ENROLLED 2023 Legislature CS for SB 1580 20231580er 1 2 An act relating to protections of medical conscience; 3 providing legislative intent; creating s. 381.00321, 4 F.S.; defining terms; providing that health care 5 providers and health care payors have the right to opt 6 out of participation in or payment for certain health 7 care services on the basis of conscience-based 8 objections; providing requirements for a health care 9 provider’s notice and documentation of such objection; 10 requiring health care providers to notify patients or 11 potential patients seeking a specific health care 12 service of any such objection before scheduling an 13 appointment; providing construction; prohibiting 14 health care payors from declining to cover any health 15 care service they are obligated to cover during the 16 plan year; prohibiting discrimination or adverse 17 action against health care providers who decline to 18 participate in a health care service on the basis of 19 conscience-based objection; providing whistle-blower 20 protections for health care providers and health care 21 payors that take certain actions or disclose certain 22 information relating to the reporting of certain 23 violations; authorizing health care providers and 24 health care payors to file complaints with the 25 Attorney General for violation of specified 26 provisions; providing for civil penalties; authorizing 27 the Attorney General to take specified actions for 28 purposes of conducting an investigation of such 29 complaints; authorizing the Department of Legal 30 Affairs to adopt rules; providing health care 31 providers and health care payors immunity from civil 32 liability solely for declining to participate in or 33 pay for a health care service on the basis of 34 conscience-based objection; providing construction; 35 creating s. 456.61, F.S.; prohibiting boards, or the 36 Department of Health if there is no board, from taking 37 disciplinary action against or denying a license to an 38 individual based solely on specified conduct; 39 authorizing boards within the department’s 40 jurisdiction to revoke their approval of a specialty 41 board or other recognizing agency under certain 42 circumstances; providing severability; providing an 43 effective date. 44 45 Be It Enacted by the Legislature of the State of Florida: 46 47 Section 1. It is the intent of the Legislature to provide 48 the right of medical conscience for health care providers and 49 payors to ensure they can care for patients in a manner 50 consistent with their moral, ethical, and religious convictions. 51 Further, it is the intent of the Legislature that licensed 52 health care providers and payors be free from threat of 53 discrimination for providing conscience-based health care. 54 Section 2. Section 381.00321, Florida Statutes, is created 55 to read: 56 381.00321 The right of medical conscience of health care 57 providers and health care payors.— 58 (1) DEFINITIONS.—As used in this section, the term: 59 (a) “Adverse action” means the discharge, transfer, 60 demotion, discipline, suspension, exclusion, revocation of 61 privileges, withholding of bonuses, or reduction in salary or 62 benefits; any action that may negatively impact the advancement 63 or graduation of a student, including, but not limited to, the 64 withholding of scholarship funds; or any other disciplinary or 65 retaliatory action taken against a health care provider. 66 (b) “Conscience-based objection” means an objection based 67 on a sincerely held religious, moral, or ethical belief. 68 Conscience with respect to entities is determined by reference 69 to the entities’ governing documents; any published ethical, 70 moral, or religious guidelines or directives; mission 71 statements; constitutions; articles of incorporation; bylaws; 72 policies; or regulations. 73 (c) “Department” means the Department of Health. 74 (d) “Educational institution” means a public or private 75 school, college, or university. 76 (e) “Health care payor” means a health insurer, an 77 employer, a health care sharing organization, a health plan, a 78 health maintenance organization, a management services 79 organization, or any other entity that pays for, or arranges for 80 the payment of, any health care service, whether such payment is 81 in whole or in part. 82 (f) “Health care provider” means: 83 1. Any person or entity licensed under chapter 394; chapter 84 400; chapter 401; chapter 457; chapter 458; chapter 459; chapter 85 460; chapter 461; chapter 462; chapter 463; chapter 464; chapter 86 465; chapter 466; chapter 467; part I, part II, part III, part 87 IV, part V, part X, part XIII, or part XIV of chapter 468; 88 chapter 478; chapter 480; part I, part II, or part III of 89 chapter 483; chapter 484; chapter 486; chapter 490; or chapter 90 491; or 91 2. Any provider as defined in s. 408.803, a continuing care 92 facility licensed under chapter 651, or a pharmacy permitted 93 under chapter 465. 94 95 This term includes any student enrolled in an educational 96 institution who is seeking to become a health care provider. 97 (g) “Health care service” means medical research, medical 98 procedures, or medical services, including, but not limited to, 99 testing; diagnosis; referral; dispensing or administering any 100 drug, medication, or device; psychological therapy or 101 counseling; research; therapy; recordmaking procedures; set up 102 or performance of a surgery or procedure; or any other care or 103 services performed or provided by any health care provider. 104 (h) “Participate” or “participation” means to pay for or 105 take part in any way in providing or facilitating any health 106 care service or any part of such service. 107 (i) “Right of medical conscience” means the right of a 108 health care provider or health care payor to abide by sincerely 109 held religious, moral, or ethical beliefs. With respect to 110 health care providers or payors that are entities, such beliefs 111 are determined by reference to the entities’ governing 112 documents; any published ethical, moral, or religious guidelines 113 or directives; mission statements; constitutions; articles of 114 incorporation; bylaws; policies; or regulations. 115 (2) RIGHT OF MEDICAL CONSCIENCE.