HB 1615 2003
1	A bill to be entitled
2	An act relating to the practice of naturopathic medicine;
3	redesignating ch. 462, F.S., as "Naturopathic Medicine,"
4	rather than "Naturopathy"; creating s. 462.001, F.S.;
5	providing legislative findings and purpose; amending s.
6	462.01, F.S.; defining and redefining terms used in ch.
7	462, F.S.; creating s. 462.0215, F.S.; creating the Board
8	of Naturopathic Medicine; providing membership and duties
9	of the board; providing guidelines for probable cause
10	panels and disciplinary decisions; providing applicability
11	of ch. 456, F.S.; amending s. 462.023, F.S.; providing
12	powers and duties of the board; amending s. 462.08, F.S.;
13	conforming terminology; revising the maximum amount of the
14	biennial license fee; amending s. 462.11, F.S.; conforming
15	terminology; amending s. 462.13, F.S.; conforming
16	terminology; providing duties of the board; providing
17	additional duties of the Department of Health; providing
18	requirements for license applications; providing
19	conditions under which applications are considered
20	withdrawn; amending s. 462.14, F.S.; amending grounds for
21	disciplinary action; authorizing the department to file a
22	petition for enforcement, as specified; defining terms;
23	reassigning certain department responsibilities to the
24	board; providing for rulemaking; providing evidentiary
25	standards; allowing the Division of Medical Quality
26	Assurance to bring a legal action in certain
27	circumstances; providing for investigations by the
28	department; providing procedures; providing requirements
29	for orders; amending ss. 462.16, 462.17, F.S.; conforming
30	terminology; amending s. 462.18, F.S., relating to
31	educational requirements; providing that the section
32	applies only to naturopathic physicians licensed before a
33	specified date; providing that certain rights and
34	privileges are retained; amending s. 462.19, F.S.;
35	increasing the inactive status fee; creating s. 462.195,
36	F.S.; providing requirements for licensure as a
37	naturopathic physician; providing fees; providing grounds
38	for denying or restricting licenses; providing for the
39	applicability of certain rights to naturopathic physicians
40	who have certain qualifications; creating s. 462.196,
41	F.S.; providing educational requirements for naturopathic
42	physicians licensed on or after a specified date;
43	providing exemptions from licensure requirements;
44	providing an effective date.
45
46	Be It Enacted by the Legislature of the State of Florida:
47
48	Section 1. Chapter 462, Florida Statutes, which is
49	presently entitled "Naturopathy," is redesignated as
50	"Naturopathic Medicine."
51	Section 2. Section 462.001, Florida Statutes, is created
52	to read:
53	462.001 Legislative findings; purpose.--The Legislature
54	finds that the practice of naturopathic medicine by unskilled
55	and incompetent practitioners presents a danger to the public
56	health and safety. The Legislature further finds that it is
57	difficult for the public to make an informed choice about
58	doctors of naturopathic medicine or naturopathic physicians and
59	that the consequences of a wrong choice could seriously endanger
60	the public's health and safety. The sole legislative purpose for
61	enacting this chapter is to ensure that each doctor of
62	naturopathic medicine or naturopathic physician practicing in
63	this state meets minimum requirements for safe practice. It is
64	the intent of the Legislature that doctors of naturopathic
65	medicine or naturopathic physicians who fall below minimum
66	competency or who otherwise present a danger to the public
67	health be prohibited from practicing in this state.
68	Section 3. Section 462.01, Florida Statutes, is amended to
69	read:
70	462.01 Definitions.--As used in this chapter, the term:
71	(1) "Approved clinical training program" or "clinical
72	training program" means a program for naturopathic medical
73	students in which the training occurred or is being conducted by
74	or in conjunction with an approved school of naturopathic
75	medicine.
76	(2) "Approved internship program" or "internship" means a
77	program of training to practice naturopathic medicine which has
78	been approved for internship training for physicians or for
79	graduates of a school of naturopathic medicine by the board or
80	has been approved or accredited by an educational or
81	professional association recognized by the board or approved by
82	another state's or country's licensing agency recognized by the
83	board.
84	(3) "Approved postdoctoral training" or "postdoctoral
85	training" means training that is part of a program that has been
86	approved for specialty training or for graduate medical
87	education in naturopathic medicine by the board or approved or
88	accredited by an educational or professional association
89	recognized by the board or by another state's or country's
90	licensing agency recognized by the board. Postdoctorate
91	residency programs in this state must be approved by the Council
92	on Naturopathic Medical Education(CNME) or be a Florida-licensed
93	naturopathic medical school.
94	(4) "Approved preceptorship program" or "preceptorship"
95	means a preceptorship program that has been approved for
96	preceptorship training for physicians or for graduates of a
97	school of naturopathic medicine by the board or has been
98	approved or accredited by an educational or professional
99	association recognized by the board or by another state's or
100	country's licensing agency recognized by the board.
101	(5) "Board" means the Board of Naturopathic Medicine.
102	(1) "Natureopathy" and "Naturopathy" shall be construed as
103	synonymous terms and mean the use and practice of psychological,
104	mechanical, and material health sciences to aid in purifying,
105	cleansing, and normalizing human tissues for the preservation or
106	restoration of health, according to the fundamental principles
107	of anatomy, physiology, and applied psychology, as may be
108	required. Naturopathic practice employs, among other agencies,
109	phytotherapy, dietetics, psychotherapy, suggestotherapy,
110	hydrotherapy, zone therapy, biochemistry, external applications,
111	electrotherapy, mechanotherapy, mechanical and electrical
112	appliances, hygiene, first aid, sanitation, and heliotherapy;
113	provided, however, that nothing in this chapter shall be held or
114	construed to authorize any naturopathic physician licensed
115	hereunder to practice materia medica or surgery or chiropractic
116	medicine, nor shall the provisions of this law in any manner
117	apply to or affect the practice of osteopathic medicine,
118	chiropractic medicine, Christian Science, or any other treatment
119	authorized and provided for by law for the cure or prevention of
120	disease and ailments.
