Florida Senate - 2025                                     SB 932
       
       
        
       By Senator Jones
       
       
       
       
       
       34-00613-25                                            2025932__
    1                        A bill to be entitled                      
    2         An act relating to the Health Care Freedom Act;
    3         providing a short title; repealing ss. 286.31,
    4         286.311, and 381.00321, F.S., relating to the
    5         prohibited use of state funds for travel to another
    6         state for purpose of abortion services, the prohibited
    7         use of state funds for sex-reassignment prescriptions
    8         or procedures, and the right of medical conscience of
    9         health care providers and health care payors,
   10         respectively; creating s. 381.027, F.S.; providing a
   11         short title; defining terms; requiring a covered
   12         entity to, by a specified date, adopt a policy
   13         relating to providing written notice of a complete
   14         list of its refused services to patients; providing
   15         requirements for such notice; requiring a covered
   16         entity to submit a complete list of its refused
   17         services to the Department of Health by a specified
   18         date; requiring a covered entity to notify the
   19         department within a specified timeframe after a change
   20         is made to such list; requiring a covered entity to
   21         submit the list, along with its application, if
   22         applying for certain state grants or contracts;
   23         providing a civil penalty; requiring the department to
   24         adopt rules; requiring the department to publish and
   25         maintain on its website a current list of covered
   26         entities and their refused services by a specified
   27         date; requiring the department to develop and
   28         administer a certain public education and awareness
   29         program; providing construction; providing for
   30         severability; amending s. 381.96, F.S.; revising the
   31         definition of the term “eligible client” and
   32         redefining the term “pregnancy and parenting support
   33         services” as “pregnancy support services,”; revising
   34         department duties and contract requirements to conform
   35         to changes made by the act; amending s. 390.011, F.S.;
   36         deleting the definition of the term “fatal fetal
   37         abnormality”; amending s. 390.0111, F.S.; revising the
   38         timeframe in which a physician may perform a
   39         termination of pregnancy; revising exceptions;
   40         deleting the prohibition against the use of telehealth
   41         to perform abortions, the requirement that medications
   42         intended for use in a medical abortion be dispensed in
   43         person by a physician, and the prohibition against
   44         dispensing such medication through the United States
   45         Postal Service or any other courier or shipping
   46         service; amending s. 390.012, F.S.; revising rules the
   47         Agency for Health Care Administration may develop and
   48         enforce to regulate abortion clinics; repealing s.
   49         395.3027, F.S., relating to patient immigration status
   50         data collection in hospitals; amending s. 409.905,
   51         F.S.; defining the terms “gender identity” and
   52         “transgender individual”; requiring the agency to
   53         provide Medicaid reimbursement for medically necessary
   54         treatment for or related to gender dysphoria or a
   55         comparable or equivalent diagnosis; prohibiting the
   56         agency from discriminating in its reimbursement on the
   57         basis of a recipient’s gender identity or that the
   58         recipient is a transgender individual; amending s.
   59         456.001, F.S.; deleting the definition of the terms
   60         “sex” and “sex-reassignment prescriptions or
   61         procedures”; amending s. 456.47, F.S.; deleting the
   62         prohibition against the use of telehealth to perform
   63         abortions, including medical abortions; repealing ss.
   64         456.52 and 766.318, F.S., relating to sex-reassignment
   65         prescriptions and procedures and civil liability for
   66         provision of sex-reassignment prescriptions or
   67         procedures to minors, respectively; amending ss.
   68         61.517, 61.534, 409.908, 409.913, 456.074, and
   69         636.0145, F.S.; conforming provisions and cross
   70         references to changes made by the act; providing an
   71         effective date.
   72          
   73  Be It Enacted by the Legislature of the State of Florida:
   74  
   75         Section 1. This act may be cited as the “Health Care
   76  Freedom Act.”
   77         Section 2. Section 286.31, Florida Statutes, is repealed.
   78         Section 3. Section 286.311, Florida Statutes, is repealed.
   79         Section 4. Section 381.00321, Florida Statutes, is
   80  repealed.
