Text of FL H 823 (2025)

HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 1 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S A bill to be entitled 1 An act relating to health care; providing a short 2 title; repealing ss. 286.31, 286.311, and 381.00321, 3 F.S., relating to the prohibited use of state funds 4 for travel to another state for purpose of abortion 5 services, the prohibited use of state funds for sex- 6 reassignment prescriptions or procedures, and the 7 right of medical conscience of health care providers 8 and health care payors, respectively; creating s. 9 381.027, F.S.; providing a short title; defining 10 terms; requiring a covered entity to, by a specified 11 date, adopt a policy relating to providing written 12 notice of a complete list of its refused services to 13 patients; providing requirements for such notice; 14 requiring a covered entity to submit a complete list 15 of its refused services to the Department of Health by 16 a specified date; requiring a covered entity to notify 17 the department within a specified timeframe after a 18 change is made to such list; requiring a covered 19 entity to submit the list, along with its application, 20 if applying for certain state grants or contracts; 21 providing a civil penalty; requiring the department to 22 adopt rules; requiring the department to publish and 23 maintain on its website a current list of covered 24 entities and their refused services by a specified 25 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 2 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S date; requiring the department to develop and 26 administer a certain public education and awareness 27 program; providing construction; providing for 28 severability; amending s. 381.96, F.S.; revising the 29 definition of the term "eligible client" and 30 redefining the term "pregnancy and parenting support 31 services" as "pregnancy support services,"; revising 32 department duties and contract requirements to conform 33 to changes made by the act; amending s. 390.011, F.S.; 34 deleting the definition of the term "fatal fetal 35 abnormality"; amending s. 390.0111, F.S.; revising the 36 timeframe in which a physician may perform a 37 termination of pregnancy; revising exceptions; 38 deleting the prohibition against the use of telehealth 39 to perform abortions, the requirement that medications 40 intended for use in a medical abortion be dispensed in 41 person by a physician, and the prohibition against 42 dispensing such medication through the United States 43 Postal Service or any other courier or shipping 44 service; amending s. 390.012, F.S.; revising rules the 45 Agency for Health Care Administration may develop and 46 enforce to regulate abortion clinics; repealing s. 47 395.3027, F.S., relating to patient immigration status 48 data collection in hospitals; amending s. 409.905, 49 F.S.; defining the terms "gender identity" and 50 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 3 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S "transgender individual"; requiring the agency to 51 provide Medicaid reimbursement for medically necessary 52 treatment for or related to gender dysphoria or a 53 comparable or equivalent diagnosis; prohibiting the 54 agency from discriminating in its reimbursement on the 55 basis of a recipient's gender identity or that the 56 recipient is a transgender individual; amending s. 57 456.001, F.S.; deleting the definition of the terms 58 "sex" and "sex-reassignment prescriptions or 59 procedures"; amending s. 456.47, F.S.; deleting the 60 prohibition against the use of telehealth to perform 61 abortions, including medical abortions; repealing ss. 62 456.52 and 766.318, F.S., relating to sex-reassignment 63 prescriptions and procedures and civil liability for 64 provision of sex-reassignment prescriptions or 65 procedures to minors, respectively; amending ss. 66 61.517, 61.534, 409.908, 409.913, 456.074, and 67 636.0145, F.S.; conforming provisions and cross- 68 references to changes made by the act; providing an 69 effective date. 70 71 Be It Enacted by the Legislature of the State of Florida: 72 73 Section 1. This act may be cited as the "Health Care 74 Freedom Act." 75 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 4 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Section 2. Section 286.31, Florida Statutes, is repealed. 76 Section 3. Section 286.311, Florida Statutes, is repealed. 77 Section 4. Section 381.00321, Florida Statutes, is 78 repealed. 79 Section 5. Section 381.027, Florida Statutes, is created 80 to read: 81 381.027 Requirements for covered entities; notice of 82 refused services; department duties.— 83 (1) SHORT TITLE.—This section may be cited as the "Health 84 Care Transparency and Accessibility Act." 85 (2) DEFINITIONS.—As used in this section, the term: 86 (a) "Covered entity" means any health care facility that 87 uses, plans to use, or relies upon a denial of care provision to 88 refuse to provide a health care service, or referral for a 89 health care service, for any reason. The term does not include a 90 health care practitioner. 