Florida Senate - 2024                                     SB 898
       
       
        
       By Senator Rodriguez
       
       
       
       
       
       40-00147B-24                                           2024898__
    1                        A bill to be entitled                      
    2         An act relating to naturopathic medicine;
    3         redesignating the title of ch. 462, F.S., from
    4         “Naturopathy” to “Naturopathic Medicine”; creating s.
    5         462.001, F.S.; providing legislative findings and
    6         purpose; creating s. 462.002, F.S.; providing
    7         applicability and construction; renumbering and
    8         amending s. 462.01, F.S.; revising and defining terms;
    9         creating s. 462.004, F.S.; creating the Board of
   10         Naturopathic Medicine within the Department of Health;
   11         providing for membership of the board; requiring the
   12         board, in conjunction with the department, to
   13         establish a disciplinary training program for board
   14         members; providing requirements for the program;
   15         providing that board members may not participate in
   16         probable cause panels or disciplinary decisions unless
   17         they have completed the training program; requiring
   18         board members appointed to probable cause panels to
   19         attempt to complete their work on every case presented
   20         to them; authorizing board members to reconvene a
   21         probable cause panel under certain circumstances;
   22         providing applicability; renumbering and amending s.
   23         462.023, F.S.; authorizing the board to adopt rules;
   24         deleting obsolete language; creating s. 462.006, F.S.;
   25         prohibiting certain unlicensed persons from practicing
   26         naturopathic medicine or promoting, identifying, or
   27         describing themselves using specified titles or
   28         abbreviations; providing construction; creating ss.
   29         462.007 and 462.008, F.S.; providing for licensure by
   30         examination and by endorsement, respectively, of
   31         naturopathic physicians; requiring the department and
   32         the board to use an investigative process to ensure
   33         that applicants meet the applicable criteria;
   34         authorizing the State Surgeon General or her or his
   35         designee to issue a 90-day licensure delay under
   36         certain circumstances; providing construction;
   37         prohibiting the board from certifying for licensure
   38         certain applicants until a certain investigation is
   39         completed; providing applicability; prohibiting the
   40         department from issuing a license to certain
   41         applicants until the board has reviewed the
   42         application and certified the applicant for licensure;
   43         authorizing the board to enter an order imposing
   44         certain sanctions against or conditions on an
   45         applicant for licensure under certain circumstances;
   46         renumbering and amending s. 462.08, F.S.; revising
   47         requirements for licensure renewal for naturopathic
   48         physicians; requiring the department to adopt rules;
   49         renumbering and amending s. 462.18, F.S.; revising
   50         continuing education requirements for naturopathic
   51         physicians; requiring naturopathic physicians to use
   52         the department’s electronic continuing education
   53         tracking system to demonstrate compliance with
   54         continuing education requirements; renumbering and
   55         amending s. 462.19, F.S.; revising provisions related
   56         to reactivation of inactive naturopathic physician
   57         licenses; requiring the board to adopt rules relating
   58         to the reactivation of inactive licenses; providing
   59         requirements for the rules; prohibiting the department
   60         from reactivating a license until certain conditions
   61         have been met; renumbering and amending s. 462.11,
   62         F.S.; conforming a provision to changes made by the
   63         act; creating s. 462.014, F.S.; requiring the board to
   64         adopt rules providing for the handling of medical
   65         records by licensed naturopathic physicians; providing
   66         requirements for such rules; creating s. 462.015,
   67         F.S.; providing financial responsibility requirements
   68         as a condition of licensure for naturopathic
   69         physicians; providing exemptions from such
   70         requirements; requiring certain insuring entities to
   71         promptly notify the department of a naturopathic
   72         physician’s cancellation or nonrenewal of insurance;
   73         requiring the department to suspend the license of a
   74         naturopathic physician under certain circumstances
   75         until the licensee demonstrates compliance with
   76         specified requirements; providing applicability;
   77         requiring certain naturopathic physicians to provide a
   78         specified notice to their patients; providing
   79         requirements for the notice; providing for permanent
   80         disqualification from any exemption from the financial
   81         responsibility requirements, and for disciplinary
   82         action, for specified conduct; requiring certain
   83         naturopathic physicians to notify the department in
   84         writing of any change in circumstance and demonstrate
   85         compliance with certain requirements; requiring the
   86         department to suspend the license of a naturopathic
   87         physician under certain circumstances until certain
   88         requirements are met; providing applicability;
   89         requiring the board to adopt rules; renumbering and
   90         amending s. 462.13, F.S.; conforming a provision to
   91         changes made by the act; renumbering and amending s.
   92         462.14, F.S.; revising grounds for disciplinary
   93         action; providing construction; providing for
   94         disciplinary actions by the board and department;
   95         providing for the standard of proof in certain
   96         administrative actions; providing requirements for the
   97         reinstatement of a license for certain persons;
   98         providing requirements for disciplinary guidelines
   99         adopted by the board; providing requirements and
  100         procedures for the department’s receipt of certain
  101         closed claims and reports involving a licensed
  102         naturopathic physician; authorizing the department to
  103         bring an action to enjoin a naturopathic physician
  104         from providing medical services under certain
  105         circumstances; requiring the department to promptly
  106         furnish certain documents to a naturopathic physician
  107         or her or his attorney upon undertaking an
  108         investigation of the naturopathic physician;
  109         authorizing a naturopathic physician who is the
  110         subject of such investigation to submit a written
  111         response within a specified timeframe; requiring the
  112         response to be considered by the probable cause panel,
  113         if held on the matter; creating s. 462.018, F.S.;
  114         prohibiting licensed naturopathic physicians from
  115         holding themselves out as board-certified specialists
  116         unless certified by the board regulating such
  117         specialty; authorizing licensed naturopathic
  118         physicians to accurately indicate or state which
  119         services or types of services they provide within the
  120         scope of practice of naturopathic medicine;
  121         renumbering and amending s. 462.17, F.S.; providing
  122         criminal penalties for specified violations relating
  123         to the practice of naturopathic medicine; creating s.
  124         462.024, F.S.; providing that patients are responsible
  125         for advising treating health care practitioners about
  126         any legend drugs, nutrients, or natural medicinal
  127         substances that a naturopathic physician has
  128         prescribed or recommended to the patient; requiring
  129         naturopathic physicians to advise their patients of
  130         such responsibility; creating a rebuttable presumption
  131         that certain injuries sustained by a patient are
  132         caused by her or his failure to disclose such
  133         information as required; providing for the rebuttal of
  134         such presumption under certain circumstances;
  135         providing construction; providing that a naturopathic
  136         physician is not required to confirm whether a patient
  137         has disclosed this information to another treating
  138         health care practitioner; creating s. 462.025, F.S.;
  139         establishing the Naturopathic Medical Formulary
  140         Council, separate and distinct from the board;
  141         providing for membership of the council; requiring the
  142         council to establish the Naturopathic Medical
  143         Formulary; providing requirements for the formulary;
  144         requiring the council to review the formulary annually
  145         and at any time upon board request; providing that
  146         naturopathic physicians may prescribe, administer, and
  147         dispense only those drugs included in the formulary;
  148         providing construction; creating s. 462.026, F.S.;
  149         providing severability; renumbering s. 462.09, F.S.,
  150         relating to disposition of fees; repealing s. 462.16,
  151         F.S., relating to reissue of license; repealing s.
  152         462.2001, F.S., relating to saving clause; amending s.
  153         921.0022, F.S.; conforming a cross-reference;
  154         providing an effective date.
  155          
  156  Be It Enacted by the Legislature of the State of Florida:
  157  
  158         Section 1. Chapter 462, Florida Statutes, entitled
  159  “Naturopathy,” is redesignated as “Naturopathic Medicine.”
  160         Section 2. Section 462.001, Florida Statutes, is created to
  161  read:
  162         462.001 Legislative findings; purpose.—
  163         (1) The Legislature finds that a significant number of this
  164  state’s residents choose naturopathic medicine for their health
  165  care needs, and the Legislature acknowledges that naturopathic
  166  medicine is a distinct health care profession that affects the
  167  public health, safety, and welfare and contributes to freedom of
  168  choice in health care.
  169         (2) The purpose of this chapter is to provide standards for
  170  the licensing and regulation of naturopathic physicians in order
  171  to protect the public health, safety, and welfare; to ensure
  172  that naturopathic health care provided by qualified naturopathic
  173  physicians is available to residents of this state; and to
  174  provide a means of identifying qualified naturopathic
  175  physicians.
  176         Section 3. Section 462.002, Florida Statutes, is created to
  177  read:
  178         462.002 Exceptions.—
  179         (1) This chapter does not apply to:
  180         (a) Other duly licensed health care practitioners acting
  181  within their scopes of practice, as authorized by statute.
  182         (b) Students practicing under the direct supervision of a
  183  licensed naturopathic physician as part of a preceptorship
  184  program while enrolled in a college or university program that
  185  is accredited by, or has candidacy status with, the Council on
  186  Naturopathic Medical Education or an equivalent accrediting body
  187  for the naturopathic medical profession which is recognized by
  188  the United States Department of Education and the board.
  189         (c) Naturopathic residents practicing under the direct
  190  supervision of a licensed naturopathic physician at a residency
  191  site recognized by the Council on Naturopathic Medical Education
  192  or by an equivalent accrediting body for the naturopathic
  193  medical profession which is recognized by the United States
  194  Department of Education and the board.
  195         (d) The practice of the religious tenets of any church in
  196  this state.
  197         (e) The domestic administration of recognized family
  198  remedies.
  199         (2) This chapter may not be construed to prohibit any
  200  service rendered by a person if such service is rendered under
  201  the direct supervision and control of a licensed naturopathic
  202  physician who is available if needed, provides specific
  203  direction for any service to be performed, and gives final
  204  approval for all services performed.
  205         Section 4. Section 462.01, Florida Statutes, is renumbered
  206  as section 462.003, Florida Statutes, and amended to read:
  207         462.003 462.01 Definitions.—As used in this chapter, the
  208  term:
  209         (1) “Board” means the Board of Naturopathic Medicine
  210  “Natureopathy” and “Naturopathy” shall be construed as
  211  synonymous terms and mean the use and practice of psychological,
  212  mechanical, and material health sciences to aid in purifying,
  213  cleansing, and normalizing human tissues for the preservation or
  214  restoration of health, according to the fundamental principles
  215  of anatomy, physiology, and applied psychology, as may be
  216  required. Naturopathic practice employs, among other agencies,
  217  phytotherapy, dietetics, psychotherapy, suggestotherapy,
  218  hydrotherapy, zone therapy, biochemistry, external applications,
  219  electrotherapy, mechanotherapy, mechanical and electrical
  220  appliances, hygiene, first aid, sanitation, and heliotherapy;
  221  provided, however, that nothing in this chapter shall be held or
  222  construed to authorize any naturopathic physician licensed
  223  hereunder to practice materia medica or surgery or chiropractic
  224  medicine, nor shall the provisions of this law in any manner
  225  apply to or affect the practice of osteopathic medicine,
  226  chiropractic medicine, Christian Science, or any other treatment
  227  authorized and provided for by law for the cure or prevention of
  228  disease and ailments.
  229         (2) “Department” means the Department of Health.
  230         (3) “Division” means the Division of Medical Quality
  231  Assurance of the department.
  232         (4) “Legend drug” has the same meaning as “prescription
  233  drug” as defined in s. 499.003.
