64B8-8.001: Disciplinary Guidelines
PURPOSE AND EFFECT: The proposed rule amendments are intended to delete the requirement for community service in the Board’s various disciplinary guidelines.
SUMMARY: The proposed rule amendments delete the requirements for community service.
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(5) FS.
LAW IMPLEMENTED: 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 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:
64B8-8.001 Disciplinary Guidelines.
(1) No change.
(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
VIOLATION (a) No change. |
FIRST OFFENSE |
SECOND OFFENSE |
THIRD OFFENSE |
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(b) Action taken against license by another jurisdiction. (458.331(1)(b), F.S.) (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 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. |
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1. No change. |
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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. A $10,000.00 administrative fine |
2. Revocation or denial and a fine of $10,000.00. |
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(c) Guilty of crime directly relating to practice or ability to practice. (458.331(1)(c), F.S.) (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 |
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1. No change. |
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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 |
2. Revocation and a fine of $10,000.00. |
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(d) False, deceptive, or misleading advertising. (458.331(1)(d), F.S.) 1. Negligent false, deceptive, or misleading advertising. (458.331(1)(d), F.S.) 2. Fraudulent false, deceptive or misleading advertising |
1. From a letter of concern to one (1) year suspension or denial, to be followed by a period of probation, 2. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, |
1. From reprimand to up to one (1) year suspension or denial, to be followed by a period of probation, 2. From suspension, to be followed by a period of probation, up to revocation, |
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(e) Failure to report another licensee in violation. (458.331(1)(e), F.S.) (456.072(1)(i), F.S.) |
(e) From a letter of concern to probation or denial, |
(e) From probation to suspension or denial, |
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(f) Aiding unlicensed practice. (458.331(1)(f), F.S.) (456.072(1)(j), F.S.) |
(f) From probation to revocation or denial |
(f) From suspension, to be followed by a period of probation, to revocation or denial |
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(g) Failure to perform legal obligation. (458.331(1)(g), F.S.) (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, |
(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, |
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1. Failing to register a laser device. (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, |
1. If the device is an approved device, from a reprimand to probation or restriction of practice, |
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2. No change. |
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3. Failing to comply with the requirements for profiling and credentialing. (456.039, F.S.) (456.072(1)(v), F.S.); (458.319, F.S.); |
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a. No change. |
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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. |
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(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, |
(I) From suspension, to be followed by a period of probation, and a reprimand, |
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(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, |
(II) Referral to State Attorney for prosecution and revocation or denial and a $10,000.00 fine. |
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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. (456.072(1)(w), F.S.) |
4. From an administrative fine of $2,000.00 to a fine of $5,000.00 |
4. From suspension, to be followed by a period of probation |
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5. Failing to comply with obligations regarding ownership and control of medical records, patient records; report or copies of records to be furnished. (456.054, F.S.) |
5. From a letter of concern to two (2) years suspension followed by probation or denial |
5. From a reprimand to two (2) years suspension followed by probation or denial, |
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6. Failing to maintain confidentiality of communication between a patient and a psychiatrist. (456.059, F.S.) |
6. From a $5,000.00 administrative fine |
6. From suspension, to be followed by a period of probation, |
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7. No change. |
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8. Failing to disclose financial interest to patient. (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 |
8. A refund of fees paid by or on behalf of the patient and from restriction of practice, |
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(h) No change. Filing a false report or failing to file a report as required. (458.331(1)(h), F.S.) (456.072(1)(l), F.S.) |
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1. through 3. No change. |
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4. Involving healthcare fraud in dollar amounts of $5,000.00 or less. |
4. A $10,000.00 administrative fine, |
4. Revocation and a $10,000.00 fine. |
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(i) Kickbacks or split fee arrangements. (458.331(1)(i), F.S.) (456.054, 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 |
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(j) Sexual misconduct (458.331(1)(j), F.S.) (458.329, F.S.) (456.072(1)(u), F.S.) |
(j) From one (1) year suspension to be followed by a period of probation and a reprimand |
(j) Revocation. |
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(k) Deceptive, untrue, or fraudulent representations in the practice of medicine. (458.331(1)(k), F.S.) (456.072(1)(a), (m), F.S.) |