91 (b) "Denial of care provision" means any federal or state 92 law that purports or is asserted to allow a health care facility 93 to opt out of providing a health care service, or referral for a 94 health care service, including, but not limited to, ss. 95 381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss. 96 18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n; 97 42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of 98 Labor, Health and Human Services, and Education, and Related 99 Agencies Appropriations Act of 2019, Division B of Pub. L. No. 100 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 5 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 115-245; and 45 C.F.R. part 88. 101 (c) "Department" means the Department of Health. 102 (d) "Health care facility" has the same meaning as in s. 103 381.026(2). 104 (e) "Health care practitioner" has the same meaning as in 105 s. 456.001. 106 (f) "Health care services" has the same meaning as in s. 107 624.27(1). 108 (g) "Referral" has the same meaning as in s. 456.053(3). 109 (h) "Refused service" means a health care service that a 110 covered entity chooses not to provide, or not to provide a 111 referral for, based on one or more denials of care provisions. 112 The term includes health care services that the covered entity 113 selectively provides to some, but not all, patients based on 114 their identity, objections to a health care service, or other 115 nonmedical reasons. 116 (3) REQUIREMENTS FOR COVERED ENTITIES; PENALTY.— 117 (a) By October 1, 2025, each covered entity shall adopt a 118 policy for providing patients with a complete list of its 119 refused services. A covered entity shall: 120 1. Provide written notice to the patient or the patient's 121 representative which includes the complete list of its refused 122 services before any health care service is initiated. 123 a. In the case of an emergency, the covered entity must 124 promptly provide written notice after the patient is capable of 125 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 6 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S receiving such notice or when the patient's representative is 126 available. 127 b. The patient or patient's representative shall 128 acknowledge receipt of the written notice of refused services. 129 2. Retain all acknowledgments of receipt of the written 130 notice of refused services for a period of at least 3 years. 131 3. Provide a complete list of its refused services to any 132 person upon request. 133 (b) By October 1, 2025, a covered entity shall submit to 134 the department a complete list of its refused services. If any 135 change is made to the list, the covered entity must notify the 136 department within 30 days after making the change. 137 (c) If applying for any state grant or contract related to 138 providing a health care service, a covered entity must submit, 139 along with its application, a complete list of its refused 140 services. 141 (d) A covered entity that fails to comply with this 142 subsection is subject to a fine not to exceed $5,000 for each 143 day the covered entity is not in compliance. 144 (4) DEPARTMENT DUTIES.— 145 (a) The department shall adopt rules to implement this 146 section which must include a process for receiving and 147 investigating complaints regarding covered entities not in 148 compliance with this section. 149 (b) By January 1, 2026, the department shall publish and 150 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 7 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S maintain on its website a current list of covered entities and 151 the refused services for each covered entity. 152 (c) The department shall develop and administer a public 153 education and awareness program regarding the denial of health 154 care services, including how the denial of health care services 155 can negatively impact health care access and quality, how the 156 denial of health care services may be avoided, and how the 157 denial of health care services affects vulnerable people and 158 communities. 159 (5) CONSTRUCTION.— 160 (a) This section does not authorize denials of health care 161 services or discrimination in the provision of health care 162 services. 163 (b) This section does not limit any cause of action under 164 state or federal law, or limit any remedy in law or equity, 165 against a health care facility or health care practitioner. 166 (c) Compliance with this section does not reduce or limit 167 any potential liability for covered entities associated with the 168 refused services or any violations of state or federal law. 169 (d) Section 761.03 does not provide a claim relating to, 170 or a defense to a claim under, this section, or provide a basis 171 for challenging the application or enforcement of this section 172 or the use of funds associated with the application or 173 enforcement of this section. 174 (6) SEVERABILITY.