CS for CS for SB 732                            Second Engrossed
       
       
       
       
       
       
       
       
       2019732e2
       
    1                        A bill to be entitled                      
    2         An act relating to office surgery; amending s.
    3         456.074, F.S.; requiring the Department of Health to
    4         issue an emergency order suspending or restricting the
    5         registration of certain facilities upon specified
    6         findings; amending s. 458.309, F.S.; deleting a
    7         provision relating to registration and inspection of
    8         an office in which a physician performs certain
    9         procedures or office surgeries; creating s. 458.328,
   10         F.S.; requiring an office in which a physician
   11         performs certain procedures or office surgeries to
   12         register with the department; requiring an office to
   13         designate a physician to be responsible for certain
   14         compliance requirements as part of registration by a
   15         specified date; requiring an office and physicians
   16         practicing at the office to meet certain financial
   17         responsibility requirements; authorizing the
   18         department to deny or revoke the registration of or
   19         impose certain penalties against a facility in which
   20         certain procedures or office surgeries are performed
   21         under certain circumstances; requiring the department
   22         to conduct certain inspections; providing exceptions;
   23         requiring the Board of Medicine to adopt rules
   24         governing the standards of practice for physicians
   25         practicing in such offices and to impose a specified
   26         fine on physicians who perform certain procedures or
   27         office surgeries in an unregistered office;
   28         authorizing the board to adopt rules to administer the
   29         registration, inspection, and safety of offices in
   30         which certain procedures or office surgeries are
   31         performed; amending s. 458.331, F.S.; providing that a
   32         physician performing certain procedures or office
   33         surgeries in an unregistered office constitutes
   34         grounds for denial of a license or disciplinary
   35         action; amending s. 459.005, F.S.; deleting a
   36         provision relating to registration and inspection of
   37         an office in which a physician performs certain
   38         procedures or office surgeries; creating s. 459.0138,
   39         F.S.; requiring an office in which a physician
   40         performs certain procedures or office surgeries to
   41         register with the department; requiring an office to
   42         designate a physician to be responsible for certain
   43         compliance requirements as part of registration by a
   44         specified date; requiring an office and physicians
   45         practicing at the office to meet certain financial
   46         responsibility requirements; authorizing the
   47         department to deny or revoke the registration of or
   48         impose certain penalties against a facility in which
   49         certain procedures or office surgeries are performed
   50         under certain circumstances; requiring the department
   51         to conduct certain inspections; providing exceptions;
   52         requiring the Board of Osteopathic Medicine to adopt
   53         rules governing the standards of practice for
   54         physicians practicing in such offices and to impose a
   55         specified fine on physicians who perform certain
   56         procedures or office surgeries in an unregistered
   57         office; authorizing the board to adopt rules to
   58         administer the registration, inspection, and safety of
   59         offices in which certain procedures or office
   60         surgeries are performed; amending s. 459.015, F.S.;
   61         providing that the performance of certain procedures
   62         or office surgeries by a physician in an unregistered
   63         office constitutes grounds for denial of a license or
   64         disciplinary action; providing an effective date.
   65          
   66  Be It Enacted by the Legislature of the State of Florida:
   67  
   68         Section 1. Subsection (6) is added to section 456.074,
   69  Florida Statutes, to read:
   70         456.074 Certain health care practitioners; immediate
   71  suspension of license.—
   72         (6) The department must issue an emergency order suspending
   73  or restricting the registration of an office registered under s.
   74  458.328 or s. 459.0139 upon a finding of probable cause that the
   75  office or a physician practicing in the office is not in
   76  compliance with the standards of practice for office surgery
   77  adopted by the boards pursuant to s. 458.328 or s. 459.0138, as
   78  applicable, or is in violation of s. 458.331(1)(v) or s.
   79  459.015(1)(z), and that such noncompliance or violation
   80  constitutes an immediate danger to the public.
   81         Section 2. Subsection (3) of section 458.309, Florida
   82  Statutes, is amended to read:
   83         458.309 Rulemaking authority.—
   84         (3)A physician who performs liposuction procedures in
   85  which more than 1,000 cubic centimeters of supernatant fat is
   86  removed, level 2 procedures lasting more than 5 minutes, and all
   87  level 3 surgical procedures in an office setting must register
   88  the office with the department unless that office is licensed as
   89  a facility under chapter 395. The department shall inspect the
   90  physician’s office annually unless the office is accredited by a
   91  nationally recognized accrediting agency or an accrediting
   92  organization subsequently approved by the Board of Medicine. The
   93  actual costs for registration and inspection or accreditation
   94  shall be paid by the person seeking to register and operate the
