The Board proposed rule amendments address violations for telehealth registrants, clarify other existing disciplinary guidelines and set forth additional violations and penalties in response to recent legislation.

 

DEPARTMENT OF HEALTH

Board of Medicine

RULE NO.:RULE TITLE:

64B8-8.001Disciplinary Guidelines

PURPOSE AND EFFECT: The Board proposed rule amendments address violations for telehealth registrants, clarify other existing disciplinary guidelines and set forth additional violations and penalties in response to recent legislation.

SUMMARY: The proposed rule amendments address violations for telehealth registrants, clarify other existing disciplinary guidelines and set forth additional violations and penalties in response to recent legislation.

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, 456.47(7), 458.309, 458.331(5) FS.

LAW IMPLEMENTED: 381.986(3)(a), 456.47, 456.50(2), 456.0575, 456.072, 456.079, 458.331(5) 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, J.D., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin # C03, Tallahassee, Florida 32399-3253, or by email at [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B8-8.001 Disciplinary Guidelines.

(1) Purpose. Pursuant to Section 456.079, F.S., the Board provides within this rule disciplinary guidelines which shall be imposed upon applicants or licensees whom it regulates under Chapter 458, F.S., or telehealth providers registered under section 456.47(4), F.S. 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; multiple counts of the violated provisions or a combination of the violations may result in a higher penalty than that for a single, isolated violation. Each range includes the lowest and highest penalty and all penalties falling between, including appropriate 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 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.

