The proposed rule amendment is intended to clarify disciplinary guidelines, to add guidelines for telehealth registrants pursuant to Section 456.47(4), and to address recent legislation regarding SB 698 (Reproductive Health) ....

 

DEPARTMENT OF HEALTH

Board of Medicine

RULE NO.:RULE TITLE:

64B8-30.015Disciplinary Guidelines

PURPOSE AND EFFECT: The proposed rule amendment is intended to clarify disciplinary guidelines, to add guidelines for telehealth registrants pursuant to Section 456.47(4), and to address recent legislation regarding SB 698 (Reproductive Health) and SB 1084 (Emotional Support Animals).

SUMMARY: The proposed rule amendment will clarify guidelines and address reproductive health and emotional support animals.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board concluded that this rule change will not have any impact on licensees and their businesses or the businesses that employ them. The rule will not increase any fees, business costs, personnel costs, will not decrease profit opportunities, and will not require any specialized knowledge to comply. This change will not increase any direct or indirect regulatory costs. Hence, the Board determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 456.079, 458.309, 458.331(5) FS.

LAW IMPLEMENTED: 456.072, 456.079, 458.331(5), 458.347(4)(e)1., (7)(f) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Claudia Kemp, Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

     64B8-30.015 Disciplinary Guidelines.

     (1) Purpose. Pursuant to section 456.079, 456.072,  F.S., the Boards provide within this rule disciplinary guidelines which shall be imposed upon physician assistant applicants or licensees whom it regulates under chapters 458 and 459, F.S., or telehealth providers registered under section 456.47(4), F.S.  The purpose of this rule is to notify such applicants and licensees of the ranges of penalties which will routinely be imposed unless the Boards find it necessary to deviate from the guidelines for the stated reasons given within this rule. The ranges of penalties provided below are based upon a single count violation of each provision listed; for multiple counts of the violated provisions or a combination of the violations the Boards shall consider a higher penalty than that for a single, isolated violation. Each range includes the lowest and highest penalty and all penalties falling between, including continuing medical education (CME). For telehealth registrants, a suspension may be accompanied by a corrective action plan that addresses the conduct which resulted in the underlying disciplinary violations.  The Board may require a corrective action plan to be completed prior to reinstatement of the suspended registration or the corrective action plan may follow a suspension for a definite term.  The purposes of the imposition of discipline are to punish the applicants or licensees for violations and to deter them from future violations; to offer opportunities for rehabilitation, when appropriate; and to deter other applicants or licensees from violations.

     (2) Violations and Range of Penalties. In imposing discipline upon physician assistant applicants and licensees, in proceedings pursuant to sections 120.57(1) and (2), F.S., the Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the violations set forth below. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included.

