CS for CS for SB 1756                            First Engrossed
       
       
       
       
       
       
       
       
       20261756e1
       
    1                        A bill to be entitled                      
    2         An act relating to medical freedom; providing a short
    3         title; repealing s. 9 of chapter 2023-43, Laws of
    4         Florida, as amended by chapter 2025-114, Laws of
    5         Florida, relating to the future repeal of the
    6         definition of the term “messenger ribonucleic acid
    7         vaccine”; amending s. 381.00315, F.S.; providing
    8         construction; amending s. 456.054, F.S.; prohibiting a
    9         vaccine manufacturer from offering or paying, and a
   10         health care practitioner from receiving, specified
   11         financial incentives for the administration of a
   12         vaccine; providing a penalty; amending s. 456.0575,
   13         F.S.; requiring certain health care practitioners and
   14         paramedics to, before administering one or more
   15         vaccines to a minor child, provide the parent or legal
   16         guardian with specified materials; requiring such
   17         practitioners and paramedics to obtain the signature
   18         of a minor child’s parent or guardian acknowledging
   19         receipt of such information; requiring health care
   20         practitioners to discuss certain information with a
   21         minor child’s parent or guardian when more than one
   22         vaccine is to be administered; authorizing a health
   23         care practitioner, at the request of the parent or
   24         guardian, to administer the vaccines to the minor
   25         child over multiple encounters; providing that
   26         specified amendments made by the act to s. 456.0575,
   27         F.S., take effect on a specified date or within a
   28         specified timeframe after the Board of Medicine and
   29         the Board of Osteopathic Medicine adopt certain
   30         materials by joint rule, whichever occurs later;
   31         requiring the boards to adopt the joint rule within a
   32         specified timeframe and immediately notify the
   33         Division of Law Revision of their adoption of the
   34         joint rule; creating ss. 458.3351, 459.0156, and
   35         464.0181, F.S.; providing certain health care
   36         practitioners immunity from civil and criminal
   37         liability and disciplinary action for prescribing or
   38         administering ivermectin to adults under certain
   39         circumstances; creating s. 465.1897, F.S.; authorizing
   40         pharmacists to provide ivermectin to adults without a
   41         prescription as a behind-the-counter medication until
   42         the United States Food and Drug Administration
   43         approves it for over-the-counter sale; requiring
   44         pharmacists to provide specified information before
   45         providing the ivermectin; providing pharmacists acting
   46         in good faith with immunity from civil and criminal
   47         liability and disciplinary action for providing
   48         ivermectin to adults; authorizing the Board of
   49         Pharmacy to adopt rules; amending s. 1003.22, F.S.;
   50         revising exemptions from school-entry immunization
   51         requirements; requiring the Department of Health to
   52         make the immunization exemption form for religious or
   53         conscience-based exemptions publicly available on its
   54         website; specifying procedures and requirements for
   55         receiving such exemptions; requiring the department to
   56         ensure that when a certain exemption form is
   57         downloaded from its website, the download includes the
   58         form and specified materials as a single document;
   59         providing that the requirement takes effect upon
   60         adoption of a specified rule; requiring that the web
   61         page containing the download link also include and
   62         prominently display certain other links; revising
   63         requirements and procedures for declarations of a
   64         communicable disease emergency; providing effective
   65         dates.
   66          
   67  Be It Enacted by the Legislature of the State of Florida:
   68  
   69         Section 1. This act may be cited as the “Medical Freedom
   70  Act.”
   71         Section 2. Section 9 of chapter 2023-43, Laws of Florida,
   72  as amended by section 1 of chapter 2025-114, Laws of Florida, is
   73  repealed.
   74         Section 3. Paragraph (d) of subsection (2) of section
   75  381.00315, Florida Statutes, is amended to read:
   76         381.00315 Public health advisories; public health
   77  emergencies; isolation and quarantines.—The State Health Officer
   78  is responsible for declaring public health emergencies, issuing
   79  public health advisories, and ordering isolation or quarantines.
   80         (2)
   81         (d) The State Health Officer, upon declaration of a public
   82  health emergency, may take actions that are necessary to protect
   83  the public health. Such actions include, but are not limited to:
   84         1. Directing manufacturers of prescription drugs or over
   85  the-counter drugs who are permitted under chapter 499 and
   86  wholesalers of prescription drugs located in this state who are
   87  permitted under chapter 499 to give priority to the shipping of
   88  specified drugs to pharmacies and health care providers within
   89  geographic areas identified by the State Health Officer. The
   90  State Health Officer must identify the drugs to be shipped.
   91  Manufacturers and wholesalers located in the state must respond
   92  to the State Health Officer’s priority shipping directive before
   93  shipping the specified drugs.
