27 456.063, Florida Statutes, to read:
28 456.063 Sexual misconduct; disqualification for
29 license, certificate, or registration; reports of allegation
30 of sexual misconduct.--
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1 (3) Licensed health care practitioners shall report
2 allegations of sexual misconduct to the department, regardless
3 of the practice setting in which the alleged sexual misconduct
4 occurred.
5 Section 73. Paragraphs (c) and (q) of subsection (1)
6 of section 456.072, Florida Statutes, are amended, paragraphs
7 (aa), (bb), and (cc) are added to said subsection, paragraphs
8 (c), (d), and (e) of subsection (2) and subsection (4) are
9 amended, and paragraphs (i) and (j) are added to subsection
10 (2) of said section, to read:
11 456.072 Grounds for discipline; penalties;
12 enforcement.--
13 (1) The following acts shall constitute grounds for
14 which the disciplinary actions specified in subsection (2) may
15 be taken:
16 (c) Being convicted or found guilty of, or entering a
17 plea of guilty or nolo contendere to, regardless of
18 adjudication, a crime in any jurisdiction which relates to the
19 practice of, or the ability to practice, a licensee's
20 profession.
21 (q) Violating any provision of this chapter, the
22 applicable professional practice act, a rule of the department
23 or the board, or a lawful order of the department or the
24 board, or failing to comply with a lawfully issued subpoena of
25 the department.
26 (aa) Performing or attempting to perform health care
27 services on the wrong patient, a wrong-site procedure, a wrong
28 procedure, or an unauthorized procedure or a procedure that is
29 medically unnecessary or otherwise unrelated to the patient's
30 diagnosis or medical condition. For the purposes of this
31
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1 paragraph, performing or attempting to perform health care
2 services includes the preparation of the patient.
3 (bb) Leaving a foreign body in a patient, such as a
4 sponge, clamp, forceps, surgical needle, or other
5 paraphernalia commonly used in surgical, examination, or other
6 diagnostic procedures. For the purposes of this paragraph, it
7 shall be legally presumed that retention of a foreign body is
8 not in the best interest of the patient and is not within the
9 standard of care of the profession, regardless of the intent
10 of the professional.
11 (cc) Violating any provision of this chapter, the
12 applicable practice act, or any rules adopted pursuant
13 thereto.
14 (2) When the board, or the department when there is no
15 board, finds any person guilty of the grounds set forth in
16 subsection (1) or of any grounds set forth in the applicable
17 practice act, including conduct constituting a substantial
18 violation of subsection (1) or a violation of the applicable
19 practice act which occurred prior to obtaining a license, it
20 may enter an order imposing one or more of the following
21 penalties:
22 (c) Restriction of practice or license, including, but
23 not limited to, restricting the licensee from practicing in
24 certain settings, restricting the licensee to work only under
25 designated conditions or in certain settings, restricting the
26 licensee from performing or providing designated clinical and
27 administrative services, restricting the licensee from
28 practicing more than a designated number of hours, or any
29 other restriction found to be necessary for the protection of
30 the public health, safety, and welfare.
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1 (d) Imposition of an administrative fine not to exceed
2 $10,000 for each count or separate offense. If the violation
3 is for fraud or making a false or fraudulent representation,
4 the board, or the department if there is no board, must impose
5 a fine of $10,000 per count or offense.
6 (e) Issuance of a reprimand or letter of concern.
7 (i) Refund of fees billed and collected from the
8 patient or a third party on behalf of the patient.
9 (j) Requirement that the practitioner undergo remedial
10 education.
11
12 In determining what action is appropriate, the board, or
13 department when there is no board, must first consider what
14 sanctions are necessary to protect the public or to compensate
15 the patient. Only after those sanctions have been imposed may
16 the disciplining authority consider and include in the order
17 requirements designed to rehabilitate the practitioner. All
18 costs associated with compliance with orders issued under this
19 subsection are the obligation of the practitioner.
20 (4) In addition to any other discipline imposed
21 through final order, or citation, entered on or after July 1,
22 2001, pursuant to this section or discipline imposed through
23 final order, or citation, entered on or after July 1, 2001,
24 for a violation of any practice act, the board, or the
25 department when there is no board, shall may assess costs
26 related to the investigation and prosecution of the case. In
27 any case where the board or the department imposes a fine or
28 assessment and the fine or assessment is not paid within a
29 reasonable time, such reasonable time to be prescribed in the
30 rules of the board, or the department when there is no board,
31 or in the order assessing such fines or costs, the department
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1 or the Department of Legal Affairs may contract for the
2 collection of, or bring a civil action to recover, the fine or
3 assessment.
4 Section 74. Paragraphs (a) and (c) of subsection (9)
5 of section 456.073, Florida Statutes, are amended, and,
6 effective upon this act becoming a law, subsection (13) is
7 added to said section, to read:
8 456.073 Disciplinary proceedings.--Disciplinary
9 proceedings for each board shall be within the jurisdiction of
10 the department.
11 (9)(a) The department shall periodically notify the
12 person who filed the complaint, as well as the patient or the
13 patient's legal representative, of the status of the
14 investigation, indicating whether probable cause has been
15 found and the status of any civil action or administrative
16 proceeding or appeal.
17 (c) In any disciplinary case for which probable cause
18 is not found, the department shall so inform the person who
19 filed the complaint and notify that person that he or she may,
20 within 60 days, provide any additional information to the
21 department probable cause panel which may be relevant to the
22 decision. To facilitate the provision of additional
23 information, the person who filed the complaint may receive,
24 upon request, a copy of the department's expert report that
25 supported the recommendation for closure, if such a report was
26 relied upon by the department. In no way does this require the
27 department to procure an expert opinion or report if none was
28 used. Additionally, the identity of the expert shall remain
29 confidential. In any administrative proceeding under s.
