HB 1561 — Office Surgeries

Nothing in This paragraph does not shall abrogate a judgment debtor's obligation to satisfy the entire amount of any judgment.

(6)(5) The requirements of subsections (1), (2), and (3), and (4) do not apply to:

(a) Any person licensed under this chapter who practices medicine exclusively as an officer, employee, or agent of the Federal Government or of the state or its agencies or its subdivisions.

For the purposes of this subsection, an agent of the state, its agencies, or its subdivisions is a person who is eligible for coverage under any self-insurance or insurance program authorized by the provisions of s.

768.28(16).

(b) Any person whose license has become inactive under this chapter and who is not practicing medicine in this state.

Any person applying for reactivation of a license must show either that such licensee maintained tail insurance coverage which provided liability coverage for incidents that occurred on or after January 1, 1987, or the initial date of licensure in this state, whichever is later, and incidents that occurred before the date on which the license became inactive;

or such licensee must submit an affidavit stating that such licensee has no unsatisfied medical malpractice judgments or settlements at Page 4of 29 CODING:

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hb1561-01-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/HB1561 2024 the time of application for reactivation.

(c) Any person holding a limited license pursuant to s.

458.317 and practicing under the scope of such limited license.

(d) Any person licensed or certified under this chapter who practices only in conjunction with his or her teaching duties at an accredited medical school or in its main teaching hospitals.

Such person may engage in the practice of medicine to the extent that such practice is incidental to and a necessary part of duties in connection with the teaching position in the medical school.

(e) Any person holding an active license under this chapter who is not practicing medicine in this state.

If such person initiates or resumes any practice of medicine in this state, he or she must notify the department of such activity and fulfill the financial responsibility requirements of this section before resuming the practice of medicine in this state.

(f) Any person holding an active license under this chapter who meets all of the following criteria:

1.

The licensee has held an active license to practice in this state or another state or some combination thereof for more than 15 years.

2.

The licensee has either retired from the practice of medicine or maintains a part-time practice of no more than 1,000 patient contact hours per year.

3.

The licensee has had no more than two claims for Page 5of 29 CODING:

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hb1561-01-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/HB1561 2024 medical malpractice resulting in an indemnity exceeding $25,000 within the previous 5-year period.

4.

The licensee has not been convicted of, or pled guilty or nolo contendere to, any criminal violation specified in this chapter or the medical practice act of any other state.

5.

The licensee has not been subject within the last 10 years of practice to license revocation or suspension for any period of time;

probation for a period of 3 years or longer;

or a fine of $500 or more for a violation of this chapter or the medical practice act of another jurisdiction.

The regulatory agency's acceptance of a physician's relinquishment of a license, stipulation, consent order, or other settlement, offered in response to or in anticipation of the filing of administrative charges against the physician's license, constitutes action against the physician's license for the purposes of this paragraph.

6.

The licensee has submitted a form supplying necessary information as required by the department and an affidavit affirming compliance with this paragraph.

7.

The licensee must submit biennially to the department certification stating compliance with the provisions of this paragraph.

The licensee must, upon request, demonstrate to the department information verifying compliance with this paragraph.

A licensee who meets the requirements of this paragraph must Page 6of 29 CODING:

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hb1561-01-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/HB1561 2024 post notice in the form of a sign prominently displayed in the reception area and clearly noticeable by all patients or provide a written statement to any person to whom medical services are being provided.

The sign or statement must read as follows:

"Under Florida law, physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice.

However, certain part-time physicians who meet state requirements are exempt from the financial responsibility law.

YOUR DOCTOR MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE.

This notice is provided pursuant to Florida law." (g) Any person holding an active license under this chapter who agrees to meet all of the following criteria:

1.

