Florida Senate - 2023                                    SB 1580
       By Senator Trumbull
       2-00821C-23                                           20231580__
    1                        A bill to be entitled                      
    2         An act relating to protections of medical conscience;
    3         creating s. 381.00321, F.S.; defining terms; providing
    4         that health care providers and health care payors have
    5         the right to opt out of participation in or payment
    6         for certain health care services on the basis of
    7         conscience-based objections; providing requirements
    8         for a health care provider’s notice and documentation
    9         of such objection; providing construction; prohibiting
   10         health care payors from declining to cover any health
   11         care service they are obligated to cover during the
   12         plan year; prohibiting persons, governmental entities,
   13         business entities, and educational institutions from
   14         discriminating against health care providers and
   15         health care payors that exercise such right; providing
   16         whistle-blower protections for health care providers
   17         and health care payors that take certain actions or
   18         disclose certain information relating to the reporting
   19         of certain violations; providing construction;
   20         creating s. 456.61, F.S.; prohibiting boards, or the
   21         Department of Health if there is no board, from taking
   22         disciplinary action against or denying a license to an
   23         individual based solely on specified conduct;
   24         providing construction; providing severability;
   25         providing an effective date.
   27  Be It Enacted by the Legislature of the State of Florida:
   29         Section 1. Section 381.00321, Florida Statutes, is created
   30  to read:
   31         381.00321Rights of conscience of health care providers and
   32  health care payors.—
   33         (1)DEFINITIONS.—As used in this section, the term:
   34         (a)“Adverse action” means the discharge, transfer,
   35  demotion, discipline, suspension, exclusion, revocation of
   36  privileges, withholding of bonuses, or reduction in salary or
   37  benefits; any action that may negatively impact the advancement
   38  or graduation of a student, including, but not limited to, the
   39  withholding of scholarship funds; or any other negative action
   40  taken against a health care provider.
   41         (b)“Agency” means the Agency for Health Care
   42  Administration.
   43         (c)“Business entity” has the same meaning as provided in
   44  s. 606.03. The term also includes a charitable organization as
   45  defined in s. 496.404 and a corporation not for profit as
   46  defined in s. 617.01401.
   47         (d)“Conscience-based objection” means an objection based
   48  on a sincerely held religious, moral, or ethical belief.
   49  Conscience with respect to entities is determined by reference
   50  to the entities’ governing documents; any published ethical,
   51  moral, or religious guidelines or directives; mission
   52  statements; constitutions; articles of incorporation; bylaws;
   53  policies; or regulations.
   54         (e)“Department” means the Department of Health.
   55         (f)“Educational institution” means a public or private
   56  school, college, or university.
   57         (g)“Governmental entity” means the state or any political
   58  subdivision thereof, including the executive, legislative, and
   59  judicial branches of government; the independent establishments
   60  of the state, counties, municipalities, districts, authorities,
   61  boards, or commissions; and any agencies that are subject to
   62  chapter 286, including, but not limited to, the department and
   63  any boards under the jurisdiction of the department.
   64         (h)“Health care payor” means a health insurer, an
   65  employer, a health care sharing organization, a health plan, a
   66  health maintenance organization, a management services
   67  organization, or any other entity that pays for, or arranges for
   68  the payment of, any health care service, whether such payment is
   69  in whole or in part.
   70         (i)“Health care provider” means:
   71         1.Any person or entity licensed under chapter 394; chapter
   72  400; chapter 401; chapter 457; chapter 458; chapter 459; chapter
   73  460; chapter 461; chapter 462; chapter 463; chapter 464; chapter
   74  465; chapter 466; chapter 467; part I, part II, part III, part
   75  IV, part V, part X, part XIII, or part XIV of chapter 468;
   76  chapter 478; chapter 480; chapter 483; chapter 484; chapter 486;
   77  chapter 490; or chapter 491; or
   78         2.Any provider as defined in s. 408.803, a continuing care
   79  facility licensed under chapter 651, or a pharmacy permitted
   80  under chapter 465.
   82  This term includes any student enrolled in an educational
   83  institution who is seeking to become a health care provider.