30 120.57, the person who filed the disciplinary complaint shall
31 have the right to present oral or written communication
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1 relating to the alleged disciplinary violations or to the
2 appropriate penalty.
3 (13) Notwithstanding any provision of law to the
4 contrary, an administrative complaint against a licensee shall
5 be filed within 6 years after the time of the incident or
6 occurrence giving rise to the complaint against the licensee.
7 If such incident or occurrence involved criminal actions,
8 diversion of controlled substances, sexual misconduct, or
9 impairment by the licensee, this subsection does not apply to
10 bar initiation of an investigation or filing of an
11 administrative complaint beyond the 6-year timeframe. In those
12 cases covered by this subsection in which it can be shown that
13 fraud, concealment, or intentional misrepresentation of fact
14 prevented the discovery of the violation of law, the period of
15 limitations is extended forward, but in no event to exceed 12
16 years after the time of the incident or occurrence.
17 Section 75. Subsection (1) of section 456.074, Florida
18 Statutes, is amended to read:
19 456.074 Certain health care practitioners; immediate
20 suspension of license.--
21 (1) The department shall issue an emergency order
22 suspending the license of any person licensed under chapter
23 458, chapter 459, chapter 460, chapter 461, chapter 462,
24 chapter 463, chapter 464, chapter 465, chapter 466, or chapter
25 484 who pleads guilty to, is convicted or found guilty of, or
26 who enters a plea of nolo contendere to, regardless of
27 adjudication, a felony under chapter 409, chapter 817, or
28 chapter 893 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C.
29 ss. 1395-1396.
30 Section 76. Subsections (2) and (6) of section
31 456.077, Florida Statutes, are amended to read:
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1 456.077 Authority to issue citations.--
2 (2) The board, or the department if there is no board,
3 shall adopt rules designating violations for which a citation
4 may be issued. Such rules shall designate as citation
5 violations those violations for which there is no substantial
6 threat to the public health, safety, and welfare. Violations
7 for which a citation may be issued shall include violations of
8 continuing education requirements, failure to timely pay
9 required fees and fines, failure to comply with the
10 requirements of ss. 381.026 and 381.0261 regarding the
11 dissemination of information regarding patient rights, failure
12 to comply with advertising requirements, failure to timely
13 update practitioner profile and credentialing files, failure
14 to display signs, licenses, and permits, failure to have
15 required reference books available, and all other violations
16 that do not pose a direct and serious threat to the health and
17 safety of the patient.
18 (6) A board created on or after January 1, 1992, has 6
19 months in which to enact rules designating violations and
20 penalties appropriate for citation offenses. Failure to enact
21 such rules gives the department exclusive authority to adopt
22 rules as required for implementing this section. A board has
23 continuous authority to amend its rules adopted pursuant to
24 this section.
25 Section 77. Section 456.081, Florida Statutes, is
26 amended to read:
27 456.081 Publication of information.--The department
28 and the boards shall have the authority to advise licensees
29 periodically, through the publication of a newsletter, about
30 information that the department or the board determines is of
31 interest to the industry. The department and the boards shall
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1 maintain a website which contains copies of the newsletter;
2 information relating to adverse incident reports without
3 identifying the patient, practitioner, or facility in which
4 the adverse incident occurred until 10 days after probable
5 cause is found, at which time the name of the practitioner and
6 facility shall become public as part of the investigative
7 file; information about error prevention and safety
8 strategies; and information concerning best practices. Unless
9 otherwise prohibited by law, the department and the boards
10 shall publish on the website a summary of final orders entered
11 after July 1, 2001, resulting in disciplinary action fines,
12 suspensions, or revocations, and any other information the
13 department or the board determines is of interest to the
14 public. In order to provide useful and timely information at
15 minimal cost, the department and boards may consult with, and
16 include information provided by, professional associations and
17 national organizations.
18 Section 78. Subsection (2) of section 458.315, Florida
19 Statutes, is amended to read:
20 458.315 Temporary certificate for practice in areas of
21 critical need.--Any physician who is licensed to practice in
22 any other state, whose license is currently valid, and who
23 pays an application fee of $300 may be issued a temporary
24 certificate to practice in communities of Florida where there
25 is a critical need for physicians. A certificate may be
26 issued to a physician who will be employed by a county health
27 department, correctional facility, community health center
28 funded by s. 329, s. 330, or s. 340 of the United States
29 Public Health Services Act, or other entity that provides
30 health care to indigents and that is approved by the State
31
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1 Health Officer. The Board of Medicine may issue this
2 temporary certificate with the following restrictions:
3 (2) The board may administer an abbreviated oral
4 examination to determine the physician's competency, but no
5 written regular examination is necessary. Within 60 days after
6 receipt of an application for a temporary certificate, the
7 board shall review the application and issue the temporary
8 certificate or notify the applicant of denial.
9 (3) The board may administer an abbreviated oral
10 examination to determine the physician's competency, but no
11 written regular examination is necessary. Within 60 days after
12 receipt of an application for a temporary certificate, the
13 board shall review the application and issue the temporary
14 certificate or notify the applicant of denial.
15 Section 79. Section 458.3147, Florida Statutes, is
16 created to read:
17 458.3147 Medical school eligibility of military
18 academy students or graduates.--Any Florida resident who is a
19 student at or a graduate of any of the United States military
20 academies who qualifies for assignment to the Medical Corps of
21 the United States military shall be admitted to any medical
22 school in the State University System.
