2015 Florida Laws and Rules

Transcription

1 Florida Laws and Rules 2015 Florida Laws and Rules Paul R. Fowler D.O., J.D. FAOCOPM, FCLM, FAAFP Chapter 459, Florida Statute which regulates Osteopathic Physicians. Chapter 456, Florida Statute which provides General Provisions Florida Administrative Code 64B15, Rules promulgated by the Board of Osteopathic Medicine. Dr. Fowler- How many times do I have to take an HIV/ AIDS/ Domestic Violence course to keep my Florida license? 1. Every two years at live AOA approved conference 2. I don t have a clue, Ask Jeff LeBoeuf, he knows everything and everybody 3. HIV/AIDS not required after first time 4. Domestic Violence 2 hours every third biennium 64B CME Requirements for Florida Relicensure 40 CME hours, 20 of which must be AOA Category 1-A. Included in the 40 hours, there are five (5) mandatory hours required for Florida relicensure (each licensure period) and cannot be taken by correspondence. The following must be LIVE, PARTICIPATORY credits: 2 hours of Prevention of Medical Errors 1 hour of Professional and Medical Ethics 1 hour of Florida Laws & Rules 1 hour of Federal and State Laws Related to the Prescribing of Controlled Substances In addition to the above 5 hours, you are required to take 2 hours of Domestic Violence every 6 years. This may be taken by correspondence: 1-hour of HIV/AIDS must be taken before the end of your FIRST licensure renewal. All those that are not in first two years of licensure, you are NOT REQUIRED to take an HIV/AIDS course! CS/HB 1263 LIPOSUCTION Jeff LeBoeuf placed second in the Mr. Florida contest last year and wants to win it all this year! His good friend Dr. Walker recently took a weekend CME course on liposuction and has offered to give Jeff a Discounted Liposuction to help him get ready for the Contest. Dr. Walker has set up an office in Miami offering Liposuction under local anesthesia. Last night he removed 10 pounds of fat from Jeff. Dr. Walker has never contacted the State of Florida concerning his private Liposuction office. What will happen next: 1: Jeff will certainly now win the Mr. Florida title. 2: Dr. Walker should have only removed 999 cubic centimeters(2 pds) of fat. 3. Dr. Walker needs to get his office licensed and accredited with Florida. 4. All of the above and contact Dr. Fowler immediately for his legal defense. CS/HB 1263 LIPOSUCTION New Rule: All liposuctions that remove more than two pounds(1000cc) of fat must now take place in regulated offices equipped with lifesaving equipment and a physician specially trained in lifesaving techniques. Offices will also have to be inspected by the State and undergo accreditation. Y-1

2 Dr. Fowler hooks up with a Mississippi internet company to prescribe medication via the internet from his Ft. Lauderdale vacation house. Dr. Fowler gets paid $300 for each prescription. He writes prescriptions solely based on an electronic medical questionnaire form. If Dr. Fowler continues to do this he will: 1. Get rich quick and retire early 2. Need bail money from Jeff LeBoeuf 3. Might get in trouble with Florida Board 64B Standards for Telemedicine Practice Prescribing medications solely on electronic record constitutes failure to practice osteopathic medicine with that level of care, skill and treatment which is recognized by reasonably prudent osteopathic physicians. Telemedicine DO s shall not provide treatment recommendations via electronic means unless: 1. Documented patient evaluation including H&P adequate to establish diagnosis 2. Sufficient dialog regarding treatment options and risk and benefits 3. Maintenance of medical records BOM EMERGENCY RULE RELATED TO TELEMEDICINE 64B Emergency Rule which specifically precludes physicians from prescribing controlled substances through the use of telemedicine. Ordering of controlled substances for hospitalized patients through the use of telemedicine modalities is NOT precluded. Dr. Fowler writes the following prescription: Oxycontin 10 mg, # 30, Sig: Take one tablet BID p.o. daily. Date: 5/31/2014 A rude Pharmacist calls Dr. Fowler from Miami at 2 AM in the morning and tells him that he refuses to fill this prescription because it does not comply with the law. Dr Fowler should: 1. Report the Pharmacist to the Florida Pharmacy Board 2. Rewrite this prescription immediately on counterfeit-proof pad! Written Prescriptions for Medicinal Drugs A written prescription for a controlled substance must be: 1. Legibly printed or typed 2. Name of prescribing doctor 3. Name and strength of drug 4. Quantity of drug in both textual and numerical formats 5. Be dated with month written out in textual letters and signed on same day as issued. Y-2

