The Board proposes the rule amendment to update and revise the Boards’ disciplinary guidelines.

 

DEPARTMENT OF HEALTH

Board of Chiropractic Medicine

RULE NO.:RULE TITLE:

64B2-16.003Guidelines for the Disposition of Disciplinary Cases

PURPOSE AND EFFECT: The Board proposes the rule amendment to update and revise the Boards’ disciplinary guidelines.

SUMMARY: Substantial rewrite of disciplinary guidelines.

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, based upon the expertise and experience of its members, 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: 456.039(3), 456.072, 456.079, 460.405, 460.413 FS.

LAW IMPLEMENTED: 456.039(3), 456.072, 456.079, 460.413(4) 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: Anthony Spivey, Executive Director, Board of Chiropractic Medicine, 4052 Bald Cypress Way, Bin #C07, Tallahassee, Florida 32399-3257; [phone].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

Substantial rewording of Rule 64B2-16.003 follows.  See Florida Administrative Code for present text.

64B2-16.003 Guidelines for the Disposition of Disciplinary Cases.

(1) When the Board finds that an applicant or licensee whom it regulates pursuant to Chapter 460, F.S., has violated the below-listed provisions, it shall issue a final order imposing appropriate penalties, for each count, as set forth in Section 456.072(2), F.S., within the ranges recommended in the following disciplinary guidelines. The identification of offenses are descriptive only; the full language of each statutory provision cited must be considered in order to determine the conduct included. For all persons subject to this rule, conditions of probation may be required following any period of suspension of license and probation will require compliance with conditions as set forth in subsection (3). For applicants, all offenses listed herein are sufficient for refusal to certify an application for licensure. If the Board makes a finding of pecuniary benefit or self-gain related to the violation, then the Board shall require refund of fees billed and collected from the patient or a third party on behalf of the patient. In addition to any other discipline imposed, the Board shall assess the actual costs related to the investigation and prosecution of a case. In addition to or in lieu of any guideline penalties provided herein, if the violation is for fraud or making a false or fraudulent representation, the Board shall impose a fine of $10,000 per count or offense.

(a) Section 460.411, F.S.: For a first offense, from a minimum of an $500 fine, up to a maximum of suspension of license for three (3) months, followed by six (6) months of probation.  For a second offense, from a minimum of a $1,000 fine and six (6) months probation up to a maximum of a $1,000 fine, six (6) months suspension followed by one (1) year probation.  For a third offense, from a minimum of a $2,000 fine, one (1) year suspension and two (2) years probation up to a maximum of a $2,000 fine and/or permanent revocation; 

(b) Section 460.411(1)(a), F.S.: fraud – permanent revocation or denial of license (minimum and maximum same); other – from a minimum of an administrative fine of $200 for each month of practice without an active license, up to a maximum of permanent revocation of license;

(c) Sections 460.411(1)(b), 460.411(2)(a), 460.411(2)(b), F.S.: permanent revocation or denial of license (minimum and maximum same);

(d) Section 460.411(2)(c), F.S.: denial of license;

(e) Section 460.411(2)(d), F.S.: For a first offense, from a minimum of six (6) months probation, up to a maximum of one (1) year suspension followed by two (2) years probation.  For a second offense, from a minimum of a $1,000 fine and one (1) year suspension followed by two (2) years probation up to a maximum of a $2,000 fine, two (2) years suspension followed by three (3) years probation.  For a third offense, from a minmum of a $2,000 fine, two (2) years suspension followed by three (3) years probation up to a maximum of permanent revocation; 

(f) Section 460.412 or 456.072(1)(v), F.S.:  For a first offense and any subsequent offense, from a minimum of a PRN referral for evaluation up to a maximum $10,000 fine and/or permanent revocation. 