VIOLATIONS	RECOMMENDED PENALTIES
			FOR TELEHEALTH REGISTRANTS
	First Offense	Subsequent Offenses	First Offense	Subsequent Offenses
(a) No change.
1. Attempting to obtain an initial license by bribery or fraud.	1. Denial of application and a $10,000.00 fine.		1. Denial of application.
2. Attempting to renew a license by bribery or fraud.	2. Revocation of the license and payment of a $10,000.00 fine.		2. Revocation
3. Obtaining or renewing a license by bribery or fraud.	3. Revocation of the license and payment of a $10,000.00 fine.		3. Revocation
4. Obtaining or renewing a license through error of the Department or the Board.	4. Revocation.		4. Revocation
(b) Action taken against license by another jurisdiction. (Section 459.015(1)(b), F.S. ; ) (Section 456.072(1)(f), F.S., 456.47(4)(d), F.S.)	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to reprimand through suspension or denial of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken and an administrative fine ranging from $1,000.00 to $2,500.00.	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to suspension and revocation or denial of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken, and an administrative fine ranging from $2,500.00 to $5,000.00.	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to suspension or denial of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken.	(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to revocation or denial of the license.
1. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.		1. Revocation or in the case of application for licensure, denial of licensure.
2. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. From an administrative fine of $10,000.00 and a reprimand through suspension of the license, or in the case of application for licensure, denial of licensure.	2. From an administrative fine of $10,000.00 and suspension of the license, followed by a period of probation to revocation, or in the case of application for licensure, denial of licensure.	2. A suspension of license with a corrective action plan to revocation. 2. A suspension of license with a corrective action plan to revocation.	2. Revocation or denial.
(c) Guilt of crime directly relating to practice or ability to practice. (Section 459.015(1)(c), F.S.); (Section 456.072(1)(c), F.S.)	(c) From reprimand to revocation or denial of license, and an administrative fine of $1,000.00 to $5,000.00.	(c) From probation to revocation or denial of the license, and an administrative fine ranging from $2,500.00 to $5,000.00.	(c) From a reprimand to revocation or denial.	(c) From suspension to revocation or denial.
1. Involving a crime directly related to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.		1. Revocation or denial.
2. Involving a crime directly related to healthcare fraud in dollar amounts of $5,000.00 or less.	2. From an administrative fine of $10,000.00, and a reprimand through suspension  to revocation of the license, or in case of application for licensure, denial of licensure.	2. From an administrative fine of $10,000.00, and suspension of the license, followed by a period of probation to revocation, or in case of application for licensure, denial of licensure.	2. Suspension of license with a corrective action plan to revocation.	2.  Revocation.
(d) False, deceptive, or misleading advertising. (Section 459.015(1)(d), F.S.)	(d) From a letter of concern to one (1) year suspension to be followed by a period of probation reprimand, or denial of licensure, and an administrative fine ranging from $2,500.00 to $10,000 $1,000.00 to $2,500.00.	(d) From a letter of concern to reprimand to up to one (1) year suspension to be followed by a period of probation, or denial of licensure, and an administrative fine ranging from $5,000.00 to $10,000.00 $1,000.00 to $2,500.00.	(d) From a letter of concern to one (1) year suspension with a corrective action plan or denial.	(d) From a reprimand to up to one (1) year suspension with a corrective action plan or denial.
(e) Failure to report another licensee in violation. (Section 459.015(1)(e), F.S.); (Section 456.072(1)(i), F.S.)	(e) From a letter of concern to probation and, an administrative fine ranging from $1,000.00 to $2,500.00, or denial of licensure.	(e) From reprimand to suspension or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00.	(e) From letter of concern to suspension with a corrective action plan or denial.	(e) From a suspension with a corrective action plan to revocation.
(f) Aiding unlicensed practice. (Section 459.015(1)(f), F.S.); (Section 456.072(1)(j), F.S.)	(f) From reprimand to suspension, followed by probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(f) From probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(f) From reprimand to  suspension with corrective action plan or denial.	(f) From suspension to revocation or denial.
(g) Failure to perform legal obligation. (Section 459.015(1)(g), F.S.); (Section 456.072(1)(k), F.S.)	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a letter of concern reprimand to revocation or denial of licensure, and an administrative fine from $1,000.00 to $5,000.00.	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand to revocation or denial, and an administrative fine from $2,500.00 to $5,000.00.	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a letter of concern to revocation or denial, unless otherwise provided by law.	(g) For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand to revocation or denial, unless otherwise provided by law.
1. Continuing medical education (CME) violations. (Section 456.072(1)(e), F.S.); (Section 456.072(1)(s), F.S.); (Section 456.033(9), F.S.)	1. Document compliance with the CME requirements for the relevant period; AND:	1. Document compliance with the CME requirements for the relevant period; AND:	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
