Bill Text: FL S1308 | 2016 | Regular Session | Introduced


Bill Title: Compensation for Personal Injury or Wrongful Death Arising from a Medical Injury

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2016-03-11 - Died in Health Policy [S1308 Detail]

Download: Florida-2016-S1308-Introduced.html
       Florida Senate - 2016                                    SB 1308
       
       
        
       By Senator Hays
       
       11-00970B-16                                          20161308__
    1                        A bill to be entitled                      
    2         An act relating to compensation for personal injury or
    3         wrongful death arising from a medical injury; amending
    4         s. 456.013, F.S.; requiring the Department of Health
    5         or certain boards thereof to require the completion of
    6         a course relating to communication of medical errors
    7         as part of the licensure and renewal process;
    8         providing a directive to the Division of Law Revision
    9         and Information; creating s. 766.401, F.S.; providing
   10         a short title; creating s. 766.402, F.S.; providing
   11         definitions; creating s. 766.403, F.S.; providing
   12         legislative findings and intent; creating s. 766.404,
   13         F.S.; specifying that certain provisions are an
   14         exclusive remedy for personal injury or wrongful
   15         death; prohibiting compensation for certain wrongful
   16         deaths; creating s. 766.405, F.S.; creating the
   17         Patient Compensation System and the Patient
   18         Compensation Board; providing for board membership,
   19         terms, meetings, per diem and travel reimbursement,
   20         and powers and duties; providing for offices, staff,
   21         committees, and panels and the membership, terms,
   22         meetings, per diem and travel reimbursement, and
   23         powers and duties thereof; prohibiting certain
   24         conflicts of interest; requiring the board to adopt
   25         rules; creating s. 766.406, F.S.; providing a process
   26         to file an application for compensation for a medical
   27         injury; providing for the release of protected health
   28         information; providing procedures for incomplete
   29         applications; providing an application filing period;
   30         authorizing applicants to provide supplemental
   31         information; authorizing applicants to be represented
   32         by legal counsel; creating s. 766.407, F.S.; providing
   33         for review of applications; providing for award of
   34         compensation upon determination of medical injury;
   35         providing a limitation on compensation; providing for
   36         payment of compensation awards; providing for
   37         determinations of medical malpractice for purposes of
   38         a specified constitutional provision; requiring the
   39         system to notify the Board of Medicine regarding
   40         certain providers for purposes of professional
   41         discipline; creating s. 766.408, F.S.; providing for
   42         review of awards by an administrative law judge;
   43         providing for appellate review; authorizing an
   44         administrative law judge to grant time extensions;
   45         creating s. 766.409, F.S.; requiring annual
   46         contributions from specified providers for payment of
   47         awards and administrative expenses; providing an
   48         exception; providing maximum contribution amounts;
   49         specifying payment dates; prohibiting the renewal of a
   50         license under certain circumstances; providing for
   51         deposit of funds; authorizing the State Board of
   52         Administration to invest and reinvest funds held on
   53         behalf of the system under certain circumstances;
   54         authorizing providers to opt out of participation in
   55         the system and providing requirements therefor;
   56         creating s. 766.410, F.S.; requiring each practicing
   57         provider to provide notice to patients of provider
   58         participation in the Patient Compensation System;
   59         providing exceptions; creating s. 766.411, F.S.;
   60         requiring an annual report to the Governor and the
   61         Legislature by a specified date; providing
   62         requirements for such report; providing applicability;
   63         providing severability; providing effective dates.
   64          
   65  Be It Enacted by the Legislature of the State of Florida:
   66  
   67         Section 1. Subsection (7) of section 456.013, Florida
   68  Statutes, is amended to read:
   69         456.013 Department; general licensing provisions.—
   70         (7) The boards, or the department when there is no board,
   71  shall require the completion of a 2-hour course relating to
   72  prevention and communication of medical errors as part of the
   73  licensure and renewal process. The 2-hour course shall count
   74  towards the total number of continuing education hours required
   75  for the profession. The course shall be approved by the board or
   76  department, as appropriate, and shall include a study of root
   77  cause analysis, error reduction and prevention, and patient
   78  safety, and communication of medical errors to patients and
   79  their families. In addition, the course approved by the Board of
   80  Medicine and the Board of Osteopathic Medicine shall include
   81  information relating to the five most misdiagnosed conditions
   82  during the previous biennium, as determined by the board. If the
   83  course is being offered by a facility licensed pursuant to
   84  chapter 395 for its employees, the board may approve up to 1
   85  hour of the 2-hour course to be specifically related to error
   86  reduction and prevention methods used in that facility.
   87         Section 2. The Division of Law Revision and Information is
   88  directed to designate ss. 766.101-766.1185, Florida Statutes, as
   89  part I of chapter 766, Florida Statutes, entitled “Medical
   90  Malpractice and Related Matters”; ss. 766.201-766.212, Florida
   91  Statutes, as part II of that chapter, entitled “Presuit
   92  Investigation and Voluntary Binding Arbitration”; ss. 766.301
   93  766.316, Florida Statutes, as part III of that chapter, entitled
   94  “Birth-Related Neurological Injuries”; and ss. 766.401-766.411,
   95  Florida Statutes, as created by this act, as part IV of that
   96  chapter, entitled “Patient Compensation System.”
