HOUSE AMENDMENT Bill No. HB 1713
1	CHAMBER ACTION
2	Senate House
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12	Representative Smith offered the following:
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14	Amendment (with title amendment)
15	Between lines 1380 and 1381, insert:
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17	Section 42. Effective upon this act becoming a law and
18	applying to claims accruing on or after that date, section
19	458.320, Florida Statutes, is amended to read:
20	458.320 Financial responsibility.--
21	(1) As a condition of licensing and maintaining an active
22	license,and prior to the issuance or renewal of an active
23	license or reactivation of an inactive license for the practice
24	of medicine, an applicant shall by one of the following methods
25	demonstrate to the satisfaction of the board and the department
26	financial responsibility to pay claims and costs ancillary
27	thereto arising out of the rendering of, or the failure to
28	render, medical care or services:
29	(a) Establishing and maintaining an escrow account
30	consisting of cash or assets eligible for deposit in accordance
31	with s. 625.52 in the per claim amounts specified in paragraph
32	(b). The required escrow amount set forth in this paragraph
33	shall not be used for litigation costs and attorney's fees for
34	the defense of any medical malpractice claim.
35	(b) Obtaining and maintaining professional liability
36	coverage in an amount not less than $100,000 per claim, with a
37	minimum annual aggregate of not less than $300,000, from an
38	authorized insurer as defined under s. 624.09, from a surplus
39	lines insurer as defined under s. 626.914(2), from a risk
40	retention group as defined under s. 627.942, from the Joint
41	Underwriting Association established under s. 627.351(4), or
42	through a plan of self-insurance as provided in s. 627.357. The
43	required coverage amount set forth in this paragraph shall not
44	be used for litigation costs and attorney's fees for the defense
45	of any medical malpractice claim.
46	(c) Obtaining and maintaining an unexpired, irrevocable
47	letter of credit, established pursuant to chapter 675, in an
48	amount not less than $100,000 per claim, with a minimum
49	aggregate availability of credit of not less than $300,000. The
50	letter of credit shall be payable to the physician as
51	beneficiary upon presentment of a final judgment indicating
52	liability and awarding damages to be paid by the physician or
53	upon presentment of a settlement agreement signed by all parties
54	to such agreement when such final judgment or settlement is a
55	result of a claim arising out of the rendering of, or the
56	failure to render, medical care and services. The letter of
57	credit shall not be used for litigation costs and attorney's
58	fees for the defense of any medical malpractice claim. TheSuch
59	letter of credit shall be nonassignable and nontransferable.
60	Such letter of credit shall be issued by any bank or savings
61	association organized and existing under the laws of this state
62	or any bank or savings association organized under the laws of
63	the United States that has its principal place of business in
64	this state or has a branch office which is authorized under the
65	laws of this state or of the United States to receive deposits
66	in this state.
67	(2) Physicians who perform surgery in an ambulatory
68	surgical center licensed under chapter 395 and,as a continuing
69	condition of hospital staff privileges, physicians who havewith
70	staff privileges shall also be required toestablish financial
71	responsibility by one of the following methods:
72	(a) Establishing and maintaining an escrow account
73	consisting of cash or assets eligible for deposit in accordance
74	with s. 625.52 in the per claim amounts specified in paragraph
75	(b). The required escrow amount set forth in this paragraph
76	shall not be used for litigation costs and attorney's fees for
77	the defense of any medical malpractice claim.
78	(b) Obtaining and maintaining professional liability
79	coverage in an amount not less than $250,000 per claim, with a
80	minimum annual aggregate of not less than $750,000 from an
81	authorized insurer as defined under s. 624.09, from a surplus
82	lines insurer as defined under s. 626.914(2), from a risk
83	retention group as defined under s. 627.942, from the Joint
84	Underwriting Association established under s. 627.351(4),
85	through a plan of self-insurance as provided in s. 627.357, or
86	through a plan of self-insurance which meets the conditions
87	specified for satisfying financial responsibility in s. 766.110.
88	The required coverage amount set forth in this paragraph shall
89	not be used for litigation costs and attorney's fees for the
90	defense of any medical malpractice claim.
