Florida Senate - 2012                          SENATOR AMENDMENT
       Bill No. CS/CS/CS/HB 1263, 2nd Eng.
                                Barcode 668938                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
               Floor: 1e/WD/2R         .                                
             03/08/2012 06:45 PM       .                                

       Senator Jones moved the following:
    1         Senate Amendment to Amendment (371972) (with title
    2  amendment)
    4         Between lines 2987 and 2988
    5  insert:
    6         Section 93. Paragraph (e) of subsection (1) of section
    7  460.4062, Florida Statutes, is amended to read:
    8         460.4062 Chiropractic medicine faculty certificate.—
    9         (1) The department may issue a chiropractic medicine
   10  faculty certificate without examination to an individual who
   11  remits a nonrefundable application fee, not to exceed $100 as
   12  determined by rule of the board, and who demonstrates to the
   13  board that he or she meets the following requirements:
   14         (e)1. Performs research or has been offered and has
   15  accepted a full-time or part-time faculty appointment to teach
   16  in a program of chiropractic medicine at a publicly funded state
   17  university or college or at a college of chiropractic located in
   18  the state and accredited by the Council on Chiropractic
   19  Education; and
   20         2. Provides a certification from the dean of the appointing
   21  college acknowledging the appointment.
   22         Section 94. Subsection (1) of section 460.408, Florida
   23  Statutes, is amended to read:
   24         460.408 Continuing chiropractic education.—
   25         (1) The board shall require licensees to periodically
   26  demonstrate their professional competence as a condition of
   27  renewal of a license by completing up to 40 contact classroom
   28  hours of continuing education.
   29         (a) Continuing education courses sponsored by chiropractic
   30  colleges whose graduates are eligible for examination under any
   31  provision of this chapter may shall be approved upon review by
   32  the board if all other requirements of board rules setting forth
   33  criteria for course approval are met.
   34         (b) The board shall approve those courses that build upon
   35  the basic courses required for the practice of chiropractic
   36  medicine, and the board may also approve courses in adjunctive
   37  modalities. Courses that consist of instruction in the use,
   38  application, prescription, recommendation, or administration of
   39  a specific company’s brand of products or services are not
   40  eligible for approval.
   41         Section 95. Paragraph (e) of subsection (1) of section
   42  460.406, Florida Statutes, is amended to read:
   43         460.406 Licensure by examination.—
   44         (1) Any person desiring to be licensed as a chiropractic
   45  physician must apply to the department to take the licensure
   46  examination. There shall be an application fee set by the board
   47  not to exceed $100 which shall be nonrefundable. There shall
   48  also be an examination fee not to exceed $500 plus the actual
   49  per applicant cost to the department for purchase of portions of
   50  the examination from the National Board of Chiropractic
   51  Examiners or a similar national organization, which may be
   52  refundable if the applicant is found ineligible to take the
   53  examination. The department shall examine each applicant who the
   54  board certifies has:
   55         (e) Successfully completed the National Board of
   56  Chiropractic Examiners certification examination in parts I, II,
   57  and III, and IV, and the physiotherapy examination of the
   58  National Board of Chiropractic Examiners, with a score approved
   59  by the board.
   61  The board may require an applicant who graduated from an
   62  institution accredited by the Council on Chiropractic Education
   63  more than 10 years before the date of application to the board
   64  to take the National Board of Chiropractic Examiners Special
   65  Purposes Examination for Chiropractic, or its equivalent, as
   66  determined by the board. The board shall establish by rule a
   67  passing score.
   68         Section 96. Paragraph (y) of subsection (1) of section
   69  460.413, Florida Statutes, is amended to read:
   70         460.413 Grounds for disciplinary action; action by board or
   71  department.—
   72         (1) The following acts constitute grounds for denial of a
   73  license or disciplinary action, as specified in s. 456.072(2):
   74         (y) Failing to preserve identity of funds and property of a
   75  patient, the value of which is greater than $501. As provided by
   76  rule of the board, money or other property entrusted to a
   77  chiropractic physician for a specific purpose, including
   78  advances for costs and expenses of examination or treatment
   79  which may not exceed the value of $1,500, is to be held in trust
   80  and must be applied only to that purpose. Money and other
   81  property of patients coming into the hands of a chiropractic
   82  physician are not subject to counterclaim or setoff for
   83  chiropractic physician’s fees, and a refusal to account for and
   84  deliver over such money and property upon demand shall be deemed
   85  a conversion. This is not to preclude the retention of money or
   86  other property upon which the chiropractic physician has a valid
   87  lien for services or to preclude the payment of agreed fees from
   88  the proceeds of transactions for examinations or treatments.
