HB 1471 — Health Care Provider Accountability

If the agency identifies that unlicensed provideractivity ishas continued in compliance,violation of the ex parte temporary injunction, the agency shallmay dismissfile a petition for permanent injunction within 10 days after identifying the injunction.continued noncompliance at which time a full hearing shall be set as soon as practicable.

IfThe unlicensedagency activitymay, hasalong continued,with the agencyfiling mayof file a petition for permanent injunction, move for an extension of the ex parte temporary injunction withinuntil 10disposition daysof afterthe identifyingpermanent noncompliance.injunction proceedings.

The(h) agencyAn mayex alsoparte petitiontemporary toinjunction extendagainst continued unlicensed activity shall be served by the exsheriff parteof temporarythe injunctioncounty untilin which the permanentrespondent's injunctionactivities isare decided.conducted.

(g)(i) TheRemedies agencyin maythis providesubsection anyare inspectionnot recordsexclusive tobut localare lawin enforcementaddition orto aany stateother attorney'sadministrative officeor uponcriminal requestremedies andfor withoutunlicensed redaction.activity.

Section(j) 3.The agency is not required to exhaust its administrative remedies before seeking the relief provided under this subsection.

Subsection(k) (2)The ofagency section 458.328, Florida Statutes, is renumberedauthorized asto subsectionprovide (3),any paragraphs (a) and (e)all records of subsectionagency (1)inspections areto amended,local andlaw aenforcement newor subsectionstate (2)Page is5of added11 toCODING: that section, to read:

458.328 Office surgeries.— (1) REGISTRATION.— (a) An office in which a physician performs a liposuction procedure in which more than 1,000 cubic centimeters of supernatant fat is removed, a Level II office surgery, or a Level III office surgery must register with the department unless the office is licensed as a facility under chapter 390 or chapter 395.

The department must inspect any such office before Page 5of 12 CODING:

hb1471-02-c2hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471CS/HB1471 2023 registration.attorneys' offices upon request and without redaction.

TheSection department3. may not register a facility that must be licensed under chapter 390 or chapter 395.

(e)Subsection The(2) departmentof shallsection inspect458.328, aFlorida registeredStatutes, officerenumbered atas leastsubsection annually,(3), includingand a reviewnew ofsubsection patient(2) records,is added to ensure that the office is in compliance with this section andto rulesread: adopted hereunder unless the office is accredited by a nationally recognized accrediting agency approved by the board.

The458.328 inspectionOffice maysurgeries.— be(2) unannounced,STANDARD exceptOF forPRACTICE.— the(a) inspectionFor purposes of anthis officesection, that meets the descriptionterm: of a clinic specified in s.

458.3265(1)(a)3.h., and those wholly owned and operated physician offices described in s.

458.3265(1)(a)3.g.

which perform procedures referenced in s.

458.3265(1)(a)3.h., which must be announced.

The department must refuse to register a new office or must immediately suspend the registration of a registered office that refuses an inspection for 14 days.

Such office must be closed during the period of suspension.

The suspension must remain in effect until the department has completed its inspection.

(2) STANDARD OF PRACTICE.— (a) For purposes of this section, the term:

"Office surgery" means a surgery performed at an office that primarily serves as a physician's office at which a physician regularly performs consultations with surgical patients, presurgical examinations, and postoperative monitoring and care related to office surgeries and at which patient Pagerecords 6ofare 12readily CODING:maintained and available.

Words strickenare deletions;

words underlined are additions.

hb1471-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471 2023 records are readily maintained and available.

The board may not adopt by rule standards of practice that conflict with this subsection.

Require major or prolonged intracranial, intrathoracic, abdominal,Page or6of joint11 replacementCODING: procedures, except for laparoscopic procedures;

Words strickenare deletions;

words underlined are additions.

hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB1471 2023 abdominal, or joint replacement procedures, except for laparoscopic procedures;

A physician performing a gluteal fat grafting procedure must be a board-eligiblecosmetic orsurgeon board-certifiedcertified plasticby surgeon.the American Board of Cosmetic Surgery.

AAny physicianduty performingdelegated by a physician, with a patient's informed consent, to be performed during a gluteal fat grafting procedure must conductbe anperformed in-personunder examination of the patientdirect nosupervision laterof thanthe 24physician hoursperforming beforesuch the procedure.

3.

Any duty delegated by a physician, with a patient's Page 7of 12 CODING:

Words strickenare deletions;

words underlined are additions.

hb1471-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471 2023 informed consent, to be performed during a gluteal fat grafting procedure must be performed under the direct supervision of the physician performing such procedure.

4.3.

5.4.

The board may establish minimum technical standards for such ultrasound guidance.

(e)Page If7of a11 procedureCODING: in an office surgery setting results in hospitalization, the type of procedure performed and the location at which the procedure was performed, if known, must be included in the hospital intake information for the purpose of adverse incident reporting.

Section 4.