   95  office setting in which office surgery is performed.
   96         Section 3. Section 458.328, Florida Statutes, is created to
   97  read:
   98         458.328Office surgeries.—
   99         (1)REGISTRATION.—
  100         (a)An office in which a physician performs a liposuction
  101  procedure in which more than 1,000 cubic centimeters of
  102  supernatant fat is removed, a Level II office surgery, or a
  103  Level III office surgery must register with the department
  104  unless the office is licensed as a facility under chapter 390 or
  105  chapter 395.
  106         (b)By January 1, 2020, each office registered under this
  107  section or s. 459.0138 must designate a physician who is
  108  responsible for the office’s compliance with the office health
  109  and safety requirements of this section and rules adopted
  110  hereunder. A designated physician must have a full, active, and
  111  unencumbered license under this chapter or chapter 459 and shall
  112  practice at the office for which he or she has assumed
  113  responsibility. Within 10 calendar days after the termination of
  114  a designated physician relationship, the office must notify the
  115  department of the designation of another physician to serve as
  116  the designated physician. The department may suspend the
  117  registration of an office if the office fails to comply with the
  118  requirements of this paragraph.
  119         (c) As a condition of registration, each office must
  120  establish financial responsibility by demonstrating that it has
  121  met and continues to maintain, at a minimum, the same
  122  requirements applicable to physicians in ss. 458.320 and
  123  459.0085. Each physician practicing at an office registered
  124  under this section or s. 459.0138 must meet the financial
  125  responsibility requirements under s. 458.320 or s. 459.0085, as
  126  applicable.
  127         (d)Each physician practicing at an office registered under
  128  this section or s. 459.0138 shall advise the board, in writing,
  129  within 10 calendar days after beginning or ending his or her
  130  practice at a registered office.
  131         (e)The department shall inspect a registered office at
  132  least annually, including a review of patient records, to ensure
  133  that the office is in compliance with this section and rules
  134  adopted hereunder unless the office is accredited by a
  135  nationally recognized accrediting agency approved by the board.
  136  The inspection may be unannounced, except for the inspection of
  137  an office that meets the description of a clinic specified in s.
  138  458.3265(1)(a)3.h., and those wholly owned and operated
  139  physician offices described in s. 458.3265(1)(a)3.g. which
  140  perform procedures referenced in s. 458.3265(1)(a)3.h., which
  141  must be announced.
  142         (f)The department may suspend or revoke the registration
  143  of an office in which a procedure or surgery identified in
  144  paragraph (a) is performed for failure of any of its physicians,
  145  owners, or operators to comply with this section and rules
  146  adopted hereunder or s. 459.0138 and rules adopted thereunder.
  147  If an office’s registration is revoked for any reason, the
  148  department may deny any person named in the registration
  149  documents of the office, including the persons who own or
  150  operate the office, individually or as part of a group, from
  151  registering an office to perform procedures or office surgeries
  152  pursuant to this section or s. 459.0138 for 5 years after the
  153  revocation date.
  154         (g)The department may impose any penalty set forth in s.
  155  456.072(2) against the designated physician for failure of the
  156  office to operate in compliance with the office health and
  157  safety requirements of this section and rules adopted hereunder
  158  or s. 459.0138 and rules adopted thereunder.
  159         (h)A physician may only perform a procedure or surgery
  160  identified in paragraph (a) in an office that is registered with
  161  the department. The board shall impose a fine of $5,000 per day
  162  on a physician who performs a procedure or surgery in an office
  163  that is not registered with the department.
  164         (i)The actual costs of registration and inspection or
  165  accreditation shall be paid by the person seeking to register
  166  and operate the office in which a procedure or surgery
  167  identified in paragraph (a) will be performed.
  168         (2)RULEMAKING.—
  169         (a)The board shall adopt by rule standards of practice for
  170  physicians who perform procedures or office surgeries pursuant
  171  to this section.
  172         (b)The board may adopt rules to administer the
  173  registration, inspection, and safety of offices in which a
  174  physician performs procedures or office surgeries pursuant to
  175  this section.
  176         Section 4. Paragraph (vv) is added to subsection (1) of
  177  section 458.331, Florida Statutes, to read:
  178         458.331 Grounds for disciplinary action; action by the
  179  board and department.—
  180         (1) The following acts constitute grounds for denial of a
  181  license or disciplinary action, as specified in s. 456.072(2):
  182         (vv)Performing a liposuction procedure in which more than
  183  1,000 cubic centimeters of supernatant fat is removed, a Level
  184  II office surgery, or a Level III office surgery in an office
  185  that is not registered with the department pursuant to s.
  186  458.328 or s. 459.0138.
  187         Section 5. Subsection (2) of section 459.005, Florida
  188  Statutes, is amended to read:
  189         459.005 Rulemaking authority.—
  190         (2)A physician who performs liposuction procedures in
  191  which more than 1,000 cubic centimeters of supernatant fat is
  192  removed, level 2 procedures lasting more than 5 minutes, and all
  193  level 3 surgical procedures in an office setting must register
  194  the office with the department unless that office is licensed as
