64B8-8.0012. Probation Variables and Practice Restrictions

In instances where a Respondent is placed on probation or where practice restrictions are imposed by the Board, the Board shall determine the terms and conditions of Respondent’s probation or practice restrictions. The following terms of probation are utilized by the Board to ensure that Respondents are safely practicing medicine. Possible terms of probation and restrictions on practice include, but are not limited to:

(1) Appearances Required. Respondent shall appear before the Probationer’s Committee at the first meeting after said probation commences, at the last meeting of the Probationer’s Committee preceding termination of probation and either quarterly, semiannually, or annually as set forth in the final order. Respondent shall be noticed by Board staff of the date, time and place of the Board’s Probationer’s Committee whereat Respondent’s appearance is required. Failure of the Respondent to appear as requested or directed shall be considered a violation of the terms of probation, and shall subject the Respondent to disciplinary action.

(2) Direct Supervision Required. If direct supervision is required by the Board, Respondent shall not practice except under the direct supervision of a board-certified physician fully licensed under chapter 458, F.S., who has been approved by the Probationer’s Committee.

(a) The supervisory physician shall work in the same office with the Respondent.

(b) Absent provision for and compliance with the terms regarding temporary approval of a supervising physician set forth in paragraph 64B8-8.011(7)(c), F.A.C., Respondent shall cease practice and not practice until the Probationer’s Committee approves a supervising physician.

(c) Respondent shall have the supervising physician appear at the first probation appearance before the Probationer’s Committee.

1. Prior to approval of the supervising physician by the committee, the Respondent shall provide to the supervising physician a copy of the Administrative Complaint and the Board’s Order filed in the case.

2. A failure of the Respondent or the supervising physician to appear at the scheduled probation meeting shall constitute a violation of the Board’s Order.

3. Prior to the approval of the supervising physician by the committee, Respondent shall submit to the committee a current curriculum vitae and description of the current practice of the proposed supervising physician. Said materials shall be received in the Board office no later than 21 days before the Respondent’s first scheduled probation appearance.

(d) The responsibilities of a supervising physician shall include:

1. Submit quarterly reports, in affidavit form, which shall include:

a. Brief statement of why physician is on probation.

b. Description of probationer’s practice.

c. Brief statement of probationer’s compliance with terms of probation.

d. Brief description of probationer’s relationship with supervising physician.

e. Detail any problems which may have arisen with probationer.

2. Should the Board determine that Respondent’s medical records need to be reviewed, the Board shall set forth the percentage of the records and type of records to be reviewed by the supervising physician. The patient records shall be selected by the supervising physician on a random basis at least once every month.

3. Report to the Board any violation by the probationer of chapters 456 and 458, F.S., and the rules promulgated pursuant thereto.

(3) Indirect Supervision Required. Should the Board determine that indirect supervision is appropriate, Respondent shall not practice except under the indirect supervision of a board-certified physician fully licensed under chapter 458, F.S., to be approved by the Board’s Probationer’s Committee.

(a) Absent provision for and compliance with the terms regarding temporary approval of a monitoring physician set forth below, Respondent shall cease practice and not practice until the Probationer’s Committee approves a monitoring physician.

(b) Respondent shall have the monitoring physician present at the first probation appearance before the Probationer’s Committee.

(c) Prior to approval of the monitoring physician by the committee, the Respondent shall provide to the monitoring physician a copy of the Administrative Complaint and Board’s Order filed in the case.

(d) Failure of the Respondent or the monitoring physician to appear at the scheduled probation meeting shall constitute a violation of the Board’s Order.

(e) Prior to the approval of the monitoring physician by the committee, Respondent shall submit to the committee a current curriculum vitae and description of the current practice of the proposed monitoring physician. Said materials shall be received in the Board office no later than 21 days before the Respondent’s first scheduled probation appearance. The responsibilities of a monitoring physician shall include:

1. Submit quarterly reports, in affidavit form, which shall include:

a. Brief statement of why physician is on probation.

b. Description of probationer’s practice.

c. Brief statement of probationer’s compliance with terms of probation.

d. Brief description of probationer’s relationship with monitoring physician.

e. Detail any problems which may have arisen with probationer.