   94         2. Notwithstanding chapters 465 and 499 and rules adopted
   95  thereunder, directing pharmacists employed by the department to
   96  compound bulk prescription drugs and provide these bulk
   97  prescription drugs to physicians and nurses of county health
   98  departments or any qualified person authorized by the State
   99  Health Officer for administration to persons as part of a
  100  prophylactic or treatment regimen.
  101         3. Notwithstanding s. 456.036, temporarily reactivating the
  102  inactive license of the following health care practitioners,
  103  when such practitioners are needed to respond to the public
  104  health emergency: physicians licensed under chapter 458 or
  105  chapter 459; physician assistants licensed under chapter 458 or
  106  chapter 459; licensed practical nurses, registered nurses, and
  107  advanced practice registered nurses licensed under part I of
  108  chapter 464; respiratory therapists licensed under part V of
  109  chapter 468; and emergency medical technicians and paramedics
  110  certified under part III of chapter 401. Only those health care
  111  practitioners specified in this paragraph who possess an
  112  unencumbered inactive license and who request that such license
  113  be reactivated are eligible for reactivation. An inactive
  114  license that is reactivated under this paragraph shall return to
  115  inactive status when the public health emergency ends or before
  116  the end of the public health emergency if the State Health
  117  Officer determines that the health care practitioner is no
  118  longer needed to provide services during the public health
  119  emergency. Such licenses may only be reactivated for a period
  120  not to exceed 90 days without meeting the requirements of s.
  121  456.036 or chapter 401, as applicable.
  122         4. Ordering an individual to be examined, tested, treated,
  123  isolated, or quarantined for communicable diseases that have
  124  significant morbidity or mortality and present a severe danger
  125  to public health. Individuals who are unable or unwilling to be
  126  examined, tested, or treated for reasons of health, religion, or
  127  conscience may be subjected to isolation or quarantine. For the
  128  purposes of this subparagraph, the State Health Officer′s
  129  authority to treat or order treatment does not include the
  130  authority to order a vaccination.
  131         a. Examination, testing, or treatment may be performed by
  132  any qualified person authorized by the State Health Officer.
  133         b. If the individual poses a danger to the public health,
  134  the State Health Officer may subject the individual to isolation
  135  or quarantine. If there is no practical method to isolate or
  136  quarantine the individual, the State Health Officer may use any
  137  means necessary to treat the individual.
  138         c. Any order of the State Health Officer given to
  139  effectuate this paragraph is immediately enforceable by a law
  140  enforcement officer under s. 381.0012.
  141         Section 4. Present subsection (4) of section 456.054,
  142  Florida Statutes, is redesignated as subsection (5) and amended,
  143  and a new subsection (4) is added to that section, to read:
  144         456.054 Kickbacks prohibited.—
  145         (4)It is unlawful for a vaccine manufacturer to offer or
  146  pay, a commission, bonus, kickback, or rebate, directly or
  147  indirectly, overtly or covertly, in cash or in kind, for the
  148  administration of a vaccine. It is unlawful for a health care
  149  practitioner to receive such a commission, bonus, kickback, or
  150  rebate from a vaccine manufacturer for the administration of a
  151  vaccine.
  152         (5)(4) Violations of this section are shall be considered
  153  patient brokering and are shall be punishable as provided in s.
  154  817.505.
  155         Section 5. Section 456.0575, Florida Statutes, is amended
  156  to read:
  157         456.0575 Duty to notify patients.—
  158         (1) ADVERSE INCIDENTS.—A Every licensed health care
  159  practitioner shall inform each patient, or an individual
  160  identified pursuant to s. 765.401(1), in person about adverse
  161  incidents that result in serious harm to the patient.
  162  Notification of outcomes of care that result in harm to the
  163  patient under this section does not constitute an acknowledgment
  164  of admission of liability, nor can such notifications be
  165  introduced as evidence.
  166         (2) VACCINATIONS OF MINORS.—
  167         (a) Each health care practitioner authorized by law to
  168  administer vaccines, and each paramedic acting pursuant to s.
  169  401.272, shall, before administering one or more vaccines to a
  170  minor child, provide the parent or guardian with the following:
  171         1. The most recently issued Vaccine Information Statement
  172  published by the United States Centers for Disease Control and
  173  Prevention pertaining to each vaccine being administered.
  174         2. Materials approved and adopted by joint rule of the
  175  Board of Medicine and the Board of Osteopathic Medicine relating
  176  to the role of immunizations in communicable disease prevention,
  177  including risks, benefits, safety, and efficacy.