—If any provision of this section or its 175 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 8 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S application to any person or circumstance is held invalid, the 176 invalidity does not affect other provisions or applications of 177 this section which can be given effect without the invalid 178 provision or application, and to this end the provisions of this 179 section are severable. 180 Section 6. Section 381.96, Florida Statutes, is amended to 181 read: 182 381.96 Pregnancy support and wellness services.— 183 (1) DEFINITIONS.—As used in this section, the term: 184 (a) "Department" means the Department of Health. 185 (b) "Eligible client" means any of the following: 186 1. a pregnant woman or a woman who suspects she is 187 pregnant, and the family of such woman, who voluntarily seeks 188 pregnancy support services and any woman who voluntarily seeks 189 wellness services. 190 2. A woman who has given birth in the previous 12 months 191 and her family. 192 3. A parent or parents or a legal guardian or legal 193 guardians, and the families of such parents and legal guardians, 194 for up to 12 months after the birth of a child or the adoption 195 of a child younger than 3 years of age. 196 (c) "Florida Pregnancy Care Network, Inc.," or "network" 197 means the not-for-profit statewide alliance of pregnancy support 198 organizations that provide pregnancy support and wellness 199 services through a comprehensive system of care to women and 200 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 9 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S their families. 201 (d) "Pregnancy and parenting support services" means 202 services that promote and encourage childbirth, including, but 203 not limited to: 204 1. Direct client services, such as pregnancy testing, 205 counseling, referral, training, and education for pregnant women 206 and their families. A woman and her family remain eligible to 207 receive direct client services for up to 12 months after the 208 birth of the child. 209 2. Nonmedical material assistance that improves the 210 pregnancy or parenting situation of families, including, but not 211 limited to, clothing, car seats, cribs, formula, and diapers. 212 3. Counseling or mentoring, education materials, and 213 classes regarding pregnancy, parenting, adoption, life skills, 214 and employment readiness. 215 4. Network awareness activities, including a promotional 216 campaign to educate the public about the pregnancy support 217 services offered by the network and a website that provides 218 information on the location of providers in the user's area and 219 other available community resources. 220 3.5. Communication activities, including the operation and 221 maintenance of a hotline or call center with a single statewide 222 toll-free number that is available 24 hours a day for an 223 eligible client to obtain the location and contact information 224 for a pregnancy center located in the client's area. 225 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 10 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (e) "Wellness services" means services or activities 226 intended to maintain and improve health or prevent illness and 227 injury, including, but not limited to, high blood pressure 228 screening, anemia testing, thyroid screening, cholesterol 229 screening, diabetes screening, and assistance with smoking 230 cessation. 231 (2) DEPARTMENT DUTIES.—The department shall contract with 232 the network for the management and delivery of pregnancy and 233 parenting support services and wellness services to eligible 234 clients. 235 (3) CONTRACT REQUIREMENTS.—The department contract must 236 shall specify the contract deliverables, including financial 237 reports and other reports due to the department, timeframes for 238 achieving contractual obligations, and any other requirements 239 the department determines are necessary, such as staffing and 240 location requirements. The contract must shall require the 241 network to: 242 (a) Establish, implement, and monitor a comprehensive 243 system of care through subcontractors to meet the pregnancy and 244 parenting support and wellness needs of eligible clients. 245 (b) Establish and manage subcontracts with a sufficient 246 number of providers to ensure the availability of pregnancy and 247 parenting support services and wellness services for eligible 248 clients, and maintain and manage the delivery of such services 249 throughout the contract period. 250 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 11 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (c) Spend at least 90 85 percent of the contract funds on 251 pregnancy and parenting support services, excluding services 252 specified in subparagraph (1)(d)4., and wellness services. 253 (d) Offer wellness services through vouchers or other 254 appropriate arrangements that allow the purchase of services 255 from qualified health care providers. 256 (e) Require a background screening under s. 943.0542 for 257 all paid staff and volunteers of a subcontractor if such staff 258 or volunteers provide direct client services to an eligible 259 client who is a minor or an elderly person or who has a 260 disability. 261 (f) Annually Monitor its subcontractors annually and 262 specify the sanctions that will shall be imposed for 263 noncompliance with the terms of a subcontract. 