Florida Senate - 2011 SENATOR AMENDMENT
Bill No. CS for CS for SB 818
Barcode 405534
LEGISLATIVE ACTION
Senate . House
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Floor: WD/2R .
04/27/2011 02:29 PM .
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Senator Fasano moved the following:
1 Senate Amendment (with directory and title amendments)
2
3 Delete lines 529 - 559
4 and insert:
5 (a) A physician may not practice medicine in a pain
6 management clinic, as described in subsection (4), if:
7 1. The pain-management clinic is not registered with the
8 department as required by this section; or
9 2. Effective July 1, 2012, the physician has not
10 successfully completed a pain-medicine fellowship that is
11 accredited by the Accreditation Council for Graduate Medical
12 Education or a pain-medicine residency that is accredited by the
13 Accreditation Council for Graduate Medical Education or, prior
14 to July 1, 2012, met one of the following qualifications: does
15 not comply with rules adopted by the board.
16 a. Board certification by a specialty board recognized by
17 the American Board of Medical Specialties and holds a sub
18 specialty certification in pain medicine.
19 b. Board certification in pain medicine by the American
20 Board of Pain Medicine.
21 c.(I) Successful completion of a residency program in
22 physical medicine and rehabilitation, anesthesiology, neurology,
23 neurosurgery, family practice, internal medicine, orthopedics,
24 or psychiatry approved by the Accreditation Council for Graduate
25 Medical Education.
26 (II) Sub-specialty certification in hospice and palliative
27 medicine or geriatric medicine recognized by American Board of
28 Medical Specialties.
29 d. Staff privileges at a Florida-licensed hospital to
30 practice pain medicine or perform pain-medicine procedures.
31 e. Three years of documented full-time practice, which is
32 defined as an average of 20 hours per week each year, in pain
33 management and after October 1, 2011, attended and successfully
34 completed 40 hours of in-person, live-participatory AMA Category
35 I CME courses in pain-management, which address all the
36 following subject areas:
37 (I) The goals of treating both short-term and ongoing pain
38 treatment.
39 (II) Controlled substance prescribing rules, including
40 controlled substances agreements.
41 (III) Drug screening or testing, including usefulness and
42 limitations.
43 (IV) The use of controlled substances in treating short
44 term and ongoing pain syndromes, including usefulness and
45 limitations.
46 (V) Evidenced-based, noncontrolled pharmacological pain
47 treatments.
48 (VI) Evidenced-based, nonpharmacological pain treatments.
49 (VII) A complete pain-medicine history and a physical
50 examination.
51 (VIII) Appropriate progress note keeping.
52 (IX) Comorbidities with pain disorders, including
53 psychiatric and addictive disorders.
54 (X) Drug abuse and diversion, and prevention of same.
55 (XI) Risk management.
56 (XII) Medical ethics.
57
58 In addition to the CME requirements set forth in this sub-sub
59 subparagraph, physicians must be able to document hospital
60 privileges at a hospital licensed in this state; practice under
61 the direct supervision of a physician who is qualified in sub
62 sub-subparagraphs a. through c.; or have the practice reviewed
63 by a Florida-licensed risk manager and document compliance with
64 all recommendations of the risk management review. Upon
65 completion of the 40 hours of CME requirements set forth in this
66 sub-sub-subparagraph, a physician must also document the
67 completion of 15 hours of live lecture format, Category I CME in
68 pain management for every year the physician is practicing pain
69 management.
70 (b) Any physician who qualifies to practice medicine in a
71 pain-management clinic pursuant to rules adopted by the Board of
72 Medicine as of July 1, 2012, may continue to practice medicine
73 in a pain-management clinic as long as the physician continues
74 to meet the qualifications set forth in the board rules. A
75 physician who violates this paragraph is subject to disciplinary
76 action by his or her appropriate medical regulatory board.
77 (c)(b) A person may not dispense any medication, including
78 a controlled substance, on the premises of a registered pain
79 management clinic unless he or she is a physician licensed under
80 this chapter or chapter 459.
81 (d)(c) A physician, an advanced registered nurse
82 practitioner, or a physician assistant must perform an
83 appropriate medical a physical examination of a patient on the
84 same day that the physician he or she dispenses or prescribes a
85 controlled substance to a patient at a pain-management clinic.
86 If the physician prescribes or dispenses more than a 72-hour
87 dose of controlled substances for the treatment of chronic
88 nonmalignant pain, the physician must document in the patient’s
89 record the reason such dosage is within the standard of care.
90 For the purpose of this paragraph, the standard of care is set
91 forth in rule 64B8-9.013(3), Florida Administrative Code for
92 prescribing or dispensing that quantity.
93 (e)(d) A physician authorized to prescribe controlled
94 substances who practices at a pain-management clinic is
95 responsible for maintaining the control and security of his or
96 her prescription blanks and any other method used for
97 prescribing controlled substance pain medication. The physician
98 shall comply with the requirements for counterfeit-resistant
99 prescription blanks in s. 893.065 and the rules adopted pursuant
100 to that section. The physician shall notify, in writing, the
101 department within 24 hours following any theft or loss of a
102 prescription blank or breach of any other method for prescribing
103 pain medication.
104 (f)(e) The designated physician of a pain-management clinic
105 shall notify the applicable board in writing of the date of
106 termination of employment within 10 days after terminating his
107 or her employment with a pain-management clinic that is required
108 to be registered under subsection (1).
109
110 ====== D I R E C T O R Y C L A U S E A M E N D M E N T ======
111 And the directory clause is amended as follows:
112 Delete lines 496 - 499
113 and insert:
114 Section 7. Paragraph (a) of subsection (1) and subsection
115 (2) of section 458.3265, Florida Statutes, are amended, and
116 paragraphs (f) and (g) are added to subsection (5) of that
117 section, to read:
118
119 ================= T I T L E A M E N D M E N T ================
120 And the title is amended as follows:
121 Delete lines 42 - 44
122 and insert:
123 as a pain-management clinic; specifying qualifications
124 for a physician to practice medicine in a pain
125 management clinic; requiring a physician, an