The 2023 Florida Statutes (including Special Session C)

Title XXIX
PUBLIC HEALTH

Chapter 395
HOSPITAL LICENSING AND REGULATION

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F.S. 395.0193

395.0193 Licensed facilities; peer review; disciplinary powers; agency or partnership with physicians.—

(1) It is the intent of the Legislature that good faith participants in the process of investigating and disciplining physicians pursuant to the state-mandated peer review process shall, in addition to receiving immunity from retaliatory tort suits pursuant to s. 456.073(12), be protected from federal antitrust suits filed under the Sherman Anti-Trust Act, 15 U.S.C.A. ss. 1 et seq. Such intent is within the public policy of the state to secure the provision of quality medical services to the public.

(2) Each licensed facility, as a condition of licensure, shall provide for peer review of physicians who deliver health care services at the facility. Each licensed facility shall develop written, binding procedures by which such peer review shall be conducted. Such procedures shall include:

(a) Mechanism for choosing the membership of the body or bodies that conduct peer review.

(b) Adoption of rules of order for the peer review process.

(d) Mechanism to identify and avoid conflict of interest on the part of the peer review panel members.

(e) Recording of agendas and minutes which do not contain confidential material, for review by the Division of Health Quality Assurance of the agency.

(f) Review, at least annually, of the peer review procedures by the governing board of the licensed facility.

(g) Focus of the peer review process on review of professional practices at the facility to reduce morbidity and mortality and to improve patient care.

(3) If reasonable belief exists that conduct by a staff member or physician who delivers health care services at the licensed facility may constitute one or more grounds for discipline as provided in this subsection, a peer review panel shall investigate and determine whether grounds for discipline exist with respect to such staff member or physician. The governing board of any licensed facility, after considering the recommendations of its peer review panel, shall suspend, deny, revoke, or curtail the privileges, or reprimand, counsel, or require education, of any such staff member or physician after a final determination has been made that one or more of the following grounds exist:

(a) Incompetence.

(b) Being found to be a habitual user of intoxicants or drugs to the extent that he or she is deemed dangerous to himself, herself, or others.

(d) Being found liable by a court of competent jurisdiction for medical negligence or malpractice involving negligent conduct.

(e) One or more settlements exceeding $10,000 for medical negligence or malpractice involving negligent conduct by the staff member.

(f) Medical negligence other than as specified in paragraph (d) or paragraph (e).

(g) Failure to comply with the policies, procedures, or directives of the risk management program or any quality assurance committees of any licensed facility.

(4) Pursuant to ss. 458.337 and 459.016, any disciplinary actions taken under subsection (3) shall be reported in writing to the Division of Health Quality Assurance of the agency within 30 working days after its initial occurrence, regardless of the pendency of appeals to the governing board of the hospital. The notification shall identify the disciplined practitioner, the action taken, and the reason for such action. All final disciplinary actions taken under subsection (3), if different from those which were reported to the agency within 30 days after the initial occurrence, shall be reported within 10 working days to the Division of Health Quality Assurance of the agency in writing and shall specify the disciplinary action taken and the specific grounds therefor. The division shall review each report and determine whether it potentially involved conduct by the licensee that is subject to disciplinary action, in which case s. 456.073 shall apply. The reports are not subject to inspection under s. 119.07(1) even if the division’s investigation results in a finding of probable cause.

(5) There shall be no monetary liability on the part of, and no cause of action for damages against, any licensed facility, its governing board or governing board members, peer review panel, medical staff, or disciplinary body, or its agents, investigators, witnesses, or employees; a committee of a hospital; or any other person, for any action taken without intentional fraud in carrying out the provisions of this section.