RECOMMENDED RANGE OF PENALTY
				FOR TELEHEALTH REGISTRANTS
VIOLATION (a) Attempting to obtain, obtaining or renewing a license or certificate by bribery, fraud or through an error of the Department or the Board. (Section 458.331(1)(a), F.S.) (Section 456.072(1)(h), F.S.)	FIRST OFFENSE	SECOND OFFENSE	THIRD OFFENSE	FIRST OFFENSE	SECOND OR SUBSEQUENT OFFENSE
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 $5,000.00 fine to revocation and a $10,000.00 fine.	2. Revocation and a $10,000.00 fine.		2. Revocation	2. Revocation
3. Obtaining or renewing a license by bribery or fraud.	3. Revocation of the license and payment of a $5,000.00 fine to revocation and a $10,000.00 fine.	3. Revocation and a $10,000.00 fine.		3. Revocation	3. Revocation
4. Obtaining or renewing a license through error of the Department or the Board.	4. Revocation.	4. Revocation.		4. Revocation	4. Revocation
(b) Action taken against license by another jurisdiction. (Sections 458.331(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 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 $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 revocation or denial of the license, and an administrative fine ranging from $5,000.00 to $10,000.00.		(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 or in the case of application for licensure, denial of licensure, and a fine of $10,000.00.			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. A $10,000.00 administrative fine and suspension of the license, followed by a period of probation to revocation.	2. Revocation or denial and a fine of $10,000.00.		2. A suspension of license with a corrective action plan to revocation.	2. Revocation or denial.
(c) Guilty of crime directly relating to practice or ability to practice. (Section 458.331(1)(c), F.S.) (Section 456.072(1)(c), F.S.)	(c) From probation to revocation or denial of the license, an administrative fine ranging from $1,000.00 to $10,000.00.	(c) From suspension to revocation or denial of the license, an administrative fine ranging from $5,000.00 to $10,000.00.		(c) From a reprimand to revocation or denial.	(c) From suspension  to revocation or denial.
1. Involving a crime related to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure and a fine of $10,000.00			1. Revocation or denial.
2. Involving a crime related to healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, compliance with any criminal probation, a reprimand and suspension of the license, followed by a period of probation to revocation.	2. Revocation and a fine of $10,000.00.		2. Suspension of license with a corrective action plan to revocation.	2.  Revocation.
(d) False, deceptive, or misleading advertising. (Section 458.331(1)(d), F.S.)
1. Negligent false, deceptive, or misleading advertising. (Section 458.331(1)(d), F.S.)	1. From a letter of concern to one (1) year suspension or denial, to be followed by a period of probation, and an administrative fine from $1,000.00 to $5,000.00.	1. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, and an administrative fine from $5,000.00 to $10,000.00.		1. From a letter of concern to one (1) year suspension with a corrective action plan or denial.	1. From a reprimand to up to one (1) year suspension with a corrective action plan or denial.
2. Fraudulent false, deceptive or misleading advertising.	2. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, and an administrative fine of $10,000.00.	2. From suspension, to be followed by a period of probation, up to revocation, and a fine of $10,000.00.		2. From reprimand to up to one (1) year suspension with a corrective action plan or denial.	2. From suspension with a corrective action plan to revocation.
(e) Failure to report another licensee in violation. (Section 458.331(1)(e), F.S.) (Section 456.072(1)(i), F.S.)	(e) From a letter of concern to probation or denial, and an administrative fine from $1,000.00 to $5,000.00.	(e) From probation to suspension or denial, and an administrative fine from $5,000.00 to $10,000.00.		(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 458.331(1)(f), F.S.) (Section 456.072(1)(j), F.S.)	(f) From probation to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(f) 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.		(f) From suspension with corrective action plan to revocation or denial.	(f) From suspension to revocation or denial.
(g) Failure to perform legal obligation. (Section 458.331(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 to revocation or denial, and an administrative fine from $1,000.00 to $10,000.00, 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, and an administrative fine from $5,000.00 to $10,000.00, 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 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. Failing to register a laser device. (Section 456.072(1)(d), F.S.)	1. If the device is an approved device, from an administrative fine of $1,000.00 to $5,000.00; if the device is not approved, from an administrative fine from $5,000.00 to a suspension or denial, and an administrative fine of $10,000.00.	1. If the device is an approved device, from a reprimand to probation or restriction of practice, and an administrative fine of $5,000.00 to $10,000.00; if the device is not approved, from suspension to revocation and an administrative fine of $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
2. Continuing medical education (CME) violations. (Section 456.072(1)(e), F.S.) (Section 456.072(1)(s), F.S.)	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must document compliance with the CME requirements for the relevant period; AND:	2. Within twelve months of the date of the filing of the final order, the licensee must submit certified documentation of completion of all CME requirements for the period for which the citation was issued; prior to renewing the license for the next biennium, Respondent must 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 and related infections of TB or domestic violence or medical errors CME, or substituted end-of-life care CME.	a. An administrative fine of $500.00 to $1,000.00.	a. A reprimand and an administrative fine of $1,000.00 to $5,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
b. Failure to document required HIV/AIDS and related infections of TB and failure to document domestic violence and failure to document medical errors CME.	b. An administrative fine of $1,000.00 to $2,000.00.	b. A reprimand and an administrative fine of $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
c. Failure to document some, but not all CME hours.	c. An administrative fine of $100.00 per hour not documented.	c. A reprimand and an administrative fine of $500.00 per hour not documented.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
d. Failure to document any CME hours.	d. A reprimand and an administrative fine from $5,000.00 to $10,000.00	d. Suspension until documentation of completion, a reprimand and an administrative fine of $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
3. Failing to comply with the requirements for profiling and credentialing. (Section 456.039, F.S.); (Section 456.072(1)(w), F.S.); (Section 458.319, F.S.);
a. Involving a violation of any provision of Chapter 456, F.S., for failing to comply with the requirements for profiling and credentialing, by failing to timely provide updated information, on a profile, credentialing, or initial or renewal licensure application, not appropriate for a notice of noncompliance.	a. If the licensee complies within six (6) months of the violation, then an administrative fine of up to $2,000.00; if compliance after six (6) months, an administrative fine of up to $5,000.00 and a reprimand.	a. If the licensee complies within six (6) months of the violation, then a reprimand and an administrative fine from $5,000.00 to $10,000.00; if compliance after six (6) months, from suspension to revocation and an administrative fine of $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
b. Involving violations of any provision of chapter 456, F.S., for making misleading, untrue, deceptive or fraudulent representations on a profile, credentialing, or initial or renewal licensure application.				Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(I) Negligently making misleading or untrue representations on a profile, credentialing, or initial licensure or renewal application.	(I) From a $1,000.00 fine and 3 hours CME on ethics to suspension, to be followed by a period of probation, and a reprimand, and a $5,000.00 administrative fine.	(I) From suspension, to be followed by a period of probation, and a reprimand, and a $10,000.00 fine to revocation or denial.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(II) Fraudulently making misleading, untrue, deceptive or fraudulent representations on a profile, credentialing, or initial licensure or renewal application.	(II) Referral to State Attorney for prosecution pursuant to sections 456.067 and 456.066, F.S., and from suspension, to be followed by a period of probation, and a reprimand and a $10,000.00 fine to revocation or denial and a $10,000 fine.	(II) Referral to State Attorney for prosecution and revocation or denial and a $10,000.00 fine.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