Upon the entry of an adverse final judgment arising from a medical malpractice arbitration award, from a claim of medical malpractice either in contract or tort, or from noncompliance with the terms of a settlement agreement arising from a claim of medical malpractice either in contract or tort, the licensee shall pay the judgment creditor the lesser of the entire amount of the judgment with all accrued interest or either $100,000, if the physician is licensed pursuant to this chapter but does not maintain hospital staff privileges, or $250,000, if the physician is licensed pursuant to this chapter and maintains hospital staff privileges, within 60 days after Page 7of 29 CODING:

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hb1561-01-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/HB1561 2024 the date such judgment became final and subject to execution, unless otherwise mutually agreed to in writing by the parties.

Such adverse final judgment shall include any cross-claim, counterclaim, or claim for indemnity or contribution arising from the claim of medical malpractice.

Upon notification of the existence of an unsatisfied judgment or payment pursuant to this subparagraph, the department shall notify the licensee by certified mail that he or she shall be subject to disciplinary action unless, within 30 days from the date of mailing, he or she either:

a.

Shows proof that the unsatisfied judgment has been paid in the amount specified in this subparagraph;

or b.

Furnishes the department with a copy of a timely filed notice of appeal and either:

(I) A copy of a supersedeas bond properly posted in the amount required by law;

or (II) An order from a court of competent jurisdiction staying execution on the final judgment pending disposition of the appeal.

2.

The Department of Health shall issue an emergency order suspending the license of any licensee who, after 30 days following receipt of a notice from the Department of Health, has failed to:

satisfy a medical malpractice claim against him or her;

furnish the Department of Health a copy of a timely filed notice of appeal;

furnish the Department of Health a copy of a Page 8of 29 CODING:

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hb1561-01-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/HB1561 2024 supersedeas bond properly posted in the amount required by law;

or furnish the Department of Health an order from a court of competent jurisdiction staying execution on the final judgment pending disposition of the appeal.

3.

Upon the next meeting of the probable cause panel of the board following 30 days after the date of mailing the notice of disciplinary action to the licensee, the panel shall make a determination of whether probable cause exists to take disciplinary action against the licensee pursuant to subparagraph 1.

4.

If the board determines that the factual requirements of subparagraph 1.

are met, it shall take disciplinary action as it deems appropriate against the licensee.

Such disciplinary action shall include, at a minimum, probation of the license with the restriction that the licensee must make payments to the judgment creditor on a schedule determined by the board to be reasonable and within the financial capability of the physician.

Notwithstanding any other disciplinary penalty imposed, the disciplinary penalty may include suspension of the license for a period not to exceed 5 years.

In the event that an agreement to satisfy a judgment has been met, the board shall remove any restriction on the license.

5.

The licensee has completed a form supplying necessary information as required by the department.

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hb1561-01-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/HB1561 2024 A licensee who meets the requirements of this paragraph shall be required either to post notice in the form of a sign prominently displayed in the reception area and clearly noticeable by all patients or to provide a written statement to any person to whom medical services are being provided.

Such sign or statement shall state:

"Under Florida law, physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice.

YOUR DOCTOR HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE.

This is permitted under Florida law subject to certain conditions.

Florida law imposes penalties against noninsured physicians who fail to satisfy adverse judgments arising from claims of medical malpractice.

This notice is provided pursuant to Florida law." Section 2.

Paragraph (i) of subsection (1) of section 458.328, Florida Statutes, is redesignated as paragraph (h), and present paragraphs (a), (b), and (h) of subsection (1) and subsection (2) of that section are amended to read:

An office in which a physician performs a liposuction procedure in which more than 1,000 cubic centimeters of supernatant fat is temporarily or permanently removed, a Level II office surgery, or a Level III office surgery must Pageregister 1ofwith 11the CODING:department.

unless the office is licensed as A Page 10 of29 CODING:

hb1561-02-e1hb1561-01-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/HB156,CS/HB1561 Engrossed2024 1facility 2024licensed registerunder withchapter the390 department.or chapter 395 may not be registered under this section.

unless the office is licensed as A facility licensed under chapter 390 or chapter 395 may not be registered under this section.