(6) For a single incident or series of isolated incidents that are nonwillful violations of the reporting requirements of this section or part II of chapter 408, the agency shall first seek to obtain corrective action by the facility. If correction is not demonstrated within the timeframe established by the agency or if there is a pattern of nonwillful violations of this section or part II of chapter 408, the agency may impose an administrative fine, not to exceed $5,000 for any violation of the reporting requirements of this section or part II of chapter 408. The administrative fine for repeated nonwillful violations may not exceed $10,000 for any violation. The administrative fine for each intentional and willful violation may not exceed $25,000 per violation, per day. The fine for an intentional and willful violation of this section or part II of chapter 408 may not exceed $250,000. In determining the amount of fine to be levied, the agency shall be guided by s. 395.1065(2)(b).

(7) The proceedings and records of peer review panels, committees, and governing boards or agent thereof which relate solely to actions taken in carrying out this section are not subject to inspection under s. 119.07(1); and meetings held pursuant to achieving the objectives of such panels, committees, and governing boards are not open to the public under the provisions of chapter 286.

(8) The investigations, proceedings, and records of the peer review panel, a committee of a hospital, a disciplinary board, or a governing board, or agent thereof with whom there is a specific written contract for that purpose, as described in this section shall not be subject to discovery or introduction into evidence in any civil or administrative action against a provider of professional health services arising out of the matters which are the subject of evaluation and review by such group or its agent, and a person who was in attendance at a meeting of such group or its agent may not be permitted or required to testify in any such civil or administrative action as to any evidence or other matters produced or presented during the proceedings of such group or its agent or as to any findings, recommendations, evaluations, opinions, or other actions of such group or its agent or any members thereof. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such civil or administrative action merely because they were presented during proceedings of such group, and any person who testifies before such group or who is a member of such group may not be prevented from testifying as to matters within his or her knowledge, but such witness may not be asked about his or her testimony before such a group or opinions formed by him or her as a result of such group hearings.

(9)(a) If the defendant prevails in an action brought by a staff member or physician who delivers health care services at the licensed facility against any person or entity that initiated, participated in, was a witness in, or conducted any review as authorized by this section, the court shall award reasonable attorney’s fees and costs to the defendant.

(b) As a condition of any staff member or physician bringing any action against any person or entity that initiated, participated in, was a witness in, or conducted any review as authorized by this section and before any responsive pleading is due, the staff member or physician shall post a bond or other security, as set by the court having jurisdiction of the action, in an amount sufficient to pay the costs and attorney’s fees.

(10)(a) A hospital’s compliance with the requirements of this chapter or s. 766.110(1) may not be the sole basis to establish an agency or partnership relationship between the hospital and physicians who provide services within the hospital.

(b) A hospital may create an agency relationship with a physician by written contract signed by the hospital and:

1. The physician;

2. A health care professional association; or

3. A corporate medical group and its employees.

A written contract is not the exclusive means to establish an agency or partnership relationship between a hospital and any other person described in this paragraph.

History.—ss. 26, 30, ch. 82-182; s. 1, ch. 82-402; s. 3, ch. 85-175; s. 3, ch. 88-1; s. 2, ch. 88-277; s. 4, ch. 89-162; s. 14, ch. 90-344; ss. 12, 13, 98, ch. 92-289; s. 726, ch. 95-148; s. 213, ch. 96-406; s. 24, ch. 98-89; s. 21, ch. 98-166; s. 13, ch. 2000-160; s. 43, ch. 2007-230.

Note.—Former s. 395.0115.

F.S. 395.0193 on Google Scholar

F.S. 395.0193 on Casetext

Amendments to 395.0193

Arrestable Offenses / Crimes under Fla. Stat. 395.0193

Level: Degree
Misdemeanor/Felony: First/Second/Third

Current data shows no reason an arrest or criminal charge should have occurred directly under Florida Statute 395.0193.

Annotations, Discussions, Cases:

Cases from cite.case.law:

A. HAKKI, M. D. v. GALENCARE, INC. a d b a, 237 So. 3d 440 (Fla. App. Ct. 2018)

. . . amended complaint on the basis that it was immune from the suit pursuant to sections 395.0191(7) and 395.0193 . . . provided to the NPDB, which is protected by 42 U.S.C. § 11137(c) (2006), not sections 395.0191(7) and 395.0193 . . .

