Florida Senate - 2024 SB 898 By Senator Rodriguez 40-00147B-24 2024898__ 1 A bill to be entitled 2 An act relating to naturopathic medicine; 3 redesignating the title of ch. 462, F.S., from 4 Naturopathy to Naturopathic Medicine; creating s. 5 462.001, F.S.; providing legislative findings and 6 purpose; creating s. 462.002, F.S.; providing 7 applicability and construction; renumbering and 8 amending s. 462.01, F.S.; revising and defining terms; 9 creating s. 462.004, F.S.; creating the Board of 10 Naturopathic Medicine within the Department of Health; 11 providing for membership of the board; requiring the 12 board, in conjunction with the department, to 13 establish a disciplinary training program for board 14 members; providing requirements for the program; 15 providing that board members may not participate in 16 probable cause panels or disciplinary decisions unless 17 they have completed the training program; requiring 18 board members appointed to probable cause panels to 19 attempt to complete their work on every case presented 20 to them; authorizing board members to reconvene a 21 probable cause panel under certain circumstances; 22 providing applicability; renumbering and amending s. 23 462.023, F.S.; authorizing the board to adopt rules; 24 deleting obsolete language; creating s. 462.006, F.S.; 25 prohibiting certain unlicensed persons from practicing 26 naturopathic medicine or promoting, identifying, or 27 describing themselves using specified titles or 28 abbreviations; providing construction; creating ss. 29 462.007 and 462.008, F.S.; providing for licensure by 30 examination and by endorsement, respectively, of 31 naturopathic physicians; requiring the department and 32 the board to use an investigative process to ensure 33 that applicants meet the applicable criteria; 34 authorizing the State Surgeon General or her or his 35 designee to issue a 90-day licensure delay under 36 certain circumstances; providing construction; 37 prohibiting the board from certifying for licensure 38 certain applicants until a certain investigation is 39 completed; providing applicability; prohibiting the 40 department from issuing a license to certain 41 applicants until the board has reviewed the 42 application and certified the applicant for licensure; 43 authorizing the board to enter an order imposing 44 certain sanctions against or conditions on an 45 applicant for licensure under certain circumstances; 46 renumbering and amending s. 462.08, F.S.; revising 47 requirements for licensure renewal for naturopathic 48 physicians; requiring the department to adopt rules; 49 renumbering and amending s. 462.18, F.S.; revising 50 continuing education requirements for naturopathic 51 physicians; requiring naturopathic physicians to use 52 the departments electronic continuing education 53 tracking system to demonstrate compliance with 54 continuing education requirements; renumbering and 55 amending s. 462.19, F.S.; revising provisions related 56 to reactivation of inactive naturopathic physician 57 licenses; requiring the board to adopt rules relating 58 to the reactivation of inactive licenses; providing 59 requirements for the rules; prohibiting the department 60 from reactivating a license until certain conditions 61 have been met; renumbering and amending s. 462.11, 62 F.S.; conforming a provision to changes made by the 63 act; creating s. 462.014, F.S.; requiring the board to 64 adopt rules providing for the handling of medical 65 records by licensed naturopathic physicians; providing 66 requirements for such rules; creating s. 462.015, 67 F.S.; providing financial responsibility requirements 68 as a condition of licensure for naturopathic 69 physicians; providing exemptions from such 70 requirements; requiring certain insuring entities to 71 promptly notify the department of a naturopathic 72 physicians cancellation or nonrenewal of insurance; 73 requiring the department to suspend the license of a 74 naturopathic physician under certain circumstances 75 until the licensee demonstrates compliance with 76 specified requirements; providing applicability; 77 requiring certain naturopathic physicians to provide a 78 specified notice to their patients; providing 79 requirements for the notice; providing for permanent 80 disqualification from any exemption from the financial 81 responsibility requirements, and for disciplinary 82 action, for specified conduct; requiring certain 83 naturopathic physicians to notify the department in 84 writing of any change in circumstance and demonstrate 85 compliance with certain requirements; requiring the 86 department to suspend the license of a naturopathic 87 physician under certain circumstances until certain 88 requirements are met; providing applicability; 89 requiring the board to adopt rules; renumbering and 90 amending s. 462.13, F.S.; conforming a provision to 91 changes made by the act; renumbering and amending s. 92 462.14, F.S.; revising grounds for disciplinary 93 action; providing construction; providing for 94 disciplinary actions by the board and department; 95 providing for the standard of proof in certain 96 administrative actions; providing requirements for the 97 reinstatement of a license for certain persons; 98 providing requirements for disciplinary guidelines 99 adopted by the board; providing requirements and 100 procedures for the departments receipt of certain 101 closed claims and reports involving a licensed 102 naturopathic physician; authorizing the department to 103 bring an action to enjoin a naturopathic physician 104 from providing medical services under certain 105 circumstances; requiring the department to promptly 106 furnish certain documents to a naturopathic physician 107 or her or his attorney upon undertaking an 108 investigation of the naturopathic physician; 109 authorizing a naturopathic physician who is the 110 subject of such investigation to submit a written 111 response within a specified timeframe; requiring the 112 response to be considered by the probable cause panel, 113 if held on the matter; creating s. 462.018, F.S.; 114 prohibiting licensed naturopathic physicians from 115 holding themselves out as board-certified specialists 116 unless certified by the board regulating such 117 specialty; authorizing licensed naturopathic 118 physicians to accurately indicate or state which 119 services or types of services they provide within the 120 scope of practice of naturopathic medicine; 121 renumbering and amending s. 462.17, F.S.; providing 122 criminal penalties for specified violations relating 123 to the practice of naturopathic medicine; creating s. 124 462.024, F.S.; providing that patients are responsible 125 for advising treating health care practitioners about 126 any legend drugs, nutrients, or natural medicinal 127 substances that a naturopathic physician has 128 prescribed or recommended to the patient; requiring 129 naturopathic physicians to advise their patients of 130 such responsibility; creating a rebuttable presumption 131 that certain injuries sustained by a patient are 132 caused by her or his failure to disclose such 133 information as required; providing for the rebuttal of 134 such presumption under certain circumstances; 135 providing construction; providing that a naturopathic 136 physician is not required to confirm whether a patient 137 has disclosed this information to another treating 138 health care practitioner; creating s. 462.025, F.S.; 139 establishing the Naturopathic Medical Formulary 140 Council, separate and distinct from the board; 141 providing for membership of the council; requiring the 142 council to establish the Naturopathic Medical 143 Formulary; providing requirements for the formulary; 144 requiring the council to review the formulary annually 145 and at any time upon board request; providing that 146 naturopathic physicians may prescribe, administer, and 147 dispense only those drugs included in the formulary; 148 providing construction; creating s. 462.026, F.S.; 149 providing severability; renumbering s. 462.09, F.S., 150 relating to disposition of fees; repealing s. 462.16, 151 F.S., relating to reissue of license; repealing s. 152 462.2001, F.S., relating to saving clause; amending s. 153 921.0022, F.S.; conforming a cross-reference; 154 providing an effective date. 155 156 Be It Enacted by the Legislature of the State of Florida: 157 158 Section 1.Chapter 462, Florida Statutes, entitled 159 Naturopathy, is redesignated as Naturopathic Medicine. 160 Section 2.Section 462.001, Florida Statutes, is created to 161 read: 162 462.001Legislative findings; purpose. 163 (1)The Legislature finds that a significant number of this 164 states residents choose naturopathic medicine for their health 165 care needs, and the Legislature acknowledges that naturopathic 166 medicine is a distinct health care profession that affects the 167 public health, safety, and welfare and contributes to freedom of 168 choice in health care. 169 (2)The purpose of this chapter is to provide standards for 170 the licensing and regulation of naturopathic physicians in order 171 to protect the public health, safety, and welfare; to ensure 172 that naturopathic health care provided by qualified naturopathic 173 physicians is available to residents of this state; and to 174 provide a means of identifying qualified naturopathic 175 physicians. 176 Section 3.Section 462.002, Florida Statutes, is created to 177 read: 178 462.002Exceptions. 179 (1)This chapter does not apply to: 180 (a)Other duly licensed health care practitioners acting 181 within their scopes of practice, as authorized by statute. 182 (b)Students practicing under the direct supervision of a 183 licensed naturopathic physician as part of a preceptorship 184 program while enrolled in a college or university program that 185 is accredited by, or has candidacy status with, the Council on 186 Naturopathic Medical Education or an equivalent accrediting body 187 for the naturopathic medical profession which is recognized by 188 the United States Department of Education and the board. 189 (c)Naturopathic residents practicing under the direct 190 supervision of a licensed naturopathic physician at a residency 191 site recognized by the Council on Naturopathic Medical Education 192 or by an equivalent accrediting body for the naturopathic 193 medical profession which is recognized by the United States 194 Department of Education and the board. 195 (d)The practice of the religious tenets of any church in 196 this state. 197 (e)The domestic administration of recognized family 198 remedies. 199 (2)This chapter may not be construed to prohibit any 200 service rendered by a person if such service is rendered under 201 the direct supervision and control of a licensed naturopathic 202 physician who is available if needed, provides specific 203 direction for any service to be performed, and gives final 204 approval for all services performed. 205 Section 4.Section 462.01, Florida Statutes, is renumbered 206 as section 462.003, Florida Statutes, and amended to read: 207 462.003 462.01Definitions.As used in this chapter, the 208 term: 209 (1)Board means the Board of Naturopathic Medicine 210 Natureopathy and Naturopathy shall be construed as 211 synonymous terms and mean the use and practice of psychological, 212 mechanical, and material health sciences to aid in purifying, 213 cleansing, and normalizing human tissues for the preservation or 214 restoration of health, according to the fundamental principles 215 of anatomy, physiology, and applied psychology, as may be 216 required. Naturopathic practice employs, among other agencies, 217 phytotherapy, dietetics, psychotherapy, suggestotherapy, 218 hydrotherapy, zone therapy, biochemistry, external applications, 219 electrotherapy, mechanotherapy, mechanical and electrical 220 appliances, hygiene, first aid, sanitation, and heliotherapy; 221 provided, however, that nothing in this chapter shall be held or 222 construed to authorize any naturopathic physician licensed 223 hereunder to practice materia medica or surgery or chiropractic 224 medicine, nor shall the provisions of this law in any manner 225 apply to or affect the practice of osteopathic medicine, 226 chiropractic medicine, Christian Science, or any other treatment 227 authorized and provided for by law for the cure or prevention of 228 disease and ailments. 229 (2)Department means the Department of Health. 230 (3)Division means the Division of Medical Quality 231 Assurance of the department. 232 (4)Legend drug has the same meaning as prescription 233 drug as defined in s. 499.003. 