Florida Senate - 2009                             CS for SB 2620
       
       
       
       By the Committee on Health Regulation; and Senator Altman
       
       
       
       
       588-04070-09                                          20092620c1
    1                        A bill to be entitled                      
    2         An act relating to medical quality assurance; amending
    3         s. 395.0193, F.S.; requiring certain disciplinary
    4         actions to be reported to the Division of Medical
    5         Quality Assurance of the Department of Health rather
    6         than the Division of Health Quality Assurance of the
    7         Agency for Health Care Administration; amending s.
    8         395.0197, F.S.; requiring the agency to forward copies
    9         of adverse incident reports to the department;
   10         amending s. 395.3025, F.S.; authorizing disclosure of
   11         certain patient records to the agency and the
   12         department; requiring the administrator or records
   13         custodian of a facility to certify which records have
   14         been provided to the department; requiring the
   15         facility to charge a fee for copies of the records
   16         provided to the department; amending s. 400.145, F.S.;
   17         requiring the administrator or records custodian of a
   18         facility to certify which records have been provided
   19         to the department; amending s. 400.147, F.S.;
   20         authorizing the agency, department, or appropriate
   21         regulatory board to receive notification of adverse
   22         incidents for purposes of certain disciplinary
   23         proceedings; requiring the department to review
   24         certain adverse incident reports; requiring the agency
   25         to forward adverse incident reports to the department;
   26         amending s. 456.001, F.S.; providing a definition;
   27         amending s. 456.011, F.S.; providing additional
   28         requirements for the constitution of a quorum for
   29         meetings of certain committees and boards operating
   30         under ch. 456, F.S.; amending s. 456.013, F.S.;
   31         requiring an application fee for licensure
   32         examinations; providing for extension of a temporary
   33         license; revising licensure requirements; authorizing
   34         the board or department to adopt rules requiring the
   35         display of a professional license; amending s.
   36         456.025, F.S.; authorizing the imposition of certain
   37         licensure fees; authorizing the imposition of
   38         reinspection fees; amending s. 456.036, F.S.;
   39         prohibiting the department from renewing the license
   40         of licensees owing outstanding fees, costs, or fines;
   41         providing for notice; providing for renewal of a
   42         license when requirements are met; amending s.
   43         456.037, F.S.; authorizing the board or department to
   44         require by rule the display of a business
   45         establishment license; amending s. 456.063, F.S.;
   46         authorizing the board or department to adopt rules
   47         relating to the reporting of sexual misconduct by
   48         licensed health care practitioners; amending s.
   49         456.072, F.S.; providing that failure to report
   50         disciplinary actions taken against a licensee’s
   51         license to practice is an additional ground under
   52         which the practitioner is subject to discipline by the
   53         department or the board having jurisdiction over the
   54         practitioner; providing penalties; amending ss.
   55         381.00593, 381.0303, 456.074, 456.41, 468.703,
   56         627.6474, 641.315, 766.1016, 766.1116, 768.13, and
   57         768.28, F.S.; conforming cross-references; providing
   58         an effective date.
   59  
   60  Be It Enacted by the Legislature of the State of Florida:
   61  
   62         Section 1. Subsection (4) of section 395.0193, Florida
   63  Statutes, is amended to read:
   64         395.0193 Licensed facilities; peer review; disciplinary
   65  powers; agency or partnership with physicians.—
   66         (4) Pursuant to ss. 458.337 and 459.016, any disciplinary
   67  actions taken under subsection (3) shall be reported in writing
   68  to the Division of Medical Health Quality Assurance of the
   69  Department of Health agency within 30 working days after its
   70  initial occurrence, regardless of the pendency of appeals to the
   71  governing board of the hospital. The notification shall identify
   72  the disciplined practitioner, the action taken, and the reason
   73  for such action. All final disciplinary actions taken under
   74  subsection (3), if different from those which were reported to
   75  the division agency within 30 days after the initial occurrence,
   76  shall be reported within 10 working days to the Division of
   77  Medical Health Quality Assurance of the department agency in
   78  writing and shall specify the disciplinary action taken and the
   79  specific grounds therefor. The division shall review each report
   80  and determine whether it potentially involved conduct by the
   81  licensee that is subject to disciplinary action, in which case
   82  s. 456.073 shall apply. The reports are not subject to
   83  inspection under s. 119.07(1) even if the division’s
   84  investigation results in a finding of probable cause.