(c) As a condition of registration, each office must establish financial responsibility by demonstrating that it has met and continues to maintain, at a minimum, the same requirements applicable to physicians in ss.

458.320 and 459.0085.

An office in which a physician performs a gluteal fat grafting procedure must also establish financial responsibility Page 2of 11 CODING:

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hb1561-02-e1 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/HB156, Engrossed 1 2024 by demonstrating that it has met and continues to maintain, at a minimum, the same requirements applicable to physicians in ss.

458.320(2)(b) or (c) and 459.0085(2)(b) or (c), as applicable.

Each physician practicing at an office registered under this section or s.

459.0138 must meet the financial responsibility requirements under s.

458.320 or s.

459.0085, as applicable.

(2) STANDARDS OF PRACTICE.— (a) A physician may not perform any surgery or procedure identifiedPage in11 paragraphof29 (1)(a)CODING: in a setting other than an office surgery setting registered under this section or a facility licensed under chapter 390 or chapter 395, as applicable.

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hb1561-01-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/HB1561 2024 identified in paragraph (1)(a) in a setting other than an office surgery setting registered under this section or a facility licensed under chapter 390 or chapter 395, as applicable.

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hb1561-02-e1 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/HB15, Engrossed 1 2024 2.

A physician performing a gluteal fat grafting procedure must conduct an in-person examination of the patient while physicallyPage present12 inof29 theCODING: same room as the patient no later than the day before the procedure.

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hb1561-01-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/HB1561 2024 physically present in the same room as the patient no later than the day before the procedure.

Fat may only be injected into the subcutaneous space of the patient and may not cross the fascia overlying the gluteal Pagemuscle. 4of 11 CODING:

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hb1561-02-e1 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/HB15, Engrossed 1 2024 muscle.

An office in which a physician performs gluteal fat graftingPage procedures13 mustof29 atCODING: all times maintain a ratio of one physician to one patient during all phases of the procedure, beginning with the administration of anesthesia to the patient and concluding with the extubation of the patient.

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hb1561-01-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/HB1561 2024 grafting procedures must at all times maintain a ratio of one physician to one patient during all phases of the procedure, beginning with the administration of anesthesia to the patient and concluding with the extubation of the patient.

(e) An office in which a physician performs gluteal fat Pagegrafting 5ofprocedures 11must CODING:at all times maintain a ratio of one physician to one patient during all phases of the procedure, beginning with the administration of anesthesia to the patient and concluding with the extubation of the patient.

After a physician has commenced, and while he or she is engaged in, a gluteal fat grafting procedure, the physician may not commence or engage in another gluteal fat grafting procedure or any other procedure with another patient at the same time.

Section 3.

Subsections (3) through (10) of section 459.0085, Florida Statutes, are renumbered as subsections (4) through (11), respectively, paragraph (b) of present subsection (4) and present subsection (5) are amended, and a new subsection (3) is added to that section, to read:

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hb1561-02-e1hb1561-01-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/HB15,CS/HB1561 Engrossed 1 2024 grafting459.0085 proceduresFinancial mustresponsibility.— at(3) allA timesphysician maintainperforming a ratiogluteal offat onegrafting physicianprocedure toin onean patientoffice duringsurgery allsetting phasesregistered ofunder thes. procedure, beginning with the administration of anesthesia to the patient and concluding with the extubation of the patient.

After459.0138 amust physicianalso hasestablish commenced,financial andresponsibility whileby heeither orof she is engaged in, a gluteal fat grafting procedure, the physicianfollowing maymethods: not commence or engage in another gluteal fat grafting procedure or any other procedure with another patient at the same time.

Section(a) 2.Obtaining and maintaining professional liability coverage in an amount not less than $250,000 per claim, with a minimum annual aggregate of not less than $750,000, from an authorized insurer as defined in s.