234 (5)Naturopathic doctoral degree means the Doctor of 235 Naturopathic Medicine, Doctor of Naturopathy, or Diploma of 236 Naturopathic Medicine degree, designated as N.D. or N.M.D., 237 from a college or university that is accredited by, or has 238 candidacy with, the Council on Naturopathic Medical Education or 239 an equivalent accrediting body for the naturopathic medical 240 profession which is recognized by the United States Department 241 of Education and the board. When referring to a naturopathic 242 school of medicine degree, each of these degrees must be 243 construed as equivalent to each other. 244 (6)Naturopathic Medical Formulary or formulary means 245 the Naturopathic Medical Formulary established under s. 462.025, 246 which authorizes licensed naturopathic physicians to prescribe, 247 dispense, and administer specific legend drugs that are 248 consistent with the practice of naturopathic medicine. 249 (7)Naturopathic physician means a person licensed to 250 practice naturopathic medicine under this chapter. 251 (8)Naturopathic therapeutic order means a set of 252 guidelines to help naturopathic physicians completely resolve a 253 patients symptoms and address the underlying cause while using 254 the least force necessary. 255 (9)(a)Practice of naturopathic medicine means the 256 diagnosis, prevention, treatment, and prescription of lifestyle 257 change, natural medicines, including vitamins, minerals, dietary 258 supplements, botanical medicines, medicinal fungi, and 259 homeopathic medicines, and legend drugs as specified by the 260 Naturopathic Medical Formulary established under s. 462.025 261 which are provided and administered, through the appropriate 262 route of administration, by a naturopathic physician for 263 preventative and therapeutic purposes for any human disease, 264 pain, injury, deformity, or other physical or mental condition; 265 which is based on and consistent with the naturopathic 266 educational standards and requirements of the Council on 267 Naturopathic Medical Education or an equivalent accrediting body 268 for the naturopathic medical profession which is recognized by 269 the United States Department of Education and the board; and 270 which emphasizes the importance of the principles of 271 naturopathic medicine and the naturopathic therapeutic order in 272 the maintenance and restoration of health. 273 (b)The term does not include any of the following: 274 1.Prescribing, dispensing, or administering any legend 275 drug other than those authorized under the Naturopathic Medical 276 Formulary established under s. 462.025. 277 2.Performing any surgical procedure. 278 3.Practicing or claiming to practice as a medical doctor 279 or physician, an osteopathic physician, a dentist, a podiatric 280 physician, an optometrist, a psychologist, a nurse practitioner, 281 a physician assistant, a chiropractic physician, a physical 282 therapist, an acupuncturist, a midwife, or any other health care 283 practitioner as defined in s. 456.001. 284 4.Using general or spinal anesthetics. 285 5.Administering ionizing radioactive substances. 286 6.Performing chiropractic or osteopathic adjustments or 287 manipulations that include highvelocity thrusts at or beyond 288 the end range of normal joint motion, unless the naturopathic 289 physician is also licensed as a chiropractic physician or an 290 osteopathic physician. 291 7.Performing acupuncture, unless the naturopathic 292 physician is also licensed as an acupuncturist. 293 8.Prescribing, dispensing, or administering for cosmetic 294 purposes any nonprescription drug or legend drug listed in the 295 Naturopathic Medical Formulary. 296 (10)Preceptorship program means a component of a 297 naturopathic doctoral degree program which allows naturopathic 298 medical students to observe health care practitioners while 299 attending patients, giving naturopathic medical students a wide 300 variety of experiences in different health care settings in 301 order to develop clinical knowledge, attitudes, and skills 302 relevant to the role of a naturopathic physician. 303 (11)Principles of naturopathic medicine means the 304 foundations of naturopathic medical education and practice as 305 set forth by the American Association of Naturopathic 306 Physicians, including all of the following principles: 307 (a)The healing power of nature. 308 (b)Identify and treat the causes. 309 (c)First do no harm. 310 (d)Doctor as teacher. 311 (e)Treat the whole person. 312 (f)Prevention. 313 Section 5.Section 462.004, Florida Statutes, is created to 314 read: 315 462.004Board of Naturopathic Medicine. 316 (1)There is created within the department the Board of 317 Naturopathic Medicine, composed of seven members appointed by 318 the Governor and confirmed by the Senate. 319 (2)(a)Five members of the board must be licensed 320 naturopathic physicians in good standing in this state who are 321 residents of this state. 322 (b)Two members must be residents of this state who are 323 not, and have never been, licensed health care practitioners. 324 (c)At least one member must be 55 years of age or older. 325 (3)For the purpose of staggering terms, the Governor shall 326 initially appoint to the board three members for terms of 4 327 years each, two members for terms of 3 years each, and two 328 members for terms of 2 years each. As the terms of board members 329 expire, the Governor shall appoint successors for terms of 4 330 years, and such members shall serve until their successors are 331 appointed. 332 (4)The board, in conjunction with the department, shall 333 establish a disciplinary training program for members of the 334 board. The program must provide for initial and, thereafter, 335 periodic training on the grounds for disciplinary action, the 336 actions that may be taken by the board and the department, 337 changes in relevant statutes and rules, and any relevant 338 judicial and administrative decisions. A member of the board may 339 not participate on a probable cause panel or in a disciplinary 340 decision of the board unless she or he has completed the 341 disciplinary training program. 342 (5)During the terms of service of members of the board on 343 a probable cause panel, such members shall attempt to complete 344 their work on every case presented to them. If consideration of 345 a case has begun but is not completed during the terms of 346 service of the board members on the panel, the board members may 347 reconvene as a probable cause panel for the purpose of 348 completing their deliberations on that case. 349 (6)All provisions of chapter 456 relating to activities of 350 boards apply to the board. 351 Section 6.Section 462.023, Florida Statutes, is renumbered 352 as section 462.005, Florida Statutes, and amended to read: 353 462.005 462.023Rulemaking authority; powers and duties of 354 the board department.The board department may adopt such rules 355 pursuant to ss. 120.536(1) and 120.54 to implement the 356 provisions of this chapter conferring duties upon it and as are 357 necessary to carry out the purposes of this chapter, and may 358 initiate disciplinary action as provided by this chapter, and 359 shall establish fees based on its estimates of the revenue 360 required to administer this chapter but shall not exceed the fee 361 amounts provided in this chapter. The department shall not adopt 362 any rules which would cause any person who was not licensed in 363 accordance with this chapter on July 1, 1959, and had not been a 364 resident of the state for 2 years prior to such date, to become 365 licensed. 366 Section 7.Section 462.006, Florida Statutes, is created to 367 read: 368 462.006License required.Unless licensed under this 369 chapter, a person may not practice naturopathic medicine in this 370 state and may not promote, identify, or describe himself or 371 herself as a doctor of naturopathic medicine, a naturopathic 372 doctor, a doctor of naturopathy, or a naturopathic 373 physician or use the abbreviations N.D. or N.M.D. However, 374 this section may not be construed to prohibit any person 375 licensed in this state under any other law from engaging in the 376 practice for which she or he is licensed. 377 Section 8.Section 462.007, Florida Statutes, is created to 378 read: 379 462.007Licensure by examination. 380 (1)Any person desiring to be licensed as a naturopathic 381 physician must apply to the department on forms furnished by the 382 department. The department shall license each applicant who 383 completes the application form and who the board certifies has 384 met all of the following criteria: 385 (a)Is at least 21 years of age. 386 (b)Has received a bachelors degree from one of the 387 following: 388 1.A college or university accredited by an accrediting 389 agency recognized by the United States Department of Education 390 or the Council for Higher Education Accreditation or its 391 successor entity. 392 2.A college or university in Canada which is a member of 393 Universities Canada. 394 3.A college or university in a foreign country and has 395 provided evidence that her or his educational credentials are 396 deemed equivalent to those provided in this country. To have 397 educational credentials deemed equivalent, the applicant must 398 provide her or his foreign educational credentials, including 399 transcripts, course descriptions or syllabi, and diplomas, to a 400 nationally recognized educational credential evaluating agency 401 approved by the board for the evaluation and determination of 402 equivalency of the foreign educational credentials. 403 (c)Has received a naturopathic doctoral degree from a 404 college or program accredited by the Council on Naturopathic 405 Medical Education or another accrediting agency recognized by 406 the United States Department of Education. 407 (d)Is physically and mentally fit to practice as a 408 naturopathic physician. 409 (e)Is of good moral character and has not: 410 1.Committed any act or offense in this or any other 411 jurisdiction which would constitute the basis for disciplining a 412 naturopathic physician pursuant to s. 462.017. 413 2.Had an application for licensure in any profession 414 denied or had her or his license to practice any profession 415 revoked or suspended by any other state, district, or territory 416 of the United States or another country for reasons that relate 417 to her or his ability to practice skillfully and safely as a 418 naturopathic physician. 419 3.Been found guilty of a felony. 420 421 The board and the department shall ensure that applicants for 422 licensure meet the criteria of this paragraph by independently 423 verifying the provided information through the departments 424 investigative process. 425 (f)Has submitted to the department a set of fingerprints 426 on a form and in accordance with procedures specified by the 427 department under s. 456.039(4), along with payment in an amount 428 equal to the costs incurred by the department for the criminal 429 background check of the applicant. 430 (g)Has demonstrated compliance with the financial 431 responsibility requirements imposed under s. 462.015. 432 (h)Has obtained a passing score, as determined by board 433 rule, on Part I - Biomedical Science Examination, Part II - Core 434 Clinical Science Examination, and Part II - Clinical Elective 435 Pharmacology Examination of the competency-based national 436 Naturopathic Physician Licensing Examination administered by the 437 North American Board of Naturopathic Examiners, or an equivalent 438 examination offered by an equivalent or successor entity, as 439 approved by the board. 440 (2)The department and the board shall ensure that 441 applicants for licensure satisfy applicable criteria in this 442 section through an investigative process. If the investigative 443 process is not completed within the timeframe established in s. 444 120.60(1) and the department or board has reason to believe that 445 the applicant does not meet such criteria, the State Surgeon 446 General or her or his designee may issue a 90-day licensure 447 delay, which must be in writing and sufficient to notify the 448 applicant of the reason for the delay. This subsection prevails 449 over any conflicting provisions of s. 120.60(1). 450 (3)The board may not certify to the department for 451 licensure any applicant who is under investigation in another 452 jurisdiction for an offense that would constitute a violation of 453 this chapter or chapter 456 until the investigation has been 454 completed. Upon completion of the investigation, s. 462.017 455 applies. 456 (4)(a)The department may not issue a license to any 457 individual who has committed an act or offense in any 458 jurisdiction which would constitute the basis for disciplining a 459 naturopathic physician under s. 462.017 until the board has 460 reviewed the application and certified the applicant for 461 licensure. 462 (b)If the board finds that an applicant for licensure has 463 committed an act or offense in any jurisdiction which would 464 constitute the basis for disciplining a naturopathic physician 465 under s. 462.017, the board may enter an order imposing one or 466 more of the sanctions set forth in that section and s. 467 456.072(2) as applicable to applicants for licensure, including 468 refusing to certify an application for licensure or certifying 469 an application for licensure with conditions. 