   81         Section 5. Section 381.027, Florida Statutes, is created to
   82  read:
   83         381.027Requirements for covered entities; notice of
   84  refused services; department duties.—
   85         (1)SHORT TITLE.—This section may be cited as the “Health
   86  Care Transparency and Accessibility Act.”
   87         (2)DEFINITIONS.—As used in this section, the term:
   88         (a)“Covered entity” means any health care facility that
   89  uses, plans to use, or relies upon a denial of care provision to
   90  refuse to provide a health care service, or referral for a
   91  health care service, for any reason. The term does not include a
   92  health care practitioner.
   93         (b)“Denial of care provision” means any federal or state
   94  law that purports or is asserted to allow a health care facility
   95  to opt out of providing a health care service, or referral for a
   96  health care service, including, but not limited to, ss.
   97  381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss.
   98  18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n;
   99  42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of
  100  Labor, Health and Human Services, and Education, and Related
  101  Agencies Appropriations Act of 2019, Division B of Pub. L. No.
  102  115-245; and 45 C.F.R. part 88.
  103         (c)“Department” means the Department of Health.
  104         (d)“Health care facility” has the same meaning as in s.
  105  381.026(2).
  106         (e)“Health care practitioner” has the same meaning as in
  107  s. 456.001.
  108         (f)“Health care services” has the same meaning as in s.
  109  624.27(1).
  110         (g)“Referral” has the same meaning as in s. 456.053(3).
  111         (h) “Refused service” means a health care service that a
  112  covered entity chooses not to provide, or not to provide a
  113  referral for, based on one or more denials of care provisions.
  114  The term includes health care services that the covered entity
  115  selectively provides to some, but not all, patients based on
  116  their identity, objections to a health care service, or other
  117  nonmedical reasons.
  118         (3) REQUIREMENTS FOR COVERED ENTITIES; PENALTY.—
  119         (a) By October 1, 2025, each covered entity shall adopt a
  120  policy for providing patients with a complete list of its
  121  refused services. A covered entity shall:
  122         1. Provide written notice to the patient or the patient’s
  123  representative which includes the complete list of its refused
  124  services before any health care service is initiated.
  125         a. In the case of an emergency, the covered entity must
  126  promptly provide written notice after the patient is capable of
  127  receiving such notice or when the patient’s representative is
  128  available.
  129         b. The patient or patient’s representative shall
  130  acknowledge receipt of the written notice of refused services.
  131         2. Retain all acknowledgments of receipt of the written
  132  notice of refused services for a period of at least 3 years.
  133         3. Provide a complete list of its refused services to any
  134  person upon request.
  135         (b) By October 1, 2025, a covered entity shall submit to
  136  the department a complete list of its refused services. If any
  137  change is made to the list, the covered entity must notify the
  138  department within 30 days after making the change.
  139         (c) If applying for any state grant or contract related to
  140  providing a health care service, a covered entity must submit,
  141  along with its application, a complete list of its refused
  142  services.
  143         (d) A covered entity that fails to comply with this
  144  subsection is subject to a fine not to exceed $5,000 for each
  145  day the covered entity is not in compliance.
  146         (4) DEPARTMENT DUTIES.—
  147         (a) The department shall adopt rules to implement this
  148  section which must include a process for receiving and
  149  investigating complaints regarding covered entities not in
  150  compliance with this section.
  151         (b) By January 1, 2026, the department shall publish and
  152  maintain on its website a current list of covered entities and
  153  the refused services for each covered entity.
  154         (c) The department shall develop and administer a public
  155  education and awareness program regarding the denial of health
  156  care services, including how the denial of health care services
  157  can negatively impact health care access and quality, how the
  158  denial of health care services may be avoided, and how the
  159  denial of health care services affects vulnerable people and
  160  communities.
  161         (5) CONSTRUCTION.—
  162         (a) This section does not authorize denials of health care
  163  services or discrimination in the provision of health care
  164  services.
  165         (b) This section does not limit any cause of action under
  166  state or federal law, or limit any remedy in law or equity,
  167  against a health care facility or health care practitioner.
  168         (c) Compliance with this section does not reduce or limit
  169  any potential liability for covered entities associated with the
  170  refused services or any violations of state or federal law.