   89  Controversies as to the amount of the fees are not grounds for
   90  disciplinary proceedings unless the amount demanded is clearly
   91  excessive or extortionate, or the demand is fraudulent. All
   92  funds of patients paid to a chiropractic physician, other than
   93  advances for costs and expenses, shall be deposited into in one
   94  or more identifiable bank accounts maintained in the state in
   95  which the chiropractic physician’s office is situated, and no
   96  funds belonging to the chiropractic physician may not shall be
   97  deposited therein except as follows:
   98         1. Funds reasonably sufficient to pay bank charges may be
   99  deposited therein.
  100         2. Funds belonging in part to a patient and in part
  101  presently or potentially to the physician must be deposited
  102  therein, but the portion belonging to the physician may be
  103  withdrawn when due unless the right of the physician to receive
  104  it is disputed by the patient, in which event the disputed
  105  portion may shall not be withdrawn until the dispute is finally
  106  resolved.
  108  Every chiropractic physician shall maintain complete records of
  109  all funds, securities, and other properties of a patient coming
  110  into the possession of the physician and render appropriate
  111  accounts to the patient regarding them. In addition, every
  112  chiropractic physician shall promptly pay or deliver to the
  113  patient, as requested by the patient, the funds, securities, or
  114  other properties in the possession of the physician which the
  115  patient is entitled to receive.
  116         Section 97. Subsections (2) and (5) of section 460.4165,
  117  Florida Statutes, are amended to read:
  118         460.4165 Certified chiropractic physician’s assistants.—
  120  ASSISTANT.—Notwithstanding any other provision of law, a
  121  certified chiropractic physician’s assistant may perform
  122  chiropractic services in the specialty area or areas for which
  123  the certified chiropractic physician’s assistant is trained or
  124  experienced when such services are rendered under the
  125  supervision of a licensed chiropractic physician or group of
  126  chiropractic physicians certified by the board. Any certified
  127  chiropractic physician’s assistant certified under this section
  128  to perform services may perform those services only:
  129         (a) In the office of the chiropractic physician to whom the
  130  certified chiropractic physician’s assistant has been assigned,
  131  in which office such physician maintains her or his primary
  132  practice;
  133         (b) Under indirect supervision if the indirect supervision
  134  occurs at the supervising chiropractic physician’s address of
  135  record or place of practice required by s. 456.035, other than
  136  at a clinic licensed under part X of chapter 400, of the
  137  chiropractic physician to whom she or he is assigned as defined
  138  by rule of the board;
  139         (c) In a hospital in which the chiropractic physician to
  140  whom she or he is assigned is a member of the staff; or
  141         (d) On calls outside of the office of the chiropractic
  142  physician to whom she or he is assigned, on the direct order of
  143  the chiropractic physician to whom she or he is assigned.
  144         (5) PROGRAM APPROVAL.—The department shall issue
  145  certificates of approval for programs for the education and
  146  training of certified chiropractic physician’s assistants which
  147  meet board standards. Any basic program curriculum certified by
  148  the board shall cover a period of 24 months. The curriculum must
  149  consist of a curriculum of at least 200 didactic classroom hours
  150  during those 24 months.
  151         (a) In developing criteria for program approval, the board
  152  shall give consideration to, and encourage, the use utilization
  153  of equivalency and proficiency testing and other mechanisms
  154  whereby full credit is given to trainees for past education and
  155  experience in health fields.
  156         (b) The board shall create groups of specialty
  157  classifications of training for certified chiropractic
  158  physician’s assistants. These classifications must shall reflect
  159  the training and experience of the certified chiropractic
  160  physician’s assistant. The certified chiropractic physician’s
  161  assistant may receive training in one or more such
  162  classifications, which shall be shown on the certificate issued.
  163         (c) The board shall adopt and publish standards to ensure
  164  that such programs operate in a manner that which does not
  165  endanger the health and welfare of the patients who receive
  166  services within the scope of the program. The board shall review
  167  the quality of the curricula, faculties, and facilities of such
  168  programs; issue certificates of approval; and take whatever
  169  other action is necessary to determine that the purposes of this
  170  section are being met.