264 (g) Subcontract only with providers that exclusively 265 promote and support childbirth. 266 (h) Ensure that informational materials provided to an 267 eligible client by a provider are current and accurate and cite 268 the reference source of any medical statement included in such 269 materials. 270 (i) Ensure that the department is provided with all 271 information necessary for the report required under subsection 272 (5). 273 (4) SERVICES.—Services provided pursuant to this section 274 must be provided in a noncoercive manner and may not include any 275 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 12 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S religious content. 276 (5) REPORT.—By July 1, 2024, and each year thereafter, the 277 department shall report to the Governor, the President of the 278 Senate, and the Speaker of the House of Representatives on the 279 amount and types of services provided by the network; the 280 expenditures for such services; and the number of, and 281 demographic information for, women, parents, and families served 282 by the network. 283 Section 7. Subsection (6) of section 390.011, Florida 284 Statutes, is amended to read: 285 390.011 Definitions.—As used in this chapter, the term: 286 (6) "Fatal fetal abnormality" means a terminal condition 287 that, in reasonable medical judgment, regardless of the 288 provision of life-saving medical treatment, is incompatible with 289 life outside the womb and will result in death upon birth or 290 imminently thereafter. 291 Section 8. Subsections (1) and (2) of section 390.0111, 292 Florida Statutes, are amended to read: 293 390.0111 Termination of pregnancies.— 294 (1) TERMINATION IN THIRD TRIMESTER AFTER GESTATIONAL AGE 295 OF 6 WEEKS; WHEN ALLOWED.—A physician may not knowingly perform 296 or induce a termination of pregnancy on any person in the third 297 trimester of pregnancy if the physician determines the 298 gestational age of the fetus is more than 6 weeks unless one of 299 the following conditions is met: 300 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 13 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (a) Two physicians certify in writing that, in reasonable 301 medical judgment, the termination of the pregnancy is necessary 302 to save the pregnant woman's life or avert a serious risk of 303 substantial and irreversible physical impairment of a major 304 bodily function of the pregnant woman other than a psychological 305 condition. 306 (b) The physician certifies in writing that, in reasonable 307 medical judgment, there is a medical necessity for legitimate 308 emergency medical procedures for termination of the pregnancy to 309 save the pregnant woman's life or avert a serious risk of 310 imminent substantial and irreversible physical impairment of a 311 major bodily function of the pregnant woman other than a 312 psychological condition, and another physician is not available 313 for consultation. 314 (c) The pregnancy has not progressed to the third 315 trimester and two physicians certify in writing that, in 316 reasonable medical judgment, the fetus has a fatal fetal 317 abnormality. 318 (d) The pregnancy is the result of rape, incest, or human 319 trafficking and the gestational age of the fetus is not more 320 than 15 weeks as determined by the physician. At the time the 321 woman schedules or arrives for her appointment to obtain the 322 abortion, she must provide a copy of a restraining order, police 323 report, medical record, or other court order or documentation 324 providing evidence that she is obtaining the termination of 325 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 14 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S pregnancy because she is a victim of rape, incest, or human 326 trafficking. If the woman is 18 years of age or older, the 327 physician must report any known or suspected human trafficking 328 to a local law enforcement agency. If the woman is a minor, the 329 physician must report the incident of rape, incest, or human 330 trafficking to the central abuse hotline as required by s. 331 39.201. 332 (2) IN-PERSON PERFORMANCE BY PHYSICIAN REQUIRED.—Only a 333 physician may perform or induce a termination of pregnancy. A 334 physician may not use telehealth as defined in s. 456.47 to 335 perform an abortion, including, but not limited to, medical 336 abortions. Any medications intended for use in a medical 337 abortion must be dispensed in person by a physician and may not 338 be dispensed through the United States Postal Service or by any 339 other courier or shipping service. 340 Section 9. Subsection (1) of section 390.012, Florida 341 Statutes, is amended to read: 342 390.012 Powers of agency; rules; disposal of fetal 343 remains.