  195  a facility under chapter 395. The department shall inspect the
  196  physician’s office annually unless the office is accredited by a
  197  nationally recognized accrediting agency or an accrediting
  198  organization subsequently approved by the Board of Osteopathic
  199  Medicine. The actual costs for registration and inspection or
  200  accreditation shall be paid by the person seeking to register
  201  and operate the office setting in which office surgery is
  202  performed.
  203         Section 6. Section 459.0138, Florida Statutes, is created
  204  to read:
  205         459.0138Office surgeries.—
  206         (1)REGISTRATION.—
  207         (a)An office in which a physician performs a liposuction
  208  procedure in which more than 1,000 cubic centimeters of
  209  supernatant fat is removed, a Level II office surgery, or a
  210  Level III office surgery must register with the department
  211  unless the office is licensed as a facility under chapter 390 or
  212  chapter 395.
  213         (b)By January 1, 2020, each office registered under this
  214  section or s. 458.328 must designate a physician who is
  215  responsible for the office’s compliance with the office health
  216  and safety requirements of this section and rules adopted
  217  hereunder. A designated physician must have a full, active, and
  218  unencumbered license under this chapter or chapter 458 and shall
  219  practice at the office for which he or she has assumed
  220  responsibility. Within 10 calendar days after the termination of
  221  a designated physician relationship, the office must notify the
  222  department of the designation of another physician to serve as
  223  the designated physician. The department may suspend a
  224  registration for an office if the office fails to comply with
  225  the requirements of this paragraph.
  226         (c) As a condition of registration, each office must
  227  establish financial responsibility by demonstrating that it has
  228  met and continues to maintain, at a minimum, the same
  229  requirements applicable to physicians in ss. 458.320 and
  230  459.0085. Each physician practicing at an office registered
  231  under this section or s. 458.328 must meet the financial
  232  responsibility requirements under s. 458.320 or s. 459.0085, as
  233  applicable.
  234         (d)Each physician practicing at an office registered under
  235  this section or s. 458.328 shall advise the board, in writing,
  236  within 10 calendar days after beginning or ending his or her
  237  practice at the registered office.
  238         (e)The department shall inspect a registered office at
  239  least annually, including a review of patient records, to ensure
  240  that the office is in compliance with this section and rules
  241  adopted hereunder unless the office is accredited by a
  242  nationally recognized accrediting agency approved by the board.
  243  The inspection may be unannounced, except for the inspection of
  244  an office that meets the description of clinic specified in s.
  245  459.0137(1)(a)3.h., and those wholly owned and operated
  246  physician offices described in s. 459.0137(1)(a)3.g. which
  247  perform procedures referenced in s. 459.0137(1)(a)3.h., which
  248  must be announced.
  249         (f)The department may suspend or revoke the registration
  250  of an office in which a procedure or surgery identified in
  251  paragraph (a) is performed for failure of any of its physicians,
  252  owners, or operators to comply with this section and rules
  253  adopted hereunder or s. 458.328 and rules adopted thereunder. If
  254  an office’s registration is revoked for any reason, the
  255  department may deny any person named in the registration
  256  documents of the office, including the persons who own or
  257  operate the office, individually or as part of a group, from
  258  registering an office to perform procedures or office surgeries
  259  pursuant to this section or s. 458.328 for 5 years after the
  260  revocation date.
  261         (g)The department may impose any penalty set forth in s.
  262  456.072(2) against the designated physician for failure of the
  263  office to operate in compliance with the office health and
  264  safety requirements of this section and rules adopted hereunder
  265  or s. 458.328 and rules adopted thereunder.
  266         (h)A physician may only perform a procedure or surgery
  267  identified in paragraph (a) in an office that is registered with
  268  the department. The board shall impose a fine of $5,000 per day
  269  on a physician who performs a procedure or surgery in an office
  270  that is not registered with the department.
  271         (i)The actual costs of registration and inspection or
  272  accreditation shall be paid by the person seeking to register
  273  and operate the office in which a procedure or surgery
  274  identified in paragraph (a) will be performed.
  275         (2)RULEMAKING.—
  276         (a)The board shall adopt by rule standards of practice for
  277  physicians who perform procedures or office surgeries pursuant
  278  to this section.
  279         (b)The board may adopt rules to administer the
  280  registration, inspection, and safety of offices in which a
  281  physician performs procedures or office surgeries pursuant to
  282  this section.
  283         Section 7. Paragraph (xx) is added to subsection (1) of
  284  section 459.015, Florida Statutes, to read:
  285         459.015 Grounds for disciplinary action; action by the
  286  board and department.—
  287         (1) The following acts constitute grounds for denial of a
  288  license or disciplinary action, as specified in s. 456.072(2):
  289         (xx)Performing a liposuction procedure in which more than
  290  1,000 cubic centimeters of supernatant fat is removed, a Level
  291  II office surgery, or a Level III office surgery in an office
  292  that is not registered with the department pursuant to s.
  293  458.328 or s. 459.0138.
  294         Section 8. This act shall take effect January 1, 2020.