Florida Senate - 2021                                     SB 352
       By Senator Rodriguez
       39-00680-21                                            2021352__
    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.; revising a short title; amending s.
    5         480.032, F.S.; revising the purpose of ch. 480, F.S.;
    6         reordering and amending s. 480.033, F.S.; revising and
    7         defining terms; amending ss. 477.013, 477.0135,
    8         477.0265, 480.034, 480.035, 480.041, 480.043, 480.046,
    9         480.0465, 480.047, 480.052, 480.0535, 627.6407,
   10         627.6619, 627.736, 641.31, and 823.05, F.S.;
   11         conforming provisions to changes made by the act;
   12         making technical changes; providing an effective date.
   14  Be It Enacted by the Legislature of the State of Florida:
   16         Section 1. Chapter 480, Florida Statutes, entitled “Massage
   17  Practice,” is renamed “Massage Therapy Practice.”
   18         Section 2. Section 480.031, Florida Statutes, is amended to
   19  read:
   20         480.031 Short title.—This act shall be known and may be
   21  cited as the “Massage Therapy Practice Act.”
   22         Section 3. Section 480.032, Florida Statutes, is amended to
   23  read:
   24         480.032 Purpose.—The Legislature recognizes that the
   25  unregulated practice of massage therapy poses a danger is
   26  potentially dangerous to the public in that massage therapists
   27  must have a knowledge of anatomy and physiology and an
   28  understanding of the relationship between the structure and the
   29  function of the tissues being treated and the total function of
   30  the body. Massage therapy is a therapeutic health care practice,
   31  and regulations are necessary to protect the public from
   32  unqualified practitioners. It is therefore deemed necessary in
   33  the interest of public health, safety, and welfare to regulate
   34  the practice of massage therapy in this state and, therefore;
   35  however, restrictions must shall be imposed to the extent
   36  necessary to protect the public from significant and discernible
   37  danger to health and yet not in such a manner that does not
   38  which will unreasonably affect the competitive market. Further,
   39  consumer protection for both health and economic matters must
   40  shall be afforded the public through legal remedies provided for
   41  in this act.
   42         Section 4. Section 480.033, Florida Statutes, is reordered
   43  and amended to read:
   44         480.033 Definitions.—As used in this act:
   45         (2)(1) “Board” means the Board of Massage Therapy.
   46         (5)(2) “Department” means the Department of Health.
   47         (11)(3) “Massage therapy” means the manipulation of the
   48  soft tissues of the human body with the hand, foot, knee, arm,
   49  or elbow, regardless of whether or not such manipulation is
   50  aided by hydrotherapy, including colonic irrigation, or thermal
   51  therapy; any electrical or mechanical device; or the application
   52  to the human body of a chemical or herbal preparation, an over
   53  the-counter topical agent, or a topical agent prescribed by a
   54  health care practitioner applied in accordance with board rule.
   55         (10)(4) “Massage therapist” means a person licensed as
   56  required by this act, who performs administers massage therapy,
   57  including massage therapy assessment, for compensation.
   58         (1)(5) “Apprentice” means a person approved by the board to
   59  study colonic irrigation under the instruction of a licensed
   60  massage therapist practicing colonic irrigation.
   61         (4)(6) “Colonic irrigation” means a method of hydrotherapy
   62  used to cleanse the colon with the aid of a mechanical device
   63  and water.
   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)(8) “Licensure” means the procedure by which a person,
   68  hereinafter referred to as a “practitioner,” applies to the
   69  board for approval to practice massage therapy or to operate an
   70  establishment.
   71         (3)(9) “Board-approved massage therapy school” means a
   72  facility that meets minimum standards for training and
   73  curriculum as determined by rule of the board and that is
   74  licensed by the Department of Education pursuant to chapter 1005
   75  or the equivalent licensing authority of another state or is
   76  within the public school system of this state or a college or
   77  university that is eligible to participate in the William L.