4. Failing to report to the board within 30 days after the licensee has been convicted of a crime in any jurisdiction. Convictions prior to the enactment of this section not reported in writing to the board, on or before October 1, 1999. (Section 456.072(1)(x), F.S.)	4. From an administrative fine of $2,000.00 to a fine of $5,000.00 and a reprimand or denial.	4. From suspension, to be followed by a period of probation to revocation and an administrative fine from $5,000.00 to $10,000.00.		4. From a letter of concern to a  reprimand or denial.	4. From suspension to revocation.
5. Failing to comply with obligations regarding ownership and control of medical records, patient records; report or copies of records to be furnished. (Section 456.057, F.S.)	5. From a letter of concern to two (2) years suspension followed by probation or denial and an administrative fine from $1,000.00 to $5,000.00.	5. From a reprimand to two (2) years suspension followed by probation or denial, and an administrative fine from $5,000.00 to $10,000.00.		5. From a letter of concern to two (2) years suspension with corrective action plan or denial.	5. From a reprimand to two (2) years suspension with corrective action plan.
6. Failing to maintain confidentiality of communication between a patient and a psychiatrist. (Section 456.059, F.S.)	6. From a $5,000.00 administrative fine and a reprimand to suspension, to be followed by a period of probation, and a $10,000.00 administrative fine or denial.	6. From suspension, to be followed by a period of probation, to revocation or denial.		6. From a reprimand to  suspension with corrective action plan or denial.	6.  From suspension to revocation.
7. Failing to report final disposition of professional liability claims and actions. (Section 456.049, F.S.)	7. If the licensee complies within six (6) months of the violation then an administrative fine of up to $2,000.00; if compliance after six (6) months, an administrative fine of up to $5,000.00 and a reprimand.	7. If the licensee complies within six (6) months of the violation, then a reprimand and an administrative fine from $5,000.00 to $10,000.00; if compliance after six (6) months, from suspension, to be followed by a period of probation, to revocation and an administrative fine of $10,000.00.		7. If the licensee complies within six (6) months of the violation then a letter of concern; if compliance after six (6) months, a reprimand.	7. If the licensee complies within six (6) months of the violation then a reprimand; if compliance after six (6) months, from suspension to revocation.
8. Failing to disclose financial interest to patient. (Section 456.052, F.S.)	8. A refund of fees paid by or on behalf of the patient and from an administrative fine of $1,000.00 and an administrative fine of $5,000.00.	8. A refund of fees paid by or on behalf of the patient and from restriction of practice, and an administrative fine of $5,000.00 to a reprimand, and an administrative fine of $10,000.00.		8.  A refund of fees paid by or on behalf of the patient and a letter of concern to a reprimand.	8. A refund of fees paid by or on behalf of the patient and reprimand to a suspension.
9. Failing to comply with the requirements for qualified physicians or medical directors required by Section 381.986(3), F.S. (Section 456.072(1)(k), F.S.	9. A letter of concern, and an administrative fine of $1,000.00 to probation and an administrative fine of $5,000.00.	9. A reprimand, and an administrative fine of $5,000.00 to revocation and an administrative fine of $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(h) Filing a false report or failing to file a report as required. (Section 458.331(1)(h), F.S.) (Section 456.072(1)(l), F.S.)
1. Negligently filing a false report or failing to file a report as required.	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. 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. From one (1) year probation to revocation or denial and a $10,000.00 fine.	2. From suspension, to be followed by a period of probation, to revocation and a $10,000.00 fine.		2.  From a reprimand to revocation or denial.	2.  From suspension to revocation.
3. Involving healthcare fraud in dollar amounts in excess of $5,000.00.	3. Revocation or in the case of application for licensure, denial of licensure, and a $10,000.00 fine.
4. Involving healthcare fraud in dollar amounts of $5,000.00 or less.	4. A $10,000.00 administrative fine, suspension of the license, followed by a period of probation.	4. Revocation and a $10,000.00 fine.
(i) Kickbacks or split fee arrangements. (Section 458.331(1)(i), F.S.); (Section 456.054, F.S.)	(i) A refund of fees paid by or on behalf of the patient, and from six (6) months suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(i) A refund of fees paid by or on behalf of the patient, and from a two (2) year 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.		(i) A refund of fees paid by or on behalf of the patient, and from six (6) months suspension with a corrective action plan, to revocation or denial.	(i) A refund of fees paid by or on behalf of the patient, and from a two (2) year suspension with a corrective action plan, to revocation.
(j) Sexual misconduct (Section 458.331(1)(j), F.S.); (Section 458.329, 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, and an administrative fine of $5,000.00 to revocation or denial and an administrative fine of $10,000.00.	(j) Revocation.		(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 medicine. (Section 458.331(1)(k), F.S.); (Sections 456.072 (1)(a), (m), F.S.)	(k) From probation to revocation or denial, and an administrative fine from $1,000.00 to $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.		(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 medicine involving healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure.	1. Revocation or denial and payment of a $10,000.00 fine.
2. Deceptive, untrue, or fraudulent representations in the practice of medicine involving healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, suspension of the license, followed by a period of probation .	2. Revocation.
(l) Improper solicitation of patients. (Section 458.331(1)(l), F.S.)	(l) From one (1) year suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(l) From one (1) year 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.		(l) From 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 appropriate written medical records. (Sections 458.331 (1)(m), F.S.; 456.47(3), F.S.)	(m) From a reprimand to denial or two (2) years suspension followed by probation, and an administrative fine from $1,000.00 to $10,000.00.	(m) From probation to suspension followed by probation or denial, and an administrative fine from $5,000.00 to $10,000.00.		(m) From a reprimand to two (2) years suspension with a corrective action plan or denial.	(m) From six (6) month suspension with a corrective action plan to  (2) years suspension with a corrective action plan.
1. Failure to keep appropriate written medical records involving healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation or in the case of application for licensure, denial of licensure.	1. Revocation or denial and payment of a $10,000.00 fine.
2. Failure to keep appropriate written medical records involving healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, suspension of the license, followed by a period of probation.	2. Revocation or denial.
(n) Exercising influence on patient for financial gain. (Section 458.331(1)(n), F.S.); (Section 456.072(1)(n), F.S.)	(n) Payment of fees paid by or on behalf of the patient and from probation to denial or two (2) years suspension, to be followed by a period of probation, or denial and an administrative fine from $5,000.00 to $10,000.00.	(n) Payment of fees paid by or on behalf of the patient and from suspension, to revocation or denial and an administrative fine of $10,000.00.		(n) Payment of fees paid by or on behalf of the patient and from three (3) month suspension with a corrective action plan 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 458.331(1)(o), F.S.)	(o) From a reprimand and $250.00 fine or denial to one year probation, to be followed by a period of probation, and an administrative fine from $250.00 to $5,000.00.	(o) From probation, to suspension, to be followed by a period of probation, or denial and an administrative fine of $5,000.00 to $10,000.00.		(o) From a  reprimand to suspension to with a corrective action plan or denial.	(o) From one (1) month suspension with a corrective action plan to six (6) month suspension to be followed by a corrective action plan.
(p) Performing professional services not authorized by patient. (Section 458.331(1)(p), F.S.)	(p) From a reprimand or denial to two (2) years suspension, to be followed by a period of probation or denial and an administrative fine from $1,000.00 to $10,000.00.	(p) From probation, to revocation or denial and an administrative fine of $5,000.00 to $10,000.00.		(p) From a reprimand or denial to two (2) years suspension with a corrective action plan or denial.	(p) From suspension with a corrective action plan to revocation or denial.
