Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. SB 1506
       
       
       
       
       
       
                                Barcode 227268                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/09/2012           .                                
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       The Committee on Health Regulation (Gaetz) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsections (3), (4), and (5) of section
    6  463.002, Florida Statutes, are amended to read:
    7         463.002 Definitions.—As used in this chapter, the term:
    8         (3)(a) “Licensed practitioner” means a person who is a
    9  primary health care provider licensed to engage in the practice
   10  of optometry under the authority of this chapter.
   11         (b) A licensed practitioner who is not a certified
   12  optometrist shall be required to display at her or his place of
   13  practice a sign which states, “I am a Licensed Practitioner, not
   14  a Certified Optometrist, and I am not able to prescribe topical
   15  ocular pharmaceutical agents.”
   16         (c) All practitioners initially licensed after July 1,
   17  1993, must be certified optometrists.
   18         (4) “Certified optometrist” means a licensed practitioner
   19  authorized by the board to administer and prescribe topical
   20  ocular pharmaceutical agents.
   21         (5) “Optometry” means the diagnosis of conditions of the
   22  human eye and its appendages; the employment of any objective or
   23  subjective means or methods, including the administration of
   24  topical ocular pharmaceutical agents, for the purpose of
   25  determining the refractive powers of the human eyes, or any
   26  visual, muscular, neurological, or anatomic anomalies of the
   27  human eyes and their appendages; and the prescribing and
   28  employment of lenses, prisms, frames, mountings, contact lenses,
   29  orthoptic exercises, light frequencies, and any other means or
   30  methods, including topical ocular pharmaceutical agents, for the
   31  correction, remedy, or relief of any insufficiencies or abnormal
   32  conditions of the human eyes and their appendages.
   33         Section 2. Paragraph (g) of subsection (1) of section
   34  463.005, Florida Statutes, is amended to read:
   35         463.005 Authority of the board.—
   36         (1) The Board of Optometry has authority to adopt rules
   37  pursuant to ss. 120.536(1) and 120.54 to implement the
   38  provisions of this chapter conferring duties upon it. Such rules
   39  shall include, but not be limited to, rules relating to:
   40         (g) Administration and prescription of topical ocular
   41  pharmaceutical agents.
   42         Section 3. Section 463.0055, Florida Statutes, is amended
   43  to read:
   44         463.0055 Administration and prescription of topical ocular
   45  pharmaceutical agents; committee.—
   46         (1)(a) Certified optometrists may administer and prescribe
   47  topical ocular pharmaceutical agents as provided in this section
   48  for the diagnosis and treatment of ocular conditions of the
   49  human eye and its appendages without the use of surgery or other
   50  invasive techniques. However, a licensed practitioner who is not
   51  certified may use topically applied anesthetics solely for the
   52  purpose of glaucoma examinations, but is otherwise prohibited
   53  from administering or prescribing topical ocular pharmaceutical
   54  agents.
   55         (b) Before a certified optometrist may administer or
   56  prescribe oral ocular pharmaceutical agents, the certified
   57  optometrist must complete a course and subsequent examination on
   58  general and ocular pharmacology which have a particular emphasis
   59  on the ingestion of oral pharmaceutical agents and the side
   60  effects of those agents. For certified optometrists licensed
   61  before January 1, 1990, the course shall consist of 50 contact
   62  hours and 25 of those hours shall be Internet-based. For
   63  certified optometrists licensed on or after January 1, 1990, the
   64  course shall consist of 20 contact hours and 10 of those hours
   65  shall be Internet-based. The first course and examination shall
   66  be presented by January 1, 2013, and shall thereafter be
   67  administered at least annually. The Florida Medical Association
   68  and the Florida Optometric Association shall jointly develop and
   69  administer a course and examination for such purpose and jointly
   70  determine the site or sites for the course and examination.
