HOUSE AMENDMENT Bill No. HB 1713
1	CHAMBER ACTION
2	Senate House
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12	Representative Homan offered the following:
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14	Amendment (with title amendment)
15	Remove line(s) 785-1389, and insert:
16	Section 22. Section 627.3575, Florida Statutes, is created
17	to read:
18	627.3575 Health Care Professional Liability Insurance
19	Facility.--
20	(1) FACILITY CREATED; PURPOSE; STATUS.--There is created
21	the Health Care Professional Liability Insurance Facility. The
22	facility is intended to meet ongoing availability and
23	affordability problems relating to liability insurance for
24	health care professionals by providing an affordable, self-
25	supporting source of excess insurance coverage for those
26	professionals who are willing and able to self-insure for
27	smaller losses. The facility shall operate on a not-for-profit
28	basis. The facility is self-funding and is intended to serve a
29	public purpose but is not a state agency or program, and no
30	activity of the facility shall create any state liability.
31	(2) GOVERNANCE; POWERS.--
32	(a) The facility shall operate under a seven-member board
33	of governors consisting of the Secretary of Health, three
34	members appointed by the Governor, and three members appointed
35	by the Chief Financial Officer. The board shall be chaired by
36	the Secretary of Health. The secretary shall serve by virtue of
37	his or her office, and the other members of the board shall
38	serve terms concurrent with the term of office of the official
39	who appointed them. Any vacancy on the board shall be filled in
40	the same manner as the original appointment. Members serve at
41	the pleasure of the official who appointed them. Members are not
42	eligible for compensation for their service on the board, but
43	the facility may reimburse them for per diem and travel expenses
44	at the same levels as are provided in s. 112.061 for state
45	employees.
46	(b) The facility shall have such powers as are necessary
47	to operate as an insurer, including the power to:
48	1. Sue and be sued.
49	2. Hire such employees and retain such consultants,
50	attorneys, actuaries, and other professionals as it deems
51	appropriate.
52	3. Contract with such service providers as it deems
53	appropriate.
54	4. Maintain offices appropriate to the conduct of its
55	business.
56	5. Take such other actions as are necessary or appropriate
57	in fulfillment of its responsibilities under this section.
58	(3) COVERAGE PROVIDED.--The facility shall provide
59	liability insurance coverage for health care professionals. The
60	facility shall allow policyholders to select from policies with
61	deductibles of $25,000 per claim, $50,000 per claim, and
62	$100,000 per claim and with coverage limits of $100,000 per
63	claim and $300,000 annual aggregate, $250,000 per claim and
64	$750,000 annual aggregate, and $1 million per claim and $3
65	million annual aggregate. To the greatest extent possible, the
66	terms and conditions of the policies shall be consistent with
67	terms and conditions commonly used by professional liability
68	insurers.
69	(4) ELIGIBILITY; TERMINATION.--
70	(a) Any health care professional is eligible for coverage
71	provided by the facility if the professional at all times
72	maintains either:
73	1. An escrow account consisting of cash or assets eligible
74	for deposit under s. 625.52 in an amount equal to the deductible
75	amount of the policy; or
76	2. An unexpired, irrevocable letter of credit, established
77	pursuant to chapter 675, in an amount not less than the
78	deductible amount of the policy. The letter of credit shall be
79	payable to the health care professional as beneficiary upon
80	presentment of a final judgment indicating liability and
81	awarding damages to be paid by the physician or upon presentment
82	of a settlement agreement signed by all parties to such
83	agreement when such final judgment or settlement is a result of
84	a claim arising out of the rendering of, or the failure to
85	render, medical care and services. Such letter of credit shall
86	be nonassignable and nontransferable. Such letter of credit
87	shall be issued by any bank or savings association organized and
88	existing under the laws of this state or any bank or savings
89	association organized under the laws of the United States that
90	has its principal place of business in this state or has a
91	branch office which is authorized under the laws of this state
92	or of the United States to receive deposits in this state.