  178         (b) Before administering one or more vaccines to a minor
  179  child, the health care practitioner or paramedic must obtain the
  180  signature of the parent or guardian acknowledging receipt of the
  181  information required under paragraph (a).
  182         (c) When more than one vaccine is to be administered, the
  183  health care practitioner shall discuss the timing of multiple
  184  vaccinations with the child′s parent or guardian and the
  185  parent’s or guardian’s options for such timing before
  186  administering the initial vaccination. At the request of the
  187  parent or guardian, a health care practitioner may administer
  188  vaccines to the minor child over multiple encounters.
  189         (3) GOOD FAITH ESTIMATE OF CHARGES.—Upon request by a
  190  patient, before providing nonemergency medical services in a
  191  facility licensed under chapter 395, a health care practitioner
  192  shall provide, in writing or by electronic means, a good faith
  193  estimate of reasonably anticipated charges to treat the
  194  patient’s condition at the facility. The health care
  195  practitioner shall provide the estimate to the patient within 7
  196  business days after receiving the request and is not required to
  197  adjust the estimate for any potential insurance coverage. The
  198  health care practitioner shall inform the patient that the
  199  patient may contact his or her health insurer or health
  200  maintenance organization for additional information concerning
  201  cost-sharing responsibilities. The health care practitioner
  202  shall provide information to uninsured patients and insured
  203  patients for whom the practitioner is not a network provider or
  204  preferred provider which discloses the practitioner’s financial
  205  assistance policy, including the application process, payment
  206  plans, discounts, or other available assistance, and the
  207  practitioner’s charity care policy and collection procedures.
  208  Such estimate does not preclude the actual charges from
  209  exceeding the estimate. Failure to provide the estimate in
  210  accordance with this subsection, without good cause, shall
  211  result in disciplinary action against the health care
  212  practitioner and a daily fine of $500 until the estimate is
  213  provided to the patient. The total fine may not exceed $5,000.
  214         Section 6. The amendments made by this act to s.
  215  456.0575(2)(a) and (b), Florida Statutes, relating to
  216  information that must be provided to parents or guardians before
  217  the administration of a vaccination to a minor are effective
  218  July 1, 2026, or 30 days after the Board of Medicine and the
  219  Board of Osteopathic Medicine adopt by joint rule the
  220  informational materials as required under s. 456.0575(2)(a),
  221  Florida Statutes, as created by this act, whichever occurs
  222  later. The Board of Medicine and the Board of Osteopathic
  223  Medicine shall adopt the joint rule no later than 120 days after
  224  this act becomes a law and shall notify the Division of Law
  225  Revision immediately upon their adoption of the joint rule. This
  226  section takes effect upon becoming a law.
  227         Section 7. Section 458.3351, Florida Statutes, is created
  228  to read:
  229         458.3351 Prescription or administration of ivermectin.—A
  230  health care practitioner who is licensed under this chapter and
  231  whose license includes prescribing authority is immune from
  232  civil or criminal liability or disciplinary action for
  233  prescribing or administering ivermectin to an adult in good
  234  faith, in accordance with the applicable standard of care and in
  235  accordance with this chapter and the rules pertaining to his or
  236  her practice.
  237         Section 8. Section 459.0156, Florida Statutes, is created
  238  to read:
  239         459.0156 Prescription or administration of ivermectin.—A
  240  health care practitioner who is licensed under this chapter and
  241  whose license includes prescribing authority is immune from
  242  civil or criminal liability or disciplinary action for
  243  prescribing or administering ivermectin to an adult in good
  244  faith, in accordance with the applicable standard of care and in
  245  accordance with this chapter and the rules pertaining to his or
  246  her practice.
  247         Section 9. Section 464.0181, Florida Statutes, is created
  248  to read:
  249         464.0181 Prescription or administration of ivermectin.—A
  250  health care practitioner who is licensed under this chapter and
  251  whose license includes prescribing authority is immune from
  252  civil or criminal liability or disciplinary action for
  253  prescribing or administering ivermectin to an adult in good
  254  faith, in accordance with the applicable standard of care and in
  255  accordance with this chapter and the rules pertaining to his or
  256  her practice.
  257         Section 10. Section 465.1897, Florida Statutes, is created
  258  to read:
  259         465.1897Sale of ivermectin without a prescription.—
  260         (1)A pharmacist may provide ivermectin to a person 18
  261  years of age or older without a prescription as a behind-the
  262  counter medication until the United States Food and Drug
  263  Administration approves it for over-the-counter sale.
  264         (2)Before providing ivermectin under this section, the
  265  pharmacist shall provide the person with written information
  266  regarding the indications and contraindications for ivermectin,
  267  the appropriate dosage, and the need to seek follow-up care from
  268  the person’s primary care physician.
