Bill Text: FL S0732 | 2019 | Regular Session | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Office Surgery
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Passed) 2019-06-26 - Chapter No. 2019-130 [S0732 Detail]
Download: Florida-2019-S0732-Engrossed.html
Bill Title: Office Surgery
Spectrum: Slight Partisan Bill (? 2-1)
Status: (Passed) 2019-06-26 - Chapter No. 2019-130 [S0732 Detail]
Download: Florida-2019-S0732-Engrossed.html
CS for CS for SB 732 First Engrossed 2019732e1 1 A bill to be entitled 2 An act relating to office surgery; amending s. 3 456.074, F.S.; authorizing the Department of Health to 4 issue an emergency order suspending or restricting the 5 registration of certain facilities upon specified 6 findings; requiring the department to revoke the 7 registration of an office when its noncompliance 8 constitutes an immediate or imminent danger to the 9 health or safety of the public; amending s. 458.309, 10 F.S.; deleting a provision relating to registration 11 and inspection of an office in which a physician 12 performs certain procedures or office surgeries; 13 creating s. 458.328, F.S.; requiring an office in 14 which a physician performs certain procedures or 15 office surgeries to register with the department; 16 requiring an office to designate a physician to be 17 responsible for certain compliance requirements as 18 part of registration by a specified date; requiring an 19 office and physicians practicing at the office to meet 20 certain financial responsibility requirements; 21 authorizing the department to deny or revoke the 22 registration of or impose certain penalties against a 23 facility in which certain procedures or office 24 surgeries are performed under certain circumstances; 25 requiring the department to conduct certain 26 inspections; providing exceptions; requiring the 27 department to revoke the registration of an office in 28 which certain procedures or office surgeries are 29 performed under certain circumstances; requiring the 30 Board of Medicine to adopt rules governing the 31 standards of practice for physicians practicing in 32 such offices and to impose a specified fine on 33 physicians who perform certain procedures or office 34 surgeries in an unregistered office; authorizing the 35 board to adopt rules to administer the registration, 36 inspection, and safety of offices in which certain 37 procedures or office surgeries are performed; amending 38 s. 458.331, F.S.; providing that a physician 39 performing certain procedures or office surgeries in 40 an unregistered office constitutes grounds for denial 41 of a license or disciplinary action; amending s. 42 459.005, F.S.; deleting a provision relating to 43 registration and inspection of an office in which a 44 physician performs certain procedures or office 45 surgeries; creating s. 459.0138, F.S.; requiring an 46 office in which a physician performs certain 47 procedures or office surgeries to register with the 48 department; requiring an office to designate a 49 physician to be responsible for certain compliance 50 requirements as part of registration by a specified 51 date; requiring an office and physicians practicing at 52 the office to meet certain financial responsibility 53 requirements; authorizing the department to deny or 54 revoke the registration of or impose certain penalties 55 against a facility in which certain procedures or 56 office surgeries are performed under certain 57 circumstances; requiring the department to conduct 58 certain inspections; providing exceptions; requiring 59 the department to revoke the registration of an office 60 in which certain procedures or office surgeries are 61 performed under certain circumstances; requiring the 62 Board of Osteopathic Medicine to adopt rules governing 63 the standards of practice for physicians practicing in 64 such offices and to impose a specified fine on 65 physicians who perform certain procedures or office 66 surgeries in an unregistered office; authorizing the 67 board to adopt rules to administer the registration, 68 inspection, and safety of offices in which certain 69 procedures or office surgeries are performed; amending 70 s. 459.015, F.S.; providing that the performance of 71 certain procedures or office surgeries by a physician 72 in an unregistered office constitutes grounds for 73 denial of a license or disciplinary action; providing 74 an effective date. 75 76 Be It Enacted by the Legislature of the State of Florida: 77 78 Section 1. Subsection (6) is added to section 456.074, 79 Florida Statutes, to read: 80 456.074 Certain health care practitioners; immediate 81 suspension of license.— 82 (6) The department may issue an emergency order suspending 83 or restricting the registration of an office registered under s. 84 458.328 or s. 459.0139 upon a finding of probable cause that the 85 office or a physician practicing in the office is not in 86 compliance with the standards of practice for office surgery 87 adopted by the boards pursuant to s. 458.328 or s. 459.0138, as 88 applicable, or is in violation of s. 458.331(1)(v) or s. 89 459.015(1)(z), and that such noncompliance or violation 90 constitutes an immediate danger to the public. The department 91 shall revoke the registration of an office if the noncompliance 92 constitutes an immediate or imminent danger to the health or 93 safety of the public. 94 Section 2. Subsection (3) of section 458.309, Florida 95 Statutes, is amended to read: 96 458.309 Rulemaking authority.— 97(3)A physician who performs liposuction procedures in98which more than 1,000 cubic centimeters of supernatant fat is99removed, level 2 procedures lasting more than 5 minutes, and all100level 3 surgical procedures in an office setting must register101the office with the department unless that office is licensed as102a facility under chapter 395. The department shall inspect the103physician’s office annually unless the office is accredited by a104nationally recognized accrediting agency or an accrediting105organization subsequently approved by the Board of Medicine. The106actual costs for registration and inspection or accreditation107shall be paid by the person seeking to register and operate the108office setting in which office surgery is performed.109 Section 3. Section 458.328, Florida Statutes, is created to 110 read: 111 458.328 Office surgeries.