The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Appropriations Subcommittee on Health and Human Services
BILL: PCS/CS/SB 1142 (337150)
INTRODUCER: Appropriations Subcommittee on Health and Human Services; Health Policy Committee;
and Senator Rodrigues
SUBJECT: Prohibited Acts by Health Care Practitioners
DATE: April 12, 2021 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Brown Brown HP Fav/CS
2. Howard Kidd AHS Recommend: Fav/CS
3. AP
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
PCS/CS/SB 1142 amends s. 456.072(1)(a), Florida Statutes, that provides grounds for discipline
applicable to all licensed health care practitioners, to:
 Add the making of misleading, deceptive, or fraudulent representations related to a
practitioner’s specialty designation as grounds for discipline.
 Provide that the term “anesthesiologist” may be used only by a practitioner licensed under
chapters 458 or 459, Florida Statutes, or licensed as a dentist under chapter 466, Florida
Statutes.
 Provide that the term “dermatologist” may be used only by a practitioner licensed under
chapters 458 or 459, Florida Statutes.
The bill requires that when the Department of Health (department) finds that a health care
practitioner has violated section 456.072(1)(a), Florida Statutes pertaining to a specialty
designation, as amended by the bill, the department must issue an emergency cease and desist
order and take disciplinary action if the practitioner fails to comply with the order.
The bill also amends section 456.072(1)(t), Florida Statutes, to provide disciplinary action based
on a licensed health care practitioner’s failure to identify his or her specialty designation and
requiring the department, not a practitioner regulatory board, to enforce section 456.072(1)(t),
Florida Statutes.
BILL: PCS/CS/SB 1142 (337150) Page 2
The department may experience a workload increase associated with additional complaints and
nonrecurring costs associated with rule-making; however, these costs can be absorbed within
existing resources.
The bill takes effect upon becoming a law.
II. Present Situation:
The Department of Health
The Legislature created the Department of Health (department) to protect and promote the health
of all residents and visitors in the state.1 The department is charged with the regulation of health
practitioners for the preservation of the health, safety, and welfare of the public. The Division of
Medical Quality Assurance (MQA) is responsible for the boards2 and professions within the
department.3 Health care practitioners licensed by the department include the following:
 Acupuncturist;4
 Allopathic physicians, physician assistants, anesthesiologist assistants, and medical
assistants;5
 Osteopathic physicians, physician assistants, and anesthesiologist assistants;6
 Chiropractic physicians and physician assistants;7
 Podiatric physicians;8
 Naturopathic physicians;9
 Optometrists;10
 Autonomous advanced practice registered nurses, advanced practice registered nurses,
registered nurses, licensed practical nurses, and certified nursing assistants;11
 Pharmacists, pharmacy interns, and pharmacy technicians;12
 Dentists, dental hygienists, and dental laboratories;13
 Midwives;14
 Speech and language pathologists;15
 Audiologists;16
1
Section 20.43, F.S.
2
Under s. 456.001(1), F.S., “board” is defined as any board, commission, or other statutorily created entity, to the extent such
entity is authorized to exercise regulatory or rulemaking functions within the department or, in some cases, within the MQA.
3
Section 20.43, F.S.
4
Chapter 457, F.S.
5
Chapter 458, F.S.
6
Chapter 459, F.S.
7
Chapter 460, F.S.
8
Chapter 461, F.S.
9
Chapter 462, F.S.
10
Chapter 463, F.S.
11
Chapter 464, F.S.
12
Chapter 465, F.S.
13
Chapter 466, F.S.
14
Chapter 467, F.S.
15
Part I, Chapter 468, F.S.
16
Id.
BILL: PCS/CS/SB 1142 (337150) Page 3
 Occupational therapists and occupational therapy assistants;17
 Respiratory therapists;18
 Dieticians and nutritionists;19
 Athletic trainers;20
 Orthotists, prosthetists, and pedorthists;21
 Electrologists;22
 Massage therapists;23
 Clinical laboratory personnel;24
 Medical physicists;25
 Opticians;26
 Hearing aid specialists;27
 Physical therapists;28
 Psychologists and school psychologists;29 and
 Clinical social workers, mental health counselors, and marriage and family therapists.30
For each profession under the jurisdiction of the department, the department appoints the board
executive director, subject to board approval.31 The duties of the boards do not include the
enlargement, modification, or contravention of the scope of practice of a profession regulated by
each board, unless expressly and specifically granted by statute, but the boards may take
disciplinary action against a licensee or issue a declaratory statement.32 Each board member is
appointed by the Governor and accountable to the Governor for the proper performance of his or
her duties as a member of a board.33
Board of Medicine (BOM)
The BOM was established to ensure that every medical doctor practicing in this state meets
minimum requirements for safe practice. The practice of medicine is a privilege granted by the
state. The BOM, through efficient and dedicated organization, is directed to license, monitor,
discipline, educate, and, when appropriate, rehabilitate physicians and other practitioners to
assure their fitness and competence.34
17
Part III, Chapter 468, F.S.