470 (5)If the board determines that an applicant for licensure 471 has failed to meet, to the boards satisfaction, any of the 472 requirements of this section, it may enter an order imposing one 473 or more of the following: 474 (a)Refusal to certify to the department an application for 475 licensure. 476 (b)Certification to the department of an application for 477 licensure with restrictions on the scope of practice of the 478 naturopathic physician. 479 (c)Certification to the department of an application for 480 licensure with a probationary period for the applicant, subject 481 to such conditions as the board specifies, including, but not 482 limited to, requiring the naturopathic physician to submit to 483 treatment, attend continuing education courses, submit to 484 reexamination, or work under the supervision of another 485 naturopathic physician. 486 Section 9.Section 462.008, Florida Statutes, is created to 487 read: 488 462.008Licensure by endorsement. 489 (1)Any person licensed to practice naturopathic medicine 490 in another state or territory of the United States or in Canada 491 who desires to be licensed as a naturopathic physician in this 492 state must apply to the department on forms furnished by the 493 department. The department shall issue a license by endorsement 494 to any applicant who completes the application form and who the 495 board certifies has met all of the following criteria: 496 (a)Has met the qualifications for licensure established in 497 s. 462.007(1)(a)-(g). 498 (b)1.Has submitted evidence of holding an active license 499 to practice naturopathic medicine in another state or territory 500 of the United States or in Canada for at least the 5 years 501 immediately preceding the filing of her or his application; or 502 2.If an applicant has held an active license to practice 503 naturopathic medicine in another state or territory of the 504 United States or in Canada for less than the 5 years immediately 505 preceding the filing of her or his application, has obtained a 506 passing score on the national licensing examination, as 507 specified in s. 462.007(1)(h), within the year immediately 508 preceding the filing of the application. 509 (2)The department and the board shall ensure that 510 applicants for licensure by endorsement meet applicable criteria 511 in this section through an investigative process. When the 512 investigative process is not completed within the timeframe 513 established in s. 120.60(1) and the department or board has 514 reason to believe that the applicant does not meet the criteria, 515 the State Surgeon General or her or his designee may issue a 90 516 day licensure delay, which must be in writing and sufficient to 517 notify the applicant of the reason for the delay. This 518 subsection controls over any conflicting provisions of s. 519 120.60(1). 520 (3)The board may not certify to the department for 521 licensure by endorsement any applicant who is under 522 investigation in another jurisdiction for an offense that would 523 constitute a violation of this chapter or chapter 456 until the 524 investigation has been completed. Upon completion of the 525 investigation, s. 462.017 applies. 526 (4)(a)The department may not issue a license by 527 endorsement to any individual who has committed an act or 528 offense in any jurisdiction which would constitute the basis for 529 disciplining a naturopathic physician under s. 462.017 until the 530 board has reviewed the application and certified the applicant 531 for licensure. 532 (b)If the board finds that an applicant for licensure by 533 endorsement has committed an act or offense in any jurisdiction 534 which would constitute the basis for disciplining a naturopathic 535 physician under s. 462.017, the board may enter an order 536 imposing one or more of the sanctions set forth in that section 537 and s. 456.072(2) as applicable to applicants for licensure, 538 including refusing to certify an application for licensure or 539 certifying an application for licensure with conditions. 540 (5)If the board determines that an applicant for licensure 541 has failed to meet, to the boards satisfaction, any of the 542 requirements of this section, it may enter an order imposing one 543 or more of the following: 544 (a)Refusal to certify to the department an application for 545 licensure. 546 (b)Certification to the department of an application for 547 licensure with restrictions on the scope of practice of the 548 naturopathic physician. 549 (c)Certification to the department of an application for 550 licensure with a probationary period for the applicant, subject 551 to such conditions as the board specifies, including, but not 552 limited to, requiring the naturopathic physician to submit to 553 treatment, attend continuing education courses, submit to 554 reexamination, or work under the supervision of another 555 naturopathic physician. 556 Section 10.Section 462.08, Florida Statutes, is renumbered 557 as section 462.009, Florida Statutes, and amended to read: 558 462.009 462.08Renewal of license to practice naturopathic 559 medicine naturopathy. 560 (1)In order to continue practicing naturopathic medicine 561 in this state, each licensed naturopathic physician must 562 licenseholder shall biennially renew her or his license to 563 practice naturopathic medicine naturopathy. The applicant for 564 license renewal must furnish to the board department such 565 evidence as it requires of the applicants compliance with s. 566 462.011 s. 462.18, relating to continuing education educational 567 requirements, and s. 462.015, relating to financial 568 responsibility requirements. The biennial renewal fee, the 569 amount of which shall be determined by the department but which 570 may not exceed $1,000, must be paid at the time the application 571 for renewal of the license is filed. 572 (2)The department shall adopt rules establishing 573 procedures for the biennial renewal of licenses under this 574 chapter. 575 Section 11.Section 462.18, Florida Statutes, is renumbered 576 as section 462.011, Florida Statutes, and amended to read: 577 462.011 462.18Continuing education Educational 578 requirements. 579 (1)At the time each licensee renews shall renew her or his 580 license as otherwise provided in s. 462.009 this chapter, each 581 licensee must, in addition to the payment of the regular renewal 582 fee, shall furnish to the board department satisfactory evidence 583 that, in the preceding biennial period, the licensee has 584 completed the continuing education requirements of this section. 585 (2)The board shall require each naturopathic physician to 586 receive at least 60 hours of continuing education during each 587 biennial renewal period. 588 (a)At least 10 hours of the 60 hours of continuing 589 education must be in pharmacology, addressing the use of legend 590 drugs that are consistent with the education and training of 591 naturopathic physicians. 592 (b)The board shall approve organizations that accredit 593 naturopathic continuing education providers, including, but not 594 limited to, the American Association of Naturopathic Physicians, 595 the North American Naturopathic Continuing Education 596 Accreditation Council, and the Oregon Association of 597 Naturopathic Physicians. 598 (c)The determination of whether substitute continuing 599 education programs are permissible is solely within the 600 discretion of the board. 601 (3)The naturopathic physician must use the electronic 602 continuing education tracking system developed by the department 603 under s. 456.0361 to demonstrate compliance with the continuing 604 education requirements of this section year preceding each such 605 application for renewal, the licensee has attended the 2-day 606 educational program as promulgated and conducted by the Florida 607 Naturopathic Physicians Association, Inc., or, as a substitute 608 therefor, the equivalent of that program as approved by the 609 department. The department shall send a written notice to this 610 effect to every person holding a valid license to practice 611 naturopathy within this state at least 30 days prior to May 1 in 612 each even-numbered year, directed to the last known address of 613 such licensee, and shall enclose with the notice proper blank 614 forms for application for annual license renewal. All of the 615 details and requirements of the aforesaid educational program 616 shall be adopted and prescribed by the department. In the event 617 of national emergencies, or for sufficient reason, the 618 department shall have the power to excuse the naturopathic 619 physicians as a group or as individuals from taking this 620 postgraduate course. 621 (2)The determination of whether a substitute annual 622 educational program is necessary shall be solely within the 623 discretion of the department. 624 Section 12.Section 462.19, Florida Statutes, is renumbered 625 as section 462.012, Florida Statutes, and amended to read: 626 462.012 462.19Renewal of license; Inactive status; 627 reactivation of license. 628 (1)A licensee may reactivate an inactive license by 629 applying to the department and submitting proof of compliance 630 with the financial responsibility requirements of s. 462.015. 631 (2)The board shall adopt rules relating to reactivation of 632 licenses that have become inactive and for the renewal of 633 inactive licenses. The rules must include continuing education 634 requirements as a condition of reactivating a license. The 635 continuing education requirements for reactivating a license may 636 not be fewer than 20 classroom hours for each year the license 637 was inactive. 638 (3)The department may not reactivate a license unless the 639 financial responsibility requirements of s. 462.015 have been 640 satisfied The department shall renew a license upon receipt of 641 the renewal application and fee. 642 (2)A licensee may request that her or his license be 643 placed in an inactive status by making application to the 644 department and paying a fee in an amount set by the department 645 not to exceed $50. 646 Section 13.Section 462.11, Florida Statutes, is renumbered 647 as section 462.013, Florida Statutes, and amended to read: 648 462.013 462.11Obligations of naturopathic physicians 649 Naturopaths to observe regulations.Naturopathic physicians 650 Doctors of naturopathy shall comply with observe and are be 651 subject to all state, county, and municipal regulations relating 652 in regard to the control of contagious and infectious diseases, 653 the reporting of births and deaths, and to any and all other 654 matters pertaining to the public health in the same manner as is 655 required of other health care practitioners of the healing art. 656 Section 14.Section 462.014, Florida Statutes, is created 657 to read: 658 462.014Patient records; termination of practice.The board 659 shall adopt rules providing for the handling of medical records 660 by licensed naturopathic physicians, including when a 661 naturopathic physician sells or otherwise terminates a practice. 662 The rules must provide for notification of the naturopathic 663 physicians patients and for an opportunity for the patients to 664 request the transfer of their medical records to another 665 physician or health care practitioner upon payment of actual 666 costs for such transfer. 667 Section 15.Section 462.015, Florida Statutes, is created 668 to read: 669 462.015Financial responsibility. 670 (1)As a condition of licensure, a naturopathic physician 671 must, by one of the following methods, demonstrate to the 672 satisfaction of the board and the department that she or he has 673 the ability to pay claims and ancillary costs arising from the 674 rendering of, or the failure to render, medical care or 675 services: 676 (a)Establishing and maintaining an escrow account 677 consisting of cash or assets eligible for deposit in accordance 678 with s. 625.52 in the per-claim amounts specified in paragraph 679 (b). Expenditures may not be made from the escrow amount for 680 litigation costs or attorney fees for the defense of any medical 681 malpractice claim. 682 (b)Obtaining and maintaining professional liability 683 coverage in an amount not less than $100,000 per claim, with a 684 minimum annual aggregate of not less than $300,000, from an 685 authorized insurer as defined under s. 624.09, from an eligible 686 surplus lines insurer as defined under s. 626.914(2), from a 687 risk retention group as defined under s. 627.942, from the Joint 688 Underwriting Association operated under s. 627.351(4), or 689 through self-insurance as provided in s. 627.357. Expenditures 690 may not be made from the required coverage amount for litigation 691 costs or attorney fees for the defense of any medical 692 malpractice claim. 