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; 850-488-0595 or by electronic mail – [e-mail].

 

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) Purpose. The purpose of this rule is to notify applicants and licensees of the ranges of penalties which will routinely be imposed unless the Board finds 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 violations the Board shall consider a higher penalty than that for a single, isolated violation.  Each range includes the lowest and highest penalty and is inclusive of all penalties falling between, including continuing education (CE). 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 (4). In addition to any other discipline imposed, the Board shall assess the actual costs related to the investigation and prosecution of a case.

     (2)  Violations and Range of Penalties. 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. 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 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.

 

Statutory or Rule cite and brief descriptor.	First Offense	Second Offense	Third or Subsequent Offenses
(a) Section 460.41, F.S., failure to provide itemized patient billing.	A fine of $1,000, six (6) months of probation with records monitoring and three (3) hours CE on Laws, Rules and Ethics.	In addition to three (3) three hours CE on Laws, Rules and Ethics, from a minimum of a $1,000 fine and six (6) months’ probation with records monitoring up to a maximum of a $2,500 fine and six (6) month suspension followed by one (1) year probation with records monitoring.	In addition to three (3) three hours CE on Laws, Rules and Ethics, from a minimum of a $2,000 fine, one (1) year suspension and two (2) years’ probation with records monitoring up to a maximum of a $5,000 fine and permanent revocation.
(b) Section 460.411, F.S., practice without active license or license fraudulently obtained.
i. License fraudulently obtained.	$10,000 fine and permanent revocation or denial of license (minimum and maximum same).
ii. Practice without active license.	From a minimum of an administrative fine of $500 for each month of practice without an active license, up to a maximum of permanent revocation of license.	From a minimum of an administrative fine of $1,000 for each month of practice without an active license, up to a maximum of permanent revocation of license.	From a minimum of an administrative fine of $2,500 for each month of practice without an active license, up to a maximum of permanent revocation of license.
(c) Section 460.411(1)(b), F.S. (use/attempted use of suspended/revoked license).	Permanent revocation or denial of license (minimum and maximum same); if fraud involved, addition of a $10,000.00 fine.
(d) Section 460.411(2)(a), F.S. (selling/fraudulently obtaining diploma, license, record, registration).	Permanent revocation or denial of license (minimum and maximum same); if fraud involved, addition of a $10,000.00 fine.
(e) Section 460.411(2)(b), F.S.: (willfully false oath or affirmation).	Permanent revocation or denial of license (minimum and maximum same); if fraud involved, addition of a $10,000.00 fine.
(f) Section 460.411(2)(c), F.S.:    (use of protected title without licensure).	Denial of license.
(g) Section  460.411(2)(d), F.S.: (knowing concealment of information on violation).	From a minimum of a $500 fine and six (6) months’ probation, up to a maximum of a $1,000 fine, one (1) year probation and three (3) hours CE on Laws, Rules and Ethics.	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 $2,500 fine, two (2) years suspension followed by three (3) years’ probation.	From a minimum of a $2,500 fine, two (2) years suspension followed by three (3) years’ probation up to a maximum of permanent revocation.
(h) Section 460.412 or 456.072(1)(v), F.S.: (sexual misconduct).	From a minimum of a PRN referral for evaluation, one (1) year suspension followed by two (2) years’ probation including a chaperone, up to a maximum $7,500 fine and/or permanent revocation.	$10,000 fine and permanent revocation.	$10,000 fine and permanent revocation.
(i) Section 460.413(1)(a) or 456.072(1)(h), F.S., Obtain license by bribery, fraudulent misrepresentation or Department or Board Error.
i. Obtain license by bribery.	From a minimum $500 fine and/or two (2) years’ probation to a maximum of permanent revocation.	From a minimum $10,000 fine and one (1) year suspension to permanent revocation.	Permanent revocation.
ii. Obtain license by fraudulent misrepresentations	From six months’ probation and a fine of $10,000 to a maximum of five (5) years suspension, passage of the SPEC Exam as condition of reinstatement, and a fine of $10,000.	$10,000 fine and permanent revocation.
iii. Obtain license by Department or Board error.	Suspension until appearance before Board, demonstration of entitlement to licensure and certification by Board, and a $500 fine.	Same Penalty as first violation.	Same Penalty as first violation
(j) Section 460.413(1)(b) or 456.072(1)(f), F.S.: having a license acted against in another state, territory, or country.	$500 fine; if action in other state involved sexual misconduct, then permanent restriction on license requiring chaperone be present.	Same Penalty as first violation	Same Penalty as first violation
(k), Section 460.413(1)(c) or 456.072(1)(c), F.S., crime related to practice.