   78  Boyd, IV, Effective Access to Student Education Grant Program.
   79         (8)(10) “Establishment owner” means a person who has
   80  ownership interest in a massage establishment. The term includes
   81  an individual who holds a massage establishment license, a
   82  general partner of a partnership, an owner or officer of a
   83  corporation, and a member of a limited liability company and its
   84  subsidiaries who holds a massage establishment license.
   85         (6)(11) “Designated establishment manager” means a massage
   86  therapist who holds a clear and active license without
   87  restriction, who is responsible for the operation of a massage
   88  establishment in accordance with the provisions of this chapter,
   89  and who is designated the manager by the rules or practices at
   90  the establishment.
   91         (12)“Massage therapy assessment” means the determination
   92  of the course of massage therapy treatment.
   93         Section 5. Subsection (13) of section 477.013, Florida
   94  Statutes, is amended to read:
   95         477.013 Definitions.—As used in this chapter:
   96         (13) “Skin care services” means the treatment of the skin
   97  of the body, other than the head, face, and scalp, by the use of
   98  a sponge, brush, cloth, or similar device to apply or remove a
   99  chemical preparation or other substance, except that chemical
  100  peels may be removed by peeling an applied preparation from the
  101  skin by hand. Skin care services must be performed by a licensed
  102  cosmetologist or facial specialist within a licensed cosmetology
  103  or specialty salon, and such services may not involve massage
  104  therapy, as defined in s. 480.033 s. 480.033(3), through
  105  manipulation of the superficial tissue.
  106         Section 6. Paragraph (a) of subsection (1) of section
  107  477.0135, Florida Statutes, is amended to read:
  108         477.0135 Exemptions.—
  109         (1) This chapter does not apply to the following persons
  110  when practicing pursuant to their professional or occupational
  111  responsibilities and duties:
  112         (a) Persons authorized under the laws of this state to
  113  practice medicine, surgery, osteopathic medicine, chiropractic
  114  medicine, massage therapy, naturopathy, or podiatric medicine.
  115         Section 7. Paragraph (f) of subsection (1) of section
  116  477.0265, Florida Statutes, is amended to read:
  117         477.0265 Prohibited acts.—
  118         (1) It is unlawful for any person to:
  119         (f) Advertise or imply that skin care services, as
  120  performed under this chapter, have any relationship to the
  121  practice of massage therapy as defined in s. 480.033 s.
  122  480.033(3), except those practices or activities defined in s.
  123  477.013.
  124         Section 8. Subsection (4) of section 480.034, Florida
  125  Statutes, is amended to read:
  126         480.034 Exemptions.—
  127         (4) An exemption granted is effective to the extent that an
  128  exempted person’s practice or profession overlaps with the
  129  practice of massage therapy.
  130         Section 9. Subsection (2) of section 480.035, Florida
  131  Statutes, is amended to read:
  132         480.035 Board of Massage Therapy.—
  133         (2) Five members of the board shall be licensed massage
  134  therapists and shall have been engaged in the practice of
  135  massage therapy for not less than 5 consecutive years prior to
  136  the date of appointment to the board. The Governor shall appoint
  137  each member for a term of 4 years. Two members of the board
  138  shall be laypersons. Each board member shall be a high school
  139  graduate or shall have received a high school equivalency
  140  diploma. Each board member shall be a citizen of the United
  141  States and a resident of this state for not less than 5 years.
  142  The appointments are will be subject to confirmation by the
  143  Senate.
  144         Section 10. Subsections (1) and (4) and paragraph (b) of
  145  subsection (5) of section 480.041, Florida Statutes, are amended
  146  to read:
  147         480.041 Massage therapists; qualifications; licensure;
  148  endorsement.—
  149         (1) Any person is qualified for licensure as a massage
  150  therapist under this act who meets all of the following
  151  requirements:
  152         (a) Is at least 18 years of age or has received a high
  153  school diploma or high school equivalency diploma.;
  154         (b) Has completed a course of study at a board-approved
  155  massage therapy school that meets standards adopted by the
  156  board.; and
  157         (c) Has received a passing grade on a national examination
  158  designated by the board.