  234         (5) “Naturopathic doctoral degree” means the “Doctor of
  235  Naturopathic Medicine,” “Doctor of Naturopathy,” or “Diploma of
  236  Naturopathic Medicine” degree, designated as “N.D.” or “N.M.D.,”
  237  from a college or university that is accredited by, or has
  238  candidacy with, the Council on Naturopathic Medical Education or
  239  an equivalent accrediting body for the naturopathic medical
  240  profession which is recognized by the United States Department
  241  of Education and the board. When referring to a naturopathic
  242  school of medicine degree, each of these degrees must be
  243  construed as equivalent to each other.
  244         (6) “Naturopathic Medical Formulary” or “formulary” means
  245  the Naturopathic Medical Formulary established under s. 462.025,
  246  which authorizes licensed naturopathic physicians to prescribe,
  247  dispense, and administer specific legend drugs that are
  248  consistent with the practice of naturopathic medicine.
  249         (7) “Naturopathic physician” means a person licensed to
  250  practice naturopathic medicine under this chapter.
  251         (8) “Naturopathic therapeutic order” means a set of
  252  guidelines to help naturopathic physicians completely resolve a
  253  patient’s symptoms and address the underlying cause while using
  254  the least force necessary.
  255         (9)(a) “Practice of naturopathic medicine” means the
  256  diagnosis, prevention, treatment, and prescription of lifestyle
  257  change, natural medicines, including vitamins, minerals, dietary
  258  supplements, botanical medicines, medicinal fungi, and
  259  homeopathic medicines, and legend drugs as specified by the
  260  Naturopathic Medical Formulary established under s. 462.025
  261  which are provided and administered, through the appropriate
  262  route of administration, by a naturopathic physician for
  263  preventative and therapeutic purposes for any human disease,
  264  pain, injury, deformity, or other physical or mental condition;
  265  which is based on and consistent with the naturopathic
  266  educational standards and requirements of the Council on
  267  Naturopathic Medical Education or an equivalent accrediting body
  268  for the naturopathic medical profession which is recognized by
  269  the United States Department of Education and the board; and
  270  which emphasizes the importance of the principles of
  271  naturopathic medicine and the naturopathic therapeutic order in
  272  the maintenance and restoration of health.
  273         (b) The term does not include any of the following:
  274         1. Prescribing, dispensing, or administering any legend
  275  drug other than those authorized under the Naturopathic Medical
  276  Formulary established under s. 462.025.
  277         2. Performing any surgical procedure.
  278         3. Practicing or claiming to practice as a medical doctor
  279  or physician, an osteopathic physician, a dentist, a podiatric
  280  physician, an optometrist, a psychologist, a nurse practitioner,
  281  a physician assistant, a chiropractic physician, a physical
  282  therapist, an acupuncturist, a midwife, or any other health care
  283  practitioner as defined in s. 456.001.
  284         4. Using general or spinal anesthetics.
  285         5. Administering ionizing radioactive substances.
  286         6. Performing chiropractic or osteopathic adjustments or
  287  manipulations that include high–velocity thrusts at or beyond
  288  the end range of normal joint motion, unless the naturopathic
  289  physician is also licensed as a chiropractic physician or an
  290  osteopathic physician.
  291         7. Performing acupuncture, unless the naturopathic
  292  physician is also licensed as an acupuncturist.
  293         8. Prescribing, dispensing, or administering for cosmetic
  294  purposes any nonprescription drug or legend drug listed in the
  295  Naturopathic Medical Formulary.
  296         (10) “Preceptorship program” means a component of a
  297  naturopathic doctoral degree program which allows naturopathic
  298  medical students to observe health care practitioners while
  299  attending patients, giving naturopathic medical students a wide
  300  variety of experiences in different health care settings in
  301  order to develop clinical knowledge, attitudes, and skills
  302  relevant to the role of a naturopathic physician.
  303         (11) “Principles of naturopathic medicine” means the
  304  foundations of naturopathic medical education and practice as
  305  set forth by the American Association of Naturopathic
  306  Physicians, including all of the following principles:
  307         (a) The healing power of nature.
  308         (b) Identify and treat the causes.
  309         (c) First do no harm.
  310         (d) Doctor as teacher.
  311         (e) Treat the whole person.
  312         (f) Prevention.
  313         Section 5. Section 462.004, Florida Statutes, is created to
  314  read:
  315         462.004 Board of Naturopathic Medicine.—
  316         (1) There is created within the department the Board of
  317  Naturopathic Medicine, composed of seven members appointed by
  318  the Governor and confirmed by the Senate.
  319         (2)(a) Five members of the board must be licensed
  320  naturopathic physicians in good standing in this state who are
  321  residents of this state.
  322         (b) Two members must be residents of this state who are
  323  not, and have never been, licensed health care practitioners.
  324         (c) At least one member must be 55 years of age or older.
  325         (3) For the purpose of staggering terms, the Governor shall
  326  initially appoint to the board three members for terms of 4
  327  years each, two members for terms of 3 years each, and two
  328  members for terms of 2 years each. As the terms of board members
  329  expire, the Governor shall appoint successors for terms of 4
  330  years, and such members shall serve until their successors are
  331  appointed.
  332         (4) The board, in conjunction with the department, shall
  333  establish a disciplinary training program for members of the
  334  board. The program must provide for initial and, thereafter,
  335  periodic training on the grounds for disciplinary action, the
  336  actions that may be taken by the board and the department,
  337  changes in relevant statutes and rules, and any relevant
  338  judicial and administrative decisions. A member of the board may
  339  not participate on a probable cause panel or in a disciplinary
  340  decision of the board unless she or he has completed the
  341  disciplinary training program.
  342         (5) During the terms of service of members of the board on
  343  a probable cause panel, such members shall attempt to complete
  344  their work on every case presented to them. If consideration of
  345  a case has begun but is not completed during the terms of
  346  service of the board members on the panel, the board members may
  347  reconvene as a probable cause panel for the purpose of
  348  completing their deliberations on that case.
  349         (6) All provisions of chapter 456 relating to activities of
  350  boards apply to the board.
  351         Section 6. Section 462.023, Florida Statutes, is renumbered
  352  as section 462.005, Florida Statutes, and amended to read:
  353         462.005 462.023 Rulemaking authority; powers and duties of
  354  the board department.—The board department may adopt such rules
  355  pursuant to ss. 120.536(1) and 120.54 to implement the
  356  provisions of this chapter conferring duties upon it and as are
  357  necessary to carry out the purposes of this chapter, and may
  358  initiate disciplinary action as provided by this chapter, and
  359  shall establish fees based on its estimates of the revenue
  360  required to administer this chapter but shall not exceed the fee
  361  amounts provided in this chapter. The department shall not adopt
  362  any rules which would cause any person who was not licensed in
  363  accordance with this chapter on July 1, 1959, and had not been a
  364  resident of the state for 2 years prior to such date, to become
  365  licensed.
  366         Section 7. Section 462.006, Florida Statutes, is created to
  367  read:
  368         462.006 License required.—Unless licensed under this
  369  chapter, a person may not practice naturopathic medicine in this
  370  state and may not promote, identify, or describe himself or
  371  herself as a “doctor of naturopathic medicine,” a “naturopathic
  372  doctor,” a “doctor of naturopathy,” or a “naturopathic
  373  physician” or use the abbreviations “N.D.” or “N.M.D.” However,
  374  this section may not be construed to prohibit any person
  375  licensed in this state under any other law from engaging in the
  376  practice for which she or he is licensed.
  377         Section 8. Section 462.007, Florida Statutes, is created to
  378  read:
  379         462.007 Licensure by examination.—
  380         (1) Any person desiring to be licensed as a naturopathic
  381  physician must apply to the department on forms furnished by the
  382  department. The department shall license each applicant who
  383  completes the application form and who the board certifies has
  384  met all of the following criteria:
  385         (a) Is at least 21 years of age.
  386         (b) Has received a bachelor’s degree from one of the
  387  following:
  388         1. A college or university accredited by an accrediting
  389  agency recognized by the United States Department of Education
  390  or the Council for Higher Education Accreditation or its
  391  successor entity.
  392         2. A college or university in Canada which is a member of
  393  Universities Canada.
  394         3. A college or university in a foreign country and has
  395  provided evidence that her or his educational credentials are
  396  deemed equivalent to those provided in this country. To have
  397  educational credentials deemed equivalent, the applicant must
  398  provide her or his foreign educational credentials, including
  399  transcripts, course descriptions or syllabi, and diplomas, to a
  400  nationally recognized educational credential evaluating agency
  401  approved by the board for the evaluation and determination of
  402  equivalency of the foreign educational credentials.
  403         (c) Has received a naturopathic doctoral degree from a
  404  college or program accredited by the Council on Naturopathic
  405  Medical Education or another accrediting agency recognized by
  406  the United States Department of Education.
  407         (d) Is physically and mentally fit to practice as a
  408  naturopathic physician.
  409         (e) Is of good moral character and has not:
  410         1. Committed any act or offense in this or any other
  411  jurisdiction which would constitute the basis for disciplining a
  412  naturopathic physician pursuant to s. 462.017.
  413         2. Had an application for licensure in any profession
  414  denied or had her or his license to practice any profession
  415  revoked or suspended by any other state, district, or territory
  416  of the United States or another country for reasons that relate
  417  to her or his ability to practice skillfully and safely as a
  418  naturopathic physician.
  419         3. Been found guilty of a felony.
  420  
  421  The board and the department shall ensure that applicants for
  422  licensure meet the criteria of this paragraph by independently
  423  verifying the provided information through the department’s
  424  investigative process.
  425         (f) Has submitted to the department a set of fingerprints
  426  on a form and in accordance with procedures specified by the
  427  department under s. 456.039(4), along with payment in an amount
  428  equal to the costs incurred by the department for the criminal
  429  background check of the applicant.
  430         (g) Has demonstrated compliance with the financial
  431  responsibility requirements imposed under s. 462.015.
  432         (h) Has obtained a passing score, as determined by board
  433  rule, on Part I - Biomedical Science Examination, Part II - Core
  434  Clinical Science Examination, and Part II - Clinical Elective
  435  Pharmacology Examination of the competency-based national
  436  Naturopathic Physician Licensing Examination administered by the
  437  North American Board of Naturopathic Examiners, or an equivalent
  438  examination offered by an equivalent or successor entity, as
  439  approved by the board.
  440         (2) The department and the board shall ensure that
  441  applicants for licensure satisfy applicable criteria in this
  442  section through an investigative process. If the investigative
  443  process is not completed within the timeframe established in s.
  444  120.60(1) and the department or board has reason to believe that
  445  the applicant does not meet such criteria, the State Surgeon
  446  General or her or his designee may issue a 90-day licensure
  447  delay, which must be in writing and sufficient to notify the
  448  applicant of the reason for the delay. This subsection prevails
  449  over any conflicting provisions of s. 120.60(1).
  450         (3) The board may not certify to the department for
  451  licensure any applicant who is under investigation in another
  452  jurisdiction for an offense that would constitute a violation of
  453  this chapter or chapter 456 until the investigation has been
  454  completed. Upon completion of the investigation, s. 462.017
  455  applies.
  456         (4)(a) The department may not issue a license to any
  457  individual who has committed an act or offense in any
  458  jurisdiction which would constitute the basis for disciplining a
  459  naturopathic physician under s. 462.017 until the board has
  460  reviewed the application and certified the applicant for
  461  licensure.
  462         (b) If the board finds that an applicant for licensure has
  463  committed an act or offense in any jurisdiction which would
  464  constitute the basis for disciplining a naturopathic physician
  465  under s. 462.017, the board may enter an order imposing one or
  466  more of the sanctions set forth in that section and s.
