HB 1647 2003
1	A bill to be entitled
2	An act relating to health care; amending s. 395.004, F.S.;
3	providing for discounted medical liability insurance based
4	on certification of certain programs; providing
5	responsibilities of the Office of Insurance Regulation in
6	reviewing discounted rates; creating s. 395.0056, F.S.;
7	requiring a licensed facility report of certain medical
8	malpractice litigation; requiring a licensed facility to
9	notify the Agency for Health Care Administration of
10	certain actions; requiring the agency to obtain certain
11	information on internal risk management program
12	requirements for compliance purposes; requiring the agency
13	to annually publish certain litigation information;
14	creating s. 395.0187, F.S.; providing for a nurse-to-
15	patient ratio; providing for circumstances and
16	methodologies for varying the ratio; amending s. 395.0193,
17	F.S.; providing for peer review and discipline of a
18	physician for staff abuse; limiting liability of certain
19	participants in certain disciplinary actions; clarifying
20	that certain documents and communications are not
21	privileged; requiring specified entities to provide lists
22	of privileged documents or communications; providing for
23	court review; providing for determination of privilege
24	application; specifying required list information;
25	providing for protection of patient-identifying
26	information; amending s. 395.0197, F.S.; deleting an
27	exception from the risk prevention education requirement
28	for certain health care practitioners; requiring a patient
29	notification system for adverse incidents; requiring risk
30	managers or their designees to give notice; requiring
31	licensed facilities to annually report certain health care
32	practitioner information; requiring the Agency for Health
33	Care Administration and the Department of Health to
34	annually publish statistics about certain licensed
35	facilities; providing for certain disciplinary actions;
36	providing a fine for adverse incident report failure;
37	revising adverse incident notification circumstances;
38	requiring certain notification of adverse incidents;
39	deleting a list of adverse incidents requiring notice;
40	adding certain information to required agency website
41	publications; requiring the agency to annually publish
42	facility incident report information; requiring public
43	access; requiring an adverse incident data use statement
44	on facility assessments; requiring licensed facility
45	sexual misconduct allegation reports to the agency;
46	requiring licensed facilities to offer testing of certain
47	persons at no cost; authorizing the agency to publish
48	certain adverse incident information; amending s. 456.025,
49	F.S.; eliminating certain restrictions on setting certain
50	licensure renewal fees; amending s. 456.026, F.S.;
51	requiring the Office of Insurance Regulation to publish a
52	certain annual report relating to health maintenance
53	organizations on its website; requiring inclusion of
54	certain information; amending s. 456.041, F.S.; requiring
55	the office to compile certain information in a
56	practitioner profile; requiring health care practitioners
57	to report certain information; providing for disciplinary
58	action and a fine for certain submissions; deleting
59	language relating to certain profile information;
60	authorizing the office or regulatory board to investigate
61	certain information; requiring the department to report on
62	certain disciplinary actions; requiring certain Internet
63	access to final orders on disciplinary matters; requiring
64	certain Internet access to certain claims experience
65	comparison reports; specifying required information
66	relating to disciplinary actions; deleting certain office
67	consultation requirements relating to a health care
68	practitioner’s profile; providing for a penalty for
69	certain compliance failures; specifying a required
70	department statement relating to certain profile
71	information; requiring the department to provide certain
72	disciplinary action information; requiring certain
73	Internet access to a practitioner’s website when
74	requested; amending s. 456.042, F.S.; providing for
75	departmental practitioner profile updates; providing
76	profile update review requirements; amending s. 456.049,
77	F.S.; deleting a practitioner report requirement; imposing
78	fines on practitioners for certain reporting compliance
79	failures; providing for discoverability of certain
80	unreported claims and actions information; amending s.
81	456.051, F.S.; establishing Department of Health
82	responsibility to provide professional liability action
83	and bankruptcy reports; requiring inclusion of such
84	reports in a practitioner’s profile; amending s. 458.320,
85	F.S.; specifying certain notice criteria; requiring
86	suspension of a medical physician’s license for not making
87	certain payments; amending s. 458.331, F.S.; providing
88	grounds for medical physician disciplinary actions;
89	requiring an explicit statement of certain findings in
90	certain orders or publications; adding liability for
91	medical malpractice judgments as a ground for disciplinary
92	action against a medical physician; making refusal to
93	provide health care to a patient participating in certain
94	actions a ground for disciplinary action; raising a
95	monetary threshold for a medical physician’s repeated
96	malpractice; amending s. 459.0085, F.S.; requiring
97	suspension of an osteopathic physician’s license for
98	failing to make certain payments; amending s. 459.015,
99	F.S.; providing grounds for osteopathic physician
100	disciplinary actions; adding liability for malpractice
101	judgments as a ground for certain disciplinary actions;
102	raising a monetary threshold for an osteopathic
103	physician’s repeated malpractice; providing civil immunity
104	for certain participants in quality improvement processes;
105	designating as privileged certain communications by
106	patient safety organizations; clarifying that certain
107	documents and communications are not privileged; requiring
108	certain entities to provide a list of privileged documents
109	or communications; providing for court review; providing
110	for privilege application determinations; specifying
111	required list information; providing for protection of
112	patient-identifying information under certain
113	circumstances; requiring provision of patient safety data
114	to certain agencies; directing the Department of Health
115	and the Office of Insurance Regulation to publish a list
116	of certain health care practitioners who do not carry
117	malpractice insurance; requiring inclusion of a specific
118	statement in medical malpractice action settlement
119	statements; prohibiting confidential legal settlements in
120	medical malpractice actions; providing for revising the
121	Office of Insurance Regulation’s closed claim form;
122	requiring the office to compile annual statistical reports
123	pertaining to closed claims; requiring annualized
124	historical statistical summaries; specifying certain
125	information to be collected on closed claim forms;
126	providing severability; providing an effective date.
127
128	Be It Enacted by the Legislature of the State of Florida:
129
130	Section 1. Subsection (3) is added to section 395.004,
131	Florida Statutes, to read:
132	395.004 Application for license, fees; expenses.--
133	(3) A licensed facility may apply to the agency for
134	certification of a quality improvement program that results in
135	the reduction of adverse incidents at that facility. The agency,
136	in consultation with the Office of Insurance Regulation, shall
137	develop criteria for such certification. Insurers shall file
138	with the office a discount in the rate or rates applicable for
139	medical liability insurance coverage to reflect the
140	implementation of a certified program. In reviewing insurance
141	company filings, as they relate to rate discounts authorized
142	under this subsection, the office shall consider whether, and
143	the extent to which, the program certified under this subsection
144	is otherwise covered under a program of risk management offered
145	by an insurance company or self-insurance plan providing medical
146	liability coverage.
147	Section 2. Section 395.0056, Florida Statutes, is created
148	to read:
149	395.0056 Litigation notice requirement.--
150	(1) A licensed facility shall notify the agency of all
151	medical malpractice lawsuits filed against the facility or a
152	member of its staff, when the underlying cause of action
153	pertaining to the staff member involves the licensed facility,
154	within 15 calendar days after the facility receives notice or
155	otherwise becomes aware that such an action has been initiated
156	against the facility or a current or former staff member.
157	(2) The agency shall obtain a copy of the complaint and
158	review the agency’s adverse incident report files pertaining to
159	each licensed facility that submits a notice required by
160	subsection (1) to determine whether the facility timely complied
161	with the requirements of s. 395.0197. The agency shall annually
162	publish information about litigation filed against licensed
163	facilities sufficient for the public to be able to clearly
164	understand the issues raised and the status of the litigation at
165	publication.