a. Failure to document required HIV/AIDS.	a. An administrative fine ranging from $250.00 to $500.00.	a. An administrative fine ranging from $500.00 to $1,000.00.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
b. Failure to document required domestic violence CME.	b. An administrative fine ranging from $250.00 to $500.00.	b. An administrative fine of $500.00 to $1,000.00.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
c. Failure to document required HIV/AIDS, and failure to document domestic violence CME.	c. An administrative fine ranging from $500.00 to $1,000.00.	c. An administrative fine ranging from $1,000.00 to $2,000.00.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
2. Failing to report to the Board within 30 days after the licensee has been convicted of a crime in any jurisdiction. (Section 456.072(1)(w), F.S.) Or failing to report to the Board convictions prior to the enactment of this section, in writing, on or before October 1, 1999. (Section 456.072(1)(w), F.S.)	2. From an administrative fine ranging from $1,000.00 to $5,000.00 and a reprimand or denial of licensure, with the ability to reapply.	2. From an administrative fine ranging from $2,500.00 to $5,000.00 and a reprimand or denial of licensure, without the ability to reapply.	2. From a letter of concern to a  reprimand or denial.	2. From suspension to revocation.
3. Failing to disclose financial interest to patient. (Section 456.052, F.S.)	3. A refund of fees paid by or on behalf of the patient and from an administrative fine of $1,000.00, to a reprimand, 100 hours of community service and an administrative fine of $2,500.00.	3. A refund of fees paid by or on behalf of the patient and from a reprimand, and an administrative fine of $2,500.00 to a reprimand, 200 hours of community service and an administrative fine of $5,000.00.	3.  A refund of fees paid by or on behalf of the patient and a letter of concern to a reprimand.	3. A refund of fees paid by or on behalf of the patient and reprimand to a suspension.
(h) Filing a false report or failing to file a report as required. (Section 459.015(1)(i), F.S.); (Section 456.072(1)(l), F.S.)	(h) From a letter of concern to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(h) From probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.
1. Negligently filing a false report or failing to file a report as required.   1. Relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. From a letter of concern or denial to one (1) year probation, and an administrative fine from $1,000.00 to $5,000.00.   1. Revocation and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.	1. From one (1) year probation to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.	1.  From a letter of concern to a reprimand or denial.	1.  From a reprimand to revocation.
2. Fraudulently filing a false report or failing to file a report as required.   2. Relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. From one (1) year probation to revocation or denial and a $10,000.00 fine.   2. An administrative fine of $10,000.00, and a reprimand through suspension of the license, or in case of application for licensure, denial of licensure.	2. From suspension, to be followed by a period of probation, to revocation and a $10,000.00 fine.   2. An administrative fine of $10,000.00 ranging from $2,500 to $5,000.00, and suspension of the license, followed by a period of probation to revocation, or in case of application for licensure, denial of licensure.	2.  From a reprimand to revocation or denial.	2.  From suspension to revocation.
(i) Kickbacks or split fee arrangements. (Section 459.015(1)(j), F.S.)	(i) A refund of fees paid by or on behalf of the patient from a reprimand and an administrative fine of $1,000.00, to a reprimand and an administrative fine of $5,000.00, or denial of licensure.	(i) A refund of fees paid by or on behalf of the patient, from suspension to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(i) A refund of fees paid by or on behalf of the patient, and from a reprimand to six (6) months suspension with a corrective action plan, or denial.	(i) A refund of fees paid by or on behalf of the patient, and from a one (1) year suspension with a corrective action plan, to revocation.
(j) Sexual Misconduct. (Section 459.015(1)(l), F.S.); (Section 456.072(1)(v), F.S.)	(j) From one (1) year suspension to be followed by a period of probation and a reprimand probation to revocation, or denial of licensure, and an administrative fine ranging from $5,000.00 to $10,000.00 $1,000.00 to $5,000.00, or denial of licensure.	(j) Revocation. From suspension, to be followed by a period of probation to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(j) From one (1) year suspension with a corrective action plan, and a reprimand, to revocation or denial.	(j) Revocation.
(k) Deceptive, untrue, or fraudulent representations in the practice of osteopathic medicine. (Section 459.015(1)(m), F.S.); (Sections 456.072(1)(a), (m), F.S.)	(k) From a reprimand letter of concern, to revocation, or denial of licensure, and an administrative fine from $1,000.00 to of $10,000.00.	(k) From suspension, to be followed by a period of probation, to revocation or denial, and an administrative fine from $5,000.00 to $10,000.00. From probation or denial of licensure, and an administrative fine of $10,000.00 to revocation.	(k) From a reprimand to revocation or denial.	(k) From suspension with a corrective action plan, to revocation.
1. Deceptive, untrue, or fraudulent representations in the practice of osteopathic medicine relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. From revocation with leave to reapply in three (3) years, and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.	1. From permanent revocation and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.