121	(6)(2)"Department" means the Department of Health.
122	(7) "Doctor of naturopathic medicine" means a person who
123	is licensed to practice naturopathic medicine under this
124	chapter.
125	(8) "Letter of reprimand" means a disciplinary letter that
126	is issued by the board and that informs a person who is
127	regulated under this chapter that the person's conduct violates
128	state or federal law but does not require the board to restrict
129	the person's license, certificate, or registration because the
130	person's conduct did not result in harm to a patient or to the
131	public.
132	(9) "Naturopathic medical student" means a person who is
133	enrolled in a course of study at an approved school of
134	naturopathic medicine.
135	(10) "Naturopathic physician" means a person licensed to
136	practice naturopathic medicine under this chapter. The term,
137	"Doctor of Naturopathic Medicine," or "Naturopath," is
138	synonymous with "Naturopathic Physician," and each term means a
139	practitioner of naturopathic medicine as defined in this
140	section, and is subject to the educational licensing
141	requirements stated in this chapter. "Natureopathy" and
142	"Naturopathy" are synonymous terms.
143	(11) "Practice of naturopathic medicine" means the
144	diagnosis, treatment, operation, or prescription for any human
145	disease, pain, injury, deformity, or other physical or mental
146	condition, which practice is based in part upon educational
147	standards and requirements that emphasize the importance of the
148	natural healing arts and natural processes of the human body.
149	The practice of naturopathic medicine includes the practice of
150	psychological, mechanical, and material health sciences to aid
151	in purifying, cleansing, and normalizing human tissues for the
152	preservation or restoration of health, according to the
153	fundamental principles of anatomy, physiology, and applied
154	psychology, as may be required. Naturopathic practice employs,
155	among other agencies, materia medica, minor surgery,
156	phytotherapy, dietetics, acupuncture, psychotherapy, diathermy,
157	suggestotherapy, natural manipulation and mobilization therapy,
158	hydrotherapy, homeopathy, zone therapy, biochemistry, external
159	applications, electrotherapy, mechanotherapy, mechanical and
160	electrical appliances, hygiene, first aid, sanitation,
161	heliotherapy, and other allied modalities. Naturopathic medicine
162	does not include the practice of chiropractic medicine or
163	osteopathic medicine.
164	Section 4. Section 462.0215, Florida Statutes, is created
165	to read:
166	462.0215 Board of Naturopathic Medicine.--
167	(1) There is created within the department the Board of
168	Naturopathic Medicine, composed of seven members appointed by
169	the Governor and confirmed by the Senate.
170	(2) Five members of the board must be licensed
171	naturopathic physicians in good standing in this state who are
172	residents of the state and who have been engaged in the active
173	practice or teaching of naturopathic medicine for at least 5
174	years, or persons holding a doctorate of naturopathic medicine
175	degree who have been teaching naturopathic medicine at an
176	approved college of naturopathic medicine in the state for at
177	least 1 year immediately preceding their appointments. One of
178	the members of the board must be on the full-time faculty of a
179	naturopathic medical school in this state, one must be a
180	physician who holds both an M.D. and a doctorate of naturopathic
181	medicine, one must be licensed as a chiropractic physician or
182	D.O., and one of the naturopathic physicians must be in private
183	practice at the time of his or her appointment. The remaining
184	two members must be residents of the state who are not, and
185	never have been, licensed health care practitioners. At least
186	one member of the board must be 60 years of age or older.
187	(3) As the terms of the members expire, the Governor shall
188	appoint successors for terms of 4 years, and such members shall
189	serve until their successors are appointed.
190	(4) The board, in conjunction with the department, shall
191	establish a disciplinary training program for board members. The
192	program shall provide for initial and periodic training in the
193	grounds for disciplinary action, the actions that may be taken
194	by the board and the department, changes in relevant statutes
195	and rules, and any relevant judicial and administrative
196	decisions. A member of the board may not participate on a
197	probable cause panel or in a disciplinary decision of the board
198	unless he or she has completed the disciplinary training
199	program.
200	(5) During the time members are appointed to a probable
201	cause panel, they shall attempt to complete their work on every
202	case presented to them. If consideration of a case is begun but
203	is not completed during the term of the members on the panel,
204	they may reconvene as a probable cause panel for the purpose of
205	completing their deliberations on that case.
206	(6) All provisions of chapter 456 relating to activities
207	of the board are applicable.
208	Section 5. Section 462.023, Florida Statutes, is amended
209	to read:
210	462.023 Powers and duties of the boarddepartment.--The
211	boarddepartmentmay adopt such rules as are necessary to carry
212	out the purposes of this chapter, mayinitiate disciplinary
213	action as provided by this chapter, and shall establish fees
214	based on its estimates of the revenue required to administer
215	this chapter which maybut shallnot exceed the fee amounts
216	provided in this chapter. The department shall not adopt any
217	rules which would cause any person who was not licensed in
218	accordance with this chapter on July 1, 1959, and had not been a
219	resident of the state for 2 years prior to such date, to become
220	licensed.
221	Section 6. Section 462.08, Florida Statutes, is amended to
222	read:
223	462.08 Renewal of license to practice naturopathic
224	medicinenaturopathy.--Each licenseholder shall biennially renew
225	her or his license to practice naturopathic medicine
226	naturopathy. The applicant must furnish to the boarddepartment
227	such evidence as it requires of the applicant's compliance with
228	s. 462.195s. 462.18, relating to educational requirements. The
229	biennial renewal fee, the amount of which shall be determined by
230	the boarddepartment but which may not exceed $3,000$1,000,
231	must be paid at the time the application for renewal of the
232	license is filed.
