Senate Bill sb0972
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Florida Senate - 2005 SB 972
By Senator Jones
13-619-05
1 A bill to be entitled
2 An act relating to the financial responsibility
3 of physicians and osteopathic physicians;
4 amending ss. 458.320 and 459.0085, F.S.;
5 increasing the minimum amounts of professional
6 liability coverage, per claim and aggregate,
7 which are required for licensure; increasing
8 the minimum amounts required, per claim and
9 aggregate, through an irrevocable letter of
10 credit; increasing the minimum amounts of
11 professional liability coverage, per claim and
12 aggregate, which are required for physicians
13 and osteopathic physicians who perform surgery;
14 increasing the minimum amounts required, per
15 claim and aggregate, through an irrevocable
16 letter of credit; removing provisions
17 authorizing a physician or osteopathic
18 physician to be exempt from the
19 financial-responsibility requirements upon
20 posting notice and meeting certain other
21 criteria; providing that requirements
22 previously applicable to self-insured
23 physicians and osteopathic physicians apply to
24 all such physicians who are required to
25 maintain financial responsibility; requiring
26 that a physician or osteopathic physician
27 satisfy an adverse final judgment within a
28 specified period unless otherwise agreed to in
29 writing; requiring the Department of Health to
30 suspend the license of a physician or
31 osteopathic physician upon notice of failure to
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1 satisfy an adverse final judgment; requiring
2 the department to verify that a physician or
3 osteopathic physician has met
4 financial-responsibility requirements before
5 granting or renewing a license; requiring the
6 Board of Medicine and the Board of Osteopathic
7 Medicine to adopt rules; providing an effective
8 date.
9
10 Be It Enacted by the Legislature of the State of Florida:
11
12 Section 1. Section 458.320, Florida Statutes, is
13 amended to read:
14 458.320 Financial responsibility.--
15 (1) As a condition of licensing and maintaining an
16 active license, and prior to the issuance or renewal of an
17 active license or reactivation of an inactive license for the
18 practice of medicine, an applicant must by one of the
19 following methods demonstrate to the satisfaction of the board
20 and the department financial responsibility to pay claims and
21 costs ancillary thereto arising out of the rendering of, or
22 the failure to render, medical care or services:
23 (a) Establishing and maintaining an escrow account
24 consisting of cash or assets eligible for deposit in
25 accordance with s. 625.52 in the per claim amounts specified
26 in paragraph (b). The required escrow amount set forth in this
27 paragraph may not be used for litigation costs or attorney's
28 fees for the defense of any medical malpractice claim.
29 (b) Obtaining and maintaining professional liability
30 coverage in an amount not less than $250,000 $100,000 per
31 claim, with a minimum annual aggregate of not less than
2
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1 $750,000 $300,000, from an authorized insurer as defined under
2 s. 624.09, from a surplus lines insurer as defined under s.
3 626.914(2), from a risk retention group as defined under s.
4 627.942, from the Joint Underwriting Association established
5 under s. 627.351(4), or through a plan of self-insurance as
6 provided in s. 627.357. The required coverage amount set forth
7 in this paragraph may not be used for litigation costs or
8 attorney's fees for the defense of any medical malpractice
9 claim.
10 (c) Obtaining and maintaining an unexpired,
11 irrevocable letter of credit, established pursuant to chapter
12 675, in an amount not less than $250,000 $100,000 per claim,
13 with a minimum aggregate availability of credit of not less
14 than $750,000 $300,000. The letter of credit must be payable
15 to the physician as beneficiary upon presentment of a final
16 judgment indicating liability and awarding damages to be paid
17 by the physician or upon presentment of a settlement agreement
18 signed by all parties to such agreement when such final
19 judgment or settlement is a result of a claim arising out of
20 the rendering of, or the failure to render, medical care and
21 services. The letter of credit may not be used for litigation
22 costs or attorney's fees for the defense of any medical
23 malpractice claim. The letter of credit must be nonassignable
24 and nontransferable. Such letter of credit must be issued by
25 any bank or savings association organized and existing under
26 the laws of this state or any bank or savings association
27 organized under the laws of the United States which has its
28 principal place of business in this state or has a branch
29 office that is authorized under the laws of this state or of
30 the United States to receive deposits in this state.
31
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1 (2) Physicians who perform surgery in an ambulatory
2 surgical center licensed under chapter 395 and, as a
3 continuing condition of hospital staff privileges, physicians
4 who have staff privileges must also establish financial
5 responsibility by one of the following methods:
6 (a) Establishing and maintaining an escrow account
7 consisting of cash or assets eligible for deposit in
8 accordance with s. 625.52 in the per claim amounts specified
9 in paragraph (b). The required escrow amount set forth in this
10 paragraph may not be used for litigation costs or attorney's
11 fees for the defense of any medical malpractice claim.