— 344 (1) The agency may develop and enforce rules pursuant to 345 ss. 390.011-390.018 and part II of chapter 408 for the health, 346 care, and treatment of persons in abortion clinics and for the 347 safe operation of such clinics. The rules must be reasonably 348 related to the preservation of maternal health of the clients, 349 must be in accordance with s. 797.03, may not impose an 350 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 15 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S unconstitutional burden on a woman's freedom to decide whether 351 to terminate her pregnancy, and must provide for all of the 352 following: 353 (a) The performance of pregnancy termination procedures 354 only by a licensed physician. 355 (b) The making, protection, and preservation of patient 356 records, which must be treated as medical records under chapter 357 458. When performing a license inspection of a clinic, the 358 agency shall inspect at least 50 percent of patient records 359 generated since the clinic's last license inspection. 360 (c) Annual inspections by the agency of all clinics 361 licensed under this chapter to ensure that such clinics are in 362 compliance with this chapter and agency rules. 363 (d) The prompt investigation of credible allegations of 364 abortions being performed at a clinic that is not licensed to 365 perform such procedures. 366 Section 10. Section 395.3027, Florida Statutes, is 367 repealed. 368 Section 11. Present subsections (4) through (12) of 369 section 409.905, Florida Statutes, are redesignated as 370 subsections (5) through (13), respectively, and a new subsection 371 (4) is added to that section, to read: 372 409.905 Mandatory Medicaid services.—The agency may make 373 payments for the following services, which are required of the 374 state by Title XIX of the Social Security Act, furnished by 375 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 16 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Medicaid providers to recipients who are determined to be 376 eligible on the dates on which the services were provided. Any 377 service under this section shall be provided only when medically 378 necessary and in accordance with state and federal law. 379 Mandatory services rendered by providers in mobile units to 380 Medicaid recipients may be restricted by the agency. Nothing in 381 this section shall be construed to prevent or limit the agency 382 from adjusting fees, reimbursement rates, lengths of stay, 383 number of visits, number of services, or any other adjustments 384 necessary to comply with the availability of moneys and any 385 limitations or directions provided for in the General 386 Appropriations Act or chapter 216. 387 (4) GENDER-AFFIRMING CARE.— 388 (a) Definitions.—As used in this section, the term: 389 1. "Gender identity" means an individual's internal sense 390 of that individual's gender, regardless of the sex assigned to 391 that individual at birth. 392 2. "Transgender individual" means an individual who 393 identifies as a gender different from the sex assigned to that 394 individual at birth. 395 (b) Reimbursement.—The agency shall provide reimbursement 396 for medically necessary treatment for or related to gender 397 dysphoria as defined by the Diagnostic and Statistical Manual of 398 Mental Disorders, Fifth Edition, published by the American 399 Psychiatric Association or a comparable or equivalent diagnosis. 400 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 17 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (c) Discrimination prohibited.—The agency may not 401 discriminate in its reimbursement of medically necessary 402 treatment on the basis of the recipient's gender identity or on 403 the basis that the recipient is a transgender individual. 404 Section 12. Subsections (8) and (9) of section 456.001, 405 Florida Statutes, are amended to read: 406 456.001 Definitions.—As used in this chapter, the term: 407 (8) "Sex" means the classification of a person as either 408 male or female based on the organization of the human body of 409 such person for a specific reproductive role, as indicated by 410 the person's sex chromosomes, naturally occurring sex hormones, 411 and internal and external genitalia present at birth. 412 (9)(a) "Sex-reassignment prescriptions or procedures" 413 means: 414 1. The prescription or administration of puberty blockers 415 for the purpose of attempting to stop or delay normal puberty in 416 order to affirm a person's perception of his or her sex if that 417 perception is inconsistent with the person's sex as defined in 418 subsection (8). 419 2. The prescription or administration of hormones or 420 hormone antagonists to affirm a person's perception of his or 421 her sex if that perception is inconsistent with the person's sex 422 as defined in subsection (8). 423 3. Any medical procedure, including a surgical procedure, 424 to affirm a person's perception of his or her sex if that 425 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 18 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S perception is inconsistent with the person's sex as defined in 426 subsection (8). 427 (b) The term does not include: 428 1. Treatment provided by a physician who, in his or her 429 good faith clinical judgment, performs procedures upon or 430 provides therapies to a minor born with a medically verifiable 431 genetic disorder of sexual development, including any of the 432 following: 433 a. External biological sex characteristics that are 434 unresolvably ambiguous. 