166	Section 3. Section 395.0187, Florida Statutes, is created
167	to read:
168	395.0187 Nurse-to-patient ratio required.--Each licensed
169	facility shall establish a nurse-to-patient ratio consistent
170	with the findings of the Pennsylvania study funded by a grant
171	from the National Institute of Nursing Research. Each licensed
172	facility shall work with the agency to determine the
173	circumstances and methods for varying an established ratio that
174	is designed to ensure that a patient’s quality of care is
175	minimally impacted.
176	Section 4. Paragraph (h) is added to subsection (3) of
177	section 395.0193, Florida Statutes, and subsection (8) and
178	paragraph (b) of subsection (9) of said section are amended, to
179	read:
180	395.0193 Licensed facilities; peer review; disciplinary
181	powers; agency or partnership with physicians.--
182	(3) If reasonable belief exists that conduct by a staff
183	member or physician who delivers health care services at the
184	licensed facility may constitute one or more grounds for
185	discipline as provided in this subsection, a peer review panel
186	shall investigate and determine whether grounds for discipline
187	exist with respect to such staff member or physician. The
188	governing board of any licensed facility, after considering the
189	recommendations of its peer review panel, shall suspend, deny,
190	revoke, or curtail the privileges, or reprimand, counsel, or
191	require education, of any such staff member or physician after a
192	final determination has been made that one or more of the
193	following grounds exist:
194	(h) Mental or physical abuse of a nurse or other staff
195	member.
196	(8)(a)The investigations, proceedings, and records of the
197	peer review panel, a committee of a hospital, a disciplinary
198	board, or a governing board, or agent thereof with whom there is
199	a specific written contract for that purpose, as described in
200	this section shall not be subject to discovery or introduction
201	into evidence in any civil or administrative action against a
202	provider of professional health services arising out of the
203	matters which are the subject of evaluation and review by such
204	group or its agent, and a person who was in attendance at a
205	meeting of such group or its agent may not be permitted or
206	required to testify in any such civil or administrative action
207	as to any evidence or other matters produced or presented during
208	the proceedings of such group or its agent or as to any
209	findings, recommendations, evaluations, opinions, or other
210	actions of such group or its agent or any members thereof.
211	However, information, documents, or records otherwise available
212	from original sources are not to be construed as immune from
213	discovery or use in any such civil or administrative action
214	merely because they were presented during proceedings of such
215	group, and any person who testifies before such group or who is
216	a member of such group may not be prevented from testifying as
217	to matters within his or her knowledge, but such witness may not
218	be asked about his or her testimony before such a group or
219	opinions formed by him or her as a result of such group
220	hearings.
221	(b) Documents and communications pertaining to the
222	professional conduct of a physician or staff member of a
223	hospital or pertaining to service delivered by a physician or
224	staff member of a hospital that are not generated during the
225	course of deliberation, investigation, and analysis of a peer
226	review panel, committee of a hospital, disciplinary board, or
227	governing board or agent thereof with whom there is a specific
228	written contract for that purpose, as described in this section,
229	are not considered privileged. In response to a request for
230	discovery, a claim of privilege by any such entities or agents
231	must be accompanied by a list identifying all documents or
232	communications for which privilege is asserted. The list, and a
233	document or communication, when appropriate, shall be reviewed
234	in camera for determination of whether the document or
235	communication is privileged. Patient-identifying information
236	shall be redacted or otherwise excluded from the list, unless a
237	court of competent jurisdiction orders disclosure of such
238	information in the list. A list of documents or communications
239	for which privilege is asserted must include:
240	1. The date the subject document or communication was
241	created.
242	2. The name and address of the document’s author or
243	communication’s originator, unless a patient whose identity has
244	not been ordered disclosed by a court of competent jurisdiction.
245	3. The name and address of the party from whom the
246	document or communication was received.
247	4. The date the document or communication was received.
248	5. The name and address of the original document’s
249	custodian or communication’s originator.
250	6. The statutory or case law on which the privilege is
251	asserted.
252	(9)
253	(b) As a condition of any staff member or physician
254	bringing any action against any person or entity that initiated,
255	participated in, was a witness in, or conducted any review as
256	authorized by this section and before any responsive pleading is
257	due, the staff member or physician shall post a bond or other
258	security, as set by the court having jurisdiction of the action,
259	in an amount sufficient to pay the costs and attorney's fees. A
260	defendant’s monetary liability under this section shall not
261	exceed $250,000.
262	Section 5. Paragraph (b) of subsection (1), subsections
263	(3), (4), (7), (8), and (9), paragraph (b) of subsection (10),
264	and subsection (13) of section 395.0197, Florida Statutes, are
265	amended, paragraph (e) is added to subsection (1) of said
266	section, and subsections (21) and (22) are added to said
267	section, to read:
268	395.0197 Internal risk management program.--
269	(1) Every licensed facility shall, as a part of its
270	administrative functions, establish an internal risk management
271	program that includes all of the following components:
272	(b) The development of appropriate measures to minimize
273	the risk of adverse incidents to patients, including, but not
274	limited to:
275	1. Risk management and risk prevention education and
276	training of all nonphysician personnel as follows:
277	a. Such education and training of all nonphysician
278	personnel as part of their initial orientation; and
279	b. At least 1 hour of such education and training annually
280	for all personnel of the licensed facility working in clinical
281	areas and providing patient care, except those persons licensed
282	as health care practitioners who are required to complete
283	continuing education coursework pursuant to chapter 456 or the
284	respective practice act.
285	2. A prohibition, except when emergency circumstances
286	require otherwise, against a staff member of the licensed
287	facility attending a patient in the recovery room, unless the
288	staff member is authorized to attend the patient in the recovery
289	room and is in the company of at least one other person.
290	However, a licensed facility is exempt from the two-person
291	requirement if it has:
292	a. Live visual observation;
293	b. Electronic observation; or
294	c. Any other reasonable measure taken to ensure patient
295	protection and privacy.
296	3. A prohibition against an unlicensed person from
297	assisting or participating in any surgical procedure unless the
298	facility has authorized the person to do so following a
299	competency assessment, and such assistance or participation is
300	done under the direct and immediate supervision of a licensed
301	physician and is not otherwise an activity that may only be
302	performed by a licensed health care practitioner.
303	4. Development, implementation, and ongoing evaluation of
304	procedures, protocols, and systems to accurately identify
305	patients, planned procedures, and the correct site of the
306	planned procedure so as to minimize the performance of a
307	surgical procedure on the wrong patient, a wrong surgical
308	procedure, a wrong-site surgical procedure, or a surgical
309	procedure otherwise unrelated to the patient's diagnosis or
310	medical condition.
311	(e) A system for giving written notification to a patient,
312	a family member of the patient, or a designated representative
313	of a patient who is specified in accordance with the
314	requirements of chapter 709, chapter 744, or chapter 765, that
315	the patient is the victim of an adverse incident. Such notice
316	shall be given by the risk manager, or his or her designee, as
317	soon as practicable to allow the patient an opportunity to
318	minimize damage or injury.
319	(3) In addition to the programs mandated by this section,
320	other innovative approaches intended to reduce the frequency and
321	severity of medical malpractice and patient injury claims shall
322	be encouraged and their implementation and operation
323	facilitated. Such additional approaches may include extending
324	internal risk management programs to health care providers'
325	offices and the assuming of provider liability by a licensed
326	health care facility for acts or omissions occurring within the
327	licensed facility. Each licensed facility shall annually report
328	to the agency and the Department of Health the name, license
329	number, period of coverage, notices of intent to sue received,
330	and judgments entered against each health care practitioner for
331	which the facility assumes liability. The agency and Department
332	of Health, in their respective annual reports, shall include
333	statistics that report the number of licensed facilities that
334	assume such liability and the number of health care
335	practitioners, by profession, for whom they assume liability.