91	(c) Obtaining and maintaining an unexpired irrevocable
92	letter of credit, established pursuant to chapter 675, in an
93	amount not less than $250,000 per claim, with a minimum
94	aggregate availability of credit of not less than $750,000. The
95	letter of credit shall be payable to the physician as
96	beneficiary upon presentment of a final judgment indicating
97	liability and awarding damages to be paid by the physician or
98	upon presentment of a settlement agreement signed by all parties
99	to such agreement when such final judgment or settlement is a
100	result of a claim arising out of the rendering of, or the
101	failure to render, medical care and services. The letter of
102	credit shall not be used for litigation costs and attorney's
103	fees for the defense of any medical malpractice claim. TheSuch
104	letter of credit shall be nonassignable and nontransferable. The
105	Suchletter of credit shall be issued by any bank or savings
106	association organized and existing under the laws of this state
107	or any bank or savings association organized under the laws of
108	the United States that has its principal place of business in
109	this state or has a branch office which is authorized under the
110	laws of this state or of the United States to receive deposits
111	in this state.
112
113	This subsection shall be inclusive of the coverage in subsection
114	(1).
115	(3)(a) The financial responsibility requirements of
116	subsections (1) and (2) shall apply to claims for incidents that
117	occur on or after January 1, 1987, or the initial date of
118	licensure in this state, whichever is later.
119	(b)Meeting the financial responsibility requirements of
120	this section or the criteria for any exemption from such
121	requirements shall be established at the time of issuance or
122	renewal of a license on or after January 1, 1987.
123	(b)(c)Any person may, at any time, submit to the
124	department a request for an advisory opinion regarding such
125	person's qualifications for exemption.
126	(4)(a) Each insurer, self-insurer, risk retention group,
127	or Joint Underwriting Association shall promptly notify the
128	department of cancellation or nonrenewal of insurance required
129	by this section. Unless the physician demonstrates that he or
130	she is otherwise in compliance with the requirements of this
131	section, the department shall suspend the license of the
132	physician pursuant to ss. 120.569 and 120.57 and notify all
133	health care facilities licensed under chapter 395 of such
134	action. Any suspension under this subsection shall remain in
135	effect until the physician demonstrates compliance with the
136	requirements of this section. If any judgment or settlement is
137	pending at the time of suspension, such judgment or settlement
138	shall be paid in accordance with this section unless otherwise
139	mutually agreed to in writing by the parties. This paragraph
140	does not abrogate a judgment debtor’s obligation to satisfy the
141	entire amount of any judgment, except that a license suspended
142	under paragraph (5)(g) shall not be reinstated until the
143	physician demonstrates compliance with the requirements of that
144	provision.
145	(b) If financial responsibility requirements are met by
146	maintaining an escrow account or letter of credit as provided in
147	this section, upon the entry of an adverse final judgment
148	arising from a medical malpractice arbitration award, from a
149	claim of medical malpractice either in contract or tort, or from
150	noncompliance with the terms of a settlement agreement arising
151	from a claim of medical malpractice either in contract or tort,
152	the licensee shall pay the entire amount of the judgment
153	together with all accrued interest, or the amount maintained in
154	the escrow account or provided in the letter of credit as
155	required by this section, whichever is less, within 60 days
156	after the date such judgment became final and subject to
157	execution, unless otherwise mutually agreed to in writing by the
158	parties. If timely payment is not made by the physician, the
159	department shall suspend the license of the physician pursuant
160	to procedures set forth in subparagraphs (5)(g)3., 4., and 5.
161	Nothing in this paragraph shall abrogate a judgment debtor's
162	obligation to satisfy the entire amount of any judgment.
163	(5) The requirements of subsections (1), (2), and (3) do
164	shallnot apply to:
165	(a) Any person licensed under this chapter who practices
166	medicine exclusively as an officer, employee, or agent of the
167	Federal Government or of the state or its agencies or its
168	subdivisions. For the purposes of this subsection, an agent of
169	the state, its agencies, or its subdivisions is a person who is
170	eligible for coverage under any self-insurance or insurance
171	program authorized by the provisions of s. 768.28(15).
172	(b) Any person whose license has become inactive under
173	this chapter and who is not practicing medicine in this state.