   84         (j)“Health care service” means medical research or medical
   85  procedures, medical care, or medical services provided to any
   86  patient at any time over the entire course of treatment,
   87  including, but not limited to, testing; diagnosis; referral;
   88  dispensing or administering any drug, medication, or device;
   89  psychological therapy or counseling; research; prognosis;
   90  therapy; recordmaking procedures; notes related to treatment;
   91  set up or performance of a surgery or procedure; or any other
   92  care or services performed or provided by any health care
   93  provider.
   94         (k)“Participate” or “participation” means to pay for or
   95  take part in any way in providing or facilitating any health
   96  care service or any part of such service.
   97         (2)RIGHTS OF CONSCIENCE.—
   98         (a)A health care provider or health care payor has the
   99  right to opt out of participation in or payment for any health
  100  care service on the basis of a conscience-based objection. A
  101  health care provider must, at the time of the conscience-based
  102  objection or as soon as practicable thereafter, provide written
  103  notice of his or her conscience-based objection to the health
  104  care provider’s supervisor or employer, if applicable, or
  105  document his or her conscience-based objection to a particular
  106  health care service in the patient’s medical file. A health care
  107  provider who is a student must provide written notice of his or
  108  her conscience-based objection to the educational institution at
  109  the time the conscience-based objection is made or as soon as
  110  practicable thereafter.
  111         (b)The exercise of the right of medical conscience is
  112  limited to conscience-based objections to a specific health care
  113  service. This section may not be construed to waive or modify
  114  any duty a health care provider or health care payor may have to
  115  provide or pay for other health care services that do not
  116  violate the rights of conscience or any duty to provide any
  117  informed consent required by law. Additionally, a health care
  118  payor may not decline to pay for a health care service it is
  119  contractually obligated to cover during the plan year.
  120         (c)A person, a governmental entity, a business entity, or
  121  an educational institution may not discriminate against any
  122  health care provider or health care payor because the health
  123  care provider or health care payor declined to participate in or
  124  pay for a health care service on the basis of a conscience-based
  125  objection.
  127         (a)A health care provider or health care payor may not be
  128  discriminated against or suffer any adverse action in any manner
  129  with respect to:
  130         1.Providing or causing to be provided, or intending to
  131  provide or cause to be provided, information relating to any
  132  violation of or any act or omission the health care provider or
  133  health care payor reasonably believes to be a violation of any
  134  provision of this act to his or her employer, the Attorney
  135  General, the department, any other state agency charged with
  136  protecting health care rights of conscience, the United States
  137  Department of Health and Human Services, the Office of Civil
  138  Rights, or any other federal agency charged with protecting
  139  health care rights of conscience;
  140         2. Testifying or intending to testify in a proceeding
  141  concerning such violation; or
  142         3. Assisting or participating in or intending to assist or
  143  participate in such a proceeding.
  144         (b) Unless the disclosure is specifically prohibited by
  145  law, a health care provider or health care payor may not be
  146  discriminated against in any manner for disclosing information
  147  that the health care provider or health care payor reasonably
  148  believes constitutes:
  149         1. A violation of any law, rule, or regulation;
  150         2. A violation of any ethical guidelines for the provision
  151  of any medical procedure or service; or
  152         3. A practice or method of treatment that may put patient
  153  health at risk or present a substantial and specific danger to
  154  public health or safety.
  156  This section may not be construed to override any requirement to
  157  provide emergency medical treatment in accordance with federal
  158  or state law.
  159         Section 2. Section 456.61, Florida Statutes, is created to
  160  read:
  161         456.61 Use of free speech by a health care practitioner;
  162  prohibition.—A board, or the department if there is no board,
  163  may not take disciplinary action against a health care
  164  practitioner’s license or deny a license to an individual solely
  165  because the individual has spoken or written publicly about a
  166  health care service, including, but not limited to, speech
  167  through the use of a social media platform as defined in s.
  168  501.2041, provided that the individual is not using such speech
  169  or written communication to provide medical advice or treatment
  170  to a specific patient or patients, and provided that such speech
  171  or written communication does not separately violate any other
  172  applicable law or rule.
  173         Section 3. If any provision of this act or its application
  174  to any person or circumstance is held invalid, the invalidity
  175  does not affect other provisions or applications of the act
  176  which can be given effect without the invalid provision or
  177  application, and to this end the provisions of this act are
  178  severable.
  179         Section 4. This act shall take effect July 1, 2023.