336	(4) The agency shall adopt rules governing the
337	establishment of internal risk management programs to meet the
338	needs of individual licensed facilities. Each internal risk
339	management program shall include the use of incident reports to
340	be filed with an individual of responsibility who is competent
341	in risk management techniques in the employ of each licensed
342	facility, such as an insurance coordinator, or who is retained
343	by the licensed facility as a consultant. The individual
344	responsible for the risk management program shall have free
345	access to all medical records of the licensed facility. The
346	incident reports are part of the workpapers of the attorney
347	defending the licensed facility in litigation relating to the
348	licensed facility and are subject to discovery, but are not
349	admissible as evidence in court. A person filing an incident
350	report is not subject to civil suit by virtue of such incident
351	report. A person who has the duty to file an incident report but
352	who fails to do so within the timeframes established under this
353	section shall be subject to disciplinary action by the licensed
354	facility and the appropriate regulatory board and is subject to
355	a fine of up to $1,000 for each day the report was not timely
356	submitted.As a part of each internal risk management program,
357	the incident reports shall be used to develop categories of
358	incidents which identify problem areas. Once identified,
359	procedures shall be adjusted to correct the problem areas.
360	(7) The licensed facility shall notify the agency no later
361	than 1 business day after the risk manager or his or her
362	designee has received a report pursuant to paragraph (1)(d) and
363	can determine within 1 business day that anany of the following
364	adverse incidentincidents has occurred or there is a reasonable
365	possibility that an adverse incident has occurred, whether
366	occurring in the licensed facility or arising from health care
367	prior to admission in the licensed facility:
368	(a) The death of a patient;
369	(b) Brain or spinal damage to a patient;
370	(c) The performance of a surgical procedure on the wrong
371	patient;
372	(d) The performance of a wrong-site surgical procedure; or
373	(e) The performance of a wrong surgical procedure.
374
375	The notification must be made in writing and be provided by
376	facsimile device or overnight mail delivery. The notification
377	must include information regarding the identity of the affected
378	patient, the type of adverse incident, the initiation of an
379	investigation by the facility, and whether the events causing or
380	resulting in the adverse incident represent a potential risk to
381	other patients.
382	(8) An adverse incidentAny of the following adverse
383	incidents, whether occurring in the licensed facility or arising
384	from health care prior to admission in the licensed facility,
385	shall be reported by the facility to the agency within 15
386	calendar days after its occurrence:
387	(a) The death of a patient;
388	(b) Brain or spinal damage to a patient;
389	(c) The performance of a surgical procedure on the wrong
390	patient;
391	(d) The performance of a wrong-site surgical procedure;
392	(e) The performance of a wrong surgical procedure;
393	(f) The performance of a surgical procedure that is
394	medically unnecessary or otherwise unrelated to the patient's
395	diagnosis or medical condition;
396	(g) The surgical repair of damage resulting to a patient
397	from a planned surgical procedure, where the damage is not a
398	recognized specific risk, as disclosed to the patient and
399	documented through the informed-consent process; or
400	(h) The performance of procedures to remove unplanned
401	foreign objects remaining from a surgical procedure.
402
403	The agency may grant extensions to this reporting requirement
404	for more than 15 days upon justification submitted in writing by
405	the facility administrator to the agency. The agency may require
406	an additional, final report. These reports shall not be
407	available to the public pursuant to s. 119.07(1) or any other
408	law providing access to public records, nor be discoverable or
409	admissible in any civil or administrative action, except in
410	disciplinary proceedings by the agency or the appropriate
411	regulatory board, nor shall they be available to the public as
412	part of the record of investigation for and prosecution in
413	disciplinary proceedings made available to the public by the
414	agency or the appropriate regulatory board. However, the agency
415	or the appropriate regulatory board shall make available, upon
416	written request by a health care professional against whom
417	probable cause has been found, any such records which form the
418	basis of the determination of probable cause. The agency may
419	investigate, as it deems appropriate, any such incident and
420	prescribe measures that must or may be taken in response to the
421	incident. The agency shall review each incident and determine
422	whether it potentially involved conduct by the health care
423	professional who is subject to disciplinary action, in which
424	case the provisions of s. 456.073 shall apply.
425	(9) The agency shall publish on the agency's website, no
426	less than quarterly, a summary and trend analysis of adverse
427	incident reports received pursuant to this section, which shall
428	not include information that would identify the patient, the
429	reporting facility, or the health care practitioners involved.
430	The agency shall publish on the agency's website an annual
431	summary and trend analysis of all adverse incident reports and
432	malpractice claims and errors, omissions, or negligence
433	information provided by facilities in their annual reports or as
434	reported under ss. 627.912 and 627.9122, which shall not include
435	information that would identify the patient, the reporting
436	facility, or the practitioners involved. The purpose of the
437	publication of the summary and trend analysis is to promote the
438	rapid dissemination of information relating to adverse incidents
439	and malpractice claims to assist in avoidance of similar
440	incidents and reduce morbidity and mortality.
441	(10) The internal risk manager of each licensed facility
442	shall:
443	(b) Report every allegation of sexual misconduct to the
444	administrator of the licensed facility and the agency.
445	(13) In addition to any penalty imposed pursuant to this
446	section, the agency shall require a written plan of correction
447	from the facility. For a single incident or series of isolated
448	incidents that are nonwillful violations of the reporting
449	requirements of this section, the agency shall first seek to
450	obtain corrective action by the facility. If the correction is
451	not demonstrated within the timeframe established by the agency
452	or if there is a pattern of nonwillful violations of this
453	section, the agency may impose an administrative fine, not to
454	exceed $5,000 for any violation of the reporting requirements of
455	this section. The administrative fine for repeated nonwillful
456	violations shall not exceed $10,000 for any violation. The
457	administrative fine for each intentional and willful violation
458	may not exceed $25,000 per violation, per day. The fine for an
459	intentional and willful violation of this section may not exceed
460	$250,000. In determining the amount of fine to be levied, the
461	agency shall be guided by s. 395.1065(2)(b). This subsection
462	does not apply to the notice requirements under subsection (7).
463	The agency may make available to the public information about
464	any nonwillful or willful adverse incident that the agency
465	discovers was not timely reported as required under this
466	section, in addition to the sanctions authorized under this
467	subsection.
468	(21) The agency shall annually publish a report card
469	providing statistical summaries and narrative explanation, as
470	appropriate, of the information contained in the annual incident
471	reports submitted by licensed facilities pursuant to subsection
472	(6) and disciplinary actions reported to the agency pursuant to
473	s. 395.0193. The report card must be made available to the
474	public through the Internet and other commonly used means of
475	distribution no later than July 1 of each year. The report card
476	must be organized by county and, at a minimum, for each facility
477	licensed under this part, present an itemized list showing:
478	(a) The name and address of the facility.
479	(b) Whether the entity is a private, for-profit or not-
480	for-profit, public, or teaching facility.
481	(c) The total number of beds.
482	(d) A description of the categories of services provided
483	by the facility.
484	(e) Whether the hospital facility, including the emergency
485	room or trauma center, has medical equipment and instruments
486	appropriate for pediatric care.
487	(f) On an annual basis, the percentage of adverse
488	incidents per total number of patients in the facility, by
489	category of reported incident and by type of professional
490	involved.
491	(g) A listing, by category, of the types of operations,
492	diagnostic or treatment procedures, or other actions or
493	inactions, giving rise to the adverse incidents and the number
494	of adverse incidents in each category.
495	(h) Types of malpractice claims filed, by type of
496	professional involved.
497	(i) Disciplinary actions taken against professionals, by
498	type of professional involved.
499	(j) The abduction of an infant or discharge of an infant
500	to the wrong family.