174	Any person applying for reactivation of a license must show
175	either that such licensee maintained tail insurance coverage
176	which provided liability coverage for incidents that occurred on
177	or after January 1, 1987, or the initial date of licensure in
178	this state, whichever is later, and incidents that occurred
179	before the date on which the license became inactive; or such
180	licensee must submit an affidavit stating that such licensee has
181	no unsatisfied medical malpractice judgments or settlements at
182	the time of application for reactivation.
183	(c) Any person holding a limited license pursuant to s.
184	458.317 and practicing under the scope of such limited license.
185	(d) Any person licensed or certified under this chapter
186	who practices only in conjunction with his or her teaching
187	duties at an accredited medical school or in its main teaching
188	hospitals. Such person may engage in the practice of medicine to
189	the extent that such practice is incidental to and a necessary
190	part of duties in connection with the teaching position in the
191	medical school.
192	(e) Any person holding an active license under this
193	chapter who is not practicing medicine in this state. If such
194	person initiates or resumes any practice of medicine in this
195	state, he or she must notify the department of such activity and
196	fulfill the financial responsibility requirements of this
197	section before resuming the practice of medicine in this state.
198	(f) Any person holding an active license under this
199	chapter who meets all of the following criteria:
200	1. The licensee has held an active license to practice in
201	this state or another state or some combination thereof for more
202	than 15 years.
203	2. The licensee has either retired from the practice of
204	medicine or maintains a part-time practice of no more than 1,000
205	patient contact hours per year.
206	3. The licensee has had no more than two claims for
207	medical malpractice resulting in an indemnity exceeding $25,000
208	within the previous 5-year period.
209	4. The licensee has not been convicted of, or pled guilty
210	or nolo contendere to, any criminal violation specified in this
211	chapter or the medical practice act of any other state.
212	5. The licensee has not been subject within the last 10
213	years of practice to license revocation or suspension for any
214	period of time; probation for a period of 3 years or longer; or
215	a fine of $500 or more for a violation of this chapter or the
216	medical practice act of another jurisdiction. The regulatory
217	agency's acceptance of a physician's relinquishment of a
218	license, stipulation, consent order, or other settlement,
219	offered in response to or in anticipation of the filing of
220	administrative charges against the physician's license,
221	constitutesshall be construed asaction against the physician's
222	license for the purposes of this paragraph.
223	6. The licensee has submitted a form supplying necessary
224	information as required by the department and an affidavit
225	affirming compliance with the provisions ofthis paragraph.
226	7. The licensee shall submit biennially to the department
227	certification stating compliance with the provisions ofthis
228	paragraph. The licensee shall, upon request, demonstrate to the
229	department information verifying compliance with this paragraph.
230
231	A licensee who meets the requirements of this paragraph shall be
232	required either topost notice in the form of a sign prominently
233	displayed in the reception area and clearly noticeable by all
234	patients or provide a written statement to any person to whom
235	medical services are being provided. Such sign or statement
236	shall state that: Under Florida law, physicians are generally
237	required to carry medical malpractice insurance or otherwise
238	demonstrate financial responsibility to cover potential claims
239	for medical malpractice. However, certain part-time physicians
240	who meet state requirements are exempt from the financial
241	responsibility law. YOUR DOCTOR MEETS THESE REQUIREMENTS AND HAS
242	DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice
243	is provided pursuant to Florida law.
244	(g) Any person holding an active license under this
245	chapter who agrees to meet all of the following criteria:
246	(6)(a)1.Upon the entry of an adverse final judgment
247	arising from a medical malpractice arbitration award, from a
248	claim of medical malpractice either in contract or tort, or from
249	noncompliance with the terms of a settlement agreement arising
250	from a claim of medical malpractice either in contract or tort,
251	the licensee shall pay the judgment creditor the lesser of the
252	entire amount of the judgment with all accrued interest or
253	either $250,000$100,000, if the physician is licensed pursuant
254	to this chapter but does not maintain hospital staff privileges,
255	or $500,000$250,000, if the physician is licensed pursuant to
256	this chapter and maintains hospital staff privileges, within 60
257	days after the date such judgment became final and subject to
258	execution, unless otherwise mutually agreed to in writing by the
259	parties. Such adverse final judgment shall include any cross-
260	claim, counterclaim, or claim for indemnity or contribution
261	arising from the claim of medical malpractice. Upon notification
262	of the existence of an unsatisfied judgment or payment pursuant
263	to this subparagraph, the department shall notify the licensee
264	by certified mail that he or she shall be subject to
265	disciplinary action unless, within 30 days from the date of
266	mailing, he or she either:
267	1.a.Shows proof that the unsatisfied judgment has been
268	paid in the amount specified in this subparagraph; or
269	2.b.Furnishes the department with a copy of a timely
270	filed notice of appeal and either:
271	a.(I)A copy of a supersedeas bond properly posted in the
272	amount required by law; or
273	b.(II)An order from a court of competent jurisdiction
274	staying execution on the final judgment pending disposition of
275	the appeal.
