Health Care

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A bill to be entitled 1
An act relating to health care; providing a short 2
title; repealing ss. 286.31, 286.311, and 381.00321, 3
F.S., relating to the prohibited use of state funds 4
for travel to another state for the purpose of 5
abortion services, the prohibited use of state funds 6
for sex-reassignment prescriptions or procedures, and 7
the right of medical conscience of health care 8
providers and health care payors, respectively; 9
creating s. 381.027, F.S.; providing a short title; 10
defining terms; requiring a covered entity to, by a 11
specified date, adopt a policy relating to providing 12
written notice of a complete list of its refused 13
services to patients; providing requirements for such 14
notice; requiring a covered entity to submit a 15
complete list of its refused services to the 16
Department of Health by a specified date; requiring a 17
covered entity to notify the department within a 18
specified timeframe after a change is made to such 19
list; requiring a covered entity to submit the list, 20
along with its application, if applying for certain 21
state grants or contracts; providing a civil penalty; 22
requiring the department to adopt rules; requiring the 23
department to publish and maintain on its website a 24
current list of covered entities and their refused 25

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services by a specified date; requiring the department 26
to develop and administer a certain public education 27
and awareness program; providing construction; 28
providing for severability; amending s. 381.96, F.S.; 29
revising the definition of the term "eligible client" 30
and redefining the term "pregnancy and parenting 31
support services" as "pregnancy support services"; 32
revising department duties and contract requirements 33
to conform to changes made by the act; removing an 34
obsolete provision; amending s. 390.011, F.S.; 35
deleting the definition of the term "fatal fetal 36
abnormality"; amending s. 390.0111, F.S.; revising the 37
timeframe in which a physician may perform a 38
termination of pregnancy; revising exceptions; 39
deleting the prohibition against the use of telehealth 40
to perform abortions, the requirement that medications 41
intended for use in a medical abortion be dispensed in 42
person by a physician, and the prohibition against 43
dispensing such medication through the United States 44
Postal Service or any other courier or shipping 45
service; amending s. 390.012, F.S.; revising rules the 46
Agency for Health Care Administration may develop and 47
enforce to regulate abortion clinics; repealing s. 48
395.3027, F.S., relating to patient immigration status 49
data collection in hospitals; amending s. 409.905, 50

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F.S.; defining the terms "gender identity" and 51
"transgender individual"; requiring the agency to 52
provide Medicaid reimbursement for medically necessary 53
treatment for or related to gender dysphoria or a 54
comparable or equivalent diagnosis; prohibiting the 55
agency from discriminating in its reimbursement on the 56
basis of a recipient's gender identity or that the 57
recipient is a transgender individual; amending s. 58
456.001, F.S.; deleting the definition of the terms 59
"sex" and "sex-reassignment prescriptions or 60
procedures"; amending s. 456.47, F.S.; deleting the 61
prohibition against the use of telehealth to perform 62
abortions, including medical abortions; repealing ss. 63
456.52 and 766.318, F.S., relating to sex-reassignment 64
prescriptions and procedures and civil liability for 65
provision of sex-reassignment prescriptions or 66
procedures to minors, respectively; amending ss. 67
61.517, 61.534, 409.908, 409.913, 456.074, and 68
636.0145, F.S.; conforming provisions and cross-69
references to changes made by the act; providing an 70
effective date. 71
72
Be It Enacted by the Legislature of the State of Florida: 73
74
Section 1. This act may be cited as the "Health Care 75

