Bill Text: FL S1498 | 2019 | Regular Session | Introduced


Bill Title: Access to Health Care Practitioner Services

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2019-05-03 - Died in Health Policy [S1498 Detail]

Download: Florida-2019-S1498-Introduced.html
       Florida Senate - 2019                                    SB 1498
       
       
        
       By Senator Lee
       
       
       
       
       
       20-01219-19                                           20191498__
    1                        A bill to be entitled                      
    2         An act relating to access to health care practitioner
    3         services; amending s. 456.013, F.S.; exempting
    4         physicians who provide a certain number of hours of
    5         pro bono services from continuing education
    6         requirements; amending s. 458.310, F.S.; revising the
    7         eligibility criteria for a restricted license;
    8         creating s. 458.3105, F.S.; establishing a
    9         registration program for volunteer retired physicians;
   10         providing eligibility criteria for such registration;
   11         requiring biennial registration renewal; requiring the
   12         Department of Health to waive certain fees;
   13         authorizing the Board of Medicine to deny, revoke, or
   14         impose restrictions or conditions on a registration
   15         for certain violations; amending s. 458.311, F.S.;
   16         revising the physician licensure criteria applicable
   17         to Canadian applicants; amending s. 458.319, F.S.;
   18         requiring the department to waive a physician’s
   19         license renewal fee under certain circumstances;
   20         deleting an obsolete date; creating s. 459.00751,
   21         F.S.; providing legislative intent; authorizing the
   22         Board of Osteopathic Medicine to issue a restricted
   23         license to qualified applicants; providing eligibility
   24         criteria for such license; prohibiting licensure if a
   25         restricted licensee breaches the terms of an
   26         employment contract; creating s. 459.00752, F.S.;
   27         establishing a registration program for volunteer
   28         retired osteopathic physicians; providing eligibility
   29         criteria for such registration; requiring biennial
   30         registration renewal; requiring the department to
   31         waive certain fees; authorizing the Board of
   32         Osteopathic Medicine to deny, revoke, or impose
   33         restrictions or conditions on a registration for
   34         certain violations; amending s. 459.008, F.S.;
   35         requiring the department to waive an osteopathic
   36         physician’s license renewal fee under certain
   37         circumstances; deleting an obsolete date; amending s.
   38         766.1115, F.S.; revising the definition of the term
   39         “low-income” for purposes of the Access to Health Care
   40         Act; providing an effective date.
   41          
   42  Be It Enacted by the Legislature of the State of Florida:
   43  
   44         Section 1. Subsection (6) of section 456.013, Florida
   45  Statutes, is republished, and subsection (9) is amended, to
   46  read:
   47         456.013 Department; general licensing provisions.—
   48         (6) As a condition of renewal of a license, the Board of
   49  Medicine, the Board of Osteopathic Medicine, the Board of
   50  Chiropractic Medicine, and the Board of Podiatric Medicine shall
   51  each require licensees which they respectively regulate to
   52  periodically demonstrate their professional competency by
   53  completing at least 40 hours of continuing education every 2
   54  years. The boards may require by rule that up to 1 hour of the
   55  required 40 or more hours be in the area of risk management or
   56  cost containment. This provision shall not be construed to limit
   57  the number of hours that a licensee may obtain in risk
   58  management or cost containment to be credited toward satisfying
   59  the 40 or more required hours. This provision shall not be
   60  construed to require the boards to impose any requirement on
   61  licensees except for the completion of at least 40 hours of
   62  continuing education every 2 years. Each of such boards shall
   63  determine whether any specific continuing education requirements
   64  not otherwise mandated by law shall be mandated and shall
   65  approve criteria for, and the content of, any continuing
   66  education mandated by such board. Notwithstanding any other
   67  provision of law, the board, or the department when there is no
   68  board, may approve by rule alternative methods of obtaining
   69  continuing education credits in risk management. The alternative
   70  methods may include attending a board meeting at which another
   71  licensee is disciplined, serving as a volunteer expert witness
   72  for the department in a disciplinary case, or serving as a
   73  member of a probable cause panel following the expiration of a
   74  board member’s term. Other boards within the Division of Medical
   75  Quality Assurance, or the department if there is no board, may
   76  adopt rules granting continuing education hours in risk
   77  management for attending a board meeting at which another
