Florida Senate - 2024                                    SB 1404
       By Senator Jones
       34-00450A-24                                          20241404__
    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 adopt a policy relating to providing notice
   13         of its refused services by a specified date; providing
   14         requirements for such notice; requiring a covered
   15         entity to submit a complete list of refused services
   16         to the Department of Health by a specified date;
   17         requiring a covered entity to notify the department
   18         within a specified period after a change is made to
   19         such list; requiring a covered entity to submit the
   20         list, along with its application, if applying for
   21         certain state grants or contracts; providing a civil
   22         penalty; requiring the department to adopt rules;
   23         requiring the department to publish and maintain on
   24         its website a current list of covered entities and
   25         their refused services; requiring the department to
   26         develop and administer a certain public education and
   27         awareness program; providing construction; providing
   28         for severability; amending s. 381.96, F.S.; revising
   29         the definition of the term “eligible client” and
   30         defining the term “pregnancy support services,” rather
   31         than “pregnancy and parenting support services”;
   32         revising department duties and contract requirements
   33         to conform to changes made by the act; repealing ss.
   34         4, 6, and 7 of chapter 2023-21, Laws of Florida,
   35         relating to termination of pregnancies, powers of the
   36         Agency for Health Care Administration, and the use of
   37         telehealth to provide services, respectively; amending
   38         s. 390.011, F.S.; deleting the definition of the term
   39         “fatal fetal abnormality”; amending s. 390.0111, F.S.;
   40         revising the timeframe in which a physician may
   41         perform a termination of pregnancy; revising
   42         exceptions; repealing s. 395.3027, F.S., relating to
   43         patient immigration status data collection in
   44         hospitals; amending s. 409.905, F.S.; defining the
   45         terms “gender identity” and “transgender individual”;
   46         requiring the agency to provide Medicaid reimbursement
   47         for medically necessary treatment for or related to
   48         gender dysphoria or comparable or equivalent
   49         diagnoses; prohibiting the agency from discriminating
   50         in its reimbursement on the basis of a recipient’s
   51         gender identity or that the recipient is a transgender
   52         individual; amending s. 456.001, F.S.; deleting the
   53         definition of the terms “sex” and “sex-reassignment
   54         prescriptions or procedures”; repealing ss. 456.52 and
   55         766.318, F.S., relating to sex-reassignment
   56         prescriptions and procedures and civil liability for
   57         provision of sex-reassignment prescriptions or
   58         procedures to minors, respectively; amending ss.
   59         61.517, 61.534, 409.908, 409.913, 456.074, and
   60         636.0145, F.S.; conforming provisions and cross
   61         references to changes made by the act; providing an
   62         effective date.
   64  Be It Enacted by the Legislature of the State of Florida:
   66         Section 1. This act may be cited as the “Health Care
   67  Freedom Act.”
   68         Section 2. Section 286.31, Florida Statutes, is repealed.
   69         Section 3. Section 286.311, Florida Statutes, is repealed.
   70         Section 4. Section 381.00321, Florida Statutes, is
   71  repealed.
   72         Section 5. Section 381.027, Florida Statutes, is created to
   73  read:
   74         381.027Requirements for covered entities; notice of
   75  refused services; department duties.—
   76         (1)SHORT TITLE.—This section may be cited as the “Health
   77  Care Transparency and Accessibility Act.”
   78         (2)DEFINITIONS.—As used in this section, the term:
   79         (a)“Covered entity” means any health care facility that
   80  uses, plans to use, or relies upon a denial of care provision to
   81  refuse to provide a health care service, or referral for a
   82  health care service, for any reason. The term does not include a
   83  health care practitioner.
   84         (b)“Denial of care provision” means any federal or state
   85  law that purports or is asserted to allow a health care facility
   86  to opt out of providing a health care service, or referral for a
   87  health care service, including, but not limited to, ss.
   88  381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss.
   89  18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n;
   90  42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of
   91  Labor, Health and Human Services, and Education, and Related
   92  Agencies Appropriations Act of 2019, Division B of Pub. L. No.
   93  115-245; and 45 C.F.R. part 88.
   94         (c)“Department” means the Department of Health.
   95         (d)“Health care facility” has the same meaning as in s.
   96  381.026(2).
   97         (e)“Health care practitioner” has the same meaning as in
   98  s. 456.001.
   99         (f)“Health care services” has the same meaning as in s.
  100  624.27(1).
  101         (g)“Referral” has the same meaning as in s. 456.053(3).
  102         (h) “Refused service” means a health care service that a
  103  covered entity chooses not to provide, or not to provide a
  104  referral for, based on one or more denials of care provisions.
