Health Care Freedom Act

Florida Senate
-
2026

SB 782

By
Senator Jones

34-00668-26 2026782__
1 A bill to be entitled
2 An act relating to the Health Care Freedom Act;
3 providing a short title; repealing ss. 286.31,
4 286.311, and 381.00321, F.S., relating to the
5 prohibited use of state funds for travel to another
6 state for purpose of abortion services, the prohibited
7 use of state funds for sex-reassignment prescriptions
8 or procedures, and the right of medical conscience of
9 health care providers and health care payors,
10 respectively; creating s. 381.027, F.S.; providing a
11 short title; defining terms; requiring a covered
12 entity to, by a specified date, adopt a policy
13 relating to providing written notice of a complete
14 list of its refused services to patients; specifying
15 requirements for such notice; requiring a covered
16 entity to submit a complete list of its refused
17 services to the Department of Health by a specified
18 date; requiring a covered entity to notify the
19 department within a specified timeframe after a change
20 is made to such list; requiring a covered entity to
21 submit the list, along with its application, if
22 applying for certain state grants or contracts;
23 providing a civil penalty; requiring the department to
24 adopt rules; requiring the department to publish and
25 maintain on its website a current list of covered
26 entities and their refused services by a specified
27 date; requiring the department to develop and
28 administer a certain public education and awareness
29 program; providing construction; providing for
30 severability; amending s. 381.96, F.S.; revising the
31 definition of the term “eligible client” and
32 redefining the term “pregnancy and parenting support
33 services” as “pregnancy support services”; revising
34 department duties and contract requirements to conform
35 to changes made by the act; amending s. 390.011, F.S.;
36 deleting the definition of the term “fatal fetal
37 abnormality”; amending s. 390.0111, F.S.; revising the
38 timeframe in which a physician may perform a
39 termination of pregnancy; revising exceptions;
40 deleting the prohibition against the use of telehealth
41 to perform abortions, the requirement that medications
42 intended for use in a medical abortion be dispensed in
43 person by a physician, and the prohibition against
44 dispensing such medication through the United States
45 Postal Service or any other courier or shipping
46 service; amending s. 390.012, F.S.; revising rules the
47 Agency for Health Care Administration may develop and
48 enforce to regulate abortion clinics; repealing s.
49 395.3027, F.S., relating to patient immigration status
50 data collection in hospitals; amending s. 409.905,
51 F.S.; defining the terms “gender identity” and
52 “transgender individual”; requiring the agency to
53 provide Medicaid reimbursement for medically necessary
54 treatment for or related to gender dysphoria or a
55 comparable or equivalent diagnosis; prohibiting the
56 agency from discriminating in its reimbursement on the
57 basis of a recipient’s gender identity or that the
58 recipient is a transgender individual; amending s.
59 456.001, F.S.; deleting the definition of the terms
60 “sex” and “sex-reassignment prescriptions or
61 procedures”; amending s. 456.47, F.S.; deleting the
62 prohibition against the use of telehealth to perform
63 abortions, including medical abortions; repealing ss.
64 456.52 and 766.318, F.S., relating to sex-reassignment
65 prescriptions and procedures and civil liability for
66 provision of sex-reassignment prescriptions or
67 procedures to minors, respectively; amending ss.
68 61.517, 61.534, 409.908, 409.913, 456.074, and
69 636.0145, F.S.; conforming provisions and cross
70 references to changes made by the act; providing an
71 effective date.
72
73 Be It Enacted by the Legislature of the State of Florida:
74
75 Section 1.
This act may be cited as the “Health Care

76
Freedom Act.”

77 Section 2.
Section 286.31, Florida Statutes, is repealed.

78 Section 3.
Section 286.311, Florida Statutes, is repealed.

79 Section 4.
Section 381.00321, Florida Statutes, is

80
repealed.

81 Section 5. Section 381.027, Florida Statutes, is created to
82 read:
83
381.027

Requirements for covered entities; notice of

84
refused services; department duties.—

85
(1)

SHORT TITLE.—This section may be cited as the “Health

86
Care Transparency and Accessibility Act.”

87
(2)

DEFINITIONS.—As used in this section, the term:

88
(a)

“Covered entity” means any health care facility that

89
uses, plans to use, or relies upon a denial of care provision to

90
refuse to provide a health care service, or referral for a

91
health care service, for any reason. The term does not include a

92
health care practitioner.