(g) Section 460.413(1)(a) or 456.072(1)(h), F.S.:

Obtain license by bribery – For a first offense, from a minimum $500 fine and/or up to two (2) years probation to a maximum of permanent revocation.  For a second offense, from a minimum $5,000 fine to permanent revocation. For a third offense, permanent revocation;

Obtain license by fraudulent misrepresentations – For a first offense, from six (6) months probation and a $10,000 fine to a maximum of permanent revocation and a $10,000 fine. For a second offense, a $10,000 fine and permanent revocation.  For a third offense, permanent revocation;

Obtain license by Department or Board error – For a first offense, from a minimum letter of concern and/or a $500 fine, up to a maximum of one (1) year suspension, followed by two (2) years probation, and a $5,000 fine. For a second offense, from a minimum $5,000 fine to permanent revocation of license. For a third offense, permanent revocation of license;

(h) Section 460.413(1)(b) or 456.072(1)(f), F.S.: having a license acted against in another state, territory, or country – action consistent with the disciplinary guidelines for the offense that would have been taken had the violation occurred in the State of Florida. After the first offense, action consistent with the disciplinary guidelines for a repeat offense had the violation occurred in Florida;

(i) Section 460.413(1)(c) or 456.072(1)(c), F.S.: guilt of a crime that relates to the practice or the ability to practice – misdemeanor: For a first offense, from a minimum $1,500 fine and six (6) months probation, up to a $5,000 fine and one (1) year suspension. For a second offense, from a minimum $3,000 fine, six (6) months suspension and one (1) year probation up to a $5,000 fine and one (1) year suspension, and after the second offense, permanent revocation;

Felony: For a first offense, from a minimum $7,500 fine and two (2) years probation, up to a maximum $10,000 fine and permanent revocation. For a second offense, from a minimum six (6) months probation, up to a maximum $10,000 fine and/or permanent revocation of license.  For a third offense, permanent revocation;

(j) Section 460.413(1)(d), F.S.: false/misleading advertising – For a first offense, from a minimum $1,000 fine, and a letter of concern, up to a maximum $7,500 fine and one (1) year probation. For a second offense, from a minimum $2,500 fine and/or one (1) year probation to a maximum $10,000 fine and/or three (3) months suspension. For a third offense, a $10,000 fine and/or one (1) year suspension to a maximum $10,000 fine and/or permanent revocation;

(k) Section 460.413(1)(e) or 456.072(1)(t), F.S.: non-identifying advertisement – For a first offense, from a minimum $500 fine, up to a maximum of one (1) year probation. For a second offense, from a minimum $2,000 fine and one (1) year probation to a maximum $5,000 fine and/or three (3) years suspension. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or one (1) year of suspension up to permanent revocation;

(l) Section 460.413(1)(f), F.S.: phony name – For a first offense, from a minium $500 fine up to a maximum $3,000 fine and/or six (6) months probation.  For a second offense, from a minimum $3,500 fine and one (1) year probation, up to a maximum $10,000 fine and/or six (6) months suspension, followed by one (1) year probation. For a third offense, a minimum $5,000 fine and six (6) months suspension up to a maximum $10,000 fine and/or permanent revocation;

(m) Section 460.413(1)(g), 456.039(3), or 456.072(1)(i), F.S.: failure to report another – For a first offense, from a minimum letter of concern and/or a $500 fine, up to a maximum $2,000 fine and/or six (6) months probation. For a second offense, from a minimum $2,000 fine and/or one (1) year probation up to a maximum $7,500 fine and one (1) year suspension. For a third offense, a minimum $3,000 fine and six (6) months suspension to a maximum $10,000 fine and/or permanent revocation;

(n) Section 460.413(1)(h) or 456.072(1)(j), F.S.: assisting unlicensed person to practice – For a first offense, from a minimum $5,000 fine and/or one (1) year suspension to permanent revocation of license. For a second offense, from a minimum $7,500 fine up to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(o) Section 460.413(1)(i) or 456.072(1)(k), F.S.: failure to perform statutory or legal obligation – For a first offense, from a minimum $1,000 fine and a letter of concern, up to a maximum $7,500 fine and/or two (2)  years suspension followed by two (2) years probation. For a second offense, from a minimum $2,500 fine and six (6) months probation up to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(p) Section 460.413(1)(j) or 456.072(1)(l), F.S.: negligent filing of false report – For a first offense, from a minimum $1,000 fine, up to a maximum $5,000 fine and one (1) year probation. For a second offense, a minimum $2,500 fine and a reprimand to a maximum $10,000 fine and two (2) years suspension. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