693 (c)Obtaining and maintaining an unexpired, irrevocable 694 letter of credit, issued pursuant to chapter 675, in an amount 695 not less than $100,000 per claim, with a minimum aggregate 696 availability of credit of not less than $300,000. The letter of 697 credit must be payable to the naturopathic physician as 698 beneficiary upon presentment of a final judgment indicating 699 liability and awarding damages to be paid by the naturopathic 700 physician or upon presentment of a settlement agreement signed 701 by all parties to such agreement when such final judgment or 702 settlement is a result of a claim arising out of the rendering 703 of, or the failure to render, medical care or services. The 704 letter of credit may not be used for litigation costs or 705 attorney fees for the defense of any medical malpractice claim. 706 The letter of credit must be nonassignable and nontransferable 707 and be issued by a bank or savings association organized and 708 existing under the laws of this state or a bank or savings 709 association organized under the laws of the United States which 710 has its principal place of business in this state or has a 711 branch office that is authorized under the laws of this state or 712 of the United States to receive deposits in this state. 713 (2)(a)Meeting the financial responsibility requirements of 714 this section or the criteria for any exemption from such 715 requirements must be demonstrated at the time of issuance, 716 renewal, or reactivation of a naturopathic physician license. 717 (b)Any person may, at any time, submit to the department a 718 request for an advisory opinion regarding such persons 719 qualifications for exemption. 720 (3)(a)Each insurer, self-insurer, or risk retention group 721 or the Joint Underwriting Association must promptly notify the 722 department of a cancellation or nonrenewal of insurance required 723 by this section. Unless the naturopathic physician demonstrates 724 that she or he is otherwise in compliance with the requirements 725 of this section, the department shall suspend the license of the 726 naturopathic physician pursuant to ss. 120.569 and 120.57 and 727 notify all health care facilities licensed under part IV of 728 chapter 394 or chapter 395 or a health maintenance organization 729 certified under part I of chapter 641 of such action. Any 730 suspension imposed under this subsection remains in effect until 731 the naturopathic physician demonstrates compliance with the 732 requirements of this section. If any judgments or settlements 733 are pending at the time of suspension, those judgments or 734 settlements must be paid in accordance with this section unless 735 otherwise mutually agreed to in writing by the parties. This 736 paragraph does not abrogate a judgment debtors obligation to 737 satisfy the entire amount of any judgment. 738 (b)If the financial responsibility requirements are met by 739 maintaining an escrow account or letter of credit as provided in 740 this section, upon the entry of an adverse final judgment 741 arising from a medical malpractice arbitration award, from a 742 claim in contract or tort of medical malpractice, or from 743 noncompliance with the terms of a settlement agreement arising 744 from a claim in contract or tort of medical malpractice, the 745 naturopathic physician must pay the entire amount of the 746 judgment together with all accrued interest or the amount 747 maintained in the escrow account or provided in the letter of 748 credit as required by this section, whichever is less, within 60 749 days after the date such judgment becomes final and subject to 750 execution, unless otherwise mutually agreed to in writing by the 751 parties. If timely payment is not made by the naturopathic 752 physician, the department must suspend the license of the 753 naturopathic physician pursuant to procedures set forth in 754 subparagraphs (4)(f)3., 4., and 5. This paragraph does not 755 abrogate a judgment debtors obligation to satisfy the entire 756 amount of any judgment. 757 (4)The requirements imposed in subsection (1) do not apply 758 to: 759 (a)Any person licensed under this chapter who practices 760 naturopathic medicine exclusively as an officer, employee, or 761 agent of the Federal Government or of the state or its agencies 762 or subdivisions. For purposes of this subsection, an agent of 763 the state, its agencies, or its subdivisions is a person who is 764 eligible for coverage under any self-insurance or insurance 765 program as provided in s. 768.28(16). 766 (b)Any person whose license has become inactive under this 767 chapter and who is not practicing naturopathic medicine in this 768 state. Any person applying for reactivation of a naturopathic 769 physician license must either: 770 1.Demonstrate that she or he maintained tail insurance 771 coverage that provided liability coverage for incidents that 772 occurred on or after the initial date of licensure in this state 773 and for incidents that occurred before the date on which the 774 license became inactive; or 775 2.Submit an affidavit stating that she or he has no 776 unsatisfied medical malpractice judgments or settlements at the 777 time of application for reactivation of the license. 778 (c)Any person licensed under this chapter who practices 779 only in conjunction with her or his teaching duties at a college 780 of naturopathic medicine. Such person may engage in the practice 781 of naturopathic medicine to the extent that such practice is 782 incidental to and a necessary part of duties in connection with 783 the teaching position in the college of naturopathic medicine. 784 (d)Any person holding an active naturopathic physician 785 license under this chapter who is not practicing naturopathic 786 medicine in this state. If such person initiates or resumes any 787 practice of naturopathic medicine in this state, she or he must 788 notify the department of such activity and fulfill the financial 789 responsibility requirements of this section before resuming the 790 practice of naturopathic medicine in this state. 791 (e)Any person holding an active naturopathic physician 792 license under this chapter who meets all of the following 793 criteria: 794 1.Has held an active license to practice naturopathic 795 medicine in this state or another state or some combination 796 thereof for more than 15 years. 797 2.Has either retired from the practice of naturopathic 798 medicine or maintains a part-time practice of naturopathic 799 medicine of no more than 1,000 patient contact hours per year. 800 3.Has had no more than two claims for medical malpractice 801 resulting in an indemnity exceeding $25,000 within the previous 802 5-year period. 803 4.Has not been convicted of, or pled guilty or nolo 804 contendere to, any criminal violation specified in this chapter 805 or the practice act of any other state. 806 5.Has not been subject, within the last 10 years of 807 practice, to license revocation or suspension for any period of 808 time, probation for a period of 3 years or longer, or a fine of 809 $500 or more for a violation of this chapter or the naturopathic 810 medical practice act of another jurisdiction. A regulatory 811 agencys acceptance of a naturopathic physicians relinquishment 812 of her or his license or of a stipulation, consent order, or 813 other settlement, offered in response to or in anticipation of 814 the filing of administrative charges against her or his license, 815 constitutes action against the naturopathic physicians license 816 for the purposes of this paragraph. 817 6.Has submitted a form supplying necessary information as 818 required by the department and an affidavit affirming compliance 819 with this paragraph. 820 7.Biennially submits to the department a certification 821 stating compliance with this paragraph. The naturopathic 822 physician must also demonstrate compliance with this paragraph 823 at any time upon department request. 824 825 A naturopathic physician who meets the requirements of this 826 paragraph must provide notice to patients, either by prominently 827 displaying a sign in the reception area of her or his practice 828 in a manner clearly visible to patients or by providing a 829 written statement to each patient to whom she or he provides 830 naturopathic medical services. The sign or statement must read 831 as follows: Under Florida law, naturopathic physicians are 832 generally required to carry medical malpractice insurance or 833 otherwise demonstrate financial responsibility to cover 834 potential claims for medical malpractice. However, certain part 835 time naturopathic physicians who meet certain criteria are 836 exempt from the financial responsibility requirements. YOUR 837 NATUROPATHIC PHYSICIAN MEETS THE EXEMPTION CRITERIA AND HAS 838 DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice 839 is provided pursuant to Florida law. 840 (f)Any person holding an active naturopathic physician 841 license under this chapter who agrees to all of the following 842 conditions: 843 1.Upon the entry of an adverse final judgment arising from 844 a medical malpractice arbitration award, from a claim of medical 845 malpractice either in contract or tort, or from noncompliance 846 with the terms of a settlement agreement arising from a claim of 847 medical malpractice either in contract or tort, the naturopathic 848 physician agrees to pay the judgment creditor the lesser of the 849 entire amount of the judgment with all accrued interest or 850 either $100,000, if the naturopathic physician is licensed 851 pursuant to this chapter but does not maintain hospital staff 852 privileges, or $250,000, if the naturopathic physician is 853 licensed pursuant to this chapter and maintains hospital staff 854 privileges, within 60 days after the date such judgment becomes 855 final and subject to execution, unless otherwise mutually agreed 856 to in writing by the parties. Such adverse final judgment must 857 include any cross-claim, counterclaim, or claim for indemnity or 858 contribution arising from the claim of medical malpractice. Upon 859 notification of the existence of an unsatisfied judgment or 860 payment pursuant to this subparagraph, the department shall 861 notify the naturopathic physician by certified mail that she or 862 he is subject to disciplinary action unless, within 30 days 863 after the date of mailing, the naturopathic physician either: 864 a.Shows proof that the unsatisfied judgment has been paid 865 in the amount specified in this subparagraph; or 866 b.Furnishes the department with a copy of a timely filed 867 notice of appeal and either: 868 (I)A copy of a supersedeas bond properly posted in the 869 amount required by law; or 870 (II)An order from a court of competent jurisdiction 871 staying execution on the final judgment, pending disposition of 872 the appeal. 873 2.The department shall issue an emergency order suspending 874 the license of any naturopathic physician who, 31 days or more 875 after receipt of a notice from the department, has failed to 876 satisfy a medical malpractice claim against him or her; furnish 877 the department a copy of a timely filed notice of appeal; 878 furnish the department a copy of a supersedeas bond properly 879 posted in the amount required by law; or furnish the department 880 an order from a court of competent jurisdiction staying 881 execution on the final judgment pending disposition of the 882 appeal. 883 3.Upon the next meeting of the probable cause panel of the 884 board 31 days or more after the date of mailing the notice of 885 disciplinary action to the naturopathic physician, the panel 886 shall make a determination as to whether probable cause exists 887 to take disciplinary action against the naturopathic physician 888 for a violation of subparagraph 1. 889 4.If the board determines that the factual requirements of 890 subparagraph 1. are met, it must take disciplinary action as it 891 deems appropriate against the naturopathic physician. Such 892 disciplinary action must include, at a minimum, probation of the 893 license with the restriction that the naturopathic physician 894 must make payments to the judgment creditor on a schedule 895 determined by the board to be reasonable and within the 896 financial capability of the naturopathic physician. 897 Notwithstanding any other disciplinary penalty imposed, the 898 disciplinary penalty may include suspension of the license for a 899 period not to exceed 5 years. In the event that an agreement to 900 satisfy a judgment has been met, the board must remove any 901 restriction on the license. 