  467  456.072(2) as applicable to applicants for licensure, including
  468  refusing to certify an application for licensure or certifying
  469  an application for licensure with conditions.
  470         (5) If the board determines that an applicant for licensure
  471  has failed to meet, to the board’s satisfaction, any of the
  472  requirements of this section, it may enter an order imposing one
  473  or more of the following:
  474         (a) Refusal to certify to the department an application for
  475  licensure.
  476         (b) Certification to the department of an application for
  477  licensure with restrictions on the scope of practice of the
  478  naturopathic physician.
  479         (c) Certification to the department of an application for
  480  licensure with a probationary period for the applicant, subject
  481  to such conditions as the board specifies, including, but not
  482  limited to, requiring the naturopathic physician to submit to
  483  treatment, attend continuing education courses, submit to
  484  reexamination, or work under the supervision of another
  485  naturopathic physician.
  486         Section 9. Section 462.008, Florida Statutes, is created to
  487  read:
  488         462.008 Licensure by endorsement.—
  489         (1) Any person licensed to practice naturopathic medicine
  490  in another state or territory of the United States or in Canada
  491  who desires to be licensed as a naturopathic physician in this
  492  state must apply to the department on forms furnished by the
  493  department. The department shall issue a license by endorsement
  494  to any applicant who completes the application form and who the
  495  board certifies has met all of the following criteria:
  496         (a) Has met the qualifications for licensure established in
  497  s. 462.007(1)(a)-(g).
  498         (b)1. Has submitted evidence of holding an active license
  499  to practice naturopathic medicine in another state or territory
  500  of the United States or in Canada for at least the 5 years
  501  immediately preceding the filing of her or his application; or
  502         2. If an applicant has held an active license to practice
  503  naturopathic medicine in another state or territory of the
  504  United States or in Canada for less than the 5 years immediately
  505  preceding the filing of her or his application, has obtained a
  506  passing score on the national licensing examination, as
  507  specified in s. 462.007(1)(h), within the year immediately
  508  preceding the filing of the application.
  509         (2) The department and the board shall ensure that
  510  applicants for licensure by endorsement meet applicable criteria
  511  in this section through an investigative process. When the
  512  investigative process is not completed within the timeframe
  513  established in s. 120.60(1) and the department or board has
  514  reason to believe that the applicant does not meet the criteria,
  515  the State Surgeon General or her or his designee may issue a 90
  516  day licensure delay, which must be in writing and sufficient to
  517  notify the applicant of the reason for the delay. This
  518  subsection controls over any conflicting provisions of s.
  519  120.60(1).
  520         (3) The board may not certify to the department for
  521  licensure by endorsement any applicant who is under
  522  investigation in another jurisdiction for an offense that would
  523  constitute a violation of this chapter or chapter 456 until the
  524  investigation has been completed. Upon completion of the
  525  investigation, s. 462.017 applies.
  526         (4)(a) The department may not issue a license by
  527  endorsement to any individual who has committed an act or
  528  offense in any jurisdiction which would constitute the basis for
  529  disciplining a naturopathic physician under s. 462.017 until the
  530  board has reviewed the application and certified the applicant
  531  for licensure.
  532         (b) If the board finds that an applicant for licensure by
  533  endorsement has committed an act or offense in any jurisdiction
  534  which would constitute the basis for disciplining a naturopathic
  535  physician under s. 462.017, the board may enter an order
  536  imposing one or more of the sanctions set forth in that section
  537  and s. 456.072(2) as applicable to applicants for licensure,
  538  including refusing to certify an application for licensure or
  539  certifying an application for licensure with conditions.
  540         (5) If the board determines that an applicant for licensure
  541  has failed to meet, to the board’s satisfaction, any of the
  542  requirements of this section, it may enter an order imposing one
  543  or more of the following:
  544         (a) Refusal to certify to the department an application for
  545  licensure.
  546         (b) Certification to the department of an application for
  547  licensure with restrictions on the scope of practice of the
  548  naturopathic physician.
  549         (c) Certification to the department of an application for
  550  licensure with a probationary period for the applicant, subject
  551  to such conditions as the board specifies, including, but not
  552  limited to, requiring the naturopathic physician to submit to
  553  treatment, attend continuing education courses, submit to
  554  reexamination, or work under the supervision of another
  555  naturopathic physician.
  556         Section 10. Section 462.08, Florida Statutes, is renumbered
  557  as section 462.009, Florida Statutes, and amended to read:
  558         462.009 462.08 Renewal of license to practice naturopathic
  559  medicine naturopathy.—
  560         (1) In order to continue practicing naturopathic medicine
  561  in this state, each licensed naturopathic physician must
  562  licenseholder shall biennially renew her or his license to
  563  practice naturopathic medicine naturopathy. The applicant for
  564  license renewal must furnish to the board department such
  565  evidence as it requires of the applicant’s compliance with s.
  566  462.011 s. 462.18, relating to continuing education educational
  567  requirements, and s. 462.015, relating to financial
  568  responsibility requirements. The biennial renewal fee, the
  569  amount of which shall be determined by the department but which
  570  may not exceed $1,000, must be paid at the time the application
  571  for renewal of the license is filed.
  572         (2) The department shall adopt rules establishing
  573  procedures for the biennial renewal of licenses under this
  574  chapter.
  575         Section 11. Section 462.18, Florida Statutes, is renumbered
  576  as section 462.011, Florida Statutes, and amended to read:
  577         462.011 462.18 Continuing education Educational
  578  requirements.—
  579         (1) At the time each licensee renews shall renew her or his
  580  license as otherwise provided in s. 462.009 this chapter, each
  581  licensee must, in addition to the payment of the regular renewal
  582  fee, shall furnish to the board department satisfactory evidence
  583  that, in the preceding biennial period, the licensee has
  584  completed the continuing education requirements of this section.
  585         (2) The board shall require each naturopathic physician to
  586  receive at least 60 hours of continuing education during each
  587  biennial renewal period.
  588         (a) At least 10 hours of the 60 hours of continuing
  589  education must be in pharmacology, addressing the use of legend
  590  drugs that are consistent with the education and training of
  591  naturopathic physicians.
  592         (b) The board shall approve organizations that accredit
  593  naturopathic continuing education providers, including, but not
  594  limited to, the American Association of Naturopathic Physicians,
  595  the North American Naturopathic Continuing Education
  596  Accreditation Council, and the Oregon Association of
  597  Naturopathic Physicians.
  598         (c) The determination of whether substitute continuing
  599  education programs are permissible is solely within the
  600  discretion of the board.
  601         (3) The naturopathic physician must use the electronic
  602  continuing education tracking system developed by the department
  603  under s. 456.0361 to demonstrate compliance with the continuing
  604  education requirements of this section year preceding each such
  605  application for renewal, the licensee has attended the 2-day
  606  educational program as promulgated and conducted by the Florida
  607  Naturopathic Physicians Association, Inc., or, as a substitute
  608  therefor, the equivalent of that program as approved by the
  609  department. The department shall send a written notice to this
  610  effect to every person holding a valid license to practice
  611  naturopathy within this state at least 30 days prior to May 1 in
  612  each even-numbered year, directed to the last known address of
  613  such licensee, and shall enclose with the notice proper blank
  614  forms for application for annual license renewal. All of the
  615  details and requirements of the aforesaid educational program
  616  shall be adopted and prescribed by the department. In the event
  617  of national emergencies, or for sufficient reason, the
  618  department shall have the power to excuse the naturopathic
  619  physicians as a group or as individuals from taking this
  620  postgraduate course.
  621         (2) The determination of whether a substitute annual
  622  educational program is necessary shall be solely within the
  623  discretion of the department.
  624         Section 12. Section 462.19, Florida Statutes, is renumbered
  625  as section 462.012, Florida Statutes, and amended to read:
  626         462.012 462.19 Renewal of license; Inactive status;
  627  reactivation of license.—
  628         (1) A licensee may reactivate an inactive license by
  629  applying to the department and submitting proof of compliance
  630  with the financial responsibility requirements of s. 462.015.
  631         (2) The board shall adopt rules relating to reactivation of
  632  licenses that have become inactive and for the renewal of
  633  inactive licenses. The rules must include continuing education
  634  requirements as a condition of reactivating a license. The
  635  continuing education requirements for reactivating a license may
  636  not be fewer than 20 classroom hours for each year the license
  637  was inactive.
  638         (3) The department may not reactivate a license unless the
  639  financial responsibility requirements of s. 462.015 have been
  640  satisfied The department shall renew a license upon receipt of
  641  the renewal application and fee.
  642         (2) A licensee may request that her or his license be
  643  placed in an inactive status by making application to the
  644  department and paying a fee in an amount set by the department
  645  not to exceed $50.
  646         Section 13. Section 462.11, Florida Statutes, is renumbered
  647  as section 462.013, Florida Statutes, and amended to read:
  648         462.013 462.11 Obligations of naturopathic physicians
  649  Naturopaths to observe regulations.—Naturopathic physicians
  650  Doctors of naturopathy shall comply with observe and are be
  651  subject to all state, county, and municipal regulations relating
  652  in regard to the control of contagious and infectious diseases,
  653  the reporting of births and deaths, and to any and all other
  654  matters pertaining to the public health in the same manner as is
  655  required of other health care practitioners of the healing art.
  656         Section 14. Section 462.014, Florida Statutes, is created
  657  to read:
  658         462.014 Patient records; termination of practice.—The board
  659  shall adopt rules providing for the handling of medical records
  660  by licensed naturopathic physicians, including when a
  661  naturopathic physician sells or otherwise terminates a practice.
  662  The rules must provide for notification of the naturopathic
  663  physician’s patients and for an opportunity for the patients to
  664  request the transfer of their medical records to another
  665  physician or health care practitioner upon payment of actual
  666  costs for such transfer.
  667         Section 15. Section 462.015, Florida Statutes, is created
  668  to read:
  669         462.015 Financial responsibility.—
  670         (1) As a condition of licensure, a naturopathic physician
  671  must, by one of the following methods, demonstrate to the
  672  satisfaction of the board and the department that she or he has
  673  the ability to pay claims and ancillary costs arising from the
  674  rendering of, or the failure to render, medical care or
  675  services:
  676         (a) Establishing and maintaining an escrow account
  677  consisting of cash or assets eligible for deposit in accordance
  678  with s. 625.52 in the per-claim amounts specified in paragraph
  679  (b). Expenditures may not be made from the escrow amount for
  680  litigation costs or attorney fees for the defense of any medical
  681  malpractice claim.
  682         (b) Obtaining and maintaining professional liability
  683  coverage in an amount not less than $100,000 per claim, with a
  684  minimum annual aggregate of not less than $300,000, from an
  685  authorized insurer as defined under s. 624.09, from an eligible
  686  surplus lines insurer as defined under s. 626.914(2), from a
  687  risk retention group as defined under s. 627.942, from the Joint
  688  Underwriting Association operated under s. 627.351(4), or
  689  through self-insurance as provided in s. 627.357. Expenditures
  690  may not be made from the required coverage amount for litigation
  691  costs or attorney fees for the defense of any medical
  692  malpractice claim.