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Freedom Act." 76
Section 2. Section 286.31, Florida Statutes, is repealed. 77
Section 3. Section 286.311, Florida Statutes, is repealed. 78
Section 4. Section 381.00321, Florida Statutes, is 79
repealed. 80
Section 5. Section 381.027, Florida Statutes, is created 81
to read: 82
381.027 Requirements for covered entities; notice of 83
refused services; department duties.— 84
(1) SHORT TITLE.—This section may be cited as the "Health 85
Care Transparency and Accessibility Act." 86
(2) DEFINITIONS.—As used in this section, the term: 87
(a) "Covered entity" means any health care facility that 88
uses, plans to use, or relies upon a denial of care provision to 89
refuse to provide a health care service, or referral for a 90
health care service, for any reason. The term does not include a 91
health care practitioner. 92
(b) "Denial of care provision" means any federal or state 93
law that purports or is asserted to allow a health care facility 94
to opt out of providing a health care service, or referral for a 95
health care service, including, but not limited to, ss. 96
381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss. 97
18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n; 98
42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of 99
Labor, Health and Human Services, and Education, and Related 100

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Agencies Appropriations Act of 2019, Division B of Pub. L. No. 101
115-245; and 45 C.F.R. part 88. 102
(c) "Department" means the Department of Health. 103
(d) "Health care facility" has the same meaning as in s. 104
381.026(2). 105
(e) "Health care practitioner" has the same meaning as in 106
s. 456.001. 107
(f) "Health care services" has the same meaning as in s. 108
624.27(1). 109
(g) "Referral" has the same meaning as in s. 456.053(3). 110
(h) "Refused service" means a health care service that a 111
covered entity chooses not to provide, or not to provide a 112
referral for, based on one or more denials of care provisions. 113
The term includes health care services that the covered entity 114
selectively provides to some, but not all, patients based on 115
their identity, objections to a health care service, or other 116
nonmedical reasons. 117
(3) REQUIREMENTS FOR COVERED ENTITIES; PENALTY.— 118
(a) By October 1, 2026, each covered entity shall adopt a 119
policy for providing patients with a complete list of its 120
refused services. A covered entity shall: 121
1. Provide written notice to the patient or the patient's 122
representative which includes the complete list of its refused 123
services before any health care service is initiated. 124
a. In the case of an emergency, the covered entity must 125

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promptly provide written notice after the patient is capable of 126
receiving such notice or when the patient's representative is 127
available. 128
b. The patient or patient's representative shall 129
acknowledge receipt of the written notice of refused services. 130
2. Retain all acknowledgments of receipt of the written 131
notice of refused services for a period of at least 3 years. 132
3. Provide a complete list of its refused services to any 133
person upon request. 134
(b) By October 1, 2026, a covered entity shall submit to 135
the department a complete list of its refused services. If any 136
change is made to the list, the covered entity must notify the 137
department within 30 days after making the change. 138
(c) If applying for any state grant or contract related to 139
providing a health care service, a covered entity must submit, 140
along with its application, a complete list of its refused 141
services. 142
(d) A covered entity that fails to comply with this 143
subsection is subject to a fine not to exceed $5,000 for each 144
day the covered entity is not in compliance. 145
(4) DEPARTMENT DUTIES.— 146
(a) The department shall adopt rules to implement this 147
section which must include a process for receiving and 148
investigating complaints regarding covered entities not in 149
compliance with this section. 150

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(b) By January 1, 2027, the department shall publish and 151
maintain on its website a current list of covered entities and 152
the refused services for each covered entity. 153
(c) The department shall develop and administer a public 154
education and awareness program regarding the denial of health 155
care services, including how the denial of health care services 156
can negatively impact health care access and quality, how the 157
denial of health care services may be avoided, and how the 158
denial of health care services affects vulnerable people and 159
communities. 160
(5) CONSTRUCTION.— 161
(a) This section does not authorize denials of health care 162
services or discrimination in the provision of health care 163
services. 164
(b) This section does not limit any cause of action under 165
state or federal law, or limit any remedy in law or equity, 166
against a health care facility or health care practitioner. 167
(c) Compliance with this section does not reduce or limit 168
any potential liability for covered entities associated with the 169
refused services or any violations of state or federal law. 170
(d) Section 761.03 does not provide a claim relating to, 171
or a defense to a claim under, this section, or provide a basis 172
for challenging the application or enforcement of this section 173
or the use of funds associated with the application or 174
enforcement of this section. 175