Willful filing of false report, impeding, or inducing another to file false report – For a first offense, from a minimum $5,000 fine  and/or three (3) months suspension, followed by six (6) months probation, up to a maximum of permanent revocation of license. For a second offense, from a minimum $7,500 fine and one (1) year suspension up to a maximum $10,000 fine and permanent revocation.  For a third offense, from a minimum  $10,000 fine up to a maximum $10,000 fine and/or permanent revocation.

(q) Section 460.413(1)(k) or 456.072(1)(a) or (m), F.S.: misrepresentations/trick or scheme – For a first offense, from a minimum $1,000 fine and six (6) months probation, up to a maximum $10,000 fine, one (1) year suspension, followed by two (2) years probation. For a second offense, a $5,000 fine and two (2) years suspension followed by two (2) years probation up to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $7,500 fine and two (2) years of suspension followed by two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(r) Section 460.413(1)(l) or 456.072(1)(y), F.S.: soliciting patients or commercial solicitation from accident report information – For a first offense, from a minimum $1,000 fine and/or one (1) year probation, up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $5,000 fine and/or six (6) months suspension up to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(s) Section 460.413(1)(m), F.S.: medical record-keeping – For a first offense, from a minimum $500 fine and/or one (1) year probation, up to a maximum $7,500 fine, three (3) months suspension, followed by six (6) months probation. For a second offense, from a minimum of $2,500 fine one (1) year suspension followed by one (1) year probation  up to a maximum $5,000 fine, one (1) year suspension followed by two (2) years probation.  For a third offense, a minimum $7,500 fine and two (2) years suspension followed by two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(t) Section 460.413(1)(n) or 456.072(1)(n), F.S.: exploit patient for financial gain – For a first offense, from a minimum $1,000 fine and/or one (1) year probation, up to a maximum  $10,000 fine and/or permanent revocation of license.   For a second offense, from a $5,000 fine, one (1) year suspension followed by one (1) year probation up to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $7,500 fine, two (2) years suspension then two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(u) Section 460.413(1)(o), F.S.: unauthorized services – For a first offense, from a minimum $1,000 fine and/or one (1) year probation, up to a maximum $5,000 fine and/or two (2) years probation.  For a second offense,  from a minimum $2,500 fine and two (2) years probation up to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $7,500 fine, one (1) year suspension and two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(v) Section 460.413(1)(p), F.S.: dispensing drugs/performing surgery – For a first offense, from a minimum $5,000 fine and/or one (1) year probation, up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $7,500 fine, one (1) year suspension and two (2) years suspension up to a maximum.   For a third offense, a $10,000 fine and/or permanent revocation;

(w) Section 460.413(1)(q) or 456.072(1)(z), F.S.: unable to practice with skill and safety – For a first offense, from a minimum $1,000 fine, three (3) years probation and referral for a PRN evaluation, up to a maximum of one (1) year suspension, followed by up to five (5) years probation. For a second offense, from a $3,500 fine, referral for a PRN evaluation, and two (2) years probation to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $5,000 fine, suspension until PRN referral and evaluation, followed by five (5) years probation up to a maximum $10,000 fine and/or permanent revocation;

(x) Section 460.413(1)(r), F.S.: gross malpractice – For a first offense, from a minimum $1,000 fine, up to a maximum $10,000 fine and/or permanent revocation.  For a second offense, from a minimum $5,000 fine and one (1) year probation up to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $10,000 fine, two (2) years suspension and two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

Repeated malpractice – For a first offense, from a minimum $1,000 fine and one (1) year probation up to a maximum $10,000 fine  and/or permanent revocation.  For a second offense, from a minimum $5,000 fine, one (1) year suspension and one (1) year probation up to a maximum $10,000 fine and/or permanent revocation. For a third offense, $10,000 fine and/or permanent revocation (minimum and maximum same).