(k) From probation |
(k) From suspension, to be followed by a period of probation, |
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1. No change. |
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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. |
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(l) Improper solicitation of patients. (458.331(1)(l), F.S.) |
(l) From one (1) year suspension, to be followed by a period of probation, |
(l) From one (1) year suspension, to be followed by a period of probation, |
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(m) Failure to keep appropriate written medical records. (458.331(1)(m), F.S.) |
(m) From a reprimand to denial or two (2) years suspension followed by probation, |
(m) From probation to suspension followed by probation or denial, |
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1. No change. |
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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. |
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(n) Exercising influence on patient for financial gain. (458.331(1)(n), F.S.) (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, |
(n) Payment of fees paid by or on behalf of the patient and from suspension, |
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(o) Improper advertising of pharmacy. (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, |
(o) From probation |
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(p) Performing professional services not authorized by patient. (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 |
(p) From probation |
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(q) Inappropriate or excessive prescribing. (458.331(1)(q), F.S.) |
(q) From one (1) year probation to revocation or denial |
(q) From suspension, to be followed by a period of probation, |
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(r) Prescribing or dispensing of a scheduled drug by the physician to himself. (458.331(1)(r), F.S.) |
(r) From one (1) year probation |
(r) From suspension, to be followed by a period of probation, |
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(s) Inability to practice medicine with skill and safety. (458.331(1)(s), F.S.) |
(s) From probation |
(s) From indefinite suspension, followed by probation, |
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(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. (456.50(1)(g), F.S.) (458.331(1)(t), F.S.) |
(t) From one (1) year probation |
(t) From two (2) years probation |
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1. Gross Malpractice. |
1. From one (1) year suspension followed by three (3) years probation |
1. From suspension, to be followed by a period of probation |
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2. No change. |
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(u) Performing of experimental treatment without informed consent. (458.331(1)(u), F.S.) |
(u) From one (1) year suspension, to be followed by a period of probation; |
(u) Revocation or denial. |
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(v) Practicing beyond scope permitted. (458.331(1)(v), F.S.) (456.072(1)(o), F.S.) |
(v) From two (2) years suspension; |
(v) From suspension |
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(w) Delegation of professional responsibilities to unqualified person. (458.331(1)(w), F.S.) (456.072(1)(p), F.S.) |
(w) From one (1) year probation, |
(w) From suspension, to be followed by a period of probation; |
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(x)1. Violation of law, rule, or failure to comply with subpoena. (458.331(1)(nn), F.S.) (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, |
(x)1. From probation, |
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2. Violation of an order of the Board. 458.331(1)(x), F.S. |
2. Reprimand |
2. From suspension, to be followed by a period of probation, |
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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, |
3. From a $7,500.00 fine, a reprimand, a term of probation, completion of a laws and rules course, |
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(y) Conspiring to restrict another from lawfully advertising services. (458.331(1)(y), F.S.) |
(y) A reprimand or denial; |
(y) Probation or denial; |
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(z) Aiding an unlawful abortion. (458.331(1)(z), F.S.) |
(z) From one (1) year suspension, to be followed by a period of probation, |
(z) From suspension, to be followed by a period of probation; |
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(aa) Presigning prescription forms. (458.331(1)(aa), F.S.) |
(aa) From a reprimand to two (2) years probation, |
(aa) From suspension, to be followed by a period of probation, |
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(bb) Prescribing a Schedule II substance for Office use. (458.331(1)(bb), F.S.) |
(bb) From a reprimand to probation with CME in pharmacology, |
(bb) From probation to suspension, to be followed by a period of probation, or denial, |
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(cc) Improper prescribing of Schedule II amphetamine or sympathomimetic amine drug. (458.331(1)(cc), F.S. |
(cc) From probation |
(cc) From suspension, to be followed by a period of probation, |
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(dd) Failure to adequately supervise assisting personnel. (458.331(1)(dd), F.S.) |
(dd) From probation |
(dd) From one (1) year suspension, to be followed by a period of probation, |
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(ee) Improper use of substances for muscle building or enhancement of athletic performance. (458.331(1)(ee), F.S.) |
(ee) From one (1) year suspension, to be followed by a period of probation, |
(ee) From suspension, to be followed by a period of probation, |
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(ff) Use of amygdalin (laetrile). (458.331(1)(ff), F.S.) |
(ff) From one (1) year suspension, to be followed by a period of probation, |
(ff) From suspension, to be followed by a period of probation, |
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(gg) Misrepresenting or concealing a material fact. (458.331(1)(gg), F.S.) |
