HB 0665

1	A bill to be entitled
2	An act relating to the financial responsibility of
3	physicians and osteopathic physicians; amending ss.
4	458.320 and 459.0085, F.S.; increasing the minimum amounts
5	of professional liability coverage, per claim and
6	aggregate, which are required for licensure; increasing
7	the minimum amounts required, per claim and aggregate,
8	through an irrevocable letter of credit; increasing the
9	minimum amounts of professional liability coverage, per
10	claim and aggregate, which are required for physicians and
11	osteopathic physicians who perform surgery; increasing the
12	minimum amounts required, per claim and aggregate, through
13	an irrevocable letter of credit; removing provisions
14	authorizing a physician or osteopathic physician to be
15	exempt from the financial responsibility requirements upon
16	posting notice and meeting certain other criteria;
17	providing that requirements previously applicable to self-
18	insured physicians and osteopathic physicians apply to all
19	such physicians who are required to maintain financial
20	responsibility; requiring that a physician or osteopathic
21	physician satisfy an adverse final judgment within a
22	specified period unless otherwise agreed to in writing;
23	requiring the Department of Health to suspend the license
24	of a physician or osteopathic physician upon notice of
25	failure to satisfy an adverse final judgment; requiring
26	the department to verify that a physician or osteopathic
27	physician has met financial responsibility requirements
28	before granting or renewing a license; requiring the Board
29	of Medicine and the Board of Osteopathic Medicine to adopt
30	rules; providing an effective date.
31
32	Be It Enacted by the Legislature of the State of Florida:
33
34	Section 1.  Section 458.320, Florida Statutes, is amended
35	to read:
36	458.320  Financial responsibility.--
37	(1)  As a condition of licensing and maintaining an active
38	license, and prior to the issuance or renewal of an active
39	license or reactivation of an inactive license for the practice
40	of medicine, an applicant must by one of the following methods
41	demonstrate to the satisfaction of the board and the department
42	financial responsibility to pay claims and costs ancillary
43	thereto arising out of the rendering of, or the failure to
44	render, medical care or services:
45	(a)  Establishing and maintaining an escrow account
46	consisting of cash or assets eligible for deposit in accordance
47	with s. 625.52 in the per claim amounts specified in paragraph
48	(b). The required escrow amount set forth in this paragraph may
49	not be used for litigation costs or attorney's fees for the
50	defense of any medical malpractice claim.
51	(b)  Obtaining and maintaining professional liability
52	coverage in an amount not less than $250,000 $100,000 per claim,
53	with a minimum annual aggregate of not less than $750,000
54	$300,000, from an authorized insurer as defined under s. 624.09,
55	from a surplus lines insurer as defined under s. 626.914(2),
56	from a risk retention group as defined under s. 627.942, from
57	the Joint Underwriting Association established under s.
58	627.351(4), or through a plan of self-insurance as provided in
59	s. 627.357. The required coverage amount set forth in this
60	paragraph may not be used for litigation costs or attorney's
61	fees for the defense of any medical malpractice claim.
62	(c)  Obtaining and maintaining an unexpired, irrevocable
63	letter of credit, established pursuant to chapter 675, in an
64	amount not less than $250,000 $100,000 per claim, with a minimum
65	aggregate availability of credit of not less than $750,000
66	$300,000. The letter of credit must be payable to the physician
67	as beneficiary upon presentment of a final judgment indicating
68	liability and awarding damages to be paid by the physician or
69	upon presentment of a settlement agreement signed by all parties
70	to such agreement when such final judgment or settlement is a
71	result of a claim arising out of the rendering of, or the
72	failure to render, medical care and services. The letter of
73	credit may not be used for litigation costs or attorney's fees
74	for the defense of any medical malpractice claim. The letter of
75	credit must be nonassignable and nontransferable. Such letter of
76	credit must be issued by any bank or savings association
77	organized and existing under the laws of this state or any bank
78	or savings association organized under the laws of the United
79	States which has its principal place of business in this state
80	or has a branch office that is authorized under the laws of this
81	state or of the United States to receive deposits in this state.
82	(2)  Physicians who perform surgery in an ambulatory
83	surgical center licensed under chapter 395 and, as a continuing
84	condition of hospital staff privileges, physicians who have
85	staff privileges must also establish financial responsibility by
86	one of the following methods:
87	(a)  Establishing and maintaining an escrow account
88	consisting of cash or assets eligible for deposit in accordance
89	with s. 625.52 in the per claim amounts specified in paragraph
90	(b). The required escrow amount set forth in this paragraph may
91	not be used for litigation costs or attorney's fees for the
92	defense of any medical malpractice claim.