Paragraphs624.09, (a),from (b),an (c),eligible andsurplus (h)lines ofinsurer subsectionas (1)defined andin subsections. (2) of section 459.0138, Florida Statutes, are amended to read:

626.914(2), from a risk retention group as defined in s.

627.942, from the Joint Underwriting Association established under s.

627.351(4), through a plan of self-insurance as provided in s.

627.357, or through a plan of self-insurance which meets the conditions specified for satisfying financial responsibility in s.

766.110.

The required coverage amount set forth in this subsection may not be used for litigation costs or attorney fees for the defense of any medical malpractice claim;

or (b) Obtaining and maintaining an unexpired irrevocable letter of credit, established pursuant to chapter 675, in an amount not less than $250,000 per claim, with a minimum aggregate availability of credit of not less than $750,000.

The letter of credit must be payable to the physician as beneficiary upon presentment of a final judgment indicating liability and awarding damages to be paid by the physician or upon presentment Page 15 of29 CODING:

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hb1561-01-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/HB1561 2024 of a settlement agreement signed by all parties to such agreement when such final judgment or settlement is a result of a claim arising out of the rendering of, or the failure to render, medical care and services.

The letter of credit may not be used for litigation costs or attorney fees for the defense of any medical malpractice claim.

The letter of credit must be nonassignable and nontransferable.

The letter of credit must be issued by any bank or savings association organized and existing under the laws of this state or any bank or savings association organized under the laws of the United States which has its principal place of business in this state or has a branch office that is authorized under the laws of this state or of the United States to receive deposits in this state.

The exemption under paragraph (6)(f) does not apply to this subsection.

This subsection shall be inclusive of the coverage in subsection (1).

(5)(4) (b) If financial responsibility requirements are met by maintaining an escrow account or letter of credit as provided in this section, upon the entry of an adverse final judgment arising from a medical malpractice arbitration award, from a claim of medical malpractice either in contract or tort, or from noncompliance with the terms of a settlement agreement arising from a claim of medical malpractice either in contract or tort, Page 16 of29 CODING:

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hb1561-01-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/HB1561 2024 the licensee shall pay the entire amount of the judgment together with all accrued interest or the amount maintained in the escrow account or provided in the letter of credit as required by this section, whichever is less, within 60 days after the date such judgment became final and subject to execution, unless otherwise mutually agreed to in writing by the parties.

If timely payment is not made by the osteopathic physician, the department shall suspend the license of the osteopathic physician pursuant to procedures set forth in subparagraphs (6)(g)3., 4., and 5.

subparagraphs (5)(g)3., 4., and 5.

Nothing in This paragraph does not shall abrogate a judgment debtor's obligation to satisfy the entire amount of any judgment.

(6)(5) The requirements of subsections (1), (2), and (3), and (4) do not apply to:

(a) Any person licensed under this chapter who practices medicine exclusively as an officer, employee, or agent of the Federal Government or of the state or its agencies or its subdivisions.

For the purposes of this subsection, an agent of the state, its agencies, or its subdivisions is a person who is eligible for coverage under any self-insurance or insurance program authorized by the provisions of s.

768.28(16).

(b) Any person whose license has become inactive under this chapter and who is not practicing medicine in this state.

Any person applying for reactivation of a license must show Page 17 of29 CODING:

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hb1561-01-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/HB1561 2024 either that such licensee maintained tail insurance coverage that provided liability coverage for incidents that occurred on or after January 1, 1987, or the initial date of licensure in this state, whichever is later, and incidents that occurred before the date on which the license became inactive;

or such licensee must submit an affidavit stating that such licensee has no unsatisfied medical malpractice judgments or settlements at the time of application for reactivation.

(c) Any person holding a limited license pursuant to s.

459.0075 and practicing under the scope of such limited license.

(d) Any person licensed or certified under this chapter who practices only in conjunction with his or her teaching duties at a college of osteopathic medicine.

Such person may engage in the practice of osteopathic medicine to the extent that such practice is incidental to and a necessary part of duties in connection with the teaching position in the college of osteopathic medicine.