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(6) SEVERABILITY.—If any provision of this section or its 176
application to any person or circumstance is held invalid, the 177
invalidity does not affect other provisions or applications of 178
this section which can be given effect without the invalid 179
provision or application, and to this end the provisions of this 180
section are severable. 181
Section 6. Section 381.96, Florida Statutes, is amended to 182
read: 183
381.96 Pregnancy support and wellness services.— 184
(1) DEFINITIONS.—As used in this section, the term: 185
(a) "Department" means the Department of Health. 186
(b) "Eligible client" means any of the following: 187
1. a pregnant woman or a woman who suspects she is 188
pregnant, and the family of such woman, who voluntarily seeks 189
pregnancy support services and any woman who voluntarily seeks 190
wellness services. 191
2. A woman who has given birth in the previous 12 months 192
and her family. 193
3. A parent or parents or a legal guardian or legal 194
guardians, and the families of such parents and legal guardians, 195
for up to 12 months after the birth of a child or the adoption 196
of a child younger than 3 years of age. 197
(c) "Florida Pregnancy Care Network, Inc.," or "network" 198
means the not-for-profit statewide alliance of pregnancy support 199
organizations that provide pregnancy support and wellness 200

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services through a comprehensive system of care to women and 201
their families. 202
(d) "Pregnancy and parenting support services" means 203
services that promote and encourage childbirth, including, but 204
not limited to: 205
1. Direct client services, such as pregnancy testing, 206
counseling, referral, training, and education for pregnant women 207
and their families. A woman and her family remain eligible to 208
receive direct client services for up to 12 months after the 209
birth of the child. 210
2. Nonmedical material assistance that improves the 211
pregnancy or parenting situation of families, including, but not 212
limited to, clothing, car seats, cribs, formula, and diapers. 213
3. Counseling or mentoring, education materials, and 214
classes regarding pregnancy, parenting, adoption, life skills, 215
and employment readiness. 216
4. Network awareness activities, including a promotional 217
campaign to educate the public about the pregnancy support 218
services offered by the network and a website that provides 219
information on the location of providers in the user's area and 220
other available community resources. 221
3.5. Communication activities, including the operation and 222
maintenance of a hotline or call center with a single statewide 223
toll-free number that is available 24 hours a day for an 224
eligible client to obtain the location and contact information 225

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for a pregnancy center located in the client's area. 226
(e) "Wellness services" means services or activities 227
intended to maintain and improve health or prevent illness and 228
injury, including, but not limited to, high blood pressure 229
screening, anemia testing, thyroid screening, cholesterol 230
screening, diabetes screening, and assistance with smoking 231
cessation. 232
(2) DEPARTMENT DUTIES.—The department shall contract with 233
the network for the management and delivery of pregnancy and 234
parenting support services and wellness services to eligible 235
clients. 236
(3) CONTRACT REQUIREMENTS.—The department contract must 237
shall specify the contract deliverables, including financial 238
reports and other reports due to the department, timeframes for 239
achieving contractual obligations, and any other requirements 240
the department determines are necessary, such as staffing and 241
location requirements. The contract must shall require the 242
network to: 243
(a) Establish, implement, and monitor a comprehensive 244
system of care through subcontractors to meet the pregnancy and 245
parenting support and wellness needs of eligible clients. 246
(b) Establish and manage subcontracts with a sufficient 247
number of providers to ensure the availability of pregnancy and 248
parenting support services and wellness services for eligible 249
clients, and maintain and manage the delivery of such services 250