12 (b) Obtaining and maintaining professional liability
13 coverage in an amount not less than $500,000 $250,000 per
14 claim, with a minimum annual aggregate of not less than $1
15 million $750,000 from an authorized insurer as defined under
16 s. 624.09, from a surplus lines insurer as defined under s.
17 626.914(2), from a risk retention group as defined under s.
18 627.942, from the Joint Underwriting Association established
19 under s. 627.351(4), through a plan of self-insurance as
20 provided in s. 627.357, or through a plan of self-insurance
21 which meets the conditions specified for satisfying financial
22 responsibility in s. 766.110. The required coverage amount set
23 forth in this paragraph may not be used for litigation costs
24 or attorney's fees for the defense of any medical malpractice
25 claim.
26 (c) Obtaining and maintaining an unexpired irrevocable
27 letter of credit, established pursuant to chapter 675, in an
28 amount not less than $500,000 $250,000 per claim, with a
29 minimum aggregate availability of credit of not less than $1
30 million $750,000. The letter of credit must be payable to the
31 physician as beneficiary upon presentment of a final judgment
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1 indicating liability and awarding damages to be paid by the
2 physician or upon presentment of a settlement agreement signed
3 by all parties to such agreement when such final judgment or
4 settlement is a result of a claim arising out of the rendering
5 of, or the failure to render, medical care and services. The
6 letter of credit may not be used for litigation costs or
7 attorney's fees for the defense of any medical malpractice
8 claim. The letter of credit must be nonassignable and
9 nontransferable. The letter of credit must be issued by any
10 bank or savings association organized and existing under the
11 laws of this state or any bank or savings association
12 organized under the laws of the United States which has its
13 principal place of business in this state or has a branch
14 office that is authorized under the laws of this state or of
15 the United States to receive deposits in this state.
16
17 This subsection shall be inclusive of the coverage in
18 subsection (1).
19 (3)(a) Meeting the financial responsibility
20 requirements of this section or the criteria for any exemption
21 from such requirements must be established at the time of
22 issuance or renewal of a license.
23 (b) Any person may, at any time, submit to the
24 department a request for an advisory opinion regarding such
25 person's qualifications for exemption.
26 (4)(a) Each insurer, self-insurer, risk retention
27 group, or Joint Underwriting Association must promptly notify
28 the department of cancellation or nonrenewal of insurance
29 required by this section. Unless the physician demonstrates
30 that he or she is otherwise in compliance with the
31 requirements of this section, the department shall suspend the
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1 license of the physician pursuant to ss. 120.569 and 120.57
2 and notify all health care facilities licensed under chapter
3 395 of such action. Any suspension under this subsection
4 remains in effect until the physician demonstrates compliance
5 with the requirements of this section. If any judgments or
6 settlements are pending at the time of suspension, those
7 judgments or settlements must be paid in accordance with this
8 section unless otherwise mutually agreed to in writing by the
9 parties. This paragraph does not abrogate a judgment debtor's
10 obligation to satisfy the entire amount of any judgment.
11 (b) If financial responsibility requirements are met
12 by maintaining an escrow account or letter of credit as
13 provided in this section, upon the entry of an adverse final
14 judgment arising from a medical malpractice arbitration award,
15 from a claim of medical malpractice either in contract or
16 tort, or from noncompliance with the terms of a settlement
17 agreement arising from a claim of medical malpractice either
18 in contract or tort, the licensee shall pay the entire amount
19 of the judgment together with all accrued interest, or the
20 amount maintained in the escrow account or provided in the
21 letter of credit as required by this section, whichever is
22 less, within 60 days after the date such judgment became final
23 and subject to execution, unless otherwise mutually agreed to
24 in writing by the parties. If timely payment is not made by
25 the physician, the department shall suspend the license of the
26 physician pursuant to procedures set forth in subparagraphs
27 (5)(g)3., 4., and 5. Nothing in this paragraph shall abrogate
28 a judgment debtor's obligation to satisfy the entire amount of
29 any judgment.
30 (5) The requirements of subsections (1), (2), and (3)
31 do not apply to:
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1 (a) Any person licensed under this chapter who
2 practices medicine exclusively as an officer, employee, or
3 agent of the Federal Government or of the state or its
4 agencies or its subdivisions. For the purposes of this
5 subsection, an agent of the state, its agencies, or its
6 subdivisions is a person who is eligible for coverage under
7 any self-insurance or insurance program authorized by the
8 provisions of s. 768.28(16).