93
(b)

“Denial of care provision” means any federal or state

94
law that purports or is asserted to allow a health care facility

95
to opt out of providing a health care service, or referral for a

96
health care service, including, but not limited to, ss.

97
381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss.

98
18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n;

99
42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of

100
Labor, Health and Human Services, and Education, and Related

101
Agencies Appropriations Act of 2019, Division B of Pub. L. No.

102
115-245; and 45 C.F.R. part 88.

103
(c)

“Department” means the Department of Health.

104
(d)

“Health care facility” has the same meaning as in s.

105
381.026(2).

106
(e)

“Health care practitioner” has the same meaning as in

107
s. 456.001.

108
(f)

“Health care service
s
” has the same meaning as in s.

109
624.27(1).

110
(g)

“Referral” has the same meaning as in s. 456.053(3).

111
(h) “Refused service” means a health care service that a

112
covered entity chooses not to provide, or not to provide a

113
referral for, based on one or more denial of care provisions.

114
The term includes health care services that the covered entity

115
selectively provides to some, but not all, patients based on

116
their identity, objections to a health care service, or other

117
nonmedical reasons.

118
(3) REQUIREMENTS FOR COVERED ENTITIES; PENALTY.—

119
(a) By October 1, 202
6
, each covered entity shall adopt a

120
policy for providing patients with a complete list of its

121
refused services. A covered entity shall:

122
1. Provide written notice to the patient or the patient’s

123
representative which includes the complete list of its refused

124
services before any health care service is initiated.

125
a. In the case of an emergency, the covered entity must

126
promptly provide written notice after the patient is capable of

127
receiving such notice or when the patient’s representative is

128
available.

129
b. The patient or patient’s representative shall

130
acknowledge receipt of the written notice of refused services.

131
2. Retain all acknowledgments of receipt of the written

132
notice of refused services for a period of at least 3 years.

133
3. Provide a complete list of its refused services to any

134
person upon request.

135
(b) By October 1, 202
6
, a covered entity shall submit to

136
the department a complete list of its refused services. If any

137
change is made to the list, the covered entity must notify the

138
department within 30 days after making the change.

139
(c) If applying for any state grant or contract related to

140
providing a health care service, a covered entity must submit,

141
along with its application, a complete list of its refused

142
services.

143
(d) A covered entity that fails to comply with this

144
subsection is subject to a fine not
to exceed
$5,000 for each

145
day the covered entity is not in compliance.

146
(4) DEPARTMENT DUTIES.—

147
(a) The department shall adopt rules to implement this

148
section which must include a process for receiving and

149
investigating complaints regarding covered entities
not in

150
compliance
with this section.

151
(b) By January 1, 202
7
, the department shall publish and

152
maintain on its website a current list of covered entities and

153
the refused services for each covered entity.

154
(c) The department shall develop and administer a public

155
education and awareness program regarding the denial of health

156
care services, including how the denial of health care services

157
can negatively impact health care access and quality, how the

158
denial of health care services may be avoided, and how the

159
denial of health care services affects vulnerable people and

160
communities.

161
(5) CONSTRUCTION.—

162
(a) This section does not authorize denials of health care

163
services or discrimination in the provision of health care

164
services.

165
(b) This section does not limit any cause of action under

166
state or federal law, or limit any remedy in law or equity,

167
against a health care facility or health care practitioner.

168
(c) Compliance with this section does not reduce or limit

169
any potential liability for covered entities associated with the

170
refused services or any violations of state or federal law.

171
(d) Section 761.03 does not provide a claim relating to, or

172
a defense to a claim under, this section, or provide a basis for

173
challenging the application or enforcement of this section or

174
the use of funds associated with the application or enforcement

175
of this section.

176
(6) SEVERABILITY.—If any provision of this section or its

177
application to any person or circumstance is held invalid, the

178
invalidity does not affect other provisions or applications of

179
this section which can be given effect without the invalid

180
provision or application, and to this end the provisions of this

181
section are severable.