  269         (3)A pharmacist acting in good faith is immune from civil
  270  or criminal liability or disciplinary action for providing
  271  ivermectin to an adult in accordance with this section.
  272         (4)The board may adopt rules to implement this section.
  273         Section 11. Subsections (5) and (9) of section 1003.22,
  274  Florida Statutes, are amended to read:
  275         1003.22 School-entry health examinations; immunization
  276  against communicable diseases; exemptions; duties of Department
  277  of Health.—
  278         (5) A child is exempt from immunization requirements in
  279  subsection (3) The provisions of this section shall not apply
  280  if:
  281         (a) The parent of the child presents to the school, on a
  282  form adopted by rule of the Department of Health and made
  283  available on its website, an attestation objects in writing that
  284  the administration of immunizing agents conflicts with the
  285  parent’s his or her religious tenets or practices or conscience;
  286         (b) A physician licensed under the provisions of chapter
  287  458 or chapter 459 certifies in writing, on a form approved and
  288  provided by the Department of Health, that the child should be
  289  permanently exempt from one or more of the required
  290  immunizations immunization for medical reasons stated in
  291  writing, based upon valid clinical reasoning or evidence,
  292  demonstrating the need for the permanent exemption;
  293         (c) A physician licensed under the provisions of chapter
  294  458, chapter 459, or chapter 460 certifies in writing, on a form
  295  approved and provided by the Department of Health, that the
  296  child has received as many immunizations as are medically
  297  indicated at the time and is in the process of completing the
  298  other required necessary immunizations;
  299         (d) The Department of Health determines that, according to
  300  recognized standards of medical practice, any required
  301  immunization is unnecessary or hazardous; or
  302         (e) An authorized school official issues a temporary
  303  exemption, for up to 30 school days, to allow permit a student
  304  who transfers into a new county to attend class until his or her
  305  records can be obtained. Children and youths who are
  306  experiencing homelessness and children who are known to the
  307  department, as defined in s. 39.0016, shall be given a temporary
  308  exemption for 30 school days. The public school health nurse or
  309  authorized private school official is responsible for follow-up
  310  followup of each such student until proper documentation or
  311  immunizations are obtained. An exemption for 30 days may be
  312  issued for a student who enters a juvenile justice program to
  313  allow permit the student to attend class until his or her
  314  records can be obtained or until the immunizations can be
  315  administered obtained. An authorized juvenile justice official
  316  is responsible for follow-up followup of each student who enters
  317  a juvenile justice program until proper documentation is
  318  obtained or immunizations are administered obtained.
  319  
  320  Upon making the exemption form referenced under paragraph (a)
  321  available on its website, the Department of Health shall ensure
  322  that when the form is downloaded, such download includes, as a
  323  single document, the form and materials approved and adopted by
  324  joint rule of the Board of Medicine and the Board of Osteopathic
  325  Medicine under s. 456.0575(2)(a) relating to the role of
  326  immunizations in communicable disease prevention, including
  327  risks, benefits, safety, and efficacy. This requirement shall
  328  take effect upon the adoption of the joint rule. The web page
  329  containing the download link must also include and prominently
  330  display a link or links to the United States Centers for Disease
  331  Control and Prevention’s current Vaccine Information Statements.
  332         (9) The presence of any of the communicable diseases for
  333  which immunization is required under subsection (3) by the
  334  Department of Health in a Florida public or private school
  335  authorizes shall permit the county health department director or
  336  administrator or the State Health Officer to declare a
  337  communicable disease emergency. The declaration of such
  338  emergency must shall mandate that all students attending in
  339  attendance in the school who have not been immunized against the
  340  diseases specified in subsection (3) or related Department of
  341  Health rules are not in compliance with the provisions of this
  342  section be identified by the district school board or by the
  343  governing authority of the private school,; and the school
  344  health and immunization records of such children must shall be
  345  made available to the county health department director or
  346  administrator. Those Children who are identified as not having
  347  been being immunized against the disease for which the emergency
  348  has been declared must shall be temporarily excluded from school
  349  attendance by the district school board, or the governing
  350  authority of the private school, until such time as is specified
  351  by the county health department director or administrator
  352  declares that the communicable disease emergency has ended.
  353         Section 12. Except as otherwise expressly provided in this
  354  act and except for this section, which shall take effect upon
  355  this act becoming a law, this act shall take effect July 1,
  356  2026.