902 5.The naturopathic physician must complete a form 903 supplying necessary information as required by department rule. 904 905 A naturopathic physician who agrees to the conditions of this 906 paragraph must provide notice to patients, either by prominently 907 displaying a sign in the reception area of her or his practice 908 in a manner clearly visible to patients or by providing a 909 written statement to each patient to whom she or he provides 910 naturopathic medical services. The sign or statement must read 911 as follows: Under Florida law, naturopathic physicians are 912 generally required to carry medical malpractice insurance or 913 otherwise demonstrate financial responsibility to cover 914 potential claims for medical malpractice. However, certain part 915 time naturopathic physicians who meet certain criteria are 916 exempt from the financial responsibility requirements. YOUR 917 NATUROPATHIC PHYSICIAN MEETS THE EXEMPTION CRITERIA AND HAS 918 DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This notice 919 is provided pursuant to Florida law. 920 (5)A naturopathic physician who makes any deceptive, 921 untrue, or fraudulent representation with respect to any 922 provision of this section is permanently disqualified from any 923 exemption from financial responsibility requirements under this 924 section and is subject to disciplinary action under s. 462.017 925 for such conduct. 926 (6)Any naturopathic physician who relies on an exemption 927 from the financial responsibility requirements must notify the 928 department in writing of any change of circumstance regarding 929 her or his qualifications for such exemption and must 930 demonstrate that she or he is in compliance with the 931 requirements of this section. 932 (7)Notwithstanding any other provision of this section, 933 the department shall suspend the license of any naturopathic 934 physician against whom a final judgment, arbitration award, or 935 other order has been entered or who has entered into a 936 settlement agreement to pay damages arising out of a claim for 937 medical malpractice if all appellate remedies have been 938 exhausted and payment up to the amounts required by this section 939 has not been made within 30 days after the entering of such 940 judgment, award, or order or agreement. A suspension under this 941 subsection remains in effect until proof of payment is received 942 by the department or a payment schedule has been agreed upon by 943 the naturopathic physician and the claimant and presented to the 944 department. This subsection does not apply to a naturopathic 945 physician who has met the financial responsibility requirements 946 under paragraph (1)(b). 947 (8)The board shall adopt rules to implement this section. 948 Section 16.Section 462.13, Florida Statutes, is renumbered 949 as section 462.016, Florida Statutes, and amended to read: 950 462.016 462.13Additional powers and duties of the board 951 and the department.The board and the department may administer 952 oaths, summon witnesses, and take testimony in all matters 953 relating to their respective its duties under pursuant to this 954 chapter. Evidence of an active, Every unrevoked license must 955 shall be presumed by presumptive evidence in all courts and 956 places to be evidence that the person therein named is legally 957 licensed to practice naturopathic medicine in this state 958 naturopathy. The board and the department shall aid the 959 prosecuting attorneys of the state in the enforcement of this 960 chapter. 961 Section 17.Section 462.14, Florida Statutes, is renumbered 962 as section 462.017, Florida Statutes, and amended to read: 963 462.017 462.14Grounds for disciplinary action; action by 964 the board and department. 965 (1)The following acts constitute grounds for denial of a 966 license or disciplinary action, as specified in s. 456.072(2): 967 (a)Attempting to obtain, obtaining, or renewing a license 968 to practice naturopathic medicine by bribery, by fraudulent 969 misrepresentation, or through an error of the board or the 970 department. 971 (b)Having a license to practice naturopathic medicine 972 revoked, suspended, or otherwise acted against, including the 973 denial of licensure, by the licensing authority of another 974 state, territory, or country. The licensing authoritys 975 acceptance of a naturopathic physicians relinquishment of her 976 or his license or of a stipulation, a consent order, or other 977 settlement offered in response to or in anticipation of the 978 filing of administrative charges against her or his license 979 shall be construed as action against the naturopathic 980 physicians license. 981 (c)Being convicted or found guilty, regardless of 982 adjudication, of a crime in any jurisdiction which directly 983 relates to the practice of naturopathic medicine or to the 984 ability to practice naturopathic medicine. Any plea of nolo 985 contendere creates a rebuttable presumption of guilt to the 986 underlying criminal charges shall be considered a conviction for 987 purposes of this chapter. 988 (d)False, deceptive, or misleading advertising. 989 (e)Advertising, practicing, or attempting to practice 990 under a name other than ones own. 991 (f)Failing to report to the department or the departments 992 impaired practitioner program consultant, as applicable, any 993 person whom who the licensee knows is in violation of this 994 chapter or of the rules of the board or department. However, a 995 person whom who the licensee knows is unable to practice 996 naturopathic medicine with reasonable skill and safety to 997 patients by reason of illness or use of alcohol, drugs, 998 narcotics, chemicals, or any other type of material, or as a 999 result of a mental or physical condition, may be reported to a 1000 consultant operating an impaired practitioner program as 1001 described in s. 456.076 rather than to the department. 1002 (f)(g)Aiding, assisting, procuring, or advising any 1003 unlicensed person to practice naturopathic medicine contrary to 1004 this chapter or to a rule of the board or department. 1005 (g)(h)Failing to perform any statutory or legal obligation 1006 placed upon a licensed naturopathic physician. 1007 (h)Giving false testimony in the course of any legal or 1008 administrative proceedings relating to the practice of 1009 naturopathic medicine or the delivery of health care services. 1010 (i)Making or filing a report which the licensee knows to 1011 be false, intentionally or negligently failing to file a report 1012 or record required by state or federal law, willfully impeding 1013 or obstructing such filing or inducing another person to do so. 1014 Such reports or records must shall include only those which are 1015 signed in the capacity as a licensed naturopathic physician. 1016 (j)Paying or receiving any commission, bonus, kickback, or 1017 rebate, or engaging in any split-fee arrangement in any form 1018 whatsoever with a physician, an organization, an agency, a or 1019 person, a partnership, a firm, a corporation, or other business 1020 entity, either directly or indirectly, for patients referred to 1021 providers of health care goods and services, including, but not 1022 limited to, hospitals, nursing homes, clinical laboratories, 1023 ambulatory surgical centers, or pharmacies. The provisions of 1024 This paragraph may shall not be construed to prevent a 1025 naturopathic physician from receiving a fee for professional 1026 consultation services. 1027 (k)Refusing to provide health care based on a patients 1028 participation in pending or past litigation or participation in 1029 any disciplinary action conducted pursuant to this chapter, 1030 unless such litigation or disciplinary action directly involves 1031 the naturopathic physician requested to provide services. 1032 (l)Exercising influence within a patient-physician 1033 relationship for purposes of engaging a patient in sexual 1034 activity. A patient is shall be presumed to be incapable of 1035 giving free, full, and informed consent to sexual activity with 1036 her or his naturopathic physician. 1037 (m)(l)Making deceptive, untrue, or fraudulent 1038 representations in or related to the practice of naturopathic 1039 medicine or employing a trick or scheme in the practice of 1040 naturopathic medicine when such scheme or trick fails to conform 1041 to the generally prevailing standards of treatment in the 1042 medical community. 1043 (n)(m)Soliciting patients, either personally or through an 1044 agent, through the use of fraud, intimidation, undue influence, 1045 or a form of overreaching or vexatious conduct. A (n)Failing to keep legible, written medical records, as 1049 defined by department rule in consultation with the board, which 1050 identify by name and professional title the licensed 1051 naturopathic physician or the supervising naturopathic physician 1052 who is responsible for rendering, ordering, supervising, or 1053 billing for each diagnostic or treatment procedure and which 1054 justify justifying the course of treatment of the patient, 1055 including, but not limited to, patient histories, examination 1056 results, test results, X rays, and records of medicine 1057 prescribed, dispensed, or administered, and reports of 1058 consultations and hospitalizations the prescribing, dispensing 1059 and administering of drugs. 1060 (p)Fraudulently altering or destroying records relating to 1061 patient care or treatment, including, but not limited to, 1062 patient histories, examination results, test results, X rays, 1063 records of medicine prescribed, dispensed, or administered, and 1064 reports of consultations and hospitalizations. 1065 (q)(o)Exercising influence on the patient or client in 1066 such a manner as to exploit the patient or client for the 1067 financial gain of the licensee or of a third party, which 1068 includes shall include, but is not be limited to, the promoting 1069 or selling of services, goods, appliances, or medicines. drugs 1070 and the 1071 (r)Promoting or advertising on any prescription form of a 1072 community pharmacy unless the form also states This 1073 prescription may be filled at any pharmacy of your choice. 1074 (s)(p)Performing professional services that which have not 1075 been duly authorized by the patient or client, or her or his 1076 legal representative, except as provided in s. 743.064, s. 1077 766.103, or s. 768.13. 1078 (t)(q)Except as authorized by the Naturopathic Medical 1079 Formulary established under s. 462.025, prescribing, dispensing, 1080 administering, supplying, selling, giving, mixing, or otherwise 1081 preparing a legend drug, including any controlled substance, 1082 other than in the course of the naturopathic physicians 1083 professional practice. For the purposes of this paragraph, it is 1084 shall be legally presumed that prescribing, dispensing, 1085 administering, supplying, selling, giving, mixing, or otherwise 1086 preparing legend drugs, including all controlled substances, 1087 inappropriately or in excessive or inappropriate quantities is 1088 not in the best interest of the patient and is not in the scope 1089 course of the naturopathic physicians professional practice, 1090 regardless of without regard to her or his intent. 1091 (u)(r)Prescribing or, dispensing, or administering any 1092 legend medicinal drug appearing on any schedule set forth in 1093 chapter 893 by the naturopathic physician to herself or himself 1094 or administering any such drug to herself or himself unless such 1095 drug is, except one prescribed for, dispensed, or administered 1096 to the naturopathic physician by another practitioner authorized 1097 to prescribe legend, dispense, or administer medicinal drugs. 1098 (v)(s)Being unable to practice naturopathic medicine with 1099 reasonable skill and safety to patients by reason of illness or 1100 use of alcohol, drugs, narcotics, chemicals, or any other type 1101 of material or as a result of any mental or physical condition. 1102 In enforcing this paragraph, the department shall have, upon a 1103 showing of probable cause, has the authority to issue an order 1104 to compel a naturopathic physician to submit to a mental or 1105 physical examination by naturopathic physicians designated by 1106 the department. If the failure of a naturopathic physician 1107 refuses to comply with such order, the departments order 1108 directing submit to such an examination may be enforced by 1109 filing a petition for enforcement in the circuit court where the 1110 naturopathic physician resides or does business. The 1111 naturopathic physician against whom the petition is filed may 1112 not be named or identified by initials in any public court 1113 records or documents, and the proceedings must be closed to the 1114 public. The department is entitled to the summary procedure 1115 provided in s. 51.011 when so directed shall constitute an 1116 admission of the allegations against her or him upon which a 1117 default and final order may be entered without the taking of 1118 testimony or presentation of evidence, unless the failure was 1119 due to circumstances beyond the naturopathic physicians 1120 control. A naturopathic physician subject to an order issued 1121 affected under this paragraph must, shall at reasonable 1122 intervals, be afforded an opportunity to demonstrate that she or 1123 he can resume the competent practice of naturopathic medicine 1124 with reasonable skill and safety to patients. In any proceeding 1125 under this paragraph, neither the record of proceedings nor the 1126 orders entered by the department may be used against a 1127 naturopathic physician in any other proceeding. 