501	(k) Pertinent information reported to the Office of
502	Insurance Regulation under s. 627.912 or s. 627.9122.
503
504	The report card must include the following statement: ”Adverse
505	incident reports are just one part of the picture that emerges
506	about a facility. You should also consider that facility’s
507	survey results and complaint investigations and conduct your own
508	research on a facility before forming your final conclusion
509	about that facility. When making comparisons among facilities,
510	some may have many more adverse incidents than others because
511	this report is not adjusted for the size of the facility nor the
512	severity or complexity of the health problems of the people it
513	serves.”
514	(22) If appropriate, a licensed facility in which sexual
515	abuse occurs must offer the victim of sexual abuse testing for
516	sexually transmissible diseases at no cost to the victim.
517	Section 6. Subsection (1) of section 456.025, Florida
518	Statutes, is amended to read:
519	456.025 Fees; receipts; disposition.--
520	(1) It is the intent of the Legislature that all costs of
521	regulating health care professions and practitioners shall be
522	borne solely by licensees and licensure applicants. It is also
523	the intent of the Legislature that fees should be reasonable and
524	not serve as a barrier to licensure. Moreover, it is the intent
525	of the Legislature that the department operate as efficiently as
526	possible and regularly report to the Legislature additional
527	methods to streamline operational costs. Therefore, the boards
528	in consultation with the department, or the department if there
529	is no board, shall, by rule, set renewal fees which:
530	(a) Shall be based on revenue projections prepared using
531	generally accepted accounting procedures;
532	(b) Shall be adequate to cover all expenses relating to
533	that board identified in the department's long-range policy
534	plan, as required by s. 456.005;
535	(c) Shall be reasonable, fair, and not serve as a barrier
536	to licensure;
537	(d) Shall be based on potential earnings from working
538	under the scope of the license;
539	(e) Shall be similar to fees imposed on similar licensure
540	types; and
541	(f) Shall not be more than 10 percent greater than the fee
542	imposed for the previous biennium;
543	(g) Shall not be more than 10 percent greater than the
544	actual cost to regulate that profession for the previous
545	biennium; and
546	(f)(h)Shall be subject to challenge pursuant to chapter
547	120.
548	Section 7. Section 456.026, Florida Statutes, is amended
549	to read:
550	456.026 Annual report concerning finances, administrative
551	complaints, disciplinary actions, and recommendations.--The
552	department, in consultation with the Agency for Health Care
553	Administration and the Office of Insurance Regulation, relating
554	to information pertaining to health maintenance organizations,
555	is directed to prepare and submit a report to the President of
556	the Senate and the Speaker of the House of Representatives by
557	November 1 of each year. The department shall publish the report
558	to its website simultaneously with delivery to the President of
559	the Senate and the Speaker of the House of Representatives. The
560	department must present report contents in language that is at
561	the ninth-grade reading level. The report must be directly
562	accessible on the department’s Internet homepage highlighted by
563	easily identifiable links and buttons.In addition to finances
564	and any other information the Legislature may require, the
565	report shall include statistics and relevant information,
566	profession by profession, detailing:
567	(1) The revenues, expenditures, and cash balances for the
568	prior year, and a review of the adequacy of existing fees.
569	(2) The number of complaints received and investigated.
570	(3) The number of findings of probable cause made.
571	(4) The number of findings of no probable cause made.
572	(5) The number of administrative complaints filed.
573	(6) The disposition of all administrative complaints.
574	(7) A description of disciplinary actions taken.
575	(8) A description of any effort by the department to
576	reduce or otherwise close any investigation or disciplinary
577	proceeding not before the Division of Administrative Hearings
578	under chapter 120 or otherwise not completed within 1 year after
579	the initial filing of a complaint under this chapter.
580	(9) The status of the development and implementation of
581	rules providing for disciplinary guidelines pursuant to s.
582	456.079.
583	(10) Such recommendations for administrative and statutory
584	changes necessary to facilitate efficient and cost-effective
585	operation of the department and the various boards.
586	(11) The number of health care professionals licensed by
587	the department or otherwise authorized to provide services in
588	the state, if known to the department.
589	(12) For licensees under chapters 395, 458, 459, 461, 466,
590	and part I of chapter 641, the professional liability claims and
591	actions reported by insurers, as provided in s. 627.912. Such
592	information must be provided in a separate section of the report
593	restricted to providing professional liability claims and
594	actions data.
595	(13) For licensees under part I of chapter 641, any claim
596	or action for damages caused by the errors, omissions, or
597	negligence of officers or directors, as provided in s. 627.9122.
598	Such information must be provided in a separate section of the
599	report restricted to providing professional liability claims and
600	actions data.
601	Section 8. Section 456.041, Florida Statutes, is amended
602	to read:
603	456.041 Practitioner profile; creation.--
604	(1)(a)Beginning July 1, 1999, the Department of Health
605	shall compile the information submitted pursuant to s. 456.039
606	into a practitioner profile of the applicant submitting the
607	information, except that the Department of Health may develop a
608	format to compile uniformly any information submitted under s.
609	456.039(4)(b). Beginning July 1, 2001, the Department of Health
610	shallmaycompile the information submitted pursuant to s.
611	456.0391 into a practitioner profile of the applicant submitting
612	the information.
613	(b) Each practitioner licensed under chapter 458 or
614	chapter 459 must report to the Department of Health and the
615	Board of Medicine or the Board of Osteopathic Medicine,
616	respectively, all final disciplinary actions, sanctions by a
617	governmental agency or a facility or entity licensed under state
618	law, and claims or actions, as provided under s. 456.051, to
619	which he or she is subjected no later than 15 calendar days
620	after such action or sanction is imposed. Failure to submit the
621	requisite information within 15 calendar days, in accordance
622	with the requirements of this section, shall subject the
623	practitioner to discipline by the Board of Medicine or the Board
624	of Osteopathic Medicine and a fine of $100 for each day that the
625	information is not submitted after the expiration of the 15-day
626	reporting period provided under this section.
627	(c) The department shall take no longer than 15 business
628	days to update the practitioner’s profile, in accordance with
629	the requirements of subsection (7).
630	(2) On the profile published under subsection (1), the
631	department shall indicate if the information provided under s.
632	456.039(1)(a)7. or s. 456.0391(1)(a)7. is or isnot corroborated
633	by a criminal history check conducted according to this
634	subsection. If the information provided under s. 456.039(1)(a)7.
635	or s. 456.0391(1)(a)7. is corroborated by the criminal history
636	check, the fact that the criminal history check was performed
637	need not be indicated on the profile.The department, or the
638	board having regulatory authority over the practitioner acting
639	on behalf of the department, mayshallinvestigate any
640	information received by the department or the board when it has
641	reasonable grounds to believe that the practitioner has violated
642	any law that relates to the practitioner's practice.
643	(3) The Department of Health shallmayinclude in each
644	practitioner's practitioner profile that criminal information
645	that directly relates to the practitioner's ability to
646	competently practice his or her profession. The department must
647	include in each practitioner's practitioner profile the
648	following statement: "The criminal history information, if any
649	exists, may be incomplete; federal criminal history information
650	is not available to the public." The department shall provide in
651	each practitioner profile, for every final disciplinary action
652	taken against the practitioner, a narrative description written
653	in plain English that explains the administrative complaint
654	filed against the practitioner and the final disciplinary action
655	imposed on the practitioner. The department shall include a
656	hyperlink to each final order listed in its website report of
657	dispositions of recent disciplinary actions taken against
658	practitioners.
659	(4) The Department of Health shall include, with respect
660	to a practitioner licensed under chapter 458 or chapter 459, a
661	statement of how the practitioner has elected to comply with the
662	financial responsibility requirements of s. 458.320 or s.