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throughout the contract period. 251
(c) Spend at least 90 85 percent of the contract funds on 252
pregnancy and parenting support services, excluding services 253
specified in subparagraph (1)(d)4., and wellness services. 254
(d) Offer wellness services through vouchers or other 255
appropriate arrangements that allow the purchase of services 256
from qualified health care providers. 257
(e) Require a background screening under s. 943.0542 for 258
all paid staff and volunteers of a subcontractor if such staff 259
or volunteers provide direct client services to an eligible 260
client who is a minor or an elderly person or who has a 261
disability. 262
(f) Annually Monitor its subcontractors annually and 263
specify the sanctions that will shall be imposed for 264
noncompliance with the terms of a subcontract. 265
(g) Subcontract only with providers that exclusively 266
promote and support childbirth. 267
(h) Ensure that informational materials provided to an 268
eligible client by a provider are current and accurate and cite 269
the reference source of any medical statement included in such 270
materials. 271
(i) Ensure that the department is provided with all 272
information necessary for the report required under subsection 273
(5). 274
(4) SERVICES.—Services provided pursuant to this section 275

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must be provided in a noncoercive manner and may not include any 276
religious content. 277
(5) REPORT.—By July 1, 2024, and each year thereafter, The 278
department shall annually report to the Governor, the President 279
of the Senate, and the Speaker of the House of Representatives 280
on the amount and types of services provided by the network; the 281
expenditures for such services; and the number of, and 282
demographic information for, women, parents, and families served 283
by the network. 284
Section 7. Subsection (6) of section 390.011, Florida 285
Statutes, is amended to read: 286
390.011 Definitions.—As used in this chapter, the term: 287
(6) "Fatal fetal abnormality" means a terminal condition 288
that, in reasonable medical judgment, regardless of the 289
provision of life-saving medical treatment, is incompatible with 290
life outside the womb and will result in death upon birth or 291
imminently thereafter. 292
Section 8. Subsections (1) and (2) of section 390.0111, 293
Florida Statutes, are amended to read: 294
390.0111 Termination of pregnancies.— 295
(1) TERMINATION IN THIRD TRIMESTER AFTER GESTATIONAL AGE 296
OF 6 WEEKS; WHEN ALLOWED.—A physician may not knowingly perform 297
or induce a termination of pregnancy on any person in the third 298
trimester of pregnancy if the physician determines the 299
gestational age of the fetus is more than 6 weeks unless one of 300

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the following conditions is met: 301
(a) Two physicians certify in writing that, in reasonable 302
medical judgment, the termination of the pregnancy is necessary 303
to save the pregnant woman's life or avert a serious risk of 304
substantial and irreversible physical impairment of a major 305
bodily function of the pregnant woman other than a psychological 306
condition. 307
(b) The physician certifies in writing that, in reasonable 308
medical judgment, there is a medical necessity for legitimate 309
emergency medical procedures for termination of the pregnancy to 310
save the pregnant woman's life or avert a serious risk of 311
imminent substantial and irreversible physical impairment of a 312
major bodily function of the pregnant woman other than a 313
psychological condition, and another physician is not available 314
for consultation. 315
(c) The pregnancy has not progressed to the third 316
trimester and two physicians certify in writing that, in 317
reasonable medical judgment, the fetus has a fatal fetal 318
abnormality. 319
(d) The pregnancy is the result of rape, incest, or human 320
trafficking and the gestational age of the fetus is not more 321
than 15 weeks as determined by the physician. At the time the 322
woman schedules or arrives for her appointment to obtain the 323
abortion, she must provide a copy of a restraining order, police 324
report, medical record, or other court order or documentation 325

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providing evidence that she is obtaining the termination of 326
pregnancy because she is a victim of rape, incest, or human 327
trafficking. If the woman is 18 years of age or older, the 328
physician must report any known or suspected human trafficking 329
to a local law enforcement agency. If the woman is a minor, the 330
physician must report the incident of rape, incest, or human 331
trafficking to the central abuse hotline as required by s. 332
39.201. 333
(2) IN-PERSON PERFORMANCE BY PHYSICIAN REQUIRED.—Only a 334
physician may perform or induce a termination of pregnancy. A 335
physician may not use telehealth as defined in s. 456.47 to 336
perform an abortion, including, but not limited to, medical 337
abortions. Any medications intended for use in a medical 338
abortion must be dispensed in person by a physician and may not 339
be dispensed through the United States Postal Service or by any 340
other courier or shipping service. 341
Section 9. Subsection (1) of section 390.012, Florida 342
Statutes, is amended to read: 343
390.012 Powers of agency; rules; disposal of fetal 344
remains.— 345
(1) The agency may develop and enforce rules pursuant to 346
ss. 390.011-390.018 and part II of chapter 408 for the health, 347
care, and treatment of persons in abortion clinics and for the 348
safe operation of such clinics. The rules must be reasonably 349
related to the preservation of maternal health of the clients, 350