Subsection (2) of section 459.0138, Florida Statutes, is renumbered as subsection (3), paragraphs (a) and (e) of subsection (1) are amended, and a new subsection (2) is Page 8of 12 CODING:

hb1471-02-c2hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471CS/HB1471 2023 added(e) toAn thatoffice section,at towhich read:office surgeries will be performed must be inspected by the department before registration.

459.0138If Officethe surgeries.— (1) REGISTRATION.— (a) An office inrefuses whichthe apreregistration physicianinspection, performsthe a liposuction procedure in which more than 1,000 cubic centimeters of supernatant fat is removed, a Level II office surgery,may ornot abe Levelregistered IIIby office surgery must register with the department unlessuntil thecompletion officeof isan licensedinspection. as a facility under chapter 390 or chapter 395.

TheIf departmenta mustregistered inspectoffice refuses any subsequent inspection, the registration of such office beforeshall registration.be immediately suspended until completion of an inspection by the department.

The(f) departmentIf maya notprocedure registerin aan facilityoffice thatsurgery setting results in hospitalization, the type of procedure performed and the location at which the procedure was performed, if known, must be licensedincluded underin chapterthe 390hospital orintake chapterinformation 395.for the purpose of adverse incident reporting.

(e)(g) TheA departmenthealth shallcare inspectfacility athat registeredmeets officethe atdefinition least annually, including a review of patientan records,ambulatory tosurgical ensurecenter thatas thedefined office is in compliances. with this section and rules adopted hereunder unless the office is accredited by a nationally recognized accrediting agency approved by the board.

The395.002 inspectionor maya behospital unannounced,or except for the inspection of an officeabortion that meets the description of clinic specifiedas defined in s.

459.0137(1)(a)3.h.,390.011, andrespectively, thosemay whollynot ownedregister andas operatedan physicianoffice officesunder describedthis insection s.or rules adopted by the board.

459.0137(1)(a)3.g.Section 4.

whichSubsection perform(2) proceduresof referencedsection in459.0138, s.Florida Statutes, is renumbered as subsection (3), and a new subsection (2) is added to that section to read:

459.0137(1)(a)3.h.,459.0138 whichOffice mustsurgeries.— be(2) announced.STANDARD OF PRACTICE.— (a) For purposes of this section, the term:

The1. department must refuse to register a new office or immediately suspend the registration of a registered office that refuses an inspection for 14 days.

Such"Office surgery" means a surgery performed at an office mustthat beprimarily closedserves duringas thea periodphysician's ofoffice suspension.at which a Page 8of 11 CODING:

The suspension must Page 9of 12 CODING:

hb1471-02-c2hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471CS/HB1471 2023 remainphysician inperforms effectsurgeries untilas thepermitted departmentunder hasthis completedsection. its inspection.

(2) STANDARD OF PRACTICE.— (a) For purposes of this section, the term:

1.

"Office surgery" means a surgery performed at an office that primarily serves as a physician's office at which a physician performs surgeries as permitted under this section.

The board may not adopt by rule standards of practice that conflict with this subsection.

Page3. 10 of12 CODING:

Words strickenare deletions;

words underlined are additions.

hb1471-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471 2023 3.

A physician performing a gluteal fat grafting procedurePage must9of be11 aCODING: board-eligible or board-certified plastic surgeon.

Words strickenare deletions;

words underlined are additions.

hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB1471 2023 procedure must be a cosmetic surgeon certified by the American Board of Cosmetic Surgery.

A physician performing a gluteal fat grafting procedure must conduct an in-person examination of the patient no later than 24 hours before the procedure.

3.

4.3.

5.4.

TheUltrasound boardguidance mayis establishnot Pagerequired 11for of12other CODING:portions of such procedure.

(e) An office at which office surgeries will be performed must be inspected by the department before registration.

If the office refuses the preregistration inspection, the office may not be registered by the department until completion of an inspection.

If a registered office refuses any subsequent inspection, the registration of such office shall be immediately suspended until completion of an inspection by the department.

Page 10 of11 CODING:

hb1471-02-c2hb1471-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB1471CS/HB1471 2023 minimum(f) technicalIf standardsa procedure in an office surgery setting results in hospitalization, the type of procedure performed and the location at which the procedure was performed, if known, must be included in the hospital intake information for suchthe ultrasoundpurpose guidance.of adverse incident reporting.

Ultrasound(g) guidanceA ishealth notcare requiredfacility forthat othermeets portionsthe definition of suchan procedure.ambulatory surgical center in s.

(e)395.002 Ifor a procedurehospital inor an officeabortion surgeryclinic settingas resultsdefined in hospitalization,s. the type of procedure performed and the location at which the procedure was performed, if known, must be included in the hospital intake information for the purpose of adverse incident reporting.

390.011, respectively, may not register as an office under this section or rules adopted by the board.

Page 1211 of12of11 CODING:

hb1471-02-c2hb1471-01-c1