The proposed rule amendments are intended to clarify requirements for those who are licensed but are required to practice under the supervision of another Florida licensed physician.

 

DEPARTMENT OF HEALTH

Board of Medicine

RULE NO.:RULE TITLE:

64B8-4.025Licensure Under Supervision

PURPOSE AND EFFECT: The proposed rule amendments are intended to clarify requirements for those who are licensed but are required to practice under the supervision of another Florida licensed physician.

SUMMARY: The proposed rule amendments clarify requirements for those who are licensed but are required to practice under the supervision of another Florida licensed physician.

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: 458.309 FS.

LAW IMPLEMENTED: 458.311, 458.313, 458.3145, 458.315, 458.316, 458.3165, 458.317 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: Allison M. Dudley, J.D., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B8-4.025 Licensure Under Supervision.

Unless otherwise approved by the Board or its designee, or addressed by Board Order, the following are provisions applicable to Orders rendered by the Board when an applicant is certified for licensure but said licensure is restricted or conditioned in such a manner as to require a period of practice under supervision of another licensee approved by the Board.

(1) When an applicant is certified for licensure, but said licensure is restricted in such a manner as to require a period of practice under supervision of another licensee approved by the Board, Tthe applicant’s license shall not be issued until a supervisor is approved by the Board or its designee. However, unless provided otherwise in the Board’s Order, the person who is certified for licensure must have a supervisor approved within 12 months of the date the Board certifies the applicant for licensure. If the person certified for licensure does not obtain an approved supervisor within that 12 month period, the certification for licensure expires and the person must reapply for licensure.

(2) Required Supervision.

(a)(1) Direct Supervision. If an applicant is required to work under the direct supervision of another physician, “direct supervision” shall require the physical presence of the supervising physician in the building on the premises so that the supervising physician is immediately available when needed.

(b)(2) Indirect Supervision. If an applicant is required to work under the indirect supervision of another physician, “indirect supervision” shall mean the responsible supervision of the licensee by a supervising physician, approved by the Bboard, which supervision shall not require the physical presence of the supervising physician when procedures are performed, but shall require the supervisor to be reasonably available, so as to be physically present to provide consultation or direction in a timely fashion as required for appropriate care of the patient. The supervisor shall practice within a reasonable geographic proximity to the applicant, which shall be within 20 miles.

(c) If the terms of the Order include indirect or direct supervision of the applicant’s practice, the applicant shall not practice medicine without an approved supervisor.

(d) The applicant shall furnish to the proposed supervisor a copy of the Board’s order requiring supervision and any other relevant orders.

(e) The supervisor must be licensed under Chapter 458, Florida Statutes, in good standing, in active status, without restriction or limitation on his or her license, must be qualified by training and experience, and must not have any conflicts of interest that would prohibit him or her from impartially performing his or her duties as a monitor. Specific grounds for rejecting a proposed supervisor by the Board or its designee shall include but are not limited to the following:

1. The proposed supervisor has previously been subject to disciplinary action against his or her medical license in this or any other jurisdiction;

2. The proposed supervisor is currently under investigation, or is the subject of a pending disciplinary action;

3. The proposed supervisor is not actively engaged in the same or similar specialty area;

4. If under indirect supervision, the proposed supervisor is not practicing within a distance of no more than 20 miles from the applicant’s practice location. If under direct supervision, the proposed supervisor is not practicing on the premises.

(f) Failure to complete the supervision in the required time period may result in an additional required appearance before the Credentials Committee and may result in extending the time to complete the required supervision.

(3) Approval. The Board confers authority on the Chair of the Credentials Committee to temporarily approve an applicant’s supervisor, practice plans, and designation of an area of practice. To obtain this temporary approval, applicant shall submit to the Board the name and curriculum vitae of the proposed supervisor, the proposed practice plan, and designation of an area of practice. Absent said approval, applicant shall not practice medicine until a supervising physician is approved. Temporary approval shall only remain in effect until the next meeting of the Board. Final approval is to be made by the Board.

(3) The proposed supervisor, practice plans, and designation of an area of practice shall be reviewed by the Probation Committee which shall make recommendations to the Board. The Chairman of the Probation Committee may grant temporary approval of the proposed supervisor, practice plan, and designation of an area of practice. Final approval may not be granted until the proposed supervisor and the applicant appear before the Probation Committee unless the appearance requirement is waived by the Probation Committee.

(4) Change in Supervisor. In the event that applicant’s supervisor is unable or unwilling to fulfill his or her responsibilities as a supervisor, the applicant shall advise the Board of this fact within 24 hours of becoming aware of the situation. Applicant shall submit to the Board the name of a temporary supervisor for consideration. Applicant shall not practice medicine pending approval of this temporary supervisor by the Chair of the Credentials Committee. Temporary approval shall only remain in effect until the next meeting of the Board. Final approval is be made by the Board.

(5) Reports. Prior to termination of the supervisory period, supervision reports, in affidavit format, shall be submitted by the applicant and the supervisor and shall contain the information set forth below:

(a) A report submitted by the applicant shall contain a brief statement of why the applicant is being supervised; the applicant’s practice location; description of current practice (type and composition); compliance with supervisory terms; description of relationship with supervising physician; and advising of any problems.

(b) A report submitted by the supervising physician shall contain a brief statement of why the applicant is being supervised; description of applicant’s practice; applicant’s compliance with terms of supervision; applicant’s relationship with supervisor; and details of any problems which may have arisen with applicant.

(6) Tolling Provisions. After the period of supervision begins, in the event that the applicant leaves the State of Florida for a period of 30 days or more or otherwise does not or may not engage in the active practice of medicine in the State of Florida, then the time period and provisions regarding supervision and required reports shall be tolled and shall remain in a tolled status until applicant returns to the active practice of medicine in the State of Florida. Applicant shall notify the Board 10 days prior to his or her return to practice in the State of Florida.

(7) Supervisors must serve as volunteers without compensation but in instances where an applicant is unable to find a volunteer supervisor, the applicant, with the approval of the Board, may contract with a third party entity that provides supervisors for a fee.

Rulemaking Specific Authority 458.309 FS. Law Implemented 458.311, 458.313, 458.3145, 458.315, 458.316, 458.3165, 458.317 FS. History–New 9-21-93, Formerly 61F6-22.025, 59R-4.025, Amended 3-12-08,_________ .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Credentials Committee, Board of Medicine

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

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 5, 2013

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 14, 2012