(e) Any person holding an active license under this chapter who is not practicing osteopathic medicine in this state.

If such person initiates or resumes any practice of osteopathic medicine in this state, he or she must notify the department of such activity and fulfill the financial responsibility requirements of this section before resuming the practice of osteopathic medicine in this state.

(f) Any person holding an active license under this Page 18 of29 CODING:

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hb1561-01-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/HB1561 2024 chapter who meets all of the following criteria:

1.

The licensee has held an active license to practice in this state or another state or some combination thereof for more than 15 years.

2.

The licensee has either retired from the practice of osteopathic medicine or maintains a part-time practice of osteopathic medicine of no more than 1,000 patient contact hours per year.

3.

The licensee has had no more than two claims for medical malpractice resulting in an indemnity exceeding $25,000 within the previous 5-year period.

4.

The licensee has not been convicted of, or pled guilty or nolo contendere to, any criminal violation specified in this chapter or the practice act of any other state.

5.

The licensee has not been subject within the last 10 years of practice to license revocation or suspension for any period of time, probation for a period of 3 years or longer, or a fine of $500 or more for a violation of this chapter or the medical practice act of another jurisdiction.

The regulatory agency's acceptance of an osteopathic physician's relinquishment of a license, stipulation, consent order, or other settlement, offered in response to or in anticipation of the filing of administrative charges against the osteopathic physician's license, constitutes action against the physician's license for the purposes of this paragraph.

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hb1561-01-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/HB1561 2024 6.

The licensee has submitted a form supplying necessary information as required by the department and an affidavit affirming compliance with this paragraph.

7.

The licensee must submit biennially to the department a certification stating compliance with this paragraph.

The licensee must, upon request, demonstrate to the department information verifying compliance with this paragraph.

A licensee who meets the requirements of this paragraph must post notice in the form of a sign prominently displayed in the reception area and clearly noticeable by all patients or provide a written statement to any person to whom medical services are being provided.

The sign or statement must read as follows:

"Under Florida law, osteopathic physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice.

However, certain part-time osteopathic physicians who meet state requirements are exempt from the financial responsibility law.

YOUR OSTEOPATHIC PHYSICIAN MEETS THESE REQUIREMENTS AND HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE.

This notice is provided pursuant to Florida law." (g) Any person holding an active license under this chapter who agrees to meet all of the following criteria.

1.

Upon the entry of an adverse final judgment arising Page 20 of29 CODING:

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hb1561-01-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/HB1561 2024 from a medical malpractice arbitration award, from a claim of medical malpractice either in contract or tort, or from noncompliance with the terms of a settlement agreement arising from a claim of medical malpractice either in contract or tort, the licensee shall pay the judgment creditor the lesser of the entire amount of the judgment with all accrued interest or either $100,000, if the osteopathic physician is licensed pursuant to this chapter but does not maintain hospital staff privileges, or $250,000, if the osteopathic physician is licensed pursuant to this chapter and maintains hospital staff privileges, within 60 days after the date such judgment became final and subject to execution, unless otherwise mutually agreed to in writing by the parties.

Such adverse final judgment shall include any cross-claim, counterclaim, or claim for indemnity or contribution arising from the claim of medical malpractice.

Upon notification of the existence of an unsatisfied judgment or payment pursuant to this subparagraph, the department shall notify the licensee by certified mail that he or she shall be subject to disciplinary action unless, within 30 days from the date of mailing, the licensee either:

a.

Shows proof that the unsatisfied judgment has been paid in the amount specified in this subparagraph;

or b.

Furnishes the department with a copy of a timely filed notice of appeal and either:

(I) A copy of a supersedeas bond properly posted in the Page 21 of29 CODING:

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hb1561-01-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/HB1561 2024 amount required by law;

or (II) An order from a court of competent jurisdiction staying execution on the final judgment, pending disposition of the appeal.

2.

