HB 1265

1	A bill to be entitled
2	An act relating to medical quality assurance; amending s.
3	395.0193, F.S.; requiring certain disciplinary actions to
4	be reported to the Division of Medical Quality Assurance
5	of the Department of Health rather than the Division of
6	Health Quality Assurance of the Agency for Health Care
7	Administration; amending s. 395.0197, F.S.; requiring the
8	agency to forward copies of adverse incident reports to
9	the department; amending s. 395.3025, F.S.; authorizing
10	disclosure of certain patient records to the department;
11	requiring the administrator or records custodian of a
12	facility to certify which records have been provided to
13	the department; requiring the facility to charge a fee for
14	copies of the records provided to the department; amending
15	s. 400.145, F.S.; requiring the administrator or records
16	custodian of a facility to certify which records have been
17	provided to the department; amending s. 400.147, F.S.;
18	authorizing the department to receive notification of
19	adverse incidents for purposes of certain disciplinary
20	proceedings; requiring the department to review certain
21	adverse incident reports; requiring the agency to forward
22	adverse incident reports to the department; amending s.
23	456.001, F.S.; providing a definition; amending s.
24	456.011, F.S.; providing additional requirements for the
25	constitution of a quorum for meetings of certain
26	committees and boards operating under ch. 456, F.S.;
27	amending s. 456.013, F.S.; requiring an application fee
28	for licensure examinations; providing for extension of a
29	temporary license; revising licensure requirements;
30	authorizing the board or department to adopt rules
31	requiring the display of a professional license; amending
32	s. 456.025, F.S.; authorizing the increase of certain
33	licensure fees; authorizing the imposition of reinspection
34	fees; amending s. 456.036, F.S.; prohibiting the
35	department from renewing the license of licensees owing
36	outstanding fees, costs, or fines; providing for notice;
37	providing for renewal of a license when requirements are
38	met; amending s. 456.037, F.S.; authorizing the board or
39	department to require by rule the display of a business
40	establishment license; amending s. 456.063, F.S.;
41	authorizing the board or department to adopt rules
42	relating to the reporting of sexual misconduct by licensed
43	health care practitioners; amending s. 456.072, F.S.;
44	providing that failure to report disciplinary actions
45	taken against a licensee's license to practice is an
46	additional ground under which the practitioner is subject
47	to discipline by the department or the board having
48	jurisdiction over the practitioner; providing penalties;
49	amending ss. 381.00593, 381.0303, 456.074, 456.41,
50	468.703, 627.6474, 641.315, 766.1016, 766.1116, 768.13,
51	and 768.28, F.S.; conforming cross-references; providing
52	an effective date.
53
54	Be It Enacted by the Legislature of the State of Florida:
55
56	Section 1.  Subsection (4) of section 395.0193, Florida
57	Statutes, is amended to read:
58	395.0193  Licensed facilities; peer review; disciplinary
59	powers; agency or partnership with physicians.--
60	(4)  Pursuant to ss. 458.337 and 459.016, any disciplinary
61	actions taken under subsection (3) shall be reported in writing
62	to the Division of Medical Health Quality Assurance of the
63	Department of Health agency within 30 working days after its
64	initial occurrence, regardless of the pendency of appeals to the
65	governing board of the hospital. The notification shall identify
66	the disciplined practitioner, the action taken, and the reason
67	for such action. All final disciplinary actions taken under
68	subsection (3), if different from those which were reported to
69	the division agency within 30 days after the initial occurrence,
70	shall be reported within 10 working days to the Division of
71	Medical Health Quality Assurance of the department agency in
72	writing and shall specify the disciplinary action taken and the
73	specific grounds therefor. The division shall review each report
74	and determine whether it potentially involved conduct by the
75	licensee that is subject to disciplinary action, in which case
76	s. 456.073 shall apply. The reports are not subject to
77	inspection under s. 119.07(1) even if the division's
78	investigation results in a finding of probable cause.
