HB 587

1
A bill to be entitled
2An act relating to health care practitioners; providing
3legislative findings and intent; amending s. 456.072,
4F.S., relating to grounds for discipline, penalties, and
5enforcement applicable to health care practitioners;
6providing that a practitioner's failure to identify the
7type of license under which he or she is practicing
8constitutes grounds for disciplinary action; providing
9exceptions; authorizing certain entities to determine
10compliance with a disclosure requirement; providing
11penalties; specifying that a reference to the section
12constitutes a general reference under the doctrine of
13incorporation by reference; providing an effective date.
14
15Be It Enacted by the Legislature of the State of Florida:
16
17     Section 1.  The Legislature finds that there exists a
18compelling state interest in patients being informed of the
19credentials of the health care practitioners who treat them and
20in the public being protected from misleading health care
21advertising. The Legislature further finds that the areas of
22licensure for the practice of health care can be extremely
23confusing for patients and that health care practitioners can
24easily mislead patients into believing that the practitioner is
25better qualified than other health care practitioners simply by
26creating a sham practice designation. Therefore, the Legislature
27has determined that the most direct and effective manner in
28which to protect patients from this identifiable harm is to
29ensure that patients and the public be informed of the training
30of health care practitioners and intends by this act to require
31the provision of the information.
32     Section 2.  Section 456.072, Florida Statutes, is amended
33to read:
34     456.072  Grounds for discipline; penalties; enforcement.--
35     (1)  The following acts shall constitute grounds for which
36the disciplinary actions specified in subsection (2) may be
37taken:
38     (a)  Making misleading, deceptive, or fraudulent
39representations in or related to the practice of the licensee's
40profession.
41     (b)  Intentionally violating any rule adopted by the board
42or the department, as appropriate.
43     (c)  Being convicted or found guilty of, or entering a plea
44of guilty or nolo contendere to, regardless of adjudication, a
45crime in any jurisdiction which relates to the practice of, or
46the ability to practice, a licensee's profession.
47     (d)  Using a Class III or a Class IV laser device or
48product, as defined by federal regulations, without having
49complied with the rules adopted under pursuant to s. 501.122(2)
50governing the registration of the such devices.
51     (e)  Failing to comply with the educational course
52requirements for human immunodeficiency virus and acquired
53immune deficiency syndrome.
54     (f)  Having a license or the authority to practice any
55regulated profession revoked, suspended, or otherwise acted
56against, including the denial of licensure, by the licensing
57authority of any jurisdiction, including its agencies or
58subdivisions, for a violation that would constitute a violation
59under Florida law. The licensing authority's acceptance of a
60relinquishment of licensure, stipulation, consent order, or
61other settlement, offered in response to or in anticipation of
62the filing of charges against the license, shall be construed as
63action against the license.
64     (g)  Having been found liable in a civil proceeding for
65knowingly filing a false report or complaint with the department
66against another licensee.
67     (h)  Attempting to obtain, obtaining, or renewing a license
68to practice a profession by bribery, by fraudulent
69misrepresentation, or through an error of the department or the
70board.
71     (i)  Except as provided in s. 465.016, failing to report to
72the department any person who the licensee knows is in violation
73of this chapter, the chapter regulating the alleged violator, or
74the rules of the department or the board.
75     (j)  Aiding, assisting, procuring, employing, or advising
76any unlicensed person or entity to practice a profession
77contrary to this chapter, the chapter regulating the profession,
78or the rules of the department or the board.
79     (k)  Failing to perform any statutory or legal obligation
80placed upon a licensee. For purposes of this section, failing to
81repay a student loan issued or guaranteed by the state or the
82Federal Government in accordance with the terms of the loan or
83failing to comply with service scholarship obligations shall be
84considered a failure to perform a statutory or legal obligation,
85and the minimum disciplinary action imposed shall be a
86suspension of the license until new payment terms are agreed
87upon or the scholarship obligation is resumed, followed by
88probation for the duration of the student loan or remaining
89scholarship obligation period, and a fine equal to 10 percent of
90the defaulted loan amount. Fines collected shall be deposited
91into the Medical Quality Assurance Trust Fund.