276	(b)2.The Department of Health shall issue an emergency
277	order suspending the license of any licensee who, after 30 days
278	following receipt of a notice from the Department of Health, has
279	failed to: satisfy a medical malpractice claim against him or
280	her; furnish the Department of Health a copy of a timely filed
281	notice of appeal; furnish the Department of Health a copy of a
282	supersedeas bond properly posted in the amount required by law;
283	or furnish the Department of Health an order from a court of
284	competent jurisdiction staying execution on the final judgment
285	pending disposition of the appeal.
286	(c)3.Upon the next meeting of the probable cause panel of
287	the board following 30 days after the date of mailing the notice
288	of disciplinary action to the licensee, the panel shall make a
289	determination of whether probable cause exists to take
290	disciplinary action against the licensee pursuant to
291	subparagraph 1.
292	(d)4.If the board determines that the factual
293	requirements of subparagraph 1. are met, it shall take
294	disciplinary action as it deems appropriate against the
295	licensee. Such disciplinary action shall include, at a minimum,
296	probation of the license with the restriction that the licensee
297	must make payments to the judgment creditor on a schedule
298	determined by the board to be reasonable and within the
299	financial capability of the physician. Notwithstanding any other
300	disciplinary penalty imposed, the disciplinary penalty may
301	include suspension of the license for a period not to exceed 5
302	years. In the event that an agreement to satisfy a judgment has
303	been met, the board shall remove any restriction on the license.
304	(e)5.The licensee has completed a form supplying
305	necessary information as required by the department.
306
307	A licensee who meets the requirements of this paragraph shall be
308	required either to post notice in the form of a sign prominently
309	displayed in the reception area and clearly noticeable by all
310	patients or to provide a written statement to any person to whom
311	medical services are being provided. Such sign or statement
312	shall state: "Under Florida law, physicians are generally
313	required to carry medical malpractice insurance or otherwise
314	demonstrate financial responsibility to cover potential claims
315	for medical malpractice. YOUR DOCTOR HAS DECIDED NOT TO CARRY
316	MEDICAL MALPRACTICE INSURANCE. This is permitted under Florida
317	law subject to certain conditions. Florida law imposes penalties
318	against noninsured physicians who fail to satisfy adverse
319	judgments arising from claims of medical malpractice. This
320	notice is provided pursuant to Florida law."
321	(7)(6)Any deceptive, untrue, or fraudulent representation
322	by the licensee with respect to any provision of this section
323	shall result in permanent disqualification from any exemption to
324	mandated financial responsibility as provided in this section
325	and shall constitute grounds for disciplinary action under s.
326	458.331.
327	(8)(7)Any licensee who relies on any exemption from the
328	financial responsibility requirement shall notify the
329	department, in writing, of any change of circumstance regarding
330	his or her qualifications for such exemption and shall
331	demonstrate that he or she is in compliance with the
332	requirements of this section.
333	(9)(8)The board shall adopt rules to implement the
334	provisions of this section.
335	Section 42. Effective upon this act becoming a law and
336	applying to claims accruing on or after that date, section
337	459.0085, Florida Statutes, is amended to read:
338	459.0085 Financial responsibility.--
339	(1) As a condition of licensing and maintaining an active
340	license,and prior to the issuance or renewal of an active
341	license or reactivation of an inactive license for the practice
342	of osteopathic medicine, an applicant shall by one of the
343	following methods demonstrate to the satisfaction of the board
344	and the department financial responsibility to pay claims and
345	costs ancillary thereto arising out of the rendering of, or the
346	failure to render, medical care or services:
347	(a) Establishing and maintaining an escrow account
348	consisting of cash or assets eligible for deposit in accordance
349	with s. 625.52 in the per-claim amounts specified in paragraph
350	(b).