  171         (d) Section 761.03 does not provide a claim relating to, or
  172  a defense to a claim under, this section, or provide a basis for
  173  challenging the application or enforcement of this section or
  174  the use of funds associated with the application or enforcement
  175  of this section.
  176         (6) SEVERABILITY.—If any provision of this section or its
  177  application to any person or circumstance is held invalid, the
  178  invalidity does not affect other provisions or applications of
  179  this section which can be given effect without the invalid
  180  provision or application, and to this end the provisions of this
  181  section are severable.
  182         Section 6. Section 381.96, Florida Statutes, is amended to
  183  read:
  184         381.96 Pregnancy support and wellness services.—
  185         (1) DEFINITIONS.—As used in this section, the term:
  186         (a) “Department” means the Department of Health.
  187         (b) “Eligible client” means any of the following:
  188         1. a pregnant woman or a woman who suspects she is
  189  pregnant, and the family of such woman, who voluntarily seeks
  190  pregnancy support services and any woman who voluntarily seeks
  191  wellness services.
  192         2. A woman who has given birth in the previous 12 months
  193  and her family.
  194         3. A parent or parents or a legal guardian or legal
  195  guardians, and the families of such parents and legal guardians,
  196  for up to 12 months after the birth of a child or the adoption
  197  of a child younger than 3 years of age.
  198         (c) “Florida Pregnancy Care Network, Inc.,” or “network”
  199  means the not-for-profit statewide alliance of pregnancy support
  200  organizations that provide pregnancy support and wellness
  201  services through a comprehensive system of care to women and
  202  their families.
  203         (d) “Pregnancy and parenting support services” means
  204  services that promote and encourage childbirth, including, but
  205  not limited to:
  206         1. Direct client services, such as pregnancy testing,
  207  counseling, referral, training, and education for pregnant women
  208  and their families. A woman and her family remain eligible to
  209  receive direct client services for up to 12 months after the
  210  birth of the child.
  211         2. Nonmedical material assistance that improves the
  212  pregnancy or parenting situation of families, including, but not
  213  limited to, clothing, car seats, cribs, formula, and diapers.
  214         3. Counseling or mentoring, education materials, and
  215  classes regarding pregnancy, parenting, adoption, life skills,
  216  and employment readiness.
  217         4. Network awareness activities, including a promotional
  218  campaign to educate the public about the pregnancy support
  219  services offered by the network and a website that provides
  220  information on the location of providers in the user’s area and
  221  other available community resources.
  222         3.5. Communication activities, including the operation and
  223  maintenance of a hotline or call center with a single statewide
  224  toll-free number that is available 24 hours a day for an
  225  eligible client to obtain the location and contact information
  226  for a pregnancy center located in the client’s area.
  227         (e) “Wellness services” means services or activities
  228  intended to maintain and improve health or prevent illness and
  229  injury, including, but not limited to, high blood pressure
  230  screening, anemia testing, thyroid screening, cholesterol
  231  screening, diabetes screening, and assistance with smoking
  232  cessation.
  233         (2) DEPARTMENT DUTIES.—The department shall contract with
  234  the network for the management and delivery of pregnancy and
  235  parenting support services and wellness services to eligible
  236  clients.
  237         (3) CONTRACT REQUIREMENTS.—The department contract must
  238  shall specify the contract deliverables, including financial
  239  reports and other reports due to the department, timeframes for
  240  achieving contractual obligations, and any other requirements
  241  the department determines are necessary, such as staffing and
  242  location requirements. The contract must shall require the
  243  network to:
  244         (a) Establish, implement, and monitor a comprehensive
  245  system of care through subcontractors to meet the pregnancy and
  246  parenting support and wellness needs of eligible clients.
  247         (b) Establish and manage subcontracts with a sufficient
  248  number of providers to ensure the availability of pregnancy and
  249  parenting support services and wellness services for eligible
  250  clients, and maintain and manage the delivery of such services
  251  throughout the contract period.
  252         (c) Spend at least 90 85 percent of the contract funds on
  253  pregnancy and parenting support services, excluding services
  254  specified in subparagraph (1)(d)4., and wellness services.
  255         (d) Offer wellness services through vouchers or other
  256  appropriate arrangements that allow the purchase of services
  257  from qualified health care providers.
