ENROLLED
       2023 Legislature                                  CS for SB 1580
       
       
       
       
       
       
                                                             20231580er
    1  
    2         An act relating to protections of medical conscience;
    3         providing legislative intent; creating s. 381.00321,
    4         F.S.; defining terms; providing that health care
    5         providers and health care payors have the right to opt
    6         out of participation in or payment for certain health
    7         care services on the basis of conscience-based
    8         objections; providing requirements for a health care
    9         provider’s notice and documentation of such objection;
   10         requiring health care providers to notify patients or
   11         potential patients seeking a specific health care
   12         service of any such objection before scheduling an
   13         appointment; providing construction; prohibiting
   14         health care payors from declining to cover any health
   15         care service they are obligated to cover during the
   16         plan year; prohibiting discrimination or adverse
   17         action against health care providers who decline to
   18         participate in a health care service on the basis of
   19         conscience-based objection; providing whistle-blower
   20         protections for health care providers and health care
   21         payors that take certain actions or disclose certain
   22         information relating to the reporting of certain
   23         violations; authorizing health care providers and
   24         health care payors to file complaints with the
   25         Attorney General for violation of specified
   26         provisions; providing for civil penalties; authorizing
   27         the Attorney General to take specified actions for
   28         purposes of conducting an investigation of such
   29         complaints; authorizing the Department of Legal
   30         Affairs to adopt rules; providing health care
   31         providers and health care payors immunity from civil
   32         liability solely for declining to participate in or
   33         pay for a health care service on the basis of
   34         conscience-based objection; providing construction;
   35         creating s. 456.61, F.S.; prohibiting boards, or the
   36         Department of Health if there is no board, from taking
   37         disciplinary action against or denying a license to an
   38         individual based solely on specified conduct;
   39         authorizing boards within the department’s
   40         jurisdiction to revoke their approval of a specialty
   41         board or other recognizing agency under certain
   42         circumstances; providing severability; providing an
   43         effective date.
   44          
   45  Be It Enacted by the Legislature of the State of Florida:
   46  
   47         Section 1. It is the intent of the Legislature to provide
   48  the right of medical conscience for health care providers and
   49  payors to ensure they can care for patients in a manner
   50  consistent with their moral, ethical, and religious convictions.
   51  Further, it is the intent of the Legislature that licensed
   52  health care providers and payors be free from threat of
   53  discrimination for providing conscience-based health care.
   54         Section 2. Section 381.00321, Florida Statutes, is created
   55  to read:
   56         381.00321The right of medical conscience of health care
   57  providers and health care payors.—
   58         (1)DEFINITIONS.—As used in this section, the term:
   59         (a)“Adverse action” means the discharge, transfer,
   60  demotion, discipline, suspension, exclusion, revocation of
   61  privileges, withholding of bonuses, or reduction in salary or
   62  benefits; any action that may negatively impact the advancement
   63  or graduation of a student, including, but not limited to, the
   64  withholding of scholarship funds; or any other disciplinary or
   65  retaliatory action taken against a health care provider.
   66         (b)“Conscience-based objection” means an objection based
   67  on a sincerely held religious, moral, or ethical belief.
   68  Conscience with respect to entities is determined by reference
   69  to the entities’ governing documents; any published ethical,
   70  moral, or religious guidelines or directives; mission
   71  statements; constitutions; articles of incorporation; bylaws;
   72  policies; or regulations.
   73         (c)“Department” means the Department of Health.
   74         (d)“Educational institution” means a public or private
   75  school, college, or university.
   76         (e)“Health care payor” means a health insurer, an
   77  employer, a health care sharing organization, a health plan, a
   78  health maintenance organization, a management services
   79  organization, or any other entity that pays for, or arranges for
   80  the payment of, any health care service, whether such payment is
   81  in whole or in part.