93	(b) The eligibility of a health care professional for
94	coverage terminates upon:
95	1. The failure of the professional to comply with
96	paragraph (a);
97	2. The failure of the professional to timely pay premiums;
98	or
99	3. The commission of any act of fraud in connection with
100	the policy, as determined by the board of governors.
101	(c) The board of governors, in its discretion, may
102	reinstate the eligibility of a health care professional whose
103	eligibility has terminated pursuant to paragraph (b) upon
104	determining that the professional has come back into compliance
105	with paragraph (a) or has paid the overdue premiums. Eligibility
106	may be reinstated in the case of fraud only if the board
107	determines that its initial determination of fraud was in error.
108	(5) PREMIUMS.--
109	(a) The facility shall charge the actuarially indicated
110	premium for the coverage provided and shall retain the services
111	of consulting actuaries to prepare its rate filings. The
112	facility shall not provide dividends to policyholders, and, to
113	the extent that premiums are more than the amount required to
114	cover claims and expenses, such excess shall be retained by the
115	facility for payment of future claims. In the event of
116	dissolution of the facility, any amounts not required as a
117	reserve for outstanding claims shall be transferred to the
118	policyholders of record as of the last day of operation.
119	(b) To ensure that the facility has the funds to pay
120	claims:
121	1. From each judgment awarded and settlement agreed to
122	from which a claim will be paid in whole or in part by the
123	facility, the facility shall retain 1 percent of its portion of
124	the award or settlement for deposit into a separate account for
125	guaranteeing payment of claims.
126	2. From the funds of the Florida Birth-Related
127	Neurological Injury Compensation Association, the facility shall
128	receive the interest on the association’s investments for
129	deposit into a separate account for guaranteeing payment of
130	claims.
131	(6) REGULATION; APPLICABILITY OF OTHER STATUTES.--
132	(a) The facility shall operate pursuant to a plan of
133	operation approved by order of the Office of Insurance
134	Regulation of the Financial Services Commission. The board of
135	governors may at any time adopt amendments to the plan of
136	operation and submit the amendments to the Office of Insurance
137	Regulation for approval.
138	(b) The facility is subject to regulation by the Office of
139	Insurance Regulation of the Financial Services Commission in the
140	same manner as other insurers.
141	(c) The facility is not subject to part II of chapter 631,
142	relating to the Florida Insurance Guaranty Association.
143	(7) STARTUP PROVISIONS.--
144	(a) It is the intent of the Legislature that the facility
145	begin providing coverage no later than January 1, 2004.
146	(b) The Governor and the Chief Financial Officer shall
147	make their appointments to the board of governors of the
148	facility no later than July 1, 2003. Until the board is
149	appointed, the Secretary of Health may perform ministerial acts
150	on behalf of the facility as chair of the board of governors.
151	(c) Until the facility is able to hire permanent staff and
152	enter into contracts for professional services, the office of
153	the Secretary of Health shall provide support services to the
154	facility.
155	(d) In order to provide startup funds for the facility,
156	the board of governors may incur debt or enter into agreements
157	for lines of credit, provided that the sole source of funds for
158	repayment of any debt is future premium revenues of the
159	facility. The amount of such debt or lines of credit may not
160	exceed $10 million. In addition to the debt or lines of credit
161	provided for in this paragraph, the facility shall be authorized
162	to borrow up to $10 million from the Florida Birth-Related
163	Neurological Injury Compensation Association and repay the
164	association in equal annual installments over a period of 10
165	years.