Unacceptable level of care, skill, and treatment – For a first offense, from a minimum $1,000 fine and one (1) year probation up to a maximum $10,000 fine and/or permanent revocation.  For a second offense, from a minimum $5,000 fine and two (2) years probation up to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $7,500 fine, one (1) year suspension then two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(y) Section 460.413(1)(s), F.S.: experimentation on human subjects without consent – For a first offense, from a $1,000 fine  and/or five (5) years probation, up to a maximum of permanent revocation. For the second offense, a minimum $5,000 fine, one (1) year suspension and/or five (5) years probation. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(z) Section 460.413(1)(t) or 456.072(1)(o), F.S.: practicing beyond the scope permitted or competent to perform – For a first offense, from a minimum $2,500 fine and/or one (1) year probation, up to a maximum two (2) years suspension followed by probation and a $10,000 fine. For a second offense, from a minimum $5,000 fine and/or two (2) years probation up to a maximum $10,000 fine, three (3) years suspension followed by probation.  For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(aa) Section 460.413(1)(u) or 456.072(1)(p), F.S.: delegating responsibilities to unqualified person – For a first offense, from a minimum $1,000 fine and/or six (6) months probation, up to a maximum $5,000 fine and three (3) years suspension, followed by up to three (3) years probation. For a second offense, from a minimum $5,000 fine, one (1) year suspension followed by probation to a maximum of a $10,000 fine, five (5) years suspension followed by five (5) years probation.  For a third  offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(bb) Section 460.413(1)(v) or 456.072(1)(b) or (q), F.S.: violating any lawfully issued order or subpoena – For a first offense, from a minimum $1,000 fine and a letter of concern, up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $5,000 fine and/or two (2) years of probation up to a maximum $10,000 fine and/or permanent revocation of license.  For a third offense, from a minimum $7,500 fine and/or six (6) months suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation;

(cc) Section 460.413(1)(w), F.S.: conspiring or committing an act to prevent a licensee from advertising –  For a first offense, from a minimum $1,000 fine and/or one (1) year probation, up to a maximum of six (6) months suspension, followed by one (1) year probation and a $5,000 fine.  For a second offense, from a minimum $5,000 fine and one (1) year suspension up to a maximum $10,000 fine, two (2) years suspension followed by two (2) years probation.    For a third offense, from a minimum $7,500 fine and/or two (2) years suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation;

(dd) Section 460.413(1)(x) or 456.072(1)(ee) or (ff), F.S.: submitting upcoded claims or claims for treatment not provided  – For a first offense, from a minimum $1,000 fine and/or one (1) year probation, up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $5,000 fine and/or six (6) months suspension followed by two (2) years probation to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(ee) Section 460.413(1)(y), F.S.: commingling or conversion of patient funds and financial recordkeeping – For a first offense, from a minimum $2,000 fine and/or one (1) year probation, up to a maximum $10,000 fine and/or permanent revocation.  For a second offense, a minimum $5,000 fine and three (3) months suspension followed by one (1) year probation.   For a third offense, from a minimum $7,500 fine and/or one (1) year suspension followed by two (2) years probation up to a maximum $10,000 fine and/ or permanent revocation;

(ff) Section 460.413(1)(z), F.S.: offering or accepting payment by assignment if it appears to eliminate requirement for insured to pay deductible – For a first offense, from minimum $1,000 fine, and/or a letter of concern up to a maximum $3,000 fine and/or two (2) years probation. For a second offense, from a minimum $3,000 fine and/or one (1) year probation to a maximum $7,500 fine and one (1) year suspension followed by probation. For a third offense, from a minimum of a $10,000 fine up to a $10,000 fine and/or permanent revocation;