3 Written Prescriptions for Medicinal Drugs A written prescription for a non-controlled substance must be: 1. Legibly printed or typed 2. Name of prescribing doctor 3. Name and strength of drug 4. Quantity of drug ( don t really need textual- but good idea) 5. Be dated and signed on same day as issued. (Don t need month written out.) Written Prescriptions for Medicinal Drugs A prescription that is electronically generated and transmitted must: 1. Name of prescribing doctor 2. Name and strength of drug 3. Quantity of drug in numerical format 4. Be dated and signed only on same day as issued and signature may be in an electronic format. HB 7095 Counterfeit-proof prescription blanks MUST be used by practitioners for prescribing of any controlled substance! No longer authorized to dispense Schedule II or Schedule III controlled substances with few exceptions. Controlled Substance Monitoring and Pain Clinic Regulation New Law- Florida is going to be watching Controlled Substance prescribing. BE CAREFULL!!!! New program for controlled substance monitoring- new rules. WARNING- If you work in Pain Clinic Pain Clinics are required to be registered. Don t work in any pain clinic that is not registered. CHECK IT OUT!!!! You must notify Board within 10 days. Dr. Walker while doing a face and necklift operation on Jeffrey LeBoeuf, accidently cuts too deep and severs a nerve leaving Jeff looking and talking funny! What should Dr. Walker do? 1. Tell Jeff his wife and kids still love him. 2. Tell Jeff that he consented to this risk of surgery. 3. Inform Jeff about the adverse outcome and immediately hire Dr. Fowler as his defense attorney Duty to notify patients Every licensed health care practitioner shall inform each patient or (Health care surrogate) in person about adverse incidents that result in serious harm to the patient. Notification of outcomes of care that result in harm to the patient under this section shall not constitute an acknowledgment of admission of liability, nor can such notification be introduced as evidence. Y-3

4 Dr. Fowler is defending Dr. Walker in a malpractice claim filed in Ft. Lauderdale. The plaintiff has hired the elite law firm of Monney, Moremonney, and Mostmonney out of Miami to put pressure on Dr. Walker to settle. Mr. Monney paid a New York licensed unemployed physician, Ned Cash D.O., $20,000 to act as a expert witness and testify in Florida that Dr. Walker did not meet the standard of care. DR FOWLER SHOULD: 1. Cave in and settle now, Dr. Fowler is no match for the Monney, Moremonney, Mostmonney Law Firm. 2. Tell Dr. Walker to empty all his bank accounts and head to Mexico. 3. File a complaint with Florida Board of Osteopathic Medicine that Dr. Cash does not have an expert witness certificate Expert Witness Certificate Expert Witness Certificate authorizes the physician to: 1. Provide written medical expert opinion 2. Provide expert testimony about standard of care 3. Cannot engage in practice of Osteopathic Medicine 4. Subject to discipline by the Board Penalty: Subject now to Florida disciplinary action for offering false and misleading information as an expert witness. Dr. Fowler gets ready to perform a Left hip replacement on a 82 y/o man in Orlando, Florida. He has several surgeries scheduled today and is running behind. The OR tech marks the Right leg with a marker indicating the leg to operate on. Dr. Fowler never asked the surgical team about the mark as he cuts the Right side. Is Dr Fowler in big trouble? 1. Yes, he is in big trouble! 2. It is not his fault, the hospital who employed the tech is responsible. 64B Standards of Practice for Surgery DR. FOWLER IS IN BIG TROUBLE WITH THE FLORIDA BOARD OF OSTEOPATHIC MEDICINE! 1. Rule intended to prevent wrong site, wrong side, wrong patient and wrong surgeries or procedures. 2. Requires surgical team to pause prior to initiation of surgery to confirm the side, patient identity and surgery/procedure. 3. The operating physician shall not make any incision or perform any surgery or procedure prior to performing this required confirmation. 4. This requirement for confirmation applies also to physicians performing procedures in office settings. Y-4