  159         (4) Upon an applicant’s passing the examination and paying
  160  the initial licensure fee, the department shall issue to the
  161  applicant a license, valid until the next scheduled renewal
  162  date, to practice massage therapy.
  163         (5) The board shall adopt rules:
  164         (b) Providing for educational standards, examination, and
  165  certification for the practice of colonic irrigation, as defined
  166  in s. 480.033 s. 480.033(6), by massage therapists.
  167         Section 11. Subsection (14) of section 480.043, Florida
  168  Statutes, is amended to read:
  169         480.043 Massage establishments; requisites; licensure;
  170  inspection; human trafficking awareness training and policies.—
  171         (14) Except for the requirements of subsection (13), this
  172  section does not apply to a physician licensed under chapter
  173  457, chapter 458, chapter 459, or chapter 460 who employs a
  174  licensed massage therapist to perform massage therapy on the
  175  physician’s patients at the physician’s place of practice. This
  176  subsection does not restrict investigations by the department
  177  for violations of chapter 456 or this chapter.
  178         Section 12. Paragraphs (a), (b), (c), (f) through (i), and
  179  (o) of subsection (1) of section 480.046, Florida Statutes, are
  180  amended to read:
  181         480.046 Grounds for disciplinary action by the board.—
  182         (1) The following acts constitute grounds for denial of a
  183  license or disciplinary action, as specified in s. 456.072(2):
  184         (a) Attempting to procure a license to practice massage
  185  therapy by bribery or fraudulent misrepresentation.
  186         (b) Having a license to practice massage therapy revoked,
  187  suspended, or otherwise acted against, including the denial of
  188  licensure, by the licensing authority of another state,
  189  territory, or country.
  190         (c) Being convicted or found guilty, regardless of
  191  adjudication, of a crime in any jurisdiction which directly
  192  relates to the practice of massage therapy or to the ability to
  193  practice massage therapy. Any plea of nolo contendere shall be
  194  considered a conviction for purposes of this chapter.
  195         (f) Aiding, assisting, procuring, or advising any
  196  unlicensed person to practice massage therapy contrary to the
  197  provisions of this chapter or to department or board a rule of
  198  the department or the board.
  199         (g) Making deceptive, untrue, or fraudulent representations
  200  in the practice of massage therapy.
  201         (h) Being unable to practice massage therapy with
  202  reasonable skill and safety by reason of illness or use of
  203  alcohol, drugs, narcotics, chemicals, or any other type of
  204  material or as a result of any mental or physical condition. In
  205  enforcing this paragraph, the department shall have, upon
  206  probable cause, may authority to compel a massage therapist to
  207  submit to a mental or physical examination by physicians
  208  designated by the department. Failure of a massage therapist to
  209  submit to such examination when so directed, unless the failure
  210  was due to circumstances beyond her or his control, constitutes
  211  shall constitute an admission of the allegations against her or
  212  him, consequent upon which a default and final order may be
  213  entered without the taking of testimony or presentation of
  214  evidence. A massage therapist affected under this paragraph
  215  shall at reasonable intervals be afforded an opportunity to
  216  demonstrate that she or he can resume the competent practice of
  217  massage therapy with reasonable skill and safety to clients.
  218         (i) Gross or repeated malpractice or the failure to
  219  practice massage therapy with that level of care, skill, and
  220  treatment which is recognized by a reasonably prudent massage
  221  therapist as being acceptable under similar conditions and
  222  circumstances.
  223         (o) Practicing massage therapy at a site, location, or
  224  place which is not duly licensed as a massage establishment,
  225  except that a massage therapist, as provided by rules adopted by
  226  the board rule, may provide massage therapy services, excluding
  227  colonic irrigation, at the residence of a client, at the office
  228  of the client, at a sports event, at a convention, or at a trade
  229  show.
  230         Section 13. Section 480.0465, Florida Statutes, is amended
  231  to read:
  232         480.0465 Advertisement.—Each massage therapist or massage
  233  establishment licensed under the provisions of this act shall
  234  include the number of the license in any advertisement of
  235  massage therapy services appearing in a newspaper, airwave
  236  transmission, telephone directory, or other advertising medium.