2. Be available for consultation with Respondent whenever necessary, at a frequency to be determined by the Board.

3. Should the Board determine that Respondent’s medical records need to be reviewed, the Board shall set forth the percentage of the records and type of records to be reviewed by the monitoring physician. The patient records shall be selected by the monitoring physician on a random basis at least once every month. In order to comply with this responsibility of random review, the monitoring physician shall go to Respondent’s office once every month unless a different time frame is set forth in the Board’s Order. At that time, the monitoring physician shall be responsible for making the random selection of the records to be reviewed by the monitoring physician.

4. Report to the Board any violations by the probationer of chapters 456 and 458, F.S., and the rules promulgated pursuant thereto.

(4) Immediate Supervision Required. If immediate supervision is required by the Board, Respondent shall not perform designated procedures unless under the immediate supervision of a board-certified physician fully licensed under chapter 458, F.S., who has been approved by the Probationer’s Committee.

(a) The supervisory physician shall be physically located in the same room with the Respondent where the designated procedure is performed.

(b) Absent provision for and compliance with the terms regarding temporary approval of a supervising physician set forth in paragraph 64B8-8.0011(7)(c), F.A.C., Respondent shall cease performing the designated procedure[s] until the Probationer’s Committee approves a supervising physician.

(c) Respondent shall have the supervising physician appear at the first probation appearance before the Probationer’s Committee.

1. Prior to approval of the supervising physician by the committee, the Respondent shall provide to the supervising physician a copy of the Administrative Complaint and the Board’s Order filed in the case.

2. A failure of the Respondent or the supervising physician to appear at the scheduled probation meeting shall constitute a violation of the Board’s Order.

3. Prior to the approval of the supervising physician by the committee, Respondent shall submit to the committee a current curriculum vitae and description of the current practice of the proposed supervising physician. Said materials shall be received in the Board office no later than 21 days before the Respondent’s first scheduled probation appearance.

(d) The responsibilities of a supervising physician shall include:

1. Submit quarterly reports, in affidavit form, which shall include:

a. Brief statement of why physician is on probation.

b. Description of probationer’s practice.

c. Brief statement of probationer’s compliance with terms of probation.

d. Brief description of probationer’s relationship with supervising physician.

e. Detail any problems which may have arisen with probationer.

2. Should the Board determine that Respondent’s medical records need to be reviewed, the Board shall set forth the percentage of the records and type of records to be reviewed by the supervising physician. The patient records shall be selected by the supervising physician on a random basis at least once every month.

3. Report to the Board any violation by the probationer of chapters 456 and 458, F.S., and the rules promulgated pursuant thereto.

(5) Alternate Monitor/Supervisor. In view of the need for ongoing and continuous monitoring or supervision, Respondent shall also be required to submit the curriculum vitae and name of an alternate supervising/monitoring board-certified physician who shall be approved by Probationer’s Committee. Such physician shall be licensed pursuant to chapter 458, F.S., and shall have the same duties and responsibilities as specified for Respondent’s monitoring/supervising physician during those periods of time which Respondent’s monitoring/supervising physician is temporarily unable to provide supervision. Prior to practicing under the indirect supervision of the alternate monitoring physician or the direct supervision of the alternate supervising physician, Respondent shall so advise the Board in writing. Respondent shall further advise the Board in writing of the period of time during which Respondent shall practice under the supervision of the alternate monitoring/supervising physician. Respondent shall not practice unless Respondent is under the supervision of either the approved supervising/monitoring physician or the approved alternate.

(6) In the event the Respondent is unable to locate a physician who is board-certified in the Respondent’s specialty area/area of practice who is available and willing to serve as his or her monitor, the Committee may allow the Respondent to be supervised by a non board-certified physician, provided that Respondent is able to demonstrate that after diligent effort he or she was unable to locate a board-certified physician in the Respondent’s specialty area/area of practice who is available and willing to serve as his or her monitor. Respondent must also demonstrate that the proposed non board-certified physician is qualified by specialty area/area of practice and experience to serve as Respondent’s monitor.

(7) In the event the Respondent is unable to locate a qualified physician monitor who is located within 20 miles of Respondent’s practice, the Committee may allow the Respondent to be supervised by a physician outside the 20-mile area, provided that the Respondent is able to demonstrate that after diligent effort he or she was unable to locate a qualified monitor within the 20 mile area.