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must be in accordance with s. 797.03, may not impose an 351
unconstitutional burden on a woman's freedom to decide whether 352
to terminate her pregnancy, and must provide for all of the 353
following: 354
(a) The performance of pregnancy termination procedures 355
only by a licensed physician. 356
(b) The making, protection, and preservation of patient 357
records, which must be treated as medical records under chapter 358
458. When performing a license inspection of a clinic, the 359
agency shall inspect at least 50 percent of patient records 360
generated since the clinic's last license inspection. 361
(c) Annual inspections by the agency of all clinics 362
licensed under this chapter to ensure that such clinics are in 363
compliance with this chapter and agency rules. 364
(d) The prompt investigation of credible allegations of 365
abortions being performed at a clinic that is not licensed to 366
perform such procedures. 367
Section 10. Section 395.3027, Florida Statutes, is 368
repealed. 369
Section 11. Present subsections (4) through (12) of 370
section 409.905, Florida Statutes, are redesignated as 371
subsections (5) through (13), respectively, and a new subsection 372
(4) is added to that section, to read: 373
409.905 Mandatory Medicaid services.—The agency may make 374
payments for the following services, which are required of the 375

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state by Title XIX of the Social Security Act, furnished by 376
Medicaid providers to recipients who are determined to be 377
eligible on the dates on which the services were provided. Any 378
service under this section shall be provided only when medically 379
necessary and in accordance with state and federal law. 380
Mandatory services rendered by providers in mobile units to 381
Medicaid recipients may be restricted by the agency. Nothing in 382
this section shall be construed to prevent or limit the agency 383
from adjusting fees, reimbursement rates, lengths of stay, 384
number of visits, number of services, or any other adjustments 385
necessary to comply with the availability of moneys and any 386
limitations or directions provided for in the General 387
Appropriations Act or chapter 216. 388
(4) GENDER-AFFIRMING CARE.— 389
(a) Definitions.—As used in this section, the term: 390
1. "Gender identity" means an individual's internal sense 391
of that individual's gender, regardless of the sex assigned to 392
that individual at birth. 393
2. "Transgender individual" means an individual who 394
identifies as a gender different from the sex assigned to that 395
individual at birth. 396
(b) Reimbursement.—The agency shall provide reimbursement 397
for medically necessary treatment for or related to gender 398
dysphoria as defined by the Diagnostic and Statistical Manual of 399
Mental Disorders, Fifth Edition, published by the American 400

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Psychiatric Association or a comparable or equivalent diagnosis. 401
(c) Discrimination prohibited.—The agency may not 402
discriminate in its reimbursement of medically necessary 403
treatment on the basis of the recipient's gender identity or on 404
the basis that the recipient is a transgender individual. 405
Section 12. Subsections (8) and (9) of section 456.001, 406
Florida Statutes, are amended to read: 407
456.001 Definitions.—As used in this chapter, the term: 408
(8) "Sex" means the classification of a person as either 409
male or female based on the organization of the human body of 410
such person for a specific reproductive role, as indicated by 411
the person's sex chromosomes, naturally occurring sex hormones, 412
and internal and external genitalia present at birth. 413
(9)(a) "Sex-reassignment prescriptions or procedures" 414
means: 415
1. The prescription or administration of puberty blockers 416
for the purpose of attempting to stop or delay normal puberty in 417
order to affirm a person's perception of his or her sex if that 418
perception is inconsistent with the person's sex as defined in 419
subsection (8). 420
2. The prescription or administration of hormones or 421
hormone antagonists to affirm a person's perception of his or 422
her sex if that perception is inconsistent with the person's sex 423
as defined in subsection (8). 424
3. Any medical procedure, including a surgical procedure, 425