i. Misdemeanor.	From a minimum $1,500 fine and six (6) months’ probation, up to a $3,000 fine and one (1) year suspension.	From a minimum $3,000 fine, six (6) months suspension and one (1) year probation up to a $5,000 fine and eighteen (18) month suspension.	From a minimum of $4,000 fine, two (2) year Permanent revocation.
ii. Felony.	From a minimum $5,000 fine and 1 year probation up to a maximum $7,500 fine and one (1) year suspension followed by two (2) years’ probation or permanent revocation.	From 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 four (4) year suspension, passage of the SPEC exam as a condition of reinstatement of license to be followed by four (4) years’ probation.	Permanent revocation.
(l) Section 460.413(1)(d), F.S.: false/misleading advertising.	From a minimum $1,000 fine and a letter of concern, up to a maximum $2,500 fine and 3 hours Laws, Rules and Ethics CE.	In addition to three (3) three hours CE on Laws, Rules and Ethics, from a minimum $2,500 fine and one (1) year probation to a maximum $5,000 fine and three (3) months suspension.	From a minimum of a $10,000 fine and/or one (1) year suspension to a maximum $10,000 fine and permanent revocation.
(m) Section 460.413(1)(e) or 456.072(1)(t), F.S.: non-identifying advertisement.	From a minimum $1,000 fine, up to a maximum of three (3) three hours CE on Laws, Rules and Ethics.	In addition to three (3) three hours CE on Laws, Rules and Ethics, from a minimum $2,000 fine and one (1) year probation to a maximum $3,000 fine and three (3) years’ probation.	In addition to three (3) three hours Laws Rules, and Ethics CE, from a minimum $4,000 fine up to a maximum $7,500 fine and one (1) year of suspension followed by three (3) years’ probation.
(n) Section 460.413(1)(f), F.S.: phony name.	In addition to two (2) hours CE on Ethics, from a minimum $1,000 fine up to a maximum $3,000 fine and six (6) months’ probation.	In addition to two (2) hours CE on Ethics, from a minimum $3,500 fine and one (1) year probation, up to a maximum $5,000 fine and one (1) year suspension, followed by one (1) year probation.	From a minimum $5,000 fine and six (6) months suspension up to a maximum $10,000 fine and permanent revocation.
(o) Section 460.413(1)(g) or 456.072(1)(i), F.S.: failure to report another.	In addition to three (3) three hours Laws, Rules and Ethics CE, from a minimum letter of concern and a $500 fine, up to a maximum $2,000 fine and six (6) months’ probation.	In addition to three (3) three hours Laws, Rules and Ethics CE, from a minimum $2,000 fine up to a maximum $4,000 fine and six (6) month suspension.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum $3,000 fine and six (6) months suspension to a maximum $10,000 fine.
(p) Section 460.413(1)(h) or 456.072(1)(j), F.S.: assisting unlicensed person to practice.	In addition to three (3) three hours Laws, Rules and Ethics CE, from a minimum $5,000 fine and one (1) year suspension to $10,000 fine and five year suspension with passage of the SPEC Exam as a condition of reinstatement followed by three (3) years’ probation with monitoring.	$10,000 fine and permanent revocation.	$10,000 fine and permanent revocation.
(q) Section 460.413(1)(i) or 456.072(1)(k), F.S.: failure to perform statutory or legal obligation.	In addition to three (3) three hours Laws, Rules and Ethics CE, from a minimum $1,000 fine and a letter of concern, up to a maximum $3,000 fine and one (1)  year suspension followed by two (2) years’ probation.	From a minimum three (3) three hours Laws, Rules and Ethics CE, $2,500 fine and one (1) year probation up to a maximum $5,000 fine, 2 year suspension, SPEC Exam as condition of reinstatement followed by 2 years’ probation or permanent revocation.	From a minimum $10,000 fine and 1 year suspension up to a maximum $10,000 fine and permanent revocation.