   85         Section 2. Subsection (7) of section 395.0197, Florida
   86  Statutes, is amended to read:
   87         395.0197 Internal risk management program.—
   88         (7) Any of the following adverse incidents, whether
   89  occurring in the licensed facility or arising from health care
   90  prior to admission in the licensed facility, shall be reported
   91  by the facility to the agency within 15 calendar days after its
   92  occurrence:
   93         (a) The death of a patient;
   94         (b) Brain or spinal damage to a patient;
   95         (c) The performance of a surgical procedure on the wrong
   96  patient;
   97         (d) The performance of a wrong-site surgical procedure;
   98         (e) The performance of a wrong surgical procedure;
   99         (f) The performance of a surgical procedure that is
  100  medically unnecessary or otherwise unrelated to the patient’s
  101  diagnosis or medical condition;
  102         (g) The surgical repair of damage resulting to a patient
  103  from a planned surgical procedure, where the damage is not a
  104  recognized specific risk, as disclosed to the patient and
  105  documented through the informed-consent process; or
  106         (h) The performance of procedures to remove unplanned
  107  foreign objects remaining from a surgical procedure.
  108  
  109  The agency may grant extensions to this reporting requirement
  110  for more than 15 days upon justification submitted in writing by
  111  the facility administrator to the agency. The agency may require
  112  an additional, final report. These reports shall not be
  113  available to the public pursuant to s. 119.07(1) or any other
  114  law providing access to public records, nor be discoverable or
  115  admissible in any civil or administrative action, except in
  116  disciplinary proceedings by the agency or the appropriate
  117  regulatory board, nor shall they be available to the public as
  118  part of the record of investigation for and prosecution in
  119  disciplinary proceedings made available to the public by the
  120  agency or the appropriate regulatory board. However, the agency
  121  or the appropriate regulatory board shall make available, upon
  122  written request by a health care professional against whom
  123  probable cause has been found, any such records which form the
  124  basis of the determination of probable cause. The agency may
  125  investigate, as it deems appropriate, any such incident and
  126  prescribe measures that must or may be taken in response to the
  127  incident. The agency shall forward a copy of each incident
  128  report received from a facility to the Division of Medical
  129  Quality Assurance within the Department of Health review each
  130  incident and determine whether it potentially involved conduct
  131  by the health care professional who is subject to disciplinary
  132  action, in which case the provisions of s. 456.073 shall apply.
  133         Section 3. Paragraph (e) of subsection (4) of section
  134  395.3025, Florida Statutes, is amended to read:
  135         395.3025 Patient and personnel records; copies;
  136  examination.—
  137         (4) Patient records are confidential and must not be
  138  disclosed without the consent of the person to whom they
  139  pertain, but appropriate disclosure may be made without such
  140  consent to:
  141         (e) The agency upon subpoena issued pursuant to s. 408.15
  142  or the department upon subpoena issued pursuant to s. 456.071,
  143  but the records obtained thereby must be used solely for the
  144  purpose of the agency, the department, and the appropriate
  145  professional board in their its investigation, prosecution, and
  146  appeal of disciplinary proceedings. The administrator or records
  147  custodian in a facility licensed under this chapter shall
  148  certify that true and complete copies of the records requested
  149  pursuant to a subpoena or a patient release have been provided
  150  to the department or otherwise identify those documents that
  151  have not been provided. If the department agency requests copies
  152  of the records, the facility shall charge a fee pursuant to s.