   97         Section 3. Section 766.401, Florida Statutes, is created to
   98  read:
   99         766.401Short title.—This part may be cited as the “Patient
  100  Compensation System.”
  101         Section 4. Section 766.402, Florida Statutes, is created to
  102  read:
  103         766.402Definitions.—As used in this part, the term:
  104         (1)“Applicant” means a person who files an application
  105  under this part requesting the investigation of an alleged
  106  occurrence of a medical injury.
  107         (2)“Application” means a request for investigation by the
  108  Patient Compensation System of an alleged occurrence of a
  109  medical injury.
  110         (3)“Board” means the Patient Compensation Board as
  111  established in s. 766.405.
  112         (4)“Collateral source payment” means any payment made to
  113  the applicant, or made on his or her behalf, by or pursuant to:
  114         (a)The federal Social Security Act; any federal, state, or
  115  local income disability act; or any other public program
  116  providing medical expenses, disability payments, or other
  117  similar benefits, except as prohibited by federal law.
  118         (b)Any health, sickness, or income disability insurance;
  119  any automobile accident insurance that provides health benefits
  120  or income disability coverage; and any other similar insurance
  121  benefits, except life insurance benefits, available to the
  122  applicant, whether purchased by the applicant or provided by
  123  others.
  124         (c)Any contract or agreement of any group, organization,
  125  partnership, or corporation to provide, pay for, or reimburse
  126  the costs of hospital, medical, dental, or other health care
  127  services.
  128         (d)Any contractual or voluntary wage continuation plan
  129  provided by employers or by any other system intended to provide
  130  wages during a period of disability.
  131         (5)“Compensation schedule” means a schedule of
  132  compensation for medical injuries.
  133         (6)“Department” means the Department of Health.
  134         (7)“Independent medical review panel” or “panel” means a
  135  panel convened by the chief medical officer to review each
  136  application.
  137         (8)(a)“Medical injury” means a personal injury or wrongful
  138  death due to medical treatment, including a missed diagnosis,
  139  which could have been avoided by an experienced specialist
  140  provider practicing in the same field of care under the same or
  141  similar circumstances or, for a general practitioner provider,
  142  an experienced general practitioner provider practicing under
  143  the same or similar circumstances. Only information that would
  144  have been known to an experienced specialist at the time of the
  145  medical treatment may be considered when determining the
  146  existence of a medical injury.
  147         (b)For purposes of this subsection, the term “medical
  148  injury” includes a personal injury or wrongful death for which
  149  all of the following criteria exist:
  150         1.The participating provider performed a medical treatment
  151  on the applicant.
  152         2.The applicant suffered medical harm.
  153         3.The medical treatment was the proximate cause of the
  154  medical injury.
  155         4.One or both of the following occurred:
  156         a.An accepted method of medical treatment was not used.
  157         b.An accepted method of medical treatment was used but was
  158  executed in a substandard fashion.
  159         (c)For purposes of this subsection, the term “medical
  160  injury” does not include a personal injury or wrongful death if
  161  the independent medical review panel determines that the medical
  162  treatment performed conformed with national practice standards
  163  for the care and treatment of patients with the underlying
  164  condition.
  165         (9)“Panelist” means a person licensed under chapter 458 or
  166  chapter 459 and practicing in this state.
  167         (10)“Participating provider” means a provider who, at the
  168  time of the medical injury, had paid the contribution required
  169  for participation in the Patient Compensation System for the
  170  year in which the medical injury occurred.
  171         (11)“System” means the Patient Compensation System as
  172  established in s. 766.405.
  173         (12)“Provider” means a person licensed under chapter 458
  174  or chapter 459 and practicing in this state.
  175         Section 5. Effective July 1, 2017, section 766.403, Florida
  176  Statutes, is created to read:
  177         766.403Legislative findings and intent.—
  178         (1)LEGISLATIVE FINDINGS.—The Legislature finds that:
  179         (a)The lack of legal representation, and, thus,
  180  compensation, for the majority of patients with legitimate
  181  medical injuries is creating an access-to-courts crisis.
  182         (b)Seeking compensation through medical malpractice
  183  litigation is a costly and protracted process, such that legal
  184  counsel cannot afford to finance more than a small number of
  185  legitimate claims.
  186         (c)Even for patients who are able to obtain legal
  187  representation, the delay in obtaining compensation is an
  188  average of 5 years, creating a significant hardship for patients
  189  and their caregivers who often need access to immediate care and
  190  compensation.
  191         (d)Because of continued exposure to liability, an
  192  overwhelming majority of physicians practice defensive medicine
  193  by ordering unnecessary tests and procedures, increasing the
  194  cost of health care for individuals covered by a public or
  195  private health care or health insurance program and exposing
  196  patients to unnecessary clinical risks.
  197         (e)A significant number of physicians, particularly
  198  obstetricians, intend to relocate out of state, retire, or
  199  change specialties as a result of the costs and risks of medical
  200  liability in this state, according to the Department of Health
  201  2014 Physician Workforce Annual Report.
  202         (f)Recruiting physicians to practice in this state and
  203  ensuring that current physicians continue to practice in this
  204  state is an overwhelming public necessity.