i. Negligent filing of false report.	From a minimum $2,000 fine, up to a maximum $5,000 fine, two (2) hours Ethics and three (3) hours Laws and Rules CE and one (1) year probation with records monitoring.	From a minimum $3,000 fine and a reprimand to a maximum $5,000 fine, two (2) hours Ethics and three (3) hours Laws and Rules CE and two (2) year suspension.	From a minimum $5,000 fine up to a maximum $10,000 fine and permanent revocation.
ii. Willful filing of false report, impeding, or inducing another to file false report.	From a minimum $5,000 fine  and one (1) year suspension, followed by one (1) year probation with records monitoring, up to a maximum of 1 year suspension, SPEC Exam as condition of license reinstatement, followed by 3 years’ probation	From a minimum $5,000 fine and three (3) year suspension with two (2) hours Ethics and three (3) hours Laws and Rules CE and passage of the SPEC Exam as conditions of licensure reinstatement followed by 3 years’ probation with records monitoring up to a maximum $7,500 fine and permanent revocation.	From a minimum  $10,000 fine and five (5) year suspension up to a maximum $10,000 fine and permanent revocation.
(s) Section 460.413(1)(k) or 456.072(1)(m), F.S.: misrepresentations/trick or scheme.	In addition to two (2) hours Ethics CE, from a minimum $1,000 fine and one (1) year probation, up to a maximum $3,000 fine, one (1) year suspension, followed by two (2) years’ probation.	In addition to two (2)  hours Ethics CE, from a $5,000 fine and two (2) years suspension with passage of the SPEC Exam as a condition of license reinstatement followed by two (2) years’ probation up to a maximum $7,500 fine and permanent revocation.	Permanent Revocation.
(t) Section 460.413(1)(l) or 456.072(1)(y), F.S.: soliciting patients or commercial solicitation from accident report information.	From a minimum $3,000 fine and/or two (2) years’ probation, up to a maximum $6,000 fine, two (2) year suspension followed by two (2) year probation and two (2) hours Ethics and three (3) hours Laws and Rules CE.	From a minimum $5,000 fine and/or one year suspension followed by two (2) years’ probation, up to a maximum $10,000 fine, and permanent revocation.	Permanent Revocation.
(u) Section 460.413(1)(m), F.S.: medical recordkeeping.	In addition to three (3) hours Laws, Rules and Ethics and six (6) hours Documentation and Coding CE, from a minimum $1,000 fine and/or one (1) year probation with records monitoring, up to a maximum $3,000 fine, six (6) months suspension, followed by one (1) year probation with records monitoring.	From a minimum of $2,500 fine and one (1) year suspension followed by one (1) year probation up to a maximum $10,000 fine, one (1) year suspension followed by two (2) years’ probation.	From a minimum $7,500 fine and two (2) years suspension, followed by two (2) years’ probation with records monitoring up to a maximum $10,000 fine and permanent revocation.
(v) Section 460.413(1)(n) or 456.072(1)(n), F.S.: exploit patient for financial gain.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum $2,000 fine and/or one (1) year probation, up to a maximum  $4,000 fine and/or two (2) year suspension followed by two (2) years’ probation of license.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE from a $3,000 fine, one (1) year suspension with passage of the SPEC Exam as a condition of reinstatement followed by two (2)  year probation with monitoring up to a maximum $7,500 fine or permanent revocation	From a minimum $7,500 fine, two (2) years suspension followed by two (2) years’ probation up to a maximum $10,000 fine and permanent revocation;
(w) Section 460.413(1)(o), F.S.: unauthorized services.	From a minimum $1,000 fine and/or one (1) year probation with monitoring, up to a maximum $3,000 fine and two (2) years’ probation with monitoring,	From a minimum $3,000 fine and two (2) years’ probation with monitoring, up to a maximum $5,000 fine, two (2) years suspension with passage of the SPEC Exam as a condition of license reinstatement followed by two (2) years’ probation with monitoring or permanent revocation.	For a third offense, from a minimum $5,000 fine, two (2)  year suspension with passage of the SPEC Exam as a condition of license reinstatement followed by two (2) years’ probation with monitoring, up to a maximum $10,000 fine and permanent revocation.
(x) Section 460.413(1)(p), F.S.: dispensing drugs/performing surgery.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum fine of $5,000 and/or one year of probation, up to a maximum fine of $10,000 and/or five (5) year suspension with passage of the SPEC Exam as a condition of license reinstatement followed by two (2) years’ probation.	$10,000 fine and permanent revocation.	$10,000 fine and permanent revocation.