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to affirm a person's perception of his or her sex if that 426
perception is inconsistent with the person's sex as defined in 427
subsection (8). 428
(b) The term does not include: 429
1. Treatment provided by a physician who, in his or her 430
good faith clinical judgment, performs procedures upon or 431
provides therapies to a minor born with a medically verifiable 432
genetic disorder of sexual development, including any of the 433
following: 434
a. External biological sex characteristics that are 435
unresolvably ambiguous. 436
b. A disorder of sexual development in which the physician 437
has determined through genetic or biochemical testing that the 438
patient does not have a normal sex chromosome structure, sex 439
steroid hormone production, or sex steroid hormone action for a 440
male or female, as applicable. 441
2. Prescriptions or procedures to treat an infection, an 442
injury, a disease, or a disorder that has been caused or 443
exacerbated by the performance of any sex-reassignment 444
prescription or procedure, regardless of whether such 445
prescription or procedure was performed in accordance with state 446
or federal law. 447
3. Prescriptions or procedures provided to a patient for 448
the treatment of a physical disorder, physical injury, or 449
physical illness that would, as certified by a physician 450

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licensed under chapter 458 or chapter 459, place the individual 451
in imminent danger of death or impairment of a major bodily 452
function without the prescription or procedure. 453
Section 13. Paragraph (f) of subsection (2) of section 454
456.47, Florida Statutes, is amended to read: 455
456.47 Use of telehealth to provide services.— 456
(2) PRACTICE STANDARDS.— 457
(f) A telehealth provider may not use telehealth to 458
perform an abortion, including, but not limited to, medical 459
abortions as defined in s. 390.011. 460
Section 14. Section 456.52, Florida Statutes, is repealed. 461
Section 15. Section 766.318, Florida Statutes, is 462
repealed. 463
Section 16. Subsection (1) of section 61.517, Florida 464
Statutes, is amended to read: 465
61.517 Temporary emergency jurisdiction.— 466
(1) A court of this state has temporary emergency 467
jurisdiction if the child is present in this state and: 468
(a) The child has been abandoned; or 469
(b) It is necessary in an emergency to protect the child 470
because the child, or a sibling or parent of the child, is 471
subjected to or threatened with mistreatment or abuse; or 472
(c) It is necessary in an emergency to protect the child 473
because the child has been subjected to or is threatened with 474
being subjected to sex-reassignment prescriptions or procedures, 475

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as defined in s. 456.001. 476
Section 17. Subsection (1) of section 61.534, Florida 477
Statutes, is amended to read: 478
61.534 Warrant to take physical custody of child.— 479
(1) Upon the filing of a petition seeking enforcement of a 480
child custody determination, the petitioner may file a verified 481
application for the issuance of a warrant to take physical 482
custody of the child if the child is likely to imminently suffer 483
serious physical harm or removal from this state. Serious 484
physical harm includes, but is not limited to, being subjected 485
to sex-reassignment prescriptions or procedures as defined in s. 486
456.001. 487
Section 18. Paragraph (a) of subsection (1) of section 488
409.908, Florida Statutes, is amended to read: 489
409.908 Reimbursement of Medicaid providers.—Subject to 490
specific appropriations, the agency shall reimburse Medicaid 491
providers, in accordance with state and federal law, according 492
to methodologies set forth in the rules of the agency and in 493
policy manuals and handbooks incorporated by reference therein. 494
These methodologies may include fee schedules, reimbursement 495
methods based on cost reporting, negotiated fees, competitive 496
bidding pursuant to s. 287.057, and other mechanisms the agency 497
considers efficient and effective for purchasing services or 498
goods on behalf of recipients. If a provider is reimbursed based 499
on cost reporting and submits a cost report late and that cost 500