5 STRIKE THREE- YOU ARE OUT! Dr. Walker had a lousy attorney and lost two jury malpractice trials in Florida last year. He has been sued again in Florida. What should he do? 1. Never go back to Florida and move to Texas. 2. Hire Dr. Fowler as his attorney who can settle the case and save his license. 3. Hire Dr. Fowler after settlement who will argue to the FL Board of Osteopathic Medicine that the negligence of Dr. Walker did not rise to a level supported by clear and convincing evidence. STRIKE THREE- YOU ARE OUT! In 2004, Florida voters passed Three Strikes Amendment under which physicians could lose their licenses if a malpractice jury found them negligent of three incidents of medical malpractice or three arbitration proceedings. ( Does not apply to settlements). In 2005, FL Legislature enacted statute that for a liability judgment to be counted as a strike, the negligence finding had to be proved by a standard of clear and convincing evidence. STRIKE THREE- YOU ARE OUT! Curve Ball- Plaintiffs only have to prove negligence based on preponderance of the evidence- Therefore the implementing legislation effectively nullified the three strike rule. Osteopathic Medical Board will review whether the alleged negligence would be supported by clear and convincing evidence. FL law is being challenged by Orlando Trial attorney. Stay tuned! Foul Ball- Board will revoke your license for standard of care violations. Mr. LeBoeuf s Top Ten Reasons for Getting into Trouble Reason #10- Charging too high a copy fee for patient records. 64B Reasonable costs are $1.00 per page for first 25 pages and 25 cents/ page after that. #9 Failure to timely comply with patient s request for copies of records and reports! #8 Failure to Designate Yourself as a Controlled Substance Prescribing Physician on your Florida physician s practitioner profile. (FL Section (2)) 64B timely means less than 30 days! This applies for DO s who prescribe controlled substances for the treatment of chronic nonmalignant pain. Y-5

6 #7 Florida will not renew your license if you: 1. Convicted or plead guilty or nolo contendre to felony violation unless sentence ended 15 years prior. 2. Terminated for cause from Florida Medicaid. 3. Terminated for cause from any other state Medicaid or Medicare. #6 Failure to post schedule of prices charged for the 50 most common services in your reception area! ( CS/CS/HB 935) FINE OF UP TO $ 1,000 per day!!! Only applies to certain offices, with exemptions from license fees. #5 Failure to register as a dispensing practitioner! #4 Failure to update physician profile. Fine: $500 Fine: $50 per day!!! Not to exceed $5000 #3 FAILURE TO CHECK YOUR ELECTRONIC RECORD AT CE BROKER FAILURE TO SELF-REPORT CME HOURS IF CME PROVIDER DOES NOT. PENALTY: NO RENEWAL OF LICENSE!!!!!! #2 Falsely certifying compliance with required continuing education hours. Florida will now verify CME record in the electronic tracking system at the time of renewal. Fine: $2000 Y-6

7 The NUMBER ONE REASON IS: GIVING JEFF A BAD CREDIT CARD NUMBER FOR THIS CONFERENCE!!!!!!!!!!!!!!!!!!!!!!!!!! REMEMBER TEXT *9999 to vote for Jeff for MR. FLORIDA Y-7