(y) Section 460.413(1)(q) or 456.072(1)(z), F.S.; unable to practice with reasonable skill and safety.	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, with a recommendation of ability to practice with reasonable skill and safety to patients as a condition of reinstatement, followed by  three (3) years’ probation.	From a $3,500 fine, referral for a PRN evaluation, and one (1) year suspension with a recommendation of ability to practice with reasonable skill and safety to patients as a condition of reinstatement, followed by four (4)  years’ probation to a maximum of three (3) year suspension with a recommendation of ability to practice with reasonable skill and safety to patients and passage of the SPEC Exam as conditions of reinstatement, and a $7,500 fine or permanent revocation.	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 permanent revocation.
(z) Section 460.413(1)(t) or 456.072(1)(o), F.S., practicing beyond scope or competency.
i.  Gross malpractice.	From a minimum $2,500 fine, up to a maximum $5,000 fine and/or permanent revocation.	From a minimum $5,000 fine and one (1) year suspension followed by one (1) year probation up to a maximum $7,500 fine, three (3) year suspension followed by three (3) year probation or permanent revocation.	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.
ii. Repeated malpractice.	From a minimum $1,000 fine, three (3) hours Laws, Rules and Ethics CE, and one (1) year suspension followed by one (1) year probation up to a maximum $6,000 fine, two (2) year suspension, three (3) hours Laws, Rules and Ethics CE and passage of the SPEC Exam as conditions of license reinstatement, followed by two (2) year probation with monitoring or permanent revocation.	From a minimum $5,000 fine, two (2)  year suspension and two (2)  year probation up to a maximum $10,000 fine, four (4) year suspension, three (3) hours Laws, Rules and Ethics CE and passage of the SPEC Exam as conditions of license reinstatement, followed by four (4) years’ probation with monitoring or permanent revocation.	$10,000 fine and permanent revocation (minimum and maximum same).
iii. Unacceptable level of care, skill, and treatment.	For a first offense, from a minimum $3,000 fine, 1 year suspension followed by two (2)  years’ probation up to a maximum $6,000 fine, 5 year suspension, SPEC Exam as condition of licensure reinstatement, followed by 2 year probation with monitoring.	From a minimum $5,000 fine and 2 year suspension, passage of SPEC Exam as condition of license renewal, followed by two (2) years’ probation with monitoring up to a maximum $8,000 fine and three (3) year suspension, six (6) hours Documentation and Coding CE and passage of the SPEC Exam as a condition of license reinstatement, followed by three (3) years’ probation with monitoring 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.
(aa) Section 460.413(1)(s), F.S.: experimentation on human subjects without consent.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a $2,000 fine  and/or five (5) years’ probation, up to a maximum of five (5) year suspension, passage of the SPEC Exam as condition of reinstatement, followed by two (2) years’ probation.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum $5,000 fine, one (1) year suspension and/or five (5) years’ probation up to permanent revocation.	$10,000 fine and permanent revocation.
(bb) Section 460.413(1)(t) or 456.072(1)(o), F.S.: practicing beyond the scope permitted or competent to perform.	In addition to three (3) hours Laws, Rules and Ethics CE,  a minimum $2,500 fine and/or one (1) year probation with monitoring, up to a maximum two (2) year suspension followed by two (2) years’ probation with monitoring and a $5,000 fine.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum $5,000 fine and/or two (2) year suspension followed by two (2) years’ probation up to a maximum $7,500 fine, four (4) year suspension, passage of the SPEC Exam as condition of license reinstatement, followed by four (4) year probation.	From a minimum $10,000 fine up to a maximum $10,000 fine and permanent revocation.
(cc) Section 460.413(1)(u) or 456.072(1)(p), F.S.: delegating responsibilities to unqualified person.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, $1,000 fine and a Letter of Concern.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum $5,000 fine, one (1) year suspension followed by two (2) years’ probation with monitoring to a maximum of a $7,500.	From a minimum $10,000 fine up to a maximum $10,000 fine and permanent revocation.
(dd) Section 460.413(1)(v) or 456.072(1)(q), F.S.: violating any lawfully issued order or subpoena.	From a minimum $1,000 fine and a letter of concern, up to a maximum three (3) hours Laws, Rules and Ethics CE.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, from a minimum $3,000 fine and/or two (2) years of probation up to a maximum $5,000 fine or one (1) year suspension.	From a minimum $7,500 fine and/or six (6) month suspension followed by probation up to a maximum $10,000 fine and permanent revocation.