— 112 (1) REGISTRATION.— 113 (a) An office in which a physician performs a liposuction 114 procedure in which more than 1,000 cubic centimeters of 115 supernatant fat is removed, a Level II office surgery, or a 116 Level III office surgery must register with the department 117 unless the office is licensed as a facility under chapter 390 or 118 chapter 395. 119 (b) By January 1, 2020, each office registered under this 120 section or s. 459.0138 must designate a physician who is 121 responsible for the office’s compliance with the office health 122 and safety requirements of this section and rules adopted 123 hereunder. A designated physician must have a full, active, and 124 unencumbered license under this chapter or chapter 459 and shall 125 practice at the office for which he or she has assumed 126 responsibility. Within 10 calendar days after the termination of 127 a designated physician relationship, the office must notify the 128 department of the designation of another physician to serve as 129 the designated physician. The department may suspend the 130 registration of an office if the office fails to comply with the 131 requirements of this paragraph. 132 (c) As a condition of registration, each office must 133 establish financial responsibility by demonstrating that it has 134 met and continues to maintain, at a minimum, the same 135 requirements applicable to physicians in ss. 458.320 and 136 459.0085. Each physician practicing at an office registered 137 under this section or s. 459.0138 must meet the financial 138 responsibility requirements under s. 458.320 or s. 459.0085, as 139 applicable. 140 (d) Each physician practicing at an office registered under 141 this section or s. 459.0138 shall advise the board, in writing, 142 within 10 calendar days after beginning or ending his or her 143 practice at a registered office. 144 (e) The department shall inspect a registered office at 145 least annually, including a review of patient records, to ensure 146 that the office is in compliance with this section and rules 147 adopted hereunder unless the office is accredited by a 148 nationally recognized accrediting agency approved by the board. 149 The inspection may be unannounced, except for the inspection of 150 an office that meets the description of a clinic specified in s. 151 458.3265(1)(a)3.h., and those wholly owned and operated 152 physician offices described in s. 458.3265(1)(a)3.g. which 153 perform procedures referenced in s. 458.3265(1)(a)3.h., which 154 must be announced. 155 (f) The department may suspend or revoke the registration 156 of an office in which a procedure or surgery identified in 157 paragraph (a) is performed for failure of any of its physicians, 158 owners, or operators to comply with this section and rules 159 adopted hereunder or s. 459.0138 and rules adopted thereunder. 160 The department must revoke the registration if the noncompliance 161 constitutes an immediate or imminent danger to the health or 162 safety of the public. If an office’s registration is revoked for 163 any reason, the department may deny any person named in the 164 registration documents of the office, including the persons who 165 own or operate the office, individually or as part of a group, 166 from registering an office to perform procedures or office 167 surgeries pursuant to this section or s. 459.0138 for 5 years 168 after the revocation date. 169 (g) The department may impose any penalty set forth in s. 170 456.072(2) against the designated physician for failure of the 171 office to operate in compliance with the office health and 172 safety requirements of this section and rules adopted hereunder 173 or s. 459.0138 and rules adopted thereunder. 174 (h) A physician may only perform a procedure or surgery 175 identified in paragraph (a) in an office that is registered with 176 the department. The board shall impose a fine of $5,000 per day 177 on a physician who performs a procedure or surgery in an office 178 that is not registered with the department. 179 (i) The actual costs of registration and inspection or 180 accreditation shall be paid by the person seeking to register 181 and operate the office in which a procedure or surgery 182 identified in paragraph (a) will be performed. 183 (2) RULEMAKING.— 184 (a) The board shall adopt by rule standards of practice for 185 physicians who perform procedures or office surgeries pursuant 186 to this section. 187 (b) The board may adopt rules to administer the 188 registration, inspection, and safety of offices in which a 189 physician performs procedures or office surgeries pursuant to 190 this section. 191 Section 4. Paragraph (vv) is added to subsection (1) of 192 section 458.331, Florida Statutes, to read: 193 458.331 Grounds for disciplinary action; action by the 194 board and department.— 195 (1) The following acts constitute grounds for denial of a 196 license or disciplinary action, as specified in s. 456.072(2): 197 (vv) Performing a liposuction procedure in which more than 198 1,000 cubic centimeters of supernatant fat is removed, a Level 199 II office surgery, or a Level III office surgery in an office 200 that is not registered with the department pursuant to s. 201 458.328 or s. 459.0138. 202 Section 5. Subsection (2) of section 459.005, Florida 203 Statutes, is amended to read: 204 459.005 Rulemaking authority.