  153  395.3025 no more than its actual copying costs, including
  154  reasonable staff time. The records must be sealed and must not
  155  be available to the public pursuant to s. 119.07(1) or any other
  156  statute providing access to records, nor may they be available
  157  to the public as part of the record of investigation for and
  158  prosecution in disciplinary proceedings made available to the
  159  public by the agency, the department, or the appropriate
  160  regulatory board. However, the department agency must make
  161  available, upon written request by a practitioner against whom
  162  probable cause has been found, any such records that form the
  163  basis of the determination of probable cause.
  164         Section 4. Subsection (3) is added to section 400.145,
  165  Florida Statutes, to read:
  166         400.145 Records of care and treatment of resident; copies
  167  to be furnished.—
  168         (3)The administrator or records custodian in a facility
  169  licensed under this chapter shall certify that true and complete
  170  copies of records or documents subpoenaed pursuant to s. 456.057
  171  or s. 456.071 or requested by a patient release have been
  172  provided to the Department of Health or otherwise identify those
  173  documents that have not been provided.
  174         Section 5. Subsection (7) and paragraph (b) of subsection
  175  (8) of section 400.147, Florida Statutes, are amended to read:
  176         400.147 Internal risk management and quality assurance
  177  program.—
  178         (7) The facility shall initiate an investigation and shall
  179  notify the agency within 1 business day after the risk manager
  180  or his or her designee has received a report pursuant to
  181  paragraph (1)(d). The notification must be made in writing and
  182  be provided electronically, by facsimile device or overnight
  183  mail delivery. The notification must include information
  184  regarding the identity of the affected resident, the type of
  185  adverse incident, the initiation of an investigation by the
  186  facility, and whether the events causing or resulting in the
  187  adverse incident represent a potential risk to any other
  188  resident. The notification is confidential as provided by law
  189  and is not discoverable or admissible in any civil or
  190  administrative action, except in disciplinary proceedings by the
  191  agency, the Department of Health, or the appropriate regulatory
  192  board. The agency may investigate, as it deems appropriate, any
  193  such incident and prescribe measures that must or may be taken
  194  in response to the incident. The Department of Health agency
  195  shall review each incident and determine whether it potentially
  196  involved conduct by the health care professional who is subject
  197  to disciplinary action, in which case the provisions of s.
  198  456.073 shall apply.
  199         (8)
  200         (b) A copy of the adverse incident report submitted The
  201  information reported to the agency pursuant to paragraph (a)
  202  which relates to health care practitioners as defined in s.
  203  456.001(4) shall be forwarded to the Division of Medical Quality
  204  Assurance within the Department of Health for review persons
  205  licensed under chapter 458, chapter 459, chapter 461, or chapter
  206  466 shall be reviewed by the agency. The agency shall determine
  207  whether any of the incidents potentially involved conduct by a
  208  health care professional who is subject to disciplinary action,
  209  in which case the provisions of s. 456.073 shall apply.
  210         Section 6. Subsections (1) through (7) of section 456.001,
  211  Florida Statutes, are renumbered as subsections (2) through (8),
  212  respectively, and a new subsection (1) is added to that section
  213  to read:
  214         456.001 Definitions.—As used in this chapter, the term:
  215         (1)“Application” means the documents required by the
  216  department to initiate the licensing process, including, but not
  217  limited to, the initial document filing and responses to
  218  requests from the department for additional data and
  219  information.