233	Section 7. Section 462.11, Florida Statutes, is amended to
234	read:
235	462.11 Naturopaths to observe regulations.--Doctors of
236	naturopathic medicinenaturopathyshall observe and be subject
237	to all state, county, and municipal regulations in regard to the
238	control of contagious and infectious diseases, the reporting of
239	births and deaths, and to any and all other matters pertaining
240	to the public health in the same manner as is required of other
241	practitioners of the healing art.
242	Section 8. Section 462.13, Florida Statutes, is amended to
243	read:
244	462.13 Additional powers and duties of the department and
245	board.--
246	(1) The board and thedepartment may administer oaths,
247	summon witnesses, and take testimony in all matters relating to
248	its duties pursuant to this chapter. Every unrevoked license
249	shall be presumptive evidence in all courts and places that the
250	person therein named is legally licensed to practice
251	naturopathic medicinenaturopathy. The board and thedepartment
252	shall aid the prosecuting attorneys of the state in the
253	enforcement of this chapter.
254	(2) In addition, the board and the department may:
255	(a) Require an applicant to submit credentials or other
256	written or oral proof.
257	(b) Conduct investigations as it considers proper to
258	adequately advise itself with respect to the qualifications of
259	an applicant.
260	(c) Require that the application contain the oath of the
261	applicant that:
262	1. All information contained in the application and
263	evidence submitted with it are true and correct.
264	2. The credentials submitted were not produced by fraud or
265	misrepresentation or any mistake of which the applicant is
266	aware.
267	3. The applicant is the lawful holder of the credentials.
268	(3)(a) All applications submitted to the board and any
269	attendant evidence, credentials, or other proof submitted with
270	an application are the property of the board, are part of the
271	permanent record of the board, and may not be returned to a
272	withdrawing applicant.
273	(b) The board shall promptly inform an applicant, in
274	writing, of any deficiencies in the application which prevent it
275	from being considered by the board as a completed application.
276	(c) An applicant who disagrees with the statement of
277	deficiencies and believes that he or she has filed a completed
278	application must submit a request to the board within 30 days
279	and, on request, shall be granted a hearing. The hearing may not
280	be held less than 30 days after the board receives the request
281	but must be held at the first meeting of the board which takes
282	place thereafter. At the hearing, the burden of proof is on the
283	applicant to show that he has filed a completed application.
284	(d) The board may interview the applicant to determine
285	whether the application is sufficient or whether the applicant
286	otherwise qualifies for licensure.
287	(e) Applications are considered withdrawn if the
288	applicant:
289	1. Requests that the application be withdrawn;
290	2. Fails to appear for an interview with the board, except
291	for good cause shown;
292	3. Fails to submit a completed application within 1 year
293	after the date on which the board mails to him or her a
294	statement of the deficiencies in his or her application;
295	4. Fails to show, at the hearing, that deficiencies do not
296	exist; or
297	5. Fails to show, within 1 year after the interview, that
298	his or her completed application is true and correct.
299	Section 9. Section 462.14, Florida Statutes, is amended to
300	read:
301	462.14 Grounds for disciplinary action; action by the
302	board and thedepartment.--
303	(1) The following acts constitute grounds for denial of a
304	license or disciplinary action, as specified in s. 456.072(2):
305	(a) Attempting to obtain, obtaining, or renewing a license
306	to practice naturopathic medicine by bribery, by fraudulent
307	misrepresentation, or through an error of the department or the
308	board.
309	(b) Having a license to practice naturopathic medicine
310	revoked, suspended, or otherwise acted against, including the
311	denial of licensure, by the licensing authority of any
312	jurisdiction or its agencies or subdivisionsanother state,
313	territory, or country. The licensing authority's acceptance of a
314	physician's relinquishment of a license, stipulation, consent
315	order, or other settlement, offered in response to or in
316	anticipation of the filing of administrative charges against the
317	physician's license, constitutes action against the physician's
318	license.
319	(c) Being convicted or found guilty of, or entering a plea
320	of nolo contendere to, regardless of adjudication, ofa crime in
321	any jurisdiction which directly relates to the practice of
322	naturopathic medicine or to the ability to practice naturopathic
323	medicine. Any plea of nolo contendere shall be considered a
324	conviction for purposes of this chapter.
325	(d) False, deceptive, or misleading advertising.
326	(e) Advertising, practicing, or attempting to practice
327	under a name other than one's own.
328	(f) Failing to report to the department any person who the
329	licensee knows is in violation of this chapter or of the rules
330	of the department or the board. A treatment provider approved
331	under s. 456.076 shall provide the department or the consultant
332	with information in accordance with the requirements of s.
333	456.076(3), (4), (5), and (6).
334	(g) Aiding, assisting, procuring, or advising any
335	unlicensed person to practice naturopathic medicine contrary to
336	this chapter or to a rule of the department or the board.
337	(h) Failing to perform any statutory or legal obligation
338	placed upon a licensed naturopathic physician.
339	(i) Making or filing a report which the licensee knows to
340	be false, intentionally or negligently failing to file a report
341	or record required by state or federal law, willfully impeding
342	or obstructing such filing or inducing another person to do so.
343	Such reports or records shall include only those which are
344	signed in the capacity as a licensed naturopathic physician.