  205         (2)LEGISLATIVE INTENT.—The Legislature intends:
  206         (a)To supersede medical malpractice litigation by creating
  207  a new remedy whereby patients are fairly and expeditiously
  208  compensated for medical injuries. As provided in this part, this
  209  alternative remedy is intended to significantly reduce the
  210  practice of defensive medicine, thereby reducing health care
  211  costs; increase patient safety; increase the number of
  212  physicians practicing in this state; and provide patients fair
  213  and timely compensation without the expense and delay of the
  214  court system.
  215         (b)That an application filed under this part does not
  216  constitute a claim for medical malpractice or a written demand
  217  for payment, any action on such application does not constitute
  218  a judgment or an adjudication for medical malpractice, and,
  219  therefore, professional liability carriers are not obligated to
  220  report such applications or actions on such applications to the
  221  National Practitioner Data Bank.
  222         (c)That the definition of the term “medical injury” be
  223  construed to encompass a broader range of personal injuries as
  224  compared to a negligence standard, such that a greater number of
  225  applications qualify for compensation under this part as
  226  compared to the current system.
  227         Section 6. Effective July 1, 2017, section 766.404, Florida
  228  Statutes, is created to read:
  229         766.404Exclusive remedy; wrongful death.—
  230         (1)EXCLUSIVE REMEDY.—All statutes in conflict with this
  231  part shall stand repealed with respect to an applicant who has
  232  suffered a personal injury or wrongful death while in the care
  233  of a participating provider. Except as provided in part III of
  234  this chapter, the rights and remedies granted by this part due
  235  to a personal injury or wrongful death exclude all other rights
  236  and remedies of the applicant and his or her personal
  237  representative, parents, dependents, and next of kin, at common
  238  law or as provided in general law, against any participating
  239  provider directly involved in providing the medical treatment
  240  resulting in such injury or death arising out of or related to a
  241  medical negligence claim, whether in tort or in contract, with
  242  respect to such injury or death. Notwithstanding any other law,
  243  this part applies exclusively to applications submitted under
  244  this part.
  245         (2)WRONGFUL DEATH.—Compensation may not be provided under
  246  this part for an application requesting an investigation of an
  247  alleged wrongful death due to medical treatment if such
  248  application is filed by an adult child on behalf of his or her
  249  parent or by a parent on behalf of his or her adult child.
  250         Section 7. Section 766.405, Florida Statutes, is created to
  251  read:
  252         766.405Patient Compensation System; Patient Compensation
  253  Board; offices; staff; committees; independent medical review
  254  panels; conflicts of interest; rulemaking.—
  255         (1)PATIENT COMPENSATION SYSTEM.—The Patient Compensation
  256  System is created and shall be governed by the Patient
  257  Compensation Board created in this section. The Patient
  258  Compensation System is not a state agency, board, or commission.
  259  Notwithstanding s. 15.03, the system is authorized to use the
  260  state seal.
  261         (2)PATIENT COMPENSATION BOARD.—The Patient Compensation
  262  Board is a board of trustees, as defined in s. 20.03,
  263  established to govern the Patient Compensation System.
  264         (a)Members.—The board shall be composed of 11 members who
  265  represent the medical, legal, patient, and business communities
  266  from diverse geographic areas throughout this state. Members of
  267  the board shall serve at the pleasure of, and be appointed by,
  268  the Governor as follows:
  269         1.Five members, two of whom shall be physicians licensed
  270  under chapter 458 or chapter 459 who actively practice in this
  271  state, one of whom shall be an executive in the business
  272  community who works in this state, one of whom shall be a
  273  certified public accountant who actively practices in this
  274  state, and one of whom shall be a member of The Florida Bar who
  275  actively practices in this state.
  276         2.Three members from a list of persons recommended by the
  277  President of the Senate, one of whom shall be a physician
  278  licensed under chapter 458 or chapter 459 who actively practices
  279  in this state and one of whom shall be a patient advocate who
  280  resides in this state.
  281         3.Three members from a list of persons recommended by the
  282  Speaker of the House of Representatives, one of whom shall be a
  283  physician licensed under chapter 458 or chapter 459 who actively
  284  practices in this state and one of whom shall be a patient
  285  advocate who resides in this state.
  286         (b)Terms of appointment.—Each member shall be appointed
  287  for a 4-year term. For the purpose of providing staggered terms
  288  of the initial appointments, the five members appointed pursuant
  289  to subparagraph (a)1. shall be appointed to 2-year terms and the
  290  six members appointed pursuant to subparagraphs (a)2. and 3.
  291  shall be appointed to 3-year terms. If a vacancy occurs on the
  292  board before the expiration of a term, the Governor shall
  293  appoint a successor to serve the remainder of the term.
  294         (c)Chair and vice chair.—The board shall annually elect
  295  from its membership one member to serve as chair and one member
  296  to serve as vice chair.
  297         (d)Meetings.—The first meeting of the board shall be held
  298  no later than August 1, 2016. Thereafter, the board shall meet
  299  at least quarterly upon the call of the chair. A majority of the
  300  board members constitutes a quorum. Meetings may be held by
  301  teleconference, web conference, or other electronic means.
  302         (e)Compensation.—Members of the board shall serve without
  303  compensation but may be reimbursed for per diem and travel
  304  expenses for required attendance at board meetings in accordance
  305  with s. 112.061.