93	(b)  Obtaining and maintaining professional liability
94	coverage in an amount not less than $500,000 $250,000 per claim,
95	with a minimum annual aggregate of not less than $1 million
96	$750,000 from an authorized insurer as defined under s. 624.09,
97	from a surplus lines insurer as defined under s. 626.914(2),
98	from a risk retention group as defined under s. 627.942, from
99	the Joint Underwriting Association established under s.
100	627.351(4), through a plan of self-insurance as provided in s.
101	627.357, or through a plan of self-insurance which meets the
102	conditions specified for satisfying financial responsibility in
103	s. 766.110. The required coverage amount set forth in this
104	paragraph may not be used for litigation costs or attorney's
105	fees for the defense of any medical malpractice claim.
106	(c)  Obtaining and maintaining an unexpired irrevocable
107	letter of credit, established pursuant to chapter 675, in an
108	amount not less than $500,000 $250,000 per claim, with a minimum
109	aggregate availability of credit of not less than $1 million
110	$750,000. The letter of credit must be payable to the physician
111	as beneficiary upon presentment of a final judgment indicating
112	liability and awarding damages to be paid by the physician or
113	upon presentment of a settlement agreement signed by all parties
114	to such agreement when such final judgment or settlement is a
115	result of a claim arising out of the rendering of, or the
116	failure to render, medical care and services. The letter of
117	credit may not be used for litigation costs or attorney's fees
118	for the defense of any medical malpractice claim. The letter of
119	credit must be nonassignable and nontransferable. The letter of
120	credit must be issued by any bank or savings association
121	organized and existing under the laws of this state or any bank
122	or savings association organized under the laws of the United
123	States which has its principal place of business in this state
124	or has a branch office that is authorized under the laws of this
125	state or of the United States to receive deposits in this state.
126
127	This subsection shall be inclusive of the coverage in subsection
128	(1).
129	(3)(a)  Meeting the financial responsibility requirements
130	of this section or the criteria for any exemption from such
131	requirements must be established at the time of issuance or
132	renewal of a license.
133	(b)  Any person may, at any time, submit to the department
134	a request for an advisory opinion regarding such person's
135	qualifications for exemption.
136	(4)(a)  Each insurer, self-insurer, risk retention group,
137	or Joint Underwriting Association must promptly notify the
138	department of cancellation or nonrenewal of insurance required
139	by this section. Unless the physician demonstrates that he or
140	she is otherwise in compliance with the requirements of this
141	section, the department shall suspend the license of the
142	physician pursuant to ss. 120.569 and 120.57 and notify all
143	health care facilities licensed under chapter 395 of such
144	action. Any suspension under this subsection remains in effect
145	until the physician demonstrates compliance with the
146	requirements of this section. If any judgments or settlements
147	are pending at the time of suspension, those judgments or
148	settlements must be paid in accordance with this section unless
149	otherwise mutually agreed to in writing by the parties. This
150	paragraph does not abrogate a judgment debtor's obligation to
151	satisfy the entire amount of any judgment.
152	(b)  If financial responsibility requirements are met by
153	maintaining an escrow account or letter of credit as provided in
154	this section, upon the entry of an adverse final judgment
155	arising from a medical malpractice arbitration award, from a
156	claim of medical malpractice either in contract or tort, or from
157	noncompliance with the terms of a settlement agreement arising
158	from a claim of medical malpractice either in contract or tort,
159	the licensee shall pay the entire amount of the judgment
160	together with all accrued interest, or the amount maintained in
161	the escrow account or provided in the letter of credit as
162	required by this section, whichever is less, within 60 days
163	after the date such judgment became final and subject to
164	execution, unless otherwise mutually agreed to in writing by the
165	parties. If timely payment is not made by the physician, the
166	department shall suspend the license of the physician pursuant
167	to procedures set forth in paragraphs (6)(c) and (d)
168	subparagraphs (5)(g)3., 4., and 5. Nothing in this paragraph
169	shall abrogate a judgment debtor's obligation to satisfy the
170	entire amount of any judgment.
171	(5)  The requirements of subsections (1), (2), and (3) do
172	not apply to:
173	(a)  Any person licensed under this chapter who practices
174	medicine exclusively as an officer, employee, or agent of the
175	Federal Government or of the state or its agencies or its
176	subdivisions. For the purposes of this subsection, an agent of
177	the state, its agencies, or its subdivisions is a person who is
178	eligible for coverage under any self-insurance or insurance
179	program authorized by the provisions of s. 768.28(16).