   78  licensee is disciplined, for serving as a volunteer expert
   79  witness for the department in a disciplinary case, or for
   80  serving as a member of a probable cause panel following the
   81  expiration of a board member’s term.
   82         (9) Any board that currently requires continuing education
   83  for renewal of a license, or the department if there is no
   84  board, shall adopt rules to establish the criteria for
   85  continuing education courses. The rules may provide that up to a
   86  maximum of 25 percent of the required continuing education hours
   87  can be fulfilled by the performance of pro bono services to the
   88  indigent or to underserved populations or in areas of critical
   89  need within the state where the licensee practices. However, a
   90  physician licensed under chapter 458 or chapter 459 who submits
   91  to the department documentation proving that he or she has
   92  completed at least 120 hours of pro bono services within a
   93  biennial licensure period is exempt from the continuing
   94  education requirements established by board rule under
   95  subsection (6). The board, or the department if there is no
   96  board, must require that any pro bono services be approved in
   97  advance in order to receive credit for continuing education
   98  under this subsection. The standard for determining indigency
   99  shall be that recognized by the Federal Poverty Income
  100  Guidelines produced by the United States Department of Health
  101  and Human Services. The rules may provide for approval by the
  102  board, or the department if there is no board, that a part of
  103  the continuing education hours can be fulfilled by performing
  104  research in critical need areas or for training leading to
  105  advanced professional certification. The board, or the
  106  department if there is no board, may make rules to define
  107  underserved and critical need areas. The department shall adopt
  108  rules for administering continuing education requirements
  109  adopted by the boards or the department if there is no board.
  110         Section 2. Subsections (2) and (3) of section 458.310,
  111  Florida Statutes, are amended to read:
  112         458.310 Restricted licenses.—
  113         (2) The board of Medicine may annually, by rule, develop
  114  criteria and, without examination, issue restricted licenses
  115  authorizing the practice of medicine in this state to not more
  116  than 300 persons and to an unlimited number of physicians who
  117  hold active, unencumbered licenses to practice medicine in
  118  Canada if such applicants annually to up to 100 persons to
  119  practice medicine in this state who:
  120         (a)Submit to the department a completed application form;
  121         (b)(a) Meet the requirements of s. 458.311(1)(b), (c), (d),
  122  and (g). A Canadian applicant shall also provide the board with
  123  a printed or electronic copy of his or her fingerprint-based
  124  national Canadian criminal history records check conducted
  125  within 6 months after the date of application;
  126         (c)(b) Show evidence of the active licensed practice of
  127  medicine in another jurisdiction for at least 2 years of the
  128  immediately preceding 4 years, or completion of board-approved
  129  postgraduate training within the year immediately preceding the
  130  filing of an application; and
  131         (d)(c) Enter into a contract to practice for a period of up
  132  to 36 24 months solely in the employ of the state, or a
  133  federally funded community health center, or a migrant health
  134  center; a free clinic that delivers only medical diagnostic
  135  services or nonsurgical medical treatment free of charge to all
  136  low-income residents; or a health care provider in a health
  137  professional shortage area or medically underserved area
  138  designated by the United States Department of Health and Human
  139  Services, at the current salary level for that position. The
  140  board may of Medicine shall designate other areas of critical
  141  need in the state where these restricted licensees may practice.
  142         (3) Before the end of the contracted 24-month practice
  143  period, the physician must take and successfully complete the
  144  licensure examination under s. 458.311 to become fully licensed
  145  in this state.
  146         Section 3. Section 458.3105, Florida Statutes, is created
  147  to read:
  148         458.3105Registration of volunteer retired physicians.—
  149         (1)A physician may register under this section to practice
  150  medicine as a volunteer retired physician if he or she:
  151         (a)Submits an application to the board on a form developed
  152  by the department within 2 years after the date on which his or
  153  her license changed from active to retired status;
  154         (b)Provides proof to the department that he or she
  155  actively practiced medicine for at least 3 of the 5 years
  156  immediately preceding the date on which his or her license
  157  changed from active to retired status;
  158         (c)Has held an active license to practice medicine and has
  159  maintained such license in good standing in this state or in at
  160  least one other jurisdiction of the United States or Canada for
  161  at least 20 years;
