Florida Senate - 2020                                     SB 390
       By Senator Hooper
       16-00601-20                                            2020390__
    1                        A bill to be entitled                      
    2         An act relating to massage therapy; renaming ch. 480,
    3         F.S., as “Massage Therapy Practice”; amending s.
    4         480.031, F.S.; conforming a provision to changes made
    5         by the act; amending s. 480.032, F.S.; revising the
    6         purpose of ch. 480, F.S.; amending s. 480.033, F.S.;
    7         revising terms and definitions; amending s. 480.041,
    8         F.S.; revising requirements for licensure as a massage
    9         therapist; conforming provisions to changes made by
   10         the act; providing applicability for persons who were
   11         issued a license as a massage apprentice before a
   12         specified date; repealing s. 480.042, F.S., relating
   13         to examinations; amending ss. 477.013, 477.0135,
   14         480.034, 480.035, 480.043, 480.046, 480.0465, 480.047,
   15         480.052, 480.0535, 627.6407, 627.6619, 627.736, and
   16         641.31 F.S.; conforming provisions to changes made by
   17         the act; making technical changes; providing an
   18         effective date.
   20  Be It Enacted by the Legislature of the State of Florida:
   22         Section 1. Chapter 480, Florida Statutes, entitled “Massage
   23  Practice,” is renamed “Massage Therapy Practice.”
   24         Section 2. Section 480.031, Florida Statutes, is amended to
   25  read:
   26         480.031 Short title.—This act shall be known and may be
   27  cited as the “Massage Therapy Practice Act.”
   28         Section 3. Section 480.032, Florida Statutes, is amended to
   29  read:
   30         480.032 Purpose.—The Legislature recognizes that the
   31  practice of massage therapy is potentially dangerous to the
   32  public in that massage therapists must have a knowledge of
   33  anatomy and physiology and an understanding of the relationship
   34  between the structure and the function of the tissues being
   35  treated and the total function of the body. Massage therapy is a
   36  therapeutic health care practice, and regulations are necessary
   37  to protect the public from unqualified practitioners. It is
   38  therefore deemed necessary in the interest of public health,
   39  safety, and welfare to regulate the practice of massage therapy
   40  in this state; however, restrictions shall be imposed to the
   41  extent necessary to protect the public from significant and
   42  discernible danger to health and yet not in such a manner which
   43  will unreasonably affect the competitive market. Further,
   44  consumer protection for both health and economic matters shall
   45  be afforded the public through legal remedies provided for in
   46  this act.
   47         Section 4. Subsections (3), (4), (5), (7), and (9) of
   48  section 480.033, Florida Statutes, are amended to read:
   49         480.033 Definitions.—As used in this act:
   50         (3) “Massage therapy” means the manipulation of the soft
   51  tissues of the human body with the hand, foot, knee, arm, or
   52  elbow, regardless of whether or not such manipulation is aided
   53  by hydrotherapy, including colonic irrigation, or thermal
   54  therapy; any electrical or mechanical device; or the application
   55  to the human body of a chemical or herbal preparation, an over
   56  the-counter topical agent, or a topical agent prescribed by a
   57  health care practitioner applied in accordance with board rule.
   58         (4) “Massage therapist” means a person licensed as required
   59  by this act, who administers massage therapy for compensation
   60  and assesses or evaluates persons for massage therapy treatment.
   61         (5) “Apprentice” means a person approved by the board to
   62  study colon irrigation massage under the instruction of a
   63  licensed massage therapist practicing colon irrigation.
   64         (7) “Establishment” or “massage establishment” means a site
   65  or premises, or portion thereof, wherein a massage therapist
   66  practices massage therapy.
   67         (9) “Board-approved massage therapy school” means a
   68  facility that meets minimum standards for training and
   69  curriculum as determined by rule of the board and that is
   70  licensed by the Department of Education pursuant to chapter 1005
   71  or the equivalent licensing authority of another state or is
   72  within the public school system of this state or a college or
   73  university that is eligible to participate in the William L.
   74  Boyd, IV, Effective Access to Student Education Grant Program.
   75         Section 5. Subsections (1), (2), and (4) of section
   76  480.041, Florida Statutes, are amended, and subsection (8) is
   77  added to that section, to read:
   78         480.041 Massage therapists; qualifications; licensure;
   79  endorsement.—
   80         (1) Any person is qualified for licensure as a massage
   81  therapist under this act who:
   82         (a) Is at least 18 years of age or has received a high
   83  school diploma or high school equivalency diploma;
   84         (b) Has completed a course of study at a board-approved
   85  massage therapy school or has completed an apprenticeship
   86  program that meets standards adopted by the board; and
   87         (c) Has received a passing grade on a national an
   88  examination designated administered by the board department.