2. Deceptive, untrue, or fraudulent representations in the practice of osteopathic medicine relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. An administrative fine of $10,000.00, and a reprimand through suspension of the license, or in case of application for licensure, denial of licensure.	2. An administrative fine of $10,000.00, and suspension of the license, followed by a period of probation to revocation, or in case of application for licensure, denial of licensure.
(l) Improper solicitation of patients. (Section 459.015(1)(n), F.S.)	(l) From an administrative fine ranging from $1,000.00 to $5,000.00, and a reprimand to probation, or denial of licensure.	(l) From suspension, to be followed by a period of probation, to revocation or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00.	(l) From a reprimand to one (1) year suspension with a corrective action plan, to revocation or denial.	(l) From suspension with a corrective action plan, to revocation.
(m) Failure to keep legible written medical records. (Section 459.015(1)(o), F.S. ; 456.47(3), F.S.)	(m) From letter of concern, to a reprimand, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(m) From a reprimand to suspension followed by probation, and an administrative fine ranging from $2,500.00 to $5,000.00, or denial of licensure.	(m) From a letter of concern to a suspension with a corrective action plan or denial.	(m) From a reprimand to two (2) years suspension with a corrective action plan.
1. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. From revocation with leave to reapply in three (3) years, and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.	1. From permanent revocation and an administrative fine of $10,000.00, or in the case of application for licensure, denial of licensure.
2. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. An administrative fine of $10,000.00 to suspension of the license, or in case of application for licensure, denial of licensure.	2. An administrative fine of $10,000.00, and suspension of the license, followed by a period of probation, to revocation, or in case of application for licensure, denial of licensure.
(n) Exercising influence on patient for financial gain. (Section 459.015(1)(q), F.S.); (Section 456.072(1)(n), F.S.)	(n) Payment of fees paid by or on behalf of the patient and from a reprimand, to two years suspension, to be followed by a period of probation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00 to $7,500.00.	(n) Payment of fees paid by or on behalf of the patient and from probation, to revocation suspension, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00 to $10,000.00.	(n) Payment of fees paid by or on behalf of the patient and from a reprimand to two (2) years suspension with a corrective action plan or denial.	(n) Payment of fees paid by or on behalf of the patient and from two (2) year suspension to revocation or denial.
(o) Improper advertising of pharmacy. (Section 459.015(1)(r), F.S.)	(o) From a letter of concern to probation, or a denial of licensure, and an administrative fine ranging from $250.00 to $2,500.00.	(o) From a reprimand, and an administrative fine of $2,500.00 to probation, and an administrative fine from $2,500.00 to $5,000.00, or denial of licensure.	(o) From a letter of concern to suspension to with a corrective action plan or denial.	(o) From a reprimand  to six (6) month suspension to be followed by a corrective action plan.
(p) Performing professional services not authorized by patient. (Section 459.015(1)(s), F.S.)	(p) From a letter of concern, to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(p) From a reprimand, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(p) From a reprimand or denial to revocation or denial.	(p) From suspension with a corrective action plan to revocation or denial.
(q) Inappropriate or excessive prescribing. (Section 459.015(1)(t), F.S.)	(q) From one (1) year probation to revocation, reprimand to probation, and an administrative fine ranging from $1,000.00 to $5,000.00, or denial of licensure.	(q) From probation, to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00 to $10,000.00.	(q) From a three (3) month suspension with a corrective action plan to revocation or denial.	(q) From one (1) year suspension with a corrective action plan, revocation or denial.
(r) Prescribing, dispensing, administering of a scheduled drug by the physician assistant to himself or herself. (Section 459.015(1)(u), F.S.)	(r) From probation to suspension or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00, and a mental and physical examination.	(r) From suspension, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00, and a mental and physical examination..	(r) From a 14 day  suspension with a corrective action plan to revocation and a mental and physical examination.	(r) From a 3 month suspension with a corrective action plan, to revocation or denial, and a mental and physical examination.
(s) Use of amygdalin (laetrile). (Section 459.015(1)(v), F.S.)	(s) From a reprimand to probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	(s) From suspension to be followed by a period of probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(s) From a reprimand to suspension with a corrective action plan or denial.	(s) From suspension with a corrective action plan to revocation or denial.