  162         (d)Contracts with a health care provider to provide free,
  163  volunteer health care services to indigent persons or medically
  164  underserved populations in health professional shortage areas or
  165  medically underserved areas designated by the United States
  166  Department of Health and Human Services;
  167         (e)Works under the supervision of a nonretired physician
  168  who holds an active, unencumbered license; and
  169         (f)Only provides medical services of the type and within
  170  the specialty that he or she performed before retirement and
  171  does not perform surgery or prescribe a controlled substance as
  172  defined in s. 893.02(4).
  173         (2)The physician shall apply biennially to the board for
  174  renewal of his or her registration by demonstrating to the board
  175  compliance with this section.
  176         (3)The department shall waive all application, licensure,
  177  unlicensed activity, and renewal fees for qualifying physicians
  178  under this section.
  179         (4)The board may deny, revoke, or impose restrictions or
  180  conditions on a registration for any violation of this chapter
  181  or chapter 456 or rules adopted thereunder.
  182         (5)The board may deny or revoke registration for
  183  noncompliance with this section.
  184         Section 4. Paragraph (h) of subsection (1) of section
  185  458.311, Florida Statutes, is amended to read:
  186         458.311 Licensure by examination; requirements; fees.—
  187         (1) Any person desiring to be licensed as a physician, who
  188  does not hold a valid license in any state, shall apply to the
  189  department on forms furnished by the department. The department
  190  shall license each applicant who the board certifies:
  191         (h) Has obtained a passing score, as established by rule of
  192  the board, on the licensure examination of the United States
  193  Medical Licensing Examination (USMLE); or a combination of the
  194  United States Medical Licensing Examination (USMLE), the
  195  examination of the Federation of State Medical Boards of the
  196  United States, Inc. (FLEX), or the examination of the National
  197  Board of Medical Examiners up to the year 2000; or for the
  198  purpose of examination of any applicant who was licensed on the
  199  basis of a state board examination and who is currently licensed
  200  in at least one other jurisdiction of the United States or
  201  Canada, and who has practiced pursuant to such licensure for a
  202  period of at least 10 years, or any applicant who holds an
  203  active, unencumbered license to practice medicine in Canada and
  204  who has practiced pursuant to such licensure for a period of at
  205  least 10 years, use of the Special Purpose Examination of the
  206  Federation of State Medical Boards of the United States (SPEX)
  207  upon receipt of a passing score as established by rule of the
  208  board. However, for the purpose of examination of any applicant
  209  who was licensed on the basis of a state board examination
  210  before prior to 1974, who is currently licensed in at least
  211  three other jurisdictions of the United States or Canada, and
  212  who has practiced pursuant to such licensure for a period of at
  213  least 20 years, this paragraph does not apply.
  214         Section 5. Subsection (1) of section 458.319, Florida
  215  Statutes, is amended to read:
  216         458.319 Renewal of license.—
  217         (1) The department shall renew a license upon receipt of
  218  the renewal application, evidence that the applicant has
  219  actively practiced medicine or has been on the active teaching
  220  faculty of an accredited medical school for at least 2 years of
  221  the immediately preceding 4 years, and a fee not to exceed $500;
  222  provided, however, that if the licensee is either a resident
  223  physician, assistant resident physician, fellow, house
  224  physician, or intern in an approved postgraduate training
  225  program, as defined by the board by rule, the fee shall not
  226  exceed $100 per annum. If the licensee demonstrates to the
  227  department, in a manner set by department rule, that he or she
  228  has provided at least 160 hours of pro bono medical services to
  229  indigent persons or medically underserved populations within the
  230  biennial renewal period, the department shall waive the renewal
  231  fee. If the licensee has not actively practiced medicine for at
  232  least 2 years of the immediately preceding 4 years, the board
  233  shall require that the licensee successfully complete a board
  234  approved clinical competency examination before prior to renewal
  235  of the license. “Actively practiced medicine” means that
  236  practice of medicine by physicians, including those employed by
  237  any governmental entity in community or public health, as
  238  defined by this chapter, including physicians practicing
  239  administrative medicine. An applicant for a renewed license must
  240  also submit the information required under s. 456.039 to the
  241  department on a form and under procedures specified by the
  242  department, along with payment in an amount equal to the costs
  243  incurred by the Department of Health for the statewide criminal
  244  background check of the applicant. The applicant must submit a