   89         (2) Every person desiring to be examined for licensure as a
   90  massage therapist shall apply to the department in writing upon
   91  forms prepared and furnished by the department. Such applicants
   92  are shall be subject to the provisions of s. 480.046(1).
   93  Applicants may take an examination administered by the
   94  department only upon meeting the requirements of this section as
   95  determined by the board.
   96         (4) Upon an applicant’s passing the examination and paying
   97  the initial licensure fee, the department shall issue to the
   98  applicant a license, valid until the next scheduled renewal
   99  date, to practice massage therapy.
  100         (8) A person issued a license as a massage apprentice
  101  before July 1, 2020, may continue that apprenticeship and
  102  perform massage therapy as authorized under that license until
  103  its expiration. After completing his or her apprenticeship and
  104  before July 1, 2022, a massage apprentice may apply to the board
  105  for full licensure and the board must grant the application if
  106  the applicant meets all other applicable licensure requirements.
  107         Section 6. Section 480.042, Florida Statutes, is repealed.
  108         Section 7. Subsection (13) of section 477.013, Florida
  109  Statutes, is amended to read:
  110         477.013 Definitions.—As used in this chapter:
  111         (13) “Skin care services” means the treatment of the skin
  112  of the body, other than the head, face, and scalp, by the use of
  113  a sponge, brush, cloth, or similar device to apply or remove a
  114  chemical preparation or other substance, except that chemical
  115  peels may be removed by peeling an applied preparation from the
  116  skin by hand. Skin care services must be performed by a licensed
  117  cosmetologist or facial specialist within a licensed cosmetology
  118  or specialty salon, and such services may not involve massage
  119  therapy, as defined in s. 480.033(3), through manipulation of
  120  the superficial tissue.
  121         Section 8. Paragraph (a) of subsection (1) of section
  122  477.0135, Florida Statutes, is amended to read:
  123         477.0135 Exemptions.—
  124         (1) This chapter does not apply to the following persons
  125  when practicing pursuant to their professional or occupational
  126  responsibilities and duties:
  127         (a) Persons authorized under the laws of this state to
  128  practice medicine, surgery, osteopathic medicine, chiropractic
  129  medicine, massage therapy, naturopathy, or podiatric medicine.
  130         Section 9. Subsection (4) of section 480.034, Florida
  131  Statutes, is amended to read:
  132         480.034 Exemptions.—
  133         (4) An exemption granted is effective to the extent that an
  134  exempted person’s practice or profession overlaps with the
  135  practice of massage therapy.
  136         Section 10. Subsection (2) of section 480.035, Florida
  137  Statutes, is amended to read:
  138         480.035 Board of Massage Therapy.—
  139         (2) Five members of the board shall be licensed massage
  140  therapists and shall have been engaged in the practice of
  141  massage therapy for not less than 5 consecutive years prior to
  142  the date of appointment to the board. The Governor shall appoint
  143  each member for a term of 4 years. Two members of the board
  144  shall be laypersons. Each board member shall be a high school
  145  graduate or shall have received a high school equivalency
  146  diploma. Each board member shall be a citizen of the United
  147  States and a resident of this state for not less than 5 years.
  148  The appointments are will be subject to confirmation by the
  149  Senate.
  150         Section 11. Subsection (14) of section 480.043, Florida
  151  Statutes, is amended to read:
  152         480.043 Massage establishments; requisites; licensure;
  153  inspection; human trafficking awareness training and policies.—
  154         (14) Except for the requirements of subsection (13), this
  155  section does not apply to a physician licensed under chapter
  156  457, chapter 458, chapter 459, or chapter 460 who employs a
  157  licensed massage therapist to perform massage therapy on the
  158  physician’s patients at the physician’s place of practice. This
  159  subsection does not restrict investigations by the department
  160  for violations of chapter 456 or this chapter.
  161         Section 12. Paragraphs (a), (b), (c), (f), (g), (h), (i),
  162  and (o) of subsection (1) of section 480.046, Florida Statutes,
  163  are amended to read:
  164         480.046 Grounds for disciplinary action by the board.—
  165         (1) The following acts constitute grounds for denial of a
  166  license or disciplinary action, as specified in s. 456.072(2):
  167         (a) Attempting to procure a license to practice massage
  168  therapy by bribery or fraudulent misrepresentation.
  169         (b) Having a license to practice massage therapy revoked,
  170  suspended, or otherwise acted against, including the denial of
  171  licensure, by the licensing authority of another state,
  172  territory, or country.