  220         Section 7. Subsection (3) of section 456.011, Florida
  221  Statutes, is amended to read:
  222         456.011 Boards; organization; meetings; compensation and
  223  travel expenses.—
  224         (3) The board shall meet at least once annually and may
  225  meet as often as is necessary. Meetings shall be conducted
  226  through teleconferencing or other technological means, unless
  227  disciplinary hearings involving standard of care, sexual
  228  misconduct, fraud, impairment, or felony convictions; licensure
  229  denial hearings; or controversial rule hearings are being
  230  conducted; or unless otherwise approved in advance of the
  231  meeting by the director of the Division of Medical Quality
  232  Assurance. The chairperson or a quorum of the board shall have
  233  the authority to call meetings, except as provided in this
  234  subsection above relating to in-person meetings. A quorum shall
  235  be necessary for the conduct of official business by the board
  236  or any committee thereof. Unless otherwise provided by law, 51
  237  percent or more of the appointed members of the board or any
  238  committee, when applicable, who have taken the oath of office
  239  pursuant to s. 5, Art. II of the State Constitution or s. 114.05
  240  shall constitute a quorum. The membership of committees of the
  241  board, except as otherwise authorized pursuant to this chapter
  242  or the applicable practice act, shall be composed of currently
  243  appointed members of the board. The vote of a majority of the
  244  members of the quorum shall be necessary for any official action
  245  by the board or committee. Three consecutive unexcused absences
  246  or absences constituting 50 percent or more of the board’s
  247  meetings within any 12-month period shall cause the board
  248  membership of the member in question to become void, and the
  249  position shall be considered vacant. The board, or the
  250  department when there is no board, shall, by rule, define
  251  unexcused absences.
  252         Section 8. Subsections (3) through (12) of section 456.013,
  253  Florida Statutes, are renumbered as subsections (4) through
  254  (13), respectively, subsection (1) is amended, present
  255  subsection (2) is renumbered as subsection (3) and amended, and
  256  a new subsection (2) is added to that section, to read:
  257         456.013 Department; general licensing provisions.—
  258         (1)(a) Any person desiring to be licensed in a profession
  259  within the jurisdiction of the department shall apply to the
  260  department in writing to take the licensure examination. The
  261  application shall be made on a form prepared and furnished by
  262  the department. The application form must be available on the
  263  World Wide Web and the department may accept electronically
  264  submitted applications beginning July 1, 2001. A nonrefundable
  265  application fee established by the board, or the department when
  266  there is no board, shall be submitted with the application in an
  267  amount established by rule by the board, or the department when
  268  there is no board, to comply with s. 456.025. The application
  269  shall require the social security number of the applicant,
  270  except as provided in paragraph (b). The form shall be
  271  supplemented as needed to reflect any material change in any
  272  circumstance or condition stated in the application which takes
  273  place between the initial filing of the application and the
  274  final grant or denial of the license and which might affect the
  275  decision of the department. If an application is submitted
  276  electronically, the department may require supplemental
  277  materials, including an original signature of the applicant and
  278  verification of credentials, to be submitted in a nonelectronic
  279  format. An incomplete application shall expire 1 year after
  280  initial filing. In order to further the economic development
  281  goals of the state, and notwithstanding any law to the contrary,
  282  the department may enter into an agreement with the county tax
  283  collector for the purpose of appointing the county tax collector
  284  as the department’s agent to accept applications for licenses
  285  and applications for renewals of licenses. The agreement must
  286  specify the time within which the tax collector must forward any
  287  applications and accompanying application fees to the
  288  department.
  289         (b) If an applicant has not been issued a social security
  290  number by the Federal Government at the time of application
  291  because the applicant is not a citizen or resident of this
  292  country, the department may process the application using a
  293  unique personal identification number. If such an applicant is
  294  otherwise eligible for licensure, the board, or the department
  295  when there is no board, may issue to the applicant a temporary
  296  license, as established by rule of the board, or the department
  297  when there is no board to the applicant, which shall expire 90
  298  30 days after issuance unless a social security number is
  299  obtained and submitted in writing to the department. Upon
  300  receipt of the applicant’s social security number, the
  301  department shall issue a new license, which shall expire at the
  302  end of the current biennium.
  303         (c)The license shall be issued in the legal name of the
  304  applicant as reflected on the applicant’s birth certificate or
  305  United States passport. A request to change or issue a license
  306  under any other name must be supported by either a certified
  307  copy of a marriage license, a certified copy of an order of a
  308  United States federal or state court, or the applicant’s
  309  original naturalization certificate.
  310         (2)The board, or the department when there is no board,
  311  may adopt a rule allowing an applicant for licensure to complete
  312  the coursework requirements for licensure by successfully
  313  completing the required coursework as a student or by teaching
  314  the required coursework as an instructor or professor in an
  315  accredited institution.