180	(b)  Any person whose license has become inactive under
181	this chapter and who is not practicing medicine in this state.
182	Any person applying for reactivation of a license must show
183	either that such licensee maintained tail insurance coverage
184	which provided liability coverage for incidents that occurred on
185	or after January 1, 1987, or the initial date of licensure in
186	this state, whichever is later, and incidents that occurred
187	before the date on which the license became inactive; or such
188	licensee must submit an affidavit stating that such licensee has
189	no unsatisfied medical malpractice judgments or settlements at
190	the time of application for reactivation.
191	(c)  Any person holding a limited license pursuant to s.
192	458.317 and practicing under the scope of such limited license.
193	(d)  Any person licensed or certified under this chapter
194	who practices only in conjunction with his or her teaching
195	duties at an accredited medical school or in its main teaching
196	hospitals. Such person may engage in the practice of medicine to
197	the extent that such practice is incidental to and a necessary
198	part of duties in connection with the teaching position in the
199	medical school.
200	(e)  Any person holding an active license under this
201	chapter who is not practicing medicine in this state. If such
202	person initiates or resumes any practice of medicine in this
203	state, he or she must notify the department of such activity and
204	fulfill the financial responsibility requirements of this
205	section before resuming the practice of medicine in this state.
206	(f)  Any person holding an active license under this
207	chapter who meets all of the following criteria:
208	1.  The licensee has held an active license to practice in
209	this state or another state or some combination thereof for more
210	than 15 years.
211	2.  The licensee has either retired from the practice of
212	medicine or maintains a part-time practice of no more than 1,000
213	patient contact hours per year.
214	3.  The licensee has had no more than two claims for
215	medical malpractice resulting in an indemnity exceeding $25,000
216	within the previous 5-year period.
217	4.  The licensee has not been convicted of, or pled guilty
218	or nolo contendere to, any criminal violation specified in this
219	chapter or the medical practice act of any other state.
220	5.  The licensee has not been subject within the last 10
221	years of practice to license revocation or suspension for any
222	period of time; probation for a period of 3 years or longer; or
223	a fine of $500 or more for a violation of this chapter or the
224	medical practice act of another jurisdiction. The regulatory
225	agency's acceptance of a physician's relinquishment of a
226	license, stipulation, consent order, or other settlement,
227	offered in response to or in anticipation of the filing of
228	administrative charges against the physician's license,
229	constitutes action against the physician's license for the
230	purposes of this paragraph.
231	6.  The licensee has submitted a form supplying necessary
232	information as required by the department and an affidavit
233	affirming compliance with this paragraph.
234	7.  The licensee must submit biennially to the department
235	certification stating compliance with the provisions of this
236	paragraph. The licensee must, upon request, demonstrate to the
237	department information verifying compliance with this paragraph.
238
239	A licensee who meets the requirements of this paragraph must
240	post notice in the form of a sign prominently displayed in the
241	reception area and clearly noticeable by all patients or provide
242	a written statement to any person to whom medical services are
243	being provided. The sign or statement must read as follows:
244	"Under Florida law, physicians are generally required to carry
245	medical malpractice insurance or otherwise demonstrate financial
246	responsibility to cover potential claims for medical
247	malpractice. However, certain part-time physicians who meet
248	state requirements are exempt from the financial responsibility
249	law. YOUR DOCTOR MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO
250	CARRY MEDICAL MALPRACTICE INSURANCE. This notice is provided
251	pursuant to Florida law."
252	(g)  Any person holding an active license under this
253	chapter who agrees to meet all of the following criteria:
254	(6)1.  Upon the entry of an adverse final judgment arising
255	from a medical malpractice arbitration award, from a claim of
256	medical malpractice either in contract or tort, or from
257	noncompliance with the terms of a settlement agreement arising
258	from a claim of medical malpractice either in contract or tort,
259	a licensee required to maintain financial responsibility under
260	this section the licensee shall pay the judgment creditor the
261	lesser of the entire amount of the judgment with all accrued
262	interest or either $250,000 $100,000, if the physician is
263	licensed pursuant to this chapter but does not maintain hospital
264	staff privileges, or $500,000 $250,000, if the physician is
265	licensed pursuant to this chapter and maintains hospital staff
266	privileges, within 60 days after the date such judgment became
267	final and subject to execution, unless otherwise mutually agreed
268	to in writing by the parties. Such adverse final judgment shall
269	include any cross-claim, counterclaim, or claim for indemnity or
270	contribution arising from the claim of medical malpractice.