  245  set of fingerprints to the Department of Health on a form and
  246  under procedures specified by the department, along with payment
  247  in an amount equal to the costs incurred by the department for a
  248  national criminal background check of the applicant for the
  249  initial renewal of his or her license after January 1, 2000. If
  250  the applicant fails to submit either the information required
  251  under s. 456.039 or a set of fingerprints to the department as
  252  required by this section, the department shall issue a notice of
  253  noncompliance, and the applicant will be given 30 additional
  254  days to comply. If the applicant fails to comply within 30 days
  255  after the notice of noncompliance is issued, the department or
  256  board, as appropriate, may issue a citation to the applicant and
  257  may fine the applicant up to $50 for each day that the applicant
  258  is not in compliance with the requirements of s. 456.039. The
  259  citation must clearly state that the applicant may choose, in
  260  lieu of accepting the citation, to follow the procedure under s.
  261  456.073. If the applicant disputes the matter in the citation,
  262  the procedures set forth in s. 456.073 must be followed.
  263  However, if the applicant does not dispute the matter in the
  264  citation with the department within 30 days after the citation
  265  is served, the citation becomes a final order and constitutes
  266  discipline. Service of a citation may be made by personal
  267  service or certified mail, restricted delivery, to the subject
  268  at the applicant’s last known address. If an applicant has
  269  submitted fingerprints to the department for a national criminal
  270  history check upon initial licensure and is renewing his or her
  271  license for the first time, then the applicant need only submit
  272  the information and fee required for a statewide criminal
  273  history check.
  274         Section 6. Section 459.00751, Florida Statutes, is created
  275  to read:
  276         459.00751Restricted licenses.—
  277         (1)It is the intent of the Legislature to provide medical
  278  services to all residents of this state at an affordable cost.
  279         (2)The board may annually issue restricted licenses
  280  authorizing the practice of osteopathic medicine in this state
  281  to not more than 300 persons and to an unlimited number of
  282  osteopathic physicians who hold active, unencumbered licenses to
  283  practice medicine in Canada if such applicants:
  284         (a)Submit to the department a completed application form;
  285         (b)Meet the requirements of s. 459.0055(1)(b), (c), (d),
  286  (e), (f), (g), and (j). A Canadian applicant must also provide
  287  the board with a printed or electronic copy of his or her
  288  fingerprint-based, national Canadian criminal history records
  289  check, conducted within 6 months after the date of application;
  290         (c)Show evidence of the active licensed practice of
  291  medicine in another jurisdiction for at least 2 years of the
  292  immediately preceding 4 years, or completion of board-approved
  293  postgraduate training within the year immediately preceding the
  294  filing of an application; and
  295         (d)Enter into a contract to practice osteopathic medicine
  296  for a period of up to 36 months in the employ of the state, a
  297  federally funded community health center, or a migrant health
  298  center; a free clinic that delivers only medical diagnostic
  299  services or nonsurgical medical treatment free of charge to all
  300  low-income residents; or a health care provider in a health
  301  professional shortage area or medically underserved area
  302  designated by the United States Department of Health and Human
  303  Services. The board may designate other areas of critical need
  304  in the state where these restricted licensees may practice.
  305         (3)Before the end of the contracted practice period, the
  306  osteopathic physician must take and successfully complete the
  307  licensure examination under s. 459.0055 to become fully licensed
  308  in this state.
  309         (4)If the restricted licensee breaches the terms of the
  310  employment contract, he or she may not be licensed as an
  311  osteopathic physician in this state under any licensing
  312  provisions.
  313         Section 7. Section 459.00752, Florida Statutes, is created
  314  to read:
  315         459.00752Registration of volunteer retired osteopathic
  316  physicians.—
  317         (1)An osteopathic physician may register under this
  318  section to practice medicine as a volunteer retired osteopathic
  319  physician if he or she:
  320         (a)Submits an application to the board on a form developed
  321  by the department no earlier than 6 months before the date on
  322  which his or her license permanently expires and no later than 2
  323  years after such expiration;
  324         (b)Provides proof to the department that he or she
  325  actively practiced medicine for at least 3 of the 5 years
  326  immediately preceding the date on which his or her license
  327  changed from active to retired status;
  328         (c)Has held an active license to practice osteopathic
  329  medicine and maintained such license in good standing in this