9 (b) Any person whose license has become inactive under
10 this chapter and who is not practicing medicine in this state.
11 Any person applying for reactivation of a license must show
12 either that such licensee maintained tail insurance coverage
13 which provided liability coverage for incidents that occurred
14 on or after January 1, 1987, or the initial date of licensure
15 in this state, whichever is later, and incidents that occurred
16 before the date on which the license became inactive; or such
17 licensee must submit an affidavit stating that such licensee
18 has no unsatisfied medical malpractice judgments or
19 settlements at the time of application for reactivation.
20 (c) Any person holding a limited license pursuant to
21 s. 458.317 and practicing under the scope of such limited
22 license.
23 (d) Any person licensed or certified under this
24 chapter who practices only in conjunction with his or her
25 teaching duties at an accredited medical school or in its main
26 teaching hospitals. Such person may engage in the practice of
27 medicine to the extent that such practice is incidental to and
28 a necessary part of duties in connection with the teaching
29 position in the medical school.
30 (e) Any person holding an active license under this
31 chapter who is not practicing medicine in this state. If such
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1 person initiates or resumes any practice of medicine in this
2 state, he or she must notify the department of such activity
3 and fulfill the financial responsibility requirements of this
4 section before resuming the practice of medicine in this
5 state.
6 (f) Any person holding an active license under this
7 chapter who meets all of the following criteria:
8 1. The licensee has held an active license to practice
9 in this state or another state or some combination thereof for
10 more than 15 years.
11 2. The licensee has either retired from the practice
12 of medicine or maintains a part-time practice of no more than
13 1,000 patient contact hours per year.
14 3. The licensee has had no more than two claims for
15 medical malpractice resulting in an indemnity exceeding
16 $25,000 within the previous 5-year period.
17 4. The licensee has not been convicted of, or pled
18 guilty or nolo contendere to, any criminal violation specified
19 in this chapter or the medical practice act of any other
20 state.
21 5. The licensee has not been subject within the last
22 10 years of practice to license revocation or suspension for
23 any period of time; probation for a period of 3 years or
24 longer; or a fine of $500 or more for a violation of this
25 chapter or the medical practice act of another jurisdiction.
26 The regulatory agency's acceptance of a physician's
27 relinquishment of a license, stipulation, consent order, or
28 other settlement, offered in response to or in anticipation of
29 the filing of administrative charges against the physician's
30 license, constitutes action against the physician's license
31 for the purposes of this paragraph.
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1 6. The licensee has submitted a form supplying
2 necessary information as required by the department and an
3 affidavit affirming compliance with this paragraph.
4 7. The licensee must submit biennially to the
5 department certification stating compliance with the
6 provisions of this paragraph. The licensee must, upon request,
7 demonstrate to the department information verifying compliance
8 with this paragraph.
9
10 A licensee who meets the requirements of this paragraph must
11 post notice in the form of a sign prominently displayed in the
12 reception area and clearly noticeable by all patients or
13 provide a written statement to any person to whom medical
14 services are being provided. The sign or statement must read
15 as follows: "Under Florida law, physicians are generally
16 required to carry medical malpractice insurance or otherwise
17 demonstrate financial responsibility to cover potential claims
18 for medical malpractice. However, certain part-time physicians
19 who meet state requirements are exempt from the financial
20 responsibility law. YOUR DOCTOR MEETS THESE REQUIREMENTS AND
21 HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This
22 notice is provided pursuant to Florida law."
23 (g) Any person holding an active license under this
24 chapter who agrees to meet all of the following criteria:
25 (6)1. Upon the entry of an adverse final judgment
26 arising from a medical malpractice arbitration award, from a
27 claim of medical malpractice either in contract or tort, or
28 from noncompliance with the terms of a settlement agreement
29 arising from a claim of medical malpractice either in contract
30 or tort, a licensee required to maintain financial
31 responsibility under this section the licensee shall pay the
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1 judgment creditor the lesser of the entire amount of the
2 judgment with all accrued interest or either $250,000
3 $100,000, if the physician is licensed pursuant to this
4 chapter but does not maintain hospital staff privileges, or
5 $500,000 $250,000, if the physician is licensed pursuant to
6 this chapter and maintains hospital staff privileges, within
7 60 days after the date such judgment became final and subject
8 to execution, unless otherwise mutually agreed to in writing
9 by the parties. Such adverse final judgment shall include any
10 cross-claim, counterclaim, or claim for indemnity or
11 contribution arising from the claim of medical malpractice.