  237  Pending licensure of a new massage establishment pursuant to the
  238  provisions of s. 480.043(7), the license number of a licensed
  239  massage therapist who is an owner or principal officer of the
  240  establishment may be used in lieu of the license number for the
  241  establishment.
  242         Section 14. Paragraphs (a), (b), and (c) of subsection (1)
  243  of section 480.047, Florida Statutes, are amended to read:
  244         480.047 Penalties.—
  245         (1) It is unlawful for any person to:
  246         (a) Hold himself or herself out as a massage therapist or
  247  to practice massage therapy unless duly licensed under this
  248  chapter or unless otherwise specifically exempted from licensure
  249  under this chapter.
  250         (b) Operate any massage establishment unless it has been
  251  duly licensed as provided herein, except that nothing herein
  252  shall be construed to prevent the teaching of massage therapy in
  253  this state at a board-approved massage therapy school.
  254         (c) Permit an employed person to practice massage therapy
  255  unless duly licensed as provided herein.
  256         Section 15. Section 480.052, Florida Statutes, is amended
  257  to read:
  258         480.052 Power of county or municipality to regulate massage
  259  therapy.—A county or municipality, within its jurisdiction, may
  260  regulate persons and establishments licensed under this chapter.
  261  Such regulation may shall not exceed the powers of the state
  262  under this act or be inconsistent with this act. This section
  263  may shall not be construed to prohibit a county or municipality
  264  from enacting any regulation of persons or establishments not
  265  licensed pursuant to this act.
  266         Section 16. Subsections (1) and (2) of section 480.0535,
  267  Florida Statutes, are amended to read:
  268         480.0535 Documents required while working in a massage
  269  establishment.—
  270         (1) In order to provide the department and law enforcement
  271  agencies the means to more effectively identify, investigate,
  272  and arrest persons engaging in human trafficking, a person
  273  employed by a massage establishment and any person performing
  274  massage therapy therein must immediately present, upon the
  275  request of an investigator of the department or a law
  276  enforcement officer, valid government identification while in
  277  the establishment. Any of the following is a valid government
  278  identification for the purposes of this section is:
  279         (a) A valid, unexpired driver license issued by any state,
  280  territory, or district of the United States.;
  281         (b) A valid, unexpired identification card issued by any
  282  state, territory, or district of the United States.;
  283         (c) A valid, unexpired United States passport.;
  284         (d) A naturalization certificate issued by the United
  285  States Department of Homeland Security.;
  286         (e) A valid, unexpired alien registration receipt card
  287  (green card).; or
  288         (f) A valid, unexpired employment authorization card issued
  289  by the United States Department of Homeland Security.
  290         (2) A person operating a massage establishment must:
  291         (a) Immediately present, upon the request of an
  292  investigator of the department or a law enforcement officer:
  293         1. Valid government identification while in the
  294  establishment.
  295         2. A copy of the documentation specified in paragraph
  296  (1)(a) for each employee and any person performing massage
  297  therapy in the establishment.
  298         (b) Ensure that each employee and any person performing
  299  massage therapy in the massage establishment is able to
  300  immediately present, upon the request of an investigator of the
  301  department or a law enforcement officer, valid government
  302  identification while in the establishment.
  303         Section 17. Section 627.6407, Florida Statutes, is amended
  304  to read:
  305         627.6407 Massage.—Any policy of health insurance that
  306  provides coverage for massage shall also cover the services of
  307  persons licensed to practice massage therapy pursuant to chapter
  308  480, where the massage therapy, as defined in chapter 480, has
  309  been prescribed by a physician licensed under chapter 458,
  310  chapter 459, chapter 460, or chapter 461, as being medically
  311  necessary and the prescription specifies the number of
  312  treatments.