435 b. A disorder of sexual development in which the physician 436 has determined through genetic or biochemical testing that the 437 patient does not have a normal sex chromosome structure, sex 438 steroid hormone production, or sex steroid hormone action for a 439 male or female, as applicable. 440 2. Prescriptions or procedures to treat an infection, an 441 injury, a disease, or a disorder that has been caused or 442 exacerbated by the performance of any sex-reassignment 443 prescription or procedure, regardless of whether such 444 prescription or procedure was performed in accordance with state 445 or federal law. 446 3. Prescriptions or procedures provided to a patient for 447 the treatment of a physical disorder, physical injury, or 448 physical illness that would, as certified by a physician 449 licensed under chapter 458 or chapter 459, place the individual 450 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 19 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S in imminent danger of death or impairment of a major bodily 451 function without the prescription or procedure. 452 Section 13. Paragraph (f) of subsection (2) of section 453 456.47, Florida Statutes, is amended to read: 454 456.47 Use of telehealth to provide services.— 455 (2) PRACTICE STANDARDS.— 456 (f) A telehealth provider may not use telehealth to 457 perform an abortion, including, but not limited to, medical 458 abortions as defined in s. 390.011. 459 Section 14. Section 456.52, Florida Statutes, is repealed. 460 Section 15. Section 766.318, Florida Statutes, is 461 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 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 20 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 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 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 21 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 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 520 provided in s. 409.905(6) s. 409.905(5), except as otherwise 521 provided in 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 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 22 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 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 531 established 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 536 other methodologies recognized in the General Appropriations 537 Act. 538 539 The agency may receive funds from state entities, including, but 540 not limited to, the Department of Health, local governments, and 541 other local political subdivisions, for the purpose of making 542 special exception payments, including federal matching funds, 543 through the Medicaid inpatient reimbursement methodologies. 544 Funds received for this purpose shall be separately accounted 545 for and may not be commingled with other state or local funds in 546 any manner. The agency may certify all local governmental funds 547 used as state match under Title XIX of the Social Security Act, 548 to the extent and in the manner authorized under the General 549 Appropriations Act and pursuant to an agreement between the 550 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 23 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S agency and the local governmental entity. In order for the 551 agency to certify such local governmental funds, a local 552 governmental entity must submit a final, executed letter of 553 agreement to the agency, which must be received by October 1 of 554 each fiscal year and provide the total amount of local 555 governmental funds authorized by the entity for that fiscal year 556 under this paragraph, paragraph (b), or the General 557 Appropriations Act. The local governmental entity shall use a 558 certification form prescribed by the agency. At a minimum, the 559 certification form must identify the amount being certified and 560 describe the relationship between the certifying local 561 governmental entity and the local health care provider. The 562 agency shall prepare an annual statement of impact which 563 documents the specific activities undertaken during the previous 564 fiscal year pursuant to this paragraph, to be submitted to the 565 Legislature annually by January 1. 566 Section 19. Subsection (36) of section 409.913, Florida 567 Statutes, is amended to read: 568 409.913 Oversight of the integrity of the Medicaid 569 program.