79	Section 2.  Subsection (7) of section 395.0197, Florida
80	Statutes, is amended to read:
81	395.0197  Internal risk management program.--
82	(7)  Any of the following adverse incidents, whether
83	occurring in the licensed facility or arising from health care
84	prior to admission in the licensed facility, shall be reported
85	by the facility to the agency within 15 calendar days after its
86	occurrence:
87	(a)  The death of a patient;
88	(b)  Brain or spinal damage to a patient;
89	(c)  The performance of a surgical procedure on the wrong
90	patient;
91	(d)  The performance of a wrong-site surgical procedure;
92	(e)  The performance of a wrong surgical procedure;
93	(f)  The performance of a surgical procedure that is
94	medically unnecessary or otherwise unrelated to the patient's
95	diagnosis or medical condition;
96	(g)  The surgical repair of damage resulting to a patient
97	from a planned surgical procedure, where the damage is not a
98	recognized specific risk, as disclosed to the patient and
99	documented through the informed-consent process; or
100	(h)  The performance of procedures to remove unplanned
101	foreign objects remaining from a surgical procedure.
102
103	The agency may grant extensions to this reporting requirement
104	for more than 15 days upon justification submitted in writing by
105	the facility administrator to the agency. The agency may require
106	an additional, final report. These reports shall not be
107	available to the public pursuant to s. 119.07(1) or any other
108	law providing access to public records, nor be discoverable or
109	admissible in any civil or administrative action, except in
110	disciplinary proceedings by the agency or the appropriate
111	regulatory board, nor shall they be available to the public as
112	part of the record of investigation for and prosecution in
113	disciplinary proceedings made available to the public by the
114	agency or the appropriate regulatory board. However, the agency
115	or the appropriate regulatory board shall make available, upon
116	written request by a health care professional against whom
117	probable cause has been found, any such records which form the
118	basis of the determination of probable cause. The agency may
119	investigate, as it deems appropriate, any such incident and
120	prescribe measures that must or may be taken in response to the
121	incident. The agency shall forward a copy of each incident
122	report received from a facility to the Division of Medical
123	Quality Assurance within the Department of Health review each
124	incident and determine whether it potentially involved conduct
125	by the health care professional who is subject to disciplinary
126	action, in which case the provisions of s. 456.073 shall apply.
127	Section 3.  Paragraph (e) of subsection (4) of section
128	395.3025, Florida Statutes, is amended to read:
129	395.3025  Patient and personnel records; copies;
130	examination.--
131	(4)  Patient records are confidential and must not be
132	disclosed without the consent of the person to whom they
133	pertain, but appropriate disclosure may be made without such
134	consent to:
135	(e)  The Department of Health agency upon subpoena issued
136	pursuant to s. 456.071, but the records obtained thereby must be
137	used solely for the purpose of the department agency and the
138	appropriate professional board in its investigation,
139	prosecution, and appeal of disciplinary proceedings. The
140	administrator or records custodian in a facility licensed under
141	this chapter shall certify that true and complete copies of the
142	records requested pursuant to a subpoena or a patient release
143	have been provided to the department or otherwise identify those
144	documents that have not been provided. If the department agency
145	requests copies of the records, the facility shall charge a
146	reasonable fee as determined by rule of the department no more
147	than its actual copying costs, including reasonable staff time.
148	The records must be sealed and must not be available to the
149	public pursuant to s. 119.07(1) or any other statute providing
150	access to records, nor may they be available to the public as
151	part of the record of investigation for and prosecution in
152	disciplinary proceedings made available to the public by the
153	department agency or the appropriate regulatory board. However,
154	the department agency must make available, upon written request
155	by a practitioner against whom probable cause has been found,
156	any such records that form the basis of the determination of
157	probable cause.
158	Section 4.  Subsection (3) is added to section 400.145,
159	Florida Statutes, to read:
160	400.145  Records of care and treatment of resident; copies
161	to be furnished.--
162	(3)  The administrator or records custodian in a facility
163	licensed under this chapter shall certify that true and complete
164	copies of records or documents subpoenaed pursuant to s. 456.057
165	or s. 456.071 or requested by a patient release have been
166	provided to the Department of Health or otherwise identify those
167	documents that have not been provided.
168	Section 5.  Subsection (7) and paragraph (b) of subsection
169	(8) of section 400.147, Florida Statutes, are amended to read:
170	400.147  Internal risk management and quality assurance
171	program.--
172	(7)  The facility shall initiate an investigation and shall
173	notify the agency within 1 business day after the risk manager
174	or his or her designee has received a report pursuant to
175	paragraph (1)(d). The notification must be made in writing and
176	be provided electronically, by facsimile device or overnight
177	mail delivery. The notification must include information
178	regarding the identity of the affected resident, the type of
179	adverse incident, the initiation of an investigation by the
180	facility, and whether the events causing or resulting in the
181	adverse incident represent a potential risk to any other
182	resident. The notification is confidential as provided by law
183	and is not discoverable or admissible in any civil or
184	administrative action, except in disciplinary proceedings by the
185	Department of Health agency or the appropriate regulatory board.
186	The agency may investigate, as it deems appropriate, any such
187	incident and prescribe measures that must or may be taken in
188	response to the incident. The Department of Health agency shall
189	review each incident and determine whether it potentially
190	involved conduct by the health care professional who is subject
191	to disciplinary action, in which case the provisions of s.