12 (a) Upon notification of the existence of an
13 unsatisfied judgment or payment pursuant to this subsection
14 subparagraph, the department shall notify the licensee by
15 certified mail that he or she shall be subject to disciplinary
16 action unless, within 30 days from the date of mailing, he or
17 she either:
18 1.a. Shows proof that the unsatisfied judgment has
19 been paid in the amount specified in this subsection
20 subparagraph; or
21 2.b. Furnishes the department with a copy of a timely
22 filed notice of appeal and either:
23 a.(I) A copy of a supersedeas bond properly posted in
24 the amount required by law; or
25 b.(II) An order from a court of competent jurisdiction
26 staying execution on the final judgment pending disposition of
27 the appeal.
28 (b)2. The Department of Health shall issue an
29 emergency order suspending the license of any licensee who,
30 after 30 days following receipt of a notice from the
31 Department of Health, has failed to: satisfy a medical
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1 malpractice claim against him or her; furnish the Department
2 of Health a copy of a timely filed notice of appeal; furnish
3 the Department of Health a copy of a supersedeas bond properly
4 posted in the amount required by law; or furnish the
5 Department of Health an order from a court of competent
6 jurisdiction staying execution on the final judgment pending
7 disposition of the appeal.
8 (c)3. Upon the next meeting of the probable cause
9 panel of the board following 30 days after the date of mailing
10 the notice of disciplinary action to the licensee, the panel
11 shall make a determination of whether probable cause exists to
12 take disciplinary action against the licensee pursuant to
13 paragraph (a) subparagraph 1.
14 (d)4. If the board determines that the factual
15 requirements of this subsection subparagraph 1. are met, it
16 shall take disciplinary action as it deems appropriate against
17 the licensee. Such disciplinary action shall include, at a
18 minimum, probation of the license with the restriction that
19 the licensee must make payments to the judgment creditor on a
20 schedule determined by the board to be reasonable and within
21 the financial capability of the physician. Notwithstanding any
22 other disciplinary penalty imposed, the disciplinary penalty
23 may include suspension of the license for a period not to
24 exceed 5 years. In the event that an agreement to satisfy a
25 judgment has been met, the board shall remove any restriction
26 on the license.
27 5. The licensee has completed a form supplying
28 necessary information as required by the department.
29
30 A licensee who meets the requirements of this paragraph shall
31 be required either to post notice in the form of a sign
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1 prominently displayed in the reception area and clearly
2 noticeable by all patients or to provide a written statement
3 to any person to whom medical services are being provided.
4 Such sign or statement shall state: "Under Florida law,
5 physicians are generally required to carry medical malpractice
6 insurance or otherwise demonstrate financial responsibility to
7 cover potential claims for medical malpractice. YOUR DOCTOR
8 HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This
9 is permitted under Florida law subject to certain conditions.
10 Florida law imposes penalties against noninsured physicians
11 who fail to satisfy adverse judgments arising from claims of
12 medical malpractice. This notice is provided pursuant to
13 Florida law."
14 (7)(6) Any deceptive, untrue, or fraudulent
15 representation by the licensee with respect to any provision
16 of this section shall result in permanent disqualification
17 from any exemption to mandated financial responsibility as
18 provided in this section and shall constitute grounds for
19 disciplinary action under s. 458.331.
20 (8)(7) Any licensee who relies on any exemption from
21 the financial responsibility requirement shall notify the
22 department, in writing, of any change of circumstance
23 regarding his or her qualifications for such exemption and
24 shall demonstrate that he or she is in compliance with the
25 requirements of this section.
26 (9)(8) Notwithstanding any other provision of this
27 section, the department shall suspend the license of any
28 physician against whom has been entered a final judgment,
29 arbitration award, or other order or who has entered into a
30 settlement agreement to pay damages arising out of a claim for
31 medical malpractice, if all appellate remedies have been
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1 exhausted and payment up to the amounts required by this
2 section has not been made within 30 days after the entering of
3 such judgment, award, or order or agreement, until proof of
4 payment is received by the department or a payment schedule
5 has been agreed upon by the physician and the claimant and
6 presented to the department. This subsection does not apply to
7 a physician who has met the financial responsibility
8 requirements in paragraphs (1)(b) and (2)(b).
9 (10) The Department of Health shall verify that the
10 licensee has the required financial responsibility in
11 accordance with subsections (1) and (2) before a license is
12 granted or renewed.
13 (11)(9) The board shall adopt rules to implement the
14 provisions of this section.