(ee) Section 460.413(1)(w), F.S. conspiring or committing an act to prevent a licensee from advertising.	From a minimum $1,000 fine to a maximum of Letter of Concern and two (2) hours Ethics and Three (3) hours Laws and Rules CE.	From a minimum $3,000 fine and six (6) months suspension up to a maximum $5,000 fine, one (1) year suspension, two (2) hours Ethics and Three (3) hours Laws and Rules CE as conditions of reinstatement of license	From a minimum $7,500 fine and/or two (2) year suspension followed by probation up to a maximum $10,000 fine and/or permanent revocation.
(ff) Section 460.413(1)(x) or 345.072(1)(ee), F.S.: submitting claims for treatment not provided.	From a minimum $3,000 fine and/or two (2) year probation, up to a maximum $5,000 fine or one (1) year suspension, three (3) hours Laws and Rules, two (2) hours Ethics and six (6) hours Documentation and Coding CE as conditions of licensure reinstatement, followed by one (1) year probation with records monitoring.	From a minimum $5,000 fine and one (1) year suspension followed by two (2) years’ probation with monitoring to a maximum $7,500 fine and/or five (5) year suspension, SPEC Exam as condition of licensure reinstatement, followed by five (5) years’ probation with monitoring.	$10,000 fine and permanent revocation.
(gg) Section 460.413(1)(y), F.S.: commingling or conversion of patient funds and financial recordkeeping.	In addition to three (3) hours Laws and Rules CE, from a minimum $2,000 fine and/or one (1) year probation, up to a maximum $4,000 fine, one (1) year suspension followed by one (1) year probation with records monitoring and three (3) hours Laws and Rules and two (2) hours Ethics CE.	In addition to three (3) hours Laws and Rules and two (2) hours Documentation and Coding CE, from a minimum $5,000 fine and one (1) year suspension followed by one (1) year probation with records monitoring to a maximum of $7,500 fine, five (5) year suspension, passage of the SPEC Exam as condition of reinstatement of license, followed by five (5) years’ probation with records monitoring.	From a minimum $7,500 fine and/or one (1) year suspension, followed by two (2) years’ probation with records monitoring up to a maximum $10,000 fine and permanent revocation.
(hh) Section 460.413(1)(z), F.S.: offering or accepting payment by assignment if it appears to eliminate requirement for insured to pay deductible.	From minimum $1,000 fine and/or a letter of concern up to a maximum $3,000 fine and three (3) hours Laws, Rules and Ethics CE.	From a minimum $3,000 fine and/or one (1) year probation with monitoring to a maximum $5,000 fine and one (1) year suspension followed by one (1) probation with records monitoring and three (3) hours Laws, Rules and Ethics CE.	From a minimum of a $10,000 fine up to a $10,000 fine and permanent revocation.
(ii) Section 460.413(1)(aa), F.S.: failure to provide insured with copy of claim (citation offense).	From a minimum $1,000 fine and Letter of Concern up to a maximum of two (2) hours Ethics and Three (3) hours Laws and Rules CE.	From a minimum $3,000 fine and/or one (1) years’ probation to a maximum $4,000 fine, two (2) hours Ethics and Three (3) hours Laws and Rules CE and 3  years suspension, SPEC Exam as condition of license reinstatement, followed by probation with monitoring.	From a minimum $10,000 fine up to a maximum $10,000 fine and permanent revocation.
(jj) Section 460.413(1)(bb), F.S.: advertised fee different from that submitted to payors.	From a minimum $2,000 fine and one (1) year probation with monitoring, to a maximum $5,000 fine and two (2) years’ probation with records monitoring and three (3) hours Laws and Rules CE.	From a minimum of passage of the SPEC Exam or a $3,500 fine and one (1) year suspension followed by one (1) year probation  up to a maximum $5,000 fine and two (2) year suspension, passage of the SPEC Exam as condition of license reinstatement, followed by two (2) year probation with records monitoring and three (3) hours Laws and Rules and two (2) hours Ethics CE.	In addition to three (3) hours Laws and Rules and two (2) hours Ethics CE, From a minimum $7,500 fine, two (2) year suspension followed by two (2) year probation with monitoring, passage of the SPEC Exam as a condition of licensure reinstatement, up to a maximum $10,000 fine, five (5) year suspension, passage of the SPEC Exam and six (6) hours Documentation and Coding CE as conditions of licensure reinstatement, followed by five (5) years’ probation with monitoring  or permanent revocation.