271	(a)  Upon notification of the existence of an unsatisfied
272	judgment or payment pursuant to this subsection subparagraph,
273	the department shall notify the licensee by certified mail that
274	he or she shall be subject to disciplinary action unless, within
275	30 days from the date of mailing, he or she either:
276	1.a.  Shows proof that the unsatisfied judgment has been
277	paid in the amount specified in this subsection subparagraph; or
278	2.b.  Furnishes the department with a copy of a timely
279	filed notice of appeal and either:
280	a.(I)  A copy of a supersedeas bond properly posted in the
281	amount required by law; or
282	b.(II)  An order from a court of competent jurisdiction
283	staying execution on the final judgment pending disposition of
284	the appeal.
285	(b)2.  The Department of Health shall issue an emergency
286	order suspending the license of any licensee who, after 30 days
287	following receipt of a notice from the Department of Health, has
288	failed to: satisfy a medical malpractice claim against him or
289	her; furnish the Department of Health a copy of a timely filed
290	notice of appeal; furnish the Department of Health a copy of a
291	supersedeas bond properly posted in the amount required by law;
292	or furnish the Department of Health an order from a court of
293	competent jurisdiction staying execution on the final judgment
294	pending disposition of the appeal.
295	(c)3.  Upon the next meeting of the probable cause panel of
296	the board following 30 days after the date of mailing the notice
297	of disciplinary action to the licensee, the panel shall make a
298	determination of whether probable cause exists to take
299	disciplinary action against the licensee pursuant to paragraph
300	(a) subparagraph 1.
301	(d)4.  If the board determines that the factual
302	requirements of this subsection subparagraph 1. are met, it
303	shall take disciplinary action as it deems appropriate against
304	the licensee. Such disciplinary action shall include, at a
305	minimum, probation of the license with the restriction that the
306	licensee must make payments to the judgment creditor on a
307	schedule determined by the board to be reasonable and within the
308	financial capability of the physician. Notwithstanding any other
309	disciplinary penalty imposed, the disciplinary penalty may
310	include suspension of the license for a period not to exceed 5
311	years. In the event that an agreement to satisfy a judgment has
312	been met, the board shall remove any restriction on the license.
313	5.  The licensee has completed a form supplying necessary
314	information as required by the department.
315
316	A licensee who meets the requirements of this paragraph shall be
317	required either to post notice in the form of a sign prominently
318	displayed in the reception area and clearly noticeable by all
319	patients or to provide a written statement to any person to whom
320	medical services are being provided. Such sign or statement
321	shall state: "Under Florida law, physicians are generally
322	required to carry medical malpractice insurance or otherwise
323	demonstrate financial responsibility to cover potential claims
324	for medical malpractice. YOUR DOCTOR HAS DECIDED NOT TO CARRY
325	MEDICAL MALPRACTICE INSURANCE. This is permitted under Florida
326	law subject to certain conditions. Florida law imposes penalties
327	against noninsured physicians who fail to satisfy adverse
328	judgments arising from claims of medical malpractice. This
329	notice is provided pursuant to Florida law."
330	(7)(6)  Any deceptive, untrue, or fraudulent representation
331	by the licensee with respect to any provision of this section
332	shall result in permanent disqualification from any exemption to
333	mandated financial responsibility as provided in this section
334	and shall constitute grounds for disciplinary action under s.
335	458.331.
336	(8)(7)  Any licensee who relies on any exemption from the
337	financial responsibility requirement shall notify the
338	department, in writing, of any change of circumstance regarding
339	his or her qualifications for such exemption and shall
340	demonstrate that he or she is in compliance with the
341	requirements of this section.
342	(9)(8)  Notwithstanding any other provision of this
343	section, the department shall suspend the license of any
344	physician against whom has been entered a final judgment,
345	arbitration award, or other order or who has entered into a
346	settlement agreement to pay damages arising out of a claim for
347	medical malpractice, if all appellate remedies have been
348	exhausted and payment up to the amounts required by this section
349	has not been made within 30 days after the entering of such
350	judgment, award, or order or agreement, until proof of payment
351	is received by the department or a payment schedule has been
352	agreed upon by the physician and the claimant and presented to
353	the department. This subsection does not apply to a physician
354	who has met the financial responsibility requirements in
355	paragraphs (1)(b) and (2)(b).