  105  The term includes health care services that the covered entity
  106  selectively provides to some, but not all, patients based on
  107  their identity, objections to a health care service, or other
  108  nonmedical reasons.
  110         (a) By October 1, 2024, each covered entity shall adopt a
  111  policy for providing patients with a complete list of its
  112  refused services. A covered entity shall:
  113         1. Provide written notice to the patient or the patient’s
  114  representative which includes the complete list of its refused
  115  services before any health care service is initiated.
  116         a. In the case of an emergency, the covered entity must
  117  promptly provide written notice after the patient is capable of
  118  receiving such notice or when the patient’s representative is
  119  available.
  120         b. The patient or patient’s representative shall
  121  acknowledge receipt of the written notice of refused services.
  122         2. Retain all acknowledgements of receipt of the written
  123  notice of refused services for a period of at least 3 years.
  124         3. Provide a complete list of its refused services to any
  125  person upon request.
  126         (b) By October 1, 2024, a covered entity shall submit to
  127  the department a complete list of its refused services. If any
  128  change is made to the list, the covered entity must notify the
  129  department within 30 days after making the change.
  130         (c) If applying for any state grant or contract related to
  131  providing a health care service, a covered entity must submit,
  132  along with its application, a complete list of its refused
  133  services.
  134         (d) A covered entity that fails to comply with this
  135  subsection is subject to a fine not exceeding $5,000 for each
  136  day the covered entity is not in compliance.
  137         (4) DEPARTMENT DUTIES.—
  138         (a) The department shall adopt rules to implement this
  139  section, which must include a process for receiving and
  140  investigating complaints regarding covered entities that fail to
  141  comply with this section.
  142         (b) By January 1, 2025, the department shall publish and
  143  maintain on its website a current list of covered entities and
  144  the refused services for each covered entity.
  145         (c) The department shall develop and administer a public
  146  education and awareness program regarding the denial of health
  147  care services, including how the denial of health care services
  148  can negatively impact health care access and quality, how the
  149  denial of health care services may be avoided, and how the
  150  denial of health care services affects vulnerable people and
  151  communities.
  152         (5) CONSTRUCTION.—
  153         (a) This section does not authorize denials of health care
  154  services or discrimination in the provision of health care
  155  services.
  156         (b) This section does not limit any cause of action under
  157  state or federal law, or limit any remedy in law or equity,
  158  against a health care facility or health care practitioner.
  159         (c) Compliance with this section does not reduce or limit
  160  any potential liability for covered entities associated with the
  161  refused services or any violations of state or federal law.
  162         (d) Section 761.03 does not provide a claim relating to, or
  163  a defense to a claim under, this section, or provide a basis for
  164  challenging the application or enforcement of this section or
  165  the use of funds associated with the application or enforcement
  166  of this section.
  167         (6) SEVERABILITY.—If any provision of this section or its
  168  application to any person or circumstance is held invalid, the
  169  invalidity does not affect other provisions or applications of
  170  this section which can be given effect without the invalid
  171  provision or application, and to this end the provisions of this
  172  section are severable.
  173         Section 6. Section 381.96, Florida Statutes, is amended to
  174  read:
  175         381.96 Pregnancy support and wellness services.—
  176         (1) DEFINITIONS.—As used in this section, the term:
  177         (a) “Department” means the Department of Health.
  178         (b) “Eligible client” means any of the following:
  179         1. a pregnant woman or a woman who suspects she is
  180  pregnant, and the family of such woman, who voluntarily seeks
  181  pregnancy support services and any woman who voluntarily seeks
  182  wellness services.
  183         2. A woman who has given birth in the previous 12 months
  184  and her family.
  185         3. A parent or parents or a legal guardian or legal
  186  guardians, and the families of such parents and legal guardians,
  187  for up to 12 months after the birth of a child or the adoption
  188  of a child younger than 3 years of age.
  189         (c) “Florida Pregnancy Care Network, Inc.,” or “network”
  190  means the not-for-profit statewide alliance of pregnancy support
  191  organizations that provide pregnancy support and wellness
  192  services through a comprehensive system of care to women and
  193  their families.
  194         (d) “Pregnancy and parenting support services” means
  195  services that promote and encourage childbirth, including, but
  196  not limited to:
  197         1. Direct client services, such as pregnancy testing,
  198  counseling, referral, training, and education for pregnant women
  199  and their families. A woman and her family continue to be
  200  eligible to receive direct client services for up to 12 months
  201  after the birth of the child.