351	(b) Obtaining and maintaining professional liability
352	coverage for the current year and for each of the prior years
353	that the applicant or licensee has been in the active practice
354	of medicine, up to a maximum of 4 prior years,in an amount not
355	less than $100,000 per claim, with a minimum annual aggregate of
356	not less than $300,000, from an authorized insurer as defined
357	under s. 624.09, from a surplus lines insurer as defined under
358	s. 626.914(2), from a risk retention group as defined under s.
359	627.942, from the Joint Underwriting Association established
360	under s. 627.351(4), or through a plan of self-insurance as
361	provided in s. 627.357. The required coverage amount set forth
362	in this paragraph shall not be used for litigation costs and
363	attorney's fees for the defense of any medical negligence claim.
364	(c) Obtaining and maintaining an unexpired, irrevocable
365	letter of credit, established pursuant to chapter 675, for the
366	current year and for each of the prior years that the applicant
367	or licensee has been in the active practice of medicine, up to a
368	maximum of 4 prior years,in an amount not less than $100,000
369	per claim, with a minimum aggregate availability of credit of
370	not less than $300,000. The letter of credit shall be payable to
371	the osteopathic physician as beneficiary upon presentment of a
372	final judgment indicating liability and awarding damages to be
373	paid by the osteopathic physician or upon presentment of a
374	settlement agreement signed by all parties to such agreement
375	when such final judgment or settlement is a result of a claim
376	arising out of the rendering of, or the failure to render,
377	medical care and services. Such letter of credit shall be
378	nonassignable and nontransferable. Such letter of credit shall
379	be issued by any bank or savings association organized and
380	existing under the laws of this state or any bank or savings
381	association organized under the laws of the United States that
382	has its principal place of business in this state or has a
383	branch office which is authorized under the laws of this state
384	or of the United States to receive deposits in this state.
385	(2) Osteopathic physicians who perform surgery in an
386	ambulatory surgical center licensed under chapter 395 and,as a
387	continuing condition of hospital staff privileges, osteopathic
388	physicians who havewith staff privileges shall also be required
389	toestablish financial responsibility by one of the following
390	methods:
391	(a) Establishing and maintaining an escrow account
392	consisting of cash or assets eligible for deposit in accordance
393	with s. 625.52 in the per-claim amounts specified in paragraph
394	(b).
395	(b) Obtaining and maintaining professional liability
396	coverage for the current year and for each of the prior years
397	that the applicant or licensee has been in the active practice
398	of medicine, up to a maximum of 4 prior years,in an amount not
399	less than $250,000 per claim, with a minimum annual aggregate of
400	not less than $750,000 from an authorized insurer as defined
401	under s. 624.09, from a surplus lines insurer as defined under
402	s. 626.914(2), from a risk retention group as defined under s.
403	627.942, from the Joint Underwriting Association established
404	under s. 627.351(4), through a plan of self-insurance as
405	provided in s. 627.357, or through a plan of self-insurance
406	which meets the conditions specified for satisfying financial
407	responsibility in s. 766.110.
408	(c) Obtaining and maintaining an unexpired, irrevocable
409	letter of credit, for the current year and for each of the prior
410	years that the applicant or licensee has been in the active
411	practice of medicine, up to a maximum of 4 prior years,
412	established pursuant to chapter 675, in an amount not less than
413	$250,000 per claim, with a minimum aggregate availability of
414	credit of not less than $750,000. The letter of credit shall be
415	payable to the osteopathic physician as beneficiary upon
416	presentment of a final judgment indicating liability and
417	awarding damages to be paid by the osteopathic physician or upon
418	presentment of a settlement agreement signed by all parties to
419	such agreement when such final judgment or settlement is a
420	result of a claim arising out of the rendering of, or the
421	failure to render, medical care and services. TheSuchletter of
422	credit shall be nonassignable and nontransferable. Such letter
423	of credit shall be issued by any bank or savings association
424	organized and existing under the laws of this state or any bank
425	or savings association organized under the laws of the United
426	States that has its principal place of business in this state or
427	has a branch office which is authorized under the laws of this
428	state or of the United States to receive deposits in this state.