23 Section 80. Subsection (9) of section 458.331, Florida
24 Statutes, is amended to read:
25 458.331 Grounds for disciplinary action; action by the
26 board and department.--
27 (9) When an investigation of a physician is
28 undertaken, the department shall promptly furnish to the
29 physician or the physician's attorney a copy of the complaint
30 or document which resulted in the initiation of the
31 investigation. For purposes of this subsection, such
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1 documents include, but are not limited to: the pertinent
2 portions of an annual report submitted to the department
3 pursuant to s. 395.0197(6); a report of an adverse incident
4 which is provided to the department pursuant to s.
5 395.0197(8); a report of peer review disciplinary action
6 submitted to the department pursuant to s. 395.0193(4) or s.
7 458.337, providing that the investigations, proceedings, and
8 records relating to such peer review disciplinary action shall
9 continue to retain their privileged status even as to the
10 licensee who is the subject of the investigation, as provided
11 by ss. 395.0193(8) and 458.337(3); a report of a closed claim
12 submitted pursuant to s. 627.912; a presuit notice submitted
13 pursuant to s. 766.106(2); and a petition brought under the
14 Florida Birth-Related Neurological Injury Compensation Plan,
15 pursuant to s. 766.305(2). The physician may submit a written
16 response to the information contained in the complaint or
17 document which resulted in the initiation of the investigation
18 within 45 days after service to the physician of the complaint
19 or document. The physician's written response shall be
20 considered by the probable cause panel.
21 Section 81. Subsection (9) of section 459.015, Florida
22 Statutes, is amended to read:
23 459.015 Grounds for disciplinary action; action by the
24 board and department.--
25 (9) When an investigation of an osteopathic physician
26 is undertaken, the department shall promptly furnish to the
27 osteopathic physician or his or her attorney a copy of the
28 complaint or document which resulted in the initiation of the
29 investigation. For purposes of this subsection, such documents
30 include, but are not limited to: the pertinent portions of an
31 annual report submitted to the department pursuant to s.
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1 395.0197(6); a report of an adverse incident which is provided
2 to the department pursuant to s. 395.0197(8); a report of peer
3 review disciplinary action submitted to the department
4 pursuant to s. 395.0193(4) or s. 459.016, provided that the
5 investigations, proceedings, and records relating to such peer
6 review disciplinary action shall continue to retain their
7 privileged status even as to the licensee who is the subject
8 of the investigation, as provided by ss. 395.0193(8) and
9 459.016(3); a report of a closed claim submitted pursuant to
10 s. 627.912; a /resuit notice submitted pursuant to s.
11 766.106(2); and a petition brought under the Florida
12 Birth-Related Neurological Injury Compensation Plan, pursuant
13 to s. 766.305(2). The osteopathic physician may submit a
14 written response to the information contained in the complaint
15 or document which resulted in the initiation of the
16 investigation within 45 days after service to the osteopathic
17 physician of the complaint or document. The osteopathic
18 physician's written response shall be considered by the
19 probable cause panel.
20 Section 82. Effective January 1, 2002, subsection (4)
21 of section 641.51, Florida Statutes, is amended to read:
22 641.51 Quality assurance program; second medical
23 opinion requirement.--
24 (4) The organization shall ensure that only a
25 physician with an active, unencumbered license licensed under
26 chapter 458 or chapter 459, or an allopathic or osteopathic
27 physician with an active, unencumbered license in another
28 state with similar licensing requirements may render an
29 adverse determination regarding a service provided by a
30 physician licensed in this state. The organization shall
31 submit to the treating provider and the subscriber written
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1 notification regarding the organization's adverse
2 determination within 2 working days after the subscriber or
3 provider is notified of the adverse determination. The written
4 notification must include the utilization review criteria or
5 benefits provisions used in the adverse determination,
6 identify the physician who rendered the adverse determination,
7 and be signed by an authorized representative of the
8 organization or the physician who rendered the adverse
9 determination. The organization must include with the
10 notification of an adverse determination information
11 concerning the appeal process for adverse determinations. This
12 provision does not create authority for the Board of Medicine
13 or Board of Osteopathic Medicine to regulate the organization;
14 however, the Board of Medicine and the Board of Osteopathic
15 Medicine continue to have jurisdiction over licensees of their
16 respective boards.
17 Section 83. Subsection (5) of section 465.019, Florida
18 Statutes, is amended to read:
19 465.019 Institutional pharmacies; permits.--
20 (5) All institutional pharmacies shall be under the
21 professional supervision of a consultant pharmacist, and the
22 compounding and dispensing of medicinal drugs shall be done
23 only by a licensed pharmacist. Every institutional pharmacy
24 that employs or otherwise utilizes pharmacy technicians shall
25 have a written policy and procedures manual specifying those
26 duties, tasks, and functions which a pharmacy technician is
27 allowed to perform.
28 Section 84. Section 465.0196, Florida Statutes, is
29 amended to read:
30 465.0196 Special pharmacy permits.--Any person
31 desiring a permit to operate a pharmacy which does not fall
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1 within the definitions set forth in s. 465.003(11)(a)1., 2.,
2 and 3. shall apply to the department for a special pharmacy
3 permit. If the board certifies that the application complies
4 with the applicable laws and rules of the board governing the
5 practice of the profession of pharmacy, the department shall
6 issue the permit. No permit shall be issued unless a licensed
7 pharmacist is designated to undertake the professional
8 supervision of the compounding and dispensing of all drugs
9 dispensed by the pharmacy. The licensed pharmacist shall be
10 responsible for maintaining all drug records and for providing
11 for the security of the area in the facility in which the
12 compounding, storing, and dispensing of medicinal drugs
13 occurs. The permittee shall notify the department within 10
14 days of any change of the licensed pharmacist responsible for
15 such duties. Every permittee that employs or otherwise
16 utilizes pharmacy technicians shall have a written policy and
17 procedures manual specifying those duties, tasks, and
18 functions which a pharmacy technician is allowed to perform.