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report would have been used to set a lower reimbursement rate 501
for a rate semester, then the provider's rate for that semester 502
shall be retroactively calculated using the new cost report, and 503
full payment at the recalculated rate shall be effected 504
retroactively. Medicare-granted extensions for filing cost 505
reports, if applicable, shall also apply to Medicaid cost 506
reports. Payment for Medicaid compensable services made on 507
behalf of Medicaid-eligible persons is subject to the 508
availability of moneys and any limitations or directions 509
provided for in the General Appropriations Act or chapter 216. 510
Further, nothing in this section shall be construed to prevent 511
or limit the agency from adjusting fees, reimbursement rates, 512
lengths of stay, number of visits, or number of services, or 513
making any other adjustments necessary to comply with the 514
availability of moneys and any limitations or directions 515
provided for in the General Appropriations Act, provided the 516
adjustment is consistent with legislative intent. 517
(1) Reimbursement to hospitals licensed under part I of 518
chapter 395 must be made prospectively or on the basis of 519
negotiation. 520
(a) Reimbursement for inpatient care is limited as 521
provided in s. 409.905(6) s. 409.905(5), except as otherwise 522
provided in this subsection. 523
1. If authorized by the General Appropriations Act, the 524
agency may modify reimbursement for specific types of services 525

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or diagnoses, recipient ages, and hospital provider types. 526
2. The agency may establish an alternative methodology to 527
the DRG-based prospective payment system to set reimbursement 528
rates for: 529
a. State-owned psychiatric hospitals. 530
b. Newborn hearing screening services. 531
c. Transplant services for which the agency has 532
established a global fee. 533
d. Recipients who have tuberculosis that is resistant to 534
therapy who are in need of long-term, hospital-based treatment 535
pursuant to s. 392.62. 536
3. The agency shall modify reimbursement according to 537
other methodologies recognized in the General Appropriations 538
Act. 539
540
The agency may receive funds from state entities, including, but 541
not limited to, the Department of Health, local governments, and 542
other local political subdivisions, for the purpose of making 543
special exception payments, including federal matching funds, 544
through the Medicaid inpatient reimbursement methodologies. 545
Funds received for this purpose shall be separately accounted 546
for and may not be commingled with other state or local funds in 547
any manner. The agency may certify all local governmental funds 548
used as state match under Title XIX of the Social Security Act, 549
to the extent and in the manner authorized under the General 550

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Appropriations Act and pursuant to an agreement between the 551
agency and the local governmental entity. In order for the 552
agency to certify such local governmental funds, a local 553
governmental entity must submit a final, executed letter of 554
agreement to the agency, which must be received by October 1 of 555
each fiscal year and provide the total amount of local 556
governmental funds authorized by the entity for that fiscal year 557
under this paragraph, paragraph (b), or the General 558
Appropriations Act. The local governmental entity shall use a 559
certification form prescribed by the agency. At a minimum, the 560
certification form must identify the amount being certified and 561
describe the relationship between the certifying local 562
governmental entity and the local health care provider. The 563
agency shall prepare an annual statement of impact which 564
documents the specific activities undertaken during the previous 565
fiscal year pursuant to this paragraph, to be submitted to the 566
Legislature annually by January 1. 567
Section 19. Subsection (36) of section 409.913, Florida 568
Statutes, is amended to read: 569
409.913 Oversight of the integrity of the Medicaid 570
program.—The agency shall operate a program to oversee the 571
activities of Florida Medicaid recipients, and providers and 572
their representatives, to ensure that fraudulent and abusive 573
behavior and neglect of recipients occur to the minimum extent 574
possible, and to recover overpayments and impose sanctions as 575