  316         (3)(2) Before the issuance of any license, the department
  317  shall charge an initial license fee as determined by the
  318  applicable board or, if there is no board, by rule of the
  319  department. Upon receipt of the appropriate license fee, the
  320  department shall issue a license to any person certified by the
  321  appropriate board, or its designee, as having met the licensure
  322  requirements imposed by law or rule. The license shall consist
  323  of a wallet-size identification card and a wall card measuring 6
  324  1/2 inches by 5 inches. The licensee shall surrender to the
  325  department the wallet-size identification card and the wall card
  326  if the licensee’s license is issued in error or is revoked. The
  327  board, or the department when there is no board, may by rule
  328  require the display of a license.
  329         Section 9. Subsection (12) is added to section 456.025,
  330  Florida Statutes, to read:
  331         456.025 Fees; receipts; disposition.—
  332         (12)Each board, or the department if there is no board,
  333  may charge a fee as determined by rule for the reinspection of a
  334  business establishment prior to its licensure.
  335         Section 10. Subsections (14) and (15) of section 456.036,
  336  Florida Statutes, are renumbered as subsections (15) and (16),
  337  respectively, and a new subsection (14) is added to that section
  338  to read:
  339         456.036 Licenses; active and inactive status; delinquency.—
  340         (14)The department may not renew the license of a
  341  licensee, as defined in s. 456.001, who owes outstanding fees,
  342  costs, or fines to the department. The department shall notify
  343  each licensee who has failed to pay outstanding fees, costs, or
  344  fines at the licensee’s last known address of record with the
  345  department when issuing the license renewal notice required by
  346  s. 456.038. The department shall renew the license of any
  347  licensee when the outstanding fees, costs, or fines are paid if
  348  all other requirements for renewal are met.
  349         Section 11. Subsections (4) and (5) of section 456.037,
  350  Florida Statutes, are renumbered as subsections (5) and (6),
  351  respectively, and a new subsection (4) is added to that section
  352  to read:
  353         456.037 Business establishments; requirements for active
  354  status licenses; delinquency; discipline; applicability.—
  355         (4)The board, or the department if there is no board, may
  356  by rule require the display of a business establishment license.
  357         Section 12. Subsection (3) of section 456.063, Florida
  358  Statutes, is amended to read:
  359         456.063 Sexual misconduct; disqualification for license,
  360  certificate, or registration.—
  361         (3) Licensed health care practitioners shall report
  362  allegations of sexual misconduct to the department, regardless
  363  of the practice setting in which the alleged sexual misconduct
  364  occurred. Each board, or the department if there is no board,
  365  may adopt rules pursuant to ss. 120.536(1) and 120.54 to
  366  implement this subsection.
  367         Section 13. Paragraph (ii) is added to subsection (1) of
  368  section 456.072, Florida Statutes, to read:
  369         456.072 Grounds for discipline; penalties; enforcement.—
  370         (1) The following acts shall constitute grounds for which
  371  the disciplinary actions specified in subsection (2) may be
  372  taken:
  373         (ii)Failing to report to the board, or the department if
  374  there is no board, in writing, within 30 days after an action as
  375  provided in subsection (2) has been taken against a licensee’s
  376  license to practice any profession in this state or another
  377  state, territory, or jurisdiction.
  378         (2) When the board, or the department when there is no
  379  board, finds any person guilty of the grounds set forth in
  380  subsection (1) or of any grounds set forth in the applicable
  381  practice act, including conduct constituting a substantial
  382  violation of subsection (1) or a violation of the applicable
  383  practice act which occurred prior to obtaining a license, it may
  384  enter an order imposing one or more of the following penalties:
  385         (a) Refusal to certify, or to certify with restrictions, an
  386  application for a license.
  387         (b) Suspension or permanent revocation of a license.