   71         (2)(a) There is hereby created a committee composed of two
   72  certified optometrists licensed pursuant to this chapter,
   73  appointed by the Board of Optometry, two board-certified
   74  ophthalmologists licensed pursuant to chapter 458 or chapter
   75  459, appointed by the Board of Medicine, and one additional
   76  person with a doctorate degree in pharmacology who is not
   77  licensed pursuant to chapter 458, chapter 459, or this chapter,
   78  appointed by the State Surgeon General. The committee shall
   79  review requests for additions to, deletions from, or
   80  modifications of a formulary of topical ocular pharmaceutical
   81  agents for administration and prescription by certified
   82  optometrists and shall provide to the board advisory opinions
   83  and recommendations on such requests. The formulary of topical
   84  ocular pharmaceutical agents shall consist of those topical
   85  ocular pharmaceutical agents that are appropriate to treat and
   86  diagnose ocular diseases and disorders and that which the
   87  certified optometrist is qualified to use in the practice of
   88  optometry. The board shall establish, add to, delete from, or
   89  modify the formulary by rule. Notwithstanding any provision of
   90  chapter 120 to the contrary, the formulary rule shall become
   91  effective 60 days from the date it is filed with the Secretary
   92  of State.
   93         (b) The topical formulary may be added to, deleted from, or
   94  modified according to the procedure described in paragraph (a).
   95  Any person who requests an addition, deletion, or modification
   96  of an authorized topical ocular pharmaceutical agent shall have
   97  the burden of proof to show cause why such addition, deletion,
   98  or modification should be made.
   99         (c) The State Surgeon General shall have standing to
  100  challenge any rule or proposed rule of the board pursuant to s.
  101  120.56. In addition to challenges for any invalid exercise of
  102  delegated legislative authority, the administrative law judge,
  103  upon such a challenge by the State Surgeon General, may declare
  104  all or part of a rule or proposed rule invalid if it:
  105         1. Does not protect the public from any significant and
  106  discernible harm or damages;
  107         2. Unreasonably restricts competition or the availability
  108  of professional services in the state or in a significant part
  109  of the state; or
  110         3. Unnecessarily increases the cost of professional
  111  services without a corresponding or equivalent public benefit.
  112  
  113  However, there shall not be created a presumption of the
  114  existence of any of the conditions cited in this subsection in
  115  the event that the rule or proposed rule is challenged.
  116         (d) Upon adoption of the topical formulary required by this
  117  section, and upon each addition, deletion, or modification to
  118  the topical formulary, the board shall mail a copy of the
  119  amended topical formulary to each certified optometrist and to
  120  each pharmacy licensed by the state.
  121         (3) In addition to the formulary of topical ocular
  122  pharmaceutical agents in subsection (2), there is created a
  123  statutory formulary of oral pharmaceutical agents, which include
  124  the following agents:
  125         (a) The following analgesics, or their generic or
  126  therapeutic equivalents, which may not be administered or
  127  prescribed for more than 72 hours without consultation with a
  128  physician licensed under chapter 458 or chapter 459 who is
  129  skilled in diseases of the eye:
  130         1. Tramadol hydrochloride.
  131         2. Acetaminophen 300 mg with No. 3 codeine phosphate 30 mg.
  132         (b) The following antibiotics, or their generic or
  133  therapeutic equivalents:
  134         1. Amoxicillin.
  135         2. Azithromycin.
  136         3. Ciproflaxacin.
  137         4. Dicloxacillin.
  138         5. Doxycycline.
  139         6. Keflex.
  140         7. Minocycline.
  141         (c) The following antivirals, or their generic or
  142  therapeutic equivalents:
  143         1. Acyclovir.
  144         2. Famciclovir.
  145         3. Valacyclovir.
  146         (d) The following oral anti-glaucoma agents, or their
  147  generic or therapeutic equivalents, which may not be
  148  administered or prescribed for more than 72 hours without
  149  consultation with a physician licensed under chapter 458 or
  150  chapter 459 who is skilled in diseases of the eye:
  151         1. Acetazolamide.
  152         2. Methazolamide.