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appropriate. Each January 15, the agency and the Medicaid Fraud 576
Control Unit of the Department of Legal Affairs shall submit a 577
report to the Legislature documenting the effectiveness of the 578
state's efforts to control Medicaid fraud and abuse and to 579
recover Medicaid overpayments during the previous fiscal year. 580
The report must describe the number of cases opened and 581
investigated each year; the sources of the cases opened; the 582
disposition of the cases closed each year; the amount of 583
overpayments alleged in preliminary and final audit letters; the 584
number and amount of fines or penalties imposed; any reductions 585
in overpayment amounts negotiated in settlement agreements or by 586
other means; the amount of final agency determinations of 587
overpayments; the amount deducted from federal claiming as a 588
result of overpayments; the amount of overpayments recovered 589
each year; the amount of cost of investigation recovered each 590
year; the average length of time to collect from the time the 591
case was opened until the overpayment is paid in full; the 592
amount determined as uncollectible and the portion of the 593
uncollectible amount subsequently reclaimed from the Federal 594
Government; the number of providers, by type, that are 595
terminated from participation in the Medicaid program as a 596
result of fraud and abuse; and all costs associated with 597
discovering and prosecuting cases of Medicaid overpayments and 598
making recoveries in such cases. The report must also document 599
actions taken to prevent overpayments and the number of 600

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providers prevented from enrolling in or reenrolling in the 601
Medicaid program as a result of documented Medicaid fraud and 602
abuse and must include policy recommendations necessary to 603
prevent or recover overpayments and changes necessary to prevent 604
and detect Medicaid fraud. All policy recommendations in the 605
report must include a detailed fiscal analysis, including, but 606
not limited to, implementation costs, estimated savings to the 607
Medicaid program, and the return on investment. The agency must 608
submit the policy recommendations and fiscal analyses in the 609
report to the appropriate estimating conference, pursuant to s. 610
216.137, by February 15 of each year. The agency and the 611
Medicaid Fraud Control Unit of the Department of Legal Affairs 612
each must include detailed unit-specific performance standards, 613
benchmarks, and metrics in the report, including projected cost 614
savings to the state Medicaid program during the following 615
fiscal year. 616
(36) The agency may provide to a sample of Medicaid 617
recipients or their representatives through the distribution of 618
explanations of benefits information about services reimbursed 619
by the Medicaid program for goods and services to such 620
recipients, including information on how to report inappropriate 621
or incorrect billing to the agency or other law enforcement 622
entities for review or investigation, information on how to 623
report criminal Medicaid fraud to the Medicaid Fraud Control 624
Unit's toll-free hotline number, and information about the 625

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rewards available under s. 409.9203. The explanation of benefits 626
may not be mailed for Medicaid independent laboratory services 627
as described in s. 409.905(8) s. 409.905(7) or for Medicaid 628
certified match services as described in ss. 409.9071 and 629
1011.70. 630
Section 20. Paragraph (c) of subsection (5) of section 631
456.074, Florida Statutes, is amended to read: 632
456.074 Certain health care practitioners; immediate 633
suspension of license.— 634
(5) The department shall issue an emergency order 635
suspending the license of any health care practitioner who is 636
arrested for committing or attempting, soliciting, or conspiring 637
to commit any act that would constitute a violation of any of 638
the following criminal offenses in this state or similar 639
offenses in another jurisdiction: 640
(c) Section 456.52(5)(b), relating to prescribing, 641
administering, or performing sex-reassignment prescriptions or 642
procedures for a patient younger than 18 years of age. 643
Section 21. Section 636.0145, Florida Statutes, is amended 644
to read: 645
636.0145 Certain entities contracting with Medicaid.—An 646
entity that is providing comprehensive inpatient and outpatient 647
mental health care services to certain Medicaid recipients in 648
Hillsborough, Highlands, Hardee, Manatee, and Polk Counties 649
through a capitated, prepaid arrangement pursuant to the federal 650

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waiver provided for in s. 409.905(6) s. 409.905(5) must become 651
licensed under this chapter by December 31, 1998. Any entity 652
licensed under this chapter which provides services solely to 653
Medicaid recipients under a contract with Medicaid is exempt 654
from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and 655
636.066(1). 656
Section 22. This act shall take effect July 1, 2026. 657