Florida Senate - 2023                        COMMITTEE AMENDMENT
       Bill No. SB 1580
       
       
       
       
       
       
                                Ì206378HÎ206378                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/20/2023           .                                
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       The Committee on Rules (Trumbull) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. It is the intent of the Legislature to provide
    6  the right of medical conscience for health care providers and
    7  payors to ensure they can care for patients consistent with
    8  their moral, ethical, and religious convictions. Further, it is
    9  the intent of the Legislature that licensed health care
   10  providers and payors be free from threat of discrimination for
   11  providing conscience-based health care.
   12         Section 2. Section 381.00321, Florida Statutes, is created
   13  to read:
   14         381.00321The right of medical conscience of health care
   15  providers and health care payors.—
   16         (1)DEFINITIONS.—As used in this section, the term:
   17         (a)“Adverse action” means the discharge, transfer,
   18  demotion, discipline, suspension, exclusion, revocation of
   19  privileges, withholding of bonuses, or reduction in salary or
   20  benefits; any action that may negatively impact the advancement
   21  or graduation of a student, including, but not limited to, the
   22  withholding of scholarship funds; or any other disciplinary or
   23  retaliatory action taken against a health care provider.
   24         (b)“Conscience-based objection” means an objection based
   25  on a sincerely held religious, moral, or ethical belief.
   26  Conscience with respect to entities is determined by reference
   27  to the entities’ governing documents; any published ethical,
   28  moral, or religious guidelines or directives; mission
   29  statements; constitutions; articles of incorporation; bylaws;
   30  policies; or regulations.
   31         (c)“Department” means the Department of Health.
   32         (d)“Educational institution” means a public or private
   33  school, college, or university.
   34         (e)“Health care payor” means a health insurer, an
   35  employer, a health care sharing organization, a health plan, a
   36  health maintenance organization, a management services
   37  organization, or any other entity that pays for, or arranges for
   38  the payment of, any health care service, whether such payment is
   39  in whole or in part.
   40         (f)“Health care provider” means:
   41         1.Any person or entity licensed under chapter 394; chapter
   42  400; chapter 401; chapter 457; chapter 458; chapter 459; chapter
   43  460; chapter 461; chapter 462; chapter 463; chapter 464; chapter
   44  465; chapter 466; chapter 467; part I, part II, part III, part
   45  IV, part V, part X, part XIII, or part XIV of chapter 468;
   46  chapter 478; chapter 480; part I, part II, or part III of
   47  chapter 483; chapter 484; chapter 486; chapter 490; or chapter
   48  491; or
   49         2.Any provider as defined in s. 408.803, a continuing care
   50  facility licensed under chapter 651, or a pharmacy permitted
   51  under chapter 465.
   52  
   53  This term includes any student enrolled in an educational
   54  institution who is seeking to become a health care provider.
   55         (g)“Health care service” means medical research, medical
   56  procedures, or medical services including, but not limited to,
   57  testing; diagnosis; referral; dispensing or administering any
   58  drug, medication, or device; psychological therapy or
   59  counseling; research; therapy; recordmaking procedures; set up
   60  or performance of a surgery or procedure; or any other care or
   61  services performed or provided by any health care provider.
   62         (h)“Participate” or “participation” means to pay for or
   63  take part in any way in providing or facilitating any health
   64  care service or any part of such service.
   65         (i)“Right of medical conscience” means the right of a
   66  person to abide by the person’s sincerely held religious, moral,
   67  or ethical beliefs when such beliefs are contrary to the duties
   68  placed on the person in the course of the practice of the
   69  person’s profession as a health care provider or health care
   70  payor. With respect to health care providers or payors that are
   71  entities, such beliefs are determined by reference to the
   72  entity’s governing documents; any published ethical, moral, or
   73  religious guidelines or directives; mission statements;
   74  constitutions; articles of incorporation; bylaws; policies; or
   75  regulations.