663	459.0085. The department shall include, with respect to
664	practitioners subject to s. 456.048, a statement of how the
665	practitioner has elected to comply with the financial
666	responsibility requirements of that section. The department
667	shall include, with respect to practitioners licensed under
668	chapter 458, chapter 459, or chapter 461, information relating
669	to liability actions which has been reported under s. 456.049 or
670	s. 627.912 within the previous 10 years for any paid claim that
671	exceeds $5,000. Such claims information shall be reported in the
672	context of comparing an individual practitioner's claims to the
673	experience of other practitioners within the same specialty, or
674	profession if the practitioner is not a specialist, to the
675	extent such information is available to the Department of
676	Health. The department shall provide a hyperlink in such
677	practitioner’s profile to all such comparison reports.If
678	information relating to a liability action is included in a
679	practitioner's practitioner profile, the profile must also
680	include the following statement: "Settlement of a claim may
681	occur for a variety of reasons that do not necessarily reflect
682	negatively on the professional competence or conduct of the
683	practitioner. A payment in settlement of a medical malpractice
684	action or claim should not be construed as creating a
685	presumption that medical malpractice has occurred."
686	(5) The Department of Health shallmay not include the
687	date of a hospital or ambulatory surgical centerdisciplinary
688	action taken by a licensed hospital or an ambulatory surgical
689	center, in accordance with the requirements of s. 395.0193,in
690	the practitioner profile. Any practitioner disciplined under
691	paragraph (1)(b) must report to the department the date the
692	disciplinary action was imposed. The department shall state
693	whether the action related to professional competence or whether
694	it related to the delivery of services to a patient.
695	(6) The Department of Health shallmayinclude in the
696	practitioner's practitioner profile any other information that
697	is a public record of any governmental entity and that relates
698	to a practitioner's ability to competently practice his or her
699	profession. However, the department must consult with the board
700	having regulatory authority over the practitioner before such
701	information is included in his or her profile.
702	(7) Upon the completion of a practitioner profile under
703	this section, the Department of Health shall verify all
704	information included andfurnish the practitioner who is the
705	subject of the profile a copy of it for review and verification.
706	The practitioner has a period of 30 days in which to review and
707	verify the contents ofthe profile and to correct any factual
708	inaccuracies in it. The Department of Health shall make the
709	profile available to the public at the end of the 30-day period
710	regardless of whether the practitioner has provided verification
711	of the profile contents. A practitioner shall be subject to a
712	fine of up to $100 per day for failure to verify the profile
713	contents and to correct any factual errors in his or her profile
714	within the 30-day period.The department shall make the profiles
715	available to the public through the World Wide Web and other
716	commonly used means of distribution. The department shall
717	include the following statement, in boldface type, in each
718	profile that has not been reviewed by the practitioner to which
719	the profile applies: “The practitioner has not verified the
720	information contained in this profile.”
721	(8) Making a practitioner profile available to the public
722	under this section does not constitute agency action for which a
723	hearing under s. 120.57 may be sought.
724	(9) The Department of Health shall provide in each profile
725	an easy to read explanation of any disciplinary action taken and
726	the reason the sanction or sanctions were imposed.
727	(10) The Department of Health shall provide one link in
728	each profile to a practitioner’s professional website if the
729	practitioner requests that such a link be included in his or her
730	profile.
731	Section 9. Section 456.042, Florida Statutes, is amended
732	to read:
733	456.042 Practitioner profiles; update.--A practitioner
734	shall submit updates of required information within 15 days
735	after the final activity that renders such information a fact.
736	The Department of Health shall update each practitioner's
737	practitioner profile quarterlyperiodically. An updated profile
738	is subject to the same requirements as an original profile with
739	respect to the period within which the practitioner may review
740	the profile for the purpose of correcting factual inaccuracies.
741	Section 10. Subsection (1) of section 456.049, Florida
742	Statutes, is amended, and subsections (3) and (4) are added to
743	said section, to read:
744	456.049 Health care practitioners; reports on professional
745	liability claims and actions.--
746	(1) Any practitioner of medicine licensed pursuant to the
747	provisions of chapter 458, practitioner of osteopathic medicine
748	licensed pursuant to the provisions of chapter 459, podiatric
749	physician licensed pursuant to the provisions of chapter 461, or
750	dentist licensed pursuant to the provisions of chapter 466 shall
751	report to the department any claim or action for damages for
752	personal injury alleged to have been caused by error, omission,
753	or negligence in the performance of such licensee's professional
754	services or based on a claimed performance of professional
755	services without consent if the claim was not covered by an
756	insurer required to report under s. 627.912and the claim
757	resulted in:
758	(a) A final judgment in any amount.
759	(b) A settlement in any amount.
760	(c) A final disposition not resulting in payment on behalf
761	of the licensee.
762
763	Reports shall be filed with the department no later than 60 days
764	following the occurrence of any event listed in paragraph (a),
765	paragraph (b), or paragraph (c).
766	(3) Failure of a practitioner, as specified in subsection
767	(1), to comply with the requirements of this section within 60
768	days after the payment of a claim or disposition of action for
769	damages has been determined shall result in a fine of up to $500
770	imposed by the department. Failure to comply within 90 days shall
771	subject the practitioner to a fine of up to an additional $1,000.
772	(4) A practitioner who has not complied with the provisions
773	of this section and who is the subject of a subsequent action for
774	damages at which time it is determined that he or she paid or had
775	paid on his or her behalf a claim or was the subject of an action
776	for damages, as provided in subsection (1), shall be subject to
777	discovery of all such unreported information during the
778	subsequent action.
779	Section 11. Section 456.051, Florida Statutes, is amended
780	to read:
781	456.051 Reports of professional liability actions;
782	bankruptcies; Department of Health's responsibility to provide.--
783	(1) The report of a claim or action for damages for
784	personal injury which is required to be provided to the
785	Department of Health under s. 456.049 or s. 627.912 is public
786	information except for the name of the claimant or injured
787	person, which remains confidential as provided in ss.
788	456.049(2)(d) and 627.912(2)(e). The Department of Health shall,
789	upon request, make such report available to any person. The
790	department shall make such report available as a part of the
791	practitioner’s profile within 15 calendar days after receipt.
792	(2) Any information in the possession of the Department of
793	Health which relates to a bankruptcy proceeding by a practitioner
794	of medicine licensed under chapter 458, a practitioner of
795	osteopathic medicine licensed under chapter 459, a podiatric
796	physician licensed under chapter 461, or a dentist licensed under
797	chapter 466 is public information. The Department of Health
798	shall, upon request, make such information available to any
799	person. The department shall make such report available as a part
800	of the practitioner’s profile within 15 calendar days after
801	receipt.
802	Section 12. Paragraph (g) of subsection (5) of section
803	458.320, Florida Statutes, is amended, and subsection (9) is
804	added to said section, to read:
805	458.320 Financial responsibility.--
806	(5) The requirements of subsections (1), (2), and (3) shall
807	not apply to:
808	(g) Any person holding an active license under this chapter
809	who agrees to meet all of the following criteria:
810	1. Upon the entry of an adverse final judgment arising from
811	a medical malpractice arbitration award, from a claim of medical
812	malpractice either in contract or tort, or from noncompliance
813	with the terms of a settlement agreement arising from a claim of
814	medical malpractice either in contract or tort, the licensee
815	shall pay the judgment creditor the lesser of the entire amount
816	of the judgment with all accrued interest or either $100,000, if
817	the physician is licensed pursuant to this chapter but does not
818	maintain hospital staff privileges, or $250,000, if the physician
819	is licensed pursuant to this chapter and maintains hospital staff
820	privileges, within 60 days after the date such judgment became
821	final and subject to execution, unless otherwise mutually agreed
822	to in writing by the parties. Such adverse final judgment shall
823	include any cross-claim, counterclaim, or claim for indemnity or
824	contribution arising from the claim of medical malpractice. Upon
825	notification of the existence of an unsatisfied judgment or
826	payment pursuant to this subparagraph, the department shall
827	notify the licensee by certified mail that he or she shall be
828	subject to disciplinary action unless, within 30 days from the
829	date of mailing, he or she either:
830	a. Shows proof that the unsatisfied judgment has been paid
831	in the amount specified in this subparagraph; or
832	b. Furnishes the department with a copy of a timely filed
833	notice of appeal and either:
834	(I) A copy of a supersedeas bond properly posted in the
835	amount required by law; or
836	(II) An order from a court of competent jurisdiction
837	staying execution on the final judgment pending disposition of
838	the appeal.