182 Section 6. Section 381.96, Florida Statutes, is amended to
183 read:
184 381.96 Pregnancy support and wellness services.—
185 (1) DEFINITIONS.—As used in this section, the term:
186 (a) “Department” means the Department of Health.
187 (b) “Eligible client” means
any of the following:

188
1.
a pregnant woman or a woman who suspects she is
189 pregnant, and the family of such woman, who voluntarily seeks
190 pregnancy support services and any woman who voluntarily seeks
191 wellness services.
192
2. A woman who has given birth in the previous 12 months

193
and her family.

194
3. A parent or parents or a legal guardian or legal

195
guardians, and the families of such parents and legal guardians,

196
for up to 12 months after the birth of a child or the adoption

197
of a child younger than 3 years of age.

198 (c) “Florida Pregnancy Care Network, Inc.,” or “network”
199 means the not-for-profit statewide alliance of pregnancy support
200 organizations that provide pregnancy support and wellness
201 services through a comprehensive system of care to women and
202 their families.
203 (d) “Pregnancy
and parenting
support services” means
204 services that promote and encourage childbirth, including, but
205 not limited to:
206 1. Direct client services, such as pregnancy testing,
207 counseling, referral, training, and education for pregnant women
208 and their families.
A woman and her family
remain
eligible to

209
receive direct client services for up to 12 months after the

210
birth of the child.

211 2.
Nonmedical material assistance that improves the

212
pregnancy or parenting situation of families, including, but not

213
limited to, clothing, car seats, cribs, formula, and diapers.

214
3. Counseling or mentoring, education materials, and

215
classes regarding pregnancy, parenting, adoption, life skills,

216
and employment readiness.

217
4.
Network awareness activities, including a promotional
218 campaign to educate the public about the pregnancy support
219 services offered by the network and a website that provides
220 information on the location of providers in the user’s area and
221 other available community resources.
222
3.
5.
Communication activities, including the operation and
223 maintenance of a hotline or call center with a single statewide
224 toll-free number that is available 24 hours a day for an
225 eligible client to obtain the location and contact information
226 for a pregnancy center located in the client’s area.
227 (e) “Wellness services” means services or activities
228 intended to maintain and improve health or prevent illness and
229 injury, including, but not limited to, high blood pressure
230 screening, anemia testing, thyroid screening, cholesterol
231 screening, diabetes screening, and assistance with smoking
232 cessation.
233 (2) DEPARTMENT DUTIES.—The department shall contract with
234 the network for the management and delivery of pregnancy
and

235
parenting
support services and wellness services to eligible
236 clients.
237 (3) CONTRACT REQUIREMENTS.—The department contract
must

238
shall
specify the contract deliverables, including financial
239 reports and other reports due to the department, timeframes for
240 achieving contractual obligations, and any other requirements
241 the department determines are necessary, such as staffing and
242 location requirements. The contract
must

shall
require the
243 network to:
244 (a) Establish, implement, and monitor a comprehensive
245 system of care through subcontractors to meet the pregnancy
and

246
parenting
support and wellness needs of eligible clients.
247 (b) Establish and manage subcontracts with a sufficient
248 number of providers to ensure the availability of pregnancy
and

249
parenting
support services and wellness services for eligible
250 clients, and maintain and manage the delivery of such services
251 throughout the contract period.
252 (c) Spend at least
90

85
percent of the contract funds on
253 pregnancy
and parenting
support services
, excluding services

254
specified in subparagraph (1)(d)4.,
and wellness services.
255 (d) Offer wellness services through vouchers or other
256 appropriate arrangements that allow the purchase of services
257 from qualified health care providers.
258 (e) Require a background screening under s. 943.0542 for
259 all paid staff and volunteers of a subcontractor if such staff
260 or volunteers provide direct client services to an eligible
261 client who is a minor or an elderly person or who has a
262 disability.
263 (f)
Annually
Monitor its subcontractors
annually
and
264 specify the sanctions that
will