166	Section 23. Subsection (1) and paragraph (n) of subsection
167	(2) of section 627.912, Florida Statutes, are amended to read:
168	627.912 Professional liability claims and actions; reports
169	by insurers.--
170	(1)(a)Each self-insurer authorized under s. 627.357 and
171	each insurer or joint underwriting association providing
172	professional liability insurance to a practitioner of medicine
173	licensed under chapter 458, to a practitioner of osteopathic
174	medicine licensed under chapter 459, to a podiatric physician
175	licensed under chapter 461, to a dentist licensed under chapter
176	466, to a hospital licensed under chapter 395, to a crisis
177	stabilization unit licensed under part IV of chapter 394, to a
178	health maintenance organization certificated under part I of
179	chapter 641, to clinics included in chapter 390, to an
180	ambulatory surgical center as defined in s. 395.002, or to a
181	member of The Florida Bar shall report in duplicate to the
182	Department of Insurance any claim or action for damages for
183	personal injuries claimed to have been caused by error,
184	omission, or negligence in the performance of such insured's
185	professional services or based on a claimed performance of
186	professional services without consent, if the claim resulted in:
187	1.(a)A final judgment in any amount.
188	2.(b)A settlement in any amount.
189
190	Reports shall be filed with the department.
191	(b) In addition to the requirements of paragraph (a), if
192	the insured party is licensed under chapter 395, chapter 458,
193	chapter 459, chapter 461, or chapter 466, the insurer shall
194	report in duplicate to the Office of Insurance Regulation any
195	other disposition of the claim, including, but not limited to, a
196	dismissal. If the insured is licensed under chapter 458, chapter
197	459, or chapter 461, any claim that resulted in a final judgment
198	or settlement in the amount of $50,000 or more shall be reported
199	to the Department of Health no later than 30 days following the
200	occurrence of that event. If the insured is licensed under
201	chapter 466, any claim that resulted in a final judgment or
202	settlement in the amount of $25,000 or more shall be reported to
203	the Department of Health no later than 30 days following the
204	occurrence of that eventand, if the insured party is licensed
205	under chapter 458, chapter 459, chapter 461, or chapter 466,
206	with the Department of Health, no later than 30 days following
207	the occurrence of any event listed in paragraph (a) or paragraph
208	(b). The Department of Health shall review each report and
209	determine whether any of the incidents that resulted in the
210	claim potentially involved conduct by the licensee that is
211	subject to disciplinary action, in which case the provisions of
212	s. 456.073 shall apply. The Department of Health, as part of the
213	annual report required by s. 456.026, shall publish annual
214	statistics, without identifying licensees, on the reports it
215	receives, including final action taken on such reports by the
216	Department of Health or the appropriate regulatory board.
217	(2) The reports required by subsection (1) shall contain:
218	(n) Any other information required by the department to
219	analyze and evaluate the nature, causes, location, cost, and
220	damages involved in professional liability cases. The Financial
221	Services Commission shall adopt by rule requirements for
222	additional information to assist the Office of Insurance
223	Regulation in its analysis and evaluation of the nature, causes,
224	location, cost, and damages involved in professional liability
225	cases reported by insurers under this section.
226	Section 24. Section 627.9121, Florida Statutes, is created
227	to read:
228	627.9121 Required reporting of claims; penalties.--Each
229	entity that makes payment under a policy of insurance, self-
230	insurance, or otherwise in settlement, partial settlement, or
231	satisfaction of a judgment in a medical malpractice action or
232	claim that is required to report information to the National
233	Practitioner Data Bank under 42 U.S.C. s. 11131 must also report
234	the same information to the Office of Insurance Regulation. The
235	office shall include such information in the data that it
236	compiles under s. 627.912. The office must compile and review
237	the data collected pursuant to this section and must assess an
238	administrative fine on any entity that fails to fully comply
239	with such reporting requirements.