  693         (c) Obtaining and maintaining an unexpired, irrevocable
  694  letter of credit, issued pursuant to chapter 675, in an amount
  695  not less than $100,000 per claim, with a minimum aggregate
  696  availability of credit of not less than $300,000. The letter of
  697  credit must be payable to the naturopathic physician as
  698  beneficiary upon presentment of a final judgment indicating
  699  liability and awarding damages to be paid by the naturopathic
  700  physician or upon presentment of a settlement agreement signed
  701  by all parties to such agreement when such final judgment or
  702  settlement is a result of a claim arising out of the rendering
  703  of, or the failure to render, medical care or services. The
  704  letter of credit may not be used for litigation costs or
  705  attorney fees for the defense of any medical malpractice claim.
  706  The letter of credit must be nonassignable and nontransferable
  707  and be issued by a bank or savings association organized and
  708  existing under the laws of this state or a bank or savings
  709  association organized under the laws of the United States which
  710  has its principal place of business in this state or has a
  711  branch office that is authorized under the laws of this state or
  712  of the United States to receive deposits in this state.
  713         (2)(a) Meeting the financial responsibility requirements of
  714  this section or the criteria for any exemption from such
  715  requirements must be demonstrated at the time of issuance,
  716  renewal, or reactivation of a naturopathic physician license.
  717         (b) Any person may, at any time, submit to the department a
  718  request for an advisory opinion regarding such person’s
  719  qualifications for exemption.
  720         (3)(a) Each insurer, self-insurer, or risk retention group
  721  or the Joint Underwriting Association must promptly notify the
  722  department of a cancellation or nonrenewal of insurance required
  723  by this section. Unless the naturopathic physician demonstrates
  724  that she or he is otherwise in compliance with the requirements
  725  of this section, the department shall suspend the license of the
  726  naturopathic physician pursuant to ss. 120.569 and 120.57 and
  727  notify all health care facilities licensed under part IV of
  728  chapter 394 or chapter 395 or a health maintenance organization
  729  certified under part I of chapter 641 of such action. Any
  730  suspension imposed under this subsection remains in effect until
  731  the naturopathic physician demonstrates compliance with the
  732  requirements of this section. If any judgments or settlements
  733  are pending at the time of suspension, those judgments or
  734  settlements must be paid in accordance with this section unless
  735  otherwise mutually agreed to in writing by the parties. This
  736  paragraph does not abrogate a judgment debtor’s obligation to
  737  satisfy the entire amount of any judgment.
  738         (b) If the financial responsibility requirements are met by
  739  maintaining an escrow account or letter of credit as provided in
  740  this section, upon the entry of an adverse final judgment
  741  arising from a medical malpractice arbitration award, from a
  742  claim in contract or tort of medical malpractice, or from
  743  noncompliance with the terms of a settlement agreement arising
  744  from a claim in contract or tort of medical malpractice, the
  745  naturopathic physician must pay the entire amount of the
  746  judgment together with all accrued interest or the amount
  747  maintained in the escrow account or provided in the letter of
  748  credit as required by this section, whichever is less, within 60
  749  days after the date such judgment becomes final and subject to
  750  execution, unless otherwise mutually agreed to in writing by the
  751  parties. If timely payment is not made by the naturopathic
  752  physician, the department must suspend the license of the
  753  naturopathic physician pursuant to procedures set forth in
  754  subparagraphs (4)(f)3., 4., and 5. This paragraph does not
  755  abrogate a judgment debtor’s obligation to satisfy the entire
  756  amount of any judgment.
  757         (4) The requirements imposed in subsection (1) do not apply
  758  to:
  759         (a) Any person licensed under this chapter who practices
  760  naturopathic medicine exclusively as an officer, employee, or
  761  agent of the Federal Government or of the state or its agencies
  762  or subdivisions. For purposes of this subsection, an agent of
  763  the state, its agencies, or its subdivisions is a person who is
  764  eligible for coverage under any self-insurance or insurance
  765  program as provided in s. 768.28(16).
  766         (b) Any person whose license has become inactive under this
  767  chapter and who is not practicing naturopathic medicine in this
  768  state. Any person applying for reactivation of a naturopathic
  769  physician license must either:
  770         1. Demonstrate that she or he maintained tail insurance
  771  coverage that provided liability coverage for incidents that
  772  occurred on or after the initial date of licensure in this state
  773  and for incidents that occurred before the date on which the
  774  license became inactive; or
  775         2. Submit an affidavit stating that she or he has no
  776  unsatisfied medical malpractice judgments or settlements at the
  777  time of application for reactivation of the license.
  778         (c) Any person licensed under this chapter who practices
  779  only in conjunction with her or his teaching duties at a college
  780  of naturopathic medicine. Such person may engage in the practice
  781  of naturopathic medicine to the extent that such practice is
  782  incidental to and a necessary part of duties in connection with
  783  the teaching position in the college of naturopathic medicine.
  784         (d) Any person holding an active naturopathic physician
  785  license under this chapter who is not practicing naturopathic
  786  medicine in this state. If such person initiates or resumes any
  787  practice of naturopathic medicine in this state, she or he must
  788  notify the department of such activity and fulfill the financial
  789  responsibility requirements of this section before resuming the
  790  practice of naturopathic medicine in this state.
  791         (e) Any person holding an active naturopathic physician
  792  license under this chapter who meets all of the following
  793  criteria:
  794         1. Has held an active license to practice naturopathic
  795  medicine in this state or another state or some combination
  796  thereof for more than 15 years.
  797         2. Has either retired from the practice of naturopathic
  798  medicine or maintains a part-time practice of naturopathic
  799  medicine of no more than 1,000 patient contact hours per year.
  800         3. Has had no more than two claims for medical malpractice
  801  resulting in an indemnity exceeding $25,000 within the previous
  802  5-year period.
  803         4. Has not been convicted of, or pled guilty or nolo
  804  contendere to, any criminal violation specified in this chapter
  805  or the practice act of any other state.
  806         5. Has not been subject, within the last 10 years of
  807  practice, to license revocation or suspension for any period of
  808  time, probation for a period of 3 years or longer, or a fine of
  809  $500 or more for a violation of this chapter or the naturopathic
  810  medical practice act of another jurisdiction. A regulatory
  811  agency’s acceptance of a naturopathic physician’s relinquishment
  812  of her or his license or of a stipulation, consent order, or
  813  other settlement, offered in response to or in anticipation of
  814  the filing of administrative charges against her or his license,
  815  constitutes action against the naturopathic physician’s license
  816  for the purposes of this paragraph.
  817         6. Has submitted a form supplying necessary information as
  818  required by the department and an affidavit affirming compliance
  819  with this paragraph.
  820         7. Biennially submits to the department a certification
  821  stating compliance with this paragraph. The naturopathic
  822  physician must also demonstrate compliance with this paragraph
  823  at any time upon department request.
  824  
  825  A naturopathic physician who meets the requirements of this
  826  paragraph must provide notice to patients, either by prominently
  827  displaying a sign in the reception area of her or his practice
  828  in a manner clearly visible to patients or by providing a
  829  written statement to each patient to whom she or he provides
  830  naturopathic medical services. The sign or statement must read
  831  as follows: “Under Florida law, naturopathic physicians are
  832  generally required to carry medical malpractice insurance or
  833  otherwise demonstrate financial responsibility to cover
  834  potential claims for medical malpractice. However, certain part
  835  time naturopathic physicians who meet certain criteria are
  836  exempt from the financial responsibility requirements. YOUR
  837  NATUROPATHIC PHYSICIAN MEETS THE EXEMPTION CRITERIA AND HAS
  838  DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice
  839  is provided pursuant to Florida law.”
  840         (f) Any person holding an active naturopathic physician
  841  license under this chapter who agrees to all of the following
  842  conditions:
  843         1. Upon the entry of an adverse final judgment arising from
  844  a medical malpractice arbitration award, from a claim of medical
  845  malpractice either in contract or tort, or from noncompliance
  846  with the terms of a settlement agreement arising from a claim of
  847  medical malpractice either in contract or tort, the naturopathic
  848  physician agrees to pay the judgment creditor the lesser of the
  849  entire amount of the judgment with all accrued interest or
  850  either $100,000, if the naturopathic physician is licensed
  851  pursuant to this chapter but does not maintain hospital staff
  852  privileges, or $250,000, if the naturopathic physician is
  853  licensed pursuant to this chapter and maintains hospital staff
  854  privileges, within 60 days after the date such judgment becomes
  855  final and subject to execution, unless otherwise mutually agreed
  856  to in writing by the parties. Such adverse final judgment must
  857  include any cross-claim, counterclaim, or claim for indemnity or
  858  contribution arising from the claim of medical malpractice. Upon
  859  notification of the existence of an unsatisfied judgment or
  860  payment pursuant to this subparagraph, the department shall
  861  notify the naturopathic physician by certified mail that she or
  862  he is subject to disciplinary action unless, within 30 days
  863  after the date of mailing, the naturopathic physician either:
  864         a. Shows proof that the unsatisfied judgment has been paid
  865  in the amount specified in this subparagraph; or
  866         b. Furnishes the department with a copy of a timely filed
  867  notice of appeal and either:
  868         (I) A copy of a supersedeas bond properly posted in the
  869  amount required by law; or
  870         (II) An order from a court of competent jurisdiction
  871  staying execution on the final judgment, pending disposition of
  872  the appeal.
  873         2. The department shall issue an emergency order suspending
  874  the license of any naturopathic physician who, 31 days or more
  875  after receipt of a notice from the department, has failed to
  876  satisfy a medical malpractice claim against him or her; furnish
  877  the department a copy of a timely filed notice of appeal;
  878  furnish the department a copy of a supersedeas bond properly
  879  posted in the amount required by law; or furnish the department
  880  an order from a court of competent jurisdiction staying
  881  execution on the final judgment pending disposition of the
  882  appeal.
  883         3. Upon the next meeting of the probable cause panel of the
  884  board 31 days or more after the date of mailing the notice of
  885  disciplinary action to the naturopathic physician, the panel
  886  shall make a determination as to whether probable cause exists
  887  to take disciplinary action against the naturopathic physician
  888  for a violation of subparagraph 1.
  889         4. If the board determines that the factual requirements of
  890  subparagraph 1. are met, it must take disciplinary action as it
  891  deems appropriate against the naturopathic physician. Such
  892  disciplinary action must include, at a minimum, probation of the
  893  license with the restriction that the naturopathic physician
  894  must make payments to the judgment creditor on a schedule
  895  determined by the board to be reasonable and within the
  896  financial capability of the naturopathic physician.
  897  Notwithstanding any other disciplinary penalty imposed, the
  898  disciplinary penalty may include suspension of the license for a
  899  period not to exceed 5 years. In the event that an agreement to
  900  satisfy a judgment has been met, the board must remove any
  901  restriction on the license.
  902         5. The naturopathic physician must complete a form
  903  supplying necessary information as required by department rule.
  904  
  905  A naturopathic physician who agrees to the conditions of this
  906  paragraph must provide notice to patients, either by prominently
  907  displaying a sign in the reception area of her or his practice
  908  in a manner clearly visible to patients or by providing a
  909  written statement to each patient to whom she or he provides
  910  naturopathic medical services. The sign or statement must read
  911  as follows: “Under Florida law, naturopathic physicians are
  912  generally required to carry medical malpractice insurance or
  913  otherwise demonstrate financial responsibility to cover
  914  potential claims for medical malpractice. However, certain part
  915  time naturopathic physicians who meet certain criteria are
  916  exempt from the financial responsibility requirements. YOUR
  917  NATUROPATHIC PHYSICIAN MEETS THE EXEMPTION CRITERIA AND HAS
  918  DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice
  919  is provided pursuant to Florida law.”
