Florida Board of Medicine: Update and Overview James W. Orr, Jr., M.D. DATE

Overview Introduction to the Board of Medicine Top 10 Things Physicians Do that Can Get them in Trouble Disciplinary Process & Implications Questions

Who is the Board of Medicine? Mission: To protect and promote the health of all residents and visitors in the state through organized state and community efforts, including cooperative agreements with counties. Judge Enforce legislation Define quality License Communicate

Medical Board Structure The Medical Board is a group of volunteers who are charged with upholding the Medical Practice Act for the State of Florida. Twelve physician members Three consumer members All Members of the Board are appointed by the Governor.

Leadership

Accessing Information Board of Medicine web page http://www.doh.state.fl.us/mqa/medical/ Board of Medicine Interested Parties List (Mailman) Go to website above to sign up Address, telephone, fax and email 4052 Bald Cypress Way, Bin C03, Tallahassee, FL 32399 (850) 245-4131 (850) 488-0596 MQA_Medicine@doh.state.fl.us

Meetings The Board of Medicine meets 6 times per year to handle hearings and Board business (February, April, June, August, October, December) All meetings are open to the public and physicians may receive CME credit for attending one of the Board Meetings. Physicians may receive 5 hours CME in the area of risk management/ethics by attending a full day of disciplinary hearings. Must arrive at 8:00 am and sign in with Board Staff at the meeting.

Top 10 Things Physicians Do that Can Get them in Trouble Practitioner profiles Moving or closing your office Prescriptions Medical records Patient boundaries Advertising Adverse incidents Internet prescribing Controlled substance prescribing Wrong Site/Person/Procedure Surgery

Practitioner Profiles Must be updated within 15 days of any change [s. 456.042, F.S.] Mandatory fields: Primary practice address Secondary practice address Staff privileges Other state licensure Year began practicing Education and training Other health related degrees Professional and postgraduate training Academic appointments Specialty certification Financial responsibility Criminal Offenses Final disciplinary action (multiple categories) Actions on staff privileges Liability claims Some fields can be changed online, others have to be sent in for staff to update.

Practitioner Profiles continued . . . View the Practitioner’s Guide to Completing and Updating the Profile at www.doh.state.fl.us/MQA/profiling

Moving or Closing Your Office Steps to follow if you are moving or closing your office [s. 456.035, FS, s. 458.319, FS, s. 458.327, FS, Rule 64B8-10.002, FAC] Notify patients Publish in newspaper once per week for 4 weeks Notice with specific information required Copy Board of Medicine with notice within 1 month May place sign on facade of office location Where can copies of medical records be requested?

Prescriptions Do not pre-sign prescription pads [s. 458.331(1)(aa), FS] Know the legible prescription laws [s. 456.43, FS, s. 668, FS, and Rule 64B8-3.005, FAC]

Medical Records Maintenance of records [s. 458.331(1)(m), FS, Rule 64B8-10.002, FAC] Costs to reproduce medical records [Rule 64B8-10.003, FAC]

Patient Boundaries Sexual contact with a patient is sexual misconduct and is a violation [s. 458.331(1)(j), FS, s. 458.329, FS, Rule 64B8-9.008, FAC]

Advertising Pre-approve any advertisement of your services – disclaimer required [s. 456.062, FS, Rule 64B8-11, FAC]

Adverse Incidents Duty to notify patients about adverse incidents that result in serious harm to the patient [s. 395.0197, FS, s. 395.1051, FS, s. 456.0575, FS]

Internet Prescribing Prescribing medications based solely on an electronic medical questionnaire is a violation. [s. 458.331(1)(t), FS, Rule 64B8-9.014, FAC]

Controlled Substance Prescribing New laws [s. 456.42, FS, s. 456.44, FS, Rule 64B8-9.013, FAC] Registration as a controlled substance prescriber Pain-Management laws [s. 458.3265, FS, Rule 64B8-9.0131, FAC]

Wrong Site/Person/Procedure Surgery Pause and ensure you have the right patient, right site, right procedure [s. 456.072(1)(bb), FS, Rule 64B8-9.007, FAC]

Disciplinary Process Grounds for disciplinary action S. 458.331(1), Florida Statutes S. 457.072(1), Florida Statutes http://www.leg.state.fl.us/statutes/index.cfm Disciplinary guidelines Rule 64B8-8.001, Florida Administrative Code https://www.flrules.org/Default.asp This is where you find the statutes that outline the various types of violations and penalties.

DISCIPLINARY PROCESS = Confidential = Public Record Mediation Not Disputed Final Order = Confidential = Public Record Complaint 2d Citation Issued Agency Consumer Services Unit Closure/Referral to Other Agencies as Non-Jurisdictional OR Closure as Legally Non-sufficient Investigation Probable Cause Panel Selected by the respective professional board from the Department of Health Prosecution Attorney Review Legal Services Section Citation Formal Hearing Before DOAH (Contests Charges) Agency Director, If No formal Probable Cause Panel Exists This flow chart outlines the process a complaint goes through from when it’s filed until closed – either confidentially because no violation was found or closed through issuance of a citation or a Final Order issued by the Board. 07-08 Annual Report Stats Informal Hearing Before Respective Board (No Dispute) Final Board Action and Disposition Findings: Case Disposition Hearing Waived Before Respective Board (No Dispute) Final Order Imposing Discipline Filed with Department of Health No Probable Cause Found Probable Cause Found Dismissal/ Closure Administrative Complaint Filed With Department of Health Election of Rights By Licensee Stipulation/Settlement by Licensee to Respective Board for Approval Appeal Procedures To District Court of Appeals

Implications of Disciplinary Action If you have licenses in multiple states and have had action on a license in one state, you should report that action to the other states. Disciplinary action is reportable to the Healthcare Integrity Protection Databank, Federation of State Medical Boards, Drug Enforcement Agency and the American Medical Association. Disciplinary action may have an effect on medical malpractice insurance, HMO coverage, staff privileges and other state licensure.

How do I find Laws and Rules http://www.leg.state.fl.us/statutes/index.cfm Rules: http://www.flrules.org/

QUESTIONS?