345	(j) Paying or receiving any commission, bonus, kickback,
346	or rebate, or engaging in any split-fee arrangement in any form
347	whatsoever with a physician, organization, agency, or person,
348	either directly or indirectly, for patients referred to
349	providers of health care goods and services, including, but not
350	limited to, hospitals, nursing homes, clinical laboratories,
351	ambulatory surgical centers, or pharmacies. The provisions of
352	this paragraph shall not be construed to prevent a naturopathic
353	physician from receiving a fee for professional consultation
354	services.
355	(k) Exercising influence within a patient-physician
356	relationship for purposes of engaging a patient in sexual
357	activity. A patient shall be presumed to be incapable of giving
358	free, full, and informed consent to sexual activity with her or
359	his physician.
360	(l) Making deceptive, untrue, or fraudulent
361	representations in the practice of naturopathic medicine or
362	employing a trick or scheme in the practice of naturopathic
363	medicine when such scheme or trick fails to conform to the
364	generally prevailing standards of treatment in the medical
365	community.
366	(m) Soliciting patients, either personally or through an
367	agent, through the use of fraud, intimidation, undue influence,
368	or a form of overreaching or vexatious conduct. A
369	"solicitation" is any communication which directly or implicitly
370	requests an immediate oral response from the recipient.
371	(n) Failing to keep legible, as defined by rule by the
372	department in consultation with the board,writtenmedical
373	records that identify by name and professional title the
374	licensed naturopathic physician or the physician extender and
375	supervising naturopathic physician who are responsible for
376	rendering, ordering, supervising, or billing for each diagnostic
377	or treatment procedure and that justifyjustifyingthe course of
378	treatment of the patient, including, but not limited to, patient
379	histories;, examination results;, test results; records of drugs
380	prescribed, dispensed, or administered; and reports of
381	consultations and hospitalizations, X rays, and records of the
382	prescribing, dispensing and administering of drugs.
383	(o) Exercising influence on the patient or client in such
384	a manner as to exploit the patient or client for the financial
385	gain of the licensee or of a third party, which shall include,
386	but not be limited to, the promoting or selling of services,
387	goods, appliances, or drugs and the promoting or advertising on
388	any prescription form of a community pharmacy unless the form
389	also states "This prescription may be filled at any pharmacy of
390	your choice."
391	(p) Performing professional services which have not been
392	duly authorized by the patient or client, or her or his legal
393	representative, except as provided in s. 743.064, s. 766.103, or
394	s. 768.13.
395	(q) Prescribing, dispensing, administering, mixing, or
396	otherwise preparing a legend drug, including any controlled
397	substance, other than in the course of the naturopathic
398	physician's professional practice. For the purposes of this
399	paragraph, it shall be legally presumed that prescribing,
400	dispensing, administering, mixing, or otherwise preparing legend
401	drugs, including all controlled substances, inappropriately or
402	in excessive or inappropriate quantities is not in the best
403	interest of the patient and is not in the course of the
404	naturopathic physician's professional practice, without regard
405	to her or his intent.
406	(r) Prescribing, dispensing, or administering any
407	medicinal drug appearing on any schedule set forth in chapter
408	893 by the naturopathic physician to herself or himself, except
409	one prescribed, dispensed, or administered to the naturopathic
410	physician by another practitioner authorized to prescribe,
411	dispense, or administer medicinal drugs.
412	(s) Being unable to practice naturopathic medicine with
413	reasonable skill and safety to patients by reason of illness or
414	use of alcohol, drugs, narcotics, chemicals, or any other type
415	of material or as a result of any mental or physical condition.
416	In enforcing this paragraph, the department shall have, upon
417	probable cause, authority to compel a naturopathic physician to
418	submit to a mental or physical examination by physicians
419	designated by the department. If the licensee refuses to comply
420	with such order, the department's order directing such
421	examination may be enforced by filing a petition for enforcement
422	in the circuit court where the licensee resides or does
423	business. The licensee against whom the petition is filed may
424	not be named or identified by initials in any public court
425	records or documents, and the proceedings shall be closed to the
426	public. The department shall be entitled to the summary
427	procedure provided in s. 51.011.The failure of a naturopathic
428	physician to submit to such an examination when so directed
429	shall constitute an admission of the allegations against her or
430	him upon which a default and final order may be entered without
431	the taking of testimony or presentation of evidence, unless the
432	failure was due to circumstances beyond the naturopathic
433	physician's control.A naturopathic physician affected under
434	this paragraph shall at reasonable intervals be afforded an
435	opportunity to demonstrate that she or he can resume the
436	competent practice of naturopathic medicine with reasonable
437	skill and safety to patients. In any proceeding under this
438	paragraph, neither the record of proceedings nor the orders
439	entered by the department may be used against a naturopathic
440	physician in any other proceeding.
441	(t) Gross or repeated malpractice or the failure to
442	practice naturopathic medicine with that level of care, skill,
443	and treatment which is recognized by a reasonably prudent
444	similar physician as being acceptable under similar conditions
445	and circumstances. The boarddepartmentshall give great weight
446	to the provisions of s. 766.102 when enforcing this paragraph.
447	As used in this paragraph, the term "repeated malpractice"
448	includes, but is not limited to, three or more claims for
449	medical malpractice within the previous 5-year period resulting
450	in indemnities being paid in excess of $25,000 each to the
451	claimant in a judgment or settlement and which incidents
452	involved negligent conduct by the physician. As used in this
453	paragraph, the term "gross malpractice" or "the failure to
454	practice medicine with that level of care, skill, and treatment
455	which is recognized by a reasonably prudent similar physician as
456	being acceptable under similar conditions and circumstances"
457	shall not be construed so as to require more than one instance,
458	event, or act. Nothing in this paragraph shall be construed to
459	require that a naturopathic physician be incompetent to practice
460	medicine in order to be disciplined pursuant to this paragraph.