1128 (w)Notwithstanding s. 456.072(2) but as specified in s. 1129 456.50(2): 1130 1.Committing medical malpractice as defined in s. 456.50. 1131 The board shall give great weight to s. 766.102 when enforcing 1132 this paragraph. Medical malpractice may not be construed to 1133 require more than one instance, event, or act. 1134 2.Committing gross medical malpractice. 1135 3.Committing repeated medical malpractice as defined in s. 1136 456.50. A person found by the board to have committed such 1137 repeated malpractice may not be licensed or continue to be 1138 licensed to provide health care services as a naturopathic 1139 physician in this state. 1140 1141 This paragraph may not be construed to require that a 1142 naturopathic physician be deemed incompetent to practice 1143 naturopathic medicine in order to be disciplined pursuant to 1144 this paragraph. A recommended order by an administrative law 1145 judge or a final order of the board finding a violation under 1146 this paragraph must specify whether the naturopathic physician 1147 was found to have committed gross medical malpractice, repeated 1148 medical malpractice, or medical malpractice, or any combination 1149 thereof, and any publication by the board must include the 1150 specified finding. 1151 (t)Gross or repeated malpractice or the failure to 1152 practice naturopathic medicine with that level of care, skill, 1153 and treatment which is recognized by a reasonably prudent 1154 similar physician as being acceptable under similar conditions 1155 and circumstances. The department shall give great weight to the 1156 provisions of s. 766.102 when enforcing this paragraph. 1157 (x)(u)Performing any procedure or prescribing any therapy 1158 that which, by the prevailing standards of medical practice in 1159 the naturopathic medical community, constitutes experimentation 1160 on a human subject, without first obtaining full, informed, and 1161 written consent. 1162 (y)(v)Practicing or offering to practice beyond the scope 1163 permitted by law or accepting and performing professional 1164 responsibilities that which the licensee knows or has reason to 1165 know that she or he is not competent to perform. The board may 1166 establish by rule standards of practice and standards of care 1167 for particular practice areas, including, but not limited to, 1168 education and training, equipment and supplies, medications as 1169 specified by the Naturopathic Medical Formulary under s. 1170 462.025, assistance from and delegation to other personnel, 1171 transfer agreements, sterilization, records, performance of 1172 complex or multiple procedures, informed consent, and policy and 1173 procedure manuals. 1174 (z)(w)Delegating professional responsibilities to a person 1175 when the licensee delegating such responsibilities knows or has 1176 reason to know that such person is not qualified by training, 1177 experience, or licensure to perform them. 1178 (aa)(x)Violating a lawful order of the board or the 1179 department previously entered in a disciplinary hearing or 1180 failing to comply with a lawfully issued subpoena of the board 1181 or department. 1182 (bb)(y)Conspiring with another licensee or with any other 1183 person to commit an act, or committing an act, which would tend 1184 to coerce, intimidate, or preclude another licensee from 1185 lawfully advertising her or his services. 1186 (cc)(z)Procuring, or aiding or abetting in the procuring 1187 of, an unlawful termination of pregnancy. 1188 (dd)(aa)Presigning blank prescription forms. 1189 (ee)Failing to adequately supervise the activities of any 1190 persons acting under the supervision of the naturopathic 1191 physician. 1192 (bb)Prescribing by the naturopathic physician for office 1193 use any medicinal drug appearing on Schedule II in chapter 893. 1194 (cc)Prescribing, ordering, dispensing, administering, 1195 supplying, selling, or giving any drug which is an amphetamine 1196 or sympathomimetic amine drug, or a compound designated pursuant 1197 to chapter 893 as a Schedule II controlled substance to or for 1198 any person except for: 1199 1.The treatment of narcolepsy; hyperkinesis; behavioral 1200 syndrome in children characterized by the developmentally 1201 inappropriate symptoms of moderate to severe distractability, 1202 short attention span, hyperactivity, emotional lability, and 1203 impulsivity; or drug-induced brain dysfunction. 1204 2.The differential diagnostic psychiatric evaluation of 1205 depression or the treatment of depression shown to be refractory 1206 to other therapeutic modalities. 1207 3.The clinical investigation of the effects of such drugs 1208 or compounds when an investigative protocol therefor is 1209 submitted to, reviewed, and approved by the department before 1210 such investigation is begun. 1211 (ff)(dd)Prescribing, ordering, dispensing, administering, 1212 supplying, selling, or giving growth hormones, testosterone or 1213 its analogs, human chorionic gonadotropin (HCG), or other 1214 hormones for the purpose of muscle building or to enhance 1215 athletic performance. For the purposes of this subsection, the 1216 term muscle building does not include the treatment of injured 1217 muscle. A prescription written for the drug products identified 1218 in this paragraph listed above may be dispensed by the 1219 pharmacist with the presumption that the prescription is for 1220 legitimate medical use. 1221 (gg)Misrepresenting or concealing a material fact at any 1222 time during any phase of a licensing or disciplinary process or 1223 procedure. 1224 (hh)Interfering with an investigation or with any 1225 disciplinary proceeding. 1226 (ii)Failing to report to the department any person 1227 licensed under chapter 458, chapter 459, or this chapter whom 1228 the naturopathic physician knows has violated the grounds for 1229 disciplinary action set out in the law under which that person 1230 is licensed and who provides health care services in a facility 1231 licensed under chapter 395, or a health maintenance organization 1232 certificated under part I of chapter 641, in which the 1233 naturopathic physician also provides services. 1234 (jj)Being found by any court in this state to have 1235 provided, without reasonable investigation, corroborating 1236 written medical expert opinion attached to any statutorily 1237 required notice of claim or intent or to any statutorily 1238 required response rejecting a claim. 1239 (kk)Except as provided in s. 462.018, advertising or 1240 holding oneself out as a board-certified specialist in violation 1241 of this chapter. 1242 (ll)Failing to comply with the requirements of ss. 381.026 1243 and 381.0261 to provide patients with information about their 1244 patient rights and how to file a patient complaint. 1245 (mm)(ee)Violating any provision of this chapter or chapter 1246 456, or any rules adopted pursuant thereto. 1247 (nn)Providing deceptive or fraudulent expert witness 1248 testimony related to the practice of naturopathic medicine. 1249 (oo)Promoting or advertising through any communication 1250 medium the use, sale, or dispensing of any controlled substance 1251 appearing on any schedule in chapter 893 which is not within the 1252 scope of the Naturopathic Medical Formulary established under s. 1253 462.025. 1254 (pp)Willfully failing to comply with s. 627.64194 or s. 1255 641.513 with such frequency as to indicate a general business 1256 practice. 1257 (2)The board department may enter an order denying 1258 licensure or imposing any of the penalties in s. 456.072(2) 1259 against any applicant for licensure or licensee who commits a 1260 violation of is found guilty of violating any provision of 1261 subsection (1) of this section or who is found guilty of 1262 violating any provision of s. 456.072(1). In determining what 1263 action is appropriate, the board must first consider which 1264 sanctions are necessary to protect the public or to compensate 1265 the patient. Only after those sanctions have been imposed may 1266 the board consider and include in the order other requirements 1267 designed to rehabilitate the naturopathic physician. All costs 1268 associated with compliance with orders issued under this 1269 subsection are the obligation of the naturopathic physician. 1270 (3)In any administrative action against a naturopathic 1271 physician which does not involve a revocation or suspension of 1272 license, the division has the burden, by the greater weight of 1273 the evidence, to establish the existence of grounds for 1274 disciplinary action. The division shall establish grounds for 1275 revocation or suspension of license by clear and convincing 1276 evidence. 1277 (4)The board may department shall not reinstate the 1278 license of a naturopathic physician or cause a license to be 1279 issued to a person it has deemed unqualified until such time as 1280 it the department is satisfied that such person has complied 1281 with all the terms and conditions set forth in the final order 1282 and that such person is capable of safely engaging in the 1283 practice of naturopathic medicine. However, the board may not 1284 issue a license to, or reinstate the license of, any person 1285 found by the board to have committed repeated medical 1286 malpractice as defined in s. 456.50, regardless of the extent to 1287 which the licensed naturopathic physician or prospective 1288 licensed naturopathic physician has complied with all terms and 1289 conditions set forth in the final order or whether she or he is 1290 capable of safely engaging in the practice of naturopathic 1291 medicine. 1292 (5)(4)The board department shall establish by rule 1293 establish guidelines for the disposition of disciplinary cases 1294 involving specific types of violations. Such guidelines must 1295 establish offenses and circumstances for which revocation will 1296 be presumed to be appropriate, as well as offenses and 1297 circumstances for which suspension for particular periods of 1298 time will be presumed to be appropriate. The guidelines must 1299 also may include minimum and maximum fines, periods of 1300 supervision or probation, or conditions of probation, and 1301 conditions for or reissuance of a license with respect to 1302 particular circumstances and offenses. Gross medical 1303 malpractice, repeated medical malpractice, and medical 1304 malpractice, respectively, as specified in paragraph (1)(w), 1305 must each be considered a distinct violation requiring specific 1306 individual guidelines. 1307 (6)Upon the departments receipt of a closed claim against 1308 a naturopathic physician submitted by an insurer or self-insurer 1309 pursuant to s. 627.912 or information reported to the Office of 1310 Insurance Regulation by a health care practitioner pursuant to 1311 s. 456.049, or receipt from a claimant of presuit notice against 1312 a naturopathic physician under s. 766.106, the department shall 1313 review such information and determine whether it potentially 1314 involves conduct by a licensed naturopathic physician which is 1315 subject to disciplinary action, in which case s. 456.073 1316 applies. However, if the department receives information that a 1317 naturopathic physician has had three or more claims filed 1318 against her or him, each with indemnities exceeding $50,000, 1319 within the previous 5-year period, the department must 1320 investigate the occurrences upon which the claims were based and 1321 determine if action by the department against the naturopathic 1322 physician is warranted. 1323 (7)Upon the departments receipt of a report from the 1324 Agency for Health Care Administration pursuant to s. 395.0197 1325 related to a naturopathic physician whose conduct may constitute 1326 grounds for disciplinary action, the department shall 1327 investigate the occurrences upon which the report was based and 1328 determine if action by the department against the naturopathic 1329 physician is warranted. 