  920         (5) A naturopathic physician who makes any deceptive,
  921  untrue, or fraudulent representation with respect to any
  922  provision of this section is permanently disqualified from any
  923  exemption from financial responsibility requirements under this
  924  section and is subject to disciplinary action under s. 462.017
  925  for such conduct.
  926         (6) Any naturopathic physician who relies on an exemption
  927  from the financial responsibility requirements must notify the
  928  department in writing of any change of circumstance regarding
  929  her or his qualifications for such exemption and must
  930  demonstrate that she or he is in compliance with the
  931  requirements of this section.
  932         (7) Notwithstanding any other provision of this section,
  933  the department shall suspend the license of any naturopathic
  934  physician against whom a final judgment, arbitration award, or
  935  other order has been entered or who has entered into a
  936  settlement agreement to pay damages arising out of a claim for
  937  medical malpractice if all appellate remedies have been
  938  exhausted and payment up to the amounts required by this section
  939  has not been made within 30 days after the entering of such
  940  judgment, award, or order or agreement. A suspension under this
  941  subsection remains in effect until proof of payment is received
  942  by the department or a payment schedule has been agreed upon by
  943  the naturopathic physician and the claimant and presented to the
  944  department. This subsection does not apply to a naturopathic
  945  physician who has met the financial responsibility requirements
  946  under paragraph (1)(b).
  947         (8) The board shall adopt rules to implement this section.
  948         Section 16. Section 462.13, Florida Statutes, is renumbered
  949  as section 462.016, Florida Statutes, and amended to read:
  950         462.016 462.13 Additional powers and duties of the board
  951  and the department.—The board and the department may administer
  952  oaths, summon witnesses, and take testimony in all matters
  953  relating to their respective its duties under pursuant to this
  954  chapter. Evidence of an active, Every unrevoked license must
  955  shall be presumed by presumptive evidence in all courts and
  956  places to be evidence that the person therein named is legally
  957  licensed to practice naturopathic medicine in this state
  958  naturopathy. The board and the department shall aid the
  959  prosecuting attorneys of the state in the enforcement of this
  960  chapter.
  961         Section 17. Section 462.14, Florida Statutes, is renumbered
  962  as section 462.017, Florida Statutes, and amended to read:
  963         462.017 462.14 Grounds for disciplinary action; action by
  964  the board and department.—
  965         (1) The following acts constitute grounds for denial of a
  966  license or disciplinary action, as specified in s. 456.072(2):
  967         (a) Attempting to obtain, obtaining, or renewing a license
  968  to practice naturopathic medicine by bribery, by fraudulent
  969  misrepresentation, or through an error of the board or the
  970  department.
  971         (b) Having a license to practice naturopathic medicine
  972  revoked, suspended, or otherwise acted against, including the
  973  denial of licensure, by the licensing authority of another
  974  state, territory, or country. The licensing authority’s
  975  acceptance of a naturopathic physician’s relinquishment of her
  976  or his license or of a stipulation, a consent order, or other
  977  settlement offered in response to or in anticipation of the
  978  filing of administrative charges against her or his license
  979  shall be construed as action against the naturopathic
  980  physician’s license.
  981         (c) Being convicted or found guilty, regardless of
  982  adjudication, of a crime in any jurisdiction which directly
  983  relates to the practice of naturopathic medicine or to the
  984  ability to practice naturopathic medicine. Any plea of nolo
  985  contendere creates a rebuttable presumption of guilt to the
  986  underlying criminal charges shall be considered a conviction for
  987  purposes of this chapter.
  988         (d) False, deceptive, or misleading advertising.
  989         (e) Advertising, practicing, or attempting to practice
  990  under a name other than one’s own.
  991         (f) Failing to report to the department or the department’s
  992  impaired practitioner program consultant, as applicable, any
  993  person whom who the licensee knows is in violation of this
  994  chapter or of the rules of the board or department. However, a
  995  person whom who the licensee knows is unable to practice
  996  naturopathic medicine with reasonable skill and safety to
  997  patients by reason of illness or use of alcohol, drugs,
  998  narcotics, chemicals, or any other type of material, or as a
  999  result of a mental or physical condition, may be reported to a
 1000  consultant operating an impaired practitioner program as
 1001  described in s. 456.076 rather than to the department.
 1002         (f)(g) Aiding, assisting, procuring, or advising any
 1003  unlicensed person to practice naturopathic medicine contrary to
 1004  this chapter or to a rule of the board or department.
 1005         (g)(h) Failing to perform any statutory or legal obligation
 1006  placed upon a licensed naturopathic physician.
 1007         (h) Giving false testimony in the course of any legal or
 1008  administrative proceedings relating to the practice of
 1009  naturopathic medicine or the delivery of health care services.
 1010         (i) Making or filing a report which the licensee knows to
 1011  be false, intentionally or negligently failing to file a report
 1012  or record required by state or federal law, willfully impeding
 1013  or obstructing such filing or inducing another person to do so.
 1014  Such reports or records must shall include only those which are
 1015  signed in the capacity as a licensed naturopathic physician.
 1016         (j) Paying or receiving any commission, bonus, kickback, or
 1017  rebate, or engaging in any split-fee arrangement in any form
 1018  whatsoever with a physician, an organization, an agency, a or
 1019  person, a partnership, a firm, a corporation, or other business
 1020  entity, either directly or indirectly, for patients referred to
 1021  providers of health care goods and services, including, but not
 1022  limited to, hospitals, nursing homes, clinical laboratories,
 1023  ambulatory surgical centers, or pharmacies. The provisions of
 1024  This paragraph may shall not be construed to prevent a
 1025  naturopathic physician from receiving a fee for professional
 1026  consultation services.
 1027         (k) Refusing to provide health care based on a patient’s
 1028  participation in pending or past litigation or participation in
 1029  any disciplinary action conducted pursuant to this chapter,
 1030  unless such litigation or disciplinary action directly involves
 1031  the naturopathic physician requested to provide services.
 1032         (l) Exercising influence within a patient-physician
 1033  relationship for purposes of engaging a patient in sexual
 1034  activity. A patient is shall be presumed to be incapable of
 1035  giving free, full, and informed consent to sexual activity with
 1036  her or his naturopathic physician.
 1037         (m)(l) Making deceptive, untrue, or fraudulent
 1038  representations in or related to the practice of naturopathic
 1039  medicine or employing a trick or scheme in the practice of
 1040  naturopathic medicine when such scheme or trick fails to conform
 1041  to the generally prevailing standards of treatment in the
 1042  medical community.
 1043         (n)(m) Soliciting patients, either personally or through an
 1044  agent, through the use of fraud, intimidation, undue influence,
 1045  or a form of overreaching or vexatious conduct. A “solicitation”
 1046  is any communication which directly or implicitly requests an
 1047  immediate oral response from the recipient.
 1048         (o)(n) Failing to keep legible, written medical records, as
 1049  defined by department rule in consultation with the board, which
 1050  identify by name and professional title the licensed
 1051  naturopathic physician or the supervising naturopathic physician
 1052  who is responsible for rendering, ordering, supervising, or
 1053  billing for each diagnostic or treatment procedure and which
 1054  justify justifying the course of treatment of the patient,
 1055  including, but not limited to, patient histories, examination
 1056  results, test results, X rays, and records of medicine
 1057  prescribed, dispensed, or administered, and reports of
 1058  consultations and hospitalizations the prescribing, dispensing
 1059  and administering of drugs.
 1060         (p) Fraudulently altering or destroying records relating to
 1061  patient care or treatment, including, but not limited to,
 1062  patient histories, examination results, test results, X rays,
 1063  records of medicine prescribed, dispensed, or administered, and
 1064  reports of consultations and hospitalizations.
 1065         (q)(o) Exercising influence on the patient or client in
 1066  such a manner as to exploit the patient or client for the
 1067  financial gain of the licensee or of a third party, which
 1068  includes shall include, but is not be limited to, the promoting
 1069  or selling of services, goods, appliances, or medicines. drugs
 1070  and the
 1071         (r) Promoting or advertising on any prescription form of a
 1072  community pharmacy unless the form also states “This
 1073  prescription may be filled at any pharmacy of your choice.”
 1074         (s)(p) Performing professional services that which have not
 1075  been duly authorized by the patient or client, or her or his
 1076  legal representative, except as provided in s. 743.064, s.
 1077  766.103, or s. 768.13.
 1078         (t)(q) Except as authorized by the Naturopathic Medical
 1079  Formulary established under s. 462.025, prescribing, dispensing,
 1080  administering, supplying, selling, giving, mixing, or otherwise
 1081  preparing a legend drug, including any controlled substance,
 1082  other than in the course of the naturopathic physician’s
 1083  professional practice. For the purposes of this paragraph, it is
 1084  shall be legally presumed that prescribing, dispensing,
 1085  administering, supplying, selling, giving, mixing, or otherwise
 1086  preparing legend drugs, including all controlled substances,
 1087  inappropriately or in excessive or inappropriate quantities is
 1088  not in the best interest of the patient and is not in the scope
 1089  course of the naturopathic physician’s professional practice,
 1090  regardless of without regard to her or his intent.
 1091         (u)(r) Prescribing or, dispensing, or administering any
 1092  legend medicinal drug appearing on any schedule set forth in
 1093  chapter 893 by the naturopathic physician to herself or himself
 1094  or administering any such drug to herself or himself unless such
 1095  drug is, except one prescribed for, dispensed, or administered
 1096  to the naturopathic physician by another practitioner authorized
 1097  to prescribe legend, dispense, or administer medicinal drugs.
 1098         (v)(s) Being unable to practice naturopathic medicine with
 1099  reasonable skill and safety to patients by reason of illness or
 1100  use of alcohol, drugs, narcotics, chemicals, or any other type
 1101  of material or as a result of any mental or physical condition.
 1102  In enforcing this paragraph, the department shall have, upon a
 1103  showing of probable cause, has the authority to issue an order
 1104  to compel a naturopathic physician to submit to a mental or
 1105  physical examination by naturopathic physicians designated by
 1106  the department. If the failure of a naturopathic physician
 1107  refuses to comply with such order, the department’s order
 1108  directing submit to such an examination may be enforced by
 1109  filing a petition for enforcement in the circuit court where the
 1110  naturopathic physician resides or does business. The
 1111  naturopathic physician against whom the petition is filed may
 1112  not be named or identified by initials in any public court
 1113  records or documents, and the proceedings must be closed to the
 1114  public. The department is entitled to the summary procedure
 1115  provided in s. 51.011 when so directed shall constitute an
 1116  admission of the allegations against her or him upon which a
 1117  default and final order may be entered without the taking of
 1118  testimony or presentation of evidence, unless the failure was
 1119  due to circumstances beyond the naturopathic physician’s
 1120  control. A naturopathic physician subject to an order issued
 1121  affected under this paragraph must, shall at reasonable
 1122  intervals, be afforded an opportunity to demonstrate that she or
 1123  he can resume the competent practice of naturopathic medicine
 1124  with reasonable skill and safety to patients. In any proceeding
 1125  under this paragraph, neither the record of proceedings nor the
 1126  orders entered by the department may be used against a
 1127  naturopathic physician in any other proceeding.
 1128         (w) Notwithstanding s. 456.072(2) but as specified in s.
 1129  456.50(2):
 1130         1. Committing medical malpractice as defined in s. 456.50.
 1131  The board shall give great weight to s. 766.102 when enforcing
 1132  this paragraph. Medical malpractice may not be construed to
 1133  require more than one instance, event, or act.
 1134         2. Committing gross medical malpractice.