  388         (c) Restriction of practice or license, including, but not
  389  limited to, restricting the licensee from practicing in certain
  390  settings, restricting the licensee to work only under designated
  391  conditions or in certain settings, restricting the licensee from
  392  performing or providing designated clinical and administrative
  393  services, restricting the licensee from practicing more than a
  394  designated number of hours, or any other restriction found to be
  395  necessary for the protection of the public health, safety, and
  396  welfare.
  397         (d) Imposition of an administrative fine not to exceed
  398  $10,000 for each count or separate offense. If the violation is
  399  for fraud or making a false or fraudulent representation, the
  400  board, or the department if there is no board, must impose a
  401  fine of $10,000 per count or offense.
  402         (e) Issuance of a reprimand or letter of concern.
  403         (f) Placement of the licensee on probation for a period of
  404  time and subject to such conditions as the board, or the
  405  department when there is no board, may specify. Those conditions
  406  may include, but are not limited to, requiring the licensee to
  407  undergo treatment, attend continuing education courses, submit
  408  to be reexamined, work under the supervision of another
  409  licensee, or satisfy any terms which are reasonably tailored to
  410  the violations found.
  411         (g) Corrective action.
  412         (h) Imposition of an administrative fine in accordance with
  413  s. 381.0261 for violations regarding patient rights.
  414         (i) Refund of fees billed and collected from the patient or
  415  a third party on behalf of the patient.
  416         (j) Requirement that the practitioner undergo remedial
  417  education.
  418  
  419  In determining what action is appropriate, the board, or
  420  department when there is no board, must first consider what
  421  sanctions are necessary to protect the public or to compensate
  422  the patient. Only after those sanctions have been imposed may
  423  the disciplining authority consider and include in the order
  424  requirements designed to rehabilitate the practitioner. All
  425  costs associated with compliance with orders issued under this
  426  subsection are the obligation of the practitioner.
  427         Section 14. Paragraph (a) of subsection (4) of section
  428  381.00593, Florida Statutes, is amended to read:
  429         381.00593 Public school volunteer health care practitioner
  430  program.—
  431         (4)(a) Notwithstanding any provision of chapter 458,
  432  chapter 459, chapter 460, chapter 461, chapter 463, part I of
  433  chapter 464, chapter 465, chapter 466, chapter 467, parts I and
  434  X of chapter 468, or chapter 486 to the contrary, any health
  435  care practitioner who participates in the program established in
  436  this section and thereby agrees to provide his or her services,
  437  without compensation, in a public school for at least 80 hours a
  438  year for each school year during the biennial licensure period,
  439  or, if the health care practitioner is retired, for at least 400
  440  hours a year for each school year during the licensure period,
  441  upon providing sufficient proof from the applicable school
  442  district that the health care practitioner has completed such
  443  hours at the time of license renewal under procedures specified
  444  by the Department of Health, shall be eligible for the
  445  following:
  446         1. Waiver of the biennial license renewal fee for an active
  447  license; and
  448         2. Fulfillment of a maximum of 25 percent of the continuing
  449  education hours required for license renewal under s.
  450  456.013(10)(9).
  451  
  452  The school district may establish a schedule for health care
  453  practitioners who participate in the program.
  454         Section 15. Subsection (1) of section 381.0303, Florida
  455  Statutes, is amended to read:
  456         381.0303 Special needs shelters.—
  457         (1) PURPOSE.—The purpose of this section is to provide for
  458  the operation and closure of special needs shelters and to
  459  designate the Department of Health, through its county health
  460  departments, as the lead agency for coordination of the
  461  recruitment of health care practitioners, as defined in s.
  462  456.001(5)(4), to staff special needs shelters in times of
  463  emergency or disaster and to provide resources to the department
  464  to carry out this responsibility. However, nothing in this
  465  section prohibits a county health department from entering into
  466  an agreement with a local emergency management agency to assume
  467  the lead responsibility for recruiting health care
  468  practitioners.