240	Section 25. Subsections (3) and (4) of section 766.106,
241	Florida Statutes, are amended, and subsection (13) is added to
242	said section, to read:
243	766.106 Notice before filing action for medical
244	malpractice; presuit screening period; offers for admission of
245	liability and for arbitration; informal discovery; review.--
246	(3)(a) No suit may be filed for a period of 18090days
247	after notice is mailed to any prospective defendant. During the
248	180-day90-dayperiod, the prospective defendant's insurer or
249	self-insurer shall conduct a review to determine the liability
250	of the defendant. Each insurer or self-insurer shall have a
251	procedure for the prompt investigation, review, and evaluation
252	of claims during the 180-day90-dayperiod. This procedure shall
253	include one or more of the following:
254	1. Internal review by a duly qualified claims adjuster;
255	2. Creation of a panel comprised of an attorney
256	knowledgeable in the prosecution or defense of medical
257	malpractice actions, a health care provider trained in the same
258	or similar medical specialty as the prospective defendant, and a
259	duly qualified claims adjuster;
260	3. A contractual agreement with a state or local
261	professional society of health care providers, which maintains a
262	medical review committee;
263	4. Any other similar procedure which fairly and promptly
264	evaluates the pending claim.
265
266	Each insurer or self-insurer shall investigate the claim in good
267	faith, and both the claimant and prospective defendant shall
268	cooperate with the insurer in good faith. If the insurer
269	requires, a claimant shall appear before a pretrial screening
270	panel or before a medical review committee and shall submit to a
271	physical examination, if required. Unreasonable failure of any
272	party to comply with this section justifies dismissal of claims
273	or defenses. There shall be no civil liability for participation
274	in a pretrial screening procedure if done without intentional
275	fraud.
276	(b) At or before the end of the 18090days, the insurer
277	or self-insurer shall provide the claimant with a response:
278	1. Rejecting the claim;
279	2. Making a settlement offer; or
280	3. Making an offer of admission of liability and for
281	arbitration on the issue of damages. This offer may be made
282	contingent upon a limit of general damages.
283	(c) The response shall be delivered to the claimant if not
284	represented by counsel or to the claimant's attorney, by
285	certified mail, return receipt requested. Failure of the
286	prospective defendant or insurer or self-insurer to reply to the
287	notice within 18090days after receipt shall be deemed a final
288	rejection of the claim for purposes of this section.
289	(d) Within 30 days afterofreceipt of a response by a
290	prospective defendant, insurer, or self-insurer to a claimant
291	represented by an attorney, the attorney shall advise the
292	claimant in writing of the response, including:
293	1. The exact nature of the response under paragraph (b).
294	2. The exact terms of any settlement offer, or admission
295	of liability and offer of arbitration on damages.
296	3. The legal and financial consequences of acceptance or
297	rejection of any settlement offer, or admission of liability,
298	including the provisions of this section.
299	4. An evaluation of the time and likelihood of ultimate
300	success at trial on the merits of the claimant's action.
301	5. An estimation of the costs and attorney's fees of
302	proceeding through trial.
303	(4) The notice of intent to initiate litigation shall be
304	served within the time limits set forth in s. 95.11. However,
305	during the 180-day90-dayperiod, the statute of limitations is
306	tolled as to all potential defendants. Upon stipulation by the
307	parties, the 180-day90-dayperiod may be extended and the
308	statute of limitations is tolled during any such extension. Upon
309	receiving notice of termination of negotiations in an extended
310	period, the claimant shall have 60 days or the remainder of the
311	period of the statute of limitations, whichever is greater,
312	within which to file suit.
313	(13) In matters relating to professional liability
314	insurance coverage for medical negligence, an insurer shall not
315	be held in bad faith for failure to timely pay its policy limits
316	if it tenders its policy limits and meets all other conditions
317	of settlement prior to the conclusion of the presuit screening
318	period provided for in this section.
319	Section 26. Section 766.1065, Florida Statutes, is created
320	to read:
321	766.1065 Mandatory staging of presuit investigation and
322	mandatory mediation.--
323	(1) Within 30 days after service of the presuit notice of
324	intent to initiate medical malpractice litigation, each party
325	shall voluntarily produce to all other parties, without being
326	requested, any and all medical, hospital, health care, and
327	employment records concerning the claimant in the disclosing
328	party’s possession, custody, or control, and the disclosing
329	party shall affirmatively certify in writing that the records
330	produced include all records in that party’s possession,
331	custody, or control or that the disclosing party has no medical,
332	hospital, health care, or employment records concerning the
333	claimant.