 1135         3. Committing repeated medical malpractice as defined in s.
 1136  456.50. A person found by the board to have committed such
 1137  repeated malpractice may not be licensed or continue to be
 1138  licensed to provide health care services as a naturopathic
 1139  physician in this state.
 1140  
 1141  This paragraph may not be construed to require that a
 1142  naturopathic physician be deemed incompetent to practice
 1143  naturopathic medicine in order to be disciplined pursuant to
 1144  this paragraph. A recommended order by an administrative law
 1145  judge or a final order of the board finding a violation under
 1146  this paragraph must specify whether the naturopathic physician
 1147  was found to have committed gross medical malpractice, repeated
 1148  medical malpractice, or medical malpractice, or any combination
 1149  thereof, and any publication by the board must include the
 1150  specified finding.
 1151         (t) Gross or repeated malpractice or the failure to
 1152  practice naturopathic medicine with that level of care, skill,
 1153  and treatment which is recognized by a reasonably prudent
 1154  similar physician as being acceptable under similar conditions
 1155  and circumstances. The department shall give great weight to the
 1156  provisions of s. 766.102 when enforcing this paragraph.
 1157         (x)(u) Performing any procedure or prescribing any therapy
 1158  that which, by the prevailing standards of medical practice in
 1159  the naturopathic medical community, constitutes experimentation
 1160  on a human subject, without first obtaining full, informed, and
 1161  written consent.
 1162         (y)(v) Practicing or offering to practice beyond the scope
 1163  permitted by law or accepting and performing professional
 1164  responsibilities that which the licensee knows or has reason to
 1165  know that she or he is not competent to perform. The board may
 1166  establish by rule standards of practice and standards of care
 1167  for particular practice areas, including, but not limited to,
 1168  education and training, equipment and supplies, medications as
 1169  specified by the Naturopathic Medical Formulary under s.
 1170  462.025, assistance from and delegation to other personnel,
 1171  transfer agreements, sterilization, records, performance of
 1172  complex or multiple procedures, informed consent, and policy and
 1173  procedure manuals.
 1174         (z)(w) Delegating professional responsibilities to a person
 1175  when the licensee delegating such responsibilities knows or has
 1176  reason to know that such person is not qualified by training,
 1177  experience, or licensure to perform them.
 1178         (aa)(x) Violating a lawful order of the board or the
 1179  department previously entered in a disciplinary hearing or
 1180  failing to comply with a lawfully issued subpoena of the board
 1181  or department.
 1182         (bb)(y) Conspiring with another licensee or with any other
 1183  person to commit an act, or committing an act, which would tend
 1184  to coerce, intimidate, or preclude another licensee from
 1185  lawfully advertising her or his services.
 1186         (cc)(z) Procuring, or aiding or abetting in the procuring
 1187  of, an unlawful termination of pregnancy.
 1188         (dd)(aa) Presigning blank prescription forms.
 1189         (ee) Failing to adequately supervise the activities of any
 1190  persons acting under the supervision of the naturopathic
 1191  physician.
 1192         (bb) Prescribing by the naturopathic physician for office
 1193  use any medicinal drug appearing on Schedule II in chapter 893.
 1194         (cc) Prescribing, ordering, dispensing, administering,
 1195  supplying, selling, or giving any drug which is an amphetamine
 1196  or sympathomimetic amine drug, or a compound designated pursuant
 1197  to chapter 893 as a Schedule II controlled substance to or for
 1198  any person except for:
 1199         1. The treatment of narcolepsy; hyperkinesis; behavioral
 1200  syndrome in children characterized by the developmentally
 1201  inappropriate symptoms of moderate to severe distractability,
 1202  short attention span, hyperactivity, emotional lability, and
 1203  impulsivity; or drug-induced brain dysfunction.
 1204         2. The differential diagnostic psychiatric evaluation of
 1205  depression or the treatment of depression shown to be refractory
 1206  to other therapeutic modalities.
 1207         3. The clinical investigation of the effects of such drugs
 1208  or compounds when an investigative protocol therefor is
 1209  submitted to, reviewed, and approved by the department before
 1210  such investigation is begun.
 1211         (ff)(dd) Prescribing, ordering, dispensing, administering,
 1212  supplying, selling, or giving growth hormones, testosterone or
 1213  its analogs, human chorionic gonadotropin (HCG), or other
 1214  hormones for the purpose of muscle building or to enhance
 1215  athletic performance. For the purposes of this subsection, the
 1216  term “muscle building” does not include the treatment of injured
 1217  muscle. A prescription written for the drug products identified
 1218  in this paragraph listed above may be dispensed by the
 1219  pharmacist with the presumption that the prescription is for
 1220  legitimate medical use.
 1221         (gg) Misrepresenting or concealing a material fact at any
 1222  time during any phase of a licensing or disciplinary process or
 1223  procedure.
 1224         (hh) Interfering with an investigation or with any
 1225  disciplinary proceeding.
 1226         (ii) Failing to report to the department any person
 1227  licensed under chapter 458, chapter 459, or this chapter whom
 1228  the naturopathic physician knows has violated the grounds for
 1229  disciplinary action set out in the law under which that person
 1230  is licensed and who provides health care services in a facility
 1231  licensed under chapter 395, or a health maintenance organization
 1232  certificated under part I of chapter 641, in which the
 1233  naturopathic physician also provides services.
 1234         (jj) Being found by any court in this state to have
 1235  provided, without reasonable investigation, corroborating
 1236  written medical expert opinion attached to any statutorily
 1237  required notice of claim or intent or to any statutorily
 1238  required response rejecting a claim.
 1239         (kk) Except as provided in s. 462.018, advertising or
 1240  holding oneself out as a board-certified specialist in violation
 1241  of this chapter.
 1242         (ll) Failing to comply with the requirements of ss. 381.026
 1243  and 381.0261 to provide patients with information about their
 1244  patient rights and how to file a patient complaint.
 1245         (mm)(ee) Violating any provision of this chapter or chapter
 1246  456, or any rules adopted pursuant thereto.
 1247         (nn) Providing deceptive or fraudulent expert witness
 1248  testimony related to the practice of naturopathic medicine.
 1249         (oo) Promoting or advertising through any communication
 1250  medium the use, sale, or dispensing of any controlled substance
 1251  appearing on any schedule in chapter 893 which is not within the
 1252  scope of the Naturopathic Medical Formulary established under s.
 1253  462.025.
 1254         (pp) Willfully failing to comply with s. 627.64194 or s.
 1255  641.513 with such frequency as to indicate a general business
 1256  practice.
 1257         (2) The board department may enter an order denying
 1258  licensure or imposing any of the penalties in s. 456.072(2)
 1259  against any applicant for licensure or licensee who commits a
 1260  violation of is found guilty of violating any provision of
 1261  subsection (1) of this section or who is found guilty of
 1262  violating any provision of s. 456.072(1). In determining what
 1263  action is appropriate, the board must first consider which
 1264  sanctions are necessary to protect the public or to compensate
 1265  the patient. Only after those sanctions have been imposed may
 1266  the board consider and include in the order other requirements
 1267  designed to rehabilitate the naturopathic physician. All costs
 1268  associated with compliance with orders issued under this
 1269  subsection are the obligation of the naturopathic physician.
 1270         (3) In any administrative action against a naturopathic
 1271  physician which does not involve a revocation or suspension of
 1272  license, the division has the burden, by the greater weight of
 1273  the evidence, to establish the existence of grounds for
 1274  disciplinary action. The division shall establish grounds for
 1275  revocation or suspension of license by clear and convincing
 1276  evidence.
 1277         (4) The board may department shall not reinstate the
 1278  license of a naturopathic physician or cause a license to be
 1279  issued to a person it has deemed unqualified until such time as
 1280  it the department is satisfied that such person has complied
 1281  with all the terms and conditions set forth in the final order
 1282  and that such person is capable of safely engaging in the
 1283  practice of naturopathic medicine. However, the board may not
 1284  issue a license to, or reinstate the license of, any person
 1285  found by the board to have committed repeated medical
 1286  malpractice as defined in s. 456.50, regardless of the extent to
 1287  which the licensed naturopathic physician or prospective
 1288  licensed naturopathic physician has complied with all terms and
 1289  conditions set forth in the final order or whether she or he is
 1290  capable of safely engaging in the practice of naturopathic
 1291  medicine.
 1292         (5)(4) The board department shall establish by rule
 1293  establish guidelines for the disposition of disciplinary cases
 1294  involving specific types of violations. Such guidelines must
 1295  establish offenses and circumstances for which revocation will
 1296  be presumed to be appropriate, as well as offenses and
 1297  circumstances for which suspension for particular periods of
 1298  time will be presumed to be appropriate. The guidelines must
 1299  also may include minimum and maximum fines, periods of
 1300  supervision or probation, or conditions of probation, and
 1301  conditions for or reissuance of a license with respect to
 1302  particular circumstances and offenses. Gross medical
 1303  malpractice, repeated medical malpractice, and medical
 1304  malpractice, respectively, as specified in paragraph (1)(w),
 1305  must each be considered a distinct violation requiring specific
 1306  individual guidelines.
 1307         (6) Upon the department’s receipt of a closed claim against
 1308  a naturopathic physician submitted by an insurer or self-insurer
 1309  pursuant to s. 627.912 or information reported to the Office of
 1310  Insurance Regulation by a health care practitioner pursuant to
 1311  s. 456.049, or receipt from a claimant of presuit notice against
 1312  a naturopathic physician under s. 766.106, the department shall
 1313  review such information and determine whether it potentially
 1314  involves conduct by a licensed naturopathic physician which is
 1315  subject to disciplinary action, in which case s. 456.073
 1316  applies. However, if the department receives information that a
 1317  naturopathic physician has had three or more claims filed
 1318  against her or him, each with indemnities exceeding $50,000,
 1319  within the previous 5-year period, the department must
 1320  investigate the occurrences upon which the claims were based and
 1321  determine if action by the department against the naturopathic
 1322  physician is warranted.
 1323         (7) Upon the department’s receipt of a report from the
 1324  Agency for Health Care Administration pursuant to s. 395.0197
 1325  related to a naturopathic physician whose conduct may constitute
 1326  grounds for disciplinary action, the department shall
 1327  investigate the occurrences upon which the report was based and
 1328  determine if action by the department against the naturopathic
 1329  physician is warranted.
 1330         (8) If any naturopathic physician commits such
 1331  unprofessional conduct or negligence or demonstrates mental or
 1332  physical incapacity or impairment such that the department
 1333  determines that she or he is unable to practice with reasonable
 1334  skill and safety and presents a danger to patients, the
 1335  department may bring an action in circuit court enjoining such
 1336  naturopathic physician from providing medical services to the
 1337  public until the naturopathic physician demonstrates the ability
 1338  to practice with reasonable skill and safety and without danger
 1339  to patients.
 1340         (9)(a) If an investigation of a naturopathic physician is
 1341  undertaken, the department must promptly furnish to the
 1342  naturopathic physician or her or his attorney a copy of the
 1343  complaint or document that prompted initiation of the
 1344  investigation. For purposes of this subsection, such documents
 1345  include, but are not limited to:
 1346         1. The pertinent portions of an annual report submitted by
 1347  a licensed facility to the Agency for Health Care Administration
 1348  pursuant to s. 395.0197(6).
 1349         2. A report of an adverse incident which is provided by a
 1350  licensed facility to the department pursuant to s. 395.0197.