  306         (f)Powers and duties.—The board shall:
  307         1.Ensure the operation of the Patient Compensation System
  308  in accordance with applicable federal and state laws, rules, and
  309  regulations.
  310         2.Enter into contracts as necessary to administer this
  311  part.
  312         3.Employ an executive director and other staff as
  313  necessary to perform the functions of the Patient Compensation
  314  System. However, the Governor shall appoint the initial
  315  executive director.
  316         4.Approve the hiring of a chief compensation officer and
  317  chief medical officer, as recommended by the executive director.
  318         5.Approve a schedule of compensation for medical injuries,
  319  as recommended by the Compensation Committee.
  320         6.Approve medical review panelists, as recommended by the
  321  Medical Review Committee.
  322         7.Approve an annual budget.
  323         8.Annually approve provider contribution amounts.
  324         (3)OFFICES.—The following offices are established within
  325  the Patient Compensation System:
  326         (a)Office of Medical Review.—The Office of Medical Review
  327  shall evaluate and, as necessary, investigate all applications
  328  in accordance with this part. For the purpose of an
  329  investigation of an application, the office shall have the power
  330  to administer oaths; take depositions; issue subpoenas; compel
  331  the attendance of witnesses and the production of papers,
  332  documents, and other evidence; and obtain patient records
  333  pursuant to the applicant’s release of protected health
  334  information.
  335         (b)Office of Compensation.—The Office of Compensation
  336  shall allocate compensation for each application in accordance
  337  with the compensation schedule.
  338         (c)Office of Quality Improvement.—The Office of Quality
  339  Improvement shall regularly review application data to conduct
  340  root cause analyses and develop and disseminate best practices
  341  based on such reviews. In addition, the office shall capture and
  342  record safety-related data obtained during an investigation
  343  conducted by the Office of Medical Review, including the cause
  344  of, the factors contributing to, and any interventions that may
  345  have prevented the medical injury.
  346         (4)STAFF.—The executive director shall oversee the
  347  operation of the Patient Compensation System in accordance with
  348  this part. The following staff shall report directly to and
  349  serve at the pleasure of the executive director:
  350         (a)Advocacy director.—The advocacy director shall ensure
  351  that each applicant is provided high-quality individual
  352  assistance throughout the application process, from initial
  353  filing to disposition of the application. The advocacy director
  354  shall assist each applicant in determining whether to retain an
  355  attorney and explain possible fee arrangements and the
  356  advantages and disadvantages of retaining an attorney. If the
  357  applicant seeks to file an application without an attorney, the
  358  advocacy director shall assist the applicant in filing the
  359  application. In addition, the advocacy director shall regularly
  360  provide status reports to each applicant regarding his or her
  361  application.
  362         (b)Chief compensation officer.—The chief compensation
  363  officer shall manage the Office of Compensation. The chief
  364  compensation officer shall recommend to the Compensation
  365  Committee a compensation schedule for each type of medical
  366  injury. The chief compensation officer may not be a licensed
  367  physician or an attorney.
  368         (c)Chief financial officer.—The chief financial officer
  369  shall be responsible for overseeing the financial operations of
  370  the Patient Compensation System, including the annual
  371  development of a budget.
  372         (d)Chief legal officer.—The chief legal officer shall
  373  represent the Patient Compensation System in all contested
  374  applications, oversee the operation of the Patient Compensation
  375  System to ensure compliance with established procedures, and
  376  ensure adherence to all applicable federal and state laws,
  377  rules, and regulations.
  378         (e)Chief medical officer.—The chief medical officer shall
  379  manage the Office of Medical Review. The chief medical officer
  380  shall recommend to the Medical Review Committee a qualified list
  381  of multidisciplinary panelists for independent medical review
  382  panels. In addition, the chief medical officer shall convene
  383  independent medical review panels as necessary to review
  384  applications. The chief medical officer must be a physician
  385  licensed under chapter 458 or chapter 459 who resides in this
  386  state.
  387         (f)Chief quality officer.—The chief quality officer shall
  388  manage the Office of Quality Improvement.
  389         (5)COMMITTEES.—The board shall create a Medical Review
  390  Committee and a Compensation Committee. The board may create
  391  additional committees as necessary to assist in the performance
  392  of its duties and responsibilities.
  393         (a)Members.—Each committee shall be composed of three
  394  board members chosen by a majority vote of the board.
  395         1.The Medical Review Committee shall be composed of two
  396  physicians licensed in this state and a board member who is not
  397  an attorney who resides in this state. The board shall designate
  398  a physician committee member to serve as chair of the committee.
  399         2.The Compensation Committee shall be composed of a
  400  certified public accountant practicing in this state and two
  401  board members who are not physicians or attorneys who reside in
  402  this state. The board shall designate the certified public
  403  accountant to serve as chair of the committee.
  404         (b)Terms of appointment.—Members of each committee shall
  405  serve 2-year terms concurrent with their respective terms as
  406  board members. If a vacancy occurs on a committee, the board
  407  shall appoint a successor to serve the remainder of the term. A
  408  committee member who is removed or resigns from the board shall
  409  be removed from the committee.
  410         (c)Chair and vice chair.—The board shall annually
  411  designate a chair and vice chair of each committee.
  412         (d)Meetings.—Each committee shall meet at least quarterly
  413  or at the specific direction of the board. Meetings may be held
  414  by teleconference, web conference, or other electronic means.