429
430	This subsection shall be inclusive of the coverage in subsection
431	(1).
432	(3)(a) The financial responsibility requirements of
433	subsections (1) and (2) shall apply to claims for incidents that
434	occur on or after January 1, 1987, or the initial date of
435	licensure in this state, whichever is later.
436	(b)Meeting the financial responsibility requirements of
437	this section or the criteria for any exemption from such
438	requirements shall be established at the time of issuance or
439	renewal of a license on or after January 1, 1987.
440	(b)(c)Any person may, at any time, submit to the
441	department a request for an advisory opinion regarding such
442	person's qualifications for exemption.
443	(4)(a) Each insurer, self-insurer, risk retention group,
444	or joint underwriting association shall promptly notify the
445	department of cancellation or nonrenewal of insurance required
446	by this section. Unless the osteopathic physician demonstrates
447	that he or she is otherwise in compliance with the requirements
448	of this section, the department shall suspend the license of the
449	osteopathic physician pursuant to ss. 120.569 and 120.57 and
450	notify all health care facilities licensed under chapter 395,
451	part IV of chapter 394, or part I of chapter 641 of such action.
452	Any suspension under this subsection shall remain in effect
453	until the osteopathic physician demonstrates compliance with the
454	requirements of this section. If any judgments or settlements
455	are pending at the time of suspension, those judgments or
456	settlements must be paid in accordance with subsection (6)
457	unless otherwise mutually agreed to in writing by the parties.
458	This paragraph does not abrogate a judgment debtor’s obligation
459	to satisfy the entire amount of any judgmentexcept that a
460	license suspended under paragraph (5)(g) shall not be reinstated
461	until the osteopathic physician demonstrates compliance with the
462	requirements of that provision.
463	(b) If financial responsibility requirements are met by
464	maintaining an escrow account or letter of credit as provided in
465	this section, upon the entry of an adverse final judgment
466	arising from a medical malpractice arbitration award, from a
467	claim of medical malpractice either in contract or tort, or from
468	noncompliance with the terms of a settlement agreement arising
469	from a claim of medical malpractice either in contract or tort,
470	the licensee shall pay the entire amount of the judgment
471	together with all accrued interest or the amount maintained in
472	the escrow account or provided in the letter of credit as
473	required by this section, whichever is less, within 60 days
474	after the date such judgment became final and subject to
475	execution, unless otherwise mutually agreed to in writing by the
476	parties. If timely payment is not made by the osteopathic
477	physician, the department shall suspend the license of the
478	osteopathic physician pursuant to procedures set forth in
479	subparagraphs (5)(g)3., 4., and 5. Nothing in this paragraph
480	shall abrogate a judgment debtor's obligation to satisfy the
481	entire amount of any judgment.
482	(5) The requirements of subsections (1), (2), and (3) do
483	shallnot apply to:
484	(a) Any person licensed under this chapter who practices
485	medicine exclusively as an officer, employee, or agent of the
486	Federal Government or of the state or its agencies or its
487	subdivisions. For the purposes of this subsection, an agent of
488	the state, its agencies, or its subdivisions is a person who is
489	eligible for coverage under any self-insurance or insurance
490	program authorized by the provisions of s. 768.28(15).
491	(b) Any person whose license has become inactive under
492	this chapter and who is not practicing medicine in this state.
493	Any person applying for reactivation of a license must show
494	either that such licensee maintained tail insurance coverage
495	which provided liability coverage for incidents that occurred on
496	or after January 1, 1987, or the initial date of licensure in
497	this state, whichever is later, and incidents that occurred
498	before the date on which the license became inactive; or such
499	licensee must submit an affidavit stating that such licensee has
500	no unsatisfied medical malpractice judgments or settlements at
501	the time of application for reactivation.
502	(c) Any person holding a limited license pursuant to s.
503	459.0075 and practicing under the scope of such limited license.
504	(d) Any person licensed or certified under this chapter
505	who practices only in conjunction with his or her teaching
506	duties at a college of osteopathic medicine. Such person may
507	engage in the practice of osteopathic medicine to the extent
508	that such practice is incidental to and a necessary part of
509	duties in connection with the teaching position in the college
510	of osteopathic medicine.