18
Part V, Chapter 468, F.S.
19
Part X, Chapter 468, F.S.
20
Part XIII, Chapter 468, F.S.
21
Part XIV, Chapter 468, F.S.
22
Chapter 478, F.S.
23
Chapter 480, F.S.
24
Part II, Chapter 483, F.S.
25
Part III, Chapter 483, F.S.
26
Part I, Chapter 484, F.S.
27
Part II, Chapter 484, F.S.
28
Chapter 486, F.S.
29
Chapter 490, F.S.
30
Chapter 491, F.S.
31
Section 456.004, F.S.
32
Section 456.003(6), F.S.
33
Section 456.008, F.S.
34
The Department of Health, Board of Medicine, available at https://flboardofmedicine.gov/ (last visited Mar. 9, 2021).
BILL: PCS/CS/SB 1142 (337150) Page 4
Board of Osteopathic Medicine (BOOM)
The BOOM was legislatively established to ensure that every osteopathic physician practicing in
this state meets minimum requirements for safe practice. The BOOM is responsible for licensing,
monitoring, disciplining, and educating osteopathic physicians to assure competency and safety
to practice in Florida.35
Board of Dentistry (BOD)
The BOD was established to ensure that every dentist and dental hygienist practicing in this state
meets minimum requirements for safe practice. The practice of the profession is a privilege
granted by the state. The BOD is responsible for licensure, monitoring and ensuring the safe
practice of dentists and dental hygienists.36
Board of Nursing (BON)
The BON licenses, monitors, disciplines, educates, and, when appropriate, rehabilitates its
licensees to assure their fitness and competence in providing health care services for the people
of Florida. The sole legislative purpose in enacting the Nurse Practice Act is to ensure that every
nurse practicing in Florida meets minimum requirements for safe practice. It is the intent of the
Legislature that nurses who fall below minimum competency or who otherwise present a danger
to the public must be prohibited from practicing in Florida.37
Section 464.015, F.S., clearly specifies the permissible nursing titles a person may use that holds
a valid nursing license in this state, or a multistate license, as follows:
 Licensed Practical Nurse – L.P.N.;
 Registered Nurse – R.N.;
 Clinical Nurse Specialist – C.N.S.;
 Certified Registered Nurse Anesthetist – C.R.N.A. or nurse anesthetist;
 Certified Nurse Midwife – C.N.M. or nurse midwife; and
 Advanced Practice Registered Nurse – A.P.R.N.
A person may not practice or advertise as a registered nurse, licensed practical nurse, clinical
nurse specialist, certified registered nurse anesthetist, certified nurse midwife, certified nurse
practitioner, or advanced practice registered nurse, or use the abbreviation R.N., L.P.N., C.N.S.,
C.R.N.A., C.N.M., C.N.P., or A.P.R.N., or take any other action that would lead the public to
believe that person was authorized by law to practice professional nursing, if the person is not
licensed as such, and to do so is a first degree misdemeanor.38
35
The Department of Health, Board of Osteopathic Medicine, available at https://floridasosteopathicmedicine.gov/ (last
visited Mar. 9, 2021).
36
The Department of Health, Board of Dentistry, available at https://floridasdentistry.gov/ (last visited Mar. 9, 2021).
37
The Department of Health, Board of Nursing, available at https://floridasnursing.gov/ (last visited Mar. 9, 2021).
38
Section 464.015, F.S.
BILL: PCS/CS/SB 1142 (337150) Page 5
Disciplinary Proceedings under Chapter 456, F.S.
Section 456.072, F.S., sets out grounds for discipline and due process that are applicable to all
licensed health care practitioners, in addition to the grounds set out in each practice act, and
includes:
 Making misleading, deceptive, or fraudulent representations in or related to the practice of
the licensee’s profession;
 Intentionally violating any board or the department rule;
 Being convicted or found guilty of, or entering a plea of guilty or nolo contendere to,
regardless of adjudication, and failing to report the violation within 30 days, including a
crime:
o Relating to practice, or ability to practice, a profession;
o Relating to Medicaid fraud; and
o Relating to health care fraud.