192	456.073 shall apply.
193	(8)
194	(b)  A copy of the adverse incident report submitted The
195	information reported to the agency pursuant to paragraph (a)
196	which relates to health care practitioners as defined in s.
197	456.001(4) shall be forwarded to the Division of Medical Quality
198	Assurance within the Department of Health for review persons
199	licensed under chapter 458, chapter 459, chapter 461, or chapter
200	466 shall be reviewed by the agency. The agency shall determine
201	whether any of the incidents potentially involved conduct by a
202	health care professional who is subject to disciplinary action,
203	in which case the provisions of s. 456.073 shall apply.
204	Section 6.  Subsections (1) through (7) of section 456.001,
205	Florida Statutes, are renumbered as subsections (2) through (8),
206	respectively, and a new subsection (1) is added to that section
207	to read:
208	456.001  Definitions.--As used in this chapter, the term:
209	(1)  "Application" means the documents required by the
210	department to initiate the licensing process, including, but not
211	limited to, the initial document filing and responses to
212	requests from the department for additional data and
213	information.
214	Section 7.  Subsection (3) of section 456.011, Florida
215	Statutes, is amended to read:
216	456.011  Boards; organization; meetings; compensation and
217	travel expenses.--
218	(3)  The board shall meet at least once annually and may
219	meet as often as is necessary. Meetings shall be conducted
220	through teleconferencing or other technological means, unless
221	disciplinary hearings involving standard of care, sexual
222	misconduct, fraud, impairment, or felony convictions; licensure
223	denial hearings; or controversial rule hearings are being
224	conducted; or unless otherwise approved in advance of the
225	meeting by the director of the Division of Medical Quality
226	Assurance. The chairperson or a quorum of the board shall have
227	the authority to call meetings, except as provided in this
228	subsection above relating to in-person meetings. A quorum shall
229	be necessary for the conduct of official business by the board
230	or any committee thereof. Unless otherwise provided by law, 51
231	percent or more of the appointed members of the board or any
232	committee, when applicable, who have taken the oath of office
233	pursuant to s. 5, Art. II of the State Constitution shall
234	constitute a quorum. The membership of committees of the board,
235	except as otherwise authorized pursuant to this chapter or the
236	applicable practice act, shall be composed of currently
237	appointed members of the board. The vote of a majority of the
238	members of the quorum shall be necessary for any official action
239	by the board or committee. Three consecutive unexcused absences
240	or absences constituting 50 percent or more of the board's
241	meetings within any 12-month period shall cause the board
242	membership of the member in question to become void, and the
243	position shall be considered vacant. The board, or the
244	department when there is no board, shall, by rule, define
245	unexcused absences.
246	Section 8.  Subsections (3) through (12) of section
247	456.013, Florida Statutes, are renumbered as subsections (4)
248	through (13), respectively, subsection (1) is amended, present
249	subsection (2) is renumbered as subsection (3) and amended, and
250	a new subsection (2) is added to that section, to read:
251	456.013  Department; general licensing provisions.--
252	(1)(a)  Any person desiring to be licensed in a profession
253	within the jurisdiction of the department shall apply to the
254	department in writing to take the licensure examination. The
255	application shall be made on a form prepared and furnished by
256	the department. The application form must be available on the
257	World Wide Web and the department may accept electronically
258	submitted applications beginning July 1, 2001. A nonrefundable
259	application fee established by the board, or the department when
260	there is no board, shall be submitted with the application in an
261	amount established by rule by the board, or the department when
262	there is no board, to comply with s. 456.025. The application
263	shall require the social security number of the applicant,
264	except as provided in paragraph (b). The form shall be
265	supplemented as needed to reflect any material change in any
266	circumstance or condition stated in the application which takes
267	place between the initial filing of the application and the
268	final grant or denial of the license and which might affect the
269	decision of the department. If an application is submitted
270	electronically, the department may require supplemental
271	materials, including an original signature of the applicant and
272	verification of credentials, to be submitted in a nonelectronic
273	format. An incomplete application shall expire 1 year after
274	initial filing. In order to further the economic development
275	goals of the state, and notwithstanding any law to the contrary,
276	the department may enter into an agreement with the county tax
277	collector for the purpose of appointing the county tax collector
278	as the department's agent to accept applications for licenses
279	and applications for renewals of licenses. The agreement must
280	specify the time within which the tax collector must forward any
281	applications and accompanying application fees to the
282	department.