92     (l)  Making or filing a report which the licensee knows to
93be false, intentionally or negligently failing to file a report
94or record required by state or federal law, or willfully
95impeding or obstructing another person to do so. Such reports or
96records shall include only those that are signed in the capacity
97of a licensee.
98     (m)  Making deceptive, untrue, or fraudulent
99representations in or related to the practice of a profession or
100employing a trick or scheme in or related to the practice of a
101profession.
102     (n)  Exercising influence on the patient or client for the
103purpose of financial gain of the licensee or a third party.
104     (o)  Practicing or offering to practice beyond the scope
105permitted by law or accepting and performing professional
106responsibilities the licensee knows, or has reason to know, the
107licensee is not competent to perform.
108     (p)  Delegating or contracting for the performance of
109professional responsibilities by a person when the licensee
110delegating or contracting for performance of the such
111responsibilities knows, or has reason to know, the such person
112is not qualified by training, experience, and authorization when
113required to perform them.
114     (q)  Violating a lawful order of the department or the
115board, or failing to comply with a lawfully issued subpoena of
116the department.
117     (r)  Improperly interfering with an investigation or
118inspection authorized by statute, or with any disciplinary
119proceeding.
120     (s)  Failing to comply with the educational course
121requirements for domestic violence.
122     (t)  Failing to identify through written notice, which may
123include the wearing of a name tag, or orally to a patient the
124type of license under which the practitioner is practicing. Any
125advertisement for health care services naming the practitioner
126must identify the type of license the practitioner holds. This
127paragraph does not apply to a practitioner while the
128practitioner is providing services in a facility licensed under
129chapter 394, chapter 395, or chapter 400. Each board, or the
130department where there is no board, is authorized by rule to
131determine how its practitioners may comply with this disclosure
132requirement.
133     (u)(t)  Failing to comply with the requirements of ss.
134381.026 and 381.0261 to provide patients with information about
135their patient rights and how to file a patient complaint.
136     (v)(u)  Engaging or attempting to engage in sexual
137misconduct as defined and prohibited in s. 456.063(1).
138     (w)(v)  Failing to comply with the requirements for
139profiling and credentialing, including, but not limited to,
140failing to provide initial information, failing to timely
141provide updated information, or making misleading, untrue,
142deceptive, or fraudulent representations on a profile,
143credentialing, or initial or renewal licensure application.
144     (x)(w)  Failing to report to the board, or the department
145if there is no board, in writing within 30 days after the
146licensee has been convicted or found guilty of, or entered a
147plea of nolo contendere to, regardless of adjudication, a crime
148in any jurisdiction. Convictions, findings, adjudications, and
149pleas entered into prior to the enactment of this paragraph must
150be reported in writing to the board, or department if there is
151no board, on or before October 1, 1999.
152     (y)(x)  Using information about people involved in motor
153vehicle accidents which has been derived from accident reports
154made by law enforcement officers or persons involved in
155accidents under pursuant to s. 316.066, or using information
156published in a newspaper or other news publication or through a
157radio or television broadcast that has used information gained
158from such reports, for the purposes of commercial or any other
159solicitation whatsoever of the people involved in the such
160accidents.
161     (z)(y)  Being unable to practice with reasonable skill and
162safety to patients by reason of illness or use of alcohol,
163drugs, narcotics, chemicals, or any other type of material or as
164a result of any mental or physical condition. In enforcing this
165paragraph, the department shall have, upon a finding of the
166secretary or the secretary's designee that probable cause exists
167to believe that the licensee is unable to practice because of
168the reasons stated in this paragraph, the authority to issue an
169order to compel a licensee to submit to a mental or physical
170examination by physicians designated by the department. If the
171licensee refuses to comply with the such order, the department's
172order directing the such examination may be enforced by filing a
173petition for enforcement in the circuit court where the licensee
174resides or does business. The department shall be entitled to
175the summary procedure provided in s. 51.011. A licensee or
176certificateholder affected under this paragraph shall at
177reasonable intervals be afforded an opportunity to demonstrate
178that he or she can resume the competent practice of his or her
179profession with reasonable skill and safety to patients.