334	(a) Subpoenas may be issued according to the Florida Rules
335	of Civil Procedure as though suit had been filed for the limited
336	purpose of obtaining copies of medical, hospital, health care,
337	and employment records of the claimant. The party shall indicate
338	on the subpoena that it is being issued in accordance with the
339	presuit procedures of this section and shall not be required to
340	include a case number.
341	(b) Nothing in this section shall limit the ability of any
342	party to use any other available form of presuit discovery
343	available under this chapter or the Florida Rules of Civil
344	Procedure.
345	(2) Within 60 days after service of the presuit notice of
346	intent to initiate medical malpractice litigation, all parties
347	must be made available for a sworn deposition. Such deposition
348	may not be used in a civil suit for medical negligence.
349	(3) Within 120 days after service of the presuit notice of
350	intent to initiate medical malpractice litigation, each party’s
351	corroborating expert, who will otherwise be tendered as the
352	expert complying with the affidavit provisions set forth in s.
353	766.203, must be made available for a sworn deposition.
354	(a) The expenses associated with the expert’s time and
355	travel in preparing for and attending such deposition shall be
356	the responsibility of the party retaining such expert.
357	(b) An expert shall be deemed available for deposition if
358	suitable accommodations can be made for appearance of said
359	expert via real-time video technology.
360	(4) Within 180 days after service of the presuit notice of
361	intent to initiate medical malpractice litigation, all parties
362	shall attend in person mandatory mediation in accordance with s.
363	44.102 if binding arbitration under s. 766.106 or s. 766.207 has
364	not been agreed to by the parties. The Florida Rules of Civil
365	Procedure shall apply to mediation held pursuant to this
366	section.
367	Section 27. Section 766.1067, Florida Statutes, is created
368	to read:
369	766.1067 Mandatory mediation after suit is filed.--Within
370	120 days after suit being filed, unless such period is extended
371	by mutual agreement of all parties, all parties shall attend in-
372	person mandatory mediation in accordance with s. 44.102 if
373	binding arbitration under s. 766.106 or s. 766.207 has not been
374	agreed to by the parties. The Florida Rules of Civil Procedure
375	shall apply to mediation held pursuant to this section.
376	Section 28. Section 766.118, Florida Statutes, is created
377	to read:
378	766.118 Determination of noneconomic damages.--With
379	respect to a cause of action for personal injury or wrongful
380	death resulting from medical negligence, including actions
381	pursuant to s. 766.209, damages recoverable for noneconomic
382	losses to compensate for pain and suffering, inconvenience,
383	physical impairment, mental anguish, disfigurement, loss of
384	capacity for enjoyment of life, and all other noneconomic
385	damages shall not exceed $250,000, regardless of the number of
386	claimants or defendants involved in the action.
387	Section 29. Subsection (5) of section 766.202, Florida
388	Statutes, is amended to read:
389	766.202 Definitions; ss. 766.201-766.212.--As used in ss.
390	766.201-766.212, the term:
391	(5) "Medical expert" means a person familiar with the
392	evaluation, diagnosis, or treatment of the medical condition at
393	issue who:
394	(a) Isduly and regularly engaged in the practice of his
395	or her profession,whoholds a health care professional degree
396	from a university or college,and has had special professional
397	training and experience;or
398	(b) Hasone possessed ofspecial health care knowledge or
399	skill about the subject upon which he or she is called to
400	testify or provide an opinion.
401
402	Such expert shall certify that he or she has similar credentials
403	and expertise in the area of the defendant's particular practice
404	or specialty, if the defendant is a specialist.
405	Section 30. Subsection (2) of section 766.203, Florida
406	Statutes, is amended to read:
407	766.203 Presuit investigation of medical negligence claims
408	and defenses by prospective parties.--
409	(2) Prior to issuing notification of intent to initiate
410	medical malpractice litigation pursuant to s. 766.106, the
411	claimant shall conduct an investigation to ascertain that there
412	are reasonable grounds to believe that:
413	(a) Any named defendant in the litigation was negligent in
414	the care or treatment of the claimant; and
415	(b) Such negligence resulted in injury to the claimant.