356	(10)  The Department of Health shall verify that the
357	licensee has the required financial responsibility in accordance
358	with subsections (1) and (2) before a license is granted or
359	renewed.
360	(11)(9)  The board shall adopt rules to implement the
361	provisions of this section.
362	Section 2.  Section 459.0085, Florida Statutes, is amended
363	to read:
364	459.0085  Financial responsibility.--
365	(1)  As a condition of licensing and maintaining an active
366	license, and prior to the issuance or renewal of an active
367	license or reactivation of an inactive license for the practice
368	of osteopathic medicine, an applicant must by one of the
369	following methods demonstrate to the satisfaction of the board
370	and the department financial responsibility to pay claims and
371	costs ancillary thereto arising out of the rendering of, or the
372	failure to render, medical care or services:
373	(a)  Establishing and maintaining an escrow account
374	consisting of cash or assets eligible for deposit in accordance
375	with s. 625.52 in the per-claim amounts specified in paragraph
376	(b). The required escrow amount set forth in this paragraph may
377	not be used for litigation costs or attorney's fees for the
378	defense of any medical malpractice claim.
379	(b)  Obtaining and maintaining professional liability
380	coverage in an amount not less than $250,000 $100,000 per claim,
381	with a minimum annual aggregate of not less than $750,000
382	$300,000, from an authorized insurer as defined under s. 624.09,
383	from a surplus lines insurer as defined under s. 626.914(2),
384	from a risk retention group as defined under s. 627.942, from
385	the Joint Underwriting Association established under s.
386	627.351(4), or through a plan of self-insurance as provided in
387	s. 627.357. The required coverage amount set forth in this
388	paragraph may not be used for litigation costs or attorney's
389	fees for the defense of any medical malpractice claim.
390	(c)  Obtaining and maintaining an unexpired, irrevocable
391	letter of credit, established pursuant to chapter 675, in an
392	amount not less than $250,000 $100,000 per claim, with a minimum
393	aggregate availability of credit of not less than $750,000
394	$300,000. The letter of credit must be payable to the
395	osteopathic physician as beneficiary upon presentment of a final
396	judgment indicating liability and awarding damages to be paid by
397	the osteopathic physician or upon presentment of a settlement
398	agreement signed by all parties to such agreement when such
399	final judgment or settlement is a result of a claim arising out
400	of the rendering of, or the failure to render, medical care and
401	services. The letter of credit may not be used for litigation
402	costs or attorney's fees for the defense of any medical
403	malpractice claim. The letter of credit must be nonassignable
404	and nontransferable. Such letter of credit must be issued by any
405	bank or savings association organized and existing under the
406	laws of this state or any bank or savings association organized
407	under the laws of the United States which has its principal
408	place of business in this state or has a branch office that is
409	authorized under the laws of this state or of the United States
410	to receive deposits in this state.
411	(2)  Osteopathic physicians who perform surgery in an
412	ambulatory surgical center licensed under chapter 395 and, as a
413	continuing condition of hospital staff privileges, osteopathic
414	physicians who have staff privileges must also establish
415	financial responsibility by one of the following methods:
416	(a)  Establishing and maintaining an escrow account
417	consisting of cash or assets eligible for deposit in accordance
418	with s. 625.52 in the per-claim amounts specified in paragraph
419	(b). The required escrow amount set forth in this paragraph may
420	not be used for litigation costs or attorney's fees for the
421	defense of any medical malpractice claim.
422	(b)  Obtaining and maintaining professional liability
423	coverage in an amount not less than $500,000 $250,000 per claim,
424	with a minimum annual aggregate of not less than $1 million
425	$750,000 from an authorized insurer as defined under s. 624.09,
426	from a surplus lines insurer as defined under s. 626.914(2),
427	from a risk retention group as defined under s. 627.942, from
428	the Joint Underwriting Association established under s.
429	627.351(4), through a plan of self-insurance as provided in s.
430	627.357, or through a plan of self-insurance that meets the
431	conditions specified for satisfying financial responsibility in
432	s. 766.110. The required coverage amount set forth in this
433	paragraph may not be used for litigation costs or attorney's
434	fees for the defense of any medical malpractice claim.