15 Section 2. Section 459.0085, Florida Statutes, is
16 amended to read:
17 459.0085 Financial responsibility.--
18 (1) As a condition of licensing and maintaining an
19 active license, and prior to the issuance or renewal of an
20 active license or reactivation of an inactive license for the
21 practice of osteopathic medicine, an applicant must by one of
22 the following methods demonstrate to the satisfaction of the
23 board and the department financial responsibility to pay
24 claims and costs ancillary thereto arising out of the
25 rendering of, or the failure to render, medical care or
26 services:
27 (a) Establishing and maintaining an escrow account
28 consisting of cash or assets eligible for deposit in
29 accordance with s. 625.52 in the per-claim amounts specified
30 in paragraph (b). The required escrow amount set forth in this
31
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1 paragraph may not be used for litigation costs or attorney's
2 fees for the defense of any medical malpractice claim.
3 (b) Obtaining and maintaining professional liability
4 coverage in an amount not less than $250,000 $100,000 per
5 claim, with a minimum annual aggregate of not less than
6 $750,000 $300,000, from an authorized insurer as defined under
7 s. 624.09, from a surplus lines insurer as defined under s.
8 626.914(2), from a risk retention group as defined under s.
9 627.942, from the Joint Underwriting Association established
10 under s. 627.351(4), or through a plan of self-insurance as
11 provided in s. 627.357. The required coverage amount set forth
12 in this paragraph may not be used for litigation costs or
13 attorney's fees for the defense of any medical malpractice
14 claim.
15 (c) Obtaining and maintaining an unexpired,
16 irrevocable letter of credit, established pursuant to chapter
17 675, in an amount not less than $250,000 $100,000 per claim,
18 with a minimum aggregate availability of credit of not less
19 than $750,000 $300,000. The letter of credit must be payable
20 to the osteopathic physician as beneficiary upon presentment
21 of a final judgment indicating liability and awarding damages
22 to be paid by the osteopathic physician or upon presentment of
23 a settlement agreement signed by all parties to such agreement
24 when such final judgment or settlement is a result of a claim
25 arising out of the rendering of, or the failure to render,
26 medical care and services. The letter of credit may not be
27 used for litigation costs or attorney's fees for the defense
28 of any medical malpractice claim. The letter of credit must be
29 nonassignable and nontransferable. Such letter of credit must
30 be issued by any bank or savings association organized and
31 existing under the laws of this state or any bank or savings
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1 association organized under the laws of the United States
2 which has its principal place of business in this state or has
3 a branch office that is authorized under the laws of this
4 state or of the United States to receive deposits in this
5 state.
6 (2) Osteopathic physicians who perform surgery in an
7 ambulatory surgical center licensed under chapter 395 and, as
8 a continuing condition of hospital staff privileges,
9 osteopathic physicians who have staff privileges must also
10 establish financial responsibility by one of the following
11 methods:
12 (a) Establishing and maintaining an escrow account
13 consisting of cash or assets eligible for deposit in
14 accordance with s. 625.52 in the per-claim amounts specified
15 in paragraph (b). The required escrow amount set forth in this
16 paragraph may not be used for litigation costs or attorney's
17 fees for the defense of any medical malpractice claim.
18 (b) Obtaining and maintaining professional liability
19 coverage in an amount not less than $500,000 $250,000 per
20 claim, with a minimum annual aggregate of not less than $1
21 million $750,000 from an authorized insurer as defined under
22 s. 624.09, from a surplus lines insurer as defined under s.
23 626.914(2), from a risk retention group as defined under s.
24 627.942, from the Joint Underwriting Association established
25 under s. 627.351(4), through a plan of self-insurance as
26 provided in s. 627.357, or through a plan of self-insurance
27 that meets the conditions specified for satisfying financial
28 responsibility in s. 766.110. The required coverage amount set
29 forth in this paragraph may not be used for litigation costs
30 or attorney's fees for the defense of any medical malpractice
31 claim.
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1 (c) Obtaining and maintaining an unexpired,
2 irrevocable letter of credit, established pursuant to chapter
3 675, in an amount not less than $500,000 $250,000 per claim,
4 with a minimum aggregate availability of credit of not less
5 than $1 million $750,000. The letter of credit must be payable
6 to the osteopathic physician as beneficiary upon presentment
7 of a final judgment indicating liability and awarding damages
8 to be paid by the osteopathic physician or upon presentment of
9 a settlement agreement signed by all parties to such agreement
10 when such final judgment or settlement is a result of a claim
11 arising out of the rendering of, or the failure to render,
12 medical care and services. The letter of credit may not be
13 used for litigation costs or attorney's fees for the defense
14 of any medical malpractice claim. The letter of credit must be
15 nonassignable and nontransferable. The letter of credit must
16 be issued by any bank or savings association organized and
17 existing under the laws of this state or any bank or savings
18 association organized under the laws of the United States
19 which has its principal place of business in this state or has
20 a branch office that is authorized under the laws of this
21 state or of the United States to receive deposits in this
22 state.