416
417	Corroboration of reasonable grounds to initiate medical
418	negligence litigation shall be provided by the claimant's
419	submission of a verified written medical expert opinion from a
420	medical expert as defined in s. 766.202(5), at the time the
421	notice of intent to initiate litigation is mailed, which
422	statement shall corroborate reasonable grounds to support the
423	claim of medical negligence. This opinion and statement are
424	subject to discovery and are admissible in future proceedings,
425	subject to exclusion under s. 90.403.
426	Section 31. Subsections (2) and (3) of section 766.207,
427	Florida Statutes, are amended to read:
428	766.207 Voluntary binding arbitration of medical
429	negligence claims.--
430	(2) Upon the completion of presuit investigation with
431	preliminary reasonable grounds for a medical negligence claim
432	intact, the parties may elect to have damages determined by an
433	arbitration panel. Such election may be initiated by either
434	party by serving a request for voluntary binding arbitration of
435	damages within 18090days after service of the claimant's
436	notice of intent to initiate litigation upon the defendant. The
437	evidentiary standards for voluntary binding arbitration of
438	medical negligence claims shall be as provided in ss.
439	120.569(2)(g) and 120.57(1)(c).
440	(3) Upon receipt of a party's request for such
441	arbitration, the opposing party may accept the offer of
442	voluntary binding arbitration within 30 days. However, in no
443	event shall the defendant be required to respond to the request
444	for arbitration sooner than 18090days after service of the
445	notice of intent to initiate litigation under s. 766.106. Such
446	acceptance within the time period provided by this subsection
447	shall be a binding commitment to comply with the decision of the
448	arbitration panel. The liability of any insurer shall be subject
449	to any applicable insurance policy limits.
450	Section 32. (1) The Department of Health shall study and
451	report to the Legislature as to whether medical review panels
452	should be included as part of the presuit process in medical
453	malpractice litigation. Medical review panels review a medical
454	malpractice case during the presuit process and make judgments
455	on the merits of the case based on established standards of care
456	with the intent of reducing the number of frivolous claims. The
457	panel's report could be used as admissible evidence at trial or
458	for other purposes. The department's report should address:
459	(a) Historical use of medical review panels and similar
460	pretrial programs in this state, including the mediation panels
461	created by chapter 75-9, Laws of Florida.
462	(b) Constitutional issues relating to the use of medical
463	review panels.
464	(c) The use of medical review panels or similar programs
465	in other states.
466	(d) Whether medical review panels or similar panels should
467	be created for use during the presuit process.
468	(e) Other recommendations and information that the
469	department deems appropriate.
470	(2) If the department finds that medical review panels or
471	a similar structure should be created in this state, it shall
472	include draft legislation to implement its recommendations in
473	its report.
474	(3) The department shall submit its report to the Speaker
475	of the House of Representatives and the President of the Senate
476	no later than December 31, 2003.
477	Section 33. Subsection (5) of section 768.81, Florida
478	Statutes, is amended to read:
479	768.81 Comparative fault.--
480	(5) Notwithstanding anything in law to the contrary, in an
481	action for damages for personal injury or wrongful death arising
482	out of medical malpractice, whether in contract or tort, when an
483	apportionment of damages pursuant to this section is attributed
484	to a teaching hospital as defined in s. 408.07,the court shall
485	enter judgment against the teaching hospital on the basis of
486	eachsuchparty's percentage of fault and not on the basis of
487	the doctrine of joint and several liability. In the trial of any
488	action for medical malpractice which follows a settlement
489	between the plaintiff and one or more defendants or potential
490	defendants for the same injury, the plaintiff shall be estopped
491	from denying that the fault on the part of any such settled
492	defendant or prospective defendant contributed to causing the
493	plaintiff’s injuries.