435	(c)  Obtaining and maintaining an unexpired, irrevocable
436	letter of credit, established pursuant to chapter 675, in an
437	amount not less than $500,000 $250,000 per claim, with a minimum
438	aggregate availability of credit of not less than $1 million
439	$750,000. The letter of credit must be payable to the
440	osteopathic physician as beneficiary upon presentment of a final
441	judgment indicating liability and awarding damages to be paid by
442	the osteopathic physician or upon presentment of a settlement
443	agreement signed by all parties to such agreement when such
444	final judgment or settlement is a result of a claim arising out
445	of the rendering of, or the failure to render, medical care and
446	services. The letter of credit may not be used for litigation
447	costs or attorney's fees for the defense of any medical
448	malpractice claim. The letter of credit must be nonassignable
449	and nontransferable. The letter of credit must be issued by any
450	bank or savings association organized and existing under the
451	laws of this state or any bank or savings association organized
452	under the laws of the United States which has its principal
453	place of business in this state or has a branch office that is
454	authorized under the laws of this state or of the United States
455	to receive deposits in this state.
456
457	This subsection shall be inclusive of the coverage in subsection
458	(1).
459	(3)(a)  Meeting the financial responsibility requirements
460	of this section or the criteria for any exemption from such
461	requirements must be established at the time of issuance or
462	renewal of a license.
463	(b)  Any person may, at any time, submit to the department
464	a request for an advisory opinion regarding such person's
465	qualifications for exemption.
466	(4)(a)  Each insurer, self-insurer, risk retention group,
467	or joint underwriting association must promptly notify the
468	department of cancellation or nonrenewal of insurance required
469	by this section. Unless the osteopathic physician demonstrates
470	that he or she is otherwise in compliance with the requirements
471	of this section, the department shall suspend the license of the
472	osteopathic physician pursuant to ss. 120.569 and 120.57 and
473	notify all health care facilities licensed under chapter 395,
474	part IV of chapter 394, or part I of chapter 641 of such action.
475	Any suspension under this subsection remains in effect until the
476	osteopathic physician demonstrates compliance with the
477	requirements of this section. If any judgments or settlements
478	are pending at the time of suspension, those judgments or
479	settlements must be paid in accordance with this section unless
480	otherwise mutually agreed to in writing by the parties. This
481	paragraph does not abrogate a judgment debtor's obligation to
482	satisfy the entire amount of any judgment.
483	(b)  If financial responsibility requirements are met by
484	maintaining an escrow account or letter of credit as provided in
485	this section, upon the entry of an adverse final judgment
486	arising from a medical malpractice arbitration award, from a
487	claim of medical malpractice either in contract or tort, or from
488	noncompliance with the terms of a settlement agreement arising
489	from a claim of medical malpractice either in contract or tort,
490	the licensee shall pay the entire amount of the judgment
491	together with all accrued interest or the amount maintained in
492	the escrow account or provided in the letter of credit as
493	required by this section, whichever is less, within 60 days
494	after the date such judgment became final and subject to
495	execution, unless otherwise mutually agreed to in writing by the
496	parties. If timely payment is not made by the osteopathic
497	physician, the department shall suspend the license of the
498	osteopathic physician pursuant to procedures set forth in
499	paragraphs (6)(c) and (d) subparagraphs (5)(g)3., 4., and 5.
500	Nothing in this paragraph shall abrogate a judgment debtor's
501	obligation to satisfy the entire amount of any judgment.
502	(5)  The requirements of subsections (1), (2), and (3) do
503	not apply to:
504	(a)  Any person licensed under this chapter who practices
505	medicine exclusively as an officer, employee, or agent of the
506	Federal Government or of the state or its agencies or its
507	subdivisions. For the purposes of this subsection, an agent of
508	the state, its agencies, or its subdivisions is a person who is
509	eligible for coverage under any self-insurance or insurance
510	program authorized by the provisions of s. 768.28(16).
511	(b)  Any person whose license has become inactive under
512	this chapter and who is not practicing medicine in this state.
513	Any person applying for reactivation of a license must show
514	either that such licensee maintained tail insurance coverage
515	that provided liability coverage for incidents that occurred on
516	or after January 1, 1987, or the initial date of licensure in
517	this state, whichever is later, and incidents that occurred
518	before the date on which the license became inactive; or such
519	licensee must submit an affidavit stating that such licensee has
520	no unsatisfied medical malpractice judgments or settlements at
521	the time of application for reactivation.
522	(c)  Any person holding a limited license pursuant to s.
523	459.0075 and practicing under the scope of such limited license.