511	(e) Any person holding an active license under this
512	chapter who is not practicing osteopathic medicine in this
513	state. If such person initiates or resumes any practice of
514	osteopathic medicine in this state, he or she must notify the
515	department of such activity and fulfill the financial
516	responsibility requirements of this section before resuming the
517	practice of osteopathic medicine in this state.
518	(f) Any person holding an active license under this
519	chapter who meets all of the following criteria:
520	1. The licensee has held an active license to practice in
521	this state or another state or some combination thereof for more
522	than 15 years.
523	2. The licensee has either retired from the practice of
524	osteopathic medicine or maintains a part-time practice of
525	osteopathic medicine of no more than 1,000 patient contact hours
526	per year.
527	3. The licensee has had no more than two claims for
528	medical malpractice resulting in an indemnity exceeding $25,000
529	within the previous 5-year period.
530	4. The licensee has not been convicted of, or pled guilty
531	or nolo contendere to, any criminal violation specified in this
532	chapter or the practice act of any other state.
533	5. The licensee has not been subject within the last 10
534	years of practice to license revocation or suspension for any
535	period of time, probation for a period of 3 years or longer, or
536	a fine of $500 or more for a violation of this chapter or the
537	medical practice act of another jurisdiction. The regulatory
538	agency's acceptance of an osteopathic physician's relinquishment
539	of a license, stipulation, consent order, or other settlement,
540	offered in response to or in anticipation of the filing of
541	administrative charges against the osteopathic physician's
542	license, constitutesshall be construed asaction against the
543	physician's license for the purposes of this paragraph.
544	6. The licensee has submitted a form supplying necessary
545	information as required by the department and an affidavit
546	affirming compliance with the provisions ofthis paragraph.
547	7. The licensee shall submit biennially to the department
548	a certification stating compliance with the provisions ofthis
549	paragraph. The licensee shall, upon request, demonstrate to the
550	department information verifying compliance with this paragraph.
551
552	A licensee who meets the requirements of this paragraph shall be
553	required either topost notice in the form of a sign prominently
554	displayed in the reception area and clearly noticeable by all
555	patients or to provide a written statement to any person to whom
556	medical services are being provided. TheSuchsign or statement
557	shall state that: Under Florida law, osteopathic physicians are
558	generally required to carry medical malpractice insurance or
559	otherwise demonstrate financial responsibility to cover
560	potential claims for medical malpractice. However, certain part-
561	time osteopathic physicians who meet state requirements are
562	exempt from the financial responsibility law. YOUR OSTEOPATHIC
563	PHYSICIAN MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY
564	MEDICAL MALPRACTICE INSURANCE. This notice is provided pursuant
565	to Florida law.
566	(g) Any person holding an active license under this
567	chapter who agrees to meet all of the following criteria:
568	(6)(a)1.Upon the entry of an adverse final judgment
569	arising from a medical malpractice arbitration award, from a
570	claim of medical malpractice either in contract or tort, or from
571	noncompliance with the terms of a settlement agreement arising
572	from a claim of medical malpractice either in contract or tort,
573	the licensee shall pay the judgment creditor the lesser of the
574	entire amount of the judgment with all accrued interest or
575	either $250,000$100,000, if the osteopathic physician is
576	licensed pursuant to this chapter but does not maintain hospital
577	staff privileges, or $500,000$250,000, if the osteopathic
578	physician is licensed pursuant to this chapter and maintains
579	hospital staff privileges, within 60 days after the date such
580	judgment became final and subject to execution, unless otherwise
581	mutually agreed to in writing by the parties. Such adverse final
582	judgment shall include any cross-claim, counterclaim, or claim
583	for indemnity or contribution arising from the claim of medical
584	malpractice. Upon notification of the existence of an
585	unsatisfied judgment or payment pursuant to this subparagraph,
586	the department shall notify the licensee by certified mail that
587	he or she shall be subject to disciplinary action unless, within
588	30 days from the date of mailing, the licensee either:
589	1.a.Shows proof that the unsatisfied judgment has been
590	paid in the amount specified in this subparagraph; or
591	2.b.Furnishes the department with a copy of a timely
592	filed notice of appeal and either:
593	a.(I)A copy of a supersedeas bond properly posted in the
594	amount required by law; or
595	b.(II)An order from a court of competent jurisdiction
596	staying execution on the final judgment, pending disposition of
597	the appeal.