EDWARDS, v. D. THOMAS, M. D., 229 So. 3d 277 (Fla. 2017)

. . . .”); see generally § 395.0193, Fla. . . .

DESAI, M. D. v. LAWNWOOD MEDICAL CENTER, INC., 219 So. 3d 869 (Fla. Dist. Ct. App. 2017)

. . . . § 395.0193(2), Fla. Stat. (2009). . . .

HEALTH FIRST, INC. v. HYNES, M. D., 628 F. App'x 723 (11th Cir. 2016)

. . . . § 395.0193(5) from Health First’s claims. . . .

FIGUEROA, M. D. W. M. D. v. HYNES, M. D., 200 So. 3d 98 (Fla. Dist. Ct. App. 2015)

. . . Section 395.0193, Florida Statutes, provides that “[e]ach licensed facility, as a condition of licensure . . . Id. § 395.0193(3). . . . Further, section 395.0193(5) immunizes participants in peer review proceedings from liability for their . . . Id. § 395.0193(5). . . . As a result, the court determined that the privileges afforded under section 395.0193(5) shielded Hynes . . .

BARTOW HMA, LLC a k a v. J. KIRKLAND D. M. D. R. M. D. LLC,, 171 So. 3d 783 (Fla. Dist. Ct. App. 2015)

. . . Amendment 7 trumps the application of the statutory discovery protections set forth in sections 395.0191, 395.0193 . . . documents could fall within the statutory protections set forth in sections 381.028(6)(b), 395.0191(8), 395.0193 . . .

BARTOW HMA, LLC d b a v. EDWARDS M. D., 175 So. 3d 820 (Fla. Dist. Ct. App. 2015)

. . . See §§ 395.0191(8), 395.0193(8), 766.101(5), Fla. Stat. (2010); W. Fla. Reg’l Med. Ctr., Inc. v. . . . See §§ 395.0193, 395.0197, Fla. Stat. (2010). . . .

BARTOW HMA, LLC a k a v. J. KIRKLAND,, 126 So. 3d 1247 (Fla. Dist. Ct. App. 2013)

. . . Amendment 7 trumps the application of the statutory discovery protections set forth in sections 395.0191, 395.0193 . . .

CITY OF FREEPORT, v. BEACH COMMUNITY BANK,, 108 So. 3d 684 (Fla. Dist. Ct. App. 2013)

. . . certiorari in part and quashing trial court order erroneously denying immunity from suit pursuant to section 395.0193 . . .

WEST FLORIDA REGIONAL MEDICAL CENTER, INC. v. S. SEE,, 79 So. 3d 1 (Fla. 2012)

. . . restrictions against the disclosure of peer review and credentialing materials embodied in sections 395.0191, 395.0193 . . . they related to peer review and fell within the statutory privileges provided in sections 395.0191, 395.0193 . . .

MIAMI- DADE COUNTY, v. RODRIGUEZ,, 67 So. 3d 1213 (Fla. Dist. Ct. App. 2011)

. . . Mehta, 16 So.3d 914, 917 (Fla. 3d DCA 2009) (“Since subsection 395.0193(5) [affording immunity from suit . . .

LAWNWOOD MEDICAL CENTER INC. v. H. SADOW, M. D., 43 So. 3d 710 (Fla. Dist. Ct. App. 2010)

. . . . § 395.0193, Fla. . . .

WEST FLORIDA REGIONAL MEDICAL CENTER, INC. d b a v. S. SEE C., 18 So. 3d 676 (Fla. Dist. Ct. App. 2009)

. . . documents maintained by hospitals from discovery in civil litigation, including sections 395.0191(8), 395.0193 . . .

COLUMBIA HOSPITAL CORPORATION OF SOUTH BROWARD d b a a v. FAIN,, 16 So. 3d 236 (Fla. Dist. Ct. App. 2009)

. . . See §§ 395.0191(8), 395.0193(8), and 766.101(5), Fla. . . .

