Florida Senate - 2023 SB 956 By Senator Rodriguez 40-01427A-23 2023956__ 1 A bill to be entitled 2 An act relating to foreign-licensed physicians; 3 creating s. 458.3131, F.S.; providing for provisional 4 licenses by endorsement for certain foreign-licensed 5 physicians; requiring the Department of Health to 6 issue a provisional license by endorsement to any 7 applicant whom the Board of Medicine certifies as 8 having met specified criteria; defining the term 9 “active licensed practice of medicine”; authorizing 10 the board to require the applicant to take and pass 11 the appropriate licensure examination before 12 certifying him or her for provisional licensure by 13 endorsement; requiring the department and the board to 14 use an investigative process to ensure that applicants 15 meet the criteria for provisional licensure by 16 endorsement; authorizing the State Surgeon General or 17 his or her designee to issue a 90-day licensure delay 18 if the investigative process is not completed within 19 specified timeframes; providing requirements for 20 notice of such delay; providing construction; 21 requiring the department to impose conditions, 22 limitations, or restrictions on a provisional license 23 by endorsement under certain circumstances; specifying 24 circumstances under which the department may not issue 25 a provisional license by endorsement or an 26 unrestricted provisional license; authorizing the 27 board to enter an order imposing certain conditions on 28 a provisional license by endorsement under certain 29 circumstances; authorizing the board to take specified 30 actions if it determines that an applicant has failed 31 to meet all of the requirements for provisional 32 licensure by endorsement; authorizing the board to 33 revoke a provisional license by endorsement under 34 certain circumstances; providing for the appeal of 35 such revocation and reinstatement of the license under 36 certain circumstances; providing that a provisional 37 license by endorsement is valid for 2 years unless 38 revoked or suspended and is subject to specified 39 provisions; upon expiration of a provisional license 40 by endorsement, requiring the department to issue a 41 full license if the licensee meets specified criteria; 42 requiring the department to renew a provisional 43 license by endorsement under certain circumstances; 44 providing that such licensee is eligible for full 45 licensure after a specified time period; providing 46 that certain physicians are not required to maintain 47 employment with a certain entity as a condition of 48 licensure; authorizing the board to adopt rules; 49 providing an effective date. 50 51 Be It Enacted by the Legislature of the State of Florida: 52 53 Section 1. Section 458.3131, Florida Statutes, is created 54 to read: 55 458.3131 Provisional licensure by endorsement for certain 56 foreign-licensed physicians.— 57 (1) The department shall issue a provisional license by 58 endorsement to any foreign-licensed physician applicant whom, 59 upon applying to the department on forms furnished by the 60 department, the board certifies meets all of the following 61 criteria: 62 (a) Is at least 21 years of age. 63 (b) Is of good moral character. 64 (c) Has not committed any act or offense in this or any 65 other jurisdiction which would constitute the basis for 66 disciplining a physician pursuant to s. 458.331. 67 (d) Has obtained a passing score, as established by rule of 68 the board, on the licensure examination of the United States 69 Medical Licensing Examination. 70 (e) Has submitted evidence of the active licensed practice 71 of medicine in another jurisdiction within the immediately 72 preceding 4 years. For purposes of this paragraph, “active 73 licensed practice of medicine” means the practice of medicine, 74 as defined in s. 458.305(3), by a physician, including a 75 physician employed by a governmental entity in the fields of 76 community or public health, a medical director of a health 77 maintenance organization under s. 641.495(11) who is practicing 78 medicine, and a physician on the active teaching faculty of an 79 accredited medical school. 80 (f) Has submitted evidence of completion of a residency or 81 substantially similar postgraduate medical training in a country 82 recognized by his or her licensing jurisdiction or has practiced 83 as a medical professional performing the duties of a physician 84 in his or her licensing jurisdiction for at least 5 years. 85 (g) Has submitted evidence of good standing with the 86 medical licensing or regulatory institution of his or her 87 licensing jurisdiction within the immediately preceding 4 years. 88 (h) Has demonstrated competency in English through 89 presentation of the Educational Commission for Foreign Medical 90 Graduates English proficiency certificate or by a satisfactory 91 grade on the Test of Spoken English of the Educational Testing 92 Service or a similar test approved by rule of the board. 93 (i) Has submitted evidence of being legally authorized to 94 work in the United States. 95 (j) Has submitted evidence of either: 96 1. An offer for employment as a physician for a health care 97 provider that operates in this state; or 98 2. A license to practice medicine in any of the following 99 countries: 100 a. Australia. 101 b. Canada. 102 c. Ireland. 103 d. Israel. 104 e. New Zealand. 105 f. Singapore. 106 g. South Africa. 107 h. Switzerland. 