461	(u) Performing any procedure or prescribing any therapy
462	which, by the prevailing standards of medical practice in the
463	community, constitutes experimentation on a human subject,
464	without first obtaining full, informed, and written consent.
465	(v) Practicing or offering to practice beyond the scope
466	permitted by law or accepting and performing professional
467	responsibilities which the licensee knows or has reason to know
468	that she or he is not competent to perform. The board may by
469	rule establish standards of practice and standards of care for
470	particular practice settings, including, but not limited to,
471	education and training, equipment and supplies, medications,
472	including anesthetics, assistance of and delegation to other
473	personnel, transfer agreements, sterilization, records,
474	performance of complex or multiple procedures, informed consent,
475	and policy and procedure manuals.
476	(w) Delegating professional responsibilities to a person
477	when the licensee delegating such responsibilities knows or has
478	reason to know that such person is not qualified by training,
479	experience, or licensure to perform them.
480	(x) Violating a lawful order of the board orthe
481	department which waspreviously entered in a disciplinary
482	hearing or failing to comply with a lawfully issued subpoena of
483	the department.
484	(y) Conspiring with another licensee or with any other
485	person to commit an act, or committing an act, which would tend
486	to coerce, intimidate, or preclude another licensee from
487	lawfully advertising her or his services.
488	(z) Procuring, or aiding or abetting in the procuring of,
489	an unlawful termination of pregnancy.
490	(aa) Presigning blank prescription forms.
491	(bb) Prescribing by the naturopathic physician for office
492	use any medicinal drug appearing on Schedule II in chapter 893
493	by the naturopathic physician for office use.
494	(cc) Prescribing, ordering, dispensing, administering,
495	supplying, selling, or giving any drug that is a Schedule II
496	which is an amphetamine or a Schedule IIsympathomimetic amine
497	drug, or anya compound thereof,designated pursuant to chapter
498	893 as a Schedule II controlled substanceto or for any person
499	except for:
500	1. The treatment of narcolepsy; hyperkinesis; behavioral
501	syndrome in childrencharacterized by the developmentally
502	inappropriate symptoms of moderate to severe distractability,
503	short attention span, hyperactivity, emotional lability, and
504	impulsivity; or drug-induced brain dysfunction.
505	2. The differential diagnostic psychiatric evaluation of
506	depression or the treatment of depression shown to be refractory
507	to other therapeutic modalities.
508	3. The clinical investigation of the effects of such drugs
509	or compounds when an investigative protocol therefor is
510	submitted to, reviewed, and approved by the boarddepartment
511	before such investigation is begun.
512	(dd) Failing to adequately supervise the activities of
513	licensed practitioners who are acting under the supervision of
514	the naturopathic physician.
515	(ee)(dd)Prescribing, ordering, dispensing, administering,
516	supplying, selling, or giving growth hormones, testosterone or
517	its analogs, human chorionic gonadotropin (HCG), or other
518	hormones for the purpose of muscle building or to enhance
519	athletic performance. For the purposes of this subsection, the
520	term "muscle building" does not include the treatment of injured
521	muscle. A prescription written for the drug products listed
522	above may be dispensed by the pharmacist with the presumption
523	that the prescription is for legitimate medical use.
524	(ff) Prescribing, ordering, dispensing, administering,
525	supplying, selling, or giving amygdalin (laetrile) to any
526	person.
527	(gg) Misrepresenting or concealing a material fact at any
528	time during any phase of a licensing or disciplinary process or
529	procedure.
530	(hh) Improperly interfering with an investigation or with
531	any disciplinary proceeding.
532	(ii) Failing to report to the department any licensee
533	under this chapter, chapter 458, or chapter 459 who the
534	naturopathic physician knows has violated the grounds for
535	disciplinary action set out in the law under which that person
536	is licensed and who provides health care services in a facility
537	licensed under chapter 395, or a health maintenance organization
538	certificated under part I of chapter 641, in which the
539	naturopathic physician also provides services.
540	(jj) Being found by any court in this state to have
541	provided corroborating written medical expert opinion attached
542	to any statutorily required notice of claim or intent or to any
543	statutorily required response rejecting a claim, without
544	reasonable investigation.
545	(kk) Failing to report to the board, in writing, within 30
546	days if action as defined in paragraph (b) has been taken
547	against one's license to practice naturopathic medicine in
548	another state, territory, or country.
549	(ll) Advertising or holding oneself out as a board-
550	certified specialist, if not qualified under s. 458.3312, in
551	violation of this chapter.
552	(mm) Failing to comply with the requirements of ss.
553	381.026 and 381.0261 to provide patients with information about
554	their patient rights and how to file a patient complaint.
555	(nn)(ee)Violating any provision of this chapter or
556	chapter 456, or any rules adopted pursuant thereto.
557	(2) The boarddepartmentmay enter an order denying
558	licensure or imposing any of the penalties in s. 456.072(2)
559	against any applicant for licensure or licensee who is found
560	guilty of violating any provision of subsection (1) of this
561	sectionor who is found guilty of violating any provision of s.
562	456.072(1). In determining what action is appropriate, the board
563	must first consider what sanctions are necessary to protect the
564	public or to compensate the patient. Only after those sanctions
565	have been imposed may the disciplining authority consider and
566	include in the order requirements designed to rehabilitate the
567	naturopathic physician. All costs associated with compliance
568	with orders issued under this subsection are the obligation of
569	the naturopathic physician.
570	(3) In any administrative action against a naturopathic
571	physician which does not involve revocation or suspension of
572	license, the board or department shall have the burden, by the
573	greater weight of the evidence, to establish the existence of
574	grounds for disciplinary action. The board or department shall
575	establish grounds for revocation or suspension of license by
576	clear and convincing evidence.