shall
be imposed for
265 noncompliance with the terms of a subcontract.
266 (g) Subcontract only with providers that exclusively
267 promote and support childbirth.
268 (h) Ensure that informational materials provided to an
269 eligible client by a provider are current and accurate and cite
270 the reference source of any medical statement included in such
271 materials.
272 (i) Ensure that the department is provided with all
273 information necessary for the report required under subsection
274 (5).
275 (4) SERVICES.—Services provided pursuant to this section
276 must be provided in a noncoercive manner and may not include any
277 religious content.
278 (5) REPORT.—By July 1, 2024, and each year thereafter, the
279 department shall report to the Governor, the President of the
280 Senate, and the Speaker of the House of Representatives on the
281 amount and types of services provided by the network; the
282 expenditures for such services; and the number of, and
283 demographic information for, women
, parents,
and families served
284 by the network.
285 Section 7. Subsection (6) of section 390.011, Florida
286 Statutes, is amended to read:
287 390.011 Definitions.—As used in this chapter, the term:
288
(6)

“Fatal fetal abnormality” means a terminal condition

289
that, in reasonable medical judgment, regardless of the

290
provision of life-saving medical treatment, is incompatible with

291
life outside the womb and will result in death upon birth or

292
imminently thereafter.

293 Section 8. Subsections (1) and (2) of section 390.0111,
294 Florida Statutes, are amended to read:
295 390.0111 Termination of pregnancies.—
296 (1) TERMINATION
IN THIRD TRIMESTER

AFTER GESTATIONAL AGE OF

297
6
WEEKS
; WHEN ALLOWED.—A physician may not knowingly perform or
298 induce a termination of pregnancy
on any woman in the third

299
trimester of pregnancy

if the physician determines the

300
gestational age of the fetus is more than
6
weeks
unless one of
301 the following conditions is met:
302 (a) Two physicians certify in writing that, in reasonable
303 medical judgment, the termination of the pregnancy is necessary
304 to save the pregnant woman’s life or avert a serious risk of
305 substantial and irreversible physical impairment of a major
306 bodily function of the pregnant woman other than a psychological
307 condition.
308 (b) The physician certifies in writing that, in reasonable
309 medical judgment, there is a medical necessity for legitimate
310 emergency medical procedures for termination of the pregnancy to
311 save the pregnant woman’s life or avert a serious risk of
312 imminent substantial and irreversible physical impairment of a
313 major bodily function of the pregnant woman other than a
314 psychological condition, and another physician is not available
315 for consultation.
316
(c) The
pregnancy
has not
progressed to the third trimester

317
and two physicians certify in writing that, in reasonable

318
medical judgment, the fetus has a fatal fetal 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
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
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 section
370 409.905, Florida Statutes, are redesignated as subsections (5)
371 through (13), respectively, and a new subsection (4) is added to
372 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 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
th
at
individual at birth.

393
2.

“Transgender individual” means an individual who
se

394
gender
is not exclusively the one
assigned to th
at
individual at

395
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 E
dition, published by the American

400
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
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
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 perform

458
an abortion, including, but not limited to, medical abortions as

459
defined in s. 390.011.

460 Section 14.
Section 456.52, Florida Statutes, is repealed.

461 Section 15.
Section 766.318, Florida Statutes, is repealed.

462 Section 16. Subsection (1) of section 61.517, Florida
463 Statutes, is amended to read:
464 61.517 Temporary emergency jurisdiction.—
465 (1) A court of this state has temporary emergency
466 jurisdiction if the child is present in this state and:
467 (a) The child has been abandoned;
or

468 (b) It is necessary in an emergency to protect the child
469 because the child, or a sibling or parent of the child, is
470 subjected to or threatened with mistreatment or abuse
; or

471
(c) It is necessary in an emergency to protect the child

472
because the child has been subjected to or is threatened with

473
being subjected to sex-reassignment prescriptions or procedures,

474
as defined in s. 456.001
.
475 Section 17. Subsection (1) of section 61.534, Florida
476 Statutes, is amended to read:
477 61.534 Warrant to take physical custody of child.—
478 (1) Upon the filing of a petition seeking enforcement of a
479 child custody determination, the petitioner may file a verified
480 application for the issuance of a warrant to take physical
481 custody of the child if the child is likely to imminently suffer
482 serious physical harm or removal from this state.
Serious

483
physical harm includes, but is not limited to, being subjected

484
to sex-reassignment prescriptions or procedures as defined in s.