(gg) Section 460.413(1)(aa), F.S.: failure to provide insured with copy of claim –  For a first offense, from a minimum $500 fine and one (1) year of probation, up to a maximum $5,000 fine and/or two (2) years probation. For a second offense, from a minimum $3,500 fine and/or two (2) years probation to a maximum $7,500 fine and one (1) year suspension followed by probation. For a third  offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(hh) Section 460.413(1)(bb), F.S.: advertised fee different from that submitted to payors – For a first offense, from a minimum $1,000 fine and up to one (1) year probation, to a maximum $5,000 fine and two (2) years probation. For a second offense, from a minimum $3,500 fine and/or six (6) months suspension up to a maximum $7,500 fine and two (2) years suspension. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(ii) Section 460.413(1)(cc), 456.062, F.S.: failure of advertisement to state usual fee when offers free or discount services –  For a first offense, from a minimum $2,500 fine and one (1) year of probation, up to a maximum $5,000 fine and two  (2) years of probation. For a second offense, from a minimum $3,500 fine and/or six (6) months of suspension up to a maximum $7,500 fine and two (2) years of suspension. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(jj) Section 460.413(1)(dd), F.S.: using acupuncture without certification – For a first offense, from a minimum $2,500 fine, and/or one (1) year probation, up to a maximum of two (2) years suspension followed by probation and a $10,000 fine.   For a second offense, from a minimum of a $5,000 fine, two (2) years suspension followed by probation up to a maximum of a $10,000 fine, three (3) years suspension followed by probation.  For a third offense, from a minimum of a $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(kk) Section 460.413(1)(ee), F.S.: failure to report violation in the facility – For a first offense, from a minimum letter of concern and/or a $500 fine up to a maximum $2,000 fine and/or six (6) months of probation. For a second offense, from a minimum of a $2,000 fine and six (6) months probation up to a maximum $5,000 fine and one (1) year probation. For a third  offense, a minimum $5,000 fine and one (1) year probation up to a maximum $10,000 fine and/or permanent revocation;

(ll) Section 460.413(1)(ff), 456.072(1)(b), or 456.072(1)(dd), F.S.: violating this chapter, Chapter 456, F.S., or any Board rules – For a first offense, from a minimum $1,000 fine and/or a letter of concern up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $5,000 fine and/or two (2) years probation up to a maximum $10,000  fine and/or permanent revocation of license. For a third offense, from a minimum $7,500 fine and/or six (6) months of suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation;

(mm) Section 456.082, F.S.: disclosure of confidential information – For a first offense, from a minimum $2,000 fine and/or six (6) months of probation, up to a maximum $5,000 fine and six (6) months suspension, followed by two (2) years of probation. For a second offense, from a minimum $5,000 fine and one (1) year suspension followed by probation.  For a third offense, from a minimum $7,500 fine and one (1) year suspension followed by two (2) years probation up to a maximum $10,000 fine and/or permanent revocation;

(nn) Section 456.057(6), F.S.: timely and appropriate release of medical records – For a first offense, from a minimum $1,000 fine, and/or a letter of concern up to a maximum $5,000 fine and one (1) year of probation. For a second offense, from a minimum $2,500 fine and/or one (1) year probation to a maximum $5,000 fine and three (3) months suspension followed by two (2) years  probation. For a third offense, from a minimum $7,500 fine and one (1) year suspension followed by two (2) years probation up to a maximum  $10,000 fine and/or permanent revocation;

(oo) Section 456.072(1)(d), F.S.: improper usage of laser device – For a first offense, from a minimum $1,000 fine and/or one (1) year probation up to a maximum $10,000 fine and three  (3) years suspension followed by probation. For a second offense, from a minimum $5,000 fine and one (1) year suspension followed by probation up to a maximum $10,000 fine and five (5) years suspension followed by probation.  For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(pp) Section 456.072(1)(g), F.S.:  found liable in civil proceeding for knowingly filing a false report or complaint against another licensee with DOH –  For a first offense, from a minimum $1,000 fine and (1) year probation to a maximum $3,000 fine and two (2) years probation.  For a second offense, from a minimum $5,000 fine and one (1) year suspension followed by probation to a maximum $10,000 fine and/or permanent revocation.  For a third offense from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation.

