64B8-30.015: Disciplinary Guidelines
PURPOSE AND EFFECT: The proposed rule amendments are intended to clarify the disciplinary guidelines for physician assistants and to address comments submitted by the staff of the Joint Administrative Procedures Committee.
SUMMARY: The proposed rule amendments set forth violations and the range of disciplinary guidelines for the violations with regard to physician assistants.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members, determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 456.079, 458.309, 458.331(4) FS.
LAW IMPLEMENTED: 456.072, 456.079, 458.331(4), 458.347(4)(e)1., (7)(g) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joy A. Tootle, Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253
THE FULL TEXT OF THE PROPOSED RULE IS:
64B8-30.015 Disciplinary Guidelines.
(1) No change.
(2) Violations and Range of Penalties. In imposing discipline upon physician assistant 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.
VIOLATIONS |
RECOMMENDED PENALTIES | |
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First Offense |
Subsequent Offenses |
(a) Attempting to obtain 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.) |
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1. No change. |
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2. Attempting to renew a license by bribery or fraud. |
2. Revocation of the license and payment of a |
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3. Obtaining or renewing a license by bribery or fraud. |
3. Revocation of the license and payment of a |
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4. Obtaining or renewing a license through error of the Department or the Board. |
4. Revocation. |
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(b) Action taken against license by another jurisdiction. (Section 458.331(1)(b), F.S.) (Section 456.072(1)(f), 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 reprimand through 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 $2,500.00. |
(b) From imposition of discipline comparable to the discipline which would have been imposed if the substantive violation had occurred in Florida to suspension and revocation 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 $2,500.00 to $5,000.00. |
1. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts in excess of $5,000.00. |
1. Revocation and an administrative fine of $10.000.00 |
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2. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts of $5,000.00 or less. |
2. From an administrative fine of $10,000.00 |
2. From an administrative fine of $10,000.00 |
(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 reprimand to revocation or denial of license, and an administrative fine of $1,000.00 to $5,000.00 |
(c) From probation to revocation or denial of the license, and an administrative fine ranging from $2,500.00 to $5,000.00 |
1. Involving a crime directly related to healthcare fraud in dollar amounts in excess of $5,000.00. |
1. Revocation and an administrative fine of |
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2. Involving a crime directly related to healthcare fraud in dollar amounts of $5,000.00 or less. |
2. An |
2. An |
(d) False, deceptive, or misleading advertising. (Section 458.331(1)(d), F.S.) |
(d) From a letter of concern to reprimand, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00 |
(d) From a letter of concern to reprimand, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00 |
(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 an administrative fine ranging from $1,000.00 to $2,500.00, |
(e) From reprimand to suspension or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00 |
(f) Aiding unlicensed practice. (Section 458.331(1)(f), F.S.) (Section 456.072(1)(j), F.S.) |
(f) From reprimand to suspension, followed by probation, or denial of licensure, |
(f) From probation to revocation or denial of licensure |
(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 reprimand to revocation or denial of licensure, |
(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, |
1. Continuing medical education (CME) violations. (Section 456.072(1)(e), F.S.) (Section 456.072(1)(s), F.S.) (Section 456.033(9), F.S.) |
1. Document compliance with the CME requirements for the relevant period; AND: |
1. Document compliance with the CME requirements for the relevant period; AND: |
a. Failure to document required HIV/AIDS |
a. An administrative fine ranging from $250.00 to $500.00. |