839	2. The Department of Health shall issue an emergency order
840	suspending the license of any licensee who, after 30 days
841	following receipt of a notice from the Department of Health, has
842	failed to: satisfy a medical malpractice claim against him or
843	her; furnish the Department of Health a copy of a timely filed
844	notice of appeal; furnish the Department of Health a copy of a
845	supersedeas bond properly posted in the amount required by law;
846	or furnish the Department of Health an order from a court of
847	competent jurisdiction staying execution on the final judgment
848	pending disposition of the appeal.
849	3. Upon the next meeting of the probable cause panel of the
850	board following 30 days after the date of mailing the notice of
851	disciplinary action to the licensee, the panel shall make a
852	determination of whether probable cause exists to take
853	disciplinary action against the licensee pursuant to subparagraph
854	1.
855	4. If the board determines that the factual requirements of
856	subparagraph 1. are met, it shall take disciplinary action as it
857	deems appropriate against the licensee. Such disciplinary action
858	shall include, at a minimum, probation of the license with the
859	restriction that the licensee must make payments to the judgment
860	creditor on a schedule determined by the board to be reasonable
861	and within the financial capability of the physician.
862	Notwithstanding any other disciplinary penalty imposed, the
863	disciplinary penalty may include suspension of the license for a
864	period not to exceed 5 years. In the event that an agreement to
865	satisfy a judgment has been met, the board shall remove any
866	restriction on the license.
867	5. The licensee has completed a form supplying necessary
868	information as required by the department.
869
870	A licensee who meets the requirements of this paragraph shall be
871	required either to post notice in the form of a sign, with
872	dimensions of 8 ½ inches by 11 inches in boldface type that is at
873	least 1/2 inch in height in a font style specified by the
874	department, prominently displayed in at least two distinct places
875	in the reception area and each place or room used for examination
876	or treatment of patients. Such notice shall be clearly visible to
877	noticeable by all patients and other persons who may accompany a
878	patient on an office visit. Alternatively, a licensee mayor to
879	provide a written statement, printed in boldface type with a
880	minimum font size of 12, to eachanyperson to whom medical
881	services are being provided. Such sign or statement shall state:
882	"Under Florida law, physicians are generally required to carry
883	medical malpractice insurance or otherwise demonstrate financial
884	responsibility to cover potential claims for medical malpractice.
885	YOUR DOCTOR HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE
886	INSURANCE. This is permitted under Florida law subject to certain
887	conditions. Florida law imposes penalties against noninsured
888	physicians who fail to satisfy adverse judgments arising from
889	claims of medical malpractice.This notice is provided pursuant
890	to Florida law."
891	(9) Notwithstanding any other provision of this section,
892	the department shall suspend the license of any physician
893	against whom a final judgment, arbitration award, or other order
894	has been entered or who has entered into a settlement agreement
895	to pay damages arising out of a claim for medical malpractice,
896	if all appellate remedies have been exhausted and payment up to
897	the amounts required by this section has not been made within 30
898	days after the entering of such judgment, award, or order or
899	agreement, until proof of payment is received by the department.
900	This subsection does not apply to physicians who have met the
901	financial responsibility requirements in paragraphs (1)(b) and
902	(2)(b).
903	Section 13. Paragraphs (t) and (x) of subsection (1) and
904	subsection (6) of section 458.331, Florida Statutes, are amended,
905	and paragraphs (oo) and (pp) are added to subsection (1), to
906	read:
907	458.331 Grounds for disciplinary action; action by the
908	board and department.--
909	(1) The following acts constitute grounds for denial of a
910	license or disciplinary action, as specified in s. 456.072(2):
911	(t) Gross or repeated malpractice or the failure to
912	practice medicine with that level of care, skill, and treatment
913	which is recognized by a reasonably prudent similar physician as
914	being acceptable under similar conditions and circumstances. The
915	board shall give great weight to the provisions of s. 766.102
916	when enforcing this paragraph. As used in this paragraph,
917	"repeated malpractice" includes, but is not limited to, three or
918	more claims for medical malpractice within the previous 5-year
919	period resulting in indemnities being paid in excess of $50,000
920	$25,000each to the claimant in a judgment or settlement and
921	which incidents involved negligent conduct by the physician. As
922	used in this paragraph, "gross malpractice" or "the failure to
923	practice medicine with that level of care, skill, and treatment
924	which is recognized by a reasonably prudent similar physician as
925	being acceptable under similar conditions and circumstances,"
926	shall not be construed so as to require more than one instance,
927	event, or act. Nothing in this paragraph shall be construed to
928	require that a physician be incompetent to practice medicine in
929	order to be disciplined pursuant to this paragraph. A recommended
930	order by an administrative law judge or a final order of the
931	board finding a violation under this paragraph shall specify
932	whether the licensee was found to have committed gross
933	malpractice, repeated malpractice, or a failure to practice
934	medicine with that level of care, skill, and treatment which is
935	recognized as being acceptable under similar conditions and
936	circumstances, or any combination thereof, and any publication by
937	the board shall so specify.
938	(x) Violating a lawful order of the board or department
939	previously entered in a disciplinary hearing or failing to comply
940	with a lawfully issued subpoena of the board ordepartment.
941	(oo) Being held liable for a medical malpractice judgment.
942	(pp) Refusing to provide health care based on a patient’s
943	participation in pending or past litigation or participation in
944	any disciplinary action conducted pursuant to this chapter,
945	unless such litigation or disciplinary action directly involves
946	the physician requested to provide services.
947	(6) Upon the department's receipt from an insurer or self-
948	insurer of a report of a closed claim against a physician
949	pursuant to s. 627.912 or from a health care practitioner of a
950	report pursuant to s. 456.049, or upon the receipt from a
951	claimant of a presuit notice against a physician pursuant to s.
952	766.106, the department shall review each report and determine
953	whether it potentially involved conduct by a licensee that is
954	subject to disciplinary action, in which case the provisions of
955	s. 456.073 shall apply. However, if it is reported that a
956	physician has had three or more claims with indemnities exceeding
957	$50,000$25,000each within the previous 5-year period, the
958	department shall investigate the occurrences upon which the
959	claims were based and determine whetherifaction by the
960	department against the physician is warranted.
961	Section 14. Subsection (10) is added to section 459.0085,
962	Florida Statutes, to read:
963	459.0085 Financial responsibility.--
964	(10) Notwithstanding any other provision of this section,
965	the department shall suspend the license of any osteopathic
966	physician against whom has been entered a final judgment,
967	arbitration award, or other order or who has entered into a
968	settlement agreement to pay damages arising out of a claim for
969	medical malpractice, if all appellate remedies have been
970	exhausted and payment up to the amounts required by this section
971	has not been made within 30 days after the entering of such
972	judgment, award, order, or agreement, until proof of payment is
973	received by the department. This subsection does not apply to
974	osteopathic physicians who have met the financial responsibility
975	requirements in paragraphs (1)(b) and (2)(b).