   82         (f)“Health care provider” means:
   83         1.Any person or entity licensed under chapter 394; chapter
   84  400; chapter 401; chapter 457; chapter 458; chapter 459; chapter
   85  460; chapter 461; chapter 462; chapter 463; chapter 464; chapter
   86  465; chapter 466; chapter 467; part I, part II, part III, part
   87  IV, part V, part X, part XIII, or part XIV of chapter 468;
   88  chapter 478; chapter 480; part I, part II, or part III of
   89  chapter 483; chapter 484; chapter 486; chapter 490; or chapter
   90  491; or
   91         2.Any provider as defined in s. 408.803, a continuing care
   92  facility licensed under chapter 651, or a pharmacy permitted
   93  under chapter 465.
   94  
   95  This term includes any student enrolled in an educational
   96  institution who is seeking to become a health care provider.
   97         (g)“Health care service” means medical research, medical
   98  procedures, or medical services, including, but not limited to,
   99  testing; diagnosis; referral; dispensing or administering any
  100  drug, medication, or device; psychological therapy or
  101  counseling; research; therapy; recordmaking procedures; set up
  102  or performance of a surgery or procedure; or any other care or
  103  services performed or provided by any health care provider.
  104         (h)“Participate” or “participation” means to pay for or
  105  take part in any way in providing or facilitating any health
  106  care service or any part of such service.
  107         (i)“Right of medical conscience” means the right of a
  108  health care provider or health care payor to abide by sincerely
  109  held religious, moral, or ethical beliefs. With respect to
  110  health care providers or payors that are entities, such beliefs
  111  are determined by reference to the entities’ governing
  112  documents; any published ethical, moral, or religious guidelines
  113  or directives; mission statements; constitutions; articles of
  114  incorporation; bylaws; policies; or regulations.
  115         (2)RIGHT OF MEDICAL CONSCIENCE.—
  116         (a)A health care provider or health care payor has the
  117  right to opt out of participation in or payment for any health
  118  care service on the basis of a conscience-based objection. A
  119  health care provider must, at the time of the conscience-based
  120  objection or as soon as practicable thereafter, provide written
  121  notice of his or her conscience-based objection to the health
  122  care provider’s supervisor or employer, if applicable, and
  123  document his or her conscience-based objection to a particular
  124  health care service in the patient’s medical file. Additionally,
  125  if a patient, or potential patient, when attempting to schedule
  126  an appointment with the provider indicates to the provider that
  127  he or she is seeking a specific health care service for which
  128  the provider has a conscience-based objection, the provider must
  129  notify the patient that he or she does not provide such service
  130  before scheduling the appointment. A health care provider who is
  131  a student must provide written notice of his or her conscience
  132  based objection to the educational institution at the time the
  133  conscience-based objection is made or as soon as practicable
  134  thereafter.
  135         (b)The exercise of the right of medical conscience is
  136  limited to conscience-based objections to a specific health care
  137  service. This section may not be construed to waive or modify
  138  any duty a health care provider or health care payor may have to
  139  provide or pay for other health care services that do not
  140  violate their right of medical conscience, to waive or modify
  141  any duty to provide any informed consent required by law, or to
  142  allow a health care provider or payor to opt out of providing
  143  health care services to any patient or potential patient because
  144  of that patient’s or potential patient’s race, color, religion,
  145  sex, or national origin. Additionally, a health care payor may
  146  not decline to pay for a health care service it is contractually
  147  obligated to cover during the plan year.
  148         (c)A health care provider may not be discriminated against
  149  or suffer adverse action because the health care provider
  150  declined to participate in a health care service on the basis of
  151  a conscience-based objection.
  152         (3)SPEECH AND WHISTLE-BLOWER PROTECTIONS.—
  153         (a)A health care provider or health care payor may not be
  154  discriminated against or suffer any adverse action in any manner
  155  with respect to:
  156         1.Providing or causing to be provided, or intending to
  157  provide or cause to be provided, information relating to any
  158  violation of or any act or omission the health care provider or
  159  health care payor reasonably believes to be a violation of any
  160  provision of this act to his or her employer, the Attorney
  161  General, the department, any other state agency charged with
  162  protecting the right of medical conscience, the United States
  163  Department of Health and Human Services, the Office of Civil
  164  Rights, or any other federal agency charged with protecting the
  165  right of medical conscience;
  166         2. Testifying or intending to testify in a proceeding
  167  concerning such violation; or
  168         3. Assisting or participating in or intending to assist or
  169  participate in such a proceeding.