23
24 This subsection shall be inclusive of the coverage in
25 subsection (1).
26 (3)(a) Meeting the financial responsibility
27 requirements of this section or the criteria for any exemption
28 from such requirements must be established at the time of
29 issuance or renewal of a license.
30
31
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1 (b) Any person may, at any time, submit to the
2 department a request for an advisory opinion regarding such
3 person's qualifications for exemption.
4 (4)(a) Each insurer, self-insurer, risk retention
5 group, or joint underwriting association must promptly notify
6 the department of cancellation or nonrenewal of insurance
7 required by this section. Unless the osteopathic physician
8 demonstrates that he or she is otherwise in compliance with
9 the requirements of this section, the department shall suspend
10 the license of the osteopathic physician pursuant to ss.
11 120.569 and 120.57 and notify all health care facilities
12 licensed under chapter 395, part IV of chapter 394, or part I
13 of chapter 641 of such action. Any suspension under this
14 subsection remains in effect until the osteopathic physician
15 demonstrates compliance with the requirements of this section.
16 If any judgments or settlements are pending at the time of
17 suspension, those judgments or settlements must be paid in
18 accordance with this section unless otherwise mutually agreed
19 to in writing by the parties. This paragraph does not abrogate
20 a judgment debtor's obligation to satisfy the entire amount of
21 any judgment.
22 (b) If financial responsibility requirements are met
23 by maintaining an escrow account or letter of credit as
24 provided in this section, upon the entry of an adverse final
25 judgment arising from a medical malpractice arbitration award,
26 from a claim of medical malpractice either in contract or
27 tort, or from noncompliance with the terms of a settlement
28 agreement arising from a claim of medical malpractice either
29 in contract or tort, the licensee shall pay the entire amount
30 of the judgment together with all accrued interest or the
31 amount maintained in the escrow account or provided in the
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1 letter of credit as required by this section, whichever is
2 less, within 60 days after the date such judgment became final
3 and subject to execution, unless otherwise mutually agreed to
4 in writing by the parties. If timely payment is not made by
5 the osteopathic physician, the department shall suspend the
6 license of the osteopathic physician pursuant to procedures
7 set forth in subparagraphs (5)(g)3., 4., and 5. Nothing in
8 this paragraph shall abrogate a judgment debtor's obligation
9 to satisfy the entire amount of any judgment.
10 (5) The requirements of subsections (1), (2), and (3)
11 do not apply to:
12 (a) Any person licensed under this chapter who
13 practices medicine exclusively as an officer, employee, or
14 agent of the Federal Government or of the state or its
15 agencies or its subdivisions. For the purposes of this
16 subsection, an agent of the state, its agencies, or its
17 subdivisions is a person who is eligible for coverage under
18 any self-insurance or insurance program authorized by the
19 provisions of s. 768.28(16).
20 (b) Any person whose license has become inactive under
21 this chapter and who is not practicing medicine in this state.
22 Any person applying for reactivation of a license must show
23 either that such licensee maintained tail insurance coverage
24 that provided liability coverage for incidents that occurred
25 on or after January 1, 1987, or the initial date of licensure
26 in this state, whichever is later, and incidents that occurred
27 before the date on which the license became inactive; or such
28 licensee must submit an affidavit stating that such licensee
29 has no unsatisfied medical malpractice judgments or
30 settlements at the time of application for reactivation.
31
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1 (c) Any person holding a limited license pursuant to
2 s. 459.0075 and practicing under the scope of such limited
3 license.
4 (d) Any person licensed or certified under this
5 chapter who practices only in conjunction with his or her
6 teaching duties at a college of osteopathic medicine. Such
7 person may engage in the practice of osteopathic medicine to
8 the extent that such practice is incidental to and a necessary
9 part of duties in connection with the teaching position in the
10 college of osteopathic medicine.
11 (e) Any person holding an active license under this
12 chapter who is not practicing osteopathic medicine in this
13 state. If such person initiates or resumes any practice of
14 osteopathic medicine in this state, he or she must notify the
15 department of such activity and fulfill the financial
16 responsibility requirements of this section before resuming
17 the practice of osteopathic medicine in this state.
18 (f) Any person holding an active license under this
19 chapter who meets all of the following criteria:
20 1. The licensee has held an active license to practice
21 in this state or another state or some combination thereof for
22 more than 15 years.
23 2. The licensee has either retired from the practice
24 of osteopathic medicine or maintains a part-time practice of
25 osteopathic medicine of no more than 1,000 patient contact
26 hours per year.