a. An administrative fine ranging from $500.00 to $1,000.00. |
b. Failure to document required domestic violence CME |
b. An administrative fine ranging from $250.00 to $500.00. |
b. An administrative fine of $500.00 to $1,000.00. |
c. Failure to document required HIV/AIDS |
c. An administrative fine ranging from $500.00 to $1,000.00. |
c. An administrative fine ranging from $1,000.00 to $2,000.00. |
2. No change. |
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3. Failing to disclose financial interest to patient. (Section 456.052, F.S.) |
3. A refund of fees paid by or on behalf of the patient and from an administrative fine of $1,000.00, |
3. A refund of fees paid by or on behalf of the patient and from a reprimand, |
(h) No change. |
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1. Involving healthcare fraud in dollar amounts in excess of $5,000.00. |
1. Revocation and an administrative fine of $10.000.00 |
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2. Involving healthcare fraud in dollar amounts of $5,000.00 or less. |
2. An |
2. An |
(i) Kickbacks or split fee arrangements. (Section 458.331(1)(i), F.S.) |
(i) A refund of fees paid by or on behalf of the patient, |
(i) A refund of fees paid by or on behalf of the patient, |
(j) Sexual Misconduct. (Section 458.331(1)(j), F.S.) (Section 458.329, F.S.) (Section 456.072(1)(u), F.S.) |
(j) From probation to revocation, or denial of licensure, |
(j) From suspension, to be followed by a period of probation to revocation, |
(k) Deceptive, untrue, or fraudulent representations in the practice of medicine. (Section 458.331(1)(k), F.S.) (Section 456.072(1)(a), (m), F.S.) |
(k) From a letter of concern, |
(k) From probation or denial of licensure, |
1. Deceptive, untrue, or fraudulent representations in the practice of medicine relating to healthcare fraud in dollar amounts in excess of $5,000.00. |
1. From revocation with leave to reapply in three (3) years, and an administrative fine ranging of $10.000.00 |
1. From permanent revocation and an administrative fine of $10.000.00 |
2. Deceptive, untrue, or fraudulent representations in the practice of medicine relating to healthcare fraud in dollar amounts of $5,000.00 or less. |
2. An |
2. An |
(l) Improper solicitation of patients. (Section 458.331(1)(l), F.S.) |
(l) From an administrative fine ranging from $1,000.00 to $5,000.00, |
(l) From suspension, to be followed by a period of probation, |
(m) Failure to keep legible written medical records. (Section 458.331(1)(m), F.S.) |
(m) From letter of concern, |
(m) From a reprimand to suspension followed by probation, |
1. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts in excess of $5,000.00. |
1. From revocation with leave to reapply in three (3) years, and an administrative fine of $10.000.00 |
1. From permanent revocation and an administrative fine of $10.000.00 |
2. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts of $5,000.00 or less. |
2. An |
2. An |
(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 a reprimand, |
(n) Payment of fees paid by or on behalf of the patient and from probation, |
(o) Improper advertising of pharmacy. (Section 458.331(1)(o), F.S.) |
(o) From a letter of concern to probation, or a denial of licensure, |
(o) From a reprimand, |
(p) Performing professional services not authorized by patient. (Section 458.331(1)(p), F.S.) |
(p) From a letter of concern, |
(p) From a reprimand, |
(q) Inappropriate or excessive prescribing. (Section 458.331(1)(q), F.S.) |
(q) From reprimand to probation, |
(q) From probation, |
(r) Prescribing or dispensing of a scheduled drug by the physician assistant to himself or herself. (Section 458.331(1)(r), F.S.) |
(r) From probation to suspension or denial of licensure, |
(r) From suspension to revocation or denial of licensure, |
(s) Inability to practice medicine with skill and safety. (Section 458.331(1)(s), F.S.) |
(s) From reprimand to suspension, which may be stayed to allow a period of probation with supervision, and a demonstration by the licensee of the ability to practice with reasonable skill and safety, or denial of licensure, |
(s) From probation to revocation, until the licensee is able to demonstrate ability to practice with reasonable skill and safety, followed by probation, or denial of licensure, |
(t)1. Malpractice: practicing below acceptable standard of care. (Section 458.331(1)(t), F.S.) |
(t)1. From a letter of concern, |
(t)1. From reprimand, |
2. Gross Malpractice. |