  415         (e)Compensation.—Members of the committees shall serve
  416  without compensation but may be reimbursed for per diem and
  417  travel expenses for required attendance at committee meetings in
  418  accordance with s. 112.061.
  419         (f)Powers and duties.
  420         1.The Medical Review Committee shall recommend to the
  421  board a comprehensive, multidisciplinary list of panelists who
  422  shall serve on the independent medical review panels as needed.
  423         2.The Compensation Committee shall, in consultation with
  424  the chief compensation officer, recommend to the board:
  425         a.A compensation schedule such that, in any fiscal year,
  426  the aggregate payments made by the system do not exceed the
  427  contributions received under this part.
  428         b.Guidelines for the payment of compensation awards
  429  through periodic payments.
  430         c.Guidelines for the apportionment of compensation among
  431  multiple providers, which guidelines shall be based on the
  432  historical apportionment among multiple providers for similar
  433  medical injuries with similar severity.
  434         (6)INDEPENDENT MEDICAL REVIEW PANELS.—The chief medical
  435  officer shall convene an independent medical review panel to
  436  evaluate each application to determine whether a medical injury
  437  occurred. Each panel shall be composed of an odd number of at
  438  least three panelists chosen from a list of panelists
  439  representing the same or similar specialty as the participating
  440  provider identified in the application and shall convene, either
  441  in person or by electronic means, upon the call of the chief
  442  medical officer. Each panelist shall be paid a stipend as
  443  determined by the board for his or her service on the panel. In
  444  order to expedite the review of applications, the chief medical
  445  officer may, whenever practicable, group related applications
  446  together for consideration by a single panel.
  447         (7)CONFLICTS OF INTEREST.—A board member, a panelist, or
  448  an employee of the Patient Compensation System may not engage in
  449  any conduct that constitutes a conflict of interest. For
  450  purposes of this subsection, the term “conflict of interest”
  451  means a situation in which the private interest of a board
  452  member, a panelist, or an employee could influence his or her
  453  judgment in the performance of his or her duties under this
  454  part. A board member, a panelist, or an employee shall
  455  immediately disclose in writing the presence of a conflict of
  456  interest when the board member, panelist, or employee knows or
  457  should reasonably have known that the factual circumstances
  458  surrounding a particular application constitute a conflict of
  459  interest. A board member, a panelist, or an employee who
  460  violates this subsection is subject to disciplinary action as
  461  determined by the board. A conflict of interest includes, but is
  462  not limited to:
  463         (a)Conduct that would lead a reasonable person having
  464  knowledge of all of the circumstances to conclude that a board
  465  member, a panelist, or an employee is biased against or in favor
  466  of an applicant.
  467         (b)Participation in an application in which the board
  468  member, panelist, or employee, or the parent, spouse, or child
  469  of the board member, panelist, or employee, has a financial
  470  interest.
  471         (8)RULEMAKING.—The board shall adopt rules to implement
  472  and administer this part, including rules addressing:
  473         (a)The application process, including forms necessary to
  474  collect relevant information from applicants.
  475         (b)Disciplinary procedures for a board member, a panelist,
  476  or an employee who violates subsection (7).
  477         (c)Stipends paid to panelists for their service on an
  478  independent medical review panel, which may be adjusted in
  479  accordance with the relative scarcity of the panelist’s
  480  specialty, if applicable.
  481         (d)Payment of compensation awards through periodic
  482  payments and the apportionment of compensation among multiple
  483  providers, as recommended by the Compensation Committee.
  484         (e)The opt-out process for providers who do not want to
  485  participate in the Patient Compensation System.
  486         Section 8. Effective July 1, 2017, section 766.406, Florida
  487  Statutes, is created to read:
  488         766.406Filing of applications.—
  489         (1)CONTENT.—In order to obtain compensation for a medical
  490  injury, an applicant, or his or her legal representative, shall
  491  verbally submit an application with the Patient Compensation
  492  System through a toll-free telephone number established by the
  493  system. The application shall include:
  494         (a)The full name and address of the applicant or his or
  495  her legal representative and the basis of the representation.
  496         (b)The full name and address of any participating provider
  497  who provided medical treatment allegedly resulting in the
  498  medical injury.
  499         (c)A brief statement of the facts and circumstances
  500  surrounding the medical injury that gave rise to the
  501  application.
  502         (d)Any other information that the applicant believes will
  503  benefit the investigatory process, including the full names and
  504  addresses of potential witnesses.
  505         (e)Documentation of any applicable private or governmental
  506  source of services or reimbursement relating to the medical
  507  injury.
  508         (2)RELEASE OF PROTECTED HEALTH INFORMATION.—An applicant
  509  must submit, in writing, to the Office of Medical Review an
  510  authorization for release of all protected health information
  511  that is potentially relevant to the application as required by
  512  federal law.
  513         (3)INCOMPLETE APPLICATIONS.—If an application is
  514  incomplete, the Patient Compensation System shall, within 30
  515  days after the receipt of the initial application, notify the
  516  applicant in writing of any errors or omissions. An applicant
  517  shall have 30 days after receipt of the notice in which to
  518  correct the errors or omissions in the initial application
  519  through the toll-free telephone number established by the
  520  system.