  170         (b) Unless the disclosure is specifically prohibited by
  171  law, a health care provider or health care payor may not be
  172  discriminated against in any manner for disclosing information
  173  that the health care provider or health care payor reasonably
  174  believes constitutes:
  175         1. A violation of any law, rule, or regulation;
  176         2. A violation of any ethical guidelines for the provision
  177  of any medical procedure or service; or
  178         3. A practice or method of treatment that may put patient
  179  health at risk or present a substantial and specific danger to
  180  public health or safety.
  181         (4)ENFORCEMENT.—A health care provider or health care
  182  payor may file a complaint with the Attorney General alleging
  183  any violation of this section. If the Attorney General
  184  determines there has been a violation of this section, the
  185  Attorney General may commence a civil action for damages,
  186  injunctive relief, or any other appropriate relief, including
  187  attorney fees. For the purpose of conducting an investigation,
  188  the Attorney General may administer oaths, take depositions,
  189  make inspections when authorized by law, issue subpoenas
  190  supported by affidavit, serve subpoenas and other process, and
  191  compel the attendance of witnesses and the production of books,
  192  papers, documents, and other evidence. The Department of Legal
  193  Affairs may adopt rules to implement this subsection.
  194         (5) IMMUNITY FROM LIABILITY.—A health care provider or
  195  health care payor may not be held civilly liable solely for
  196  declining to participate in or pay for a health care service on
  197  the basis of a conscience-based objection. However, this section
  198  does not limit a person′s ability to recover damages or other
  199  relief under any other applicable law due to behavior that
  200  constitutes a violation of this section or that is not related
  201  to a conscience-based objection.
  202         (6) REQUIREMENT TO PROVIDE EMERGENCY MEDICAL TREATMENT.
  203  This section may not be construed to override any requirement to
  204  provide emergency medical treatment in accordance with state law
  205  or the Emergency Medical Treatment and Active Labor Act, 42
  206  U.S.C. s. 1395dd.
  207         Section 3. Section 456.61, Florida Statutes, is created to
  208  read:
  209         456.61 Use of free speech by a health care practitioner;
  210  prohibition.—
  211         (1)A board, or the department if there is no board, may
  212  not take disciplinary action against a health care
  213  practitioner’s license or deny a license to an individual solely
  214  because the individual has spoken or written publicly about a
  215  health care service or public policy, including, but not limited
  216  to, speech through the use of a social media platform as defined
  217  in s. 501.2041, provided that the individual is not using such
  218  speech or written communication to provide medical advice or
  219  treatment to a specific patient or patients, and provided that
  220  such speech or written communication does not separately violate
  221  any other applicable law or rule.
  222         (2)If a specialty board or other recognizing agency
  223  approved by any board within the jurisdiction of the department
  224  revokes the certification of an individual solely because the
  225  individual has spoken or written publicly about a health care
  226  service or public policy, including, but not limited to, speech
  227  through the use of a social media platform as defined in s.
  228  501.2041, provided such individual was not providing medical
  229  advice or treatment to a specific patient and provided such
  230  speech did not separately violate any other applicable law, the
  231  board within the jurisdiction of the department may revoke its
  232  approval of such specialty board or other recognizing agency.
  233         Section 4. If any provision of this act or its application
  234  to any person or circumstance is held invalid, the invalidity
  235  does not affect other provisions or applications of the act
  236  which can be given effect without the invalid provision or
  237  application, and to this end the provisions of this act are
  238  severable.
  239         Section 5. This act shall take effect July 1, 2023.