(kk) Sections 460.413(1)(cc), 456.062, F.S.: failure of advertisement to state usual fee when offers free or discount services (citation offense).	From a minimum $1,000 fine, Letter of Concern and three hours Laws, Rules and Ethics CE.	From a minimum $2,000 fine and/or Letter of Concern up to one (1) year probation with monitoring to approve all advertising and three (3) hours Laws, Rules and Ethics CE.	$5,000 fine, one (1) year suspension followed by one (1) year probation with monitoring to approve all advertising and three (3) hours Laws, Rules and Ethics CE.
(ll) Section 460.413(1)(dd), F.S.: using acupuncture without certification.	$3,000 fine and/or one (1) year probation, Letter of Concern, and three (3) hours Laws, Rules and Ethics CE.	From a minimum of a $7,500 fine and 3 year suspension, passage of the SPEC Exam as a condition of license reinstatement, followed by two (2) years’ probation up to a maximum of a $7,500 fine, three (3) hours Laws, Rules and Ethics CE and three (3) year suspension followed by three (3) year probation or permanent revocation of acupuncture certification.	From a minimum of a $10,000 fine up to a maximum $10,000 fine and permanent revocation.
(mm) Section 460.413(1)(ee), F.S.: failure to report violation in the facility.	From a minimum of a letter of concern and/or a $1,000  fine up to a maximum Letter of Concern and three (3) hours Laws, Rules and Ethics CE.	From a minimum of a $2,000 fine and one (1) year probation up to a maximum $3,000 fine, three (3) hours Laws, Rules and Ethics CE, and two (2) year probation.	From a minimum $5,000 fine and two (2) year suspension followed by two (2) year probation up to a maximum $7,500 fine, passage of the SPEC Exam and three (3) hours Laws and Rules and two (2) hours Ethics CE.
(nn) Section 460.413(1)(ff), 456.072(1)(b), or 456.072(1)(dd), F.S.: violating Chapter 460, Chapter 456, F.S., or any Board rules.	$1,000 fine and/or a letter of concern.	From a minimum $5,000 fine and/or two (2) years’ probation up to a maximum $10,000 fine and permanent revocation of license.	$10,000 fine and permanent revocation.
(oo) Section 456.082, F.S.: disclosure of confidential information.	Letter of Concern and three Hours Laws and Rules and three hours Ethics CE.	From a minimum $4,000 fine and one (1) year suspension followed by one (1) year probation to three (3) year suspension, SPEC Exam and three (3) hours Laws and Rules and three (3) hours Ethics as conditions of licensure reinstatement followed by three (3) year probation.	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 permanent revocation.
(pp) Section 456.057(6), F.S.: timely and appropriate release of medical records.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum $1,000 fine and/or a letter of concern up to a maximum $3,000 fine and one (1) year of probation.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum $2,500 fine and/or one (1) year probation to a maximum $5,000 fine and six (6) month suspension followed by two (2) years’ probation.	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.
(qq) Section 456.072(1)(a), F.S.: misleading, deceptive, or fraudulent representations.	From a minimum of one (1) year suspension and a fine of $10,000 per count or offense up to a maximum of five (5) year suspension, three (3) hours Laws, Rules and Ethics CE and a fine of $10,000 per count or offense.	From a fine of $10,000 per count or offense and 5 year suspension, SPEC Exam as condition of licensure reinstatement, up to a maximum of permanent revocation.	From a minimum fine of $10,000 per count or offense and five (5) year suspension to a $10,000 fine and permanent revocation.
(rr) Section 456.072(1)(d), F.S.: improper usage of laser device.	In addition to passage of a training/competency course for the device type, from a minimum $1,000 fine and/or one (1) year probation up to a maximum $3,000 fine and two (2) year suspension followed by two (2) years’ probation.	In addition to passage of a training/competency course for the device type, from a minimum $3,000 fine and one (1) year suspension followed by one (1) year probation up to a maximum $6,000 fine and five (5) year suspension, SPEC Exam as condition of licensure reinstatement, followed by five (5) years’ probation.	From a minimum $10,000 fine, up to a maximum $10,000 fine and permanent revocation.