CEDARS HEALTHCARE GROUP, LTD. HCA v. MEHTA, M. D., 16 So. 3d 914 (Fla. Dist. Ct. App. 2009)

. . . Id. § 395.0193(2). . . . ], Id. § 395.0193(5). . . . against them stem from the peer review process outlined in section 395.0193. . . . the provisions of this section [395.0193].” . . . That count falls outside the protection of subsection 395.0193(5). . . .

FLORIDA EYE CLINIC, P. A. v. T. GMACH,, 14 So. 3d 1044 (Fla. Dist. Ct. App. 2009)

. . . of amendment 7 on the work-product doctrine as follows: Contrary to the clear effect upon [sections 395.0193 . . .

LAKELAND REGIONAL MEDICAL CENTER, a v. NEELY, a NEELY M. D. OB- GYN, P. A., 8 So. 3d 1268 (Fla. Dist. Ct. App. 2009)

. . . addressed Amendment 7’s application to existing medical records protected under sections 395.0191(8), 395.0193 . . .

H. PIERSON, III, R. v. ORLANDO REGIONAL HEALTHCARE SYSTEMS, INC. G. J. J. N. J. J. C. W. A. G. T. M. D. P. A. O. IV, 619 F. Supp. 2d 1260 (M.D. Fla. 2009)

. . . Plaintiff also challenges the state statutes— sections 766.101, 766.1015, and 395.0193, Florida Statutes . . .

LAWNWOOD MEDICAL CENTER, INC. v. SEEGER, M. D., 990 So. 2d 503 (Fla. 2008)

. . . the risk management program or any quality assurance committees of the hospital” pursuant to section 395.0193 . . . unconstitutionally impaired the contract between the medical staff and the Board; (3) the law amended section 395.0193 . . .

FLORIDA HOSPITAL WATERMAN, INC. v. M. BUSTER, v., 984 So. 2d 478 (Fla. 2008)

. . . See §§ 395.0191(8), 395.0193(8), 766.101(5), Fla. Stat. (2005); cf. § 766.1016(2), Fla. . . . See §§ 395.0191(8), 395.0193(8), 766.101(5), 766.1016(2), Fla. Stat. (2005). . . . incidents otherwise provided by law, including, but not limited to, those contained in ss. 395.0191, 395.0193 . . . committee, or other hospital board otherwise provided by law, including, but not limited to, ss. 395.0191, 395.0193 . . . . § 395.0193(8), Fla. Stat. (2002). . . . The sections protecting records and statements in peer review are sections 395.0191(8), 395.0193(8), . . .

HOROWITZ, v. PLANTATION GENERAL HOSPITAL LIMITED PARTNERSHIP,, 959 So. 2d 176 (Fla. 2007)

. . . Second, sections 395.0193(2)-(4), Florida Statutes (2006), which outline the hospital’s duties in denying . . . See § 395.0193(2)-(4), Fla. Stat. . . . Section 395.0193 was originally codified at section 395.0115, Florida Statutes (Supp. 1982), and has . . .

BRANDON REGIONAL HOSPITAL, v. MURRAY,, 957 So. 2d 590 (Fla. 2007)

. . . minutes of the hospital’s department of surgery because those documents were protected by sections 395.0193 . . . records of the investigative portion of the peer review panel are privileged from disclosure by sections 395.0193 . . .

DOE, M. D. v. DEPARTMENT OF HEALTH,, 948 So. 2d 803 (Fla. Dist. Ct. App. 2006)

. . . Doe, and that the provisions of sections 395.0193(8) and 766.101(5) do not prohibit the release of the . . . of public disclosure in a malpractice lawsuit or other civil or administrative claim that sections 395.0193 . . . Section 395.0193(8), which is located in chapter 395 of the Florida Statutes regarding hospital licensing . . . As such, the language in sections 395.0193(8) and 766.101(5) that states that these records “shall not . . . A review of the legislative history of sections 395.0193(8) and 766.101(5) reveals that prior to 1990 . . .