283	(b)  If an applicant has not been issued a social security
284	number by the Federal Government at the time of application
285	because the applicant is not a citizen or resident of this
286	country, the department may process the application using a
287	unique personal identification number. If such an applicant is
288	otherwise eligible for licensure, the board, or the department
289	when there is no board, may issue to the applicant a temporary
290	license, as established by rule of the board, or the department
291	when there is no board to the applicant, which shall expire 90
292	30 days after issuance unless a social security number is
293	obtained and submitted in writing to the department. Upon
294	receipt of the applicant's social security number, the
295	department shall issue a new license, which shall expire at the
296	end of the current biennium.
297	(c)  The license shall be issued in the legal name of the
298	applicant as reflected on the applicant's birth certificate or
299	United States passport. A request to change or issue a license
300	under any other name must be supported by either a certified
301	copy of a marriage license, a certified copy of an order of a
302	United States federal or state court, or the applicant's
303	original naturalization certificate.
304	(2)  The board, or the department when there is no board,
305	may adopt a rule allowing an applicant for licensure to complete
306	the coursework requirements for licensure by successfully
307	completing the required coursework as a student or by teaching
308	the required coursework as an instructor or professor in an
309	accredited institution.
310	(3)(2)  Before the issuance of any license, the department
311	shall charge an initial license fee as determined by the
312	applicable board or, if there is no board, by rule of the
313	department. Upon receipt of the appropriate license fee, the
314	department shall issue a license to any person certified by the
315	appropriate board, or its designee, as having met the licensure
316	requirements imposed by law or rule. The license shall consist
317	of a wallet-size identification card and a wall card measuring 6
318	1/2 inches by 5 inches. The licensee shall surrender to the
319	department the wallet-size identification card and the wall card
320	if the licensee's license is issued in error or is revoked. The
321	board, or the department when there is no board, may by rule
322	require the display of a license.
323	Section 9.  Subsections (2) through (11) of section
324	456.025, Florida Statutes, are renumbered as subsections (3)
325	through (12), respectively, present subsection (4) is amended,
326	and new subsections (2) and (13) are added to that section, to
327	read:
328	456.025  Fees; receipts; disposition.--
329	(2)  Notwithstanding any other provision of law, when a
330	profession is in a deficit, the board, or the department if
331	there is no board, shall increase fees to satisfy the
332	requirements of subsection (1).
333	(5)(4)  Each board, or the department if there is no board,
334	may charge a fee not to exceed $25, as determined by rule, for
335	the issuance of a wall certificate pursuant to s. 456.013(3)(2)
336	requested by a licensee who was licensed prior to July 1, 1998,
337	or for the issuance of a duplicate wall certificate requested by
338	any licensee.
339	(13)  Each board, or the department if there is no board,
340	may charge a fee as determined by rule for the reinspection of a
341	business establishment prior to its licensure.
342	Section 10.  Subsections (14) and (15) of section 456.036,
343	Florida Statutes, are renumbered as subsections (15) and (16),
344	respectively, and a new subsection (14) is added to that section
345	to read:
346	456.036  Licenses; active and inactive status;
347	delinquency.--
348	(14)  The department may not renew the license of a
349	licensee, as defined in s. 456.001, who owes outstanding fees,
350	costs, or fines to the department. The department shall notify
351	each licensee who has failed to pay outstanding fees, costs, or
352	fines at the licensee's last known address of record with the
353	department when issuing the license renewal notice required by
354	s. 456.038. The department shall renew the license of any
355	licensee when the outstanding fees, costs, or fines are paid if
356	all other requirements for renewal are met.
357	Section 11.  Subsections (4) and (5) of section 456.037,
358	Florida Statutes, are renumbered as subsections (5) and (6),
359	respectively, and a new subsection (4) is added to that section
360	to read:
361	456.037  Business establishments; requirements for active
362	status licenses; delinquency; discipline; applicability.--
363	(4)  The board, or the department if there is no board, may
364	by rule require the display of a business establishment license.
