Florida Senate - 2023 COMMITTEE AMENDMENT Bill No. SB 1580 Ì206378HÎ206378 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— 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: 14 381.00321 The 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.