(t) Inability to practice osteopathic medicine with skill and safety. (Section 459.015(1)(w), F.S.)	(t) From probation to indefinite reprimand to suspension until licensee is able to demonstrate ability to practice with reasonable skill and safety followed by probation, which may be stayed to allow a period of probation with supervision, and a demonstration by the licensee of the ability to practice with reasonable skill and safety, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	(t) From indefinite suspension, followed by probation, to suspension for a minimum of five (5) years or probation to revocation, until the licensee is able to demonstrate ability to practice with reasonable skill and safety, followed by probation, or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00 or denial of licensure.	(t) From indefinite suspension with corrective action plan and until licensee is able to demonstrate ability to practice with reasonable skill and safety to suspension for a minimum of one (1) year and until licensee is able to demonstrate ability to practice with reasonable skill and safety or denial.	(t) From indefinite suspension with a corrective action plan, to suspension for a minimum of five (5) years and until licensee is able to demonstrate ability to practice with reasonable skill and safety.
(u)1. Malpractice: practicing below acceptable standard of care. (Section 459.015(1)(x), F.S.)	(u)1. From a letter of concern, to revocation, or denial of licensure, and an administrative  fine ranging from $1,000.00 to $5,000.00.	(u)1. From reprimand, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(u)1. From letter of concern to revocation or denial.	(u)1. From reprimand to revocation or denial.
2. Gross Malpractice	2. From a probation, to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	2. From suspension followed by probation to revocation or denial, and an administrative fine ranging from $2,500.00 to $5,000.00.	2. From one (1) year suspension with a corrective action plan, to revocation or denial.	2. From two (2) year suspension with a corrective action plan to revocation.
3. Repeated Malpractice	3. From a reprimand to Revocation revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $10,000.00.$5,000.000.	3. From probation to revocation or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00.	3. Revocation or denial.
(v) Performing of experimental treatment without informed consent. (Section 459.015(1)(y), F.S.)	(v) From a letter of concern to suspension, to be followed by a period of probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(v) From suspension to be followed by a period of probation, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(v) From a letter of conern to one (1) year suspension with a corrective action or denial,	(v) From one (1) year suspension with a corrective action plan to revocation or denial,
(w) Practicing beyond scope permitted. (Section 459.015(1)(z), F.S.) (Section 456.072(1)(o), F.S.)	(w) From a letter of concern to two (2) years suspension followed by probation,reprimand and probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(w) From two (2) years probation to suspension followed by probation to or revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00, or denial of licensure.	(w) From reprimand to two (2) years suspension or denial.	(w) From two (2) years suspension to revocation or denial.
(x) Delegation of professional responsibilities to unqualified person. (Section 459.015(1)(aa), F.S.); (Section 456.072(1)(p), F.S.)	(x) From reprimand to suspension, followed by probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(x) From probation, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(x) From reprimand to suspension with corrective action plan or denial.	(x) From six (6) month suspension with a corrective action plan to revocation or denial.
(y)1. Violation of a lawful order of the board or department previously entered in a  disciplinary hearing law, rule, or failure to comply with a lawfully issued subpoena of the department. (Section 459.015(1)(bb), F.S.); (Sections 456.072(1)(b), (q), F.S.)	(y)1. For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(y)1. From probation, to revocation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00 to $10,000.00.	(y)1. For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand, to revocation or denial.	(y)1. From suspension to revocation,or denial.
2. Violation of an order of the Board. (Section 456.072(1)(q), F.S.)	2. From a reprimand and suspension followed by a period of probation, and an administrative fine of $1,000.00 to revocation a reprimand and suspension followed by a period of probation, and an administrative fine of $5,000.00.	2. From a reprimand and suspension followed by a period of probation, and an administrative fine of $2,500.00 to revocation, a reprimand and suspension followed by a period of probation, and an administrative fine of $10,000.00.	2.  From a reprimand to revocation or denial.	2. From suspension with a corrective action plan, to revocation, or denial.
(z) Conspiring to restrict another from lawfully advertising services. (Section 459.015(1)(cc), F.S.)	(z) From a letter of concern to a reprimand, and an administrative fine ranging from $1,000.00 to $2,500.00.	(z) From a reprimand, and an administrative fine of $2,500.00 to a reprimand and an administrative fine of $5,000.00.	(z) A reprimand or denial.	(z) Suspension with a corrective action plan, or denial.
(aa) Aiding an unlawful abortion. (Section 459.015(1)(dd), F.S.)	(aa) From probation, to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(aa) From suspension, to be followed by a period of probation, to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00 to $10,000.00.	(aa) From one (1) year suspension with a corrective action plan, to revocation or denial.	(aa) From eighteen (18) month suspension with a corrective action plan, to revocation or denial.