180     (aa)(z)  Testing positive for any drug, as defined in s.
181112.0455, on any confirmed preemployment or employer-ordered
182drug screening when the practitioner does not have a lawful
183prescription and legitimate medical reason for using the such
184drug.
185     (bb)(aa)  Performing or attempting to perform health care
186services on the wrong patient, a wrong-site procedure, a wrong
187procedure, or an unauthorized procedure or a procedure that is
188medically unnecessary or otherwise unrelated to the patient's
189diagnosis or medical condition. For the purposes of this
190paragraph, performing or attempting to perform health care
191services includes the preparation of the patient.
192     (cc)(bb)  Leaving a foreign body in a patient, such as a
193sponge, clamp, forceps, surgical needle, or other paraphernalia
194commonly used in surgical, examination, or other diagnostic
195procedures. For the purposes of this paragraph, it shall be
196legally presumed that retention of a foreign body is not in the
197best interest of the patient and is not within the standard of
198care of the profession, regardless of the intent of the
199professional.
200     (dd)(cc)  Violating any provision of this chapter, the
201applicable practice act, or any rules adopted pursuant thereto.
202     (ee)(dd)  With respect to making a personal injury
203protection claim as required by s. 627.736, intentionally
204submitting a claim, statement, or bill that has been "upcoded"
205as defined in s. 627.732.
206     (ff)(ee)  With respect to making a personal injury
207protection claim as required by s. 627.736, intentionally
208submitting a claim, statement, or bill for payment of services
209that were not rendered.
210     (gg)(ff)  Engaging in a pattern of practice when
211prescribing medicinal drugs or controlled substances which
212demonstrates a lack of reasonable skill or safety to patients, a
213violation of any provision of this chapter, a violation of the
214applicable practice act, or a violation of any rules adopted
215under pursuant to this chapter or the applicable practice act of
216the prescribing practitioner. Notwithstanding s. 456.073(13),
217the department may initiate an investigation and establish such
218a pattern from billing records, data, or any other information
219obtained by the department.
220     (hh)(gg)  Being terminated from a treatment program for
221impaired practitioners, which is overseen by an impaired
222practitioner consultant as described in s. 456.076, for failure
223to comply, without good cause, with the terms of the monitoring
224or treatment contract entered into by the licensee, or for not
225successfully completing any drug treatment or alcohol treatment
226program.
227     (2)  When the board, or the department when there is no
228board, finds any person guilty of the grounds set forth in
229subsection (1) or of any grounds set forth in the applicable
230practice act, including conduct constituting a substantial
231violation of subsection (1) or a violation of the applicable
232practice act which occurred prior to obtaining a license, it may
233enter an order imposing one or more of the following penalties:
234     (a)  Refusal to certify, or to certify with restrictions,
235an application for a license.
236     (b)  Suspension or permanent revocation of a license.
237     (c)  Restriction of practice or license, including, but not
238limited to, restricting the licensee from practicing in certain
239settings, restricting the licensee to work only under designated
240conditions or in certain settings, restricting the licensee from
241performing or providing designated clinical and administrative
242services, restricting the licensee from practicing more than a
243designated number of hours, or any other restriction found to be
244necessary for the protection of the public health, safety, and
245welfare.
246     (d)  Imposition of an administrative fine not to exceed
247$10,000 for each count or separate offense. If the violation is
248for fraud or making a false or fraudulent representation, the
249board, or the department if there is no board, must impose a
250fine of $10,000 per count or offense.
251     (e)  Issuance of a reprimand or letter of concern.