— 205(2)A physician who performs liposuction procedures in206which more than 1,000 cubic centimeters of supernatant fat is207removed, level 2 procedures lasting more than 5 minutes, and all208level 3 surgical procedures in an office setting must register209the office with the department unless that office is licensed as210a facility under chapter 395. The department shall inspect the211physician’s office annually unless the office is accredited by a212nationally recognized accrediting agency or an accrediting213organization subsequently approved by the Board of Osteopathic214Medicine. The actual costs for registration and inspection or215accreditation shall be paid by the person seeking to register216and operate the office setting in which office surgery is217performed.218 Section 6. Section 459.0138, Florida Statutes, is created 219 to read: 220 459.0138 Office surgeries.— 221 (1) REGISTRATION.— 222 (a) An office in which a physician performs a liposuction 223 procedure in which more than 1,000 cubic centimeters of 224 supernatant fat is removed, a Level II office surgery, or a 225 Level III office surgery must register with the department 226 unless the office is licensed as a facility under chapter 390 or 227 chapter 395. 228 (b) By January 1, 2020, each office registered under this 229 section or s. 458.328 must designate a physician who is 230 responsible for the office’s compliance with the office health 231 and safety requirements of this section and rules adopted 232 hereunder. A designated physician must have a full, active, and 233 unencumbered license under this chapter or chapter 458 and shall 234 practice at the office for which he or she has assumed 235 responsibility. Within 10 calendar days after the termination of 236 a designated physician relationship, the office must notify the 237 department of the designation of another physician to serve as 238 the designated physician. The department may suspend a 239 registration for an office if the office fails to comply with 240 the requirements of this paragraph. 241 (c) As a condition of registration, each office must 242 establish financial responsibility by demonstrating that it has 243 met and continues to maintain, at a minimum, the same 244 requirements applicable to physicians in ss. 458.320 and 245 459.0085. Each physician practicing at an office registered 246 under this section or s. 458.328 must meet the financial 247 responsibility requirements under s. 458.320 or s. 459.0085, as 248 applicable. 249 (d) Each physician practicing at an office registered under 250 this section or s. 458.328 shall advise the board, in writing, 251 within 10 calendar days after beginning or ending his or her 252 practice at the registered office. 253 (e) The department shall inspect a registered office at 254 least annually, including a review of patient records, to ensure 255 that the office is in compliance with this section and rules 256 adopted hereunder unless the office is accredited by a 257 nationally recognized accrediting agency approved by the board. 258 The inspection may be unannounced, except for the inspection of 259 an office that meets the description of clinic specified in s. 260 459.0137(1)(a)3.h., and those wholly owned and operated 261 physician offices described in s. 459.0137(1)(a)3.g. which 262 perform procedures referenced in s. 459.0237(1)(a)3.h., which 263 must be announced. 264 (f) The department may suspend or revoke the registration 265 of an office in which a procedure or surgery identified in 266 paragraph (a) is performed for failure of any of its physicians, 267 owners, or operators to comply with this section and rules 268 adopted hereunder or s. 458.328 and rules adopted thereunder. 269 The department must revoke the registration if the noncompliance 270 constitutes an immediate or imminent danger to the health or 271 safety of the public. If an office’s registration is revoked for 272 any reason, the department may deny any person named in the 273 registration documents of the office, including the persons who 274 own or operate the office, individually or as part of a group, 275 from registering an office to perform procedures or office 276 surgeries pursuant to this section or s. 458.328 for 5 years 277 after the revocation date. 278 (g) The department may impose any penalty set forth in s. 279 456.072(2) against the designated physician for failure of the 280 office to operate in compliance with the office health and 281 safety requirements of this section and rules adopted hereunder 282 or s. 458.328 and rules adopted thereunder. 283 (h) A physician may only perform a procedure or surgery 284 identified in paragraph (a) in an office that is registered with 285 the department. The board shall impose a fine of $5,000 per day 286 on a physician who performs a procedure or surgery in an office 287 that is not registered with the department. 288 (i) The actual costs of registration and inspection or 289 accreditation shall be paid by the person seeking to register 290 and operate the office in which a procedure or surgery 291 identified in paragraph (a) will be performed. 292 (2) RULEMAKING.— 293 (a) The board shall adopt by rule standards of practice for 294 physicians who perform procedures or office surgeries pursuant 295 to this section. 296 (b) The board may adopt rules to administer the 297 registration, inspection, and safety of offices in which a 298 physician performs procedures or office surgeries pursuant to 299 this section. 300 Section 7. Paragraph (xx) is added to subsection (1) of 301 section 459.015, Florida Statutes, to read: 302 459.015 Grounds for disciplinary action; action by the 303 board and department.— 304 (1) The following acts constitute grounds for denial of a 305 license or disciplinary action, as specified in s. 456.072(2): 306 (xx) Performing a liposuction procedure in which more than 307 1,000 cubic centimeters of supernatant fat is removed, a Level 308 II office surgery, or a Level III office surgery in an office 309 that is not registered with the department pursuant to s. 310 458.328 or s. 459.0138. 311 Section 8. This act shall take effect January 1, 2020.