  173         (c) Being convicted or found guilty, regardless of
  174  adjudication, of a crime in any jurisdiction which directly
  175  relates to the practice of massage therapy or to the ability to
  176  practice massage therapy. Any plea of nolo contendere shall be
  177  considered a conviction for purposes of this chapter.
  178         (f) Aiding, assisting, procuring, or advising any
  179  unlicensed person to practice massage therapy contrary to the
  180  provisions of this chapter or to department or board a rule of
  181  the department or the board.
  182         (g) Making deceptive, untrue, or fraudulent representations
  183  in the practice of massage therapy.
  184         (h) Being unable to practice massage therapy with
  185  reasonable skill and safety by reason of illness or use of
  186  alcohol, drugs, narcotics, chemicals, or any other type of
  187  material or as a result of any mental or physical condition. In
  188  enforcing this paragraph, the department shall have, upon
  189  probable cause, may authority to compel a massage therapist to
  190  submit to a mental or physical examination by physicians
  191  designated by the department. Failure of a massage therapist to
  192  submit to such examination when so directed, unless the failure
  193  was due to circumstances beyond her or his control, constitutes
  194  shall constitute an admission of the allegations against her or
  195  him, consequent upon which a default and final order may be
  196  entered without the taking of testimony or presentation of
  197  evidence. A massage therapist affected under this paragraph
  198  shall at reasonable intervals be afforded an opportunity to
  199  demonstrate that she or he can resume the competent practice of
  200  massage therapy with reasonable skill and safety to clients.
  201         (i) Gross or repeated malpractice or the failure to
  202  practice massage therapy with that level of care, skill, and
  203  treatment which is recognized by a reasonably prudent massage
  204  therapist as being acceptable under similar conditions and
  205  circumstances.
  206         (o) Practicing massage therapy at a site, location, or
  207  place which is not duly licensed as a massage establishment,
  208  except that a massage therapist, as provided by rules adopted by
  209  the board rule, may provide massage therapy services, excluding
  210  colonic irrigation, at the residence of a client, at the office
  211  of the client, at a sports event, at a convention, or at a trade
  212  show.
  213         Section 13. Section 480.0465, Florida Statutes, is amended
  214  to read:
  215         480.0465 Advertisement.—Each massage therapist or massage
  216  establishment licensed under the provisions of this act shall
  217  include the number of the license in any advertisement of
  218  massage therapy services appearing in a newspaper, airwave
  219  transmission, telephone directory, or other advertising medium.
  220  Pending licensure of a new massage establishment pursuant to the
  221  provisions of s. 480.043(7), the license number of a licensed
  222  massage therapist who is an owner or principal officer of the
  223  establishment may be used in lieu of the license number for the
  224  establishment.
  225         Section 14. Paragraphs (a), (b), and (c) of subsection (1)
  226  of section 480.047, Florida Statutes, are amended to read:
  227         480.047 Penalties.—
  228         (1) It is unlawful for any person to:
  229         (a) Hold himself or herself out as a massage therapist or
  230  to practice massage therapy unless duly licensed under this
  231  chapter or unless otherwise specifically exempted from licensure
  232  under this chapter.
  233         (b) Operate any massage establishment unless it has been
  234  duly licensed as provided herein, except that nothing herein
  235  shall be construed to prevent the teaching of massage therapy in
  236  this state at a board-approved massage therapy school.
  237         (c) Permit an employed person to practice massage therapy
  238  unless duly licensed as provided herein.
  239         Section 15. Section 480.052, Florida Statutes, is amended
  240  to read:
  241         480.052 Power of county or municipality to regulate massage
  242  therapy.—A county or municipality, within its jurisdiction, may
  243  regulate persons and establishments licensed under this chapter.
  244  Such regulation shall not exceed the powers of the state under
  245  this act or be inconsistent with this act. This section shall
  246  not be construed to prohibit a county or municipality from
  247  enacting any regulation of persons or establishments not
  248  licensed pursuant to this act.
  249         Section 16. Subsections (1) and (2) of section 480.0535,
  250  Florida Statutes, are amended to read:
  251         480.0535 Documents required while working in a massage
  252  establishment.—
  253         (1) In order to provide the department and law enforcement
  254  agencies the means to more effectively identify, investigate,
  255  and arrest persons engaging in human trafficking, a person
  256  employed by a massage establishment and any person performing
  257  massage therapy therein must immediately present, upon the
  258  request of an investigator of the department or a law
  259  enforcement officer, valid government identification while in
  260  the establishment. A valid government identification for the
  261  purposes of this section is:
  262         (a) A valid, unexpired driver license issued by any state,
  263  territory, or district of the United States;
  264         (b) A valid, unexpired identification card issued by any
  265  state, territory, or district of the United States;
  266         (c) A valid, unexpired United States passport;
  267         (d) A naturalization certificate issued by the United
  268  States Department of Homeland Security;
  269         (e) A valid, unexpired alien registration receipt card
  270  (green card); or
  271         (f) A valid, unexpired employment authorization card issued
  272  by the United States Department of Homeland Security.