2. From probation, |
2. From suspension followed by probation to revocation or denial, |
3. No change. |
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(u) Performing of experimental treatment without informed consent. (Section 458.331(1)(u), F.S.) |
(u) From a letter of concern to suspension, to be followed by a period of probation, or denial of licensure, |
(u) From suspension to be followed by a period of probation, |
(v) Practicing beyond scope permitted. (Section 458.331(1)(v), F.S.) (Section 456.072(1)(o), F.S.) |
(v) From a letter of concern to reprimand and probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00. |
(v) From probation to suspension or revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00. |
(w) Delegation of professional responsibilities to unqualified person. (Section 458.331(1)(w), F.S.) (Section 456.072(1)(p), F.S.) |
(w) From reprimand to suspension, followed by probation, |
(w) From probation, |
(x)1. Violation of law, rule, or failure to comply with subpoena. (Section 458.331(1)(x), F.S.); (Section 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 of licensure, |
(x)1. From probation, |
2. Violation of an order of the Board. |
2. From a reprimand and suspension followed by a period of probation, |
2. From a reprimand and suspension followed by a period of probation, |
(y) Conspiring to restrict another from lawfully advertising services. (Section 458.331(1)(y), F.S.) |
(y) From a letter of concern to a reprimand, |
(y) From a reprimand, |
(z) Aiding an unlawful abortion. (Section 458.331(1)(z), F.S.) |
(z) From probation, |
(z) From suspension, to be followed by a period of probation, |
(aa) Presigning prescription forms. (Section 458.331(1)(aa), F.S.) |
(aa) From a letter of concern to a reprimand and an administrative fine of $1,000.00 to a letter of concern, and an administrative fine of $2,500.00. |
(aa) From a reprimand to probation, |
(bb) Failure to adequately supervise assisting personnel. (Section 458.331(1)(dd), F.S.) |
(bb) From a reprimand to probation, or denial of licensure, |
(bb) From probation to suspension followed by probation, or denial of licensure, |
(cc) Improper use of substances for muscle building or enhancement of athletic performance. (Section 458.331(1)(ee), F.S.) |
(cc) From a reprimand to suspension, or denial of licensure, |
(cc) From suspension to be followed by a period of probation, to revocation or denial of licensure, |
(dd) Use of amygdaline (laetrile). (Section 458.331(1)(ff), F.S.) |
(dd) From a reprimand to probation, or denial of licensure, |
(dd) From suspension to be followed by a period of probation to revocation or denial of licensure, |
(ee) Misrepresenting or concealing a material fact. (Section 458.331(1)(gg), F.S.) |
(ee) From a reprimand to probation, and an administrative fine ranging from $500.00 to $2,500.00, |
(ee) From probation, |
(ff) Improperly interfering with an investigation or a disciplinary proceeding. (Section 458.331(1)(hh), F.S.) (Section 456.072(1)(r), F.S.) |
(ff) From a reprimand to probation, |
(ff) From probation, |
(gg) Failing to report any M.D., D.O. or PA, who is in violation of law. (Section 458.331(1)(ii), F.S.); (Section 456.072(1)(i), F.S.) |
(gg) From a letter of concern to probation, or denial of licensure, |
(gg) From probation to revocation or denial of licensure, |
(hh) No change. |
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(ii) Violating Chapters 458, 456, F.S., or any rules adopted pursuant thereto. (458.331(1)(nn), F.S.) |
(ii) From a reprimand, |
(ii) From probation, |
(jj) No change. |
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(kk) 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.) |
(kk) 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 $5,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, |
(kk) From a $7,500.00 fine, a reprimand, |
(ll) 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.) |
(ll) From a $1,000.00 to a $5,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, |
(ll) From a $7,500.00 fine, a reprimand and probation, |
(mm) 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.) |
(mm) From reprimand to probation, |
(mm) From probation, |
(nn) through (rr) No change. |
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(3) through (4) No change.
Rulemaking Authority 456.079, 458.309, 458.331(4) FS. Law Implemented 456.072, 456.079, 458.331(4), 458.347(4)(e)1., (7)(g) FS. History–New 3-13-89, Formerly 21M-17.015, 61F6-17.015, 59R-30.015, Amended 6-7-98, 4-9-01, 5-16-10,________.