365	Section 12.  Subsection (3) of section 456.063, Florida
366	Statutes, is amended to read:
367	456.063  Sexual misconduct; disqualification for license,
368	certificate, or registration.--
369	(3)  Licensed health care practitioners shall report
370	allegations of sexual misconduct to the department, regardless
371	of the practice setting in which the alleged sexual misconduct
372	occurred. Each board, or the department if there is no board,
373	may adopt rules pursuant to ss. 120.536(1) and 120.54 to
374	implement this subsection.
375	Section 13.  Paragraph (ii) is added to subsection (1) of
376	section 456.072, Florida Statutes, to read:
377	456.072  Grounds for discipline; penalties; enforcement.--
378	(1)  The following acts shall constitute grounds for which
379	the disciplinary actions specified in subsection (2) may be
380	taken:
381	(ii)  Failing to report to the board, or the department if
382	there is no board, in writing, within 30 days after an action as
383	provided in subsection (2) has been taken against a licensee's
384	license to practice any profession in this state or another
385	state, territory, or jurisdiction.
386	(2)  When the board, or the department when there is no
387	board, finds any person guilty of the grounds set forth in
388	subsection (1) or of any grounds set forth in the applicable
389	practice act, including conduct constituting a substantial
390	violation of subsection (1) or a violation of the applicable
391	practice act which occurred prior to obtaining a license, it may
392	enter an order imposing one or more of the following penalties:
393	(a)  Refusal to certify, or to certify with restrictions,
394	an application for a license.
395	(b)  Suspension or permanent revocation of a license.
396	(c)  Restriction of practice or license, including, but not
397	limited to, restricting the licensee from practicing in certain
398	settings, restricting the licensee to work only under designated
399	conditions or in certain settings, restricting the licensee from
400	performing or providing designated clinical and administrative
401	services, restricting the licensee from practicing more than a
402	designated number of hours, or any other restriction found to be
403	necessary for the protection of the public health, safety, and
404	welfare.
405	(d)  Imposition of an administrative fine not to exceed
406	$10,000 for each count or separate offense. If the violation is
407	for fraud or making a false or fraudulent representation, the
408	board, or the department if there is no board, must impose a
409	fine of $10,000 per count or offense.
410	(e)  Issuance of a reprimand or letter of concern.
411	(f)  Placement of the licensee on probation for a period of
412	time and subject to such conditions as the board, or the
413	department when there is no board, may specify. Those conditions
414	may include, but are not limited to, requiring the licensee to
415	undergo treatment, attend continuing education courses, submit
416	to be reexamined, work under the supervision of another
417	licensee, or satisfy any terms which are reasonably tailored to
418	the violations found.
419	(g)  Corrective action.
420	(h)  Imposition of an administrative fine in accordance
421	with s. 381.0261 for violations regarding patient rights.
422	(i)  Refund of fees billed and collected from the patient
423	or a third party on behalf of the patient.
424	(j)  Requirement that the practitioner undergo remedial
425	education.
426
427	In determining what action is appropriate, the board, or
428	department when there is no board, must first consider what
429	sanctions are necessary to protect the public or to compensate
430	the patient. Only after those sanctions have been imposed may
431	the disciplining authority consider and include in the order
432	requirements designed to rehabilitate the practitioner. All
433	costs associated with compliance with orders issued under this
434	subsection are the obligation of the practitioner.
435	Section 14.  Paragraph (a) of subsection (4) of section
436	381.00593, Florida Statutes, is amended to read:
437	381.00593  Public school volunteer health care practitioner
438	program.--
439	(4)(a)  Notwithstanding any provision of chapter 458,
440	chapter 459, chapter 460, chapter 461, chapter 463, part I of
441	chapter 464, chapter 465, chapter 466, chapter 467, parts I and
442	X of chapter 468, or chapter 486 to the contrary, any health
443	care practitioner who participates in the program established in
444	this section and thereby agrees to provide his or her services,
445	without compensation, in a public school for at least 80 hours a
446	year for each school year during the biennial licensure period,
447	or, if the health care practitioner is retired, for at least 400
448	hours a year for each school year during the licensure period,
449	upon providing sufficient proof from the applicable school
450	district that the health care practitioner has completed such
451	hours at the time of license renewal under procedures specified
452	by the Department of Health, shall be eligible for the
453	following:
454	1.  Waiver of the biennial license renewal fee for an
455	active license; and
456	2.  Fulfillment of a maximum of 25 percent of the
457	continuing education hours required for license renewal under s.