19 Section 85. Effective upon this act becoming a law and
20 operating retroactively to July 1, 2000, section 22 of Chapter
21 2000-256, Laws of Florida, is amended to read:
22 Section 22. The amendments to ss. 395.701 and
23 395.7015, Florida Statutes, by this act shall take effect July
24 1, 2000 only upon the Agency for Health Care Administration
25 receiving written confirmation from the federal Health Care
26 Financing Administration that the changes contained in such
27 amendments will not adversely affect the use of the remaining
28 assessments as state match for the state's Medicaid program.
29 Section 86. The Department of Health and the Agency
30 for Health Care Administration shall conduct a review of all
31 statutorily imposed reporting requirements for health care
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1 practitioners and health facilities. The department and the
2 agency shall report back to the Legislature on or before
3 November 1, 2001, with recommendations and suggested statutory
4 changes to streamline reporting requirements to avoid
5 duplicative, overlapping, and unnecessary reports or data
6 elements.
7 Section 87. Paragraph (r) is added to subsection (1)
8 of section 468.1755, Florida Statutes, and, for the purpose of
9 incorporating the amendment to section 456.072(1), Florida
10 Statutes, in a reference thereto, paragraph (a) of subsection
11 (1) of said section is reenacted, to read:
12 468.1755 Disciplinary proceedings.--
13 (1) The following acts shall constitute grounds for
14 which the disciplinary actions in subsection (2) may be taken:
15 (a) Violation of any provision of s. 456.072(1) or s.
16 468.1745(1).
17 (r) Failing to implement an ongoing quality assurance
18 program directed by an interdisciplinary team that meets at
19 least every other month.
20 (2) When the board finds any nursing home
21 administrator guilty of any of the grounds set forth in
22 subsection (1), it may enter an order imposing one or more of
23 the following penalties:
24 (a) Denial of an application for licensure.
25 (b) Revocation or suspension of a license.
26 (c) Imposition of an administrative fine not to exceed
27 $1,000 for each count or separate offense.
28 (d) Issuance of a reprimand.
29 (e) Placement of the licensee on probation for a
30 period of time and subject to such conditions as the board may
31 specify, including requiring the licensee to attend continuing
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1 education courses or to work under the supervision of another
2 licensee.
3 (f) Restriction of the authorized scope of practice.
4 Section 88. For the purpose of incorporating the
5 amendment to section 468.1755(1), Florida Statutes, in
6 reference thereto, subsection (3) of section 468.1695, Florida
7 Statutes, and section 468.1735, Florida Statutes, are
8 reenacted to read:
9 468.1695 Licensure by examination.--
10 (3) The department shall issue a license to practice
11 nursing home administration to any applicant who successfully
12 completes the examination in accordance with this section and
13 otherwise meets the requirements of this part. The department
14 shall not issue a license to any applicant who is under
15 investigation in this state or another jurisdiction for an
16 offense which would constitute a violation of s. 468.1745 or
17 s. 468.1755. Upon completion of the investigation, the
18 provisions of s. 468.1755 shall apply.
19 468.1735 Provisional license.--The board may establish
20 by rule requirements for issuance of a provisional license. A
21 provisional license shall be issued only to fill a position of
22 nursing home administrator that unexpectedly becomes vacant
23 due to illness, sudden death of the administrator, or
24 abandonment of position and shall be issued for one single
25 period as provided by rule not to exceed 6 months. The
26 department shall not issue a provisional license to any
27 applicant who is under investigation in this state or another
28 jurisdiction for an offense which would constitute a violation
29 of s. 468.1745 or s. 468.1755. Upon completion of the
30 investigation, the provisions of s. 468.1755 shall apply. The
31 provisional license may be issued to a person who does not
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HB 1867, Second Engrossed
1 meet all of the licensing requirements established by this
2 part, but the board shall by rule establish minimal
3 requirements to ensure protection of the public health,
4 safety, and welfare. The provisional license shall be issued
5 to the person who is designated as the responsible person next
6 in command in the event of the administrator's departure. The
7 board may set an application fee not to exceed $500 for a
8 provisional license.
9 Section 89. For the purpose of incorporating the
10 amendment to section 456.072(1), Florida Statutes, in a
11 reference thereto, paragraph (a) of subsection (1) of section
12 484.056, Florida Statutes, is reenacted to read:
13 484.056 Disciplinary proceedings.--
14 (1) The following acts relating to the practice of
15 dispensing hearing aids shall be grounds for both disciplinary
16 action against a hearing aid specialist as set forth in this
17 section and cease and desist or other related action by the
18 department as set forth in s. 456.065 against any person
19 owning or operating a hearing aid establishment who engages
20 in, aids, or abets any such violation:
21 (a) Violation of any provision of s. 456.072(1), s.
22 484.0512, or s. 484.053.
