• HB 1111 deals with the present requirement that all Nurse Practitioners maintain a policy of insurance of at least $100,000 as a condition of licensure. 
• The proposal would repeal that requirement and permit the NP to elect to  "go bare" as is the case with physicians. (This was made law in 2003- we are trying to find out how many docs “go bare” now…Have you asked your protocol physician if they carry professional liability coverage now?)
• The supporters of this legislation advise that they that recently ARNP's were not able to secure the required coverage, or if available it is at a very high premium. We know NSO/CNA and Marsh stopped writing new policies for ARNP's, but CM&F has maintained services. We understand both Marsh and NSO will be returning to FL to write new polices for ARNP's.
• Marsh will be dropping their occurrence policies and offer claims made policies only. The will have provisions to buy "tail" coverage, but be sure that will be expensive. Marsh changes will occur around May 16, 2006.
• NSO has not announced when it will be writing new policies-but soon.
• Notwithstanding it is important that our membership understand the consequences they may face if they take advantage of this proposed change, if, or, when it becomes law.
• The bill creates an exemption from existing law requiring a NP to maintain malpractice coverage in the amount established by the Board of Nursing unless falling within one of the several exemption s in existing law.
• The bill would provide an additional exemption from this requirement for any affected NP who elects to not meet that requirement.
• In that event the NP will be required to post a notice in the waiting room of the office where he or she practices or distribute written notice that the NP does not "carry " the insurance coverage as otherwise required. 
• The bill provides for minimum financial responsibility of $100,000.00 for an NP without hospital staff privileges or $250,000.00 for an NP with hospital staff privileges. 
• In the event of a malpractice judgment the NP will have 60 days from the day the judgment becomes final to pay the amount of the judgment not to exceed the statutory limit established by the proposal.
• In the event the judgment is not paid or no payment schedule is in place after the passage of 60 days the Department of Health is authorized to inform the NP that administrative proceedings could be commenced unless within 30 days after the issuance of that notice, satisfactory arrangements for the payment of the malpractice judgment are not in place.  It is pointed out that after the passage of the 30-day period   the Department will be able to issue an emergency suspension order prohibiting the NP from practicing until payment or other arrangements are made.
• While the right to go bare" should not be denied to any NP it is important that all be aware of the consequences in the event they chose to do so.
• For years ARNP's who purchased their own liability coverage were never able to request lower coverage and we had 1/3 million of higher coverage. This is far more than the current law requires.
• New policies for ARNP's will be soon offered at much lower covered limits - $250/750  -on these claims-made policies. Higher limits will be available, but at much higher premiums. 
• The financial tab on your ARNP profile on MQA will read thus if you go bare:
  I meet all of the following criteria: (a) I have held an active license to practice in this state or another state or some combination thereof for more than 15 years; (b) I am retired or maintain part time practice of no more than 1000 patient contact hours per year; (c) I have had no more than two claims resulting in an indemnity exceeding $25,000 within the previous five year period; (d) I have not been convicted of or pled guilty or nolo contendere to any criminal violation specified in Chapter 458 or 459, F.S.; and (e) I have not been subject, within the past ten years of practice, to license revocation or suspension, probation for a period of three years or longer, or a fine of $500 or more for a violation of Chapter 458 or 459, F.S., or the medical practice act of another jurisdiction.A regulatory agency's acceptance of a relinquishment of license stipulation, consent order or other settlement offered in response to or in anticipation of filing of administrative charges against a license shall be construed as action against a license. I understand if I am claiming an exception under this section that I must either post notice in the form of a sign, prominently displayed in the reception area or provide a written statement to any person to whom medical services are being provided, that I have decided not to carry medical malpractice insurance. I understand such a sign or notice must contain the wording specified in s. 458.320(5)(f) or 459.0085(5)(f), F. S.
• From a Midwife Insurance document- As you know Midwives have struggled for years to keep affordable professional liability coverage. “Going bare” refers to practicing without professional liability insurance. This is not an option in some states (some states require that midwives show evidence of liability insurance before a license to practice is issued). Where it is a possibility, going bare raises the Ethical Question of whether professionals should be financially responsible for their professional work. Though some states have formed patient compensation funds, American society as a whole still depends on liability insurance to pay for the care of injured persons. In going without coverage, the midwife makes the assumption that the value of her personal assets is too low to be an attractive claim target. Consider the following questions before making a choice to go without coverage:

1. How will the injured patient be compensated?

2. How will I pay for my defense in court or before a state licensing board?

3. Can the patient sue me for my personal worth?

FNPN hopes this information is helpful to you to look at all aspects of this bill affecting our profession. Please contact us if any questions.

Jean Aertker, President