524	(d)  Any person licensed or certified under this chapter
525	who practices only in conjunction with his or her teaching
526	duties at a college of osteopathic medicine. Such person may
527	engage in the practice of osteopathic medicine to the extent
528	that such practice is incidental to and a necessary part of
529	duties in connection with the teaching position in the college
530	of osteopathic medicine.
531	(e)  Any person holding an active license under this
532	chapter who is not practicing osteopathic medicine in this
533	state. If such person initiates or resumes any practice of
534	osteopathic medicine in this state, he or she must notify the
535	department of such activity and fulfill the financial
536	responsibility requirements of this section before resuming the
537	practice of osteopathic medicine in this state.
538	(f)  Any person holding an active license under this
539	chapter who meets all of the following criteria:
540	1.  The licensee has held an active license to practice in
541	this state or another state or some combination thereof for more
542	than 15 years.
543	2.  The licensee has either retired from the practice of
544	osteopathic medicine or maintains a part-time practice of
545	osteopathic medicine of no more than 1,000 patient contact hours
546	per year.
547	3.  The licensee has had no more than two claims for
548	medical malpractice resulting in an indemnity exceeding $25,000
549	within the previous 5-year period.
550	4.  The licensee has not been convicted of, or pled guilty
551	or nolo contendere to, any criminal violation specified in this
552	chapter or the practice act of any other state.
553	5.  The licensee has not been subject within the last 10
554	years of practice to license revocation or suspension for any
555	period of time, probation for a period of 3 years or longer, or
556	a fine of $500 or more for a violation of this chapter or the
557	medical practice act of another jurisdiction. The regulatory
558	agency's acceptance of an osteopathic physician's relinquishment
559	of a license, stipulation, consent order, or other settlement,
560	offered in response to or in anticipation of the filing of
561	administrative charges against the osteopathic physician's
562	license, constitutes action against the physician's license for
563	the purposes of this paragraph.
564	6.  The licensee has submitted a form supplying necessary
565	information as required by the department and an affidavit
566	affirming compliance with this paragraph.
567	7.  The licensee must submit biennially to the department a
568	certification stating compliance with this paragraph. The
569	licensee must, upon request, demonstrate to the department
570	information verifying compliance with this paragraph.
571
572	A licensee who meets the requirements of this paragraph must
573	post notice in the form of a sign prominently displayed in the
574	reception area and clearly noticeable by all patients or provide
575	a written statement to any person to whom medical services are
576	being provided. The sign or statement must read as follows:
577	"Under Florida law, osteopathic physicians are generally
578	required to carry medical malpractice insurance or otherwise
579	demonstrate financial responsibility to cover potential claims
580	for medical malpractice. However, certain part-time osteopathic
581	physicians who meet state requirements are exempt from the
582	financial responsibility law. YOUR OSTEOPATHIC PHYSICIAN MEETS
583	THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY MEDICAL
584	MALPRACTICE INSURANCE. This notice is provided pursuant to
585	Florida law."
586	(g)  Any person holding an active license under this
587	chapter who agrees to meet all of the following criteria.
588	(6)1.  Upon the entry of an adverse final judgment arising
589	from a medical malpractice arbitration award, from a claim of
590	medical malpractice either in contract or tort, or from
591	noncompliance with the terms of a settlement agreement arising
592	from a claim of medical malpractice either in contract or tort,
593	a licensee required to maintain financial responsibility under
594	this section the licensee shall pay the judgment creditor the
595	lesser of the entire amount of the judgment with all accrued
596	interest or either $250,000 $100,000, if the osteopathic
597	physician is licensed pursuant to this chapter but does not
598	maintain hospital staff privileges, or $500,000 $250,000, if the
599	osteopathic physician is licensed pursuant to this chapter and
600	maintains hospital staff privileges, within 60 days after the
601	date such judgment became final and subject to execution, unless
602	otherwise mutually agreed to in writing by the parties. Such
603	adverse final judgment shall include any cross-claim,
604	counterclaim, or claim for indemnity or contribution arising
605	from the claim of medical malpractice.
606	(a)  Upon notification of the existence of an unsatisfied
607	judgment or payment pursuant to this subsection subparagraph,
608	the department shall notify the licensee by certified mail that
609	he or she shall be subject to disciplinary action unless, within
610	30 days from the date of mailing, the licensee either:
611	1.a.  Shows proof that the unsatisfied judgment has been
612	paid in the amount specified in this subsection subparagraph; or
613	2.b.  Furnishes the department with a copy of a timely
614	filed notice of appeal and either:
615	a.(I)  A copy of a supersedeas bond properly posted in the
616	amount required by law; or
617	b.(II)  An order from a court of competent jurisdiction
618	staying execution on the final judgment, pending disposition of
619	the appeal.