—The agency shall operate a program to oversee the 570 activities of Florida Medicaid recipients, and providers and 571 their representatives, to ensure that fraudulent and abusive 572 behavior and neglect of recipients occur to the minimum extent 573 possible, and to recover overpayments and impose sanctions as 574 appropriate. Each January 15, the agency and the Medicaid Fraud 575 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 24 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Control Unit of the Department of Legal Affairs shall submit a 576 report to the Legislature documenting the effectiveness of the 577 state's efforts to control Medicaid fraud and abuse and to 578 recover Medicaid overpayments during the previous fiscal year. 579 The report must describe the number of cases opened and 580 investigated each year; the sources of the cases opened; the 581 disposition of the cases closed each year; the amount of 582 overpayments alleged in preliminary and final audit letters; the 583 number and amount of fines or penalties imposed; any reductions 584 in overpayment amounts negotiated in settlement agreements or by 585 other means; the amount of final agency determinations of 586 overpayments; the amount deducted from federal claiming as a 587 result of overpayments; the amount of overpayments recovered 588 each year; the amount of cost of investigation recovered each 589 year; the average length of time to collect from the time the 590 case was opened until the overpayment is paid in full; the 591 amount determined as uncollectible and the portion of the 592 uncollectible amount subsequently reclaimed from the Federal 593 Government; the number of providers, by type, that are 594 terminated from participation in the Medicaid program as a 595 result of fraud and abuse; and all costs associated with 596 discovering and prosecuting cases of Medicaid overpayments and 597 making recoveries in such cases. The report must also document 598 actions taken to prevent overpayments and the number of 599 providers prevented from enrolling in or reenrolling in the 600 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 25 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Medicaid program as a result of documented Medicaid fraud and 601 abuse and must include policy recommendations necessary to 602 prevent or recover overpayments and changes necessary to prevent 603 and detect Medicaid fraud. All policy recommendations in the 604 report must include a detailed fiscal analysis, including, but 605 not limited to, implementation costs, estimated savings to the 606 Medicaid program, and the return on investment. The agency must 607 submit the policy recommendations and fiscal analyses in the 608 report to the appropriate estimating conference, pursuant to s. 609 216.137, by February 15 of each year. The agency and the 610 Medicaid Fraud Control Unit of the Department of Legal Affairs 611 each must include detailed unit-specific performance standards, 612 benchmarks, and metrics in the report, including projected cost 613 savings to the state Medicaid program during the following 614 fiscal year. 615 (36) The agency may provide to a sample of Medicaid 616 recipients or their representatives through the distribution of 617 explanations of benefits information about services reimbursed 618 by the Medicaid program for goods and services to such 619 recipients, including information on how to report inappropriate 620 or incorrect billing to the agency or other law enforcement 621 entities for review or investigation, information on how to 622 report criminal Medicaid fraud to the Medicaid Fraud Control 623 Unit's toll-free hotline number, and information about the 624 rewards available under s. 409.9203. The explanation of benefits 625 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 26 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S may not be mailed for Medicaid independent laboratory services 626 as described in s. 409.905(8) s. 409.905(7) or for Medicaid 627 certified match services as described in ss. 409.9071 and 628 1011.70. 629 Section 20. Paragraph (c) of subsection (5) of section 630 456.074, Florida Statutes, is amended to read: 631 456.074 Certain health care practitioners; immediate 632 suspension of license.— 633 (5) The department shall issue an emergency order 634 suspending the license of any health care practitioner who is 635 arrested for committing or attempting, soliciting, or conspiring 636 to commit any act that would constitute a violation of any of 637 the following criminal offenses in this state or similar 638 offenses in another jurisdiction: 639 (c) Section 456.52(5)(b), relating to prescribing, 640 administering, or performing sex-reassignment prescriptions or 641 procedures for a patient younger than 18 years of age. 642 Section 21. Section 636.0145, Florida Statutes, is amended 643 to read: 644 636.0145 Certain entities contracting with Medicaid.—An 645 entity that is providing comprehensive inpatient and outpatient 646 mental health care services to certain Medicaid recipients in 647 Hillsborough, Highlands, Hardee, Manatee, and Polk Counties 648 through a capitated, prepaid arrangement pursuant to the federal 649 waiver provided for in s. 409.905(6) s. 409.905(5) must become 650 HB 823 2025 CODING: Words stricken are deletions; words underlined are additions. hb823-00 Page 27 of 27 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S licensed under this chapter by December 31, 1998. Any entity 651 licensed under this chapter which provides services solely to 652 Medicaid recipients under a contract with Medicaid is exempt 653 from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and 654 636.066(1). 655 Section 22. This act shall take effect July 1, 2025. 656