976	Section 15. Paragraphs (h), (l), (w), and (x) of subsection
977	(1) and subsection (6) of section 459.015, Florida Statutes, are
978	amended, and paragraph (qq) is added to subsection (1), to read:
979	459.015 Grounds for disciplinary action; action by the
980	board and department.--
981	(1) The following acts constitute grounds for denial of a
982	license or disciplinary action, as specified in s. 456.072(2):
983	(h) Giving false testimony in the course of any legal or
984	administrative proceedings relating to the practice of
985	osteopathicmedicine or the delivery of health care services.
986	(l) Exercising influence within a patient-physician
987	relationship for purposes of engaging a patient in sexual
988	activity. A patient shall be presumed to be incapable of giving
989	free, full, and informed consent to sexual activity with his or
990	her osteopathicphysician.
991	(w) Being unable to practice osteopathic medicine with
992	reasonable skill and safety to patients by reason of illness or
993	use of alcohol, drugs, narcotics, chemicals, or any other type of
994	material or as a result of any mental or physical condition. In
995	enforcing this paragraph, the department shall, upon a finding of
996	the secretary or the secretary's designee that probable cause
997	exists to believe that the licensee is unable to practice
998	osteopathicmedicine because of the reasons stated in this
999	paragraph, have the authority to issue an order to compel a
1000	licensee to submit to a mental or physical examination by
1001	physicians designated by the department. If the licensee refuses
1002	to comply with such order, the department's order directing such
1003	examination may be enforced by filing a petition for enforcement
1004	in the circuit court where the licensee resides or does business.
1005	The licensee against whom the petition is filed shall not be
1006	named or identified by initials in any public court records or
1007	documents, and the proceedings shall be closed to the public. The
1008	department shall be entitled to the summary procedure provided in
1009	s. 51.011. A licensee or certificateholder affected under this
1010	paragraph shall at reasonable intervals be afforded an
1011	opportunity to demonstrate that he or she can resume the
1012	competent practice of osteopathicmedicine with reasonable skill
1013	and safety to patients.
1014	(x) Gross or repeated malpractice or the failure to
1015	practice osteopathic medicine with that level of care, skill, and
1016	treatment which is recognized by a reasonably prudent similar
1017	osteopathic physician as being acceptable under similar
1018	conditions and circumstances. The board shall give great weight
1019	to the provisions of s. 766.102 when enforcing this paragraph. As
1020	used in this paragraph, "repeated malpractice" includes, but is
1021	not limited to, three or more claims for medical malpractice
1022	within the previous 5-year period resulting in indemnities being
1023	paid in excess of $50,000$25,000each to the claimant in a
1024	judgment or settlement and which incidents involved negligent
1025	conduct by the osteopathic physician. As used in this paragraph,
1026	"gross malpractice" or "the failure to practice osteopathic
1027	medicine with that level of care, skill, and treatment which is
1028	recognized by a reasonably prudent similar osteopathic physician
1029	as being acceptable under similar conditions and circumstances"
1030	shall not be construed so as to require more than one instance,
1031	event, or act. Nothing in this paragraph shall be construed to
1032	require that an osteopathic physician be incompetent to practice
1033	osteopathic medicine in order to be disciplined pursuant to this
1034	paragraph. A recommended order by an administrative law judge or
1035	a final order of the board finding a violation under this
1036	paragraph shall specify whether the licensee was found to have
1037	committed "gross malpractice," "repeated malpractice," or
1038	"failure to practice osteopathic medicine with that level of
1039	care, skill, and treatment which is recognized as being
1040	acceptable under similar conditions and circumstances," or any
1041	combination thereof, and any publication by the board shall so
1042	specify.
1043	(qq) Being held liable for a malpractice judgment.
1044	(6) Upon the department's receipt from an insurer or self-
1045	insurer of a report of a closed claim against an osteopathic
1046	physician pursuant to s. 627.912 or from a health care
1047	practitioner of a report pursuant to s. 456.049, or upon the
1048	receipt from a claimant of a presuit notice against an
1049	osteopathic physician pursuant to s. 766.106, the department
1050	shall review each report and determine whether it potentially
1051	involved conduct by a licensee that is subject to disciplinary
1052	action, in which case the provisions of s. 456.073 shall apply.
1053	However, if it is reported that an osteopathic physician has had
1054	three or more claims with indemnities exceeding $50,000$25,000
1055	each within the previous 5-year period, the department shall
1056	investigate the occurrences upon which the claims were based and
1057	determine whetherifaction by the department against the
1058	osteopathic physician is warranted.
1059	Section 16. Civil immunity for members of or consultants
1060	to certain boards, committees, or other entities.--
1061	(1) Every member of, or health care professional
1062	consultant to, any committee, board, group, commission, or other
1063	entity shall be immune from civil liability for any act,
1064	decision, omission, or utterance done or made in performance of
1065	his or her duties while serving as a member of or consultant to
1066	such committee, board, group, commission, or other entity
1067	established and operated for purposes of quality improvement
1068	review, evaluation, and planning in a state-licensed health care
1069	facility. Such entities must function primarily to review,
1070	evaluate, or make recommendations relating to:
1071	(a) The duration of patient stays in health care
1072	facilities;
1073	(b) The professional services furnished with respect to
1074	the medical, dental, psychological, podiatric, chiropractic, or
1075	optometric necessity for such services;
1076	(c) The purpose of promoting the most efficient use of
1077	available health care facilities and services;
1078	(d) The adequacy or quality of professional services;
1079	(e) The competency and qualifications for professional
1080	staff privileges;
1081	(f) The reasonableness or appropriateness of charges made
1082	by or on behalf of health care facilities; or
1083	(g) Patient safety, including entering into contracts with
1084	patient safety organizations.
1085	(2) Such committee, board, group, commission, or other
1086	entity must be established in accordance with state law or in
1087	accordance with requirements of the Joint Commission on
1088	Accreditation of Healthcare Organizations, or established and
1089	duly constituted by one or more public or licensed private
1090	hospitals or behavioral health agencies, or established by a
1091	governmental agency. To be protected by this section, the act,
1092	decision, omission, or utterance may not be made or done in bad
1093	faith or with malicious intent.
1094	Section 17. Privileged communications of certain
1095	committees and entities developing, maintaining, and sharing
1096	patient safety data.--
1097	(1) For the purposes of this section:
1098	(a) "Patient safety data" means reports made to patient
1099	safety organizations together with all health care data,
1100	interviews, memoranda, analyses, root cause analyses, products
1101	of quality assurance or quality improvement processes,
1102	corrective action plans or information collected or created by a
1103	health care provider as a result of an occurrence related to the
1104	provision of health care services that exacerbates an existing
1105	medical condition or could result in injury, illness, or death.
1106	(b) "Patient safety organization" means any organization,
1107	group, or other entity that collects and analyzes patient safety
1108	data for the purpose of improving patient safety and health care
1109	outcomes and that is independent and not under the control of
1110	the entity that reports patient safety data.
1111	(2)(a) The proceedings, minutes, records, and reports of
1112	any medical staff committee, utilization review committee, or
1113	other committee, board, group, commission, or other entity, as
1114	specified in chapter 395 or chapter 641, Florida Statutes,
1115	together with all communications, both oral and written,
1116	originating in the course of deliberation, investigation, or
1117	analysis of such committees or entities, are privileged
1118	communications which may not be disclosed or obtained by legal
1119	discovery proceedings unless a circuit court, after a hearing
1120	and for good cause, orders the disclosure of such proceedings,
1121	minutes, records, reports, or communications. For the purposes
1122	of this section, accreditation and peer review records are
1123	considered privileged communications.
