Fla. Admin. Code R. 64B11-4.003

Current through Reg. 50, No. 222; November 13, 2024

Section 64B11-4.003 - Standards of Practice; Discipline

(1) The purpose of this rule is to notify applicants and licensees of the ranges of penalties which will routinely be imposed unless the Board finds it necessary to deviate from the guidelines for the stated reasons given within this rule. Each range includes the lowest and highest penalty and all penalties falling between. The purposes of the imposition of discipline are to punish the applicants or licensees for violations and to deter them from future violations; to offer opportunities for rehabilitation, when appropriate; and to deter other applicants or licensees from violations.

(2) Among the range of discipline including any and all in Section 456.072(2), F.S., in increasing severity are:

(a) Letter of concern and a minimum administrative fine of $100, remedial education, and/or refund of fees billed.

(b) Probation with conditions to include limitations on the type of practice or practice setting, requirements of supervision, employer and self reports, periodic appearances before the Board, counseling or participation in the Professionals Resource Network (PRN), payment of administrative fines, and such conditions to assure protection of the public. The licensee must choose supervisor licensed under Chapter 468, Part III, F.S., who is in good standing and without restriction or limitation on his or her license. The supervisor should ideally provide such services without compensation. However, the licensee may contract with a for-profit entity for a fee. It is the licensee's full responsibility to pay for any supervision services. All potential supervisors must be approved by the Board before providing services. The Board Chair, or any other member designated by the Board, is delegated the authority to review all potential supervisors for adequacy. The Board may reject any proposed supervisor on the basis that he or she has previously been subject to disciplinary action against his or her license in this or any other jurisdiction, is currently under investigation, or is the subject of a pending disciplinary action. The supervisor must be actively engaged in the same or similar specialty area unless otherwise provided by the Board and be practicing within a reasonable distance of Respondent's practice, a distance of 50 miles unless otherwise specifically approved by the Board. The Board may reject any proposed supervisor for good cause shown.

(c) Suspension until the licensee appears before the Board to demonstrate current competency and ability to practice safely and compliance with any previous Board orders.

(d) Licensure with conditions.

(e) Denial of licensure.

(f) Permanent Revocation.

(3) Aggravating and Mitigating Circumstances. Based upon consideration of aggravating and mitigating factors present in an individual case, the Board may deviate from the penalties recommended below. The Board shall consider as aggravating or mitigating factors the following:

(a) Exposure of patients or public to injury or potential injury, physical or otherwise; none, slight, severe, or death;

(b) Legal status at the time of the offense; no restraints, or legal constraints;

(c) The number of counts or separate offenses established;

(d) The disciplinary history of the applicant or licensee in any jurisdiction and the length of practice;

(e) Pecuniary benefit or self-gain inuring to the applicant or licensee;

(f) Any efforts at rehabilitation, attempts by the licensee to correct or to stop violations, or refusal by the licensee to correct or to stop violations;

(g) Evidence of fraud.

(4) Violations and Range of Penalties. In imposing discipline upon applicants and licensees, in proceedings pursuant to Sections 120.57(1) and (2), F.S., the Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the violations set forth below. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included. For applicants, any and all offenses listed herein are sufficient for refusal to certify an application for licensure.

In addition to the penalty imposed, the Board shall recover the costs of investigation and prosecution of the case. Additionally, if the Board makes a finding of pecuniary benefit or self-gain related to the violation, then the Board shall require refund of fees billed and collected from the patient or a third party on behalf of the patient.