458	456.013(10)(9).
459
460	The school district may establish a schedule for health care
461	practitioners who participate in the program.
462	Section 15.  Subsection (1) of section 381.0303, Florida
463	Statutes, is amended to read:
464	381.0303  Special needs shelters.--
465	(1)  PURPOSE.--The purpose of this section is to provide
466	for the operation and closure of special needs shelters and to
467	designate the Department of Health, through its county health
468	departments, as the lead agency for coordination of the
469	recruitment of health care practitioners, as defined in s.
470	456.001(5)(4), to staff special needs shelters in times of
471	emergency or disaster and to provide resources to the department
472	to carry out this responsibility. However, nothing in this
473	section prohibits a county health department from entering into
474	an agreement with a local emergency management agency to assume
475	the lead responsibility for recruiting health care
476	practitioners.
477	Section 16.  Subsection (3) of section 456.074, Florida
478	Statutes, is amended to read:
479	456.074  Certain health care practitioners; immediate
480	suspension of license.--
481	(3)  The department may issue an emergency order suspending
482	or restricting the license of any health care practitioner as
483	defined in s. 456.001(5)(4) who tests positive for any drug on
484	any government or private sector preemployment or employer-
485	ordered confirmed drug test, as defined in s. 112.0455, when the
486	practitioner does not have a lawful prescription and legitimate
487	medical reason for using such drug. The practitioner shall be
488	given 48 hours from the time of notification to the practitioner
489	of the confirmed test result to produce a lawful prescription
490	for the drug before an emergency order is issued.
491	Section 17.  Paragraph (b) of subsection (2) of section
492	456.41, Florida Statutes, is amended to read:
493	456.41  Complementary or alternative health care
494	treatments.--
495	(2)  DEFINITIONS.--As used in this section, the term:
496	(b)  "Health care practitioner" means any health care
497	practitioner as defined in s. 456.001(5)(4).
498	Section 18.  Subsection (2) of section 468.703, Florida
499	Statutes, is amended to read:
500	468.703  Board of Athletic Training.--
501	(2)  Five members of the board must be licensed athletic
502	trainers. One member of the board must be a physician licensed
503	under chapter 458 or chapter 459. One member of the board must
504	be a physician licensed under chapter 460. Two members of the
505	board shall be consumer members, each of whom must be a resident
506	of this state who has never worked as an athletic trainer, who
507	has no financial interest in the practice of athletic training,
508	and who has never been a licensed health care practitioner as
509	defined in s. 456.001(5)(4).
510	Section 19.  Section 627.6474, Florida Statutes, is amended
511	to read:
512	627.6474  Provider contracts.--A health insurer shall not
513	require a contracted health care practitioner as defined in s.
514	456.001(5)(4) to accept the terms of other health care
515	practitioner contracts with the insurer or any other insurer, or
516	health maintenance organization, under common management and
517	control with the insurer, including Medicare and Medicaid
518	practitioner contracts and those authorized by s. 627.6471, s.
519	627.6472, or s. 641.315, except for a practitioner in a group
520	practice as defined in s. 456.053 who must accept the terms of a
521	contract negotiated for the practitioner by the group, as a
522	condition of continuation or renewal of the contract. Any
523	contract provision that violates this section is void. A
524	violation of this section is not subject to the criminal penalty
525	specified in s. 624.15.
526	Section 20.  Subsection (10) of section 641.315, Florida
527	Statutes, is amended to read:
528	641.315  Provider contracts.--
529	(10)  A health maintenance organization shall not require a
530	contracted health care practitioner as defined in s.
531	456.001(5)(4) to accept the terms of other health care
532	practitioner contracts with the health maintenance organization
533	or any insurer, or other health maintenance organization, under
534	common management and control with the health maintenance
535	organization, including Medicare and Medicaid practitioner
536	contracts and those authorized by s. 627.6471, s. 627.6472, or
537	s. 641.315, except for a practitioner in a group practice as
538	defined in s. 456.053 who must accept the terms of a contract
539	negotiated for the practitioner by the group, as a condition of
540	continuation or renewal of the contract. Any contract provision
541	that violates this section is void. A violation of this section
542	is not subject to the criminal penalty specified in s. 624.15.