620	(b)2.  The Department of Health shall issue an emergency
621	order suspending the license of any licensee who, after 30 days
622	following receipt of a notice from the Department of Health, has
623	failed to: satisfy a medical malpractice claim against him or
624	her; furnish the Department of Health a copy of a timely filed
625	notice of appeal; furnish the Department of Health a copy of a
626	supersedeas bond properly posted in the amount required by law;
627	or furnish the Department of Health an order from a court of
628	competent jurisdiction staying execution on the final judgment
629	pending disposition of the appeal.
630	(c)3.  Upon the next meeting of the probable cause panel of
631	the board following 30 days after the date of mailing the notice
632	of disciplinary action to the licensee, the panel shall make a
633	determination of whether probable cause exists to take
634	disciplinary action against the licensee pursuant to paragraph
635	(a) subparagraph 1.
636	(d)4.  If the board determines that the factual
637	requirements of this subsection subparagraph 1. are met, it
638	shall take disciplinary action as it deems appropriate against
639	the licensee. Such disciplinary action shall include, at a
640	minimum, probation of the license with the restriction that the
641	licensee must make payments to the judgment creditor on a
642	schedule determined by the board to be reasonable and within the
643	financial capability of the osteopathic physician.
644	Notwithstanding any other disciplinary penalty imposed, the
645	disciplinary penalty may include suspension of the license for a
646	period not to exceed 5 years. In the event that an agreement to
647	satisfy a judgment has been met, the board shall remove any
648	restriction on the license.
649	5.  The licensee has completed a form supplying necessary
650	information as required by the department.
651
652	A licensee who meets the requirements of this paragraph shall be
653	required either to post notice in the form of a sign prominently
654	displayed in the reception area and clearly noticeable by all
655	patients or to provide a written statement to any person to whom
656	medical services are being provided. Such sign or statement
657	shall state: "Under Florida law, osteopathic physicians are
658	generally required to carry medical malpractice insurance or
659	otherwise demonstrate financial responsibility to cover
660	potential claims for medical malpractice. YOUR OSTEOPATHIC
661	PHYSICIAN HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE
662	INSURANCE. This is permitted under Florida law subject to
663	certain conditions. Florida law imposes strict penalties against
664	noninsured osteopathic physicians who fail to satisfy adverse
665	judgments arising from claims of medical malpractice. This
666	notice is provided pursuant to Florida law."
667	(7)(6)  Any deceptive, untrue, or fraudulent representation
668	by the licensee with respect to any provision of this section
669	shall result in permanent disqualification from any exemption to
670	mandated financial responsibility as provided in this section
671	and shall constitute grounds for disciplinary action under s.
672	459.015.
673	(8)(7)  Any licensee who relies on any exemption from the
674	financial responsibility requirement shall notify the department
675	in writing of any change of circumstance regarding his or her
676	qualifications for such exemption and shall demonstrate that he
677	or she is in compliance with the requirements of this section.
678	(9)(8)  If a physician is either a resident physician,
679	assistant resident physician, or intern in an approved
680	postgraduate training program, as defined by the board's rules,
681	and is supervised by a physician who is participating in the
682	Florida Birth-Related Neurological Injury Compensation Plan,
683	such resident physician, assistant resident physician, or intern
684	is deemed to be a participating physician without the payment of
685	the assessment set forth in s. 766.314(4).
686	(10)(9)  Notwithstanding any other provision of this
687	section, the department shall suspend the license of any
688	osteopathic physician against whom has been entered a final
689	judgment, arbitration award, or other order or who has entered
690	into a settlement agreement to pay damages arising out of a
691	claim for medical malpractice, if all appellate remedies have
692	been exhausted and payment up to the amounts required by this
693	section has not been made within 30 days after the entering of
694	such judgment, award, or order or agreement, until proof of
695	payment is received by the department or a payment schedule has
696	been agreed upon by the osteopathic physician and the claimant
697	and presented to the department. This subsection does not apply
698	to an osteopathic physician who has met the financial
699	responsibility requirements in paragraphs (1)(b) and (2)(b).
700	(11)  The Department of Health shall verify that the
701	licensee has the required financial responsibility in accordance
702	with subsections (1) and (2) before a license is granted or
703	renewed.
704	(12)(10)  The board shall adopt rules to implement the
705	provisions of this section.
706	Section 3.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.