VIOLATION	PENALTY RANGE
	MINIMUM	MAXIMUM
(a) Attempting to obtain, obtaining, or renewing a license to practice a profession by bribery, fraudulent misrepresentation, or through an error of the Department or the Board. (Sections 468.217(1)(a), and 456.072(1)(h), F.S.)
First Offense	6 months probation with conditions or certify application with restrictions and $1,000 fine.	1 year suspension and $5,000 fine.
Second and Subsequent Offenses	Restriction of practice or license or denial of licensure and $5,000 fine.	Permanent revocation or denial of licensure and $10,000 fine.
However, if the violation is not through an error but is for making a false or fraudulent representation or bribery, the fine is increased to $10,000 per count or offense.
(b) Action taken against license by another jurisdiction. (Sections 468.217(1)(b), and 456.072(1)(f), F.S.)
First Offense	Letter of concern and $500 fine.	Imposition of discipline which would have been if the substantive violation occurred in Florida.
Second and Subsequent Offenses	Imposition of discipline which would have been if the substantive violation occurred in Florida and a $2,500 fine.	Permanent revocation and $10,000 fine.
(c) Guilt of a crime directly relating to practice or ability to practice. (Section 468.217(1)(c), F.S.)
FIRST OFFENSE Misdemeanor Felony Felony crimes having a factual basis related to assault, battery, abuse, or which otherwise caused bodily harm. Crimes involving fraudulent misrepresentation	Reprimand and $250 fine. 1 year probation with conditions and $1,000 fine. 1 year suspension and $5,000 fine. 1 year suspension and $10,000 fine.	1 year probation with conditions and $500 fine. 1 year suspension and $2,500 fine. Permanent revocation and $10,000 fine. Permanent revocation and $10,000 fine.
SECOND AND SUBSEQUENT OFFENSES Misdemeanor Felony Felony crimes having a factual basis related to assault, battery, abuse, or which otherwise caused bodily harm. Crimes involving fraudulent misrepresentation	1 year probation with conditions and $500 fine. 1 year suspension and $2,500 fine. 2 - year suspension and $10,000 fine. 2 - year suspension and $10,000 fine.	1 year suspension and $1,000 fine. Permanent revocation and $5,000 fine. Permanent revocation and $10,000 fine. Permanent revocation and $10,000 fine.
(d) False, deceptive, or misleading advertising. (Section 468.217(1)(d), F.S.)
First Offense	Letter of concern and $100 fine.	6 months probation with conditions and $250 fine.
Second and Subsequent Offenses	6 months suspension and $500 fine.	Restriction of practice or license and $5,000 fine.
(e) Advertising, practicing under a name other than one's own name. (Section 468.217(1)(e), F.S.)
First Offense	Letter of concern and $100 fine.	6 months probation with conditions and $250 fine.
Second and Subsequent Offenses	6 months suspension and $500 fine.	Restriction of practice or license and $5,000 fine.
(f) Failure to report another licensee in violation. (Sections 468.217(1)(f), and 456.072(1)(i), F.S.)
First Offense	Letter of concern and $100 fine.	6 months probation with conditions and $500 fine.
Second and Subsequent Offenses	6 months probation with conditions and $1,000 fine.	1 year suspension and $5,000 fine.
(g) Aiding unlicensed practice. (Sections 468.217(1)(g), and 456.072(1)(j), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	6 months suspension, 1 year probation with conditions and $3,000 fine.
Second and Subsequent Offenses	1 year suspension and $6,000 fine.	Permanent revocation and $10,000 fine.
(h) Failure to perform legal obligation. (Sections 468.217(1)(h), and 456.072(1)(k), F.S.)
First Offense	Letter of Concern and $100 fine.	6 months probation with conditions and $500 fine.
Second and Subsequent Offenses	6 months suspension and $1000 fine.	Restriction of practice or license and $5,000 fine.
(i) Failing to file a report as required. (Sections 468.217(1)(i), and 456.072(1)(l), F.S.)
First Offense	1 year probation with conditions and $100 fine.	6 months suspension, 1 year probation with conditions and $250 fine.
Second and Subsequent Offenses	6 months suspension, 1 year probation with conditions and $500 fine.	1 year suspension, 2 years probation with conditions and $1,000 fine.
However, if the violation is for making a false or fraudulent representation, a fine of $10,000 per count or offense.
(j) Kickbacks or split fee arrangements. (Section 468.217(1)(j), F.S.)
First Offense	6 months suspension, 1 year probation with conditions and $500 fine.	1 year suspension, 2 years probation with conditions and $5,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $2,500 fine.	Permanent revocation and $10,000 fine.
(k) Exercising influence to engage patient in sex. (Section 468.217(1)(k), F.S.)
First Offense	1 year suspension, 4 years probation with conditions referral to PRN and $5,000 fine.	Permanent revocation and $7,500 fine.
Second and Subsequent Offenses	Restriction of practice or license and $7,500 fine.	Permanent revocation and $10,000 fine.
(l) Deceptive, untrue, or fraudulent representations in the practice. (Sections 468.217(1)(l), and 456.072(1)(a), F.S.)
First Offense	1 year probation with conditions and $10,000 fine.	1 year suspension, 1 year probation with conditions and $10,000 fine.
Second and Subsequent Offenses	2 years suspension, 1 year probation with conditions and $10,000 fine.	Revocation and $10,000 fine.
(m) Improper solicitation of patients. (Section 468.217(1)(m), F.S.)
First Offense	1 year probation with conditions and $500 fine.	6 months suspension, 1 year probation with conditions and $2,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $2,500 fine.	Permanent revocation and $5,000 fine.
(n) Failure to keep written medical records, justifying the course of treatment of the patient, including but not limited to patient history, examination results and test results. (Section 468.217(1)(n), F.S.)
First Offense	Letter of concern and $300 fine.	6 months probation with conditions and $1,000 fine.
Second and Subsequent Offenses	1 year probation and $1,000 fine.	6 months suspension, 1 year probation with conditions and $5,000 fine.