23 Section 90. Paragraph (a) of subsection (1), paragraph
24 (a) of subsection (7), and subsection (8) of section 766.101,
25 Florida Statutes, are amended to read:
26 766.101 Medical review committee, immunity from
27 liability.--
28 (1) As used in this section:
29 (a) The term "medical review committee" or "committee"
30 means:
31
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1 1.a. A committee of a hospital or ambulatory surgical
2 center licensed under chapter 395 or a health maintenance
3 organization certificated under part I of chapter 641,
4 b. A committee of a physician-hospital organization, a
5 provider-sponsored organization, or an integrated delivery
6 system,
7 c. A committee of a state or local professional
8 society of health care providers,
9 d. A committee of a medical staff of a licensed
10 hospital or nursing home, provided the medical staff operates
11 pursuant to written bylaws that have been approved by the
12 governing board of the hospital or nursing home,
13 e. A committee of the Department of Corrections or the
14 Correctional Medical Authority as created under s. 945.602, or
15 employees, agents, or consultants of either the department or
16 the authority or both,
17 f. A committee of a professional service corporation
18 formed under chapter 621 or a corporation organized under
19 chapter 607 or chapter 617, which is formed and operated for
20 the practice of medicine as defined in s. 458.305(3), and
21 which has at least 25 health care providers who routinely
22 provide health care services directly to patients,
23 g. A committee of a mental health treatment facility
24 licensed under chapter 394 or a community mental health center
25 as defined in s. 394.907, provided the quality assurance
26 program operates pursuant to the guidelines which have been
27 approved by the governing board of the agency,
28 h. A committee of a substance abuse treatment and
29 education prevention program licensed under chapter 397
30 provided the quality assurance program operates pursuant to
31
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1 the guidelines which have been approved by the governing board
2 of the agency,
3 i. A peer review or utilization review committee
4 organized under chapter 440, or
5 j. A committee of the Department of Health, a county
6 health department, healthy start coalition, or certified rural
7 health network, when reviewing quality of care, or employees
8 of these entities when reviewing mortality records, or
9 k. A continuous quality improvement committee of a
10 pharmacy licensed pursuant to chapter 465,
11
12 which committee is formed to evaluate and improve the quality
13 of health care rendered by providers of health service or to
14 determine that health services rendered were professionally
15 indicated or were performed in compliance with the applicable
16 standard of care or that the cost of health care rendered was
17 considered reasonable by the providers of professional health
18 services in the area; or
19 2. A committee of an insurer, self-insurer, or joint
20 underwriting association of medical malpractice insurance, or
21 other persons conducting review under s. 766.106.
22 (7)(a) It is the intent of the Legislature to
23 encourage medical review committees to contribute further to
24 the quality of health care in this state by reviewing
25 complaints against physicians in the manner described in this
26 paragraph. Accordingly, the Department of Health Business and
27 Professional Regulation may enter into a letter of agreement
28 with a professional society of physicians licensed under
29 chapter 458 or chapter 459, under which agreement the medical
30 or peer review committees of the professional society will
31 conduct a review of any complaint or case referred to the
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1 society by the department which involves a question as to
2 whether a physician's actions represented a breach of the
3 prevailing professional standard of care. The prevailing
4 professional standard of care is that level of care, skill,
5 and treatment which, in light of all relevant surrounding
6 circumstances, is recognized as acceptable and appropriate by
7 reasonably prudent similar health care providers. The letter
8 of agreement must specify that the professional society will
9 submit an advisory report to the department within a
10 reasonable time following the department's written and
11 appropriately supported request to the professional society.
12 The advisory report, which is not binding upon the department,
13 constitutes the professional opinion of the medical review
14 committee and must include:
15 1. A statement of relevant factual findings.
16 2. The judgment of the committee as to whether the
17 physician's actions represented a breach of the prevailing
18 professional standard of care.
19 (8) No cause of action of any nature by a person
20 licensed pursuant to chapter 458, chapter 459, chapter 461,
21 chapter 463, part I of chapter 464, chapter 465, or chapter
22 466 shall arise against another person licensed pursuant to
23 chapter 458, chapter 459, chapter 461, chapter 463, part I of
24 chapter 464, chapter 465, or chapter 466 for furnishing
25 information to a duly appointed medical review committee, to
26 an internal risk management program established under s.
27 395.0197, to the Department of Health or the Agency for Health
28 Care Administration Business and Professional Regulation, or
29 to the appropriate regulatory board if the information
30 furnished concerns patient care at a facility licensed
31 pursuant to part I of chapter 395 where both persons provide
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1 health care services, if the information is not intentionally
2 fraudulent, and if the information is within the scope of the
3 functions of the committee, department, or board. However, if
4 such information is otherwise available from original sources,
5 it is not immune from discovery or use in a civil action
6 merely because it was presented during a proceeding of the
7 committee, department, or board.
8 Section 91. For the purpose of incorporating the
9 amendment to section 766.101(1)(a), Florida Statutes, in
10 references thereto, paragraph (a) of subsection (1) of section
11 440.105, Florida Statutes, and subsection (6) of section
12 626.989, Florida Statutes, are reenacted to read:
13 440.105 Prohibited activities; reports; penalties;
14 limitations.--
15 (1)(a) Any insurance carrier, any individual
16 self-insured, any commercial or group self-insurance fund, any
17 professional practitioner licensed or regulated by the
18 Department of Business and Professional Regulation, except as
19 otherwise provided by law, any medical review committee as
20 defined in s. 766.101, any private medical review committee,
21 and any insurer, agent, or other person licensed under the
22 insurance code, or any employee thereof, having knowledge or
23 who believes that a fraudulent act or any other act or
24 practice which, upon conviction, constitutes a felony or
25 misdemeanor under this chapter is being or has been committed
26 shall send to the Division of Insurance Fraud, Bureau of
27 Workers' Compensation Fraud, a report or information pertinent
28 to such knowledge or belief and such additional information
29 relative thereto as the bureau may require. The bureau shall
30 review such information or reports and select such information
31 or reports as, in its judgment, may require further
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1 investigation. It shall then cause an independent examination
2 of the facts surrounding such information or report to be made
3 to determine the extent, if any, to which a fraudulent act or
4 any other act or practice which, upon conviction, constitutes
5 a felony or a misdemeanor under this chapter is being
6 committed. The bureau shall report any alleged violations of
7 law which its investigations disclose to the appropriate
8 licensing agency and state attorney or other prosecuting
9 agency having jurisdiction with respect to any such violations
10 of this chapter. If prosecution by the state attorney or other
11 prosecuting agency having jurisdiction with respect to such
12 violation is not begun within 60 days of the bureau's report,
13 the state attorney or other prosecuting agency having
14 jurisdiction with respect to such violation shall inform the
15 bureau of the reasons for the lack of prosecution.