  153  
  154  Any oral pharmaceutical agent that is listed in the statutory
  155  formulary set forth in this subsection and that is subsequently
  156  determined by the United States Food and Drug Administration to
  157  be unsafe for administration or prescription shall be considered
  158  to have been deleted from the formulary of oral pharmaceutical
  159  agents. The oral pharmaceutical agents on the statutory
  160  formulary set forth in this subsection may not otherwise be
  161  deleted by the board, the department, or the State Surgeon
  162  General.
  163         (4)(3) A certified optometrist shall be issued a prescriber
  164  number by the board. Any prescription written by a certified
  165  optometrist for a topical ocular pharmaceutical agent pursuant
  166  to this section shall have the prescriber number printed
  167  thereon.
  168         Section 4. Subsection (3) of section 463.0057, Florida
  169  Statutes, is amended to read:
  170         463.0057 Optometric faculty certificate.—
  171         (3) The holder of a faculty certificate may engage in the
  172  practice of optometry as permitted by this section, but may not
  173  administer or prescribe topical ocular pharmaceutical agents
  174  unless the certificateholder has satisfied the requirements of
  175  ss. 463.0055(1)(b) and s. 463.006(1)(b)4. and 5.
  176         Section 5. Subsections (2) and (3) of section 463.006,
  177  Florida Statutes, are amended to read:
  178         463.006 Licensure and certification by examination.—
  179         (2) The examination shall consist of the appropriate
  180  subjects, including applicable state laws and rules and general
  181  and ocular pharmacology with emphasis on the use topical
  182  application and side effects of ocular pharmaceutical agents.
  183  The board may by rule substitute a national examination as part
  184  or all of the examination and may by rule offer a practical
  185  examination in addition to the written examination.
  186         (3) Each applicant who successfully passes the examination
  187  and otherwise meets the requirements of this chapter is entitled
  188  to be licensed as a practitioner and to be certified to
  189  administer and prescribe topical ocular pharmaceutical agents in
  190  the diagnosis and treatment of ocular conditions.
  191         Section 6. Subsections (1) and (2) of section 463.0135,
  192  Florida Statutes, are amended, and subsection (10) is added to
  193  that section, to read:
  194         463.0135 Standards of practice.—
  195         (1) A licensed practitioner shall provide that degree of
  196  care which conforms to that level of care provided by medical
  197  practitioners in the same or similar communities. A certified
  198  optometrist shall administer and prescribe oral ocular
  199  pharmaceutical agents in a manner consistent with applicable
  200  preferred practice patterns of the American Academy of
  201  Ophthalmology. A licensed practitioner shall advise or assist
  202  her or his patient in obtaining further care when the service of
  203  another health care practitioner is required.
  204         (2) A licensed practitioner diagnosing angle closure,
  205  neovascular, infantile, or congenital forms of glaucoma shall
  206  promptly and without unreasonable delay refer the patient to a
  207  physician skilled in diseases of the eye and licensed under
  208  chapter 458 or chapter 459. In addition, a licensed practitioner
  209  shall timely refer any patient who experiences progressive
  210  glaucoma due to failed pharmaceutical intervention to a
  211  physician who is skilled in diseases of the eye and licensed
  212  under chapter 458 or chapter 459.
  213         (10) Comanagement of postoperative care shall be conducted
  214  pursuant to an established protocol that governs the
  215  relationship between the operating surgeon and the optometrist.
  216  The patient shall be informed that either physician will be
  217  available for emergency care throughout the postoperative
  218  period, and the patient shall consent in writing to the
  219  comanagement relationship.
  220         Section 7. Subsections (3) and (4) of section 463.014,
  221  Florida Statutes, are amended to read:
  222         463.014 Certain acts prohibited.—
  223         (3) Prescribing, ordering, dispensing, administering,
  224  supplying, selling, or giving any systemic drugs for the purpose
  225  of treating a systemic disease by a licensed practitioner is
  226  prohibited. However, a certified optometrist is permitted to use
  227  commonly accepted means or methods to immediately address
  228  incidents of anaphylaxis.