(o) Exercising influence on patient for financial gain. (Sections 468.217(1)(o), and 456.072(1)(n), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	1 year suspension, 2 years probation with conditions and $7,500 fine.
Second and Subsequent Offenses	Restriction of practice or license and $5,000 fine.	Permanent revocation and $10,000 fine.
(p) Performing professional services not authorized by patient. (Section 468.217(1)(p), F.S.)
First Offense	Letter of concern and $500 fine.	6 months probation with conditions and $2,500 fine.
Second and Subsequent Offenses	3 months suspension and $2,500 fine.	Permanent revocation and $10,000 fine.
(q) Malpractice. (Section 468.217(1)(q), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	1 year suspension, 2 years probation with conditions or denial and $5,000 fine.
Second and Subsequent Offenses	1 year suspension, 2 years probation with conditions and $5,000 fine.	Permanent revocation and $10,000 fine.
(r) Performing of experimental treatment without informed consent. (Section 468.217(1)(r), F.S.)
First Offense	1 year suspension, 1 year probation with conditions and $1,000 fine.	2 years suspension, 2 years probation with conditions or denial and $5,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $5,000 fine.	Permanent revocation and $10,000 fine.
(s) Practicing beyond scope permitted. (Sections 468.217(1)(s), and 456.072(1)(o), F.S.)
First Offense	Letter of concern and $100 fine.	6 months suspension, 6 months probation with conditions or denial and $1,500 fine.
Second and Subsequent Offenses	Restriction of practice or license and $1,500 fine.	Permanent revocation and $7,500 fine.
(t) Inability to practice occupational therapy with skill and safety. (Sections 468.217(1)(t), 456.072(1)(z), F.S.)
First Offense	Submit to mental/physical examination and impose conditions on practice.	Submit to mental/physical examination and suspension until able to demonstrate ability to practice with reasonable skill and safety, followed by probation with conditions.
Second and Subsequent Offenses	1 year suspension and then submit to mental/physical examination and suspension until able to demonstrate ability to practice with reasonable skill and safety.	Permanent Revocation and $5,000 fine.
(u) Delegation of professional responsibilities to unqualified person. (Sections 468.217(1)(u), 456.072(1)(p), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	6 months suspension, 1 year probation with conditions and $3,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $5,000 fine.	Permanent revocation and $10,000 fine.
First Offense	Suspension until order or subpoena complied with and $500 fine.	1 year suspension, 1 year probation with conditions and $1,500 fine.
Second and Subsequent Offenses	6 months suspension, 1 year probation with conditions and $1,500 fine.	Permanent revocation and $5,000 fine.
(w) Conspiring to restrict another from lawfully advertising services. (Section 468.217(1)(w), F.S.)
First Offense	Letter of concern.	Letter of concern and $100 fine.
Second and Subsequent Offenses	Letter of concern and $500 fine.	Letter of concern and $1,000 fine.
(x) Violating Chapters 468, 456, F.S., or any rules adopted pursuant thereto. (Sections 468.217(1)(x), and 456.072(1)(dd), F.S.)
First Offense	Suspension until law or rule complied with and $500 fine.	1 year suspension, 1 year probation with conditions and $1,500 fine.
Second and Subsequent Offenses	Restriction of practice or license and $2,500 fine.	Permanent revocation and $5,000 fine.
(y) Performing or attempting health care services on the wrong patient, wrong site wrong procedure, or unauthorized or medically unnecessary procedure including preparation of the patient. (Section 456.072(1)(bb), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	1 year suspension, 2 years probation with conditions and $5,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $5,000 fine.	Permanent revocation and $10,000 fine.
(z) Intentionally violating any rule adopted by the Board or the Department as appropriate. (Section 456.072(1)(b), F.S.)
First Offense	6 months suspension, 1 year probation with conditions and $1,000 fine.	1 year suspension, 2 years probation with conditions and $3,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $5,000 fine.	Permanent Revocation and $10,000 fine.
(aa) Being convicted or found guilty of, or entering a plea of guilty or nolo contendere to, regardless of adjudication, a crime in any jurisdiction which relates to the practice of, or the ability to practice a licensee's profession. (Section 456.072(1)(c), F.S.)
FIRST OFFENSE Misdemeanor Felony Felony crimes having a factual basis related to assault, battery, abuse, or which otherwise caused bodily harm. Crimes involving fraudulent misrepresentation. SECOND AND SUBSEQUENT OFFENSES Misdemeanor Felony Felony crimes having a factual basis related to assault, battery, abuse, or which otherwise caused bodily harm. Crimes involving fraudulent misrepresentation.	Reprimand and $250 fine. 1 year probation with conditions and $1,000 fine. 1 year suspension and $5,000 fine. 1 year suspension and $10,000 fine. 1 year probation with conditions and $500 fine. 1 year suspension and $2,500 fine. 2 year suspension and $10,000 fine. 2 year suspension and $10,000 fine.	1 year probation with conditions and $500 fine. 1 year suspension and $2,500 fine. Permanent revocation and $10,000 fine. Permanent revocation and $10,000 fine. 1 year suspension and $1,000 fine. Permanent revocation and $5,000 fine. Permanent revocation and $10,000 fine. Permanent revocation and $10,000 fine.
(bb) Failing to comply with the educational course requirements for human immunodeficiency virus and acquired immune deficiency syndrome. (Section 456.072(1)(e), F.S.)
First and Subsequent Offenses	Letter of Concern.	6 months probation with conditions and $500 fine.
(cc) Having been found liable in a civil proceeding for knowingly filing a false report or complaint with the department against another licensee. (Section 456.072(1)(g), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	1 year suspension and $5,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $2,000 fine.	Permanent revocation and $10,000 fine.
(dd) Making deceptive, untrue, or fraudulent representations in or related to the practice of a profession or employing a trick or scheme in or related to the practice of a profession. (Section 456.072(1)(a) and (m), F.S.)