485
456.001.

486 Section 18. Paragraph (a) of subsection (1) of section
487 409.908, Florida Statutes, is amended to read:
488 409.908 Reimbursement of Medicaid providers.—Subject to
489 specific appropriations, the agency shall reimburse Medicaid
490 providers, in accordance with state and federal law, according
491 to methodologies set forth in the rules of the agency and in
492 policy manuals and handbooks incorporated by reference therein.
493 These methodologies may include fee schedules, reimbursement
494 methods based on cost reporting, negotiated fees, competitive
495 bidding pursuant to s. 287.057, and other mechanisms the agency
496 considers efficient and effective for purchasing services or
497 goods on behalf of recipients. If a provider is reimbursed based
498 on cost reporting and submits a cost report late and that cost
499 report would have been used to set a lower reimbursement rate
500 for a rate semester, then the provider’s rate for that semester
501 shall be retroactively calculated using the new cost report, and
502 full payment at the recalculated rate shall be effected
503 retroactively. Medicare-granted extensions for filing cost
504 reports, if applicable, shall also apply to Medicaid cost
505 reports. Payment for Medicaid compensable services made on
506 behalf of Medicaid-eligible persons is subject to the
507 availability of moneys and any limitations or directions
508 provided for in the General Appropriations Act or chapter 216.
509 Further, nothing in this section shall be construed to prevent
510 or limit the agency from adjusting fees, reimbursement rates,
511 lengths of stay, number of visits, or number of services, or
512 making any other adjustments necessary to comply with the
513 availability of moneys and any limitations or directions
514 provided for in the General Appropriations Act, provided the
515 adjustment is consistent with legislative intent.
516 (1) Reimbursement to hospitals licensed under part I of
517 chapter 395 must be made prospectively or on the basis of
518 negotiation.
519 (a) Reimbursement for inpatient care is limited as provided
520 in
s. 409.905(6)