  229         (4) Surgery of any kind, including the use of lasers, is
  230  expressly prohibited. For purposes of this subsection, the term
  231  “surgery” means a procedure using an instrument, including
  232  lasers, scalpels, or needles, in which human tissue is cut,
  233  burned, or vaporized by incision, injection, ultrasound, laser,
  234  or radiation. The term includes procedures using instruments
  235  that require closing by suturing, clamping, or another such
  236  device. Certified optometrists may remove superficial foreign
  237  bodies. For the purposes of this subsection, the term
  238  “superficial foreign bodies” means any foreign matter that is
  239  embedded in the conjunctiva or cornea but which has not
  240  penetrated the globe.
  241         Section 8. Section 463.0141, Florida Statutes, is created
  242  to read:
  243         463.0141Reports of adverse incidents in the practice of
  244  optometry.—
  245         (1) Any adverse incident that occurs on or after January 1,
  246  2013, in the practice of optometry must be reported to the
  247  department in accordance with this section.
  248         (2) The required notification to the department must be
  249  submitted in writing by certified mail and postmarked within 15
  250  days after the occurrence of the adverse incident.
  251         (3) For purposes of notification to the department, the
  252  term “adverse incident,” as used in this section, means an event
  253  that is associated in whole or in part with the prescribing of
  254  an oral ocular pharmaceutical agent and that results in one of
  255  the following:
  256         (a) Any condition that requires the transfer of a patient
  257  to a hospital licensed under chapter 395;
  258         (b) Any condition that requires the patient to obtain care
  259  from a physician licensed under chapter 458 or chapter 459,
  260  other than a referral or a consultation required under this
  261  chapter;
  262         (c) Permanent physical injury to the patient;
  263         (d) Partial or complete permanent loss of sight by the
  264  patient; or
  265         (e) Death of the patient.
  266         (4) The department shall review each incident and determine
  267  whether it potentially involved conduct by the licensed
  268  practitioner which may be subject to disciplinary action, in
  269  which case s. 456.073 applies. Disciplinary action, if any,
  270  shall be taken by the board.
  271         Section 9. Subsection (1) of section 483.035, Florida
  272  Statutes, is amended to read:
  273         483.035 Clinical laboratories operated by practitioners for
  274  exclusive use; licensure and regulation.—
  275         (1) A clinical laboratory operated by one or more
  276  practitioners licensed under chapter 458, chapter 459, chapter
  277  460, chapter 461, chapter 462, chapter 463, or chapter 466,
  278  exclusively in connection with the diagnosis and treatment of
  279  their own patients, must be licensed under this part and must
  280  comply with the provisions of this part, except that the agency
  281  shall adopt rules for staffing, for personnel, including
  282  education and training of personnel, for proficiency testing,
  283  and for construction standards relating to the licensure and
  284  operation of the laboratory based upon and not exceeding the
  285  same standards contained in the federal Clinical Laboratory
  286  Improvement Amendments of 1988 and the federal regulations
  287  adopted thereunder.
  288         Section 10. Subsection (7) of section 483.041, Florida
  289  Statutes, is amended to read:
  290         483.041 Definitions.—As used in this part, the term:
  291         (7) “Licensed practitioner” means a physician licensed
  292  under chapter 458, chapter 459, chapter 460, or chapter 461, or
  293  chapter 463; a dentist licensed under chapter 466; a person
  294  licensed under chapter 462; or an advanced registered nurse
  295  practitioner licensed under part I of chapter 464; or a duly
  296  licensed practitioner from another state licensed under similar
  297  statutes who orders examinations on materials or specimens for
  298  nonresidents of the State of Florida, but who reside in the same
  299  state as the requesting licensed practitioner.
  300         Section 11. Subsection (5) of section 483.181, Florida
  301  Statutes, is amended to read:
  302         483.181 Acceptance, collection, identification, and
  303  examination of specimens.—
  304         (5) A clinical laboratory licensed under this part must
  305  accept a human specimen submitted for examination by a
  306  practitioner licensed under chapter 458, chapter 459, chapter
  307  460, chapter 461, chapter 462, chapter 463, s. 464.012, or
  308  chapter 466, if the specimen and test are the type performed by
  309  the clinical laboratory. A clinical laboratory may only refuse a
  310  specimen based upon a history of nonpayment for services by the
  311  practitioner. A clinical laboratory shall not charge different
  312  prices for tests based upon the chapter under which a
  313  practitioner submitting a specimen for testing is licensed.