1124	(b) Documents and communications pertaining to the
1125	professional conduct of a physician or staff of the facility or
1126	pertaining to service delivered by a physician or staff member
1127	of the facility that are not generated during the course of
1128	deliberation, investigation, and analysis of a patient safety
1129	organization are not considered privileged. In response to a
1130	request for discovery, a claim of privilege by a patient safety
1131	organization must be accompanied by a list identifying all
1132	documents or communications for which privilege is asserted. The
1133	list, and a document or communication, when appropriate, shall
1134	be reviewed in camera for determination of whether the document
1135	or communication is privileged. Patient identifying information
1136	shall be redacted or otherwise excluded from the list, unless a
1137	court of competent jurisdiction orders disclosure of such
1138	information. A list of documents or communications for which
1139	privilege is asserted must include:
1140	1. The date the subject document or communication was
1141	created.
1142	2. The name and address of the document’s author or
1143	communication’s originator, unless a patient whose identity has
1144	not been ordered disclosed by a court of competent jurisdiction.
1145	3. The name and address of the party from whom the
1146	document or communication was received.
1147	4. The date the document or communication was received.
1148	5. The name and address of the original document’s
1149	custodian or communication’s originator.
1150	6. The statutory or case law on which the privilege is
1151	asserted.
1152	(3) Nothing in this section shall be construed as
1153	providing any additional privilege to hospital; physician, for
1154	services provided in a licensed physician office; or behavioral
1155	health provider medical records kept with respect to any patient
1156	in the ordinary course of business of operating a hospital,
1157	licensed physician’s office, or behavioral health provider or to
1158	any facts or information contained in such records. This section
1159	shall not preclude or affect discovery of or production of
1160	evidence relating to hospitalization or treatment of any patient
1161	in the ordinary course of hospitalization or treatment of such
1162	patient.
1163	(4) Any patient safety organization shall promptly remove
1164	all patient-identifying information after receipt of a complete
1165	patient safety data report unless such organization is otherwise
1166	permitted by state or federal law to maintain such information.
1167	Patient safety organizations shall maintain the confidentiality
1168	of all patient-identifying information and shall not disseminate
1169	such information except as permitted by state or federal law.
1170	(5) Exchange of patient safety data among health care
1171	providers or patient safety organizations that does not identify
1172	any patient shall not constitute a waiver of any privilege
1173	established in this section.
1174	(6) Reports of patient safety data to patient safety
1175	organizations shall not abrogate obligations to make reports to
1176	the Department of Health, the Agency for Health Care
1177	Administration, or other state or federal law regulatory
1178	agencies.
1179	(7) No employer shall take retaliatory action against an
1180	employee who in good faith makes a report of patient safety data
1181	to a patient safety organization.
1182	(8) Each patient safety organization convened under this
1183	section shall quarterly submit statistical reports of its
1184	findings to the Department of Health, the Agency for Health Care
1185	Administration, and the Office of Insurance Regulation. Each
1186	department shall use such statistics for comparison to
1187	information the department generates from its regulatory
1188	operations and to improve its regulation of health care
1189	providers.
1190	Section 18. The Department of Health and the Office of
1191	Insurance Regulation shall jointly publish a list, updated
1192	semiannually, of all health care professionals authorized to
1193	practice in this state, licensed under chapter 458 or chapter
1194	459, Florida Statutes, who do not carry medical malpractice
1195	insurance. Such list shall indicate the last date such health
1196	care professional was covered by professional liability
1197	insurance and any explanation of insurance status deemed
1198	appropriate.
1199	Section 19. Each final settlement statement relating to
1200	medical malpractice shall include the following statement: “The
1201	decision to settle a case may reflect the economic
1202	practicalities pertaining to the cost of litigation and is not,
1203	alone, an admission that the insured failed to meet the required
1204	standard of care applicable to the patient’s treatment. The
1205	decision to settle a case may be made by the insurance company
1206	without consulting its client for input.”
1207	Section 20. Notwithstanding any other provision of law to
1208	the contrary, confidential legal settlements pertaining to
1209	medical malpractice actions are prohibited. A legal settlement
1210	shall be public information.
1211	Section 21. Office of Insurance Regulation; closed claim
1212	forms; report required.--The Office of Insurance Regulation
1213	shall revise its closed claim form for readability at the ninth-
1214	grade level. The office shall compile annual statistical reports
1215	that provide data summaries of all closed claims, including, but
1216	not limited to, the number of closed claims on file pertaining
1217	to the referent health care professional or health care entity,
1218	the nature of the errant conduct, the size of payments, and the
1219	frequency and size of noneconomic damage awards. The office
1220	shall develop annualized historical statistical summaries
1221	beginning with state fiscal year 1976 and publish these reports
1222	on its website no later than state fiscal year 2005. The form
1223	must comply with the following minimum requirements:
1224	(1) A practitioner of medicine licensed pursuant to the
1225	provisions of chapter 458, Florida Statutes, or practitioner of
1226	osteopathic medicine licensed pursuant to the provisions of
1227	chapter 459, Florida Statutes, shall report to the Office of
1228	Insurance Regulation and the Department of Health any claim or
1229	action for damages for personal injury alleged to have been
1230	caused by error, omission, or negligence in the performance of
1231	such licensee's professional services or based on a claimed
1232	performance of professional services without consent if the
1233	claim was not covered by an insurer required to report under s.
1234	627.912, Florida Statutes, is not a claim for medical
1235	malpractice that is subject to the provisions of s. 766.106,
1236	Florida Statutes, and the claim resulted in:
1237	(a) A final judgment in any amount.
1238	(b) A settlement in any amount.
1239	(c) A final disposition not resulting in payment on behalf
1240	of the licensee.
1241
1242	Reports shall be filed with the office no later than 60 days
1243	following the occurrence of any event listed in this subsection.
1244	(2) Health professional reports shall contain:
1245	(a) The name and address of the licensee.
1246	(b) The alleged occurrence.
1247	(c) The date of the alleged occurrence.
1248	(d) The date the claim or action was reported to the
1249	licensee.
1250	(e) The name and address of the opposing party.
1251	(f) The date of suit, if filed.
1252	(g) The injured person's age and sex.
1253	(h) The total number and names of all defendants involved
1254	in the claim.
1255	(i) The date and amount of judgment or settlement, if any,
1256	including the itemization of the verdict, together with a copy
1257	of the settlement or judgment.
1258	(j) In the case of a settlement, such information as the
1259	Office of Insurance Regulation may require with regard to the
1260	injured person's incurred and anticipated medical expenses, wage
1261	loss, and other expenses.
1262	(k) The loss adjustment expense paid to defense counsel,
1263	and all other allocated loss adjustment expense paid.
1264	(l) The date and reason for final disposition, if no
1265	judgment or settlement.
1266	(m) A summary of the occurrence which created the claim,
1267	which shall include:
1268	1. The name of the institution, if any, and the location
1269	within such institution, at which the injury occurred.
1270	2. The final diagnosis for which treatment was sought or
1271	rendered, including the patient's actual condition.
1272	3. A description of the misdiagnosis made, if any, of the
1273	patient's actual condition.
1274	4. The operation or the diagnostic or treatment procedure
1275	causing the injury.
1276	5. A description of the principal injury giving rise to
1277	the claim.
1278	6. The safety management steps that have been taken by the
1279	licensee to make similar occurrences or injuries less likely in
1280	the future.
1281	(n) Any other information required by the Office of
1282	Insurance Regulation to analyze and evaluate the nature, causes,
1283	location, cost, and damages involved in professional liability
1284	cases.
1285	Section 22. If any provision of this act or its
1286	application to any person or circumstance is held invalid, the
1287	invalidity shall not affect other provisions or applications of
1288	the act which can be given effect without the invalid provision
1289	or application, and to this end the provisions of this act are
1290	declared severable.
1291	Section 23. This act shall take effect upon becoming a law.