252     (f)  Placement of the licensee on probation for a period of
253time and subject to such conditions as the board, or the
254department when there is no board, may specify. Those conditions
255may include, but are not limited to, requiring the licensee to
256undergo treatment, attend continuing education courses, submit
257to be reexamined, work under the supervision of another
258licensee, or satisfy any terms which are reasonably tailored to
259the violations found.
260     (g)  Corrective action.
261     (h)  Imposition of an administrative fine in accordance
262with s. 381.0261 for violations regarding patient rights.
263     (i)  Refund of fees billed and collected from the patient
264or a third party on behalf of the patient.
265     (j)  Requirement that the practitioner undergo remedial
266education.
267
268In determining what action is appropriate, the board, or
269department when there is no board, must first consider what
270sanctions are necessary to protect the public or to compensate
271the patient. Only after those sanctions have been imposed may
272the disciplining authority consider and include in the order
273requirements designed to rehabilitate the practitioner. All
274costs associated with compliance with orders issued under this
275subsection are the obligation of the practitioner.
276     (3)(a)  Notwithstanding subsection (2), if the ground for
277disciplinary action is the first-time failure of the licensee to
278satisfy continuing education requirements established by the
279board, or by the department if there is no board, the board or
280department, as applicable, shall issue a citation in accordance
281with s. 456.077 and assess a fine, as determined by the board or
282department by rule. In addition, for each hour of continuing
283education not completed or completed late, the board or
284department, as applicable, may require the licensee to take 1
285additional hour of continuing education for each hour not
286completed or completed late.
287     (b)  Notwithstanding subsection (2), if the ground for
288disciplinary action is the first-time violation of a practice
289act for unprofessional conduct, as used in ss. 464.018(1)(h),
290467.203(1)(f), 468.365(1)(f), and 478.52(1)(f), and no actual
291harm to the patient occurred, the board or department, as
292applicable, shall issue a citation in accordance with s. 456.077
293and assess a penalty as determined by rule of the board or
294department.
295     (4)  In addition to any other discipline imposed through
296final order, or citation, entered on or after July 1, 2001,
297under pursuant to this section or discipline imposed through
298final order, or citation, entered on or after July 1, 2001, for
299a violation of any practice act, the board, or the department
300when there is no board, shall assess costs related to the
301investigation and prosecution of the case. The Such costs
302related to the investigation and prosecution include, but are
303not limited to, salaries and benefits of personnel, costs
304related to the time spent by the attorney and other personnel
305working on the case, and any other expenses incurred by the
306department for the case. The board, or the department when there
307in no board, shall determine the amount of costs to be assessed
308after its consideration of an affidavit of itemized costs and
309any written objections thereto. In any case where the board or
310the department imposes a fine or assessment and the fine or
311assessment is not paid within a reasonable time, the such
312reasonable time to be prescribed in the rules of the board, or
313the department when there is no board, or in the order assessing
314the such fines or costs, the department or the Department of
315Legal Affairs may contract for the collection of, or bring a
316civil action to recover, the fine or assessment.
317     (5)  In addition to, or in lieu of, any other remedy or
318criminal prosecution, the department may file a proceeding in
319the name of the state seeking issuance of an injunction or a
320writ of mandamus against any person who violates any of the
321provisions of this chapter, or any provision of law with respect
322to professions regulated by the department, or any board
323therein, or the rules adopted pursuant thereto.
324     (6)  If In the event the board, or the department when
325there is no board, determines that revocation of a license is
326the appropriate penalty, the revocation shall be permanent.
327However, the board may establish by rule requirements for
328reapplication by applicants whose licenses have been permanently
329revoked. The Such requirements may include, but are shall not be
330limited to, satisfying current requirements for an initial
331license.
332     (7)  The purpose of this section is to facilitate uniform
333discipline for those actions made punishable under this section
334and, to this end, a reference to this section constitutes a
335general reference under the doctrine of incorporation by
336reference.
337     Section 3.  This act shall take effect July 1, 2006.


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