The Department of Health shall issue an emergency order suspending the license of any licensee who, after 30 days following receipt of a notice from the Department of Health, has failed to:

satisfy a medical malpractice claim against him or her;

furnish the Department of Health a copy of a timely filed notice of appeal;

furnish the Department of Health a copy of a supersedeas bond properly posted in the amount required by law;

or furnish the Department of Health an order from a court of competent jurisdiction staying execution on the final judgment pending disposition of the appeal.

3.

Upon the next meeting of the probable cause panel of the board following 30 days after the date of mailing the notice of disciplinary action to the licensee, the panel shall make a determination of whether probable cause exists to take disciplinary action against the licensee pursuant to subparagraph 1.

4.

If the board determines that the factual requirements of subparagraph 1.

are met, it shall take disciplinary action as it deems appropriate against the licensee.

Such disciplinary action shall include, at a minimum, probation of the license with the restriction that the licensee must make payments to the Page 22 of29 CODING:

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hb1561-01-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/HB1561 2024 judgment creditor on a schedule determined by the board to be reasonable and within the financial capability of the osteopathic physician.

Notwithstanding any other disciplinary penalty imposed, the disciplinary penalty may include suspension of the license for a period not to exceed 5 years.

In the event that an agreement to satisfy a judgment has been met, the board shall remove any restriction on the license.

5.

The licensee has completed a form supplying necessary information as required by the department.

A licensee who meets the requirements of this paragraph shall be required either to post notice in the form of a sign prominently displayed in the reception area and clearly noticeable by all patients or to provide a written statement to any person to whom medical services are being provided.

Such sign or statement shall state:

"Under Florida law, osteopathic physicians are generally required to carry medical malpractice insurance or otherwise demonstrate financial responsibility to cover potential claims for medical malpractice.

YOUR OSTEOPATHIC PHYSICIAN HAS DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE.

This is permitted under Florida law subject to certain conditions.

Florida law imposes strict penalties against noninsured osteopathic physicians who fail to satisfy adverse judgments arising from claims of medical malpractice.

This notice is provided pursuant to Florida law." Page 23 of29 CODING:

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hb1561-01-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/HB1561 2024 Section 4.

Paragraph (i) of subsection (1) of section 459.0138, Florida Statutes, is redesignated as paragraph (h), and present paragraphs (a), (b), and (h) of subsection (1) and subsection (2) of that section are amended to read:

458.328 must designate a physician who is Pageresponsible 6offor 11the CODING:office's compliance with the office health and safety requirements of this section and rules adopted hereunder.

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hb1561-02-e1 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/HB15, Engrossed 1 2024 responsible for the office's compliance with the office health and safety requirements of this section and rules adopted hereunder.

Within 10 calendar days after the termination of a designated physician relationship, the office must notify the departmentPage of24 theof29 designationCODING: of another physician to serve as the designated physician.

The department may suspend a registration for an office if the office fails to comply with the requirements of this paragraph.

(c) As a condition of registration, each office must establish financial responsibility by demonstrating that it has met and continues to maintain, at a minimum, the same requirements applicable to physicians in ss.

458.320 and 459.0085.

An office in which a physician performs a gluteal fat grafting procedure must also establish financial responsibility by demonstrating that it has met and continues to maintain, at a minimum, the same requirements applicable to physicians in ss.

458.320(2)(b) or (c) and 459.0085(2)(b) or (c), as applicable.

Each physician practicing at an office registered under this section or s.

458.328 must meet the financial responsibility requirements under s.

458.320 or s.

459.0085, as applicable.

(h) A physician may only perform a procedure or surgery identified in paragraph (a) in an office that is registered with Page 7of 11 CODING:

hb1561-02-e1hb1561-01-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/HB15,CS/HB1561 Engrossed2024 1department 2024of the department.designation of another physician to serve as the designated physician.

The department may suspend a registration for an office if the office fails to comply with the requirements of this paragraph.

(h) A physician may only perform a procedure or surgery identified in paragraph (a) in an office that is registered with the department.