  258         (e) Require a background screening under s. 943.0542 for
  259  all paid staff and volunteers of a subcontractor if such staff
  260  or volunteers provide direct client services to an eligible
  261  client who is a minor or an elderly person or who has a
  262  disability.
  263         (f) Annually Monitor its subcontractors annually and
  264  specify the sanctions that will shall be imposed for
  265  noncompliance with the terms of a subcontract.
  266         (g) Subcontract only with providers that exclusively
  267  promote and support childbirth.
  268         (h) Ensure that informational materials provided to an
  269  eligible client by a provider are current and accurate and cite
  270  the reference source of any medical statement included in such
  271  materials.
  272         (i) Ensure that the department is provided with all
  273  information necessary for the report required under subsection
  274  (5).
  275         (4) SERVICES.—Services provided pursuant to this section
  276  must be provided in a noncoercive manner and may not include any
  277  religious content.
  278         (5) REPORT.—By July 1, 2024, and each year thereafter, the
  279  department shall report to the Governor, the President of the
  280  Senate, and the Speaker of the House of Representatives on the
  281  amount and types of services provided by the network; the
  282  expenditures for such services; and the number of, and
  283  demographic information for, women, parents, and families served
  284  by the network.
  285         Section 7. Subsection (6) of section 390.011, Florida
  286  Statutes, is amended to read:
  287         390.011 Definitions.—As used in this chapter, the term:
  288         (6)“Fatal fetal abnormality” means a terminal condition
  289  that, in reasonable medical judgment, regardless of the
  290  provision of life-saving medical treatment, is incompatible with
  291  life outside the womb and will result in death upon birth or
  292  imminently thereafter.
  293         Section 8. Subsections (1) and (2) of section 390.0111,
  294  Florida Statutes, are amended to read:
  295         390.0111 Termination of pregnancies.—
  296         (1) TERMINATION IN THIRD TRIMESTER AFTER GESTATIONAL AGE OF
  297  6 WEEKS; WHEN ALLOWED.—A physician may not knowingly perform or
  298  induce a termination of pregnancy on any person in the third
  299  trimester of pregnancy if the physician determines the
  300  gestational age of the fetus is more than 6 weeks unless one of
  301  the following conditions is met:
  302         (a) Two physicians certify in writing that, in reasonable
  303  medical judgment, the termination of the pregnancy is necessary
  304  to save the pregnant woman’s life or avert a serious risk of
  305  substantial and irreversible physical impairment of a major
  306  bodily function of the pregnant woman other than a psychological
  307  condition.
  308         (b) The physician certifies in writing that, in reasonable
  309  medical judgment, there is a medical necessity for legitimate
  310  emergency medical procedures for termination of the pregnancy to
  311  save the pregnant woman’s life or avert a serious risk of
  312  imminent substantial and irreversible physical impairment of a
  313  major bodily function of the pregnant woman other than a
  314  psychological condition, and another physician is not available
  315  for consultation.
  316         (c) The pregnancy has not progressed to the third trimester
  317  and two physicians certify in writing that, in reasonable
  318  medical judgment, the fetus has a fatal fetal abnormality.
  319         (d) The pregnancy is the result of rape, incest, or human
  320  trafficking and the gestational age of the fetus is not more
  321  than 15 weeks as determined by the physician. At the time the
  322  woman schedules or arrives for her appointment to obtain the
  323  abortion, she must provide a copy of a restraining order, police
  324  report, medical record, or other court order or documentation
  325  providing evidence that she is obtaining the termination of
  326  pregnancy because she is a victim of rape, incest, or human
  327  trafficking. If the woman is 18 years of age or older, the
  328  physician must report any known or suspected human trafficking
  329  to a local law enforcement agency. If the woman is a minor, the
  330  physician must report the incident of rape, incest, or human
  331  trafficking to the central abuse hotline as required by s.
  332  39.201.
  333         (2) IN-PERSON PERFORMANCE BY PHYSICIAN REQUIRED.—Only a
  334  physician may perform or induce a termination of pregnancy. A
  335  physician may not use telehealth as defined in s. 456.47 to
  336  perform an abortion, including, but not limited to, medical
  337  abortions. Any medications intended for use in a medical
  338  abortion must be dispensed in person by a physician and may not
  339  be dispensed through the United States Postal Service or by any
  340  other courier or shipping service.