494	Section 34. Section 1004.08, Florida Statutes, is created
495	to read:
496	1004.08 Patient safety instructional requirements.--Every
497	public school, college, and university that offers degrees in
498	medicine, nursing, and allied health shall include in the
499	curricula applicable to such degrees material on patient safety,
500	including patient safety improvement. Materials shall include,
501	but need not be limited to, effective communication and
502	teamwork; epidemiology of patient injuries and medical errors;
503	vigilance, attention, and fatigue; checklists and inspections;
504	automation and technological and computer support; psychological
505	factors in human error; and reporting systems.
506	Section 35. Section 1005.07, Florida Statutes, is created
507	to read:
508	1005.07 Patient safety instructional requirements.--Every
509	nonpublic school, college, and university that offers degrees in
510	medicine, nursing, and allied health shall include in the
511	curricula applicable to such degrees material on patient safety,
512	including patient safety improvement. Materials shall include,
513	but need not be limited to, effective communication and
514	teamwork; epidemiology of patient injuries and medical errors;
515	vigilance, attention, and fatigue; checklists and inspections;
516	automation and technological and computer support; psychological
517	factors in human error; and reporting systems.
518	Section 36. The Agency for Health Care Administration is
519	directed to study the types of information the public would find
520	relevant in the selection of hospitals. The agency shall review
521	and recommend appropriate methods of collection, analysis, and
522	dissemination of that information. The agency shall complete its
523	study and report its findings and recommendations to the
524	Legislature by January 15, 2004.
525	Section 37. Comprehensive study and report on the creation
526	of a Patient Safety Authority.--
527	(1) The Agency for Health Care Administration, in
528	consultation with the Department of Health, is directed to study
529	the need for, and the implementation requirements of,
530	establishing a Patient Safety Authority. The authority would be
531	responsible for performing activities and functions designed to
532	improve patient safety and the quality of care delivered by
533	health care facilities and health care practitioners.
534	(2) In undertaking its study, the agency shall examine and
535	evaluate a Patient Safety Authority that would, either directly
536	or by contract:
537	(a) Analyze information concerning adverse incidents
538	reported to the Agency for Health Care Administration pursuant
539	to s. 395.0197, Florida Statutes, for the purpose of
540	recommending changes in practices and procedures that may be
541	implemented by health care practitioners and health care
542	facilities to prevent future adverse incidents.
543	(b) Collect, analyze, and evaluate patient safety data
544	submitted voluntarily by a health care practitioner or health
545	care facility. The authority would communicate to health care
546	practitioners and health care facilities changes in practices
547	and procedures that may be implemented for the purpose of
548	improving patient safety and preventing future patient safety
549	events from resulting in serious injury or death. At a minimum,
550	the authority would:
551	1. Be designed and operated by an individual or entity
552	with demonstrated expertise in health care quality data and
553	systems analysis, health information management, systems
554	thinking and analysis, human factors analysis, and
555	identification of latent and active errors.
556	2. Include procedures for ensuring its confidentiality,
557	timeliness, and independence.
558	(c) Foster the development of a statewide electronic
559	infrastructure, which would be implemented in phases over a
560	multiyear period, that is designed to improve patient care and
561	the delivery and quality of health care services by health care
562	facilities and practitioners. The electronic infrastructure
563	would be a secure platform for communication and the sharing of
564	clinical and other data, such as business data, among providers
565	and between patients and providers. The electronic
566	infrastructure would include a core electronic medical record.
567	Health care providers would have access to individual electronic
568	medical records, subject to the consent of the individual. The
569	right, if any, of other entities, including health insurers and
570	researchers, to access the records would need further
571	examination and evaluation by the agency.
572	(d) Foster the use of computerized physician medication
573	ordering systems by hospitals that do not have such systems and
574	develop protocols for these systems.
575	(e) Implement paragraphs (c) and (d) as a demonstration
576	project for Medicaid recipients.
577	(f) Identify best practices and share this information
578	with health care providers.