  469         Section 16. Subsection (3) of section 456.074, Florida
  470  Statutes, is amended to read:
  471         456.074 Certain health care practitioners; immediate
  472  suspension of license.—
  473         (3) The department may issue an emergency order suspending
  474  or restricting the license of any health care practitioner as
  475  defined in s. 456.001(5)(4) who tests positive for any drug on
  476  any government or private sector preemployment or employer
  477  ordered confirmed drug test, as defined in s. 112.0455, when the
  478  practitioner does not have a lawful prescription and legitimate
  479  medical reason for using such drug. The practitioner shall be
  480  given 48 hours from the time of notification to the practitioner
  481  of the confirmed test result to produce a lawful prescription
  482  for the drug before an emergency order is issued.
  483         Section 17. Paragraph (b) of subsection (2) of section
  484  456.41, Florida Statutes, is amended to read:
  485         456.41 Complementary or alternative health care
  486  treatments.—
  487         (2) DEFINITIONS.—As used in this section, the term:
  488         (b) “Health care practitioner” means any health care
  489  practitioner as defined in s. 456.001(5)(4).
  490         Section 18. Subsection (2) of section 468.703, Florida
  491  Statutes, is amended to read:
  492         468.703 Board of Athletic Training.—
  493         (2) Five members of the board must be licensed athletic
  494  trainers. One member of the board must be a physician licensed
  495  under chapter 458 or chapter 459. One member of the board must
  496  be a physician licensed under chapter 460. Two members of the
  497  board shall be consumer members, each of whom must be a resident
  498  of this state who has never worked as an athletic trainer, who
  499  has no financial interest in the practice of athletic training,
  500  and who has never been a licensed health care practitioner as
  501  defined in s. 456.001(5)(4).
  502         Section 19. Section 627.6474, Florida Statutes, is amended
  503  to read:
  504         627.6474 Provider contracts.—A health insurer shall not
  505  require a contracted health care practitioner as defined in s.
  506  456.001(5)(4) to accept the terms of other health care
  507  practitioner contracts with the insurer or any other insurer, or
  508  health maintenance organization, under common management and
  509  control with the insurer, including Medicare and Medicaid
  510  practitioner contracts and those authorized by s. 627.6471, s.
  511  627.6472, or s. 641.315, except for a practitioner in a group
  512  practice as defined in s. 456.053 who must accept the terms of a
  513  contract negotiated for the practitioner by the group, as a
  514  condition of continuation or renewal of the contract. Any
  515  contract provision that violates this section is void. A
  516  violation of this section is not subject to the criminal penalty
  517  specified in s. 624.15.
  518         Section 20. Subsection (10) of section 641.315, Florida
  519  Statutes, is amended to read:
  520         641.315 Provider contracts.—
  521         (10) A health maintenance organization shall not require a
  522  contracted health care practitioner as defined in s.
  523  456.001(5)(4) to accept the terms of other health care
  524  practitioner contracts with the health maintenance organization
  525  or any insurer, or other health maintenance organization, under
  526  common management and control with the health maintenance
  527  organization, including Medicare and Medicaid practitioner
  528  contracts and those authorized by s. 627.6471, s. 627.6472, or
  529  s. 641.315, except for a practitioner in a group practice as
  530  defined in s. 456.053 who must accept the terms of a contract
  531  negotiated for the practitioner by the group, as a condition of
  532  continuation or renewal of the contract. Any contract provision
  533  that violates this section is void. A violation of this section
  534  is not subject to the criminal penalty specified in s. 624.15.
  535         Section 21. Paragraph (a) of subsection (1) and subsection
  536  (4) of section 766.1016, Florida Statutes, are amended to read:
  537         766.1016 Patient safety data privilege.—
  538         (1) As used in this section, the term:
  539         (a) “Patient safety data” means reports made to patient
  540  safety organizations, including all health care data,
  541  interviews, memoranda, analyses, root cause analyses, products
  542  of quality assurance or quality improvement processes,
  543  corrective action plans, or information collected or created by
  544  a health care facility licensed under chapter 395, or a health
  545  care practitioner as defined in s. 456.001(5)(4), as a result of
  546  an occurrence related to the provision of health care services
  547  which exacerbates an existing medical condition or could result
  548  in injury, illness, or death.