  341         Section 9. Subsection (1) of section 390.012, Florida
  342  Statutes, is amended to read:
  343         390.012 Powers of agency; rules; disposal of fetal
  344  remains.—
  345         (1) The agency may develop and enforce rules pursuant to
  346  ss. 390.011-390.018 and part II of chapter 408 for the health,
  347  care, and treatment of persons in abortion clinics and for the
  348  safe operation of such clinics. The rules must be reasonably
  349  related to the preservation of maternal health of the clients,
  350  must be in accordance with s. 797.03, may not impose an
  351  unconstitutional burden on a woman’s freedom to decide whether
  352  to terminate her pregnancy, and must provide for all of the
  353  following:
  354         (a) The performance of pregnancy termination procedures
  355  only by a licensed physician.
  356         (b) The making, protection, and preservation of patient
  357  records, which must be treated as medical records under chapter
  358  458. When performing a license inspection of a clinic, the
  359  agency shall inspect at least 50 percent of patient records
  360  generated since the clinic’s last license inspection.
  361         (c) Annual inspections by the agency of all clinics
  362  licensed under this chapter to ensure that such clinics are in
  363  compliance with this chapter and agency rules.
  364         (d) The prompt investigation of credible allegations of
  365  abortions being performed at a clinic that is not licensed to
  366  perform such procedures.
  367         Section 10. Section 395.3027, Florida Statutes, is
  368  repealed.
  369         Section 11. Present subsections (4) through (12) of section
  370  409.905, Florida Statutes, are redesignated as subsections (5)
  371  through (13), respectively, and a new subsection (4) is added to
  372  that section, to read:
  373         409.905 Mandatory Medicaid services.—The agency may make
  374  payments for the following services, which are required of the
  375  state by Title XIX of the Social Security Act, furnished by
  376  Medicaid providers to recipients who are determined to be
  377  eligible on the dates on which the services were provided. Any
  378  service under this section shall be provided only when medically
  379  necessary and in accordance with state and federal law.
  380  Mandatory services rendered by providers in mobile units to
  381  Medicaid recipients may be restricted by the agency. Nothing in
  382  this section shall be construed to prevent or limit the agency
  383  from adjusting fees, reimbursement rates, lengths of stay,
  384  number of visits, number of services, or any other adjustments
  385  necessary to comply with the availability of moneys and any
  386  limitations or directions provided for in the General
  387  Appropriations Act or chapter 216.
  388         (4) GENDER-AFFIRMING CARE.—
  389         (a)Definitions.As used in this section, the term:
  390         1.“Gender identity” means an individual’s internal sense
  391  of that individual’s gender, regardless of the sex assigned to
  392  that individual at birth.
  393         2.“Transgender individual” means an individual who
  394  identifies as a gender different from the sex assigned to that
  395  individual at birth.
  396         (b)Reimbursement.The agency shall provide reimbursement
  397  for medically necessary treatment for or related to gender
  398  dysphoria as defined by the Diagnostic and Statistical Manual of
  399  Mental Disorders, Fifth Edition, published by the American
  400  Psychiatric Association or a comparable or equivalent diagnosis.
  401         (c)Discrimination prohibited.The agency may not
  402  discriminate in its reimbursement of medically necessary
  403  treatment on the basis of the recipient’s gender identity or on
  404  the basis that the recipient is a transgender individual.
  405         Section 12. Subsections (8) and (9) of section 456.001,
  406  Florida Statutes, are amended to read:
  407         456.001 Definitions.—As used in this chapter, the term:
  408         (8) “Sex” means the classification of a person as either
  409  male or female based on the organization of the human body of
  410  such person for a specific reproductive role, as indicated by
  411  the person’s sex chromosomes, naturally occurring sex hormones,
  412  and internal and external genitalia present at birth.
  413         (9)(a) “Sex-reassignment prescriptions or procedures”
  414  means:
  415         1. The prescription or administration of puberty blockers
  416  for the purpose of attempting to stop or delay normal puberty in
  417  order to affirm a person’s perception of his or her sex if that
  418  perception is inconsistent with the person’s sex as defined in
  419  subsection (8).