 1351         3. A report of peer review disciplinary action submitted to
 1352  the department pursuant to s. 395.0193(4), provided that the
 1353  investigations, proceedings, and records relating to such peer
 1354  review disciplinary action continue to retain their privileged
 1355  status even as to the naturopathic physician who is the subject
 1356  of the investigation, as provided by s. 395.0193(8).
 1357         4. A closed claim report submitted pursuant to s. 627.912.
 1358         5. A presuit notice submitted pursuant to s. 766.106(2).
 1359         6. A petition brought under the Florida Birth-Related
 1360  Neurological Injury Compensation Plan pursuant to s. 766.305(2).
 1361         (b) A naturopathic physician may submit to the department a
 1362  written response to the information contained in the complaint
 1363  or document that prompted the initiation of the investigation
 1364  within 45 days after she or he receives service of such
 1365  complaint or document. The naturopathic physician’s written
 1366  response must be considered by the probable cause panel, if held
 1367  on the matter.
 1368         Section 18. Section 462.018, Florida Statutes, is created
 1369  to read:
 1370         462.018 Specialties.—A naturopathic physician licensed
 1371  under this chapter may not hold himself or herself out as a
 1372  board-certified specialist unless the naturopathic physician has
 1373  successfully completed the requirements for certification as set
 1374  forth by the board regulating such specialty. A naturopathic
 1375  physician may indicate the services offered and may state that
 1376  her or his practice is limited to one or more types of services
 1377  if it accurately reflects the scope of practice of the
 1378  naturopathic physician.
 1379         Section 19. Section 462.17, Florida Statutes, is renumbered
 1380  as section 462.019, Florida Statutes, and amended to read:
 1381         462.019 462.17 Penalty for offenses relating to
 1382  naturopathy.—Any person who shall:
 1383         (1) Each of the following acts constitutes a felony of the
 1384  third degree, punishable as provided in s. 775.082, s. 775.083,
 1385  or s. 775.084:
 1386         (a) Practicing, or attempting to practice, naturopathic
 1387  medicine without an active license issued under this chapter.
 1388         (b) A licensed naturopathic physician practicing beyond the
 1389  scope of practice authorized under this chapter.
 1390         (c) Obtaining, or attempting to obtain, a license to
 1391  practice naturopathic medicine by a knowing misrepresentation.
 1392         (d) Obtaining, or attempting to obtain, a position as a
 1393  naturopathic physician or naturopathic medical resident in a
 1394  clinic or hospital by knowingly misrepresenting education,
 1395  training, or experience.
 1396         (e) Dispensing a controlled substance listed in Schedule II
 1397  or Schedule III of s. 893.03 in violation of s. 465.0276.
 1398         (2) Each of the following acts constitutes a misdemeanor of
 1399  the first degree, punishable as provided in s. 775.082 or s.
 1400  775.083:
 1401         (a) Knowingly concealing information relating to violations
 1402  of this chapter.
 1403         (b) Making a false oath or affirmation when an oath or
 1404  affirmation is required by this chapter.
 1405         (3) Each of the following constitutes a misdemeanor of the
 1406  second degree, punishable as provided in s. 775.082 or s.
 1407  775.083:
 1408         (a) Fraudulently altering, defacing, or falsifying any
 1409  records relating to patient care or treatment, including, but
 1410  not limited to, patient histories, examination results, and test
 1411  results.
 1412         (b) Referring any patient for health care goods or services
 1413  to any partnership, firm, corporation, or other business entity
 1414  in which the naturopathic physician or the naturopathic
 1415  physician’s employer has an equity interest of 10 percent or
 1416  more, unless, before such referral, the naturopathic physician
 1417  notifies the patient of her or his financial interest and of the
 1418  patient’s right to obtain such goods or services at the location
 1419  of the patient’s choice. This section does not apply to the
 1420  following types of equity interest:
 1421         1. The ownership of registered securities issued by a
 1422  publicly held corporation or the ownership of securities issued
 1423  by a publicly held corporation, the shares of which are traded
 1424  on a national exchange or the over-the-counter market.
 1425         2. A naturopathic physician’s own practice, whether the
 1426  naturopathic physician is a sole practitioner or part of a
 1427  group, when the health care good or service is prescribed or
 1428  provided solely for the naturopathic physician’s own patients
 1429  and is provided or performed by the naturopathic physician or
 1430  under the naturopathic physician’s supervision.
 1431         3. An interest in real property resulting in a landlord
 1432  tenant relationship between the naturopathic physician and the
 1433  entity in which the equity interest is held, unless the rent is
 1434  determined, in whole or in part, by the business volume or
 1435  profitability of the tenant or is otherwise unrelated to fair
 1436  market value.
 1437         (c) Paying or receiving any commission, bonus, kickback, or
 1438  rebate or engaging in any split-fee arrangement in any form with
 1439  a physician, an organization, an agency, a person, a
 1440  partnership, a firm, a corporation, or other business entity for
 1441  patients referred to providers of health care goods and
 1442  services, including, but not limited to, hospitals, nursing
 1443  homes, clinical laboratories, ambulatory surgical centers, or
 1444  pharmacies. This paragraph may not be construed to prevent a
 1445  naturopathic physician from receiving a fee for professional
 1446  consultation services Sell, fraudulently obtain, or furnish any
 1447  naturopathic diploma, license, record, or registration or aid or
 1448  abet in the same;
 1449         (2) Practice naturopathy under the cover of any diploma,
 1450  license, record, or registration illegally or fraudulently
 1451  obtained or secured or issued unlawfully or upon fraudulent
 1452  representations;
 1453         (3) Advertise to practice naturopathy under a name other
 1454  than her or his own or under an assumed name;
 1455         (4) Falsely impersonate another practitioner of a like or
 1456  different name;
 1457         (5) Practice or advertise to practice naturopathy or use in
 1458  connection with her or his name any designation tending to imply
 1459  or to designate the person as a practitioner of naturopathy
 1460  without then being lawfully licensed and authorized to practice
 1461  naturopathy in this state; or
 1462         (6) Practice naturopathy during the time her or his license
 1463  is suspended or revoked
 1464  
 1465  shall be guilty of a felony of the third degree, punishable as
 1466  provided in s. 775.082, s. 775.083, or s. 775.084.
 1467         Section 20. Section 462.024, Florida Statutes, is created
 1468  to read:
 1469         462.024 Disclosure of medications by patients.—
 1470         (1) A patient who takes prescribed legend drugs consistent
 1471  with the Naturopathic Medical Formulary established under s.
 1472  462.025 or nutrients or other natural medicinal substances upon
 1473  the recommendation of her or his treating naturopathic physician
 1474  is responsible for advising any other treating health care
 1475  practitioner of her or his use of such legend drugs, nutrients,
 1476  or other natural medicinal substances.
 1477         (2) Naturopathic physicians shall advise their patients of
 1478  this requirement in writing, maintain a signed copy of a
 1479  patient’s disclosure in the patient’s medical records, and
 1480  provide a copy of the disclosure to their patients, upon
 1481  request.
 1482         (3) A patient’s failure to disclose her or his use of
 1483  prescribed legend drugs or recommended nutrients or other
 1484  natural medicinal substances to any other treating health care
 1485  practitioner creates a rebuttable presumption that any
 1486  subsequent related injuries sustained by the patient were caused
 1487  by the patient’s failure to disclose such information. This
 1488  presumption may be rebutted by clear and convincing evidence
 1489  that the patient’s injuries were caused by the negligence of the
 1490  other treating health care practitioner.
 1491         (4) This section may not be construed to preclude a patient
 1492  of a naturopathic physician from consulting with a medical
 1493  physician, an osteopathic physician, or other health care
 1494  practitioner.
 1495         (5) A naturopathic physician is not required to confirm a
 1496  patient’s consultation with, or disclosure to, any other health
 1497  care practitioner.
 1498         Section 21. Section 462.025, Florida Statutes, is created
 1499  to read:
 1500         462.025 Naturopathic Medical Formulary Council;
 1501  establishment of formulary.—
 1502         (1) The Naturopathic Medical Formulary Council is
 1503  established, separate and distinct from the board, to be
 1504  composed of five members.
 1505         (a) Two members must be naturopathic physicians licensed
 1506  under this chapter, appointed by the board.
 1507         (b) Three members must be pharmacists licensed under
 1508  chapter 465, appointed by the board from a list of nominees
 1509  provided by the Board of Pharmacy.
 1510         (c) Each member shall be appointed for a 3-year term;
 1511  however, for the purpose of providing staggered terms, the
 1512  initial appointments to the council shall be as follows: one
 1513  naturopathic physician appointed for a 1-year term, one
 1514  pharmacist appointed for a 2-year term, and two pharmacists and
 1515  one naturopathic physician, each appointed for a 3-year term.
 1516         (d) A quorum consists of three members and is required for
 1517  any vote to be taken.
 1518         (2)(a) The council shall establish the Naturopathic Medical
 1519  Formulary of legend drugs that a licensed naturopathic physician
 1520  may prescribe in the practice of naturopathic medicine. The
 1521  formulary may not include drugs:
 1522         1. That are inconsistent with the education and training
 1523  provided by approved colleges and programs of naturopathic
 1524  medicine or board-approved continuing education courses for
 1525  naturopathic physicians; or
 1526         2. The prescription of which requires education and
 1527  training beyond that of a naturopathic physician.
 1528         (b) The council shall submit the formulary to the board
 1529  immediately upon adoption of, and any revision to, the
 1530  formulary. The board shall adopt the formulary, and any revision
 1531  thereto, by rule.
 1532         (c) The council shall review the formulary at least
 1533  annually and at any time upon board request.
 1534         (d) A naturopathic physician may prescribe, administer, or
 1535  dispense only those drugs included in the formulary adopted by
 1536  the board. This section may not be construed to authorize a
 1537  naturopathic physician to prescribe, administer, or dispense any
 1538  controlled substance under s. 893.03 unless such substance is
 1539  specifically included in the formulary.
 1540         Section 22. Section 462.026, Florida Statutes, is created
 1541  to read:
 1542         462.026 Severability.—The provisions of this chapter are
 1543  severable. If any provision of this chapter or its application
 1544  is held invalid or unconstitutional by any court of competent
 1545  jurisdiction, that invalidity or unconstitutionality does not
 1546  affect other provisions or applications of this chapter which
 1547  can be given effect without the invalid or unconstitutional
 1548  provision or application.
 1549         Section 23. Section 462.09, Florida Statutes, is renumbered
 1550  as section 462.027, Florida Statutes.
 1551         Section 24. Section 462.16, Florida Statutes, is repealed.
 1552         Section 25. Section 462.2001, Florida Statutes, is
 1553  repealed.
 1554         Section 26. Paragraph (g) of subsection (3) of section
 1555  921.0022, Florida Statutes, is amended to read:
 1556         921.0022 Criminal Punishment Code; offense severity ranking
 1557  chart.—
 1558         (3) OFFENSE SEVERITY RANKING CHART
 1559         (g) LEVEL 7
 1560  
 1561  FloridaStatute           FelonyDegree         Description         
 1562  316.027(2)(c)                 1st     Accident involving death, failure to stop; leaving scene.
 1563  316.193(3)(c)2.               3rd     DUI resulting in serious bodily injury.
 1564  316.1935(3)(b)                1st     Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated.
 1565  327.35(3)(c)2.                3rd     Vessel BUI resulting in serious bodily injury.
 1566  402.319(2)                    2nd     Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
 1567  409.920 (2)(b)1.a.            3rd     Medicaid provider fraud; $10,000 or less.