NOTAMI HOSPITAL OF FLORIDA, INC. d b a v. BOWEN C. P. A. B. M. D., 927 So. 2d 139 (Fla. Dist. Ct. App. 2006)

. . . "Unquestionably, the amendment would affect sections 395.0193(8) and 766.101(5), of the Florida Statutes . . .

FLORIDA HOSPITAL WATERMAN, INC. v. M. BUSTER,, 932 So. 2d 344 (Fla. Dist. Ct. App. 2006)

. . . 880 So.2d at 620-21, wherein the court stated, “Unquestionably, the amendment would affect sections 395.0193 . . . Stat. (2005) (internal risk management); § 395.0193(8), Fla. Stat. (2005) (peer review). . . . Stat. (2005) (credentialing); § 395.0193(5), Fla. . . .

CAPE CANAVERAL HOSPITAL, INC. v. J. LEAL, M. D., 917 So. 2d 336 (Fla. Dist. Ct. App. 2005)

. . . determine whether CCH had a reasonable belief that one or more of the grounds specified in section 395.0193 . . . The only peer review privilege statute applicable to this case is that contained in [sjection 395.0193 . . . Stat. 395.0193(8)[sic]. . . . were peer review proceedings without a reasonable belief that one of the grounds set out at section 395.0193 . . . Section 395.0193(3), Florida Statutes (2001), sets forth the grounds, which, if reasonable belief exists . . .

BRAVO a v. UNITED STATES M. D., 403 F. Supp. 2d 1182 (S.D. Fla. 2005)

. . . Section 395.0193 of the Florida Statutes, “Licensed Facilities: peer review; disciplinary powers; agency . . . Section 395.0193(3) provides the following: If reasonable belief exists that conduct by a staff member . . . physician after a final determination has been made that one or more of the following grounds exist ... § 395.0193 . . .

ADVISORY OPINION TO ATTORNEY GENERAL RE PATIENTS RIGHT TO KNOW ABOUT ADVERSE MEDICAL INCIDENTS, 880 So. 2d 617 (Fla. 2004)

. . . Unquestionably, the amendment would affect sections 395.0193(8) and 766.101(5) of the Florida Statutes . . .

PALM SPRINGS GENERAL HOSPITAL, INC. v. VALDES, M. D., 784 So. 2d 1151 (Fla. Dist. Ct. App. 2001)

. . . doctor is entitled to notice, hearing and due process as set forth in the hospital bylaws and in section 395.0193 . . .

TAYLOR, v. MEMORIAL HEALTH SYSTEMS, INC., 770 So. 2d 752 (Fla. Dist. Ct. App. 2000)

. . . Additionally, section 395.0193 mandates that (1) hospitals establish peer review systems to monitor and . . .

BAYFRONT MEDICAL CENTER, INC. v. STATE AGENCY FOR HEALTHCARE ADMINISTRATION,, 741 So. 2d 1226 (Fla. Dist. Ct. App. 1999)

. . . subpoena and approved by the trial court’s summary judgment are protected from discovery by sections 395.0193 . . . Section 395.0193(2) provides in pertinent part as follows: Each licensed facility, as a condition of . . . Section 395.0193(3) provides in part as follows: If reasonable belief exists that conduct by a staff . . . Section 395.0193(7) provides: The investigations, proceedings, and records of the peer review panel, . . . “Peer review” is a separate and distinct procedure required instead by section 395.0193. . . .

ADVENTIST HEALTH SYSTEM SUNBELT HEALTH, v. K. JUDGE,, 739 So. 2d 695 (Fla. Dist. Ct. App. 1999)

. . . See § 395.0193(7), Fla. Stat. (1997). . . . While the records of a peer review evaluation are exempted from discovery under section 395.0193(7), . . .

HOLMES REGIONAL MEDICAL CENTER, INC. v. NEAL M., 734 So. 2d 432 (Fla. Dist. Ct. App. 1999)

. . . Holmes contends the information sought is privileged under sections 395.0191(8), 395.0193(7) and 766.101 . . .