  420         2. The prescription or administration of hormones or
  421  hormone antagonists to affirm a person’s perception of his or
  422  her sex if that perception is inconsistent with the person’s sex
  423  as defined in subsection (8).
  424         3. Any medical procedure, including a surgical procedure,
  425  to affirm a person’s perception of his or her sex if that
  426  perception is inconsistent with the person’s sex as defined in
  427  subsection (8).
  428         (b) The term does not include:
  429         1. Treatment provided by a physician who, in his or her
  430  good faith clinical judgment, performs procedures upon or
  431  provides therapies to a minor born with a medically verifiable
  432  genetic disorder of sexual development, including any of the
  433  following:
  434         a. External biological sex characteristics that are
  435  unresolvably ambiguous.
  436         b. A disorder of sexual development in which the physician
  437  has determined through genetic or biochemical testing that the
  438  patient does not have a normal sex chromosome structure, sex
  439  steroid hormone production, or sex steroid hormone action for a
  440  male or female, as applicable.
  441         2. Prescriptions or procedures to treat an infection, an
  442  injury, a disease, or a disorder that has been caused or
  443  exacerbated by the performance of any sex-reassignment
  444  prescription or procedure, regardless of whether such
  445  prescription or procedure was performed in accordance with state
  446  or federal law.
  447         3. Prescriptions or procedures provided to a patient for
  448  the treatment of a physical disorder, physical injury, or
  449  physical illness that would, as certified by a physician
  450  licensed under chapter 458 or chapter 459, place the individual
  451  in imminent danger of death or impairment of a major bodily
  452  function without the prescription or procedure.
  453         Section 13. Paragraph (f) of subsection (2) of section
  454  456.47, Florida Statutes, is amended to read:
  455         456.47 Use of telehealth to provide services.—
  456         (2) PRACTICE STANDARDS.—
  457         (f) A telehealth provider may not use telehealth to perform
  458  an abortion, including, but not limited to, medical abortions as
  459  defined in s. 390.011.
  460         Section 14. Section 456.52, Florida Statutes, is repealed.
  461         Section 15. Section 766.318, Florida Statutes, is repealed.
  462         Section 16. Subsection (1) of section 61.517, Florida
  463  Statutes, is amended to read:
  464         61.517 Temporary emergency jurisdiction.—
  465         (1) A court of this state has temporary emergency
  466  jurisdiction if the child is present in this state and:
  467         (a) The child has been abandoned; or
  468         (b) It is necessary in an emergency to protect the child
  469  because the child, or a sibling or parent of the child, is
  470  subjected to or threatened with mistreatment or abuse; or
  471         (c) It is necessary in an emergency to protect the child
  472  because the child has been subjected to or is threatened with
  473  being subjected to sex-reassignment prescriptions or procedures,
  474  as defined in s. 456.001.
  475         Section 17. Subsection (1) of section 61.534, Florida
  476  Statutes, is amended to read:
  477         61.534 Warrant to take physical custody of child.—
  478         (1) Upon the filing of a petition seeking enforcement of a
  479  child custody determination, the petitioner may file a verified
  480  application for the issuance of a warrant to take physical
  481  custody of the child if the child is likely to imminently suffer
  482  serious physical harm or removal from this state. Serious
  483  physical harm includes, but is not limited to, being subjected
  484  to sex-reassignment prescriptions or procedures as defined in s.
  485  456.001.
  486         Section 18. Paragraph (a) of subsection (1) of section
  487  409.908, Florida Statutes, is amended to read:
  488         409.908 Reimbursement of Medicaid providers.—Subject to
  489  specific appropriations, the agency shall reimburse Medicaid
  490  providers, in accordance with state and federal law, according
  491  to methodologies set forth in the rules of the agency and in
  492  policy manuals and handbooks incorporated by reference therein.