(bb) Presigning prescription forms. (Section 459.015(1)(ee), F.S.)	(bb) From a letter of concern to two (2) years probation, or denial, a reprimand and an administrative fine from of $1,000.00 to a letter of concern, and an administrative fine of $2,500.00.	(bb) From suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.a reprimand to probation, and an administrative fine ranging from $2,500.00 to $5,000.00.	(bb) From a letter of concern to two (2) years suspension with a corrective action plan or denial.	(bb) From suspension with a corrective action plan to revocation or denial.
(cc) Improperly interfering with an investigation or a disciplinary procedure. (Section 459.015(1)(kk), F.S.); (Section 456.072(1)(r), F.S.)	(cc) From a reprimand to probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	(cc) From probation, to revocation, or denial of licensure without ability to re-apply, and an administrative fine ranging from $2,500.00 to $5,000.00.	(cc) From a reprimand to a suspension with a corrective action plan, or denial.	(cc) From a ninety (90) day suspension with a corrective action plan to  revocation or denial.
(dd) Failing to report any M.D., D.O., or PA, who is in violation of law. (Section 459.015(1)(ll), F.S.); (Section 456.072(1)(i), F.S.)	(dd) From a letter of concern to probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	(dd) From probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(dd) From a letter of concern to suspension with a corrective action plan, or denial.	(dd) Suspension with a corrective action plan or denial.
(ee) Failure to adequately supervise assisting personnel. (Section 459.015(1)(hh), F.S.)	(ee) From a reprimand to probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.	(ee) From probation to suspension followed by probation, or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.	(ee) From a reprimand to a suspension with a corrective action plan or denial.	(ee) From a suspension with a corrective action plan, to revocation or denial.
(ff) Improper use of substances for muscle building or enhancement of performance. (Section 459.015(1)(ii), F.S.)	(ff) From a reprimand to suspension, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(ff) From suspension to be followed by a period of probation, to revocation or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(ff) From a reprimand to suspension with a corrective action plan or denial.	(ff) From suspension with a corrective action plan to revocation or denial.
(gg) Misrepresenting or concealing a material fact during disciplinary or licensure procedure. (Section 459.015(1)(jj), F.S.)	(gg) From a reprimand to revocation probation, and an administrative fine ranging from $500.00 to $2,500.00 to $5,000.00, or the denial of licensure. with the ability to reapply, upon payment of a $500.00 fine.	(gg) From probation, to revocation, or denial of licensure without the ability to reapply, and an administrative fine ranging from $500.00 to $5,000.00.	(gg) From reprimand  to revocation or denial.	(gg) From a minimum of thirty (30) day suspension with a corrective action plan to revocation, or denial.
(hh) Providing medical opinion on claim without reasonable investigation. (Section 459.015(1)(mm), F.S.)	(hh) From a letter of concern to probation, a reprimand, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(hh) From probation to revocation or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00 to $7,500.00.	(hh) From a letter of concern to a suspension with a corrective action plan or denial.	(hh) From a suspension with a corrective action plan to revocation or denial.
(ii) Failing to provide patients with information about patient rights and how to file a patient complaint. (Section 459.015(1)(oo), F.S.); (Section 456.072(1)(u), F.S.)	(ii) Corrective action for nonwillful violations. Letter of concern to reprimand and corrective action for willfull violations and an administrative fine from $100.00 to $200.00.	(ii) Administrative fine of up to $100.00 for t nonwillful violations; and an administrative fine from $250.00 to $500.00 for willful violations.	(ii) From a letter of concern to seven (7) day suspension with corrective action plan.	(ii) From a reprimand to a ten (10) day suspension with corrective action plan.
(jj) (ii) 1.Violating any provision of   Chapters 459, 456, F.S., or any rules adopted pursuant thereto. (Section 459.015(1)(pp), F.S.)	(jj) (ii)  From a reprimand, to revocation or denial and an administrative fine from $1,000.00 to $5,000.00.	(jj) (ii) From probation, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.	(jj) From a reprimand to revocation or denial.	(jj) From suspension with a corrective action plan to revocation or denial.
2. Performing a pelvic examination on a patient without the written consent of the patient or the patient’s legal representative executed specific to, and expressly identifying, the pelvic examination. (Sections 459.015(1)(pp),  456.51, F.S.)	2. From a letter of concern to a reprimand and an administrative fine from $1,000.00 to $2,500.00, or denial.	2. From a reprimand to revocation, and an administrative fine from $5,000.00 to $7,500.00 or denial.	2. From a letter of concern to suspension with a corrective action plan or denial.	2.  From a minimum of six months suspension with a corrective action plan to revocation or denial.
(kk) (jj) Theft or reproduction of an examination. (Section 456.018, F.S.)	(kk) (jj) Revocation or denial of licensure.		(kk)  Revocation or denial..
(ll) Prescribing controlled substances in violation of Section 456.47(2)(c), F.S. (Section 456.47(2)(c), F.S.)	(ll) From a reprimand and a $5,000.00 fine to revocation or denial. (rr) From a reprimand and a $5,000.00 fine to revocation or denial.	(ll) From suspension and a $10,000.00 fine to revocation or denial.	(ll) From a reprimand to revocation or denial.	(ll) From suspension with a corrective action plan to revocation or denial.