FERNANDEZ, M. D. v. CORAL GABLES HOSPITAL, INC. d b a a, 720 So. 2d 1161 (Fla. Dist. Ct. App. 1998)

. . . in violation of the express provisions of its Bylaws, as well as the mandatory provisions of section 395.0193 . . .

D. ECKERT, M. D. v. BOARD OF COMMISSIONERS OF THE NORTH BROWARD HOSPITAL DISTRICT,, 720 So. 2d 1151 (Fla. Dist. Ct. App. 1998)

. . . Eckert’s staff privileges at the Coral Springs Medical Center for two years, pursuant to section 395.0193 . . .

TOYOS, M. D. v. NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY,, 1 F. Supp. 2d 1462 (S.D. Fla. 1998)

. . . whether the statutory medical peer review privilege established by Florida Statutes §§ 395.0191(8), 395.0193 . . . Florida Statutes §§ 395.0191(8) (applicable to hospital boards), 395.0193(7) (applicable to a hospital . . . Ann. §§ 395.0191(8) (West Supp.1997), 395.0193(7) (West Supp.1997), 766.101(5) (West Supp. 1997). . . .

NOBLE, M. D. v. MARTIN MEMORIAL HOSPITAL ASSOCIATION, INC. Dr., 710 So. 2d 567 (Fla. Dist. Ct. App. 1997)

. . . In ruling on the motion, the court specifically found that the amendment of section 395.0193, Florida . . .

M. MARTINEZ, M. D. v. PROVIDENT LIFE AND ACCIDENT INSURANCE CO., 174 F.R.D. 502 (S.D. Fla. 1997)

. . . discoverable because they: (1) are “peer review” records protected by Florida Statutes §§ 395.0191(8), 395.0193 . . . Section 395.0193(7) applies the same rule to a hospital’s “peer review panel, a committee, a disciplinary . . . Fla.Stat.Ann. § 395.0193(7) (West Supp.1997). . . .

MEASE HOSPITAL, INC. v. LAWRENCE,, 687 So. 2d 883 (Fla. Dist. Ct. App. 1997)

. . . information sought is protected from disclosure and discovery by the provisions of sections 395.0191, 395.0193 . . . See §§ 395.0191(8), 395.0193(7) and 766.101(5). The petition is granted in part. . . .

VARIETY CHILDREN S HOSPITAL, v. MISHLER,, 670 So. 2d 184 (Fla. Dist. Ct. App. 1996)

. . . basis that it sought disclosure of documents privileged under subsections 766.101(5), 395.0191(8) and 395.0193 . . .

BRUMER, M. D. v. HCA HEALTH SERVICES OF FLORIDA, INC., 662 So. 2d 1385 (Fla. Dist. Ct. App. 1995)

. . . Section 395.0115, Florida Statutes (1991), has been amended and renumbered as section 395.0193, Florida . . .

MOUNT SINAI MEDICAL CENTER OF GREATER MIAMI, INC. v. BERNSTEIN,, 645 So. 2d 530 (Fla. Dist. Ct. App. 1994)

. . . interrogatories 12 and «13, claiming that the information sought was privileged under sections 766.101 and 395.0193 . . . Section 395.0193 provides that, (7) The investigations, proceedings, and records of the peer review panel . . .

T. BRYAN T. M. D. P. A. v. JAMES E. HOLMES REGIONAL MEDICAL CENTER, a k a A. M. D. HRMC HRMC N. M. D. HRMC J. M. D. HRMC V. HRMC E. III, HRMC A. M. D. HRMC W. M. D. HRMC M. HRMC F. HRMC L. HRMC E. Ph. D. HRMC A. M. D. HRMC M. D. HRMC M. HRMC R. N. HRMC P. Jr. HRMC F. Jr. HRMC R. N. HRMC,, 33 F.3d 1318 (11th Cir. 1994)

. . . . § 395.0193(5) (West 1993). . . . See Fla.Stat.Ann. § 395.0193(2) (West 1993) ("Each licensed [health care] facility, as a condition of . . . Fla.Stat.Ann. § 395.0193(5). . . . .