  493  These methodologies may include fee schedules, reimbursement
  494  methods based on cost reporting, negotiated fees, competitive
  495  bidding pursuant to s. 287.057, and other mechanisms the agency
  496  considers efficient and effective for purchasing services or
  497  goods on behalf of recipients. If a provider is reimbursed based
  498  on cost reporting and submits a cost report late and that cost
  499  report would have been used to set a lower reimbursement rate
  500  for a rate semester, then the provider’s rate for that semester
  501  shall be retroactively calculated using the new cost report, and
  502  full payment at the recalculated rate shall be effected
  503  retroactively. Medicare-granted extensions for filing cost
  504  reports, if applicable, shall also apply to Medicaid cost
  505  reports. Payment for Medicaid compensable services made on
  506  behalf of Medicaid-eligible persons is subject to the
  507  availability of moneys and any limitations or directions
  508  provided for in the General Appropriations Act or chapter 216.
  509  Further, nothing in this section shall be construed to prevent
  510  or limit the agency from adjusting fees, reimbursement rates,
  511  lengths of stay, number of visits, or number of services, or
  512  making any other adjustments necessary to comply with the
  513  availability of moneys and any limitations or directions
  514  provided for in the General Appropriations Act, provided the
  515  adjustment is consistent with legislative intent.
  516         (1) Reimbursement to hospitals licensed under part I of
  517  chapter 395 must be made prospectively or on the basis of
  518  negotiation.
  519         (a) Reimbursement for inpatient care is limited as provided
  520  in s. 409.905(6) s. 409.905(5), except as otherwise provided in
  521  this subsection.
  522         1. If authorized by the General Appropriations Act, the
  523  agency may modify reimbursement for specific types of services
  524  or diagnoses, recipient ages, and hospital provider types.
  525         2. The agency may establish an alternative methodology to
  526  the DRG-based prospective payment system to set reimbursement
  527  rates for:
  528         a. State-owned psychiatric hospitals.
  529         b. Newborn hearing screening services.
  530         c. Transplant services for which the agency has established
  531  a global fee.
  532         d. Recipients who have tuberculosis that is resistant to
  533  therapy who are in need of long-term, hospital-based treatment
  534  pursuant to s. 392.62.
  535         3. The agency shall modify reimbursement according to other
  536  methodologies recognized in the General Appropriations Act.
  537  
  538  The agency may receive funds from state entities, including, but
  539  not limited to, the Department of Health, local governments, and
  540  other local political subdivisions, for the purpose of making
  541  special exception payments, including federal matching funds,
  542  through the Medicaid inpatient reimbursement methodologies.
  543  Funds received for this purpose shall be separately accounted
  544  for and may not be commingled with other state or local funds in
  545  any manner. The agency may certify all local governmental funds
  546  used as state match under Title XIX of the Social Security Act,
  547  to the extent and in the manner authorized under the General
  548  Appropriations Act and pursuant to an agreement between the
  549  agency and the local governmental entity. In order for the
  550  agency to certify such local governmental funds, a local
  551  governmental entity must submit a final, executed letter of
  552  agreement to the agency, which must be received by October 1 of
  553  each fiscal year and provide the total amount of local
  554  governmental funds authorized by the entity for that fiscal year
  555  under this paragraph, paragraph (b), or the General
  556  Appropriations Act. The local governmental entity shall use a
  557  certification form prescribed by the agency. At a minimum, the
  558  certification form must identify the amount being certified and
  559  describe the relationship between the certifying local
  560  governmental entity and the local health care provider. The
  561  agency shall prepare an annual statement of impact which
  562  documents the specific activities undertaken during the previous
  563  fiscal year pursuant to this paragraph, to be submitted to the
  564  Legislature annually by January 1.
  565         Section 19. Subsection (36) of section 409.913, Florida
  566  Statutes, is amended to read:
  567         409.913 Oversight of the integrity of the Medicaid
  568  program.—The agency shall operate a program to oversee the
  569  activities of Florida Medicaid recipients, and providers and
  570  their representatives, to ensure that fraudulent and abusive
  571  behavior and neglect of recipients occur to the minimum extent
  572  possible, and to recover overpayments and impose sanctions as
  573  appropriate. Each January 15, the agency and the Medicaid Fraud
  574  Control Unit of the Department of Legal Affairs shall submit a
  575  report to the Legislature documenting the effectiveness of the
  576  state’s efforts to control Medicaid fraud and abuse and to
  577  recover Medicaid overpayments during the previous fiscal year.