1330 (8)If any naturopathic physician commits such 1331 unprofessional conduct or negligence or demonstrates mental or 1332 physical incapacity or impairment such that the department 1333 determines that she or he is unable to practice with reasonable 1334 skill and safety and presents a danger to patients, the 1335 department may bring an action in circuit court enjoining such 1336 naturopathic physician from providing medical services to the 1337 public until the naturopathic physician demonstrates the ability 1338 to practice with reasonable skill and safety and without danger 1339 to patients. 1340 (9)(a)If an investigation of a naturopathic physician is 1341 undertaken, the department must promptly furnish to the 1342 naturopathic physician or her or his attorney a copy of the 1343 complaint or document that prompted initiation of the 1344 investigation. For purposes of this subsection, such documents 1345 include, but are not limited to: 1346 1.The pertinent portions of an annual report submitted by 1347 a licensed facility to the Agency for Health Care Administration 1348 pursuant to s. 395.0197(6). 1349 2.A report of an adverse incident which is provided by a 1350 licensed facility to the department pursuant to s. 395.0197. 1351 3.A report of peer review disciplinary action submitted to 1352 the department pursuant to s. 395.0193(4), provided that the 1353 investigations, proceedings, and records relating to such peer 1354 review disciplinary action continue to retain their privileged 1355 status even as to the naturopathic physician who is the subject 1356 of the investigation, as provided by s. 395.0193(8). 1357 4.A closed claim report submitted pursuant to s. 627.912. 1358 5.A presuit notice submitted pursuant to s. 766.106(2). 1359 6.A petition brought under the Florida Birth-Related 1360 Neurological Injury Compensation Plan pursuant to s. 766.305(2). 1361 (b)A naturopathic physician may submit to the department a 1362 written response to the information contained in the complaint 1363 or document that prompted the initiation of the investigation 1364 within 45 days after she or he receives service of such 1365 complaint or document. The naturopathic physicians written 1366 response must be considered by the probable cause panel, if held 1367 on the matter. 1368 Section 18.Section 462.018, Florida Statutes, is created 1369 to read: 1370 462.018Specialties.A naturopathic physician licensed 1371 under this chapter may not hold himself or herself out as a 1372 board-certified specialist unless the naturopathic physician has 1373 successfully completed the requirements for certification as set 1374 forth by the board regulating such specialty. A naturopathic 1375 physician may indicate the services offered and may state that 1376 her or his practice is limited to one or more types of services 1377 if it accurately reflects the scope of practice of the 1378 naturopathic physician. 1379 Section 19.Section 462.17, Florida Statutes, is renumbered 1380 as section 462.019, Florida Statutes, and amended to read: 1381 462.019 462.17Penalty for offenses relating to 1382 naturopathy.Any person who shall: 1383 (1)Each of the following acts constitutes a felony of the 1384 third degree, punishable as provided in s. 775.082, s. 775.083, 1385 or s. 775.084: 1386 (a)Practicing, or attempting to practice, naturopathic 1387 medicine without an active license issued under this chapter. 1388 (b)A licensed naturopathic physician practicing beyond the 1389 scope of practice authorized under this chapter. 1390 (c)Obtaining, or attempting to obtain, a license to 1391 practice naturopathic medicine by a knowing misrepresentation. 1392 (d)Obtaining, or attempting to obtain, a position as a 1393 naturopathic physician or naturopathic medical resident in a 1394 clinic or hospital by knowingly misrepresenting education, 1395 training, or experience. 1396 (e)Dispensing a controlled substance listed in Schedule II 1397 or Schedule III of s. 893.03 in violation of s. 465.0276. 1398 (2)Each of the following acts constitutes a misdemeanor of 1399 the first degree, punishable as provided in s. 775.082 or s. 1400 775.083: 1401 (a)Knowingly concealing information relating to violations 1402 of this chapter. 1403 (b)Making a false oath or affirmation when an oath or 1404 affirmation is required by this chapter. 1405 (3)Each of the following constitutes a misdemeanor of the 1406 second degree, punishable as provided in s. 775.082 or s. 1407 775.083: 1408 (a)Fraudulently altering, defacing, or falsifying any 1409 records relating to patient care or treatment, including, but 1410 not limited to, patient histories, examination results, and test 1411 results. 1412 (b)Referring any patient for health care goods or services 1413 to any partnership, firm, corporation, or other business entity 1414 in which the naturopathic physician or the naturopathic 1415 physicians employer has an equity interest of 10 percent or 1416 more, unless, before such referral, the naturopathic physician 1417 notifies the patient of her or his financial interest and of the 1418 patients right to obtain such goods or services at the location 1419 of the patients choice. This section does not apply to the 1420 following types of equity interest: 1421 1.The ownership of registered securities issued by a 1422 publicly held corporation or the ownership of securities issued 1423 by a publicly held corporation, the shares of which are traded 1424 on a national exchange or the over-the-counter market. 1425 2.A naturopathic physicians own practice, whether the 1426 naturopathic physician is a sole practitioner or part of a 1427 group, when the health care good or service is prescribed or 1428 provided solely for the naturopathic physicians own patients 1429 and is provided or performed by the naturopathic physician or 1430 under the naturopathic physicians supervision. 1431 3.An interest in real property resulting in a landlord 1432 tenant relationship between the naturopathic physician and the 1433 entity in which the equity interest is held, unless the rent is 1434 determined, in whole or in part, by the business volume or 1435 profitability of the tenant or is otherwise unrelated to fair 1436 market value. 1437 (c)Paying or receiving any commission, bonus, kickback, or 1438 rebate or engaging in any split-fee arrangement in any form with 1439 a physician, an organization, an agency, a person, a 1440 partnership, a firm, a corporation, or other business entity for 1441 patients referred to providers of health care goods and 1442 services, including, but not limited to, hospitals, nursing 1443 homes, clinical laboratories, ambulatory surgical centers, or 1444 pharmacies. This paragraph may not be construed to prevent a 1445 naturopathic physician from receiving a fee for professional 1446 consultation services Sell, fraudulently obtain, or furnish any 1447 naturopathic diploma, license, record, or registration or aid or 1448 abet in the same; 1449 (2)Practice naturopathy under the cover of any diploma, 1450 license, record, or registration illegally or fraudulently 1451 obtained or secured or issued unlawfully or upon fraudulent 1452 representations; 1453 (3)Advertise to practice naturopathy under a name other 1454 than her or his own or under an assumed name; 1455 (4)Falsely impersonate another practitioner of a like or 1456 different name; 1457 (5)Practice or advertise to practice naturopathy or use in 1458 connection with her or his name any designation tending to imply 1459 or to designate the person as a practitioner of naturopathy 1460 without then being lawfully licensed and authorized to practice 1461 naturopathy in this state; or 1462 (6)Practice naturopathy during the time her or his license 1463 is suspended or revoked 1464 1465 shall be guilty of a felony of the third degree, punishable as 1466 provided in s. 775.082, s. 775.083, or s. 775.084. 1467 Section 20.Section 462.024, Florida Statutes, is created 1468 to read: 1469 462.024Disclosure of medications by patients. 1470 (1)A patient who takes prescribed legend drugs consistent 1471 with the Naturopathic Medical Formulary established under s. 1472 462.025 or nutrients or other natural medicinal substances upon 1473 the recommendation of her or his treating naturopathic physician 1474 is responsible for advising any other treating health care 1475 practitioner of her or his use of such legend drugs, nutrients, 1476 or other natural medicinal substances. 1477 (2)Naturopathic physicians shall advise their patients of 1478 this requirement in writing, maintain a signed copy of a 1479 patients disclosure in the patients medical records, and 1480 provide a copy of the disclosure to their patients, upon 1481 request. 1482 (3)A patients failure to disclose her or his use of 1483 prescribed legend drugs or recommended nutrients or other 1484 natural medicinal substances to any other treating health care 1485 practitioner creates a rebuttable presumption that any 1486 subsequent related injuries sustained by the patient were caused 1487 by the patients failure to disclose such information. This 1488 presumption may be rebutted by clear and convincing evidence 1489 that the patients injuries were caused by the negligence of the 1490 other treating health care practitioner. 1491 (4)This section may not be construed to preclude a patient 1492 of a naturopathic physician from consulting with a medical 1493 physician, an osteopathic physician, or other health care 1494 practitioner. 1495 (5)A naturopathic physician is not required to confirm a 1496 patients consultation with, or disclosure to, any other health 1497 care practitioner. 1498 Section 21.Section 462.025, Florida Statutes, is created 1499 to read: 1500 462.025Naturopathic Medical Formulary Council; 1501 establishment of formulary. 1502 (1)The Naturopathic Medical Formulary Council is 1503 established, separate and distinct from the board, to be 1504 composed of five members. 1505 (a)Two members must be naturopathic physicians licensed 1506 under this chapter, appointed by the board. 1507 (b)Three members must be pharmacists licensed under 1508 chapter 465, appointed by the board from a list of nominees 1509 provided by the Board of Pharmacy. 1510 (c)Each member shall be appointed for a 3-year term; 1511 however, for the purpose of providing staggered terms, the 1512 initial appointments to the council shall be as follows: one 1513 naturopathic physician appointed for a 1-year term, one 1514 pharmacist appointed for a 2-year term, and two pharmacists and 1515 one naturopathic physician, each appointed for a 3-year term. 1516 (d)A quorum consists of three members and is required for 1517 any vote to be taken. 1518 (2)(a)The council shall establish the Naturopathic Medical 1519 Formulary of legend drugs that a licensed naturopathic physician 1520 may prescribe in the practice of naturopathic medicine. The 1521 formulary may not include drugs: 1522 1.That are inconsistent with the education and training 1523 provided by approved colleges and programs of naturopathic 1524 medicine or board-approved continuing education courses for 1525 naturopathic physicians; or 1526 2.The prescription of which requires education and 1527 training beyond that of a naturopathic physician. 1528 (b)The council shall submit the formulary to the board 1529 immediately upon adoption of, and any revision to, the 1530 formulary. The board shall adopt the formulary, and any revision 1531 thereto, by rule. 1532 (c)The council shall review the formulary at least 1533 annually and at any time upon board request. 1534 (d)A naturopathic physician may prescribe, administer, or 1535 dispense only those drugs included in the formulary adopted by 1536 the board. This section may not be construed to authorize a 1537 naturopathic physician to prescribe, administer, or dispense any 1538 controlled substance under s. 893.03 unless such substance is 1539 specifically included in the formulary. 1540 Section 22.Section 462.026, Florida Statutes, is created 1541 to read: 1542 462.026Severability.The provisions of this chapter are 1543 severable. If any provision of this chapter or its application 1544 is held invalid or unconstitutional by any court of competent 1545 jurisdiction, that invalidity or unconstitutionality does not 1546 affect other provisions or applications of this chapter which 1547 can be given effect without the invalid or unconstitutional 1548 provision or application. 1549 Section 23.Section 462.09, Florida Statutes, is renumbered 1550 as section 462.027, Florida Statutes. 1551 Section 24.Section 462.16, Florida Statutes, is repealed. 1552 Section 25.Section 462.2001, Florida Statutes, is 1553 repealed. 1554 Section 26.Paragraph (g) of subsection (3) of section 1555 921.0022, Florida Statutes, is amended to read: 1556 921.0022Criminal Punishment Code; offense severity ranking 1557 chart. 1558 (3)OFFENSE SEVERITY RANKING CHART 1559 (g)LEVEL 7 1560 1561 FloridaStatute FelonyDegree Description 1562 316.027(2)(c) 1st Accident involving death, failure to stop; leaving scene. 1563 316.193(3)(c)2. 3rd DUI resulting in serious bodily injury. 