Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 36 No. 46, November 19, 2010 issue of the Florida Administrative Weekly.

The changes are in response to written comments submitted by the staff of the Joint Administrative Procedures Committee (JAPC). When changed, the following subsections shall read as follows:

1. Subparagraphs (2)(a) 2., 3., and 4.:

	First Offense	Subsequent Offense
2. Attempting to renew a license by bribery or fraud.	2. Revocation of the license and payment of a $10,000 fine.
3. Obtaining or renewing a license by bribery or fraud.	3. Revocation of the license and payment of a $10,000 fine.
4. Obtaining or renewing a license through error of the Department of the Board.	4. Revocation.

2. Subparagraphs (2)(b) 1. and 2.:

1. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative fine of $10,000, or in the case of application for licensure, denial of licensure.
2. Action taken against license by another jurisdiction relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. From an administrative of $10,000.00 and a reprimand through suspension of the license, or in the case of application for licensure, denial of licensure.	2. From an administrative fine of $10,000.00 and suspension of the license, followed by a period of probation to revocation, or in the case of application for licensure, denial of licensure.

3. Paragraph (2)(c):

(Section 456.072(1)(c), F.S.);

(Section 458.331(1)(c), F.S.)

1. Involving a crime directly related to healthcare fraud in dollar amounts in excess of $5,000.00.

1. Revocation, and an administrative fine of $10,000, or in the case of application for licensure, denial of licensure.

2. Involving a crime directly related to healthcare fraud in dollar amounts of $5,000.00 or less.

2. From an administrative fine of $10,000.00 and a reprimand through suspension of the license, or in case of application for licensure, denial of licensure.

2. From an administrative fine of $10,000.00 and suspension of the license, followed by a period of probation to revocation, or in case of application for licensure, denial of licensure.

4. In paragraphs (2)(d), (e), (f), and (g), the language regarding community service shall be deleted from the rule.

5. The citations in subparagraph (g)1., shall read as follows: (Section 456.013(7), F.S.); (Section 456.033, F.S.); (Section 456.072(1)(e), F.S.); (Section 456.072(1)(s), F.S.)

6. Subparagraphs (2)(h)1. and 2.:

1. Involving healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative fine of $10,000, or in the case of application for licensure, denial of licensure.
2. Involving healthcare fraud in dollar amounts of $5,000.00 or less.	2. From an administrative fine of $10,000.00 and a reprimand through suspension of the license, or in the case of application for licensure, denial of licensure.	2. From an administrative fine of $10,000.00 and suspension of the license, followed by a period of probation to revocation, or in the case of application for licensure, denial of licensure.

7. In paragraph (2)(i), the language regarding community service shall be deleted from the rule.

8. Paragraph (2)(j):

(j) Sexual misconduct.

(Section 456.072 (1)(v), F.S.);

(Section 458.329, F.S.);

(Section 458.331(1)(j), F.S.)

(j) From probation to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.

(j) From suspension, to be followed by a period of probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

9. Paragraphs (2)(k), (l), and (m):

(k) Deceptive, untrue, or fraudulent representations in the practice of medicine. (Sections 456.072(1)(a), (m), F.S.); (Section 458.331(1)(k), F.S.)	(k) From a letter of concern to revocation, or denial of licensure, and an administrative fine of $10,000.00.	(k) From probation or denial of licensure, and an administrative fine of $10,000.00 to revocation.
1. Deceptive, untrue, or fraudulent representations in the practice of medicine relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative of $10,000, or in the case of application for licensure, denial of licensure.
2. Deceptive, untrue, or fraudulent representations in the practice of medicine relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. From an administrative fine of $10,000.00 and a reprimand through suspension of the license, or in the case of application for licensure, denial of licensure.	2. From an administrative fine of $10,000.00 and suspension of the license, followed by a period of probation to revocation, or in the case of application for licensure, denial of licensure.
(l) Improper solicitation of patients. (Section 458.331(1)(l), F.S.)	(l) From an administrative fine ranging from $1,000.00 to $5,000.00, and a reprimand to probation, or denial of licensure.	(l) From suspension, to be followed by a period of probation, to revocation or denial of licensure, and an administrative fine from $2,500.00 to $5,000.00.
(m) Failure to keep legible written medical records. (Section 458.331(1)(m), F.S.)	(m) From a letter of concern to a reprimand, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.	(m) From a reprimand to suspension followed by probation and an administrative fine ranging from $2,500.00 to $5,000.00, or denial of licensure.
1. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts in excess of $5,000.00.	1. Revocation and an administrative fine of $10,000, or in the case of application for licensure, denial of licensure.
2. Failure to keep legible written medical records relating to healthcare fraud in dollar amounts of $5,000.00 or less.	2. An administrative fine of $10,000.00, and a reprimand to suspension of the license, or in the case of application for licensure, denial of licensure.	2. An administrative fine of $10.000.00, and suspension of the license, followed by a period of probation to revocation, or in the case of application for licensure, denial of licensure.