(mm) (kk) Performing or attempting to perform health care services on the wrong patient, a wrong site procedure, a wrong procedure, or an unauthorized procedure or a procedure that is medically unnecessary or otherwise unrelated to the patient’s diagnosis or medical condition. (Section 456.072(1)(bb), F.S.)	(mm) (kk) From a $1,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, and one (1) hour lecture on wrong-site surgery in the State of Florida to a $5,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, undergo a risk management assessment, a one (1) hour lecture on wrong-site surgery, and suspension to be followed by a term of probation, or denial.	(mm) (kk) From a $7,500.00 fine, a reprimand, and probation or denial to a $10,000.00 fine and revocation.	(mm) From a letter of concern to suspension with a corrective action plan or denial.	(mm) From a reprimand to revocation or denial.
(nn) (ll)  Leaving a foreign body in a patient, such as a sponge, clamp, forceps, surgical needle, or other paraphernalia commonly used in surgical, examination, or other diagnostic procedures. (Section 456.072(1)(cc), F.S.)	(nn) (ll)  From a $1,000.00 to a $5,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, and a one hour lecture to the staff of a Florida licensed healthcare facility on retained foreign body objects to suspension followed by a term of probation revocation.	(nn) (ll) From a $7,500.00 fine, a reprimand and probation, or denial to revocation.	(nn) From a letter of concern to suspension with a corrective action plan.	(nn) From a suspension with a corrective action plan to revocation or denial.
(oo) (mm) Engaging in a pattern of practice when prescribing medicinal drugs or controlled substances which demonstrates a lack of reasonable skill or safety to patients. (Section 456.072(1)(gg), F.S.)	(oo) (mm)  From one year probation to revocation, and an administrative fine ranging from $1,000.00 to $10,000.00, or denial of licensure.	(oo) (mm) From suspension to be followed by probation to revocation, and an administrative fine ranging from $5,000.00 to $10,000.00, or denial of licensure.	(oo) From one (1) month suspension with a corrective action plan, to revocation or denial.	(oo) From ninety (90) day suspension with a corrective action plan, to revocation or denial.
(pp) (nn) Being terminated from a treatment program for impaired practitioners, for failure to comply with the terms of the monitoring or treatment contract or for not successfully completing any drug-treatment or alcohol-treatment program. (Section 456.072(1)(hh) , F.S.)	(pp) (nn)  From suspension until licensee demonstrates compliance with all terms of the monitoring or treatment contract, and is able to demonstrate to the Board the ability to practice with reasonable skill and safety to be followed by a term of probation; and a fine of $1,000.00 to $2,500.00, to revocation or denial.	(pp)  (nn)  From a minimum of six (6) motnhs suspension until licensee demonstrates compliance with all terms of the monitoring or treatment contract and is able to demonstrate to the Board the ability to practice with reasonable skill and safety to be followed by a term of probation; and a fine of $2,500 to $5,000, to revocation or denial.	(pp) From suspension with a corrective action plan until licensee demonstrates compliance with all terms of the monitoring or treatment contract, and is able to demonstrate to the Board the ability to practice with reasonable skill and safety, to revocation or denial.	(pp) From a minimum of six (6) months suspension with a corrective action plan and until licensee demonstrates compliance with all terms of the monitoring or treatment contract, and is able to demonstrate to the Board the ability to practice with reasonable skill and safety, to revocation or denial.
(qq) (oo) Being convicted of, or entering a plea of guilty or nolo contendere to any misdemeanor or felony, regardless of adjudication, under 18 USC s. 669, ss. 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518, or 42 USC ss. 1320a-7b, relating to the Medicaid program. (Section 456.072(1)(ii), F.S.)	(qq) (oo)  Revocation and a fine of $10,000, or in the case of application for licensure, denial of license.		(qq) Revocation or denial.
(rr) (pp)  Failing to remit the sum owed to the state for overpayment from the Medicaid program pursuant to a final order, judgment, or settlement. (Section 456.072(1)(jj), F.S.)	(rr) (pp)  From a letter of concern to probation, and a fine of $500.00 to $5,000.00.	(rr) (pp) From a reprimand to revocation, and a fine of $2,500.00 to $5,000.00.	(rr) From a letter of concern to suspension with a corrective action plan.	(rr) From a reprimand to revocation.
(ss) (qq) Being terminated from the state Medicaid program, or any other state Medicaid program, or the federal Medicare program. (Section 456.072(1)(kk), F.S.)	(ss) (qq) From a letter of concern to suspension, and a fine of $1,000 to $5,000, or denial.	(ss) (qq) From a reprimand to revocation, and a fine of $5,000 to $10,000 or denial.	(ss) From a letter of concern to suspension with a corrective action plan, or denial.	(ss) From a reprimand to revocation or denial.
(tt) (rr) Being convicted of, or entering into a plea of guilty or nolo contendere to any misdemeanor or felony, regardless of adjudication, which relates to health care fraud. (Section 456.072(1)(ll), F.S.)	(tt) (rr) Revocation and a fine of $10,000, or in the case of application for licensure, denial of license.		(tt) Revocation or denial.