  313         Section 18. Section 627.6619, Florida Statutes, is amended
  314  to read:
  315         627.6619 Massage.—Any policy of health insurance that
  316  provides coverage for massage shall also cover the services of
  317  persons licensed to practice massage therapy pursuant to chapter
  318  480, where the massage therapy, as defined in chapter 480, has
  319  been prescribed by a physician licensed under chapter 458,
  320  chapter 459, chapter 460, or chapter 461, as being medically
  321  necessary and the prescription specifies the number of
  322  treatments.
  323         Section 19. Paragraph (a) of subsection (1) of section
  324  627.736, Florida Statutes, is amended to read:
  325         627.736 Required personal injury protection benefits;
  326  exclusions; priority; claims.—
  327         (1) REQUIRED BENEFITS.—An insurance policy complying with
  328  the security requirements of s. 627.733 must provide personal
  329  injury protection to the named insured, relatives residing in
  330  the same household, persons operating the insured motor vehicle,
  331  passengers in the motor vehicle, and other persons struck by the
  332  motor vehicle and suffering bodily injury while not an occupant
  333  of a self-propelled vehicle, subject to subsection (2) and
  334  paragraph (4)(e), to a limit of $10,000 in medical and
  335  disability benefits and $5,000 in death benefits resulting from
  336  bodily injury, sickness, disease, or death arising out of the
  337  ownership, maintenance, or use of a motor vehicle as follows:
  338         (a) Medical benefits.—Eighty percent of all reasonable
  339  expenses for medically necessary medical, surgical, X-ray,
  340  dental, and rehabilitative services, including prosthetic
  341  devices and medically necessary ambulance, hospital, and nursing
  342  services if the individual receives initial services and care
  343  pursuant to subparagraph 1. within 14 days after the motor
  344  vehicle accident. The medical benefits provide reimbursement
  345  only for:
  346         1. Initial services and care that are lawfully provided,
  347  supervised, ordered, or prescribed by a physician licensed under
  348  chapter 458 or chapter 459, a dentist licensed under chapter
  349  466, a chiropractic physician licensed under chapter 460, or an
  350  advanced practice registered nurse registered under s. 464.0123
  351  or that are provided in a hospital or in a facility that owns,
  352  or is wholly owned by, a hospital. Initial services and care may
  353  also be provided by a person or entity licensed under part III
  354  of chapter 401 which provides emergency transportation and
  355  treatment.
  356         2. Upon referral by a provider described in subparagraph
  357  1., followup services and care consistent with the underlying
  358  medical diagnosis rendered pursuant to subparagraph 1. which may
  359  be provided, supervised, ordered, or prescribed only by a
  360  physician licensed under chapter 458 or chapter 459, a
  361  chiropractic physician licensed under chapter 460, a dentist
  362  licensed under chapter 466, or an advanced practice registered
  363  nurse registered under s. 464.0123, or, to the extent permitted
  364  by applicable law and under the supervision of such physician,
  365  osteopathic physician, chiropractic physician, or dentist, by a
  366  physician assistant licensed under chapter 458 or chapter 459 or
  367  an advanced practice registered nurse licensed under chapter
  368  464. Followup services and care may also be provided by the
  369  following persons or entities:
  370         a. A hospital or ambulatory surgical center licensed under
  371  chapter 395.
  372         b. An entity wholly owned by one or more physicians
  373  licensed under chapter 458 or chapter 459, chiropractic
  374  physicians licensed under chapter 460, advanced practice
  375  registered nurses registered under s. 464.0123, or dentists
  376  licensed under chapter 466 or by such practitioners and the
  377  spouse, parent, child, or sibling of such practitioners.
  378         c. An entity that owns or is wholly owned, directly or
  379  indirectly, by a hospital or hospitals.
  380         d. A physical therapist licensed under chapter 486, based
  381  upon a referral by a provider described in this subparagraph.
  382         e. A health care clinic licensed under part X of chapter
  383  400 which is accredited by an accrediting organization whose
  384  standards incorporate comparable regulations required by this
  385  state, or
  386         (I) Has a medical director licensed under chapter 458,
  387  chapter 459, or chapter 460;
  388         (II) Has been continuously licensed for more than 3 years
  389  or is a publicly traded corporation that issues securities
  390  traded on an exchange registered with the United States
  391  Securities and Exchange Commission as a national securities
  392  exchange; and
  393         (III) Provides at least four of the following medical
  394  specialties:
  395         (A) General medicine.