  549         (4) The exchange of patient safety data among health care
  550  facilities licensed under chapter 395, or health care
  551  practitioners as defined in s. 456.001(5)(4), or patient safety
  552  organizations which does not identify any patient shall not
  553  constitute a waiver of any privilege established in this
  554  section.
  555         Section 22. Paragraph (b) of subsection (2) of section
  556  766.1116, Florida Statutes, is amended to read:
  557         766.1116 Health care practitioner; waiver of license
  558  renewal fees and continuing education requirements.—
  559         (2) Notwithstanding any provision of chapter 458, chapter
  560  459, chapter 460, chapter 461, part I of chapter 464, chapter
  561  466, or chapter 467 to the contrary, any health care
  562  practitioner who participates as a health care provider under s.
  563  766.1115 and thereby agrees with a governmental contractor to
  564  provide his or her services without compensation and as an agent
  565  of the governmental contractor to low-income recipients in
  566  accordance with s. 766.1115 for at least 80 hours a year for
  567  each year during the biennial licensure period, or, if the
  568  health care practitioner is retired, for at least 400 hours a
  569  year for each year during the licensure period, upon providing
  570  sufficient proof from the applicable governmental contractor
  571  that the health care practitioner has completed the hours at the
  572  time of license renewal under procedures specified by the
  573  Department of Health, shall be eligible for:
  574         (b) Fulfillment of a maximum of 25 percent of the
  575  continuing education hours required for license renewal under s.
  576  456.013(10)(9).
  577         Section 23. Paragraph (c) of subsection (2) of section
  578  768.13, Florida Statutes, is amended to read:
  579         768.13 Good Samaritan Act; immunity from civil liability.—
  580         (2)
  581         (c)1. Any health care practitioner as defined in s.
  582  456.001(5)(4) who is in a hospital attending to a patient of his
  583  or her practice or for business or personal reasons unrelated to
  584  direct patient care, and who voluntarily responds to provide
  585  care or treatment to a patient with whom at that time the
  586  practitioner does not have a then-existing health care patient
  587  practitioner relationship, and when such care or treatment is
  588  necessitated by a sudden or unexpected situation or by an
  589  occurrence that demands immediate medical attention, shall not
  590  be held liable for any civil damages as a result of any act or
  591  omission relative to that care or treatment, unless that care or
  592  treatment is proven to amount to conduct that is willful and
  593  wanton and would likely result in injury so as to affect the
  594  life or health of another.
  595         2. The immunity provided by this paragraph does not apply
  596  to damages as a result of any act or omission of providing
  597  medical care or treatment unrelated to the original situation
  598  that demanded immediate medical attention.
  599         3. For purposes of this paragraph, the Legislature’s intent
  600  is to encourage health care practitioners to provide necessary
  601  emergency care to all persons without fear of litigation as
  602  described in this paragraph.
  603         Section 24. Paragraph (a) of subsection (12) of section
  604  768.28, Florida Statutes, is amended to read:
  605         768.28 Waiver of sovereign immunity in tort actions;
  606  recovery limits; limitation on attorney fees; statute of
  607  limitations; exclusions; indemnification; risk management
  608  programs.—
  609         (12)(a) A health care practitioner, as defined in s.
  610  456.001(5)(4), who has contractually agreed to act as an agent
  611  of a state university board of trustees to provide medical
  612  services to a student athlete for participation in or as a
  613  result of intercollegiate athletics, to include team practices,
  614  training, and competitions, shall be considered an agent of the
  615  respective state university board of trustees, for the purposes
  616  of this section, while acting within the scope of and pursuant
  617  to guidelines established in that contract. The contracts shall
  618  provide for the indemnification of the state by the agent for
  619  any liabilities incurred up to the limits set out in this
  620  chapter.
  621         Section 25. This act shall take effect July 1, 2009.