598	(b)2.The Department of Health shall issue an emergency
599	order suspending the license of any licensee who, after 30 days
600	following receipt of a notice from the Department of Health, has
601	failed to: satisfy a medical malpractice claim against him or
602	her; furnish the Department of Health a copy of a timely filed
603	notice of appeal; furnish the Department of Health a copy of a
604	supersedeas bond properly posted in the amount required by law;
605	or furnish the Department of Health an order from a court of
606	competent jurisdiction staying execution on the final judgment
607	pending disposition of the appeal.
608	(c)3.Upon the next meeting of the probable cause panel of
609	the board following 30 days after the date of mailing the notice
610	of disciplinary action to the licensee, the panel shall make a
611	determination of whether probable cause exists to take
612	disciplinary action against the licensee pursuant to
613	subparagraph 1.
614	(d)4.If the board determines that the factual
615	requirements of subparagraph 1. are met, it shall take
616	disciplinary action as it deems appropriate against the
617	licensee. Such disciplinary action shall include, at a minimum,
618	probation of the license with the restriction that the licensee
619	must make payments to the judgment creditor on a schedule
620	determined by the board to be reasonable and within the
621	financial capability of the osteopathic physician.
622	Notwithstanding any other disciplinary penalty imposed, the
623	disciplinary penalty may include suspension of the license for a
624	period not to exceed 5 years. In the event that an agreement to
625	satisfy a judgment has been met, the board shall remove any
626	restriction on the license.
627	(e)5.The licensee has completed a form supplying
628	necessary information as required by the department.
629
630	A licensee who meets the requirements of this paragraph shall be
631	required either to post notice in the form of a sign prominently
632	displayed in the reception area and clearly noticeable by all
633	patients or to provide a written statement to any person to whom
634	medical services are being provided. Such sign or statement
635	shall state: "Under Florida law, osteopathic physicians are
636	generally required to carry medical malpractice insurance or
637	otherwise demonstrate financial responsibility to cover
638	potential claims for medical malpractice. YOUR OSTEOPATHIC
639	PHYSICIAN HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE
640	INSURANCE. This is permitted under Florida law subject to
641	certain conditions. Florida law imposes strict penalties against
642	noninsured osteopathic physicians who fail to satisfy adverse
643	judgments arising from claims of medical malpractice. This
644	notice is provided pursuant to Florida law."
645	(7)(6)Any deceptive, untrue, or fraudulent representation
646	by the licensee with respect to any provision of this section
647	shall result in permanent disqualification from any exemption to
648	mandated financial responsibility as provided in this section
649	and shall constitute grounds for disciplinary action under s.
650	459.015.
651	(8)(7)Any licensee who relies on any exemption from the
652	financial responsibility requirement shall notify the department
653	in writing of any change of circumstance regarding his or her
654	qualifications for such exemption and shall demonstrate that he
655	or she is in compliance with the requirements of this section.
656	(9)(8)If a physician is either a resident physician,
657	assistant resident physician, or intern in an approved
658	postgraduate training program, as defined by the board's rules,
659	and is supervised by a physician who is participating in the
660	Florida Birth-Related Neurological Injury Compensation Plan,
661	such resident physician, assistant resident physician, or intern
662	is deemed to be a participating physician without the payment of
663	the assessment set forth in s. 766.314(4).
664	(10)(9)The board shall adopt rules to implement the
665	provisions of this section.
666
667	================= T I T L E A M E N D M E N T =================
668	Remove line(s) 103, and insert:
669	400.4295, F.S.; correcting cross references; amending ss.
670	458.320 and 459.0085, F.S.; requiring maintenance of financial
671	responsibility as a condition of licensure of physicians and
672	osteopathic physicians; providing for payment of any outstanding
673	judgments or settlements pending at the time a physician or
674	osteopathic physician is suspended by the Department of Business
675	and Professional Regulation; providing for alternative method of
676	providing financial responsibility; providing