579	(g) Engage in other activities that improve health care
580	quality, improve the diagnosis and treatment of diseases and
581	medical conditions, increase the efficiency of the delivery of
582	health care services, increase administrative efficiency, and
583	increase access to quality health care services.
584	(3) The agency shall also consider ways in which a Patient
585	Safety Authority would be able to facilitate the development of
586	no-fault demonstration projects as means to reduce and prevent
587	medical errors and promote patient safety.
588	(4) The agency shall seek information and advice from and
589	consult with hospitals, physicians, other health care providers,
590	attorneys, consumers, and individuals involved with and
591	knowledgeable about patient safety and quality-of-care
592	initiatives.
593	(5) In evaluating the need for, and the operation of, a
594	Patient Safety Authority, the agency shall determine the costs
595	of implementing and administering an authority and suggest
596	funding sources and mechanisms.
597	(6) The agency shall complete its study and issue a report
598	to the Legislature by February 1, 2004. In its report, the
599	agency shall include specific findings, recommendations, and
600	proposed legislation.
601	Section 38. If any provision of this act or the
602	application thereof to any person or circumstance is held
603	invalid, the invalidity does not affect other provisions or
604	applications of the act which can be given effect without the
605	invalid provision or application, and to this end the provisions
606	of this act are declared severable.
607	Section 39. This act shall take effect upon becoming a law
608	and shall apply to all actions filed after the effective date of
609	the act.
610
611
612	================= T I T L E A M E N D M E N T =================
613	Remove line(s) 52-104, and insert:
614	Financial Services Commission; creating s. 627.3575, F.S.;
615	creating the Health Care Professional Liability Insurance
616	Facility; providing purpose; providing for governance and
617	powers; providing eligibility requirements; providing for
618	premiums; providing for regulation; providing
619	applicability; specifying duties of the Department of
620	Health; providing for debt and regulation thereof;
621	amending s. 627.912, F.S.; requiring certain claims
622	information to be filed with the Office of Insurance
623	Regulation and the Department of Health; providing for
624	rulemaking by the Financial Services Commission; creating
625	s. 627.9121, F.S.; requiring certain information relating
626	to medical malpractice to be reported to the Office of
627	Insurance Regulation; providing for enforcement; amending
628	s. 766.106, F.S.; extending the time period for the
629	presuit screening period; providing conditions for causes
630	of action for bad faith against insurers providing
631	coverage for medical negligence; creating s. 766.1065,
632	F.S.; requiring parties to provide certain information to
633	parties without request; authorizing the issuance of
634	subpoenas without case numbers; requiring that parties and
635	certain experts be made available for deposition;
636	providing for mandatory presuit mediation; providing an
637	exception; creating s. 766.1067, F.S.; providing for
638	mandatory mediation in medical negligence causes of
639	action; creating s. 766.118, F.S.; providing a limitation
640	on noneconomic damages which can be awarded in causes of
641	action involving medical negligence; amending s. 766.202,
642	F.S.; providing requirements for medical experts; amending
643	s. 766.203, F.S.; providing for discovery and
644	admissibility of opinions and statements tendered during
645	presuit investigation; amending s. 766.207, F.S.;
646	conforming provisions to the extension in the time period
647	for presuit investigation; requiring the Department of
648	Health to study the efficacy and constitutionality of
649	medical review panels; requiring a report; amending s.
650	768.81, F.S.; providing that a defendant's liability for
651	damages in medical negligence cases is several only;
652	estoppping plaintiffs from denying fault of settling
653	defendants; creating s. 1004.08, F.S.; requiring patient
654	safety instruction for certain students in public schools,
655	colleges, and universities; creating s. 1005.07, F.S.;
656	requiring patient safety instruction for certain students
657	in nonpublic schools, colleges, and universities;
658	requiring a report by the Agency for Health Care
659	Administration regarding information to be provided to
660	health care consumers; requiring a report by the Agency
661	for Health Care Administration regarding the establishment
662	of a Patient Safety Authority; specifying elements of the
663	report; providing severability; providing an effective
664	date.