108 i. The United Kingdom. 109 j. Additional countries as adopted by board rule or by 110 nomination of the Governor or the Legislature. 111 (2) The board may require an applicant for provisional 112 licensure by endorsement to take and pass the appropriate 113 licensure examination before certifying the applicant as 114 eligible for provisional licensure. 115 (3) The department and the board shall ensure that 116 applicants for provisional licensure by endorsement meet 117 applicable criteria in this chapter through an investigative 118 process. If the investigative process is not completed within 119 the timeframes specified in s. 120.60(1) and the department or 120 board has reason to believe that the applicant does not meet the 121 criteria, the State Surgeon General or his or her designee may 122 issue a 90-day licensure delay, notification of which must be in 123 writing and sufficient to inform the applicant of the reason for 124 the delay. This subsection controls over any conflicting 125 provisions of s. 120.60(1). 126 (4) Upon certification by the board, the department must 127 impose conditions, limitations, or restrictions on a provisional 128 license by endorsement if the applicant is on probation in 129 another jurisdiction for an act that would constitute a 130 violation of this chapter or chapter 456. 131 (5) The department may not issue a provisional license by 132 endorsement to any applicant who is under investigation in any 133 jurisdiction for an act or offense that would constitute a 134 violation of this chapter until such time as the investigation 135 is complete, at which time s. 458.331 applies. Furthermore, the 136 department may not issue an unrestricted provisional license by 137 endorsement to any individual who has committed any act or 138 offense in any jurisdiction which would constitute the basis for 139 disciplining a physician pursuant to s. 458.331. If the board 140 finds that an individual has committed an act or offense in any 141 jurisdiction which would constitute the basis for disciplining a 142 physician pursuant to s. 458.331, the board may enter an order 143 imposing one or more of the terms specified in subsection (6). 144 (6) If the board determines that any applicant for 145 provisional licensure by endorsement has failed to meet, to the 146 board’s satisfaction, each of the appropriate requirements 147 specified in this section, it may enter an order taking one or 148 more of the following actions: 149 (a) Refusal to certify to the department an application for 150 licensure. 151 (b) Certification to the department of an application for 152 licensure with restrictions on the scope of practice of the 153 licensee. 154 (c) Certification to the department of an application for 155 licensure with placement of the physician on probation for a 156 period of time and subject to such conditions as the board may 157 specify, including, but not limited to, requiring the physician 158 to submit to treatment, attend continuing education courses, 159 submit to reexamination, or work under the supervision of 160 another physician. 161 (7) The board may revoke a provisional license by 162 endorsement granted under this section based on clear and 163 convincing evidence that medical services provided by the 164 licensee have violated medical safety, competency, or conduct 165 standards for the safe and effective practice of medicine under 166 this chapter. 167 (a) Licensees may appeal the revocation of their 168 provisional license to a court of competent jurisdiction within 169 120 days of the revocation of their provisional license. 170 (b) The court shall reinstate the provisional license if it 171 finds that the board’s actions did not meet the standards as 172 required by this subsection. 173 (8)(a) A provisional license by endorsement issued by the 174 department under this section is valid for 2 years unless 175 revoked or suspended, and a provisional license by endorsement 176 licensee is subject to the requirements of chapter 456, this 177 chapter, and any other provision of law not in conflict with 178 this section. Upon expiration of a provisional license by 179 endorsement, the licensee must be issued a full license if he or 180 she meets all of the following criteria: 181 1. Is not currently subject to any discipline, 182 investigation, or prosecution for a violation that poses a 183 substantial threat to the public health, safety, or welfare. 184 2. Pays all renewal fees required of a full licensee. 185 (b) If a provisional licensee by endorsement is subject to 186 discipline, investigation, or prosecution for a violation that 187 posed or poses a substantial threat to the public health, 188 safety, or welfare and the board has not permanently revoked the 189 license, the department must renew a provisional license by 190 endorsement under this section if the licensee pays the 191 licensure renewal fee specified in s. 458.319. A licensee who 192 renews a provisional license under this paragraph is eligible 193 for full licensure when the licensee is no longer under 194 discipline, investigation, or prosecution. 195 (9) Physicians who obtain a provisional license by 196 endorsement by qualifying under subparagraph (1)(j)1. need not 197 maintain employment with that entity as a condition of 198 licensure. 199 (10) The board may adopt rules to implement this section. 200 Section 2. This act shall take effect July 1, 2023.