(q) Inappropriate or excessive prescribing. (Section 458.331(1)(q), F.S.)	(q) From one (1) year probation to revocation or denial and an administrative fine from $1,000.00 to 10,000.00.	(q) 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.		(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 or dispensing of a scheduled drug by the physician to himself. (Section 458.331(1)(r), F.S.)	(r) From one (1) year probation to revocation or denial and an administrative fine from $1,000.00 to $5,000.00, and a mental and physical examination.	(r) 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, 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) Inability to practice medicine with skill and safety. (Section 458.331(1)(s), F.S)	(s) From probation, to denial or indefinite suspension until licensee is able to demonstrate ability to practice with reasonable skill and safety followed by probation, or denial and an administrative fine from $1,000.00 to $5,000.00.	(s) From indefinite suspension, followed by probation, to suspension for a minimum of five (5) years or until licensee is able to demonstrate ability to practice with reasonable skill and safety followed by probation, and an administrative fine from $5,000.00 to $10,000.00.		(s) 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.	(s) 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.
(t) Failure to practice medicine in accordance with appropriate level of care, skill and treatment recognized in general law related to the practice of medicine. (Sections 456.50(1)(g), F.S.,); (Section 458.331(1)(t), F.S. .; 456.47(2)(a), F.S.)	(t) From one (1) year probation to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(t) From two (2) years probation to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.		(t) From three (3) month suspension with corrective action plan to revocation or denial	(t) From six  (6) month suspension with corrective action plan to revocation.
1. Gross Malpractice.	1. From one (1) year suspension followed by three (3) years probation to revocation or denial and an administrative fine from $1,000.00 to $10,000.00 and licensee shall be subject to reexamination.	1. From suspension, to be followed by a period of probation or denial to revocation or denial and an administrative fine of $5,000.00 to $10,000.00, and an evaluation or reexamination by a physician evaluation program approved by the Board.		1. From one (1) year suspension with a corrective action plan, to revocation or denial.	1. From two (2) year suspension with a corrective action plan to revocation.
2. Repeated Malpractice as defined in Section 456.50, F.S.	2. Revocation or denial and an administrative fine from $1,000.00 to $10,000.00.			2. Revocation or denial.
(u) Performing of experimental treatment without informed consent. (Section 458.331(1)(u), F.S.)	(u) From one (1) year suspension, to be followed by a period of probation; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(u) Revocation or denial.		(u) From one (1) year suspension with a corrective action plan to revocation or denial,	(u) Revocation or denial.
(v) Practicing beyond scope permitted. (Section 458.331(1)(v), F.S.); (Section 456.072(1)(o), F.S.)	(v) From two (2) years suspension; to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(v) From three (3) year suspension to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.		(v) From two (2) years suspension to revocation or denial.	(v) From three (3) year suspension to revocation or denial.
(w) Delegation of professional responsibilities to unqualified person. (Section 458.331 (1)(w), F.S.); (Section 456.072(1)(p), F.S.)	(w) From one (1) year probation, to denial or five (5) years suspension followed by probation, and an administrative fine from $1,000.00 to $10,000.00.	(w) 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.		(w) From three (3) month suspension with corrective action plan to five (5) year suspension with corrective action plan or denial.	(w) From six (6) month suspension with a corrective action plan to revocation.
(x)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. (Sections 458.331(1)(x), (nn), F.S.); (Sections 456.072(1) (b), (q), F.S.)	(x)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 and an administrative fine from $1,000.00 to $10,000.00.	(x)1. From probation, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.		(x)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.	(x)1. From suspension to revocation,or denial.
2. Violation of an order of the Board. (Section 458.331(1)(x), F.S.)	2. Reprimand and an administrative fine from $5,000.00 to $10,000.00, to revocation or denial based upon the severity of the offense and the potential for patient harm.	2. From suspension, to be followed by a period of probation, and a $10,000.00 fine or denial to revocation, or denial.		2.  From a reprimand to revocation or denial based upon the severity of the offense and the potential for patient harm.	2. From suspension with a corrective action plan, to revocation, or denial.
3. Failure to comply with any provision of rule 64B8-8.019, F.A.C.	3. From a $1,000.00 fine, letter of concern, demonstration of compliance with the rule or denial to a $5,000.00 fine, a reprimand, completion of a laws and rules course, a term of probation, demonstration of compliance with the rule or denial.	3. From a $7,500.00 fine, a reprimand, a term of probation, completion of a laws and rules course, demonstration of compliance with the rule or denial to a $10,000.00 fine and revocation.
(y) Conspiring to restrict another from lawfully advertising services. (Section 458.331(1)(y), F.S.)	(y) A reprimand or denial; and an administrative fine ranging from $1,000.00 to $5,000.00.	(y) Probation or denial; and an administrative fine from $5,000.00 to $10,000.00.		(y) A reprimand or denial.	(y) Suspension with a corrective action plan, or denial.
(z) Aiding an unlawful abortion. (Section 458.331(1)(z), F.S.)	(z) From one (1) year suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(z) From eighteen (18) month 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.		(z) From one (1) year suspension with a corrective action plan, to revocation or denial.	(z) From eighteen (18) month suspension with a corrective action plan, to revocation or denial.
(aa) Presigning prescription forms. (Section 458.331(1)(aa), F.S.)	(aa) From a reprimand to two (2) years probation or denial, and an administrative fine from $1,000.00 to $5,000.00.	(aa) 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.		(aa) From a reprimand to two (2) years suspension with a corrective action plan or denial.	(aa) From suspension with a corrective action plan to revocation or denial.
(bb) Prescribing a Schedule II substance for Office use. (Section 458.331(1)(bb), F.S.)	(bb) From a reprimand to probation with CME in pharmacology, and an administrative fine from $1,000.00 to $5,000.00.	(bb) From probation to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.		(bb) From a reprimand to 7 day suspension with a corrective action plan.	(bb) From 1 year suspension with a corrective action plan to revocation or denial.
(cc) Improper prescribing of Schedule II amphetamine or sympathomimetic amine drug. (Section 458.331(1)(cc), F.S.	(cc) From probation, to denial or two (2) years suspension followed by probation or denial, and an administrative fine from $1,000.00 to $10,000.00.	(cc) From suspension, to be followed by a period of probation, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.		(cc) From a suspension with a corrective action plan to  two (2) years suspension with a corrective action plan or denial.	(cc) From thirty (30) day suspension with a corrective action plan, to revocation or denial.
(dd) Failure to adequately supervise assisting personnel. (Section 458.331(1)(dd), F.S.)	(dd) From probation to denial or two (2) years suspension followed by probation, and an administrative fine from $1,000.00 to $5,000.00.	(dd) From one (1) year 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.		(dd) From a thirty (30) day suspension to  two (2) years suspension with a corrective action plan or denial.	(dd) From one (1) year suspension with a corrective action plan, to revocation or denial.
(ee) Improper use of substances for muscle building or enhancement of athletic performance. (Section 458.331(1)(ee), F.S.)	(ee) From one (1) year suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $1,000.00 to $5,000.00.	(ee) From eighteen (18) month suspension, to be followed by a period of probation, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.		(ee) From one (1) year suspension with a corrective action plan to revocation or denial.	(ee) From eighteen (18) month suspension with a corrective action plan to revocation or denial.
(ff) Use of amygdalin (laetrile). (Section 458.331(1)(ff), F.S.)	(ff) From one (1) year suspension, to be followed by a period of probation, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(ff) From eighteen (18) month suspension, to be followed by a period of probation, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.		(ff) From one (1) year suspension with a corrective action plan to revocation or denial.	(ff) From eighteen (18) month suspension with a corrective action plan to revocation or denial.
(gg) Misrepresenting or concealing a material fact. (Section 458.331(1)(gg), F.S.)	(gg) From suspension, to be followed by a period of probation, to denial or revocation of license or denial and an administrative fine from $1,000.00 to $5,000.00.	(gg) From a minimum of thirty (30) day 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.		(gg) From suspension with a corrective action plan or revocation to denial.	(gg) From a minimum of thirty (30) day suspension with a corrective action plan or revocation or denial.