27 3. The licensee has had no more than two claims for
28 medical malpractice resulting in an indemnity exceeding
29 $25,000 within the previous 5-year period.
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1 4. The licensee has not been convicted of, or pled
2 guilty or nolo contendere to, any criminal violation specified
3 in this chapter or the practice act of any other state.
4 5. The licensee has not been subject within the last
5 10 years of practice to license revocation or suspension for
6 any period of time, probation for a period of 3 years or
7 longer, or a fine of $500 or more for a violation of this
8 chapter or the medical practice act of another jurisdiction.
9 The regulatory agency's acceptance of an osteopathic
10 physician's relinquishment of a license, stipulation, consent
11 order, or other settlement, offered in response to or in
12 anticipation of the filing of administrative charges against
13 the osteopathic physician's license, constitutes action
14 against the physician's license for the purposes of this
15 paragraph.
16 6. The licensee has submitted a form supplying
17 necessary information as required by the department and an
18 affidavit affirming compliance with this paragraph.
19 7. The licensee must submit biennially to the
20 department a certification stating compliance with this
21 paragraph. The licensee must, upon request, demonstrate to the
22 department information verifying compliance with this
23 paragraph.
24
25 A licensee who meets the requirements of this paragraph must
26 post notice in the form of a sign prominently displayed in the
27 reception area and clearly noticeable by all patients or
28 provide a written statement to any person to whom medical
29 services are being provided. The sign or statement must read
30 as follows: "Under Florida law, osteopathic physicians are
31 generally required to carry medical malpractice insurance or
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1 otherwise demonstrate financial responsibility to cover
2 potential claims for medical malpractice. However, certain
3 part-time osteopathic physicians who meet state requirements
4 are exempt from the financial responsibility law. YOUR
5 OSTEOPATHIC PHYSICIAN MEETS THESE REQUIREMENTS AND HAS DECIDED
6 NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice is
7 provided pursuant to Florida law."
8 (g) Any person holding an active license under this
9 chapter who agrees to meet all of the following criteria.
10 (6)1. Upon the entry of an adverse final judgment
11 arising from a medical malpractice arbitration award, from a
12 claim of medical malpractice either in contract or tort, or
13 from noncompliance with the terms of a settlement agreement
14 arising from a claim of medical malpractice either in contract
15 or tort, a licensee required to maintain financial
16 responsibility under this section the licensee shall pay the
17 judgment creditor the lesser of the entire amount of the
18 judgment with all accrued interest or either $250,000
19 $100,000, if the osteopathic physician is licensed pursuant to
20 this chapter but does not maintain hospital staff privileges,
21 or $500,000 $250,000, if the osteopathic physician is licensed
22 pursuant to this chapter and maintains hospital staff
23 privileges, within 60 days after the date such judgment became
24 final and subject to execution, unless otherwise mutually
25 agreed to in writing by the parties. Such adverse final
26 judgment shall include any cross-claim, counterclaim, or claim
27 for indemnity or contribution arising from the claim of
28 medical malpractice.
29 (a) Upon notification of the existence of an
30 unsatisfied judgment or payment pursuant to this subsection
31 subparagraph, the department shall notify the licensee by
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1 certified mail that he or she shall be subject to disciplinary
2 action unless, within 30 days from the date of mailing, the
3 licensee either:
4 1.a. Shows proof that the unsatisfied judgment has
5 been paid in the amount specified in this subsection
6 subparagraph; or
7 2.b. Furnishes the department with a copy of a timely
8 filed notice of appeal and either:
9 a.(I) A copy of a supersedeas bond properly posted in
10 the amount required by law; or
11 b.(II) An order from a court of competent jurisdiction
12 staying execution on the final judgment, pending disposition
13 of the appeal.
14 (b)2. The Department of Health shall issue an
15 emergency order suspending the license of any licensee who,
16 after 30 days following receipt of a notice from the
17 Department of Health, has failed to: satisfy a medical
18 malpractice claim against him or her; furnish the Department
19 of Health a copy of a timely filed notice of appeal; furnish
20 the Department of Health a copy of a supersedeas bond properly
21 posted in the amount required by law; or furnish the
22 Department of Health an order from a court of competent
23 jurisdiction staying execution on the final judgment pending
24 disposition of the appeal.
25 (c)3. Upon the next meeting of the probable cause
26 panel of the board following 30 days after the date of mailing
27 the notice of disciplinary action to the licensee, the panel
28 shall make a determination of whether probable cause exists to
29 take disciplinary action against the licensee pursuant to
30 paragraph (a) subparagraph 1.