1564 316.1935(3)(b) 1st Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated. 1565 327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury. 1566 402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death. 1567 409.920(2)(b)1.a. 3rd Medicaid provider fraud; $10,000 or less. 1568 409.920(2)(b)1.b. 2nd Medicaid provider fraud; more than $10,000, but less than $50,000. 1569 456.065(2) 3rd Practicing a health care profession without a license. 1570 456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury. 1571 458.327(1) 3rd Practicing medicine without a license. 1572 459.013(1) 3rd Practicing osteopathic medicine without a license. 1573 460.411(1) 3rd Practicing chiropractic medicine without a license. 1574 461.012(1) 3rd Practicing podiatric medicine without a license. 1575 462.019 462.17 3rd Practicing naturopathic medicine naturopathy without a license. 1576 463.015(1) 3rd Practicing optometry without a license. 1577 464.016(1) 3rd Practicing nursing without a license. 1578 465.015(2) 3rd Practicing pharmacy without a license. 1579 466.026(1) 3rd Practicing dentistry or dental hygiene without a license. 1580 467.201 3rd Practicing midwifery without a license. 1581 468.366 3rd Delivering respiratory care services without a license. 1582 483.828(1) 3rd Practicing as clinical laboratory personnel without a license. 1583 483.901(7) 3rd Practicing medical physics without a license. 1584 484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription. 1585 484.053 3rd Dispensing hearing aids without a license. 1586 494.0018(2) 1st Conviction of any violation of chapter 494 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims. 1587 560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by a money services business. 1588 560.125(5)(a) 3rd Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000. 1589 655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution. 1590 775.21(10)(a) 3rd Sexual predator; failure to register; failure to renew driver license or identification card; other registration violations. 1591 775.21(10)(b) 3rd Sexual predator working where children regularly congregate. 1592 775.21(10)(g) 3rd Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator. 1593 782.051(3) 2nd Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony. 1594 782.07(1) 2nd Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter). 1595 782.071 2nd Killing of a human being or unborn child by the operation of a motor vehicle in a reckless manner (vehicular homicide). 1596 782.072 2nd Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide). 1597 784.045(1)(a)1. 2nd Aggravated battery; intentionally causing great bodily harm or disfigurement. 1598 784.045(1)(a)2. 2nd Aggravated battery; using deadly weapon. 1599 784.045(1)(b) 2nd Aggravated battery; perpetrator aware victim pregnant. 1600 784.048(4) 3rd Aggravated stalking; violation of injunction or court order. 1601 784.048(7) 3rd Aggravated stalking; violation of court order. 1602 784.07(2)(d) 1st Aggravated battery on law enforcement officer. 1603 784.074(1)(a) 1st Aggravated battery on sexually violent predators facility staff. 1604 784.08(2)(a) 1st Aggravated battery on a person 65 years of age or older. 1605 784.081(1) 1st Aggravated battery on specified official or employee. 1606 784.082(1) 1st Aggravated battery by detained person on visitor or other detainee. 1607 784.083(1) 1st Aggravated battery on code inspector. 1608 787.06(3)(a)2. 1st Human trafficking using coercion for labor and services of an adult. 1609 787.06(3)(e)2. 1st Human trafficking using coercion for labor and services by the transfer or transport of an adult from outside Florida to within the state. 1610 790.07(4) 1st Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2). 1611 790.16(1) 1st Discharge of a machine gun under specified circumstances. 1612 790.165(2) 2nd Manufacture, sell, possess, or deliver hoax bomb. 1613 790.165(3) 2nd Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony. 1614 790.166(3) 2nd Possessing, selling, using, or attempting to use a hoax weapon of mass destruction. 1615 790.166(4) 2nd Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony. 1616 790.23 1st,PBL Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04. 1617 794.08(4) 3rd Female genital mutilation; consent by a parent, guardian, or a person in custodial authority to a victim younger than 18 years of age. 1618 796.05(1) 1st Live on earnings of a prostitute; 2nd offense. 1619 796.05(1) 1st Live on earnings of a prostitute; 3rd and subsequent offense. 1620 800.04(5)(c)1. 2nd Lewd or lascivious molestation; victim younger than 12 years of age; offender younger than 18 years of age. 1621 800.04(5)(c)2. 2nd Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years of age; offender 18 years of age or older. 1622 800.04(5)(e) 1st Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years; offender 18 years or older; prior conviction for specified sex offense. 1623 806.01(2) 2nd Maliciously damage structure by fire or explosive. 1624 810.02(3)(a) 2nd Burglary of occupied dwelling; unarmed; no assault or battery. 1625 810.02(3)(b) 2nd Burglary of unoccupied dwelling; unarmed; no assault or battery. 1626 810.02(3)(d) 2nd Burglary of occupied conveyance; unarmed; no assault or battery. 1627 810.02(3)(e) 2nd Burglary of authorized emergency vehicle. 1628 812.014(2)(a)1. 1st Property stolen, valued at $100,000 or more or a semitrailer deployed by a law enforcement officer; property stolen while causing other property damage; 1st degree grand theft. 1629 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree. 1630 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree. 1631 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree. 1632 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree. 1633 812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree. 1634 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft. 1635 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft. 1636 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft. 1637 812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft. 1638 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle. 1639 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle. 1640 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle. 1641 812.014(2)(b)4. 2nd Property stolen, law enforcement equipment from authorized emergency vehicle. 1642 812.014(2)(f) 2nd Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5. 1643 812.014(2)(f) 2nd Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5. 1644 812.014(2)(f) 2nd Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5. 1645 812.014(2)(f) 2nd Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5. 1646 812.014(2)(f) 2nd Grand theft; second degree; firearm with previous conviction of s. 812.014(2)(c)5. 1647 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1648 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1649 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1650 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1651 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1652 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1653 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1654 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1655 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1656 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1657 812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more. 1658 812.019(2) 1st Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property. 1659 812.131(2)(a) 2nd Robbery by sudden snatching. 1660 812.133(2)(b) 1st Carjacking; no firearm, deadly weapon, or other weapon. 1661 817.034(4)(a)1. 1st Communications fraud, value greater than $50,000. 1662 817.234(8)(a) 2nd Solicitation of motor vehicle accident victims with intent to defraud. 1663 817.234(9) 2nd Organizing, planning, or participating in an intentional motor vehicle collision. 1664 817.234(11)(c) 1st Insurance fraud; property value $100,000 or more. 1665 817.2341(2)(b) & (3)(b) 1st Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity. 1666 817.418(2)(a) 3rd Offering for sale or advertising personal protective equipment with intent to defraud. 1667 817.504(1)(a) 3rd Offering or advertising a vaccine with intent to defraud. 1668 817.535(2)(a) 3rd Filing false lien or other unauthorized document. 1669 817.611(2)(b) 2nd Traffic in or possess 15 to 49 counterfeit credit cards or related documents. 1670 825.102(3)(b) 2nd Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement. 1671 825.103(3)(b) 2nd Exploiting an elderly person or disabled adult and property is valued at $10,000 or more, but less than $50,000. 1672 827.03(2)(b) 2nd Neglect of a child causing great bodily harm, disability, or disfigurement. 1673 827.04(3) 3rd Impregnation of a child under 16 years of age by person 21 years of age or older. 1674 837.05(2) 3rd Giving false information about alleged capital felony to a law enforcement officer. 1675 838.015 2nd Bribery. 1676 838.016 2nd Unlawful compensation or reward for official behavior. 1677 838.021(3)(a) 2nd Unlawful harm to a public servant. 1678 838.22 2nd Bid tampering. 1679 843.0855(2) 3rd Impersonation of a public officer or employee. 1680 843.0855(3) 3rd Unlawful simulation of legal process. 1681 843.0855(4) 3rd Intimidation of a public officer or employee. 1682 847.0135(3) 3rd Solicitation of a child, via a computer service, to commit an unlawful sex act. 1683 847.0135(4) 2nd Traveling to meet a minor to commit an unlawful sex act. 1684 872.06 2nd Abuse of a dead human body. 1685 874.05(2)(b) 1st Encouraging or recruiting person under 13 to join a criminal gang; second or subsequent offense. 1686 874.10 1st,PBL Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity. 1687 893.13(1)(c)1. 1st Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center. 1688 893.13(1)(e)1. 1st Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5., within 1,000 feet of property used for religious services or a specified business site. 1689 893.13(4)(a) 1st Use or hire of minor; deliver to minor other controlled substance. 1690 893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs. 1691 893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams. 1692 893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams. 1693 893.135(1)(c)2.a. 1st Trafficking in hydrocodone, 28 grams or more, less than 50 grams. 1694 893.135(1)(c)2.b. 1st Trafficking in hydrocodone, 50 grams or more, less than 100 grams. 1695 893.135(1)(c)3.a. 1st Trafficking in oxycodone, 7 grams or more, less than 14 grams. 1696 893.135(1)(c)3.b. 1st Trafficking in oxycodone, 14 grams or more, less than 25 grams. 1697 893.135(1)(c)4.b.(I) 1st Trafficking in fentanyl, 4 grams or more, less than 14 grams. 1698 893.135(1)(d)1.a. 1st Trafficking in phencyclidine, 28 grams or more, less than 200 grams. 1699 893.135(1)(e)1. 1st Trafficking in methaqualone, 200 grams or more, less than 5 kilograms. 1700 893.135(1)(f)1. 1st Trafficking in amphetamine, 14 grams or more, less than 28 grams. 1701 893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams. 1702 893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms. 1703 893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms. 1704 893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams. 1705 893.135(1)(m)2.a. 1st Trafficking in synthetic cannabinoids, 280 grams or more, less than 500 grams. 1706 893.135(1)(m)2.b. 1st Trafficking in synthetic cannabinoids, 500 grams or more, less than 1,000 grams. 1707 893.135(1)(n)2.a. 1st Trafficking in n-benzyl phenethylamines, 14 grams or more, less than 100 grams. 1708 893.1351(2) 2nd Possession of place for trafficking in or manufacturing of controlled substance. 1709 896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000. 1710 896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000. 1711 943.0435(4)(c) 2nd Sexual offender vacating permanent residence; failure to comply with reporting requirements. 1712 943.0435(8) 2nd Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements. 1713 943.0435(9)(a) 3rd Sexual offender; failure to comply with reporting requirements. 1714 943.0435(13) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender. 1715 943.0435(14) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information. 1716 944.607(9) 3rd Sexual offender; failure to comply with reporting requirements. 1717 944.607(10)(a) 3rd Sexual offender; failure to submit to the taking of a digitized photograph. 1718 944.607(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender. 1719 944.607(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information. 1720 985.4815(10) 3rd Sexual offender; failure to submit to the taking of a digitized photograph. 1721 985.4815(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender. 1722 985.4815(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information. 1723 Section 27.This act shall take effect December 31, 2024.