  314         Section 12. Subsection (4) of section 766.102, Florida
  315  Statutes, is amended to read:
  316         766.102 Medical negligence; standards of recovery; expert
  317  witness.—
  318         (4)(a) The Legislature is cognizant of the changing trends
  319  and techniques for the delivery of health care in this state and
  320  the discretion that is inherent in the diagnosis, care, and
  321  treatment of patients by different health care providers. The
  322  failure of a health care provider to order, perform, or
  323  administer supplemental diagnostic tests is shall not be
  324  actionable if the health care provider acted in good faith and
  325  with due regard for the prevailing professional standard of
  326  care.
  327         (b) The claimant has the burden of proving by clear and
  328  convincing evidence that the alleged actions of the health care
  329  provider represent a breach of the prevailing professional
  330  standard of care in an action for damages based on death or
  331  personal injury which alleges that the death or injury resulted
  332  from the failure of a health care provider to order, perform, or
  333  administer supplemental diagnostic tests.
  334         Section 13. Paragraph (b) of subsection (6) of section
  335  766.106, Florida Statutes, is amended to read:
  336         766.106 Notice before filing action for medical negligence;
  337  presuit screening period; offers for admission of liability and
  338  for arbitration; informal discovery; review.—
  339         (6) INFORMAL DISCOVERY.—
  340         (b) Informal discovery may be used by a party to obtain
  341  unsworn statements, the production of documents or things, and
  342  physical and mental examinations, and ex parte interviews, as
  343  follows:
  344         1. Unsworn statements.—Any party may require other parties
  345  to appear for the taking of an unsworn statement. Such
  346  statements may be used only for the purpose of presuit screening
  347  and are not discoverable or admissible in any civil action for
  348  any purpose by any party. A party desiring to take the unsworn
  349  statement of any party must give reasonable notice in writing to
  350  all parties. The notice must state the time and place for taking
  351  the statement and the name and address of the party to be
  352  examined. Unless otherwise impractical, the examination of any
  353  party must be done at the same time by all other parties. Any
  354  party may be represented by counsel at the taking of an unsworn
  355  statement. An unsworn statement may be recorded electronically,
  356  stenographically, or on videotape. The taking of unsworn
  357  statements is subject to the provisions of the Florida Rules of
  358  Civil Procedure and may be terminated for abuses.
  359         2. Documents or things.—Any party may request discovery of
  360  documents or things. The documents or things must be produced,
  361  at the expense of the requesting party, within 20 days after the
  362  date of receipt of the request. A party is required to produce
  363  discoverable documents or things within that party’s possession
  364  or control. Medical records shall be produced as provided in s.
  365  766.204.
  366         3. Physical and mental examinations.—A prospective
  367  defendant may require an injured claimant to appear for
  368  examination by an appropriate health care provider. The
  369  prospective defendant shall give reasonable notice in writing to
  370  all parties as to the time and place for examination. Unless
  371  otherwise impractical, a claimant is required to submit to only
  372  one examination on behalf of all potential defendants. The
  373  practicality of a single examination must be determined by the
  374  nature of the claimant’s condition, as it relates to the
  375  liability of each prospective defendant. Such examination report
  376  is available to the parties and their attorneys upon payment of
  377  the reasonable cost of reproduction and may be used only for the
  378  purpose of presuit screening. Otherwise, such examination report
  379  is confidential and exempt from the provisions of s. 119.07(1)
  380  and s. 24(a), Art. I of the State Constitution.
  381         4. Written questions.—Any party may request answers to
  382  written questions, the number of which may not exceed 30,
  383  including subparts. A response must be made within 20 days after
  384  receipt of the questions.
  385         5. Unsworn statements of treating health care providers.—A
  386  prospective defendant or his or her legal representative may
  387  also take unsworn statements of the claimant’s treating health
  388  care providers. The statements must be limited to those areas
  389  that are potentially relevant to the claim of personal injury or
  390  wrongful death. Subject to the procedural requirements of
  391  subparagraph 1., a prospective defendant may take unsworn
  392  statements from a claimant’s treating physicians. Reasonable
  393  notice and opportunity to be heard must be given to the claimant
  394  or the claimant’s legal representative before taking unsworn
  395  statements. The claimant or claimant’s legal representative has
  396  the right to attend the taking of such unsworn statements.