  171         Section 98. Section 460.4167, Florida Statutes, is amended
  172  to read:
  173         460.4167 Proprietorship by persons other than licensed
  174  chiropractic physicians.—
  175         (1) A No person other than a sole proprietorship, group
  176  practice, partnership, or corporation that is wholly owned by
  177  one or more chiropractic physicians licensed under this chapter
  178  or by a chiropractic physician licensed under this chapter and
  179  the spouse, parent, child, or sibling of that chiropractic
  180  physician may not employ a chiropractic physician licensed under
  181  this chapter or engage a chiropractic physician licensed under
  182  this chapter as an independent contractor to provide services
  183  that chiropractic physicians are authorized to offer by this
  184  chapter to be offered by a chiropractic physician licensed under
  185  this chapter, unless the person is any of the following, except
  186  for:
  187         (a) A sole proprietorship, group practice, partnership,
  188  corporation, limited liability company, limited partnership,
  189  professional association, or any other entity that is wholly
  190  owned by:
  191         1. One or more chiropractic physicians licensed under this
  192  chapter;
  193         2. A chiropractic physician licensed under this chapter and
  194  the spouse or surviving spouse, parent, child, or sibling of the
  195  chiropractic physician; or
  196         3. A trust whose trustees are chiropractic physicians
  197  licensed under this chapter and the spouse, parent, child, or
  198  sibling of a chiropractic physician.
  200  If the chiropractic physician described in subparagraph (a)2.
  201  dies, notwithstanding part X of chapter 400, the surviving
  202  spouse or adult children may hold, operate, pledge, sell,
  203  mortgage, assign, transfer, own, or control the chiropractic
  204  physician’s ownership interests for so long as the surviving
  205  spouse or adult children remain the sole proprietors of the
  206  chiropractic practice.
  207         (b)(a) A sole proprietorship, group practice, partnership,
  208  or corporation, limited liability company, limited partnership,
  209  professional association, or any other entity that is wholly
  210  owned by a physician or physicians licensed under this chapter,
  211  chapter 458, chapter 459, or chapter 461.
  212         (c)(b)An entity Entities that is wholly are owned,
  213  directly or indirectly, by an entity licensed or registered by
  214  the state under chapter 395.
  215         (d)(c)A clinical facility that is facilities affiliated
  216  with a college of chiropractic accredited by the Council on
  217  Chiropractic Education at which training is provided for
  218  chiropractic students.
  219         (e)(d) A public or private university or college.
  220         (f)(e) An entity wholly owned and operated by an
  221  organization that is exempt from federal taxation under s.
  222  501(c)(3) or (4) of the Internal Revenue Code, a any community
  223  college or university clinic, or an and any entity owned or
  224  operated by the Federal Government or by state government,
  225  including any agency, county, municipality, or other political
  226  subdivision thereof.
  227         (g)(f) An entity owned by a corporation the stock of which
  228  is publicly traded.
  229         (h)(g) A clinic licensed under part X of chapter 400 which
  230  that provides chiropractic services by a chiropractic physician
  231  licensed under this chapter and other health care services by
  232  physicians licensed under chapter 458 or, chapter 459, or
  233  chapter 460, the medical director of which is licensed under
  234  chapter 458 or chapter 459.
  235         (i)(h) A state-licensed insurer.
  236         (j) A health maintenance organization or prepaid health
  237  clinic regulated under chapter 641.
  238         (2) A No person other than a chiropractic physician
  239  licensed under this chapter may not shall direct, control, or
  240  interfere with a chiropractic physician’s clinical judgment
  241  regarding the medical necessity of chiropractic treatment. For
  242  purposes of this subsection, a chiropractic physician’s clinical
  243  judgment does not apply to chiropractic services that are
  244  contractually excluded, the application of alternative services
  245  that may be appropriate given the chiropractic physician’s
  246  prescribed course of treatment, or determinations that compare
  247  comparing contractual provisions and scope of coverage with a
  248  chiropractic physician’s prescribed treatment on behalf of a
  249  covered person by an insurer, health maintenance organization,
  250  or prepaid limited health service organization.
  251         (3) Any lease agreement, rental agreement, or other
  252  arrangement between a person other than a licensed chiropractic
  253  physician and a chiropractic physician whereby the person other
  254  than a licensed chiropractic physician provides the chiropractic
  255  physician with chiropractic equipment or chiropractic materials
  256  must shall contain a provision whereby the chiropractic
  257  physician expressly maintains complete care, custody, and
  258  control of the equipment or practice.