(gg) From suspension, to be followed by a period of probation, |
(gg) From suspension, to be followed by a period of probation, |
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(hh) Improperly interfering with an investigation or a disciplinary proceeding (458.331(1)(hh), F.S.) |
(hh) From suspension, to be followed by a period of probation, |
(hh) From suspension, to be followed by a period of probation, |
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(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. (458.331(1)(ii), F.S.) (456.072(1)(i), F.S.) |
(ii) From a reprimand to probation, |
(ii) From probation, |
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(jj) Providing written medical opinion without reasonable investigation. (458.331(1)(jj), F.S.) |
(jj) From suspension, to be followed by a period of probation, |
(jj) From suspension, to be followed by a period of probation, |
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(kk) Failure to report disciplinary action by another jurisdiction. (458.331(1)(kk), F.S.) |
(kk) From an administrative fine of $2,000.00 to a fine of $5,000.00 and a reprimand, |
(kk) From probation, |
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(ll) Improper holding oneself out as a specialist. (458.331(1)(ll), F.S.) |
(ll) From letter of concern, |
(ll) From reprimand, |
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(mm) No change. |
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(nn) Violating Chapters 458, 456, F.S., or any rules adopted pursuant thereto. (458.331(1)(nn), F.S.) |
(nn) From a reprimand, |
(nn) From probation, |
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(oo) Improper use of information about accident victims for commercial or any other solicitation of the people involved in such accidents. (456.072(1)(x), F.S.) |
(oo) From an administrative fine of $1,000.00 to a fine of $5,000.00, reprimand |
(oo) From reprimand to up to one (1) year suspension |
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(pp) No change. |
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(qq) Violation of Patient Self Referral Act. (456.053, F.S.) |
(qq) 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 |
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(rr) Violation of medical director clinic responsibilities. (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, |
(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, |
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1. 3. No change. |
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4. Failure to ensure that all health care practitioners employed at clinic have active, unencumbered license. |
4. From probation |
4. From suspension, to be followed by a period of probation, |
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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, |
5. A refund of fees paid by or on behalf of the patient and from restriction of practice |
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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 |
6. From suspension, to be followed by a period of probation, |
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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 |
7. From a reprimand to two (2) years suspension followed by probation |
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8. Failure to ensure compliance with recordkeeping requirements. |
8. From a letter of concern to two (2) years suspension followed by probation |
8. From a reprimand to two (2) years suspension followed by probation |
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9. Failure to ensure compliance with office surgery requirements. |
9. From probation |
9. From suspension, to be followed by a period of probation, |
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10. No change. |
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11. Failure to conduct systematic reviews of clinic billings. |
11. From a reprimand to two (2) years suspension followed by probation |
11. From probation |
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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, |
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 |
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13. Serving as medical/ clinical director for more registered clinics than provided by Department rule. |
13. From probation |
13. From one (1) year suspension, to be followed by a period of probation, |
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(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. (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, |
(ss) From a $10,000.00 fine, a reprimand, |
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(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. (456.072(1)(bb), 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, |
(tt) From a $10,000.00 fine, a reprimand and probation, |
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(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. (456.0575, F.S.) |
(uu) From a reprimand to probation, |
(uu) From probation |
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(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. (456.072(1)(gg), F.S.) |
(vv) From one (1) year probation to revocation or denial |
(vv) From suspension, to be followed by a period of probation, |
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(ww) (aaa) No change. |
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(bbb) A violation of Rule 64B8-9.0131, F.A.C. |
(bbb) From probation for a term no less than two years |
(bbb) From suspension for a minimum of one year, to be followed by a term of probation |
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(ccc) A violation of Rule 64B8-9.0132, F.A.C. |
(ccc) From probation for a term no less than one year |
(ccc) From suspension for a minimum of six months, to be followed by a term of probation |
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(ddd) (qqq) No change. |
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(3) through (7) No change.
Rulemaking Authority 456.079, 458.309, 458.331(5) FS. Law Implemented 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,________.