  397         6. Ex parte interviews of treating health care providers.—A
  398  prospective defendant or his or her legal representative may
  399  interview the claimant’s treating health care providers without
  400  the presence of the claimant or the claimant’s legal
  401  representative. If a prospective defendant or his or her legal
  402  representative intends to interview a claimant’s health care
  403  providers, the prospective defendant must provide the claimant
  404  with notice of such interview at least 10 days before the date
  405  of the interview.
  406         Section 14. Section 766.1091, Florida Statutes, is created
  407  to read:
  408         766.1091 Voluntary binding arbitration; damages.—
  409         (1)A health care provider licensed under chapter 458,
  410  chapter 459, chapter 463, or chapter 466; any entity owned in
  411  whole or in part by a health care provider licensed under
  412  chapter 458, chapter 459, chapter 463, or chapter 466; or any
  413  health care clinic licensed under part X of chapter 400, and a
  414  patient or prospective patient, may agree in writing to submit
  415  to arbitration any claim for medical negligence which may
  416  currently exist or may accrue in the future and would otherwise
  417  be brought pursuant to this chapter. Any arbitration agreement
  418  entered into pursuant to this section shall be governed by
  419  chapter 682.
  420         (2)Any arbitration agreement entered into pursuant to
  421  subsection (1) may contain a provision that limits the available
  422  damages in an arbitration award.
  423         Section 15. Subsection (21) of section 893.02, Florida
  424  Statutes, is amended to read:
  425         893.02 Definitions.—The following words and phrases as used
  426  in this chapter shall have the following meanings, unless the
  427  context otherwise requires:
  428         (21) “Practitioner” means a physician licensed pursuant to
  429  chapter 458, a dentist licensed pursuant to chapter 466, a
  430  veterinarian licensed pursuant to chapter 474, an osteopathic
  431  physician licensed pursuant to chapter 459, a naturopath
  432  licensed pursuant to chapter 462, a certified optometrist
  433  licensed under chapter 463, or a podiatric physician licensed
  434  pursuant to chapter 461, provided such practitioner holds a
  435  valid federal controlled substance registry number.