 Using a Class III or Class IV laser device without having complied with registration rules for
the devices;
 Failing to comply with the continuing education (CE) requirements for:
o HIV/AIDS; and
o Domestic violence.
 Having a license revoked, suspended, or acted against, including denial, or by
relinquishment, stipulation, consent order, or settlement, in any jurisdiction;
 Having been found civilly liable for knowingly filing a false report or complaint with the
department against another licensee;
 Attempting to obtain, or renewing a license by bribery, fraudulent misrepresentation, or
through the department error;
 Failing to report to the department any person who the licensee knows is in violation of ch.
456, F.S., or the chapter and rules regulating the practitioner;
 Aiding, assisting, procuring, employing, or advising a person to practice a profession without
a license;
 Failing to perform a statutory or legal obligation;
 Knowingly making or filing a false report;
 Making deceptive, untrue, or fraudulent representations in the licensee’s practice;
 Exercising undue influence on the patient for financial gain;
 Knowingly practicing beyond his or her scope of practice or is not competent to perform;
 Delegating professional responsibilities to person licensee knows is not qualified to perform;
 Violating a lawful order of the department or a board, or failing to comply with a lawfully
issued subpoena of the department;
 Improperly interfering with an investigation, inspection, or disciplinary proceeding;
 Failing to identify through written notice, that may include the wearing of a name tag, or
orally to a patient, the type of license under which the practitioner is practicing, including in
advertisements;39
 Failing to provide patients information about their rights and how to file a complaint;
 Engaging or attempting to engage in sexual misconduct;
39
This ground does not apply to a practitioner while the practitioner is providing services in a facility licensed under chs.
394, 395, 400, or 429, F.S.
BILL: PCS/CS/SB 1142 (337150) Page 6
 Failing to comply with the requirements for profiling and credentialing;
 Failing to report within 30 days that the licensee has been convicted or found guilty of, or
entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction;
 Using information from police reports, newspapers, other publications, or through a radio or
television, for commercial purposes or solicitation;
 Being unable to practice with reasonable skill and safety because of illness or use of alcohol,
drugs, narcotics, chemicals, or as a result of a mental or physical condition;
 Testing positive for any illegal drug on any pre-employment or employer-ordered screening
when the practitioner does not have a prescription;
 Performing or attempting to perform health care services on the wrong patient, wrong-site, or
an unauthorized procedure or medically unnecessary procedure;
 Leaving a foreign body in a patient;
 Violating any provision of the applicable practice act or rules;
 Intentionally submitting a Personal Injury Protection (PIP) claim, that has been “upcoded;”
 Intentionally submitting a PIP claim for services not rendered;
 Engaging in a pattern of practice when prescribing medicinal drugs or controlled substances
that demonstrates a lack of reasonable skill or safety to patients;
 Being terminated from an impaired practitioner program for failing to comply;
 Failure to comply with controlled substance prescribing requirements;
 Intentionally entering any information concerning firearm ownership into the patient’s
medical record; and
 Willfully failing to authorize emergency care or services with such frequency as to indicate a
general business practice.
The department, on behalf of the boards, investigates any complaint that is filed against a health
care practitioner if the complaint is:40
 In writing;
 Signed by the complainant;41 and
 Legally sufficient.
A complaint is legally sufficient if it contains allegations of ultimate facts that, if true, show that
a regulated practitioner has violated:
 Chapter 456, F.S.;
 His or her practice act; or
 A rule of his or her board or the department.42
The Consumer Services Unit receives the complaints and refers them to the closest Investigative
Services Unit (ISU) office. The ISU investigates complaints against health care practitioners.
Complaints that present an immediate threat to public safety are given priority; however, all
complaints are investigated as timely as possible. When the complaint is assigned to an
40
Section 456.073(1), F.S.
41
Id. The department may also investigate an anonymous complaint, or that of a confidential informant, if the complaint is in
writing and is legally sufficient, if the alleged violation of law or rules is substantial, and if the department has reason to
believe, after preliminary inquiry, that the violations alleged in the complaint are true.
42
Supra note 40.
BILL: PCS/CS/SB 1142 (337150) Page 7
investigator, the complainant will be contacted and given the opportunity to provide additional
information. A thorough investigation will be conducted. The steps taken in the investigation are
determined by