16 626.989 Investigation by department or Division of
17 Insurance Fraud; compliance; immunity; confidential
18 information; reports to division; division investigator's
19 power of arrest.--
20 (6) Any person, other than an insurer, agent, or other
21 person licensed under the code, or an employee thereof, having
22 knowledge or who believes that a fraudulent insurance act or
23 any other act or practice which, upon conviction, constitutes
24 a felony or a misdemeanor under the code, or under s. 817.234,
25 is being or has been committed may send to the Division of
26 Insurance Fraud a report or information pertinent to such
27 knowledge or belief and such additional information relative
28 thereto as the department may request. Any professional
29 practitioner licensed or regulated by the Department of
30 Business and Professional Regulation, except as otherwise
31 provided by law, any medical review committee as defined in s.
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1 766.101, any private medical review committee, and any
2 insurer, agent, or other person licensed under the code, or an
3 employee thereof, having knowledge or who believes that a
4 fraudulent insurance act or any other act or practice which,
5 upon conviction, constitutes a felony or a misdemeanor under
6 the code, or under s. 817.234, is being or has been committed
7 shall send to the Division of Insurance Fraud a report or
8 information pertinent to such knowledge or belief and such
9 additional information relative thereto as the department may
10 require. The Division of Insurance Fraud shall review such
11 information or reports and select such information or reports
12 as, in its judgment, may require further investigation. It
13 shall then cause an independent examination of the facts
14 surrounding such information or report to be made to determine
15 the extent, if any, to which a fraudulent insurance act or any
16 other act or practice which, upon conviction, constitutes a
17 felony or a misdemeanor under the code, or under s. 817.234,
18 is being committed. The Division of Insurance Fraud shall
19 report any alleged violations of law which its investigations
20 disclose to the appropriate licensing agency and state
21 attorney or other prosecuting agency having jurisdiction with
22 respect to any such violation, as provided in s. 624.310. If
23 prosecution by the state attorney or other prosecuting agency
24 having jurisdiction with respect to such violation is not
25 begun within 60 days of the division's report, the state
26 attorney or other prosecuting agency having jurisdiction with
27 respect to such violation shall inform the division of the
28 reasons for the lack of prosecution.
29 Section 92. Paragraph (c) of subsection (4) of section
30 766.1115, Florida Statutes, is amended to read:
31
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1 766.1115 Health care providers; creation of agency
2 relationship with governmental contractors.--
3 (4) CONTRACT REQUIREMENTS.--A health care provider
4 that executes a contract with a governmental contractor to
5 deliver health care services on or after April 17, 1992, as an
6 agent of the governmental contractor is an agent for purposes
7 of s. 768.28(9), while acting within the scope of duties
8 pursuant to the contract, if the contract complies with the
9 requirements of this section and regardless of whether the
10 individual treated is later found to be ineligible. A health
11 care provider under contract with the state may not be named
12 as a defendant in any action arising out of the medical care
13 or treatment provided on or after April 17, 1992, pursuant to
14 contracts entered into under this section. The contract must
15 provide that:
16 (c) Adverse incidents and information on treatment
17 outcomes must be reported by any health care provider to the
18 governmental contractor if such incidents and information
19 pertain to a patient treated pursuant to the contract. The
20 health care provider shall submit the reports required by s.
21 395.0197 annually submit an adverse incident report that
22 includes all information required by s. 395.0197(6)(a), unless
23 the adverse incident involves a result described by s.
24 395.0197(8), in which case it shall be reported within 15 days
25 after the occurrence of such incident. If an incident involves
26 a professional licensed by the Department of Health or a
27 facility licensed by the Agency for Health Care
28 Administration, the governmental contractor shall submit such
29 incident reports to the appropriate department or agency,
30 which shall review each incident and determine whether it
31 involves conduct by the licensee that is subject to
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1 disciplinary action. All patient medical records and any
2 identifying information contained in adverse incident reports
3 and treatment outcomes which are obtained by governmental
4 entities pursuant to this paragraph are confidential and
5 exempt from the provisions of s. 119.07(1) and s. 24(a), Art.
6 I of the State Constitution.
7 Section 93. Section 456.047, Florida Statutes, is
8 amended to read:
9 456.047 Standardized credentialing for health care
10 practitioners.--
11 (1) INTENT.--The Legislature recognizes that an
12 efficient and effective health care practitioner credentialing
13 program helps to ensure access to quality health care and also
14 recognizes that health care practitioner credentialing
15 activities have increased significantly as a result of health
16 care reform and recent changes in health care delivery and
17 reimbursement systems. Moreover, the resulting duplication of
18 health care practitioner credentialing activities is
19 unnecessarily costly and cumbersome for both the practitioner
20 and the entity granting practice privileges. Therefore, it is
21 the intent of this section that a credentials collection
22 program be established which provides that, once a health care
23 practitioner's core credentials data are collected, they need
24 not be collected again, except for corrections, updates, and
25 modifications thereto. Furthermore, it is the intent of the
26 Legislature that the department and all entities and
27 practitioners work cooperatively to ensure the integrity and
28 accuracy of the program. Participation under this section
29 shall include those individuals licensed under chapter 458,
30 chapter 459, chapter 460, chapter 461, or s. 464.012. However,
31 the department shall, with the approval of the applicable
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1 board, include other professions under the jurisdiction of the
2 Division of Medical Quality Assurance in this program,
3 provided they meet the requirements of s. 456.039 or s.