577	(4) The board shall not reinstate the license of a
578	naturopathic physician, or cause a license to be issued to a
579	person it deems or has deemed unqualified, until such time as it
580	is satisfied that he or she has complied with all the terms and
581	conditions set forth in the final order and that such person is
582	capable of safely engaging in the practice of naturopathic
583	medicine.
584	(5) The board shall by rule establish guidelines for the
585	disposition of disciplinary cases involving specific types of
586	violations. Such guidelines may include minimum and maximum
587	fines, periods of supervision or probation, or conditions of
588	probation or reissuance of a license. "Gross malpractice,"
589	"repeated malpractice," and "failure to practice medicine with
590	that level of care, skill, and treatment which is recognized as
591	being acceptable under similar circumstances" under subsection
592	(10) shall each be considered distinct types of violations
593	requiring specific individual guidelines.
594	(6) Upon the department's receipt from an insurer or self-
595	insurer of a report of a closed claim against a naturopathic
596	physician pursuant to s. 627.912 or from a health care
597	practitioner of a report pursuant to s. 456.049, or upon the
598	receipt from a claimant of a presuit notice against a
599	naturopathic physician pursuant to s. 766.106, the department
600	shall review each report and determine whether it potentially
601	involved conduct by a licensee which is subject to disciplinary
602	action, in which case the provisions of s. 456.073 shall apply.
603	However, if it is reported that a naturopathic physician has had
604	three or more claims with indemnities exceeding $25,000 each
605	within the previous 5-year period, the department shall
606	investigate the occurrences upon which the claims were based and
607	determine if action by the department against the naturopathic
608	physician is warranted.
609	(7) Upon the department's receipt from the Agency for
610	Health Care Administration pursuant to s. 395.0197 of the name
611	of a naturopathic physician whose conduct may constitute grounds
612	for disciplinary action by the department, the department shall
613	investigate the occurrences upon which the report was based and
614	determine if action by the department against the naturopathic
615	physician is warranted.
616	(8) If any naturopathic physician regulated by the
617	Division of Medical Quality Assurance is guilty of such
618	unprofessional conduct, negligence, or mental or physical
619	incapacity or impairment that the division determines that the
620	naturopathic physician is unable to practice with reasonable
621	skill and safety and presents a danger to patients, the division
622	shall be authorized to maintain an action in circuit court
623	enjoining such naturopathic physician from providing medical
624	services to the public until the naturopathic physician
625	demonstrates the ability to practice with reasonable skill and
626	safety and without danger to patients.
627	(9) When an investigation of a naturopathic physician is
628	undertaken, the department shall promptly furnish to the
629	naturopathic physician or the naturopathic physician's attorney
630	a copy of the complaint or document which resulted in the
631	initiation of the investigation. For purposes of this
632	subsection, such documents include, but are not limited to: the
633	pertinent portions of an annual report submitted to the
634	department pursuant to s. 395.0197(6); a report of an adverse
635	incident which is provided to the department pursuant to s.
636	395.0197; a report of peer review disciplinary action submitted
637	to the department pursuant to s. 395.0193(4), provided that the
638	investigations, proceedings, and records relating to such peer
639	review disciplinary action shall continue to retain their
640	privileged status even as to the licensee who is the subject of
641	the investigation, as provided by s. 395.0193(8); a report of a
642	closed claim submitted pursuant to s. 627.912; a presuit notice
643	submitted pursuant to s. 766.106(2); and a petition brought
644	under the Florida Birth-Related Neurological Injury Compensation
645	Plan, pursuant to s. 766.305(2). The naturopathic physician may
646	submit a written response to the information contained in the
647	complaint or document which resulted in the initiation of the
648	investigation within 45 days after service to the naturopathic
649	physician of the complaint or document. The naturopathic
650	physician's written response shall be considered by the probable
651	cause panel.
652	(10) A recommended order by an administrative law judge or
653	a final order of the board finding a violation under this
654	section shall specify whether the licensee was found to have
655	committed "gross malpractice," "repeated malpractice," or
656	"failure to practice medicine with that level of care, skill,
657	and treatment which is recognized as being acceptable under
658	similar conditions and circumstances" or any combination
659	thereof, and any publication by the board shall so specify.
660	(3) The department shall not reinstate the license of a
661	naturopathic physician until such time as the department is
662	satisfied that such person has complied with all the terms and
663	conditions set forth in the final order and that such person is
664	capable of safely engaging in the practice of naturopathic
665	medicine.
666	(4) The department shall by rule establish guidelines for
667	the disposition of disciplinary cases involving specific types
668	of violations. Such guidelines may include minimum and maximum
669	fines, periods of supervision or probation, or conditions of
670	probation or reissuance of a license.
671	Section 10. Section 462.16, Florida Statutes, is amended
672	to read:
673	462.16 Reissue of license.--Any person who practices
674	naturopathic medicineshall practice naturopathyafter her or
675	his license has been revoked and registration annulled shall be
676	deemed to have practiced naturopathic medicinenaturopathy
677	without a license; provided,however, at any time after 6 months
678	after the date of said conviction, the department may grant a
679	license to the person affected, restoring to her or him all the
680	rights and privileges of and pertaining to the practice of
681	naturopathic medicinenaturopathyas defined and regulated by
682	this chapter. The fee therefor shall not exceed $250.