  521         (4)TIME LIMITATION ON APPLICATIONS.—An application shall
  522  be filed within the time periods specified in s. 95.11(4) for
  523  medical malpractice actions. The applicable time period shall be
  524  tolled from the date the application is filed until the date the
  525  applicant receives the results of the initial medical review
  526  under s. 766.407.
  527         (5)SUPPLEMENTAL INFORMATION.—After filing an application,
  528  the applicant may supplement the initial application with
  529  additional information that he or she believes may be beneficial
  530  in the resolution of the application.
  531         (6)LEGAL COUNSEL.—This part does not prohibit an applicant
  532  or participating provider from retaining an attorney to
  533  represent the applicant or participating provider in the review
  534  and resolution of the application.
  535         Section 9. Effective July 1, 2017, section 766.407, Florida
  536  Statutes, is created to read:
  537         766.407Disposition of applications; scope of compensation;
  538  determination of medical malpractice; notice.—
  539         (1)INITIAL MEDICAL REVIEW.—Individuals with relevant
  540  clinical expertise in the Office of Medical Review shall
  541  determine, within 10 days after the receipt of a completed
  542  application, whether the application, prima facie, constitutes a
  543  medical injury.
  544         (a)If the Office of Medical Review determines that the
  545  application, prima facie, constitutes a medical injury, the
  546  office shall immediately notify, by registered or certified
  547  mail, each participating provider named in the application. The
  548  notification shall inform the participating provider that he or
  549  she may support the application to expedite the processing of
  550  the application. A participating provider shall have 15 days
  551  after the receipt of notification of an application to support
  552  the application. If the participating provider supports the
  553  application, the Office of Medical Review shall review the
  554  application in accordance with subsection (2).
  555         (b)If the Office of Medical Review determines that the
  556  application does not, prima facie, constitute a medical injury,
  557  the office shall send a rejection letter to the applicant by
  558  registered or certified mail informing the applicant of his or
  559  her right to appeal. The applicant shall have 15 days after
  560  receipt of the rejection letter to appeal, through the toll-free
  561  telephone number established by the Patient Compensation System,
  562  the office’s determination pursuant to s. 766.408.
  563         (2)EXPEDITED MEDICAL REVIEW.—An application that is
  564  supported by a participating provider in accordance with
  565  subsection (1) shall be reviewed by individuals with relevant
  566  clinical expertise in the Office of Medical Review within 30
  567  days after notification of the participating provider’s support
  568  of the application to determine the validity of the application.
  569  If the Office of Medical Review finds that the application is
  570  valid, the Office of Compensation shall determine an award of
  571  compensation in accordance with subsection (4). If the Office of
  572  Medical Review finds that the application is invalid, the office
  573  shall immediately notify the applicant of the rejection of the
  574  application and, in the case of fraud, shall immediately notify
  575  relevant law enforcement authorities.
  576         (3)FORMAL MEDICAL REVIEW.—If the Office of Medical Review
  577  determines that the application, prima facie, constitutes a
  578  medical injury and the participating provider does not elect to
  579  support the application, the office shall complete a thorough
  580  investigation of the application within 60 days after the
  581  office’s determination. The investigation shall be conducted by
  582  a multidisciplinary team with relevant clinical expertise and
  583  shall include a thorough investigation of all available
  584  documentation, witnesses, and other information. Within 15 days
  585  after the completion of the investigation, the chief medical
  586  officer shall allow the applicant and the participating provider
  587  to access records, statements, and other information obtained in
  588  the course of its investigation, in accordance with relevant
  589  state and federal laws.
  590         (a)Within 30 days after the completion of the
  591  investigation, the chief medical officer shall convene an
  592  independent medical review panel to determine whether the
  593  application constitutes a medical injury. The independent
  594  medical review panel shall have access to all redacted
  595  information obtained by the office in the course of its
  596  investigation of the application and shall make a written
  597  determination within 10 days after the convening of the panel,
  598  which shall be immediately provided to the applicant and the
  599  participating provider.
  600         (b)If the panel determines that the application
  601  constitutes a medical injury, the Office of Medical Review shall
  602  immediately notify the participating provider by registered or
  603  certified mail of the participating provider’s right to appeal
  604  the panel’s determination. The participating provider shall have
  605  15 days after receipt of the letter to appeal the panel’s
  606  determination pursuant to s. 766.408.
  607         (c)If the panel determines that the application does not
  608  constitute a medical injury, the Office of Medical Review shall
  609  immediately notify the applicant by registered or certified mail
  610  of his or her right to appeal the panel’s determination. The
  611  applicant shall have 15 days after receipt of the letter to
  612  appeal the panel’s determination pursuant to s. 766.408.
  613         (4)COMPENSATION REVIEW.—If an independent medical review
  614  panel determines that an application constitutes a medical
  615  injury under subsection (3) and all appeals of that finding have
  616  been exhausted by the participating provider pursuant to s.
  617  766.408, the Office of Compensation shall, within 30 days after
  618  the determination of the panel or the exhaustion of all appeals
  619  of that finding, whichever occurs later, make a written
  620  determination of an award of compensation in accordance with the
  621  compensation schedule and the findings of the panel. The office
  622  shall notify the applicant and the participating provider by
  623  registered or certified mail of the amount of compensation and
  624  shall also explain to the applicant the process for appealing
  625  the determination of the office. The applicant shall have 15
  626  days after the receipt of the letter to appeal the determination
  627  of the office pursuant to s. 766.408.