(hh) Improperly interfering with an investigation or a disciplinary proceeding. (Section 458.331(1)(hh), F.S.)	(hh) From a thirty (30) day suspension, to be followed by a period of probation, to denial or revocation of license and payment of a $5,000.00 fine.	(hh) From a ninety (90) day 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.		(hh) From a thirty (30) day suspension with a corrective action plan, to  revocation or denial.	(hh) From a ninety (90) day suspension with a corrective action plan to  revocation or denial.
(ii) Failing to report any licensee in violation who practices in a hospital or an H.M.O.; or failing to report any person in violation of chapter 456, F.S. (Section 458.331(1)(ii), F.S.); (Section 456.072(1)(i), F.S.)	(ii) From a reprimand to probation, or denial and an administrative fine from $1,000.00 to $5,000.00.	(ii) From probation, to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.		(ii) From a reprimand to suspension with a corrective action plan, or denial.	(ii) Suspension with a corrective action plan or denial.
(jj) Providing written medical opinion without reasonable investigation. (Section 458.331(1)(jj), F.S.)	(jj) From a thirty (30) day suspension, to be followed by a period of probation to denial or revocation or denial of license and payment of a $1,000.00 to $5,000.00 fine.	(jj) From a ninety (90) day suspension, to be followed by a period of probation, to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.		(jj) From a thirty (30) day suspension with a corrective action plan to revocation or denial.	(jj) From a ninety (90) day suspension with a corrective action plan to revocation or denial.
(kk) Failure to report disciplinary action by another jurisdiction, and for telehealth registrants, including the notification of pending disciplinary action. (Sections 458.331(1)(kk), F.S.; 456.47(4)(d), F.S.	(kk) From an administrative fine of $2,000.00 to a fine of $5,000.00 and a reprimand, to denial or revocation or denial of license and payment of a $5,000.00.	(kk) From probation to 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.		(kk) From a reprimand to revocation or denial.	(kk) From suspension with a corrective action plan, to revocation or denial.
(ll) Improper holding oneself out as a specialist. (Section 458.331(1)(ll), F.S.)	(ll) From letter of concern, to one (1) year suspension, to be followed by a period of probation, or denial and an administrative fine from $500.00 to $5,000.00.	(ll) From reprimand, to up to one (1) year suspension, to be followed by a perod of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.		(ll) From a letter of concern, to one (1) year suspension with a corrective action plan, or denial.	(ll) From a reprimand, to up to one (1) year suspension with a corrective action plan, or denial.
(mm) Failing to provide patients with information about patient rights and how to file a patient complaint. (Section 458.331(1)(mm), F.S.); (Section 456.072(1)(u) (t), F.S.)	(mm) 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.	(mm) Administrative fine of up to $100.00 for the second and subsequent nonwillful violations; and an administrative fine from $250.00 to $500.00 for the second and subsequent willful violations with each intentional and willful violation a separate violation subject to said fine.		(mm) From a letter of concern to seven (7) day suspension with corrective action plan.	(mm) From a reprimand to a ten (10) day suspension with corrective action plan.
(nn) 1. Violating any provision of   chapters 458, 456, F.S., or any rules adopted pursuant thereto. (Section 458.331(1)(nn), F.S.)	(nn) From a reprimand, to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(nn) From probation, to revocation or denial and an administrative fine from $5,000.00 to $10,000.00.		(nn) From a reprimand to revocation or denial.	(nn) From suspension with a corrective action plan to revocation or denial.
2. Failure to comply with any provision of rule 64B8-8.019, F.A.C. (Section 458.331(1)(nn), F.S.	2. From a $1,000.00 fine, letter of concern, demonstration of compliance with the rule or denial to a $5,000.00 fine, a reprimand, completion of a laws and rules course, a term of probation, demonstration of compliance with the rule or denial.	2. From a $7,500.00 fine, a reprimand, a term of probation, completion of a laws and rules course, demonstration of compliance with the rule or denial to a $10,000.00 fine and revocation.		2.  From a letter of concern and demonstration of compliance with the rule, to suspension with a corrective action plan or denial.	2.  From a reprimand and demonstration of compliance with the rule to revocation or denial.
3. 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 458.331(1)(nn),  456.51, F.S.)	3. From a letter of concern to a reprimand and an administrative fine from $1,000.00 to $2,500.00, or denial .	3. From a reprimand to probation, and an administrative fine from $2,500.00 to $5,000.00, or denial.	3. From probation to revocation and an administrative fine from $5,000.00 to $10,000.00, or denial.	3. From a letter of concern to suspension with a corrective action plan or denial.	3.  From a minimum of six months suspension with a corrective action plan to revocation or denial.
(oo) Improper use of information about accident victims for commercial or any other solicitation of the people involved in such accidents. (Section 456.072(1)(x), F.S.)	(oo) From an administrative fine of $1,000.00 to a fine of $5,000.00, reprimand and probation.	(oo) From reprimand to up to one (1) year suspension or denial, and an administrative fine from $5,000.00 to $10,000.00.		(oo) From a reprimand to six (6) months suspension with a corrective action plan.	(oo) From a reprimand to up to one (1) year suspension or denial.
(pp) Theft or reproduction of an examination. (Section 456.018, F.S.)	(pp)  Revocation or denial.			(pp)  Revocation or denial.
(qq) Violation of Patient Self Referral Act. (Section 456.053, F.S.)	(qq) From In addition to any civil penalty imposed pursuant to Section 456.053, F.S., for each separate violation, from an administrative fine of $5,000.00 to an administrative fine of $10,000.00.	(qq) From probation to suspension, to be followed by a period of probation, or denial, and an administrative fine from $5,000.00 to $10,000.00.		(qq) From a reprimand to a suspension with a corrective action plan or denial.	(qq) From a thirty (30) day suspension with a corrective action plan to revocation or denial.
(rr) Prescribing controlled substances in violation of Section 456.47(2)(c), F.S. (Section 456.47(2)(c), F.S.)	(rr) From a reprimand and a $5,000.00 fine to revocation or denial.	(rr) From suspension and a $10,000.00 fine to revocation or denial.		(rr) From a reprimand to revocation or denial.	(rr) From suspension with a corrective action plan to revocation or denial.
(rr) Violation of medical director clinic responsibilities. (Section 456.0375(4)(c), F.S.)	(rr) Based upon the severity of the offense and the potential for patient harm, from a letter of concern, to revocation and an administrative fine from $1,000.00 to $10,000.00.	(rr) Restricted from serving as the medical director of any registered clinic and based upon the severity of the offense and the potential for patient harm, from a reprimand, to revocation and an administrative fine from $5,000.00 to $10,000.00.
1. Failure to file or renew registration form.	1. Notice of Non-Compliance if filed or renewed within 90 days. (See Rule 64B8-8.011, F.A.C.)	1. From a reprimand and a fine of $500 for each day the licensee served as director while the clinic was not registered, to permanent restriction on serving as a medical director.
2. Failure to display registration certificate.	2. Notice of Non-Compliance. (See Rule 64B8-8.011, F.A.C.)	2. Citation or a $2,000 fine. (See Rule 64B8-8.017, F.A.C.)
3. Failure to post signs identifying medical/clinical director in conspicuous location.	3. Notice of Non-Compliance. (See Rule 64B8-8.011, F.A.C.)	3. Citation. (See Rule 64B8-8.017, F.A.C.)
4. Failure to ensure that all health care practitioners employed at clinic have active, unencumbered license.	4. From probation, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	4. From suspension, to be followed by a period of probation, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
5. Failure to review patient referral contracts or agreements executed by clinic.	5. A refund of fees paid by or on behalf of the patient, and from an administrative fine of $1,000.00 to a reprimand, and an administrative fine of $5,000.00.	5. A refund of fees paid by or on behalf of the patient and from restriction of practice, and an administrative fine of $5,000.00 to a reprimand, and an administrative fine of $10,000.00.
6. Failure to ensure that all health care practitioners employed at clinic have active appropriate certification or licensure for the level of care being provided.	6. From probation, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	6. From suspension, to be followed by a period of probation, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
7. Failure to comply with section 456.057, F.S., with regard to clinic records.	7. From a letter of concern to two (2) years suspension followed by probation, and an administrative fine from $1,000.00 to $5,000.00.	7. From a reprimand to two (2) years suspension followed by probation, and an administrative fine from $5,000.00 to $10,000.00.
8. Failure to ensure compliance with recordkeeping requirements.	8. From a letter of concern to two (2) years suspension followed by probation, and an administrative fine from $1,000.00 to $5,000.00.	8. From a reprimand to two (2) years suspension followed by probation and an administrative fine from $5,000.00 to $10,000.00.