4 456.0391.
5 (2) DEFINITIONS.--As used in this section, the term:
6 (a) "Certified" or "accredited," as applicable, means
7 approved by a quality assessment program, from the National
8 Committee for Quality Assurance, the Joint Commission on
9 Accreditation of Healthcare Organizations, the American
10 Accreditation HealthCare Commission/URAC, or any such other
11 nationally recognized and accepted organization authorized by
12 the department, used to assess and certify any credentials
13 verification program, entity, or organization that verifies
14 the credentials of any health care practitioner.
15 (b) "Core credentials data" means data that is primary
16 source verified and includes the following data: current name,
17 any former name, and any alias, any professional education,
18 professional training, licensure, current Drug Enforcement
19 Administration certification, social security number,
20 specialty board certification, Educational Commission for
21 Foreign Medical Graduates certification, and hospital or other
22 institutional affiliations, evidence of professional liability
23 coverage or evidence of financial responsibility as required
24 by s. 458.320, s. 459.0085, or s. 456.048, history of claims,
25 suits, judgments, or settlements, final disciplinary action
26 reported pursuant to s. 456.039(1)(a)8. or s. 456.0391(1)(a)8.
27 The department may by rule designate additional core
28 credentials data elements, and Medicare or Medicaid sanctions.
29 (c) "Credential" or "credentialing" means the process
30 of assessing and verifying the qualifications of a licensed
31
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1 health care practitioner or applicant for licensure as a
2 health care practitioner.
3 (d) "Credentials verification organization" means any
4 organization certified or accredited as a credentials
5 verification organization.
6 (e) "Department" means the Department of Health,
7 Division of Medical Quality Assurance.
8 (f) "Designated credentials verification organization"
9 means the credentials verification organization which is
10 selected by the health care practitioner, if the health care
11 practitioner chooses to make such a designation.
12 (g) "Drug Enforcement Administration certification"
13 means certification issued by the Drug Enforcement
14 Administration for purposes of administration or prescription
15 of controlled substances. Submission of such certification
16 under this section must include evidence that the
17 certification is current and must also include all current
18 addresses to which the certificate is issued.
19 (h) "Health care entity" means:
20 1. Any health care facility or other health care
21 organization licensed or certified to provide approved medical
22 and allied health services in this state;
23 2. Any entity licensed by the Department of Insurance
24 as a prepaid health care plan or health maintenance
25 organization or as an insurer to provide coverage for health
26 care services through a network of providers or similar
27 organization licensed under chapter 627, chapter 636, chapter
28 641, or chapter 651; or
29 3. Any accredited medical school in this state.
30 (i) "Health care practitioner" means any person
31 licensed, or, for credentialing purposes only, any person
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1 applying for licensure, under chapter 458, chapter 459,
2 chapter 460, chapter 461, or s. 464.012 or any person licensed
3 or applying for licensure under a chapter subsequently made
4 subject to this section by the department with the approval of
5 the applicable board, except a person registered or applying
6 for registration pursuant to s. 458.345 or s. 459.021.
7 (j) "Hospital or other institutional affiliations"
8 means each hospital or other institution for which the health
9 care practitioner or applicant has provided medical services.
10 Submission of such information under this section must
11 include, for each hospital or other institution, the name and
12 address of the hospital or institution, the staff status of
13 the health care practitioner or applicant at that hospital or
14 institution, and the dates of affiliation with that hospital
15 or institution.
16 (j)(k) "National accrediting organization" means an
17 organization that awards accreditation or certification to
18 hospitals, managed care organizations, credentials
19 verification organizations, or other health care
20 organizations, including, but not limited to, the Joint
21 Commission on Accreditation of Healthcare Organizations, the
22 American Accreditation HealthCare Commission/URAC, and the
23 National Committee for Quality Assurance.
24 (k) "Primary source verification" means verification
25 of professional qualifications based on evidence obtained
26 directly from the issuing source of the applicable
27 qualification or from any other source deemed as a primary
28 source for such verification by the department or an
29 accrediting body approved by the department.
30
31
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HB 1867, Second Engrossed
1 (l) "Professional training" means any internship,
2 residency, or fellowship relating to the profession for which
3 the health care practitioner is licensed or seeking licensure.
4 (m) "Specialty board certification" means
5 certification in a specialty issued by a specialty board
6 recognized by the board in this state that regulates the
7 profession for which the health care practitioner is licensed
8 or seeking licensure.
9 (3) STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.--
10 (a) Every health care practitioner shall:
11 1. Report all core credentials data to the department
12 which is not already on file with the department, either by
13 designating a credentials verification organization to submit
14 the data or by submitting the data directly.
15 2. Notify the department within 45 days of any
16 corrections, updates, or modifications to the core credentials
17 data either through his or her designated credentials
18 verification organization or by submitting the data directly.
19 Corrections, updates, and modifications to the core
20 credentials data provided the department under this section
21 shall comply with the updating requirements of s. 456.039(3)
22 or s. 456.0391(3) related to profiling.
23 (b) The department shall:
24 1. Maintain a complete, current file of applicable
25 core credentials data on each health care practitioner, which
26 shall include data provided in accordance with subparagraph
27 (a)1. and all updates provided in accordance with subparagraph
28 (a)2.