(qq) Section 456.072(1)(r), F.S.: improper interference with investigation, inspection, or discipline – For a first offense, from a minimum $1,000 fine and/or one (1) year of probation up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $2,500 fine and one (1) year suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $5,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(rr) Section 456.072(1)(w), F.S.: profiling and credentialing violations – For a first offense, from a minimum letter of concern and/or $1,000 fine, up to a maximum $10,000 fine and/or one (1) year suspension followed by two (2) years probation.  For a second offense, from a minimum $2,000 fine and one (1) year suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $5,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(ss) Section 456.072(1)(x), F.S.: failure to comply with 30-day notification of convictions and nolo pleas – For a first offense, from a minimum  $1,000 fine and/or a letter of concern, up to a maximum $9,000 fine and/or one (1) month suspension followed by probation. For a second offense, from a minimum reprimand, $5,000 fine and/or one (1) year suspension following by probation.  For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation;

(tt) Section 456.072(1)(aa), F.S.: testing positive on drug screening – For a first offense, from a minimum $500 fine and/or two (2) years probation and referral for a PRN evaluation, up to a maximum of one (1) year suspension followed by up to five (5) years probation, and a $10,000 fine. For a second offense, a $2,500 fine and suspension until PRN referral and/or evaluation followed by probation.  For a third offense, from a $5,000 fine, suspension until PRN referral and/or  evaluation and five (5) years probation up to a maximum $10,000 fine and/or permanent revocation;

(uu) Section 456.072(1)(bb), F.S.: wrong patient, wrong-site, or wrong or unnecessary procedure – For a first offense, from a minimum $1,000 fine and/or a reprimand, up to a maximum $10,000 fine and/or six (6) months suspension followed by probation. For a second offense, from a minimum $5,000 fine and/or one (1) year probation up to a maximum $10,000 fine and/or permanent revocation.   For a third offense, from a minimum $10,000 fine and/or one year probation up to a maximum $10,000 fine and/or permanent revocation;

(vv) Section 456.072(1)(hh), F.S., for being terminated from a treatment program for impaired practitioners, which is overseen by an impaired practitioner consultant as described in Section 456.076, F.S., for failure to comply, without good cause, with the terms of the monitoring or treatment contract entered into by the licensee, or for not successfully completing any drug treatment or alcohol treatment program – For a first offense, from a minimum of suspension until compliant with contract to a maximum of a $1000 fine and/or permanent revocation. For subsequent offenses, from a minimum suspension until compliant with contract up to a maximum  $10,000 fine and/or permanent revocation.

(ww) Section 456.072(1)(ii), F.S., for being convicted of or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, under 18 U.S.C. s. 669, ss. 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518, or 42 U.S.C. ss. 1320a-7b, relating to Medicaid program – $10,000 fine and permanent revocation (minimum and maximum same), or in the case of application for licensure, denial of license.

(yy) Section 456.072(1)(jj), F.S., for failing to remit the sum owed to state for an overpayment from Medicaid program pursuant to a final order, judgment, or stipulation or settlement – For a first offense, from a minimum of a letter of concern to probation and a $500 fine to a maximum of a reprimand,$2,500 fine and/or permanent revocation.   For a second offense, a minimum reprimand, $3,000 fine and one (1) year probation up to a maximum of $10,000 fine and/or permanent revocation.  For a third offense, from a minimum $5,000 fine and suspension to a maximum $10,000 fine and permanent revocation.