9. Failure to ensure compliance with office surgery requirements.	9. From probation to revocation, and an administrative fine from $1,000.00 to $10,000.00.	9. From suspension, to be followed by a period of probation, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
10. Failure to ensure compliance with adverse incident reporting requirements.	10. Notice of Non-Compliance if filed within 90 days. (See Rule 64B8-8.011, F.A.C.)	10. From a reprimand and a fine of $500 for each day the licensee served as director while the clinic was not registered, to permanent restriction on serving as a medical director.
11. Failure to conduct systematic reviews of clinic billings.	11. From a reprimand to two (2) years suspension followed by probation and an administrative fine from $1,000.00 to $10,000.00.	11. From probation to suspension followed by probation, and an administrative fine from $5,000.00 to $10,000.00.
12. Failure to take immediate corrective action upon discovery of unlawful billing.	12. A refund of fees paid by or on behalf of the patient and from six (6) months suspension, to be followed by a period of probation, to revocation, and an administrative fine from $1,000.00 to $10,000.00.	12. A refund of fees paid by or on behalf of the patient and from a two (2) year suspension, to be followed by a period of probation, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
13. Serving as medical/clinical director for more registered clinics than provided by Department rule.	13. From probation to two (2) years suspension followed by probation, and an administrative fine from $1,000.00 to $5,000.00.	13. From one (1) year suspension, to be followed by a period of probation, to revocation, and an administrative fine from $5,000.00 to $10,000.00.
(ss) 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.)	(ss) 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 $10,000.00 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.	(ss) From a $10,000.00 fine, a reprimand, undergo a risk management assessment, and probation or denial to a $10,000.00 fine and revocation.	(ss) From a $10,000.00 fine, a reprimand, undergo a competency evaluation, and suspension to be followed by a term of probation or denial, to a $10,000.00 fine and revocation.	(ss) From a letter of concern to suspension with a corrective action plan or denial.	(ss) From a reprimand to revocation or denial.
(tt) 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.)	(tt) From a $2,000.00 to a $10,000.00 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 to be followed by a term of probation. revocation.	(tt) From a $10,000.00 fine, a reprimand and probation, or denial to revocation.		(tt) From a letter of concern to  suspension with a corrective action plan.	(tt) From a suspension with a corrective action plan to revocation or denial.
(uu) For the practitioner(s) responsible for the adverse incident, failing to inform a patient, or an individual identified pursuant to Section 765.401(1), F.S., in person about adverse incidents that result in serious harm to the patient. (Section 456.0575, F.S.)	(uu) From a reprimand to probation, or denial and an administrative fine of $1,000 to $5,000.	(uu) From probation, to suspension or denial and an administrative fine of $5,000 to $10,000.		(uu) From a reprimand to suspension with a corrective action plan, or denial.	(uu) From suspension with a corrective action or denial.
(vv) 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.)	(vv) From one (1) year probation to revocation or denial and an administrative fine from $1,000.00 to $10,000.00.	(vv) 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.		(vv) From one (1) month suspension with a corrective action plan, to revocation or denial.	(vv) From ninety (90) day suspension with a corrective action plan, to revocation or denial.
(ww) 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.)	(ww) 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.	(ww) From a minimum of six (6) months suspension 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 be followed by a term of probation; and a fine of $2,500.00 to $10,000.00, to revocation or denial.		(ww) 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.	(ww) 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.
(xx) 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.)	(xx) Revocation and a fine of $10,000.00, or in the case of application for licensure, denial of license.			(xx) Revocation or denial.
(yy) 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.)	(yy) From a letter of concern to probation, and a fine of $500.00 to $5,000.00.	(yy) From a reprimand to revocation, and a fine of $2,500.00 to $5,000.00.		(yy) From a letter of concern to suspension with a corrective action plan.	(yy) From a reprimand to revocation.
(zz) Being terminated from the state Medicaid program for cause, or any other state Medicaid program, or the federal Medicare program. (Section 456.072(1)(kk), F.S.)	(zz) From a letter of concern to suspension, and a fine of $1,000.00 to $5,000.00, or denial.	(zz) From a reprimand to revocation, and a fine of $5,000.00 to $10,000.00, or denial.		(zz) From a letter of concern to suspension with a corrective action plan, or denial.	(zz) From a reprimand to revocation or denial.
(aaa) 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.)	(aaa) Revocation and a fine of $10,000, or in the case of application for licensure, denial of license.			(aaa) Revocation or denial.
(bbb) A violation of rule 64B8-9.0131, F.A.C.	(bbb) From probation for a term no less than two years and a fine of $5,000.00 to $10,000.00 to revocation.	(bbb) From suspension for a minimum of one year, to be followed by a term of probation and a $10,000.00 fine to revocation.		(bbb) From seven (7) day suspension and a corrective action plan to revocation or denial.	(bbb) From suspension for one (1) year with a corrective action plan to revocation.
(ccc) A violation of Rule 64B8-9.0132, F.A.C.	(ccc) From probation for a term no less than one year and a fine of $5,000.00 to $10,000.00 to revocation.	(ccc) From suspension for a minimum of six months, to be followed by a term of probation and a $10,000.00 fine to revocation.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(ddd) Registration of pain clinic by a designated physician through misrepresentation or fraud. (Section 458.331(1)(pp), F.S.)
1. For registering a pain clinic through misrepresentation. (Section 458.331(1)(pp)1., F.S.)	1. From a letter of concern to probation, and a fine of $1,000.00 to $5,000.00.	1. From a period of probation, to revocation, and a fine of $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
2. For registering a pain clinic through fraud. (Section 458.331(1)(pp)1., F.S.)	2. Revocation and a $10,000.00 fine.			Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(eee) Procuring or attempting to procure, the registration of a pain management clinic for any other person by making or causing to be made, any false representation. (Section 458.331(1)(pp)2., F.S.)	(eee) Revocation and a $10,000.00 fine.			Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(fff) Failing to comply with any requirement of chapter 499, F.S., the Florida Drug and Cosmetic Act; 21 U.S.C., ss. 301-392, the Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq., the Drug Abuse Prevention Control Act; or chapter 893, F.S., the Florida Comprehensive Drug Abuse Prevention and Control Act. (Section 458.331(1)(pp)3., F.S.)	(fff) From a letter of concern to probation, and a fine of $1,000.00 to $5,000.00.	(fff) From a reprimand to suspension, followed by a period of probation, and a fine of $5,000.00 to $10,000.00.	(fff) From a reprimand to revocation, and a fine of $7,500.00 to $10,000.00 fine.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(ggg) Being convicted of or found guilty of, regardless of adjudication to, a felony or any other crime involving moral turpitude, fraud, dishonesty, or deceit in any jurisdiction of the courts of this state, or any other state, or of the United States. (Section 458.331(1)(pp)4., F.S.)	(ggg) From probation to revocation, and an administrative fine ranging from $1,000.00 to $10,000.00.	(ggg) From suspension to revocation, and an administrative fine ranging from $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(hhh) Being convicted of, or disciplined by a regulatory agency of the Federal Government or a regulatory agency of another state for any offense that would constitute a violation of Chapter 458, F.S. (Section 458.331(1)(pp)5., F.S.)	(hhh) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to suspension 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 $5,000.00.	(hhh) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to revocation, and an administrative fine ranging from $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(iii) Being convicted of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime which relates to the practice of, or the ability to practice, a licensed health care profession. (Section 458.331(1)(pp)6., F.S.)	(iii) From probation to revocation, and an administrative fine ranging from $1,000.00 to $10,000.00.	(iii) From suspension to revocation, and an administrative fine ranging from $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(jjj) Being convicted of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime which relates to health care fraud. (Section 458.331(1)(pp)7., F.S.)	(jjj) A $10,000.00 administrative fine and suspension of the license, followed by a period of probation to revocation.	(jjj) Revocation and a fine of $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