  330  state or in at least one other jurisdiction of the United States
  331  or Canada for at least 20 years;
  332         (d)Contracts with a health care provider to provide free
  333  volunteer health care services to indigent persons or medically
  334  underserved populations in health professional shortage areas or
  335  medically underserved areas designated by the United States
  336  Department of Health and Human Services;
  337         (e)Works under the supervision of a nonretired osteopathic
  338  physician who holds an active, unencumbered license; and
  339         (f)Only provides medical services of the type and within
  340  the specialty that he or she performed before retirement and
  341  does not perform surgery or prescribe a controlled substance as
  342  defined in s. 893.02(4).
  343         (2)The registrant shall apply biennially to the board for
  344  renewal of his or her registration by demonstrating to the board
  345  compliance with this section.
  346         (3)The department shall waive all application, licensure,
  347  unlicensed activity, and renewal fees for qualifying applicants
  348  under this section.
  349         (4)The board may deny, revoke, or impose restrictions or
  350  conditions on a registration for any violation of this chapter
  351  or chapter 456 or rules adopted thereunder.
  352         (5)The board may deny or revoke registration for
  353  noncompliance with this section.
  354         Section 8. Subsection (1) of section 459.008, Florida
  355  Statutes, is amended to read:
  356         459.008 Renewal of licenses and certificates.—
  357         (1) The department shall renew a license or certificate
  358  upon receipt of the renewal application and fee. If the licensee
  359  demonstrates to the department, in a manner set by department
  360  rule, that he or she has provided at least 160 hours of pro bono
  361  osteopathic medical services to indigent persons or medically
  362  underserved populations within the biennial renewal period, the
  363  department shall waive the renewal fee. An applicant for a
  364  renewed license must also submit the information required under
  365  s. 456.039 to the department on a form and under procedures
  366  specified by the department, along with payment in an amount
  367  equal to the costs incurred by the department of Health for the
  368  statewide criminal background check of the applicant. The
  369  applicant must submit a set of fingerprints to the Department of
  370  Health on a form and under procedures specified by the
  371  department, along with payment in an amount equal to the costs
  372  incurred by the department for a national criminal background
  373  check of the applicant for the initial renewal of his or her
  374  license after January 1, 2000. If the applicant fails to submit
  375  either the information required under s. 456.039 or a set of
  376  fingerprints to the department as required by this section, the
  377  department shall issue a notice of noncompliance, and the
  378  applicant will be given 30 additional days to comply. If the
  379  applicant fails to comply within 30 days after the notice of
  380  noncompliance is issued, the department or board, as
  381  appropriate, may issue a citation to the applicant and may fine
  382  the applicant up to $50 for each day that the applicant is not
  383  in compliance with the requirements of s. 456.039. The citation
  384  must clearly state that the applicant may choose, in lieu of
  385  accepting the citation, to follow the procedure under s.
  386  456.073. If the applicant disputes the matter in the citation,
  387  the procedures set forth in s. 456.073 must be followed.
  388  However, if the applicant does not dispute the matter in the
  389  citation with the department within 30 days after the citation
  390  is served, the citation becomes a final order and constitutes
  391  discipline. Service of a citation may be made by personal
  392  service or certified mail, restricted delivery, to the subject
  393  at the applicant’s last known address. If an applicant has
  394  submitted fingerprints to the department for a national criminal
  395  history check upon initial licensure and is renewing his or her
  396  license for the first time, then the applicant need only submit
  397  the information and fee required for a statewide criminal
  398  history check.
  399         Section 9. Paragraph (e) of subsection (3) of section
  400  766.1115, Florida Statutes, is amended to read:
  401         766.1115 Health care providers; creation of agency
  402  relationship with governmental contractors.—
  403         (3) DEFINITIONS.—As used in this section, the term:
  404         (e) “Low-income” means:
  405         1. A person who is Medicaid-eligible under Florida law;
  406         2. A person who is without health insurance and whose
  407  family income does not exceed 400 200 percent of the federal
  408  poverty level as defined annually by the federal Office of
  409  Management and Budget; or
  410         3. Any client of the department who voluntarily chooses to
  411  participate in a program offered or approved by the department
  412  and meets the program eligibility guidelines of the department.
  413         Section 10. This act shall take effect July 1, 2019.

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