12. In paragraphs (2)(n), (o), (p), and (q), the language regarding community service shall be deleted from the rule.

13. Paragraph (2)(r):

(r) Performing of experimental treatment without informed consent.

(Section 458.331(1)(u), F.S.)

(r) From a letter of concern to suspension to be followed by a period of probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.

(r) From suspension to be followed by a period of probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

14. In paragraph (2)(t), the language regarding community service shall be deleted from the rule.

15. Subparagraph (2)(u)2.:

2. Violation of an order of the Board.

2. From a reprimand and an administrative fine of $1,000.00 to a reprimand and an administrative fine of $5,000.00.

2. From a reprimand and an administrative fine of $2,500.00 to a reprimand and an administrative fine of $5,000.00 and probation.

16. In paragraph (2)(v), the language regarding community service shall be deleted from the rule.

17. Paragraph (2)(w):

(w) Aiding an unlawful abortion.

(Section 458.331(1)(z), F.S.)

(w) From probation to revocation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.

(w) From suspension, to be followed by a period of probation, to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

18. In paragraph (2)(x), the language regarding community service shall be deleted from the rule.

19. Paragraphs (2)(y) and (z):

(y) Improper use of substances for muscle building or enhancement of athletic performance.

(Section 458.331(1)(ee), F.S.)

(y) From a reprimand to suspension, or denial of licensure, and an administrative fine ranging from $1,000.00 to $5,000.00.

(y) From suspension to be followed by a period of probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

(z) Use of amygdaline (laetrile).

(Section 458.331(1)(ff), F.S.)

(z) From a reprimand to probation, or denial of licensure, and an administrative fine ranging from $1,000.00 to $2,500.00.

(z) From suspension to be followed by a period of probation to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

20. In paragraphs (2)(aa), (bb), and (cc), the language regarding community service shall be deleted from the rule.

21. Paragraph (2)(ee):

(ee) Theft or reproduction of an examination.

(Section 456.018, F.S.)

(ee) Revocation or denial of licensure.

22. Subsections (2)(kk) and (ll):

(kk) Performing health care services on the wrong patient, wrong site, wrong procedure.

(Section 456.072(1)(bb), F.S.)

(kk) From a letter of concern, a minimum of five (5) hours of risk management education, and one (1) hour lecture on wrong-site surgery in the State of Florida, and a $1,000 fine to a $2,500.00 fine to a reprimand and probation and an administrative fine ranging from $1,000.00 to $2,500.00.

(kk) From a reprimand and probation to revocation and an administrative fine from $2,500.00 to $5,000.00.

(ll) Leaving a foreign body in a patient.

(Section 456.072(1) (cc), F.S.)

(ll) From a $1,000.00 to a $5,000.00 fine, a letter of concern, a minimum of five (5) hours of risk management education, and a one hour lecture to the staff of a Florida licensed healthcare facility on retained foreign body objects to revocation.

(ll) From a $7,500.00 fine, a reprimand and probation, or denial to revocation.

23. Paragraph (2)(oo):

(oo) Engaging in a pattern of practice when prescribing medicinal drugs or controlled substances which demonstrates a lack of reasonable skill or safety to patients.

(456.072(1)(gg), F.S.)

(oo) From reprimand to probation, and an administrative fine ranging from $1,000.00 to $5,000.00, or denial of licensure.

(oo) From probation, to revocation or denial of licensure, and an administrative fine ranging from $2,500.00 to $5,000.00.

24. The citations to Sections 459.005 and 459.023, F.S., shall be deleted from the Rulemaking Authority and Law Implemented.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joy A. Tootle, Executive Director, Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253