First Offense	1 year probation with conditions and $10,000 fine.	1 year suspension and $10,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $10,000 fine.	Permanent revocation and $10,000 fine.
(ee) Improperly interfering with an investigation or inspection authorized by statute, or with any disciplinary proceeding. (Section 456.072(1)(r), F.S.)
First Offense	6 months probation with conditions and $1,000 fine.	1 year suspension and $2,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $4,000 fine.	Permanent revocation and $10,000 fine.
(ff) Engaging or attempting to engage a patient in verbal or physical sexual activity. (Section 456.072(1)(v), F.S.)
First Offense Second and Subsequent Offenses	1 year suspension, 4 years probation with conditions referral to PRN and $5,000 fine. Permanent revocation and $7,500 fine.	Permanent revocation and $7,500 fine. Permanent revocation and $10,000 fine.
(gg) Failing to report to the board within 30 days after the licensee has been convicted or found guilty of, or entered a plea of no contendere to, regardless of adjudication, a crime in any jurisdiction. (Section 456.072(1)(x), F.S.)
First Offense	Letter of concern and $500 fine.	1 year probation with conditions and $500 fine.
(hh) Using information about people involved in motor vehicle accidents which has been derived from accident reports made by law enforcement officers for the solicitation of the people involved in the accidents. (Section 456.072(1)(y), F.S.)
First Offense	1 year probation with conditions and $1,000 fine.	1 year suspension and $4,000 fine.
Second and Subsequent Offenses	Restriction of practice or license and $4,000 fine.	Permanent revocation and $10,000 fine.
(ii) Failing to finish PRN treatment program or failing without just cause to comply with PRN contract. (Section 456.072(1)(hh), F.S.)
First Offense	Suspension until compliant with program; up to suspension until compliant with program, followed by up to 5 years probation with conditions.
Second or Subsequent Offense	Up to $2000 fine, suspension until compliant with program followed by up to 5 years probation with conditions, or revocation.
(jj) Being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, under 18 U.S.C. s. 669, ss. 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518, or 42 U.S.C. ss. 1320a-7b, relating to the Medicaid program. (Section 456.072(1)(ii), F.S.)
First and Subsequent Offenses	Permanent revocation and a fine of $10,000, or in the case of application for licensure, denial of license.
(kk) Failing to remit the sum owed to the State for an overpayment from the Medicaid Program pursuant to a final order, judgment, or Stipulation or settlement. (Section 456.072(1)(jj), F.S.)
First Offense	6 months probation with conditions $500 fine.	1 year suspension and $2,500 fine.
Second and Subsequent Offenses	1 year suspension and $3,000.	Permanent revocation and $5,000 fine.
(ll) Being terminated from the state Medicaid Program pursuant to Section 409.913, F.S., any other state Medicaid program, or the federal Medicare program, unless eligibility to participate in the program from which the practitioner was terminated has been restored. (Section 456.072(1)(kk), F.S.)
First Offense	Letter of concern and $1,000 fine.	1 year suspension $2,500 fine.
Second and Subsequent Offenses	1 year suspension $5,000 fine.	Permanent revocation $10,000 fine.
(mm) Being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, a crime in any jurisdiction which related to health care fraud. (Section 456.072(1)(ll), F.S.)
First and Subsequent Offenses	Permanent revocation and a fine of $10,000, or in the case of application for licensure, denial of license.
(nn) Willfully failing to comply with Section 627.64194 or 641.513, F.S., with such frequency as to indicate a general business practice. (Section 456.072(1)(oo), F.S.)
First Offense	Letter of Concern and $500 fine.	1 year suspension and $1,000 fine.
Second and Subsequent Offenses	1 year suspension and $3,000 fine.	Permanent revocation and $5,000 fine.
(oo) Testing positive for any drug on confirmed preemployment or employer ordered drug screening without lawful prescription. (Section 456.072(1)(aa), F.S.)
First Offense	Submit to mental/physical examination and impose conditions on practice.	Submit to mental/physical examination and suspension until able to demonstrate ability to practice with reasonable skill and safety, followed by probation with conditions.
Second and Subsequent Offenses	Submit to mental/physical examination and suspension until able to demonstrate ability to practice with reasonable skill and safety, followed by probation with conditions and $1,000 fine.	Permanent revocation and $3,000 fine.
(pp) Providing information, including written documentation, indicating that a person's need for an emotional support animal under Section 760.27, F.S., without personal knowledge of the person's disability or disability-related need for the specific emotional support animal. (Section 456.072(1)(pp), F.S.
First Offense	1 year probation with conditions and a $5,000 fine.	6 months suspension, 6 months probation with conditions, and a $10,000 fine.
Second and Subsequent Offenses	1 year suspension, 1 year probation with conditions, and a $5,000 fine.	Permanent revocation and a $10,000 fine.
(qq) Failure to comply with the parental consent requirements of s. 1014.06, F.S. (Section 456.072(1)(rr), F.S.)
First Offense	$500 fine, and up to 1 year probation with conditions.	$1,000 fine, and up to 6 months suspension.
Second and Subsequent Offense	$1,500 fine, and up to 1 year suspension.	$2,500 fine, and up to 2 years suspension.
(rr) Being convicted or found guilty of, entering a plea of guilty or nolo contendere to, regardless of adjudication, or committing or attempting, soliciting, or conspiring to commit an act that would constitute a violation of any of the offenses listed in s. 456.074(5) or a similar offense in another jurisdiction. (Section 456.072(1)(ss), F.S.)
First and Subsequent Offenses	Permanent revocation and a fine of $10,000, or in the case of application for licensure, denial of license.