  628         (5)LIMITATION ON COMPENSATION.—Compensation for each
  629  application shall be offset by any past and future collateral
  630  source payments. In addition, compensation may be paid by
  631  periodic payments as determined by the Office of Compensation in
  632  accordance with rules adopted by the board.
  633         (6)PAYMENT OF COMPENSATION.—Within 14 days after the
  634  earlier of the acceptance of compensation by the applicant or
  635  the conclusion of all appeals pursuant to s. 766.408, the
  636  Patient Compensation System shall immediately provide
  637  compensation to the applicant in accordance with the
  638  compensation award.
  639         (7)DETERMINATION OF MEDICAL MALPRACTICE.—For purposes of
  640  s. 26, Art. X of the State Constitution, a physician who is the
  641  subject of an application under this part must be found to have
  642  committed medical malpractice only upon a specific finding of
  643  the Board of Medicine or the Board of Osteopathic Medicine, as
  644  applicable, in accordance with s. 456.50.
  645         (8)PROFESSIONAL BOARD NOTICE.—If the independent medical
  646  review panel determines that care and treatment of patients by a
  647  provider represents an imminent risk of harm to the public, the
  648  chief medical officer of the Patient Compensation System shall
  649  notify the Board of Medicine of the independent medical review
  650  panel’s determination of imminent risk and provide the Board of
  651  Medicine with electronic access to all appropriate and relevant
  652  information concerning the medical injury. The Board of Medicine
  653  may review such information and conduct an investigation to
  654  determine whether any of the incidents that resulted in the
  655  application may have involved conduct by the person who is
  656  subject to disciplinary action.
  657         Section 10. Effective July 1, 2017, section 766.408,
  658  Florida Statutes, is created to read:
  659         766.408Review by administrative law judge; appellate
  660  review; extensions of time.—
  661         (1)REVIEW BY ADMINISTRATIVE LAW JUDGE.—An administrative
  662  law judge shall hear and determine appeals filed pursuant to s.
  663  766.407 and exercise the full power and authority granted to him
  664  or her in chapter 120, as necessary, to carry out the purposes
  665  of that section. The administrative law judge shall be limited
  666  in his or her review to determining whether the Office of
  667  Medical Review, the independent medical review panel, or the
  668  Office of Compensation, as appropriate, has faithfully followed
  669  the requirements of this part and rules adopted thereunder in
  670  reviewing applications. If the administrative law judge
  671  determines that such requirements were not followed in reviewing
  672  an application, he or she shall require the chief medical
  673  officer to reconvene the original independent medical review
  674  panel or convene a new panel, or require the Office of
  675  Compensation to redetermine the compensation amount, in
  676  accordance with the determination of the judge.
  677         (2)APPELLATE REVIEW.—A determination by an administrative
  678  law judge under this section regarding the award or denial of
  679  compensation under this part shall be conclusive and binding as
  680  to all questions of fact and shall be provided to the applicant
  681  and the participating provider. An applicant may appeal the
  682  award or denial of compensation to the district court of appeal.
  683  Appeals shall be filed in accordance with rules of procedure
  684  adopted by the Supreme Court for review of such orders.
  685         (3)EXTENSIONS OF TIME.—Upon a written petition by either
  686  the applicant or the participating provider, an administrative
  687  law judge may grant, for good cause, an extension of any of the
  688  time periods specified in this part. The relevant time period
  689  shall be tolled from the date of the written petition until the
  690  date of the determination by the administrative law judge.
  691         Section 11. Section 766.409, Florida Statutes, is created
  692  to read:
  693         766.409Contributions by participating providers; opt out
  694  option; administration of funds collected.—
  695         (1)The board shall annually determine a contribution that
  696  shall be paid by each participating provider for the payment of
  697  awards under this part and for administrative expenses, unless
  698  the provider opts out of participation in the Patient
  699  Compensation System pursuant to subsection (5). The contribution
  700  amount is based on the provider’s specialty and may not exceed
  701  the following amounts:
  702         (a) Administrative Medicine: $2,100.
  703         (b) Allergy/Immunology: $1,800.
  704         (c) Anesthesiology: $4,300.
  705         (d) Anesthesiology-Pain Management: $4,600.
  706         (e) Cardiology (Invasive): $6,100.
  707         (f) Cardiology (Non-invasive): $5,300.
  708         (g) Colon & Rectal Surgery (Minor Surgery Limited to Anal
  709  Ring): $6,100.
  710         (h) Dermatology: $1,800.
  711         (i) Dermatology (With Liposuction): $4,800.
  712         (j) Diagnostic Radiology (interventional): $8,400.
  713         (k) Diagnostic Radiology (Non-interventional): $8,400.
  714         (l) Emergency Medicine: $8,400.
  715         (m) Endocrinology: $2,700.
  716         (n) Family General Practice (Minor Surgery-No Obstetrics):
  717  $5,300.
  718         (o) Family General Practice (Restricted Major Surgery-No
  719  Obstetrics): $9,100.
  720         (p) Gastroenterology: $6,100.
  721         (q) General Surgery (All Other): $17,600.
  722         (r) General Surgery (Bariatric): $17,600.