29 2. Release the core credentials data that is otherwise
30 confidential or exempt from the provisions of chapter 119 and
31 s. 24(a), Art. I of the State Constitution and any
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HB 1867, Second Engrossed
1 corrections, updates, and modifications thereto, if authorized
2 by the health care practitioner.
3 3. Charge a fee to access the core credentials data,
4 which may not exceed the actual cost, including prorated setup
5 and operating costs, pursuant to the requirements of chapter
6 119.
7 4. Develop standardized forms to be used by the health
8 care practitioner or designated credentials verification
9 organization for the initial reporting of core credentials
10 data, for the health care practitioner to authorize the
11 release of core credentials data, and for the subsequent
12 reporting of corrections, updates, and modifications thereto.
13 (c) A registered credentials verification organization
14 may be designated by a health care practitioner to assist the
15 health care practitioner to comply with the requirements of
16 subparagraph (a)2. A designated credentials verification
17 organization shall:
18 1. Timely comply with the requirements of subparagraph
19 (a)2., pursuant to rules adopted by the department.
20 2. Not provide the health care practitioner's core
21 credentials data, including all corrections, updates, and
22 modifications, without the authorization of the practitioner.
23 (d) This section shall not be construed to restrict in
24 any way the authority of the health care entity to credential
25 and to approve or deny an application for hospital staff
26 membership, clinical privileges, or managed care network
27 participation.
28 (4) DUPLICATION OF DATA PROHIBITED.--
29 (a) A health care entity or credentials verification
30 organization is prohibited from collecting or attempting to
31 collect duplicate core credentials data from any health care
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1 practitioner if the information is available from the
2 department. This section shall not be construed to restrict
3 the right of any health care entity or credentials
4 verification organization to collect additional information
5 from the health care practitioner which is not included in the
6 core credentials data file. This section shall not be
7 construed to prohibit a health care entity or credentials
8 verification organization from obtaining all necessary
9 attestation and release form signatures and dates.
10 (b) Effective July 1, 2002, a state agency in this
11 state which credentials health care practitioners may not
12 collect or attempt to collect duplicate core credentials data
13 from any individual health care practitioner if the
14 information is already available from the department. This
15 section shall not be construed to restrict the right of any
16 such state agency to request additional information not
17 included in the core credentials credential data file, but
18 which is deemed necessary for the agency's specific
19 credentialing purposes.
20 (5) STANDARDS AND REGISTRATION.--Any credentials
21 verification organization that does business in this state
22 must be fully accredited or certified as a credentials
23 verification organization by a national accrediting
24 organization as specified in paragraph (2)(a) and must
25 register with the department. The department may charge a
26 reasonable registration fee, not to exceed an amount
27 sufficient to cover its actual expenses in providing and
28 enforcing such registration. The department shall establish by
29 rule for biennial renewal of such registration. Failure by a
30 registered credentials verification organization to maintain
31 full accreditation or certification, to provide data as
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1 authorized by the health care practitioner, to report to the
2 department changes, updates, and modifications to a health
3 care practitioner's records within the time period specified
4 in subparagraph (3)(a)2., or to comply with the prohibition
5 against collection of duplicate core credentials data from a
6 practitioner may result in denial of an application for
7 renewal of registration or in revocation or suspension of a
8 registration.
9 (6) PRIMARY SOURCE VERIFIED DATA.--Health care
10 entities and credentials verification organizations may rely
11 upon any data that has been primary source verified by the
12 department or its designee to meet primary source verification
13 requirements of national accrediting organizations.
14 (7)(6) LIABILITY.--No civil, criminal, or
15 administrative action may be instituted, and there shall be no
16 liability, against any registered credentials verification
17 organization or health care entity on account of its reliance
18 on any data obtained directly from the department.
19 (8)(7) LIABILITY INSURANCE REQUIREMENTS.--Each
20 credentials verification organization doing business in this
21 state shall maintain liability insurance appropriate to meet
22 the certification or accreditation requirements established in
23 this section.
24 (9)(8) RULES.--The department shall adopt rules
25 necessary to develop and implement the standardized core
26 credentials data collection program established by this
27 section.
28 Section 94. Section 232.61, Florida Statutes, is
29 amended to read:
30 232.61 Governing organization for athletics; adoption
31 of bylaws.--
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1 (1) The organization shall adopt bylaws that, unless
2 specifically provided by statute, establish eligibility
3 requirements for all students who participate in high school
4 athletic competition in its member schools. The bylaws
5 governing residence and transfer shall allow the student to be
6 eligible in the school in which he or she first enrolls each
7 school year, or makes himself or herself a candidate for an
8 athletic team by engaging in a practice prior to enrolling in
9 any member school. The student shall be eligible in that
10 school so long as he or she remains enrolled in that school.
11 Subsequent eligibility shall be determined and enforced
12 through the organization's bylaws.
13 (2) The organization shall also adopt bylaws that
14 specifically prohibit the recruiting of students for athletic
15 purposes. The bylaws shall prescribe penalties and an appeals
16 process for athletic recruiting violations.
17 (3) The organization shall adopt bylaws that require
18 all students participating in interscholastic athletic
19 competition or who are candidates for an interscholastic
20 athletic team to satisfactorily pass a medical evaluation each
21 year prior to participating in interscholastic athletic
22 competition or engaging in any practice, tryout, workout, or
23 other physical activity associated with the student's
24 candidacy for an interscholastic athletic team. Such medical
25 evaluation can only be administered by a practitioner licensed
26 under the provisions of chapter 458, chapter 459, chapter 460,
27 or s.