(5) Stipulations or Settlements. The provisions of this rule are not intended and shall not be construed to limit the ability of the Board to dispose informally of disciplinary actions by stipulation, agreed settlement, or consent order pursuant to Section 120.57(4), F.S.

(6) Letters of Guidance. The provisions of this rule cannot and shall not be construed to limit the authority of the probable cause panel of the Board to direct the Department to send a letter of guidance pursuant to Section 456.073(3), F.S., in any case for which it finds such action appropriate.

(7) Other Action. The provisions of this rule are not intended to and shall not be construed to limit the ability of the Board to pursue or recommend that the Department pursue collateral civil or criminal actions when appropriate.

Fla. Admin. Code Ann. R. 64B11-4.003

Rulemaking Authority 456.079, 468.204 FS. Law Implemented 456.072, 456.079, 468.217 FS.

New 9-12-88, Amended 11-9-92, Formerly 21M-15.002, 61F6-15.002, 59R-63.002, Amended 1-27-00, 12-27-01, 12-27-05, 4-10-08, 8-5-10, 4-18-12, Amended by Florida Register Volume 42, Number 250, December 28, 2016 effective 1/10/2017, Amended by Florida Register Volume 47, Number 149, August 3, 2021 effective 8/19/2021, Amended by Florida Register Volume 47, Number 222, November 16, 2021 effective 11/28/2021.

New 9-12-88, Amended 11-9-92, Formerly 21M-15.002, 61F6-15.002, 59R-63.002, Amended 1-27-00, 12-27-01, 12-27-05, 4-10-08, 8-5-10, 4-18-12, 1-10-17, 8-19-21, 11-28-21.