  396         (B) Radiography.
  397         (C) Orthopedic medicine.
  398         (D) Physical medicine.
  399         (E) Physical therapy.
  400         (F) Physical rehabilitation.
  401         (G) Prescribing or dispensing outpatient prescription
  402  medication.
  403         (H) Laboratory services.
  404         3. Reimbursement for services and care provided in
  405  subparagraph 1. or subparagraph 2. up to $10,000 if a physician
  406  licensed under chapter 458 or chapter 459, a dentist licensed
  407  under chapter 466, a physician assistant licensed under chapter
  408  458 or chapter 459, or an advanced practice registered nurse
  409  licensed under chapter 464 has determined that the injured
  410  person had an emergency medical condition.
  411         4. Reimbursement for services and care provided in
  412  subparagraph 1. or subparagraph 2. is limited to $2,500 if a
  413  provider listed in subparagraph 1. or subparagraph 2. determines
  414  that the injured person did not have an emergency medical
  415  condition.
  416         5. Medical benefits do not include massage therapy as
  417  defined in s. 480.033 or acupuncture as defined in s. 457.102,
  418  regardless of the person, entity, or licensee providing massage
  419  therapy or acupuncture, and a licensed massage therapist or
  420  licensed acupuncturist may not be reimbursed for medical
  421  benefits under this section.
  422         6. The Financial Services Commission shall adopt by rule
  423  the form that must be used by an insurer and a health care
  424  provider specified in sub-subparagraph 2.b., sub-subparagraph
  425  2.c., or sub-subparagraph 2.e. to document that the health care
  426  provider meets the criteria of this paragraph. Such rule must
  427  include a requirement for a sworn statement or affidavit.
  429  Only insurers writing motor vehicle liability insurance in this
  430  state may provide the required benefits of this section, and
  431  such insurer may not require the purchase of any other motor
  432  vehicle coverage other than the purchase of property damage
  433  liability coverage as required by s. 627.7275 as a condition for
  434  providing such benefits. Insurers may not require that property
  435  damage liability insurance in an amount greater than $10,000 be
  436  purchased in conjunction with personal injury protection. Such
  437  insurers shall make benefits and required property damage
  438  liability insurance coverage available through normal marketing
  439  channels. An insurer writing motor vehicle liability insurance
  440  in this state who fails to comply with such availability
  441  requirement as a general business practice violates part IX of
  442  chapter 626, and such violation constitutes an unfair method of
  443  competition or an unfair or deceptive act or practice involving
  444  the business of insurance. An insurer committing such violation
  445  is subject to the penalties provided under that part, as well as
  446  those provided elsewhere in the insurance code.
  447         Section 20. Subsection (37) of section 641.31, Florida
  448  Statutes, is amended to read:
  449         641.31 Health maintenance contracts.—
  450         (37) All health maintenance contracts that provide coverage
  451  for massage must also cover the services of persons licensed to
  452  practice massage therapy pursuant to chapter 480 if the massage
  453  is prescribed by a contracted physician licensed under chapter
  454  458, chapter 459, chapter 460, or chapter 461 as medically
  455  necessary and the prescription specifies the number of
  456  treatments. Such massage services are subject to the same terms,
  457  conditions, and limitations as those of other covered services.
  458         Section 21. Subsection (3) of section 823.05, Florida
  459  Statutes, is amended to read:
  460         823.05 Places and groups engaged in certain activities
  461  declared a nuisance; abatement and enjoinment.—
  462         (3) A massage establishment as defined in s. 480.033 s.
  463  480.033(7) which operates in violation of s. 480.0475 or s.
  464  480.0535(2) is declared a nuisance and may be abated or enjoined
  465  as provided in ss. 60.05 and 60.06.
  466         Section 22. This act shall take effect July 1, 2021.