(ss) 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.	From a minimum $2,000 fine to a maximum $3,000 fine, a letter of concern and two (2) hours Ethics CE.	From a minimum of 2 hours Ethics CE, $3,000 fine and one (1) year suspension followed by one (1) year probation to a maximum $5,000 fine and/or three (3) year suspension, SPEC Exam and two (2) hours Ethics CE as conditions of licensure reinstatement, followed by three (3) years’ probation.	From a minimum $10,000 fine up to a maximum $10,000 fine and permanent revocation.
(tt) Section 456.072(1)(e), F.S.: failure to comply with HIV/AIDS course requirements.	In addition to three (3) hours Laws, Rules and Ethics CE, a fine of $1,000 and a letter of concern.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum fine of $2,500 up to a maximum of one (1) year probation.	A fine of $10,000 and permanent revocation.
(uu) Section 456.072(1)(r), F.S.: improper interference with investigation, inspection, or discipline.	From a minimum letter of concern, $1,000 fine and/or one (1) year of probation up to a maximum $3,000 fine and two (2) hours Ethics CE.	In addition to two (2) hours Ethics CE, from a minimum $5,000 fine and three (3)  year suspension, SPEC Exam as condition of license reinstatement, followed by one (1) year probation up to a maximum $5,000 fine or permanent revocation.	From a minimum $5,000 fine up to a maximum $10,000 fine and permanent revocation.
(vv) Section 456.072(1)(w), F.S. profiling and credentialing violations.	Three hours Laws, Rules and Ethics CE and a letter of concern.	In addition to three hours Laws, Rules and Ethics CE, from a minimum $2,000 fine and one (1) year probation up to a maximum $3,000 fine and two (2) years’ probation	From a minimum $5,000 up to a maximum $10,000 fine and permanent revocation.
(ww) Section 456.072(1)(x), F.S.: failure to comply with 30-day notification of convictions and nolo pleas.	$1,000 fine and/or a letter of concern and three (3) hours Laws, Rules and Ethics CE.	From a minimum of a reprimand and a $5,000 fine up to one (1) year suspension followed by probation and a $10,000 fine.	From a minimum $10,000 fine up to a maximum $10,000 fine and/or permanent revocation.
(xx) Section 456.072(1)(aa), F.S.: testing positive on drug screening.	Suspension of license until PRN evaluation and recommendation of ability to practice with reasonable skill and safety to patients; if contract recommended, entry into contract and from a minimum $1,000 fine and one (1) year suspension and/or two (2) years’ probation and referral for a PRN evaluation, up to a maximum of one (1) year suspension followed by  three (3) years’ probation with monitoring.	From a $2,500 fine and suspension until PRN referral and/or evaluation followed by probation to a $10,000 fine and permanent revocation.	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.
(yy) Section 456.072(1)(bb), F.S.: wrong patient, wrong-site, or wrong or unnecessary procedure.	In addition to six (6) hours CE in Documentation and Coding, from a minimum $1,000 fine and/or a reprimand, up to a maximum $3,000 fine and/or one (1) year suspension followed by one (1) year probation with monitoring.	In addition to six (6) hours CE in Documentation and Coding, from a minimum $3,000 fine and/or two (2) year suspension followed by two (2) year probation with monitoring up to a maximum $6,000 fine five (5) year suspension, passage of the SPEC Exam as condition of reinstatement, followed by five (5) year probation with monitoring.	From a minimum $10,000 fine and or one (1) year probation up to a maximum $10,000 fine and permanent revocation.
(zz) Section 456.039(3), F.S.: failing to update information pursuant to Section 456.039(1), F.S., in writing within 45 days after the occurrence of an event or attainment of a status required to be reported.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum $1,000 fine to a maximum of letter of concern and three (3) hours Laws, Rules and Ethics CE.	In addition to three (3) hours Laws, Rules and Ethics CE, from a minimum of one (1) year probation to maximum of $3,500 fine and three (3) hours Laws, Rules and Ethics CE.	$10,000 fine and permanent revocation.
(aaa) 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.	From a minimum of suspension until compliant with contract and recommendation of ability to practice with reasonable skill and safety to patients to $1,000 fine and probation with monitoring.	From a minimum of suspension until compliant with contract and recommendation of ability to practice with reasonable skill and safety to patients to $3,000 or permanent restriction on practice.	From a minimum of five (5) year suspension, followed by permanent restriction on practice to a fine of $10,000 and permanent revocation.
(bbb) 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.	Permanent revocation and a fine of $10,000.