(zz) Section 456.072(1)(kk), F.S., for being terminated from the state Medicaid program pursuant to Section 409.913, F.S., any other state Medicaid program, or the federal Medicare program, unless eligibility to participate in the program from which the practitioner was terminated has been restored – For a first offense, from a minimum of letter of concern and $1,000 fine to maximum of reprimand to permanent revocation and $5,000 fine. For a second offense, from a minimum of reprimand, $5,000 fine and suspension followed by probation to a maximum $10,000 fine and/or permanent revocation. For a third, from a minimum $5,000 fine, suspension to maximum $10,000 fine and/or permanent revocation.   

(aaa) Section 456.072(1)(ll), F.S., for being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, a crime in any jurisdiction which relates to health care fraud – permanent revocation or denial of license (minimum and maximum same).

(bbb)  Section 456.072(1)(nn), F.S., violating any provisions of s. 790.338, F.S., relating to medical privacy concerning firearms – For a first offense, from a minimum $1,000 fine and letter of concern up to a maximum $5,000 fine, reprimand, and probation.  For a second offense, from a minimum $5,000 fine, suspension followed by probation up to a maximum $10,000 fine and suspension followed by probation.  For a third offense, from a minimum $10,000 fine to a maximum $10,000 fine and/or permanent revocation.

(ccc)  Section 456.072(1)(oo), F.S., willfully failing to comply with s. 627.64194 or 641.513, F.S. as to indicate a business practice – regarding provision of emergency services and insurance billing- For a first offense, from a minimum $1,000 fine and/or one (1) year of probation, up to a maximum $10,000 fine and/or permanent revocation. For a second offense, from a minimum $5,000 fine and/or six (6) months suspension followed by two (2) years of probation to a maximum $10,000 fine and/or permanent revocation. For a third offense, from a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation.

(2) The Board may take into consideration the following aggravating and mitigating factors in determining the appropriate disciplinary action to be imposed:

(a) The danger to the public;

(b) The number of unrelated and distinct offenses;

(c) The actual damage, physical or otherwise, to the patient(s);

(d) The length of time since the date of the last violation(s);

(e) The length of time the licensee has practiced his or her profession;

(f) Prior discipline imposed upon the licensee;

(g) The deterrent effect of the penalty imposed;

(h) The effect of the penalty upon the licensee’s livelihood;

(i) Rehabilitation efforts of the licensee including remorse, restitution, and corrective actions;

(j) Efforts of the licensee to correct or stop violations or failure of the licensee to correct or stop violations;

(k) Related violations against the licensee in another state, including findings of guilt or innocence, penalties imposed and penalties served;

(l) The actual negligence of the licensee pertaining to any violation;

(m) Any other mitigating or aggravating circumstances.

(3) Any or all of the following conditions may be imposed as terms of probation:

(a) Restitution of the cost of probation;

(b) Restitution to patient(s) or third-party payor(s);

(c) Payment of fine(s);

(d) Consent to Department access to all business records;

(e) Fulfilling continuing education requirements;

(f) Consent to indirect or direct supervision of practice by Board-approved sponsor;

(g) Consent to restrictions on advertising;

(h) Consent to restriction of practice, including hours, days or type of practice;

(i) Consent to disallowance of sponsorship of trainees;

(j) Submission of reports by licensee and consent to submission of reports by sponsor and/or employer and/or helping professional;

(k) Consent to urine and blood testing;

(l) Fulfilling community service requirement(s);

(m) Successful completion of the Special Purposes Examination (SPEC) examination of the National Board of Chiropractic Examiners;

(n) Other conditions as appropriate.

Rulemaking Authority 456.039(3), 456.072, 456.079, 460.405, 460.413 FS. Law Implemented 456.039(3), 456.072, 456.079, 460.413(4) FS. History–New 1-10-80, Formerly 21D-16.03, Amended 1-28-87, 1-28-90, 6-24-93, Formerly 21D-16.003, Amended 10-26-93, Formerly 61F2-16.003, Amended 7-18-95, Formerly 59N-16.003, Amended 11-4-98, 6-6-02, 5-23-04, 4-13-05, 9-15-05, 2-6-06, 5-11-10,                      .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Chiropractic Medicine

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

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 8, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: December 5, 2019