(8) Continuing Medical Education. Should the Board determine that continuing medical education (CME) is appropriate during the probationary period, the Board shall determine the number of hours and subject area of the required CME. The CME shall be Category I Continuing Medical Education. Respondent shall submit a written plan to the Chairperson of the Probationer’s Committee for approval prior to the completion of said courses. The Board confers authority on the Chairperson of the Probationer’s Committee to approve or disapprove said continuing education courses. In addition, Respondent shall submit documentation of completion of these continuing medical education courses in each report. These hours shall be in addition to those hours required for biennial renewal of licensure. Said continuing education courses shall consist of a formal live lecture format.

(9) PRN Required. Should the Board determine that a contract by the Professionals Resource Network (PRN) is appropriate, Respondent shall participate and comply with the PRN contract.

(a) Respondent shall enter into an after care contract with PRN, shall comply with all its terms, and shall be responsible for assuring that the medical director of PRN send the Board a copy of said contract.

(b) Respondent shall execute a release that authorizes PRN to release information and medical records (including psychiatric records and records relating to treatment for drug dependence and alcoholism) to the Board of Medicine as needed to monitor the progress of Respondent in the PRN program.

(c) Respondent shall authorize the director of PRN to report to the Board of Medicine any problems that may occur with Respondent and any violations of chapter 456 or 458, F.S. Such a report shall be made within 30 days of the occurrence of any problems, or violations of chapter 456 or 458, F.S.

(10) Relinquishment of DEA Registration Required. Should the Board determine that it is appropriate to require a relinquishment of Respondent’s prescribing privileges, the Board shall set forth the length of said relinquishment and determine which controlled substances shall be affected.

(a) Respondent shall relinquish his or her registration with the Drug Enforcement Administration (DEA) until such time as Respondent can demonstrate the ability to practice medicine with skill and safety to patients absent this condition or term of probation.

(b) At such time that the Board determines that reinstatement of prescribing privileges is appropriate, Respondent’s prescribing may be subject to certain conditions and restrictions to be set forth by the Board.

(11) Prescribing Prohibition or Restriction. Should the Board determine that it is appropriate to require a restriction of Respondent’s prescribing privileges, the Board shall set forth the length of said restriction and determine which controlled substances shall be affected. Such restrictions shall include, but are not limited to:

(a) Restriction from prescribing, administering, dispensing, mixing or ordering Schedule controlled substances, other than in a hospital setting.

(b) Prescribing controlled substances with the restrictions set forth below:

1. Respondent shall utilize sequentially numbered duplicate or triplicate prescriptions in the prescribing of Schedule controlled substances.

2. Respondent shall, within one month after issuance, provide one copy of each prescription for controlled substances to the Department’s investigator.

3. Respondent shall, within two weeks after issuance, provide one copy of each prescription for controlled substances to his/her monitoring/supervising physician.

4. Respondent shall maintain one copy of each prescription for controlled substances in the patient’s medical records.

(12) Prohibition on the supervision of physician assistant (PA) or advanced registered nurse practitioner (ARNP) prescribers. In the event Respondent is restricted from the prescribing of one or more classes of controlled substances, Respondent may not delegate the prescribing of such classes of controlled substances to Physician Assistants (PAs) and Advanced Registered Nurse Practitioners (ARNPs) until such time as the Respondent is no longer prohibited from prescribing said classes of controlled substances. Within ten days of entry of the final order, Respondent must provide the Board compliance officer with a copy of the amended written agreement required by Rule 64B8-30.007, F.A.C., or protocols as required by rule 64B8-35.002, F.A.C., reflecting the withdrawal of delegation of controlled substances.

(13) Restriction on Treating Female Patients. Should the Board determine there should be a restriction on treating female patients, Respondent shall not examine or treat any female patients without a female employee who is a health care practitioner licensed by the Department of Health present in the room.

Rulemaking Authority 456.072(2), 458.309, 458.331(5) FS. Law Implemented 456.072(2), 458.331(5) FS. History–New 8-1-06, Amended 5-1-17, 5-7-18, 3-10-19.