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1 (d)4. If the board determines that the factual
2 requirements of this subsection subparagraph 1. are met, it
3 shall take disciplinary action as it deems appropriate against
4 the licensee. Such disciplinary action shall include, at a
5 minimum, probation of the license with the restriction that
6 the licensee must make payments to the judgment creditor on a
7 schedule determined by the board to be reasonable and within
8 the financial capability of the osteopathic physician.
9 Notwithstanding any other disciplinary penalty imposed, the
10 disciplinary penalty may include suspension of the license for
11 a period not to exceed 5 years. In the event that an
12 agreement to satisfy a judgment has been met, the board shall
13 remove any restriction on the license.
14 5. The licensee has completed a form supplying
15 necessary information as required by the department.
16
17 A licensee who meets the requirements of this paragraph shall
18 be required either to post notice in the form of a sign
19 prominently displayed in the reception area and clearly
20 noticeable by all patients or to provide a written statement
21 to any person to whom medical services are being provided.
22 Such sign or statement shall state: "Under Florida law,
23 osteopathic physicians are generally required to carry medical
24 malpractice insurance or otherwise demonstrate financial
25 responsibility to cover potential claims for medical
26 malpractice. YOUR OSTEOPATHIC PHYSICIAN HAS DECIDED NOT TO
27 CARRY MEDICAL MALPRACTICE INSURANCE. This is permitted under
28 Florida law subject to certain conditions. Florida law
29 imposes strict penalties against noninsured osteopathic
30 physicians who fail to satisfy adverse judgments arising from
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1 claims of medical malpractice. This notice is provided
2 pursuant to Florida law."
3 (7)(6) Any deceptive, untrue, or fraudulent
4 representation by the licensee with respect to any provision
5 of this section shall result in permanent disqualification
6 from any exemption to mandated financial responsibility as
7 provided in this section and shall constitute grounds for
8 disciplinary action under s. 459.015.
9 (8)(7) Any licensee who relies on any exemption from
10 the financial responsibility requirement shall notify the
11 department in writing of any change of circumstance regarding
12 his or her qualifications for such exemption and shall
13 demonstrate that he or she is in compliance with the
14 requirements of this section.
15 (9)(8) If a physician is either a resident physician,
16 assistant resident physician, or intern in an approved
17 postgraduate training program, as defined by the board's
18 rules, and is supervised by a physician who is participating
19 in the Florida Birth-Related Neurological Injury Compensation
20 Plan, such resident physician, assistant resident physician,
21 or intern is deemed to be a participating physician without
22 the payment of the assessment set forth in s. 766.314(4).
23 (10)(9) Notwithstanding any other provision of this
24 section, the department shall suspend the license of any
25 osteopathic physician against whom has been entered a final
26 judgment, arbitration award, or other order or who has entered
27 into a settlement agreement to pay damages arising out of a
28 claim for medical malpractice, if all appellate remedies have
29 been exhausted and payment up to the amounts required by this
30 section has not been made within 30 days after the entering of
31 such judgment, award, or order or agreement, until proof of
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1 payment is received by the department or a payment schedule
2 has been agreed upon by the osteopathic physician and the
3 claimant and presented to the department. This subsection does
4 not apply to an osteopathic physician who has met the
5 financial responsibility requirements in paragraphs (1)(b) and
6 (2)(b).
7 (11) The Department of Health shall verify that the
8 licensee has the required financial responsibility in
9 accordance with subsections (1) and (2) before a license is
10 granted or renewed.
11 (12)(10) The board shall adopt rules to implement the
12 provisions of this section.
13 Section 3. This act shall take effect upon becoming a
14 law.
15
16 *****************************************
17 SENATE SUMMARY
18 Increases the minimum amounts of professional liability
coverage required for licensure as a physician or
19 osteopathic physician, per claim and in the aggregate,
from $100,000 to $250,000 and $300,000 to $750,000,
20 respectively. Increases the minimum amounts of
professional liability coverage required for physicians
21 and osteopathic physicians who perform surgery, per claim
and in the aggregate, from $250,000 to $500,000 and
22 $750,000 to $1 million, respectively. Deletes provisions
that authorize certain physicians or osteopathic
23 physicians to be exempt from the financial-responsibility
requirements. Requires the Department of Health to
24 suspend the license of any physician or osteopathic
physician upon notice of failure to satisfy an adverse
25 final judgment. Requires the department to verify that
each physician or osteopathic physician has met
26 financial-responsibility requirements before granting or
renewing a license. Requires the Board of Medicine and
27 the Board of Osteopathic Medicine to adopt rules. (See
bill for details.)
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29
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