(uu) Failure to comply with the controlled substance prescribing requirements of Section 456.44, F.S. (Section 456.072)(1)(mm), F.S.)	(uu) From a minimum of suspension of license for a period of six (6) months followed by a period of probation and an administrative fine in the amount of $10,000.00 to revocation and an administrative fine in the amount of $10,000.00.	(uu) From a minimum of suspension of license for a period of one (1) year followed by a period of probation and an administrative fine in the amount of $10,000.00 to revocation and an administrative fine in the amount of $10,000.00.	(uu) From a minimum of suspension for a period of six (6) months with a corrective action plan, to revocation.	(uu) From a minimum of suspension for a period of one (1) year with a corrective action plan, to revocation.
(vv) (ss) Willfully failing to comply with Section 627.64194 or 641.513, F.S., with such frequency as to indicate a general business practice. (Section 459.015(1)(vv), F.S.)	(vv) (ss) From a letter of concern to a reprimand and an administrative fine in the amount of $1,000.00 to $5,000.00.	(vv) (ss) From a reprimand to revocation and an administrative fine in the amount of $5,000.00 to $10,000.00.	(vv) From a letter of concern to a reprimand.	(vv) From a reprimand to revocation.
(ww) (tt)  Failure to consult the prescription drug monitoring system, as required by section 893.055(8), F.S. (Section 459.015(1)(g), F.S.)	(ww) (tt)  From a letter of concern to a reprimand and an administrative fine of $1,000.00 to $2,500.00.	(ww) (tt)  From a reprimand to revocation and an administrative fine of $2,500.00 to $10,000.00	(ww) From a letter of concern to a reprimand.	(ww) From a reprimand to revocation.
(xx) Intentionally implanting a patient or causing a patient to be implanted with a human embryo without the  recipient’s consent to the use of that human embryo, or inseminating a patient or causing a patient to be inseminated with the human reproductive material, as defined in s. 784.086, of a donor without the recipient’s consent to the use of human reproductive material from that donor. (Section 456.072(1)(pp), F.S.	(xx) From six (6)  months probation to one (1) year suspension, and an administrative fine of $5,000.00 to $10,000.00, or denial.	(xx) From one (1) year suspension to revocation and an administrative fine of $7,500.00 to $10,000.00, or denial.	(xx) From six (6) months suspension with a corrective action plan to one (1) year suspension with a corrective action plan or denial.	(xx) From one (1) year suspension with a corrective action plan to revocation or denial.
(yy) Implanting a patient or causing a patient to be implanted with a human embryo created with the human reproductive material, as defined in s. 784.086, of the licensee, or inseminating a patient or causing a patient to be inseminated with the human reproductive material of the licensee. (Section 459.015(1)(yy), F.S.)	(yy) Revocation and a $10,000,00 fine or denial.		(yy) Revocation or denial.
(zz) Providing information indicating that a person has a disability or supporting a person’s need for an emotional support animal under s. 760.27, F.S. without personal knowledge of the person’s disability or disability-related need for the specific emotional support animal. (Section 456.072(1)(pp)	(zz) From a letter of concern to probation and an administrative fine from $500.00 to $1,000.00	(zz) From a reprimand to revocation and a fine from $500 to $1,000.00.	(zz) From a letter of concern to a suspension with a corrective action plan.	(zz) From a reprimand to revocation.
(aaa) Failure to report disciplinary action by another jurisdiction including pending disciplinary action. (Section 456.47(4)(d), F.S.	(aaa) Not applicable to physician assistants licensed under Chapters 458 or 459, F.S.		(aaa) From a reprimand to revocation or denial.	(aaa) From a suspension with a corrective action plan to revocation or denial.
(bbb) Failure to display hyperlink on telehealth registrant’s website. (Section 456.47(4)(c), F.S.	(bbb) Not applicable to physician assistants licensed under Chapters 458 or 459, F.S.		(bbb) From a letter of concern to suspension with a corrective action plan.	(bbb) From a reprimand to revocation.
(ccc) Opening an office in Florida or providing in-person healthcare services to patients in Florida. (Section 456.47(4)(f), F.S.)	(ccc) Not applicable to physician assistants  licensed under Chapters 458 or 459, F.S.		(ccc) From six (6) month suspension with a corrective action plan to revocation or denial.	(ccc) From one (1) year suspension with a corrective action plan to revocation.

     (3) No change

     (4) The certification of a Physician Assistant shall be disciplined by the Board when, after due notice and a hearing in accordance with the provisions of this rule, it shall find: that the Physician Assistant has held himself or herself out or permitted another to represent the Physician Assistant him as a licensed physician. If any person addresses the Physician Assistant in a medical setting as “Doctor,” the Physician Assistant must immediately inform that person that the Physician Assistant is not a doctor. Upon a finding by the Board of failure to immediately inform the person, the following penalty shall be imposed: a letter of concern, a reprimand, a 60-day suspension and/or a fine up to $2,500.00; and for any subsequent offense, a fine up to $5,000.00 and/or revocation of the certificate.

Rulemaking Authority 456.079, 456.47(7),  459.015(5) FS. Law Implemented 456.072, 456.079, 456.47(7), 459.015(5), 459.022(4)(e)1., (7)(f) FS. History–New 4-18-89, Formerly 21R-6.011, Amended 11-4-93, Formerly 61F9-6.011, 59W-6.011, Amended 6-7-98, 4-9-01, 7-13-03, 5-16-10, 3-26-12, 5-17-17, 11-15-18,                        .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Medicine

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Medicine

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 2, 2020

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: January 14,2021