  273         (2) A person operating a massage establishment must:
  274         (a) Immediately present, upon the request of an
  275  investigator of the department or a law enforcement officer:
  276         1. Valid government identification while in the
  277  establishment.
  278         2. A copy of the documentation specified in paragraph
  279  (1)(a) for each employee and any person performing massage
  280  therapy in the establishment.
  281         (b) Ensure that each employee and any person performing
  282  massage therapy in the massage establishment is able to
  283  immediately present, upon the request of an investigator of the
  284  department or a law enforcement officer, valid government
  285  identification while in the establishment.
  286         Section 17. Section 627.6407, Florida Statutes, is amended
  287  to read:
  288         627.6407 Massage.—Any policy of health insurance that
  289  provides coverage for massage shall also cover the services of
  290  persons licensed to practice massage therapy pursuant to chapter
  291  480, where the massage therapy, as defined in chapter 480, has
  292  been prescribed by a physician licensed under chapter 458,
  293  chapter 459, chapter 460, or chapter 461, as being medically
  294  necessary and the prescription specifies the number of
  295  treatments.
  296         Section 18. Section 627.6619, Florida Statutes, is amended
  297  to read:
  298         627.6619 Massage.—Any policy of health insurance that
  299  provides coverage for massage shall also cover the services of
  300  persons licensed to practice massage therapy pursuant to chapter
  301  480, where the massage therapy, as defined in chapter 480, has
  302  been prescribed by a physician licensed under chapter 458,
  303  chapter 459, chapter 460, or chapter 461, as being medically
  304  necessary and the prescription specifies the number of
  305  treatments.
  306         Section 19. Paragraph (a) of subsection (1) of section
  307  627.736, Florida Statutes, is amended to read:
  308         627.736 Required personal injury protection benefits;
  309  exclusions; priority; claims.—
  310         (1) REQUIRED BENEFITS.—An insurance policy complying with
  311  the security requirements of s. 627.733 must provide personal
  312  injury protection to the named insured, relatives residing in
  313  the same household, persons operating the insured motor vehicle,
  314  passengers in the motor vehicle, and other persons struck by the
  315  motor vehicle and suffering bodily injury while not an occupant
  316  of a self-propelled vehicle, subject to subsection (2) and
  317  paragraph (4)(e), to a limit of $10,000 in medical and
  318  disability benefits and $5,000 in death benefits resulting from
  319  bodily injury, sickness, disease, or death arising out of the
  320  ownership, maintenance, or use of a motor vehicle as follows:
  321         (a) Medical benefits.—Eighty percent of all reasonable
  322  expenses for medically necessary medical, surgical, X-ray,
  323  dental, and rehabilitative services, including prosthetic
  324  devices and medically necessary ambulance, hospital, and nursing
  325  services if the individual receives initial services and care
  326  pursuant to subparagraph 1. within 14 days after the motor
  327  vehicle accident. The medical benefits provide reimbursement
  328  only for:
  329         1. Initial services and care that are lawfully provided,
  330  supervised, ordered, or prescribed by a physician licensed under
  331  chapter 458 or chapter 459, a dentist licensed under chapter
  332  466, or a chiropractic physician licensed under chapter 460 or
  333  that are provided in a hospital or in a facility that owns, or
  334  is wholly owned by, a hospital. Initial services and care may
  335  also be provided by a person or entity licensed under part III
  336  of chapter 401 which provides emergency transportation and
  337  treatment.
  338         2. Upon referral by a provider described in subparagraph
  339  1., followup services and care consistent with the underlying
  340  medical diagnosis rendered pursuant to subparagraph 1. which may
  341  be provided, supervised, ordered, or prescribed only by a
  342  physician licensed under chapter 458 or chapter 459, a
  343  chiropractic physician licensed under chapter 460, a dentist
  344  licensed under chapter 466, or, to the extent permitted by
  345  applicable law and under the supervision of such physician,
  346  osteopathic physician, chiropractic physician, or dentist, by a
  347  physician assistant licensed under chapter 458 or chapter 459 or
  348  an advanced practice registered nurse licensed under chapter
  349  464. Followup services and care may also be provided by the
  350  following persons or entities:
  351         a. A hospital or ambulatory surgical center licensed under
  352  chapter 395.