   76         (2)RIGHT OF MEDICAL CONSCIENCE.—
   77         (a)A health care provider or health care payor has the
   78  right to opt out of participation in or payment for any health
   79  care service on the basis of a conscience-based objection. A
   80  health care provider must, at the time of the conscience-based
   81  objection or as soon as practicable thereafter, provide written
   82  notice of his or her conscience-based objection to the health
   83  care provider’s supervisor or employer, if applicable, and
   84  document his or her conscience-based objection to a particular
   85  health care service in the patient’s medical file. Additionally,
   86  if a patient, or potential patient, when attempting to schedule
   87  an appointment with the provider indicates to the provider that
   88  he or she is seeking a specific health care service for which
   89  the provider has a conscience-based objection, the provider must
   90  notify the patient that he or she does not provide such service
   91  before scheduling the appointment. A health care provider who is
   92  a student must provide written notice of his or her conscience
   93  based objection to the educational institution at the time the
   94  conscience-based objection is made or as soon as practicable
   95  thereafter.
   96         (b)The exercise of the right of medical conscience is
   97  limited to conscience-based objections to a specific health care
   98  service. This section may not be construed to waive or modify
   99  any duty a health care provider or health care payor may have to
  100  provide or pay for other health care services that do not
  101  violate their right of medical conscience, to waive or modify
  102  any duty to provide any informed consent required by law, or to
  103  allow a health care provider or payor to opt out of providing
  104  health care services to any patient or potential patient because
  105  of that patient’s or potential patient’s race, color, religion,
  106  sex, or national origin. Additionally, a health care payor may
  107  not decline to pay for a health care service it is contractually
  108  obligated to cover during the plan year.
  109         (c)A health care provider may not be discriminated against
  110  or suffer adverse action because the health care provider
  111  declined to participate in a health care service on the basis of
  112  a conscience-based objection.
  113         (3)SPEECH AND WHISTLE-BLOWER PROTECTIONS.—
  114         (a)A health care provider or health care payor may not be
  115  discriminated against or suffer any adverse action in any manner
  116  with respect to:
  117         1.Providing or causing to be provided, or intending to
  118  provide or cause to be provided, information relating to any
  119  violation of or any act or omission the health care provider or
  120  health care payor reasonably believes to be a violation of any
  121  provision of this act to his or her employer, the Attorney
  122  General, the department, any other state agency charged with
  123  protecting the right of medical conscience, the United States
  124  Department of Health and Human Services, the Office of Civil
  125  Rights, or any other federal agency charged with protecting the
  126  right of medical conscience;
  127         2. Testifying or intending to testify in a proceeding
  128  concerning such violation; or
  129         3. Assisting or participating in or intending to assist or
  130  participate in such a proceeding.
  131         (b) Unless the disclosure is specifically prohibited by
  132  law, a health care provider or health care payor may not be
  133  discriminated against in any manner for disclosing information
  134  that the health care provider or health care payor reasonably
  135  believes constitutes:
  136         1. A violation of any law, rule, or regulation;
  137         2. A violation of any ethical guidelines for the provision
  138  of any medical procedure or service; or
  139         3. A practice or method of treatment that may put patient
  140  health at risk or present a substantial and specific danger to
  141  public health or safety.
  142         (4)ENFORCEMENT.—A health care provider or health care
  143  payor may file a complaint with the Attorney General alleging
  144  any violation of this section. If the Attorney General
  145  determines there has been a violation of this section, the
  146  Attorney General may commence a civil action for damages,
  147  injunctive relief, or any other appropriate relief, including
  148  attorney fees. For the purpose of conducting an investigation,
  149  the Attorney General may administer oaths, take depositions,
  150  make inspections when authorized by law, issue subpoenas
  151  supported by affidavit, serve subpoenas and other process, and
  152  compel the attendance of witnesses and the production of books,
  153  papers, documents, and other evidence.