543	Section 21.  Paragraph (a) of subsection (1) and subsection
544	(4) of section 766.1016, Florida Statutes, are amended to read:
545	766.1016  Patient safety data privilege.--
546	(1)  As used in this section, the term:
547	(a)  "Patient safety data" means reports made to patient
548	safety organizations, including all health care data,
549	interviews, memoranda, analyses, root cause analyses, products
550	of quality assurance or quality improvement processes,
551	corrective action plans, or information collected or created by
552	a health care facility licensed under chapter 395, or a health
553	care practitioner as defined in s. 456.001(5)(4), as a result of
554	an occurrence related to the provision of health care services
555	which exacerbates an existing medical condition or could result
556	in injury, illness, or death.
557	(4)  The exchange of patient safety data among health care
558	facilities licensed under chapter 395, or health care
559	practitioners as defined in s. 456.001(5)(4), or patient safety
560	organizations which does not identify any patient shall not
561	constitute a waiver of any privilege established in this
562	section.
563	Section 22.  Paragraph (b) of subsection (2) of section
564	766.1116, Florida Statutes, is amended to read:
565	766.1116  Health care practitioner; waiver of license
566	renewal fees and continuing education requirements.--
567	(2)  Notwithstanding any provision of chapter 458, chapter
568	459, chapter 460, chapter 461, part I of chapter 464, chapter
569	466, or chapter 467 to the contrary, any health care
570	practitioner who participates as a health care provider under s.
571	766.1115 and thereby agrees with a governmental contractor to
572	provide his or her services without compensation and as an agent
573	of the governmental contractor to low-income recipients in
574	accordance with s. 766.1115 for at least 80 hours a year for
575	each year during the biennial licensure period, or, if the
576	health care practitioner is retired, for at least 400 hours a
577	year for each year during the licensure period, upon providing
578	sufficient proof from the applicable governmental contractor
579	that the health care practitioner has completed the hours at the
580	time of license renewal under procedures specified by the
581	Department of Health, shall be eligible for:
582	(b)  Fulfillment of a maximum of 25 percent of the
583	continuing education hours required for license renewal under s.
584	456.013(10)(9).
585	Section 23.  Paragraph (c) of subsection (2) of section
586	768.13, Florida Statutes, is amended to read:
587	768.13  Good Samaritan Act; immunity from civil
588	liability.--
589	(2)
590	(c)1.  Any health care practitioner as defined in s.
591	456.001(5)(4) who is in a hospital attending to a patient of his
592	or her practice or for business or personal reasons unrelated to
593	direct patient care, and who voluntarily responds to provide
594	care or treatment to a patient with whom at that time the
595	practitioner does not have a then-existing health care patient-
596	practitioner relationship, and when such care or treatment is
597	necessitated by a sudden or unexpected situation or by an
598	occurrence that demands immediate medical attention, shall not
599	be held liable for any civil damages as a result of any act or
600	omission relative to that care or treatment, unless that care or
601	treatment is proven to amount to conduct that is willful and
602	wanton and would likely result in injury so as to affect the
603	life or health of another.
604	2.  The immunity provided by this paragraph does not apply
605	to damages as a result of any act or omission of providing
606	medical care or treatment unrelated to the original situation
607	that demanded immediate medical attention.
608	3.  For purposes of this paragraph, the Legislature's
609	intent is to encourage health care practitioners to provide
610	necessary emergency care to all persons without fear of
611	litigation as described in this paragraph.
612	Section 24.  Paragraph (a) of subsection (12) of section
613	768.28, Florida Statutes, is amended to read:
614	768.28  Waiver of sovereign immunity in tort actions;
615	recovery limits; limitation on attorney fees; statute of
616	limitations; exclusions; indemnification; risk management
617	programs.--
618	(12)(a)  A health care practitioner, as defined in s.
619	456.001(5)(4), who has contractually agreed to act as an agent
620	of a state university board of trustees to provide medical
621	services to a student athlete for participation in or as a
622	result of intercollegiate athletics, to include team practices,
623	training, and competitions, shall be considered an agent of the
624	respective state university board of trustees, for the purposes
625	of this section, while acting within the scope of and pursuant
626	to guidelines established in that contract. The contracts shall
627	provide for the indemnification of the state by the agent for
628	any liabilities incurred up to the limits set out in this
629	chapter.
630	Section 25.  This act shall take effect July 1, 2009.

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