683	Section 11. Section 462.17, Florida Statutes, is amended
684	to read:
685	462.17 Penalty for offenses relating to naturopathic
686	medicinenaturopathy.--Any person who shall:
687	(1) Sell, fraudulently obtain, or furnish any naturopathic
688	diploma, license, record, or registration or aid or abet in the
689	same;
690	(2) Practice naturopathic medicinenaturopathyunder the
691	cover of any diploma, license, record, or registration illegally
692	or fraudulently obtained or secured or issued unlawfully or upon
693	fraudulent representations;
694	(3) Advertise to practice naturopathic medicine
695	naturopathyunder a name other than her or his own or under an
696	assumed name;
697	(4) Falsely impersonate another practitioner of a like or
698	different name;
699	(5) Practice or advertise to practice naturopathic
700	medicinenaturopathyor use in connection with her or his name
701	any designation tending to imply or to designate the person as a
702	practitioner of naturopathic medicinenaturopathywithout then
703	being lawfully licensed and authorized to practice naturopathic
704	medicinenaturopathyin this state; or
705	(6) Practice naturopathic medicinenaturopathyduring the
706	time her or his license is suspended or revoked
707
708	commitsshall be guilty ofa felony of the third degree,
709	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
710	Section 12. Section 462.18, Florida Statutes, is amended
711	to read:
712	462.18 Educational requirements for naturopathic
713	physicians licensed before January 1, 2006.--
714	(1) At the time each licensee shall renew her or his
715	license as otherwise provided in this chapter, each licensee,
716	beginning with the license renewal due May 1, 1944, in addition
717	to the payment of the regular renewal fee, shall furnish to the
718	board orthe department satisfactory evidence that, in the year
719	preceding each such application for renewal, the licensee has
720	attended the 2-day educational program as promulgated and
721	conducted by the Florida Naturopathic Physicians Association,
722	Inc., or, as a substitute therefor, the equivalent of that
723	program as approved by the board or the department. The board or
724	thedepartment shall send a written notice to this effect to
725	every person holding a valid license to practice naturopathy
726	within this state at least 30 days prior to May 1 in each
727	biennial year, directed to the last known address of such
728	licensee, and shall enclose with the notice proper blank forms
729	for application for annual license renewal. All of the details
730	and requirements of the aforesaid educational program shall be
731	adopted and prescribed by the board orthe department. In the
732	event of national emergencies, or for sufficient reason, the
733	board orthe department shall have the power to excuse the
734	naturopathic physicians as a group or as individuals from taking
735	this postgraduate course.
736	(2) The determination of whether a substitute annual
737	educational program is necessary shall be solely within the
738	discretion of the board orthe department.
739	(3) Licensed naturopathic physicians (N.M.D.'s or N.D.'s)
740	shall retain the same rights and privileges that they had before
741	the implementation of amendments to this chapter.
742	Section 13. Section 462.19, Florida Statutes, is amended
743	to read:
744	462.19 Renewal of license; inactive status.--
745	(1) The board or thedepartment shall renew a license upon
746	receipt of the renewal application and fee.
747	(2) The board or thedepartment shall adopt rules
748	establishing a procedure for the biennial renewal of licenses.
749	(3) A licensee may request that her or his license be
750	placed in an inactive status by making application to the board
751	or the department and paying a fee in an amount set by the board
752	or the department not to exceed $100$50.
753	Section 14. Section 462.195, Florida Statutes, is created
754	to read:
755	462.195 Licensure by examination; requirements; fees.--
756	(1) Any person desiring to be licensed as a naturopathic
757	physician shall apply to the department on forms furnished by
758	the department. The department shall license each applicant who
759	the board certifies:
760	(a) Has completed the application form and remitted a
761	nonrefundable application fee not to exceed $500.
762	(b) Is at least 21 years of age.
763	(c) Is of good moral character.
764	(d) Has not committed any act or offense in this or any
765	other jurisdiction which would constitute the basis for
766	disciplining a naturopathic physician pursuant to s. 462.14.
767	(e) Meets one of the following naturopathic medical
768	education training requirements:
769	1. Is a graduate of an approved school of naturopathic
770	medicine which is licensed by the Florida Commission for
771	Independent Education to grant the Doctor of Naturopathic
772	Medicine degree;
773	2. Is a graduate of a regionally accredited college of
774	naturopathic medicine or of a naturopathic medical school that
775	is accredited or is a candidate for accreditation by the Council
776	on Naturopathic Medical Education(CNME);
777	3. Is a graduate of a naturopathic medical school that was
778	at the time licensed by a state board of education and approved
779	by that state's naturopathic licensure board, which has
780	requirements comparable to those of this state; or
781	4. Is a graduate of an international medical school listed
782	by the World Health Organization (WHO), approved by the
783	Educational Commission for Foreign Medical Graduates (ECFMG) to
784	be examined in the basic and clinical medical sciences, or a
785	graduate of an accredited United States allopathic or
786	osteopathic medical school, and has completed a 2-year course in
787	naturopathic medicine from an approved naturopathic medical
788	school in the United States.
789	(f) Has submitted to the department a set of fingerprints
790	on a form and in accordance with procedures specified by the
791	department, along with payment in an amount equal to the costs
792	incurred by the department for the criminal background check of
793	the applicant.
794	(g) Has obtained on the examinations in basic medical and
795	clinical medical sciences a passing score, as established by
796	rule of the board, from one of the following:
797	1. Naturopathic Physicians Licensing Examination (NPLEX),
798	with a converted score of not less than 75 percent on all part
799	one examinations and a converted score of not less than 75
800	percent on all part two examinations, or passage under the
801	compensatory model. North American Board of Naturopathic
802	Examiners (NABNE) administers the NPLEX examination;
803	2. Federation Licensing Examination (FLEX), medical
804	examination part one and two, with a minimum score of 70 percent
805	on part one (basic medical sciences) and a minimum score of 75
806	percent on part two (clinical medical sciences);
807	3. United States Medical Licensing Examination (USMLE),
808	medical examination part one and two, with a minimum score of 70
809	percent on part one(basic medical sciences) and a minimum score
810	of 75 percent on part two(clinical medical sciences);
811	4. State or national board examination for licensure in
812	another state which is comparable to the examination for
813	licensure in this state;
814	5. A Department of Health special purpose examination
815	(SPEX) for applicants who are in unusual circumstances; or
816	6. Comprehensive Osteopathic Medical Licensing Examination
817	(COMLEX), with a minimum score of 70 percent on part one (basic
818	medical sciences) and a minimum score of 75 percent on part two
819	(clinical medical sciences).