  436         Section 16. Subsection (1) of section 893.05, Florida
  437  Statutes, is amended to read:
  438         893.05 Practitioners and persons administering controlled
  439  substances in their absence.—
  440         (1) A practitioner, in good faith and in the course of his
  441  or her professional practice only, may prescribe, administer,
  442  dispense, mix, or otherwise prepare a controlled substance, or
  443  the practitioner may cause the same to be administered by a
  444  licensed nurse or an intern practitioner under his or her
  445  direction and supervision only. A veterinarian may so prescribe,
  446  administer, dispense, mix, or prepare a controlled substance for
  447  use on animals only, and may cause it to be administered by an
  448  assistant or orderly under the veterinarian’s direction and
  449  supervision only. A certified optometrist licensed under chapter
  450  463 may not administer or prescribe pharmaceutical agents in
  451  Schedule I or Schedule II of the Florida Comprehensive Drug
  452  Abuse Prevention and Control Act.
  453         Section 17. This act shall take effect July 1, 2012.
  454  
  455  ================= T I T L E  A M E N D M E N T ================
  456         And the title is amended as follows:
  457         Delete everything before the enacting clause
  458  and insert:
  459                        A bill to be entitled                      
  460         An act relating to health care; amending s. 463.002,
  461         F.S.; conforming provisions to changes made by the
  462         act; amending s. 463.005, F.S.; authorizing the Board
  463         of Optometry to adopt rules for the administration and
  464         prescription of ocular pharmaceutical agents; amending
  465         s. 463.0055, F.S.; authorizing certified optometrists
  466         to administer and prescribe pharmaceutical agents
  467         under certain circumstances; requiring that a
  468         certified optometrist complete a course and subsequent
  469         examination on general and ocular pharmacology;
  470         providing requirements for the course; requiring that
  471         the Florida Medical Association and the Florida
  472         Optometric Association jointly develop and administer
  473         the course and examination; revising qualifications of
  474         certain members of the formulary committee; providing
  475         for a formulary of topical ocular pharmaceutical
  476         agents which the committee may modify; specifying the
  477         agents that make up the statutory formulary of oral
  478         pharmaceutical agents; authorizing the deletion of an
  479         oral pharmaceutical agent listed in the statutory
  480         formulary under certain circumstances; prohibiting the
  481         board, the Department of Health, or the State Surgeon
  482         General from deleting an oral pharmaceutical agent
  483         listed in the statutory formulary; amending ss.
  484         463.0057 and 463.006, F.S.; conforming provisions to
  485         changes made by the act; amending s. 463.0135, F.S.;
  486         requiring that a certified optometrist administer and
  487         prescribe oral ocular pharmaceutical agents in a
  488         certain manner; requiring that a licensed practitioner
  489         who diagnoses a patient who has a neovascular form of
  490         glaucoma or progressive glaucoma immediately refer the
  491         patient to a physician who is skilled in the diseases
  492         of the eye; requiring that comanagement of
  493         postoperative care be conducted pursuant to an
  494         established protocol; requiring that the patient be
  495         informed that a physician will be available for
  496         emergency care throughout the postoperative period;
  497         requiring that the patient consent in writing to the
  498         comanagement relationship; amending s. 463.014, F.S.;
  499         revising certain prohibited acts regarding an
  500         optometrist conducting surgery and dispensing,
  501         administering, ordering, supplying, or selling certain
  502         drugs; creating s. 463.0141, F.S.; requiring that
  503         adverse incidents in the practice of optometry be
  504         reported to the Department of Health; providing
  505         requirements for notifying the department of an
  506         adverse incident; providing a definition; requiring
  507         that the department review each incident and determine
  508         whether it involved conduct that is subject to
  509         disciplinary action; requiring that the Board of
  510         Optometry take disciplinary action if necessary;
  511         amending s. 483.035, F.S., relating to licensure and
  512         regulation of clinical laboratories operated by
  513         practitioners for exclusive use; providing
  514         applicability to clinical laboratories operated by
  515         practitioners licensed to practice optometry; amending
  516         s. 483.041, F.S.; revising the definition of the term
  517         “licensed practitioner” to include a practitioner
  518         licensed under ch. 463, F.S.; amending s. 483.181,
  519         F.S.; requiring clinical laboratories to accept human
  520         specimens submitted by practitioners licensed to
  521         practice under ch. 463, F.S.; amending s. 766.102,
  522         F.S.; providing that the claimant has the burden of
  523         proving by clear and convincing evidence that the
  524         actions of a health care provider represented a breach
  525         of the prevailing professional standard of care in an
  526         action for damages based on death or personal injury
  527         which alleges that the death or injury resulted from
  528         the failure of a health care provider to order,
  529         perform, or administer supplemental diagnostic tests;
  530         amending s. 766.106, F.S.; authorizing a prospective
  531         defendant to obtain informal discovery by conducting
  532         ex parte interviews of treating health care providers;
  533         requiring advance notice to the claimant of an ex
  534         parte interview; creating s. 766.1091, F.S.;
  535         authorizing a health care provider or health care
  536         clinic and a patient or prospective patient to agree
  537         to submit a current or future claim of medical
  538         negligence to arbitration; requiring that the
  539         arbitration agreement be governed by ch. 682, F.S.;
  540         authorizing the arbitration agreement to contain a
  541         provision that limits an award of damages; amending s.
  542         893.02, F.S.; revising the definition of the term
  543         “practitioner” to include certified optometrists for
  544         purposes of the Florida Comprehensive Drug Abuse
  545         Prevention and Control Act; amending s. 893.05, F.S.;
  546         prohibiting certified optometrists from administering
  547         and prescribing certain controlled substances;
  548         providing an effective date.