1. Being convicted of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and a fine of $10,000.00.
2. Being convicted of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. A $10,000.00 administrative fine, and suspension of the license, followed by a period of probation.	2. Revocation and a fine of $10,000.00.
(kkk) Dispensing any medicinal drug based upon a communication that purports to be a presciption as defined in Section 465.003(14) or 893.02, F.S., if the dispensing practitioner knows or has reason to believe that the purported prescription is not based upon a valid practitioner-patient relation ship. (Section 458.331(1)(pp)8., F.S.)	(kkk) From a reprimand to revocation, and an administrative fine ranging from $1,000.00 to $10,000.00.	(kkk) From probation to revocation, and an administrative fine ranging from $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(lll) Failing to timely notify the Board of the date of his or her termination from a pain management clinic as required by section 458.3265(2), F.S. (Section 458.331(1)(pp)9., F.S.)	(lll) From a letter of concern to probation, and an administrative fine ranging from $1,000.00 to $5,000.00.	(lll) From a reprimand  to suspension, followed by a period of probation, and an administrative fine ranging from $5,000.00 to $10,000.00.	(lll) From suspension, followed by a period of probation to revocation, an administrative fine of $10,000.00.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(mmm) Failing to timely notify the Department of the theft of prescription blanks from a pain management clinic or a breach of a physician’s electronic prescribing software or other methods for prescribing within 24 hours as required by Section 458.3265(3)(2), F.S. (Section 458.331(1)(qq), F.S.)	(mmm) From a letter of concern to probation, and an administrative fine ranging from $1,000.00 to $5,000.00.	(mmm) From probation  to suspension, followed by a period of probation, and an administrative fine ranging from $5,000.00 to $10,000.00.	(mmm) From suspension, followed by a period of probation to revocation, an administrative fine of $10,000.00.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(nnn) Promoting or advertising through any communication media the use, sale, or dispensing of any controlled substance appearing on any schedule in Chapter 893, F.S. (Section 458.331(1)(rr), F.S.)	(nnn) From a letter of concern to one (1) year suspension, to be followed by a period of probation, and an administrative fine from $1,000.00 to $5,000.00.	(nnn) From reprimand to up to one (1) year suspension, to be followed by a period of probation, and an administrative fine from $5,000.00 to $10,000.00.		(nnn) From a letter of concern to one (1) year suspension with a corrective action plan.	(nnn) From reprimand to up to one (1) year suspension with a corrective action plan.
(ooo) Failure to comply with the controlled substance prescribing requirements of Section 456.44, F.S. (Section 456.072)(1)(mm), F.S.)	(ooo) From a minimum miminum 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.	(ooo) From a minimum miminum 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.		(ooo) From a minimum of suspension for a period of six (6) months with a corrective action plan, to revocation.	(ooo) From a minimum of suspension for a period of one (1) year with a corrective action plan, to revocation.
(ppp) Providing false or deceptive expert witness testimony related to the practice of medicine. (Section 458.331(1)(oo), F.S. )	(ppp) From a reprimand to revocation and an administrative fine from $5,000.00 to $10,000.00.	(ppp) From suspension to revocation and an administrative fine from $7,500.00 to $10,000.00.		(ppp) From a reprimand to revocation.	(ppp) From suspension to revocation.
(qqq) Failure to comply with the requirements of Section 390.0111(3), F.S., regarding termination of pregnancies. (Section 456.072)(1)(k), F.S.)	(qqq) From a letter of concern to a period of probation and an administrative fine in the amount of $1,000.00 to $2,500.00.	(qqq) From a reprimand to suspension followed by a period of probation and an administrative fine in the amount of  $2,500.00 to $5,000.00.	(qqq) From a reprimand to revocation and an administrative fine in the amount of $5,000.00 to $10,000.00.	(qqq) From a letter of concern to a suspension with a corrective action plan.	(qqq) From a reprimand to revocation.
(rrr) Dispensing a controlled substance listed in Schedule II or Schedule III in violation of Section 465.0276, F.S. (Section 458.331(1)(ss), F.S.)	(rrr) From probation to revocation and an administrative fine of $5,000.00 to $10,000.00.	(rrr) From suspension to be followed by a term of probation to revocation and an administrative fine of $7,500.00 to $10,000.00.		(rrr) From a one month suspension with a corrective action plan, to revocation.	(rrr) From a six month  suspension with a corrective action plan, to revocation.
(sss) Willfully failing to comply with Section 627.64194 or 641.513, F.S., with such frequency as to indicate a general business practice. (Section 458.331(1)(tt), F.S.)	(sss) From a letter of concern to a reprimand and an administrative fine in the amount of $1,000.00 to $5,000.00.	(sss) From a reprimand to revocation and an administrative fine in the amount of $5,000.00 to $10,000.00.		(sss) From a letter of concern to a reprimand.	(sss) From a reprimand to revocation.
(ttt) Issuing a physician certification, as defined in Section 381.986, F.S., in a manner out of compliance with the requirements of that section and the rules adopted thereunder. (Section 458.331(1)(uu), F.S.)	From probation to revocation or denial of the license and an administrative fine ranging from $1,000.00 to $5,000.00.	From suspension to revocation or denial of the license and an administrative fine ranging from $5,000.00 to $10,000.00.		Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(uuu) Failing to consult the prescription drug monitoring system, as required by Section 893.055(8), F.S. (Section 458.331(1)(g), F.S.)	(uuu) From a letter of concern to a reprimand and an administrative fine of $1,000.00 to $2,500.00.	(uuu) From a reprimand to suspension and an administrative fine from $2,500.00 to $5,000.00.	(uuu) From suspension to revocation and an administrative fine of $5,000.00 to $10,000.00.	(uuu) From a letter of concern to a reprimand.	(uuu) From a reprimand to revocation.
(vvv) Failing to report adverse incidents occurring in planned out-of-hospital births as required by Section 456.0495, F.S. (Section 458.331(1)(g), F.S.)	(vvv) From a letter of concern to a reprimand and an administrative fine of $1,000.00 to $2,500.00.	(vvv) From a reprimand to suspension and an administrative fine of $2,500.00 to $5,000.00.	(vvv) From suspension to revocation and an administrative fine of $5,000.00 to $10,000.00.	(vvv) From a letter of concern to a reprimand.	(vvv) From a reprimand to revocation.
(www) Performing a liposuction procedure in which more than 1,000 cubic centimeters of supernatant fat is removed, a Level II office surgery, or a Level III office surgery in an office that is not registered with the department pursuant to Section 458.328, F.S. (Section 458.331(1)(vv), F.S.)	(www) From twelve (12) months probation to twelve (12) months suspension followed by a term of probation and an administrative fine of $5,000.00 per day.	(www) From twelve (12) months suspension followed by a term of probation and permanent restriction from performing office surgery to revocation and an administrative fine of $5,000.00 per day.	(www) From eighteen (18) months suspension followed by a term of probation and permanent restriction from performing office surgery to revocation and an administrative fine of $5,000.00 per day.	Not applicable to telehealth registrants.	Not applicable to telehealth registrants.
(xxx) 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.	(xxx) From six (6) months probation to one (1) year suspension, and an administrative fine of $5,000.00 to $10,000.00, or denial.	(xxx) From one (1) year suspension to revocation and an administrative fine of $7,500.00 to $10,000.00, or denial.		(xxx) From six (6) months suspension with a corrective action plan to one (1) year suspension with a corrective action plan or denial.	(xxx) From one (1) year suspension with a corrective action plan to revocation or denial.
(yyy) 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 458.331(1)(ww), F.S.)	(yyy) Revocation and a $10,000,00 fine or denial.			(yyy) Revocation or denial.
(aaaa) Failure to display hyperlink on telehealth registrant’s website. (Section 456.47(4)(c), F.S.	(aaaa) Not applicable to physicians licensed under Chapter 458, F.S.			(aaaa) From a letter of concern to suspension with a corrective action plan.	(aaaa) From a reprimand to revocation.
(bbbb) Opening an office in Florida or providing in-person healthcare services to patients in Florida. (Section 456.47(4)(f), F.S.)	(bbbb) Not applicable to physicians licensed under Chapter 458, F.S.			(bbbb) From six (6) month suspension with a corrective action plan to revocation or denial.	(bbbb) From one (1) year suspension with a corrective action plan to revocation.