  723         (s) Gynecology (Major Surgery): $5,300.
  724         (t) Hematology: $5,300.
  725         (u) Hospitalist (General Surgery): $17,600.
  726         (v) Infectious Disease: $5,300.
  727         (w) Internal Medicine: $4,400.
  728         (x) Nephrology: $2,700.
  729         (y) Neurology: $5,300.
  730         (z) Neurosurgery: $21,900.
  731         (aa) Nuclear Medicine: $3,000.
  732         (bb) Obstetrics & Gynecology (All Other): $17,600.
  733         (cc) Occupational Medicine: $3,000.
  734         (dd) Oncology: $5,300.
  735         (ee) Ophthalmology (Minor Surgery): $4,000.
  736         (ff) Orthopedic Surgery (No Spinal): $10,600.
  737         (gg) Orthopedic Surgery (With Spinal): $12,900.
  738         (hh) Otolaryngology (Major With No Facial Plastic): $5,300.
  739         (ii) Pathology: $4,000.
  740         (jj) Pediatrics: $2,700.
  741         (kk) Physical Medicine & Rehabilitation: $2,100.
  742         (ll) Physical Medicine & Rehabilitation-Pain Management
  743  (Minor Procedures): $5,300.
  744         (mm) Physical Medicine & Rehabilitation-Pain Management
  745  (Major Procedures): $5,300.
  746         (nn) Plastic Surgery: $8,400.
  747         (oo) Psychiatry: $2,100.
  748         (pp) Pulmonary Medicine: $6,100.
  749         (qq) Rheumatology: $3,000.
  750         (rr) Thoracic/Cardiovascular Surgery: $15,200.
  751         (ss) Urology: $5,300.
  752         (2)The contribution determined under this section is
  753  payable by each participating provider upon notice delivered on
  754  or after July 1 of the following fiscal year. Each participating
  755  provider shall pay the contribution amount within 30 days after
  756  the date the notice is delivered to the provider. If the
  757  provider fails to pay the contribution determined under this
  758  section within 30 days after such notice, the board shall notify
  759  the provider by certified or registered mail that the provider’s
  760  license will not be renewed if the contribution is not paid
  761  within 60 days after the date of the original notice, unless the
  762  provider opts out of participation in the system.
  763         (3)Upon notification by the system that a provider has not
  764  opted out of participation pursuant to subsection (5) and has
  765  failed to pay the contribution amount determined under this
  766  section within 60 days after receipt of the original notice, the
  767  department may not renew the provider’s license until the
  768  contribution is paid in full.
  769         (4)All amounts collected under this section shall be
  770  deposited with the Patient Compensation System. The funds
  771  collected by the system and any income therefrom shall be
  772  disbursed only for the payment of awards under this part and for
  773  the payment of the reasonable expenses of administering the
  774  system. Funds held on behalf of the plan are funds of the state.
  775  The system may only invest plan funds in the investments and
  776  securities described in s. 215.47, and shall be subject to the
  777  limitations on investments contained in that section. All income
  778  derived from such investments shall be credited to the system.
  779  The State Board of Administration may invest and reinvest funds
  780  held on behalf of the system in accordance with the trust
  781  agreement approved by the system and the State Board of
  782  Administration and ss. 215.44-215.53.
  783         (5)A provider may elect to opt out of participation in the
  784  Patient Compensation System. The election to opt out must be
  785  made in writing at least 15 days before the due date of the
  786  contribution required under this section. A provider who opts
  787  out may subsequently elect to participate in the system by
  788  paying the appropriate contribution amount for the current
  789  fiscal year. However, any medical malpractice claim filed while
  790  the provider was not participating in the system shall be
  791  adjudicated pursuant to parts I through III of this chapter.
  792         Section 12. Section 766.410, Florida Statutes, is created
  793  to read:
  794         766.410Notice to patients of participation in the Patient
  795  Compensation System; exception.—
  796         (1)Each participating provider shall provide notice to
  797  patients that the provider is participating in the Patient
  798  Compensation System. Such notice shall be provided on a form
  799  furnished by the Patient Compensation System and shall include a
  800  concise explanation of a patient’s rights and benefits under the
  801  system.
  802         (2)Notice is not required to be given to a patient when
  803  the patient has an emergency medical condition as defined in s.
  804  395.002(8)(b) or when notice is not practicable.
  805         Section 13. Section 766.411, Florida Statutes, is created
  806  to read:
  807         766.411Annual report.—The board shall annually, beginning
  808  October 1, 2018, submit to the Governor, the President of the
  809  Senate, and the Speaker of the House of Representatives a report
  810  that describes the filing and disposition of applications in the
  811  preceding fiscal year. The report shall include, in the
  812  aggregate, the number of applications, the disposition of such
  813  applications, and the compensation awarded.
  814         Section 14. Sections 766.401-766.411, Florida Statutes, as
  815  created by this act, apply to medical incidents that occur on or
  816  after July 1, 2017.
  817         Section 15. If any provision of this act or its application
  818  to any person or circumstance is held invalid, the invalidity
  819  does not affect other provisions or applications of the act
  820  which may be given effect without the invalid provision or
  821  application, and to this end the provisions of this act are
  822  severable.
  823         Section 16. Except as otherwise expressly provided in this
  824  act, this act shall take effect July 1, 2016.

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