(ccc) 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.	From a minimum of a letter of concern to one (1) year probation and a $1,000 fine to a maximum of a reprimand, $2,500 fine and/or two (2) year suspension, three (3) hours Laws, Rules and Ethics and six (6) hours Documentation and Coding CE as conditions of reinstatement.	From a minimum of a reprimand, $3,000 fine and one (1) year suspension followed by one (1) year probation up to a maximum of $610,000 fine, three (3) year suspension followed by three (3) years’ probation, passage of the SPEC Exam, three (3) hours Laws, Rules and Ethics and six (6) hours Documentation and Coding CE as conditions of license reinstatement or permanent revocation.	From a minimum of a $5,000 fine and one (1) year suspension, to a maximum $10,000 fine and permanent revocation.
(ddd) 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.	From a minimum of a letter of concern and $1,000 fine to maximum of a reprimand, $2,000 fine, and two (2) hours Ethics CE.	From a minimum of a reprimand, $3,000 fine and one (1) year suspension followed by one (1) year probation to a maximum $5,000 fine and two (2) hours Ethics CE.	From a minimum of a $5,000 fine and one (1) year suspension to a maximum $10,000 fine and permanent revocation.
(eee) 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.	A fine of $10,000 and Permanent revocation or denial of license (minimum and maximum same).
(fff)  Section 456.072(1)(nn), F.S., violating any provisions of s. 790.338, F.S., relating to medical privacy concerning firearms.	$1,000 fine and letter of concern.	From a minimum $5,000 fine, six (6) month suspension followed by one (1) year probation up to two (2) year suspension followed by two (2) year probation.	From a minimum $10,000 fine to a maximum $10,000 fine and permanent revocation.
(ggg)  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.	From a minimum $1,000 fine and/or one (1) year of probation, up to a maximum $3,000 fine.	From a minimum $5,000 fine and/or six (6) month suspension followed by two (2) years of probation to a maximum $10,000 fine and or permanent revocation.	$10,000 fine and permanent revocation.
(hhh) Providing false information regarding Emotional Support Animal without personal knowledge. (Section 456.072(1)(pp), F.S.)	Written reprimand to $500 fine and three (3) hours Laws, Rules and Ethics CE.	Minimum of reprimand, $500 fine and 3 hours Laws, Rules and Ethics CE to a maximum of $1,000 fine, one (1) year suspension followed by two (2) years’ probation with records review.	Minimum of Reprimand, $1,000 fine, 3 hours Laws, Rules and Ethics CE and two years’ probation with records monitoring to a maximum of $10,000 fine and one year suspension followed by five (5) years of probation with records review.
(iii) Intentionally implanting a patient with an embryo or human reproductive material without consent as to donor. (Section 456.072(1)(qq), F.S.)	Minimum of reprimand, $1,000 fine, 3 hours Laws and Rules and 3 hours Ethics and Boundaries CE to a maximum of $7,500 fine, one (1) year suspension followed by two (2) years’ probation.	Minimum of $5,000 fine, six (6) month suspension followed by two (2) years’ probation, passage of national Ethics and Boundaries Exam as condition of reinstatement, to a maximum of $10,000 fine and permanent revocation of license.	$10,000 fine and permanent revocation of license.
(jjj) Failure to comply with Section 456.51, F.S., regarding consent for Pelvic Exams.	Written reprimand to $500 fine.	Minimum of reprimand, $500 fine and 3 hours Laws and Rule Laws, Rules and Ethics s CE to a maximum of $1,000 fine, one (1) year suspension followed by two (2) years’ probation with records review and/or chaperone.	Minimum of Reprimand, $1,000 fine, 3 hours Laws, Rules and Ethics CE and passage of national Ethics and Boundaries Exam to a maximum of $10,000 fine and permanent revocation.

 

(3) The Board may take into consideration the following factors in determining the appropriate disciplinary action to be imposed and in going outside of the disciplinary guidelines:

(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.

(4) When the Board orders probation, that probation will automatically include monitoring by either the Department of Health Compliance Management Unit and/or a Board-approved Monitor.  If the type of monitor is not specified, monitoring shall be by the DOH/CMU.  Unless otherwise specified, if monitoring by a Board-approved Monitor is ordered, such monitoring shall be at random intervals as chosen by the Monitor, and shall be either with or without advance notice to the Respondent, at the discretion of the Monitor.  In addition to monitoring 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: February 26, 2021

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