  353         b. An entity wholly owned by one or more physicians
  354  licensed under chapter 458 or chapter 459, chiropractic
  355  physicians licensed under chapter 460, or dentists licensed
  356  under chapter 466 or by such practitioners and the spouse,
  357  parent, child, or sibling of such practitioners.
  358         c. An entity that owns or is wholly owned, directly or
  359  indirectly, by a hospital or hospitals.
  360         d. A physical therapist licensed under chapter 486, based
  361  upon a referral by a provider described in this subparagraph.
  362         e. A health care clinic licensed under part X of chapter
  363  400 which is accredited by an accrediting organization whose
  364  standards incorporate comparable regulations required by this
  365  state, or
  366         (I) Has a medical director licensed under chapter 458,
  367  chapter 459, or chapter 460;
  368         (II) Has been continuously licensed for more than 3 years
  369  or is a publicly traded corporation that issues securities
  370  traded on an exchange registered with the United States
  371  Securities and Exchange Commission as a national securities
  372  exchange; and
  373         (III) Provides at least four of the following medical
  374  specialties:
  375         (A) General medicine.
  376         (B) Radiography.
  377         (C) Orthopedic medicine.
  378         (D) Physical medicine.
  379         (E) Physical therapy.
  380         (F) Physical rehabilitation.
  381         (G) Prescribing or dispensing outpatient prescription
  382  medication.
  383         (H) Laboratory services.
  384         3. Reimbursement for services and care provided in
  385  subparagraph 1. or subparagraph 2. up to $10,000 if a physician
  386  licensed under chapter 458 or chapter 459, a dentist licensed
  387  under chapter 466, a physician assistant licensed under chapter
  388  458 or chapter 459, or an advanced practice registered nurse
  389  licensed under chapter 464 has determined that the injured
  390  person had an emergency medical condition.
  391         4. Reimbursement for services and care provided in
  392  subparagraph 1. or subparagraph 2. is limited to $2,500 if a
  393  provider listed in subparagraph 1. or subparagraph 2. determines
  394  that the injured person did not have an emergency medical
  395  condition.
  396         5. Medical benefits do not include massage therapy as
  397  defined in s. 480.033 or acupuncture as defined in s. 457.102,
  398  regardless of the person, entity, or licensee providing massage
  399  therapy or acupuncture, and a licensed massage therapist or
  400  licensed acupuncturist may not be reimbursed for medical
  401  benefits under this section.
  402         6. The Financial Services Commission shall adopt by rule
  403  the form that must be used by an insurer and a health care
  404  provider specified in sub-subparagraph 2.b., sub-subparagraph
  405  2.c., or sub-subparagraph 2.e. to document that the health care
  406  provider meets the criteria of this paragraph. Such rule must
  407  include a requirement for a sworn statement or affidavit.
  409  Only insurers writing motor vehicle liability insurance in this
  410  state may provide the required benefits of this section, and
  411  such insurer may not require the purchase of any other motor
  412  vehicle coverage other than the purchase of property damage
  413  liability coverage as required by s. 627.7275 as a condition for
  414  providing such benefits. Insurers may not require that property
  415  damage liability insurance in an amount greater than $10,000 be
  416  purchased in conjunction with personal injury protection. Such
  417  insurers shall make benefits and required property damage
  418  liability insurance coverage available through normal marketing
  419  channels. An insurer writing motor vehicle liability insurance
  420  in this state who fails to comply with such availability
  421  requirement as a general business practice violates part IX of
  422  chapter 626, and such violation constitutes an unfair method of
  423  competition or an unfair or deceptive act or practice involving
  424  the business of insurance. An insurer committing such violation
  425  is subject to the penalties provided under that part, as well as
  426  those provided elsewhere in the insurance code.
  427         Section 20. Subsection (37) of section 641.31, Florida
  428  Statutes, is amended to read:
  429         641.31 Health maintenance contracts.—
  430         (37) All health maintenance contracts that provide coverage
  431  for massage must also cover the services of persons licensed to
  432  practice massage therapy pursuant to chapter 480 if the massage
  433  is prescribed by a contracted physician licensed under chapter
  434  458, chapter 459, chapter 460, or chapter 461 as medically
  435  necessary and the prescription specifies the number of
  436  treatments. Such massage services are subject to the same terms,
  437  conditions, and limitations as those of other covered services.
  438         Section 21. This act shall take effect July 1, 2020.