— 116 (a) A health care provider or health care payor has the 117 right to opt out of participation in or payment for any health 118 care service on the basis of a conscience-based objection. A 119 health care provider must, at the time of the conscience-based 120 objection or as soon as practicable thereafter, provide written 121 notice of his or her conscience-based objection to the health 122 care provider’s supervisor or employer, if applicable, and 123 document his or her conscience-based objection to a particular 124 health care service in the patient’s medical file. Additionally, 125 if a patient, or potential patient, when attempting to schedule 126 an appointment with the provider indicates to the provider that 127 he or she is seeking a specific health care service for which 128 the provider has a conscience-based objection, the provider must 129 notify the patient that he or she does not provide such service 130 before scheduling the appointment. A health care provider who is 131 a student must provide written notice of his or her conscience 132 based objection to the educational institution at the time the 133 conscience-based objection is made or as soon as practicable 134 thereafter. 135 (b) The exercise of the right of medical conscience is 136 limited to conscience-based objections to a specific health care 137 service. This section may not be construed to waive or modify 138 any duty a health care provider or health care payor may have to 139 provide or pay for other health care services that do not 140 violate their right of medical conscience, to waive or modify 141 any duty to provide any informed consent required by law, or to 142 allow a health care provider or payor to opt out of providing 143 health care services to any patient or potential patient because 144 of that patient’s or potential patient’s race, color, religion, 145 sex, or national origin. Additionally, a health care payor may 146 not decline to pay for a health care service it is contractually 147 obligated to cover during the plan year. 148 (c) A health care provider may not be discriminated against 149 or suffer adverse action because the health care provider 150 declined to participate in a health care service on the basis of 151 a conscience-based objection. 152 (3) SPEECH AND WHISTLE-BLOWER PROTECTIONS.— 153 (a) A health care provider or health care payor may not be 154 discriminated against or suffer any adverse action in any manner 155 with respect to: 156 1. Providing or causing to be provided, or intending to 157 provide or cause to be provided, information relating to any 158 violation of or any act or omission the health care provider or 159 health care payor reasonably believes to be a violation of any 160 provision of this act to his or her employer, the Attorney 161 General, the department, any other state agency charged with 162 protecting the right of medical conscience, the United States 163 Department of Health and Human Services, the Office of Civil 164 Rights, or any other federal agency charged with protecting the 165 right of medical conscience; 166 2. Testifying or intending to testify in a proceeding 167 concerning such violation; or 168 3. Assisting or participating in or intending to assist or 169 participate in such a proceeding. 170 (b) Unless the disclosure is specifically prohibited by 171 law, a health care provider or health care payor may not be 172 discriminated against in any manner for disclosing information 173 that the health care provider or health care payor reasonably 174 believes constitutes: 175 1. A violation of any law, rule, or regulation; 176 2. A violation of any ethical guidelines for the provision 177 of any medical procedure or service; or 178 3. A practice or method of treatment that may put patient 179 health at risk or present a substantial and specific danger to 180 public health or safety. 181 (4) ENFORCEMENT.—A health care provider or health care 182 payor may file a complaint with the Attorney General alleging 183 any violation of this section. If the Attorney General 184 determines there has been a violation of this section, the 185 Attorney General may commence a civil action for damages, 186 injunctive relief, or any other appropriate relief, including 187 attorney fees. For the purpose of conducting an investigation, 188 the Attorney General may administer oaths, take depositions, 189 make inspections when authorized by law, issue subpoenas 190 supported by affidavit, serve subpoenas and other process, and 191 compel the attendance of witnesses and the production of books, 192 papers, documents, and other evidence. The Department of Legal 193 Affairs may adopt rules to implement this subsection. 194 (5) IMMUNITY FROM LIABILITY.—A health care provider or 195 health care payor may not be held civilly liable solely for 196 declining to participate in or pay for a health care service on 197 the basis of a conscience-based objection. However, this section 198 does not limit a person′s ability to recover damages or other 199 relief under any other applicable law due to behavior that 200 constitutes a violation of this section or that is not related 201 to a conscience-based objection. 202 (6) REQUIREMENT TO PROVIDE EMERGENCY MEDICAL TREATMENT. 203 This section may not be construed to override any requirement to 204 provide emergency medical treatment in accordance with state law 205 or the Emergency Medical Treatment and Active Labor Act, 42 206 U.S.C. s. 1395dd. 207 Section 3. Section 456.61, Florida Statutes, is created to 208 read: 209 456.61 Use of free speech by a health care practitioner; 210 prohibition.— 211 (1) A board, or the department if there is no board, may 212 not take disciplinary action against a health care 213 practitioner’s license or deny a license to an individual solely 214 because the individual has spoken or written publicly about a 215 health care service or public policy, including, but not limited 216 to, speech through the use of a social media platform as defined 217 in s. 501.2041, provided that the individual is not using such 218 speech or written communication to provide medical advice or 219 treatment to a specific patient or patients, and provided that 220 such speech or written communication does not separately violate 221 any other applicable law or rule. 222 (2) If a specialty board or other recognizing agency 223 approved by any board within the jurisdiction of the department 224 revokes the certification of an individual solely because the 225 individual has spoken or written publicly about a health care 226 service or public policy, including, but not limited to, speech 227 through the use of a social media platform as defined in s. 228 501.2041, provided such individual was not providing medical 229 advice or treatment to a specific patient and provided such 230 speech did not separately violate any other applicable law, the 231 board within the jurisdiction of the department may revoke its 232 approval of such specialty board or other recognizing agency. 233 Section 4. If any provision of this act or its application 234 to any person or circumstance is held invalid, the invalidity 235 does not affect other provisions or applications of the act 236 which can be given effect without the invalid provision or 237 application, and to this end the provisions of this act are 238 severable. 239 Section 5. This act shall take effect July 1, 2023.