  578  The report must describe the number of cases opened and
  579  investigated each year; the sources of the cases opened; the
  580  disposition of the cases closed each year; the amount of
  581  overpayments alleged in preliminary and final audit letters; the
  582  number and amount of fines or penalties imposed; any reductions
  583  in overpayment amounts negotiated in settlement agreements or by
  584  other means; the amount of final agency determinations of
  585  overpayments; the amount deducted from federal claiming as a
  586  result of overpayments; the amount of overpayments recovered
  587  each year; the amount of cost of investigation recovered each
  588  year; the average length of time to collect from the time the
  589  case was opened until the overpayment is paid in full; the
  590  amount determined as uncollectible and the portion of the
  591  uncollectible amount subsequently reclaimed from the Federal
  592  Government; the number of providers, by type, that are
  593  terminated from participation in the Medicaid program as a
  594  result of fraud and abuse; and all costs associated with
  595  discovering and prosecuting cases of Medicaid overpayments and
  596  making recoveries in such cases. The report must also document
  597  actions taken to prevent overpayments and the number of
  598  providers prevented from enrolling in or reenrolling in the
  599  Medicaid program as a result of documented Medicaid fraud and
  600  abuse and must include policy recommendations necessary to
  601  prevent or recover overpayments and changes necessary to prevent
  602  and detect Medicaid fraud. All policy recommendations in the
  603  report must include a detailed fiscal analysis, including, but
  604  not limited to, implementation costs, estimated savings to the
  605  Medicaid program, and the return on investment. The agency must
  606  submit the policy recommendations and fiscal analyses in the
  607  report to the appropriate estimating conference, pursuant to s.
  608  216.137, by February 15 of each year. The agency and the
  609  Medicaid Fraud Control Unit of the Department of Legal Affairs
  610  each must include detailed unit-specific performance standards,
  611  benchmarks, and metrics in the report, including projected cost
  612  savings to the state Medicaid program during the following
  613  fiscal year.
  614         (36) The agency may provide to a sample of Medicaid
  615  recipients or their representatives through the distribution of
  616  explanations of benefits information about services reimbursed
  617  by the Medicaid program for goods and services to such
  618  recipients, including information on how to report inappropriate
  619  or incorrect billing to the agency or other law enforcement
  620  entities for review or investigation, information on how to
  621  report criminal Medicaid fraud to the Medicaid Fraud Control
  622  Unit’s toll-free hotline number, and information about the
  623  rewards available under s. 409.9203. The explanation of benefits
  624  may not be mailed for Medicaid independent laboratory services
  625  as described in s. 409.905(8) s. 409.905(7) or for Medicaid
  626  certified match services as described in ss. 409.9071 and
  627  1011.70.
  628         Section 20. Paragraph (c) of subsection (5) of section
  629  456.074, Florida Statutes, is amended to read:
  630         456.074 Certain health care practitioners; immediate
  631  suspension of license.—
  632         (5) The department shall issue an emergency order
  633  suspending the license of any health care practitioner who is
  634  arrested for committing or attempting, soliciting, or conspiring
  635  to commit any act that would constitute a violation of any of
  636  the following criminal offenses in this state or similar
  637  offenses in another jurisdiction:
  638         (c) Section 456.52(5)(b), relating to prescribing,
  639  administering, or performing sex-reassignment prescriptions or
  640  procedures for a patient younger than 18 years of age.
  641         Section 21. Section 636.0145, Florida Statutes, is amended
  642  to read:
  643         636.0145 Certain entities contracting with Medicaid.—An
  644  entity that is providing comprehensive inpatient and outpatient
  645  mental health care services to certain Medicaid recipients in
  646  Hillsborough, Highlands, Hardee, Manatee, and Polk Counties
  647  through a capitated, prepaid arrangement pursuant to the federal
  648  waiver provided for in s. 409.905(6) s. 409.905(5) must become
  649  licensed under this chapter by December 31, 1998. Any entity
  650  licensed under this chapter which provides services solely to
  651  Medicaid recipients under a contract with Medicaid is exempt
  652  from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and
  653  636.066(1).
  654         Section 22. This act shall take effect July 1, 2025.