(3) No change.

(4) It is the intent of the Board to notify applicants and licensees whom it regulates under Chapter 458, F.S., and Section 456.47. F.S., of the seriousness with which the Board deals with sexual misconduct in or related to the practice of medicine. In particular, the Board has identified those situations in which the sexual misconduct is predatory in its character because of the particular powerlessness or vulnerability of the patient, or because of the licensee’s history or manipulation of the physician/patient relationship. Therefore, it is the policy of the Board, where any one of the following aggravating conditions are present in a sexual misconduct case, to consider revocation as an appropriate penalty:

(a) through (i) No change..

(5) No change.

(6) Letters of Guidance. The provisions of this rule cannot and shall not be construed to limit the authority of the probable cause panel of the Board to direct the Department to send a letter of guidance pursuant to Section 456.073455.621(3), F.S., in any case for which it finds such action appropriate.

(7) – (8) No change.

Rulemaking Authority 456.079, 456.47(7), 458.309, 458.331(5) FS. Law Implemented 381.986(3)(a), 456.47, 456.50(2), 456.0575, 456.072, 456.079, 458.331(5) FS. History–New 12-5-79, Formerly 21M-20.01, Amended 1-11-87, 6-20-90, Formerly 21M-20.001, Amended 11-4-93, Formerly 61F6-20.001, Amended 6-24-96, 12-22-96, Formerly 59R-8.001, Amended 5-14-98, 12-28-99, 1-31-01, 7-10-01, 6-4-02, 9-10-02, 12-11-02, 8-20-03, 6-7-04, 8-17-04, 1-4-06, 8-13-06, 8-29-06, 11-22-06, 1-30-07, 2-18-09, 12-22-09, 7-27-10, 6-21-11, 12-27-11, 4-22-12, 5-28-12, 1-1-15, 11-9-16, 4-30-18, 8-15-18, 8-28-18, 12-12-19, 3-2-20.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Rules/Legislative Committee, Board of Medicine

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

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 7, 2020

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: August 27, 2020