 1568  409.920 (2)(b)1.b.            2nd     Medicaid provider fraud; more than $10,000, but less than $50,000.
 1569  456.065(2)                    3rd     Practicing a health care profession without a license.
 1570  456.065(2)                    2nd     Practicing a health care profession without a license which results in serious bodily injury.
 1571  458.327(1)                    3rd     Practicing medicine without a license.
 1572  459.013(1)                    3rd     Practicing osteopathic medicine without a license.
 1573  460.411(1)                    3rd     Practicing chiropractic medicine without a license.
 1574  461.012(1)                    3rd     Practicing podiatric medicine without a license.
 1575  462.019 462.17                3rd     Practicing naturopathic medicine naturopathy without a license.
 1576  463.015(1)                    3rd     Practicing optometry without a license.
 1577  464.016(1)                    3rd     Practicing nursing without a license.
 1578  465.015(2)                    3rd     Practicing pharmacy without a license.
 1579  466.026(1)                    3rd     Practicing dentistry or dental hygiene without a license.
 1580  467.201                       3rd     Practicing midwifery without a license.
 1581  468.366                       3rd     Delivering respiratory care services without a license.
 1582  483.828(1)                    3rd     Practicing as clinical laboratory personnel without a license.
 1583  483.901(7)                    3rd     Practicing medical physics without a license.
 1584  484.013(1)(c)                 3rd     Preparing or dispensing optical devices without a prescription.
 1585  484.053                       3rd     Dispensing hearing aids without a license.
 1586  494.0018(2)                   1st     Conviction of any violation of chapter 494 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
 1587  560.123(8)(b)1.               3rd     Failure to report currency or payment instruments exceeding $300 but less than $20,000 by a money services business.
 1588  560.125(5)(a)                 3rd     Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
 1589  655.50(10)(b)1.               3rd     Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
 1590  775.21(10)(a)                 3rd     Sexual predator; failure to register; failure to renew driver license or identification card; other registration violations.
 1591  775.21(10)(b)                 3rd     Sexual predator working where children regularly congregate.
 1592  775.21(10)(g)                 3rd     Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
 1593  782.051(3)                    2nd     Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
 1594  782.07(1)                     2nd     Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
 1595  782.071                       2nd     Killing of a human being or unborn child by the operation of a motor vehicle in a reckless manner (vehicular homicide).
 1596  782.072                       2nd     Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
 1597  784.045(1)(a)1.               2nd     Aggravated battery; intentionally causing great bodily harm or disfigurement.
 1598  784.045(1)(a)2.               2nd     Aggravated battery; using deadly weapon.
 1599  784.045(1)(b)                 2nd     Aggravated battery; perpetrator aware victim pregnant.
 1600  784.048(4)                    3rd     Aggravated stalking; violation of injunction or court order.
 1601  784.048(7)                    3rd     Aggravated stalking; violation of court order.
 1602  784.07(2)(d)                  1st     Aggravated battery on law enforcement officer.
 1603  784.074(1)(a)                 1st     Aggravated battery on sexually violent predators facility staff.
 1604  784.08(2)(a)                  1st     Aggravated battery on a person 65 years of age or older.
 1605  784.081(1)                    1st     Aggravated battery on specified official or employee.
 1606  784.082(1)                    1st     Aggravated battery by detained person on visitor or other detainee.
 1607  784.083(1)                    1st     Aggravated battery on code inspector.
 1608  787.06(3)(a)2.                1st     Human trafficking using coercion for labor and services of an adult.
 1609  787.06(3)(e)2.                1st     Human trafficking using coercion for labor and services by the transfer or transport of an adult from outside Florida to within the state.
 1610  790.07(4)                     1st     Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
 1611  790.16(1)                     1st     Discharge of a machine gun under specified circumstances.
 1612  790.165(2)                    2nd     Manufacture, sell, possess, or deliver hoax bomb.
 1613  790.165(3)                    2nd     Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
 1614  790.166(3)                    2nd     Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
 1615  790.166(4)                    2nd     Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
 1616  790.23                      1st,PBL   Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04.
 1617  794.08(4)                     3rd     Female genital mutilation; consent by a parent, guardian, or a person in custodial authority to a victim younger than 18 years of age.
 1618  796.05(1)                     1st     Live on earnings of a prostitute; 2nd offense.
 1619  796.05(1)                     1st     Live on earnings of a prostitute; 3rd and subsequent offense.
 1620  800.04(5)(c)1.                2nd     Lewd or lascivious molestation; victim younger than 12 years of age; offender younger than 18 years of age.
 1621  800.04(5)(c)2.                2nd     Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years of age; offender 18 years of age or older.
 1622  800.04(5)(e)                  1st     Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years; offender 18 years or older; prior conviction for specified sex offense.
 1623  806.01(2)                     2nd     Maliciously damage structure by fire or explosive.
 1624  810.02(3)(a)                  2nd     Burglary of occupied dwelling; unarmed; no assault or battery.
 1625  810.02(3)(b)                  2nd     Burglary of unoccupied dwelling; unarmed; no assault or battery.
 1626  810.02(3)(d)                  2nd     Burglary of occupied conveyance; unarmed; no assault or battery.
 1627  810.02(3)(e)                  2nd     Burglary of authorized emergency vehicle.
 1628  812.014(2)(a)1.               1st     Property stolen, valued at $100,000 or more or a semitrailer deployed by a law enforcement officer; property stolen while causing other property damage; 1st degree grand theft.
 1629  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1630  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1631  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1632  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1633  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1634  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1635  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1636  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1637  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1638  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1639  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1640  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1641  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1642  812.014(2)(f)                 2nd     Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5.
 1643  812.014(2)(f)                 2nd     Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5.
 1644  812.014(2)(f)                 2nd     Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5.
 1645  812.014(2)(f)                 2nd     Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5.
 1646  812.014(2)(f)                 2nd     Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5.
 1647  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1648  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1649  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1650  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1651  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1652  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1653  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1654  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1655  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1656  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1657  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1658  812.019(2)                    1st     Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
 1659  812.131(2)(a)                 2nd     Robbery by sudden snatching.
 1660  812.133(2)(b)                 1st     Carjacking; no firearm, deadly weapon, or other weapon.
 1661  817.034(4)(a)1.               1st     Communications fraud, value greater than $50,000.
 1662  817.234(8)(a)                 2nd     Solicitation of motor vehicle accident victims with intent to defraud.
 1663  817.234(9)                    2nd     Organizing, planning, or participating in an intentional motor vehicle collision.
 1664  817.234(11)(c)                1st     Insurance fraud; property value $100,000 or more.
 1665  817.2341 (2)(b) & (3)(b)      1st     Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity.
 1666  817.418(2)(a)                 3rd     Offering for sale or advertising personal protective equipment with intent to defraud.
 1667  817.504(1)(a)                 3rd     Offering or advertising a vaccine with intent to defraud.
 1668  817.535(2)(a)                 3rd     Filing false lien or other unauthorized document.
 1669  817.611(2)(b)                 2nd     Traffic in or possess 15 to 49 counterfeit credit cards or related documents.
 1670  825.102(3)(b)                 2nd     Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
 1671  825.103(3)(b)                 2nd     Exploiting an elderly person or disabled adult and property is valued at $10,000 or more, but less than $50,000.
 1672  827.03(2)(b)                  2nd     Neglect of a child causing great bodily harm, disability, or disfigurement.
 1673  827.04(3)                     3rd     Impregnation of a child under 16 years of age by person 21 years of age or older.
 1674  837.05(2)                     3rd     Giving false information about alleged capital felony to a law enforcement officer.
 1675  838.015                       2nd     Bribery.                    
 1676  838.016                       2nd     Unlawful compensation or reward for official behavior.
 1677  838.021(3)(a)                 2nd     Unlawful harm to a public servant.
 1678  838.22                        2nd     Bid tampering.              
 1679  843.0855(2)                   3rd     Impersonation of a public officer or employee.
 1680  843.0855(3)                   3rd     Unlawful simulation of legal process.
 1681  843.0855(4)                   3rd     Intimidation of a public officer or employee.
 1682  847.0135(3)                   3rd     Solicitation of a child, via a computer service, to commit an unlawful sex act.
 1683  847.0135(4)                   2nd     Traveling to meet a minor to commit an unlawful sex act.
 1684  872.06                        2nd     Abuse of a dead human body. 
 1685  874.05(2)(b)                  1st     Encouraging or recruiting person under 13 to join a criminal gang; second or subsequent offense.
 1686  874.10                      1st,PBL   Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity.
 1687  893.13(1)(c)1.                1st     Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center.
 1688  893.13(1)(e)1.                1st     Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5., within 1,000 feet of property used for religious services or a specified business site.
 1689  893.13(4)(a)                  1st     Use or hire of minor; deliver to minor other controlled substance.
 1690  893.135(1)(a)1.               1st     Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
 1691  893.135 (1)(b)1.a.            1st     Trafficking in cocaine, more than 28 grams, less than 200 grams.
 1692  893.135 (1)(c)1.a.            1st     Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
 1693  893.135 (1)(c)2.a.            1st     Trafficking in hydrocodone, 28 grams or more, less than 50 grams.
 1694  893.135 (1)(c)2.b.            1st     Trafficking in hydrocodone, 50 grams or more, less than 100 grams.
 1695  893.135 (1)(c)3.a.            1st     Trafficking in oxycodone, 7 grams or more, less than 14 grams.
 1696  893.135 (1)(c)3.b.            1st     Trafficking in oxycodone, 14 grams or more, less than 25 grams.
 1697  893.135 (1)(c)4.b.(I)         1st     Trafficking in fentanyl, 4 grams or more, less than 14 grams.
 1698  893.135 (1)(d)1.a.            1st     Trafficking in phencyclidine, 28 grams or more, less than 200 grams.
 1699  893.135(1)(e)1.               1st     Trafficking in methaqualone, 200 grams or more, less than 5 kilograms.
 1700  893.135(1)(f)1.               1st     Trafficking in amphetamine, 14 grams or more, less than 28 grams.
 1701  893.135 (1)(g)1.a.            1st     Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
 1702  893.135 (1)(h)1.a.            1st     Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
 1703  893.135 (1)(j)1.a.            1st     Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
 1704  893.135 (1)(k)2.a.            1st     Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
 1705  893.135 (1)(m)2.a.            1st     Trafficking in synthetic cannabinoids, 280 grams or more, less than 500 grams.
 1706  893.135 (1)(m)2.b.            1st     Trafficking in synthetic cannabinoids, 500 grams or more, less than 1,000 grams.
 1707  893.135 (1)(n)2.a.            1st     Trafficking in n-benzyl phenethylamines, 14 grams or more, less than 100 grams.
 1708  893.1351(2)                   2nd     Possession of place for trafficking in or manufacturing of controlled substance.
 1709  896.101(5)(a)                 3rd     Money laundering, financial transactions exceeding $300 but less than $20,000.
 1710  896.104(4)(a)1.               3rd     Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
 1711  943.0435(4)(c)                2nd     Sexual offender vacating permanent residence; failure to comply with reporting requirements.
 1712  943.0435(8)                   2nd     Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
 1713  943.0435(9)(a)                3rd     Sexual offender; failure to comply with reporting requirements.
 1714  943.0435(13)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1715  943.0435(14)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1716  944.607(9)                    3rd     Sexual offender; failure to comply with reporting requirements.
 1717  944.607(10)(a)                3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1718  944.607(12)                   3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1719  944.607(13)                   3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1720  985.4815(10)                  3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1721  985.4815(12)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1722  985.4815(13)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1723         Section 27. This act shall take effect December 31, 2024.