s. 409.905(5)
, except as otherwise provided in
521 this subsection.
522 1. If authorized by the General Appropriations Act, the
523 agency may modify reimbursement for specific types of services
524 or diagnoses, recipient ages, and hospital provider types.
525 2. The agency may establish an alternative methodology to
526 the DRG-based prospective payment system to set reimbursement
527 rates for:
528 a. State-owned psychiatric hospitals.
529 b. Newborn hearing screening services.
530 c. Transplant services for which the agency has established
531 a global fee.
532 d. Recipients who have tuberculosis that is resistant to
533 therapy who are in need of long-term, hospital-based treatment
534 pursuant to s. 392.62.
535 3. The agency shall modify reimbursement according to other
536 methodologies recognized in the General Appropriations Act.
537
538 The agency may receive funds from state entities, including, but
539 not limited to, the Department of Health, local governments, and
540 other local political subdivisions, for the purpose of making
541 special exception payments, including federal matching funds,
542 through the Medicaid inpatient reimbursement methodologies.
543 Funds received for this purpose shall be separately accounted
544 for and may not be commingled with other state or local funds in
545 any manner. The agency may certify all local governmental funds
546 used as state match under Title XIX of the Social Security Act,
547 to the extent and in the manner authorized under the General
548 Appropriations Act and pursuant to an agreement between the
549 agency and the local governmental entity. In order for the
550 agency to certify such local governmental funds, a local
551 governmental entity must submit a final, executed letter of
552 agreement to the agency, which must be received by October 1 of
553 each fiscal year and provide the total amount of local
554 governmental funds authorized by the entity for that fiscal year
555 under this paragraph, paragraph (b), or the General
556 Appropriations Act. The local governmental entity shall use a
557 certification form prescribed by the agency. At a minimum, the
558 certification form must identify the amount being certified and
559 describe the relationship between the certifying local
560 governmental entity and the local health care provider. The
561 agency shall prepare an annual statement of impact which
562 documents the specific activities undertaken during the previous
563 fiscal year pursuant to this paragraph, to be submitted to the
564 Legislature annually by January 1.
565 Section 19. Subsection (36) of section 409.913, Florida
566 Statutes, is amended to read:
567 409.913 Oversight of the integrity of the Medicaid
568 program.—The agency shall operate a program to oversee the
569 activities of Florida Medicaid recipients, and providers and
570 their representatives, to ensure that fraudulent and abusive
571 behavior and neglect of recipients occur to the minimum extent
572 possible, and to recover overpayments and impose sanctions as
573 appropriate. Each January 15, the agency and the Medicaid Fraud
574 Control Unit of the Department of Legal Affairs shall submit a
575 report to the Legislature documenting the effectiveness of the
576 state’s efforts to control Medicaid fraud and abuse and to
577 recover Medicaid overpayments during the previous fiscal year.
578 The report must describe the number of cases opened and
579 investigated each year; the sources of the cases opened; the
580 disposition of the cases closed each year; the amount of
581 overpayments alleged in preliminary and final audit letters; the
582 number and amount of fines or penalties imposed; any reductions
583 in overpayment amounts negotiated in settlement agreements or by
584 other means; the amount of final agency determinations of
585 overpayments; the amount deducted from federal claiming as a
586 result of overpayments; the amount of overpayments recovered
587 each year; the amount of cost of investigation recovered each
588 year; the average length of time to collect from the time the
589 case was opened until the overpayment is paid in full; the
590 amount determined as uncollectible and the portion of the
591 uncollectible amount subsequently reclaimed from the Federal
592 Government; the number of providers, by type, that are
593 terminated from participation in the Medicaid program as a
594 result of fraud and abuse; and all costs associated with
595 discovering and prosecuting cases of Medicaid overpayments and
596 making recoveries in such cases. The report must also document
597 actions taken to prevent overpayments and the number of
598 providers prevented from enrolling in or reenrolling in the
599 Medicaid program as a result of documented Medicaid fraud and
600 abuse and must include policy recommendations necessary to
601 prevent or recover overpayments and changes necessary to prevent
602 and detect Medicaid fraud. All policy recommendations in the
603 report must include a detailed fiscal analysis, including, but
604 not limited to, implementation costs, estimated savings to the
605 Medicaid program, and the return on investment. The agency must
606 submit the policy recommendations and fiscal analyses in the
607 report to the appropriate estimating conference, pursuant to s.
608 216.137, by February 15 of each year. The agency and the
609 Medicaid Fraud Control Unit of the Department of Legal Affairs
610 each must include detailed unit-specific performance standards,
611 benchmarks, and metrics in the report, including projected cost
612 savings to the state Medicaid program during the following
613 fiscal year.
614 (36) The agency may provide to a sample of Medicaid
615 recipients or their representatives through the distribution of
616 explanations of benefits information about services reimbursed
617 by the Medicaid program for goods and services to such
618 recipients, including information on how to report inappropriate
619 or incorrect billing to the agency or other law enforcement
620 entities for review or investigation, information on how to
621 report criminal Medicaid fraud to the Medicaid Fraud Control
622 Unit’s toll-free hotline number, and information about the
623 rewards available under s. 409.9203. The explanation of benefits
624 may not be mailed for Medicaid independent laboratory services
625 as described in
s. 409.905(8)

s. 409.905(7)
or for Medicaid
626 certified match services as described in ss. 409.9071 and
627 1011.70.
628 Section 20. Paragraph (c) of subsection (5) of section
629 456.074, Florida Statutes, is amended to read:
630 456.074 Certain health care practitioners; immediate
631 suspension of license.—
632 (5) The department shall issue an emergency order
633 suspending the license of any health care practitioner who is
634 arrested for committing or attempting, soliciting, or conspiring
635 to commit any act that would constitute a violation of any of
636 the following criminal offenses in this state or similar
637 offenses in another jurisdiction:
638
(c) Section 456.52(5)(b), relating to prescribing,

639
administering, or performing sex-reassignment prescriptions or

640
procedures for a patient younger than 18 years of age.

641 Section 21. Section 636.0145, Florida Statutes, is amended
642 to read:
643 636.0145 Certain entities contracting with Medicaid.—An
644 entity that is providing comprehensive inpatient and outpatient
645 mental health care services to certain Medicaid recipients in
646 Hillsborough, Highlands, Hardee, Manatee, and Polk Counties
647 through a capitated, prepaid arrangement pursuant to the federal
648 waiver provided for in
s. 409.905(6)

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