  259         (4) The purpose of this section is to prevent a person
  260  other than the a licensed chiropractic physician from
  261  influencing or otherwise interfering with the exercise of the a
  262  chiropractic physician’s independent professional judgment. In
  263  addition to the acts specified in subsection (2) (1), a person
  264  or entity other than an employer or entity authorized in
  265  subsection (1) a licensed chiropractic physician and any entity
  266  other than a sole proprietorship, group practice, partnership,
  267  or corporation that is wholly owned by one or more chiropractic
  268  physicians licensed under this chapter or by a chiropractic
  269  physician licensed under this chapter and the spouse, parent,
  270  child, or sibling of that physician, may not employ or engage a
  271  chiropractic physician licensed under this chapter. A person or
  272  entity may not or enter into a contract or arrangement with a
  273  chiropractic physician pursuant to which such unlicensed person
  274  or such entity exercises control over the following:
  275         (a) The selection of a course of treatment for a patient,
  276  the procedures or materials to be used as part of the such
  277  course of treatment, and the manner in which the such course of
  278  treatment is carried out by the chiropractic physician licensee;
  279         (b) The patient records of the chiropractic physician a
  280  chiropractor;
  281         (c) The policies and decisions relating to pricing, credit,
  282  refunds, warranties, and advertising; or
  283         (d) The decisions relating to office personnel and hours of
  284  practice.
  286  However, a person or entity that is authorized to employ a
  287  chiropractic physician under subsection (1) may exercise control
  288  over the patient records of the employed chiropractic physician;
  289  the policies and decisions relating to pricing, credit, refunds,
  290  warranties, and advertising; and the decisions relating to
  291  office personnel and hours of practice.
  292         (5) Any person who violates this section commits a felony
  293  of the third degree, punishable as provided in s. 775.082 s.
  294  775.081, s. 775.083, or s. 775.084 s. 775.035.
  295         (6) Any contract or arrangement entered into or undertaken
  296  in violation of this section is shall be void as contrary to
  297  public policy. This section applies to contracts entered into or
  298  renewed on or after July 1, 2008.
  300  ================= T I T L E  A M E N D M E N T ================
  301         And the title is amended as follows:
  302         Delete line 4153
  303  and insert:
  304         established its responsibilities; amending s.
  305         460.4062, F.S.; revising the requirements for
  306         obtaining a chiropractic medicine faculty certificate;
  307         amending s. 460.408, F.S.; authorizing the Board of
  308         Chiropractic Medicine to approve continuing education
  309         courses sponsored by chiropractic colleges under
  310         certain circumstances; prohibiting the board from
  311         approving certain courses in continuing chiropractic
  312         education; amending s. 460.406, F.S.; revising
  313         requirements for a person who desires to be licensed
  314         as a chiropractic physician; amending s. 460.413,
  315         F.S.; requiring that a chiropractic physician preserve
  316         the identity of funds or property of a patient in
  317         excess of a specified amount; limiting the amount that
  318         may be advanced to a chiropractic physician for
  319         certain costs and expenses; amending s. 460.4165,
  320         F.S.; providing that services rendered by a certified
  321         chiropractic physician’s assistant under indirect
  322         supervision may occur only at the supervising
  323         chiropractic physician’s address of record; deleting
  324         the length of time specified for the basic program of
  325         education and training for certified chiropractic
  326         physician’s assistants; amending s. 460.4167, F.S.;
  327         authorizing certain sole proprietorships, group
  328         practices, partnerships, corporations, limited
  329         liability companies, limited partnerships,
  330         professional associations, other entities, health care
  331         clinics licensed under part X of ch. 400, F.S., health
  332         maintenance organizations, or prepaid health clinics
  333         to employ a chiropractic physician or engage a
  334         chiropractic physician as an independent contractor to
  335         provide services authorized by ch. 460, F.S.;
  336         authorizing the spouse or adult children of a deceased
  337         chiropractic physician to hold, operate, pledge, sell,
  338         mortgage, assign, transfer, own, or control the
  339         deceased chiropractic physician’s ownership interests
  340         under certain conditions; authorizing an employer that
  341         employs a chiropractic physician to exercise control
  342         over the patient records of the employed chiropractic
  343         physician, the policies and decisions relating to
  344         pricing, credit, refunds, warranties, and advertising,
  345         and the decisions relating to office personnel and
  346         hours of practice; deleting an obsolete provision;
  347         amending s. 462.19,