820	(h) Has satisfactorily completed an approved internship
821	program, approved preceptorship program, or approved clinical
822	training program in naturopathic medicine.
823	(i) Is physically and mentally fit to practice as a doctor
824	of naturopathic medicine.
825	(j) Has not had his or her license to practice any
826	profession refused, revoked, or suspended by any other state,
827	district, or territory of the United States or another country
828	for reasons that relate to his or her ability to skillfully and
829	safely practice as a naturopathic physician in this state.
830	(k) Has not been found guilty of a felony.
831	(2) As prescribed by board rule, the board may require an
832	applicant who does not pass the licensing examination after five
833	attempts to complete additional remedial education or training.
834	The board shall prescribe the additional requirements in a
835	manner that permits the applicant to complete the requirements
836	and be reexamined within 2 years after the date the applicant
837	petitions the board to retake the examination a sixth or
838	subsequent time.
839	(3) The department and the board shall conduct an
840	investigation to assure that applicants for licensure meet the
841	criteria in subsection (1). When the investigation is not
842	completed within the time set out in s. 120.60(1) and the
843	department or board has reason to believe that the applicant
844	does not meet the criteria, the secretary or the secretary's
845	designee may issue a 90-day licensure delay, which must be in
846	writing and sufficient to notify the applicant of the reason for
847	the delay. This subsection controls over any conflicting
848	provisions of s. 120.60(1).
849	(4) The board may not certify to the department for
850	licensure any applicant who is under investigation in another
851	jurisdiction for an offense that would constitute a violation of
852	this chapter until the investigation has been completed. Upon
853	completion of the investigation, s. 462.14 applies. Furthermore,
854	the department may not issue an unrestricted license to any
855	individual who has committed an act or offense in any
856	jurisdiction which would constitute the basis for disciplining a
857	naturopathic physician under s. 462.14. If the board finds that
858	an individual has committed an act or offense in any
859	jurisdiction which would constitute the basis for disciplining a
860	naturopathic physician under s. 462.14, the board may enter an
861	order imposing one or more of the sanctions set forth in
862	subsection (7).
863	(5) Each applicant who meets the requirements of this
864	chapter shall be licensed as a naturopathic physician, with
865	rights as defined by law.
866	(6) Upon certification by the board, the department shall
867	impose conditions, limitations, or restrictions on a license if
868	the applicant is on probation in another jurisdiction for an act
869	that would constitute a violation of this chapter.
870	(7) If the board determines that an applicant for
871	licensure has failed to meet, to the board's satisfaction, any
872	of the applicable requirements set forth in this section, it may
873	enter an order that imposes one or more of the following
874	sanctions:
875	(a) Refusal to certify to the department an application
876	for licensure, certification, or registration.
877	(b) Certification to the department of an application for
878	licensure, certification, or registration with restrictions on
879	the scope of practice of the licensee.
880	(c) Certification to the department of an application for
881	licensure, certification, or registration with placement of the
882	naturopathic physician on probation for a period of time and
883	subject to such conditions as the board specifies, including,
884	but not limited to, requiring the naturopathic physician to
885	submit to treatment, attend continuing education courses, submit
886	to reexamination, or work under the supervision of another
887	naturopathic physician.
888	(8) A physician who holds the doctor of medicine or doctor
889	of osteopathy degree and has completed a 1-year M.D.-approved or
890	D.O.-approved internship and is licensed under this section, has
891	rights and privileges equal to those of physicians licensed
892	under chapter 458 or chapter 459.
893	Section 15. Section 462.196, Florida Statutes, is created
894	to read:
895	462.196 Educational requirements for naturopathic
896	physicians licensed on or after January 1, 2006.--A physician
897	who applies for a license to practice naturopathic medicine on
898	or after January 1, 2006, must have completed 1 year of approved
899	postdoctoral residence training or internship training at a
900	residency program approved by the Council of Naturopathic
901	Medical Education (CNME), the Accreditation Council for Graduate
902	Medical Education (ACGME), or the American Osteopathic
903	Association.
904	Section 16. Exemptions from naturopathic licensure
905	requirements.--Licensure requirements for practitioners of
906	naturopathic medicine are inapplicable to:
907	(1) SUPPLEMENT RETAILERS.--An individual who is engaged in
908	selling vitamins, health foods, dietary supplements, herbs, or
909	other products of nature, the sale of which is not otherwise
910	prohibited under state or federal law. This exemption does not:
911	(a) Allow a person to diagnose any human disease, ailment,
912	injury, infirmity, deformity, pain, or other condition; or
913	(b) Prohibit providing information regarding any of the
914	products listed in this subsection, which information is
915	truthful and is not misleading.
916	(2) RELIGIOUS FREEDOMS.--A person who is:
917	(a) Engaged in good faith in the practice of the religious
918	tenets of any church or religious belief, without the use of
919	prescription drugs; or
920	(b) Acting in good faith for religious reasons as a matter
921	of conscience or on the basis of a personal belief when
922	obtaining or providing information regarding health care and the
923	use of any product.
924	(3) FAMILY REMEDIES.--Individuals who are administering a
925	domestic or family remedy.
926	Section 17. This act shall take effect July 1, 2003.