Require major or prolonged intracranial, intrathoracic, abdominal, or joint replacement procedures, except for laparoscopicPage procedures;25 of29 CODING:

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hb1561-01-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/HB1561 2024 laparoscopic procedures;

(c) A physician performing a gluteal fat grafting Pageprocedure 8ofin 11an CODING:office surgery setting shall adhere to standards of practice under this subsection and rules adopted by the board which include, but are not limited to, all of the following:

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hb1561-02-e1 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/HB15, Engrossed 1 2024 procedure in an office surgery setting shall adhere to standards of practice under this subsection and rules adopted by the board which include, but are not limited to, all of the following:

4.Page 26 of29 CODING:

When the physician performing a gluteal fat grafting procedure injects fat into the subcutaneous space of the patient, the physician must use ultrasound guidance, or guidance with other technology authorized under board rule which equals or exceeds the quality of ultrasound, during the placement and navigation of the cannula to ensure that the fat is injected Page 9of 11 CODING:

hb1561-02-e1hb1561-01-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/HB15,CS/HB1561 Engrossed 1 2024 into4. the subcutaneous space of the patient above the fascia overlying the gluteal muscle.

When the physician performing a gluteal fat grafting procedure injects fat into the subcutaneous space of the patient, the physician must use ultrasound guidance, or guidance with other technology authorized under board rule which equals or exceeds the quality of ultrasound, during the placement and navigation of the cannula to ensure that the fat is injected into the subcutaneous space of the patient above the fascia overlying the gluteal muscle.

(e) An office in which a physician performs gluteal fat grafting procedures must at all times maintain a ratio of one physician to one patient during all phases of the procedure, beginningPage with27 theof29 administrationCODING: of anesthesia to the patient and concluding with the extubation of the patient.

Words strickenare deletions;

words underlined are additions.

hb1561-01-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/HB1561 2024 beginning with the administration of anesthesia to the patient and concluding with the extubation of the patient.

PageSection 105. of11 CODING:

Subsection (6) of section 458.3145, Florida Statutes, is amended to read:

458.3145 Medical faculty certificate.— (6) Notwithstanding subsection (1), any physician, when providing medical care or treatment in connection with the education of students, residents, or faculty at the request of the dean of an accredited medical school within this state or at the request of the medical director of a statutory teaching hospital as defined in s.

408.07 or a specialty-licensed children's hospital licensed under chapter 395 that is affiliated with an accredited medical school and its affiliated clinics, may do so upon registration with the board and demonstration of financial responsibility pursuant to s.

458.320(1) or (2) unless such physician is exempt under s.

458.320(6)(a) s.

458.320(5)(a).

The performance of such medical care or treatment must be limited to a single period of time, which may not exceed 180 consecutive days, and must be rendered within a facility registered under subsection (2) or within a statutory teaching hospital as defined in s.

408.07.

A Page 28 of29 CODING:

hb1561-02-e1hb1561-01-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/HB15,CS/HB1561 Engrossed2024 1registration 2024fee Sectionnot 3.to exceed $300, as set by the board, is required of each physician registered under this subsection.

SubsectionHowever, (6)no ofmore sectionthan 456.074,three Floridaphysicians Statutes,per isyear amendedper institution may be registered under this subsection, and an exemption under this subsection may not be granted to reada 456.074physician Certainmore healththan careonce practitioners;in any given 5-year period.

immediateSection suspension6. of license.— (6) The department must issue an emergency order suspending or restricting the registration of an office registered under s.

458.328 or s.

459.0138 s.

459.0139 upon a finding of probable cause that the office or a physician practicing in the office is not in compliance with the standards of practice for office surgery adopted by the boards pursuant to s.

458.328 or s.

459.0138, as applicable, or is in violation of s.

458.331(1)(v) or s.

459.015(1)(z), and that such noncompliance or violation constitutes an immediate danger to the public.

Section 4.

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