  154         (5)IMMUNITY FROM LIABILITY.—A health care provider or
  155  health care payor may not be held civilly liable solely for
  156  declining to participate in or pay for a health care service on
  157  the basis of a conscience-based objection. However, this section
  158  does not limit a person′s ability to recover damages or other
  159  relief under any other applicable law due to behavior that
  160  constitutes a violation of this section or that is not related
  161  to a conscience-based objection.
  162         (6)REQUIREMENT TO PROVIDE EMERGENCY MEDICAL TREATMENT.
  163  This section may not be construed to override any requirement to
  164  provide emergency medical treatment in accordance with federal
  165  or state law.
  166         Section 3. Section 456.61, Florida Statutes, is created to
  167  read:
  168         456.61 Use of free speech by a health care practitioner;
  169  prohibition.—
  170         (1)A board, or the department if there is no board, may
  171  not take disciplinary action against a health care
  172  practitioner’s license or deny a license to an individual solely
  173  because the individual has spoken or written publicly about a
  174  health care service or public policy, including, but not limited
  175  to, speech through the use of a social media platform as defined
  176  in s. 501.2041, provided that the individual is not using such
  177  speech or written communication to provide medical advice or
  178  treatment to a specific patient or patients, and provided that
  179  such speech or written communication does not separately violate
  180  any other applicable law or rule.
  181         (2)If a specialty board or other recognizing agency
  182  approved by any board within the jurisdiction of the department
  183  revokes the certification of an individual solely because the
  184  individual has spoken or written publicly about a health care
  185  service or public policy, including, but not limited to, speech
  186  through the use of a social media platform as defined in s.
  187  501.2041, provided such individual was not providing medical
  188  advice or treatment to a specific patient and provided such
  189  speech did not separately violate of any other applicable law,
  190  the board within the jurisdiction of the department may revoke
  191  its approval of such specialty board or other recognizing
  192  agency.
  193         Section 4. If any provision of this act or its application
  194  to any person or circumstance is held invalid, the invalidity
  195  does not affect other provisions or applications of the act
  196  which can be given effect without the invalid provision or
  197  application, and to this end the provisions of this act are
  198  severable.
  199         Section 5. This act shall take effect July 1, 2023.
  200  
  201  ================= T I T L E  A M E N D M E N T ================
  202  And the title is amended as follows:
  203         Delete everything before the enacting clause
  204  and insert:
  205                        A bill to be entitled                      
  206         An act relating to protections of medical conscience;
  207         providing legislative intent; creating s. 381.00321,
  208         F.S.; defining terms; providing that health care
  209         providers and health care payors have the right to opt
  210         out of participation in or payment for certain health
  211         care services on the basis of conscience-based
  212         objections; providing requirements for a health care
  213         provider’s notice and documentation of such objection;
  214         requiring health care providers to notify patients or
  215         potential patients seeking a specific health care
  216         service of any such objection before scheduling an
  217         appointment; providing construction; prohibiting
  218         health care payors from declining to cover any health
  219         care service they are obligated to cover during the
  220         plan year; prohibiting discrimination or adverse
  221         action against health care providers who decline to
  222         participate in a health care service on the basis of
  223         conscience-based objection; providing whistle-blower
  224         protections for health care providers and health care
  225         payors that take certain actions or disclose certain
  226         information relating to the reporting of certain
  227         violations; authorizing health care providers and
  228         health care payors to file complaints with the
  229         Attorney General for violation of specified
  230         provisions; providing for civil penalties; authorizing
  231         the Attorney General to take specified actions for
  232         purposes of conducting an investigation of such
  233         complaints; providing health care providers and health
  234         care payors immunity from civil liability solely for
  235         declining to participate in or pay for a health care
  236         service on the basis of conscience-based objection;
  237         providing construction; creating s. 456.61, F.S.;
  238         prohibiting boards, or the Department of Health if
  239         there is no board, from taking disciplinary action
  240         against or denying a license to an individual based
  241         solely on specified conduct; authorizing boards within
  242         the department’s jurisdiction to revoke their approval
  243         of a specialty board or other recognizing agency under
  244         certain circumstances; providing severability;
  245         providing an effective date.