  202         2. Nonmedical material assistance that improves the
  203  pregnancy or parenting situation of families, including, but not
  204  limited to, clothing, car seats, cribs, formula, and diapers.
  205         3. Counseling or mentoring, education materials, and
  206  classes regarding pregnancy, parenting, adoption, life skills,
  207  and employment readiness.
  208         4. Network awareness activities, including a promotional
  209  campaign to educate the public about the pregnancy support
  210  services offered by the network and a website that provides
  211  information on the location of providers in the user’s area and
  212  other available community resources.
  213         3.5. Communication activities, including the operation and
  214  maintenance of a hotline or call center with a single statewide
  215  toll-free number that is available 24 hours a day for an
  216  eligible client to obtain the location and contact information
  217  for a pregnancy center located in the client’s area.
  218         (e) “Wellness services” means services or activities
  219  intended to maintain and improve health or prevent illness and
  220  injury, including, but not limited to, high blood pressure
  221  screening, anemia testing, thyroid screening, cholesterol
  222  screening, diabetes screening, and assistance with smoking
  223  cessation.
  224         (2) DEPARTMENT DUTIES.—The department shall contract with
  225  the network for the management and delivery of pregnancy and
  226  parenting support services and wellness services to eligible
  227  clients.
  228         (3) CONTRACT REQUIREMENTS.—The department contract shall
  229  specify the contract deliverables, including financial reports
  230  and other reports due to the department, timeframes for
  231  achieving contractual obligations, and any other requirements
  232  the department determines are necessary, such as staffing and
  233  location requirements. The contract shall require the network
  234  to:
  235         (a) Establish, implement, and monitor a comprehensive
  236  system of care through subcontractors to meet the pregnancy and
  237  parenting support and wellness needs of eligible clients.
  238         (b) Establish and manage subcontracts with a sufficient
  239  number of providers to ensure the availability of pregnancy and
  240  parenting support services and wellness services for eligible
  241  clients, and maintain and manage the delivery of such services
  242  throughout the contract period.
  243         (c) Spend at least 90 85 percent of the contract funds on
  244  pregnancy and parenting support services, excluding services
  245  specified in subparagraph (1)(d)4., and wellness services.
  246         (d) Offer wellness services through vouchers or other
  247  appropriate arrangements that allow the purchase of services
  248  from qualified health care providers.
  249         (e) Require a background screening under s. 943.0542 for
  250  all paid staff and volunteers of a subcontractor if such staff
  251  or volunteers provide direct client services to an eligible
  252  client who is a minor or an elderly person or who has a
  253  disability.
  254         (f) Annually monitor its subcontractors and specify the
  255  sanctions that shall be imposed for noncompliance with the terms
  256  of a subcontract.
  257         (g) Subcontract only with providers that exclusively
  258  promote and support childbirth.
  259         (h) Ensure that informational materials provided to an
  260  eligible client by a provider are current and accurate and cite
  261  the reference source of any medical statement included in such
  262  materials.
  263         (i) Ensure that the department is provided with all
  264  information necessary for the report required under subsection
  265  (5).
  266         (4) SERVICES.—Services provided pursuant to this section
  267  must be provided in a noncoercive manner and may not include any
  268  religious content.
  269         (5) REPORT.—By July 1, 2024, and each year thereafter, the
  270  department shall report to the Governor, the President of the
  271  Senate, and the Speaker of the House of Representatives on the
  272  amount and types of services provided by the network; the
  273  expenditures for such services; and the number of, and
  274  demographic information for, women, parents, and families served
  275  by the network.
  276         Section 7. Sections 4, 6, and 7 of chapter 2023-21, Laws of
  277  Florida, are repealed.
  278         Section 8. Subsection (6) of section 390.011, Florida
  279  Statutes, is amended to read:
  280         390.011 Definitions.—As used in this chapter, the term:
  281         (6)“Fatal fetal abnormality” means a terminal condition
  282  that, in reasonable medical judgment, regardless of the
  283  provision of life-saving medical treatment, is incompatible with
  284  life outside the womb and will result in death upon birth or
  285  imminently thereafter.
  286         Section 9. Subsection (1) of section 390.0111, Florida
  287  Statutes, is amended to read:
  288         390.0111 Termination of pregnancies.—
  290  15 WEEKS; WHEN ALLOWED.—A physician may not perform a
  291  termination of pregnancy on any human being in the third
  292  trimester of pregnancy if the physician determines the
  293  gestational age of the fetus is more than 15 weeks unless one of
  294  the following conditions is met:
  295         (a) Two physicians certify in writing that, in reasonable
  296  medical judgment, the termination of the pregnancy is necessary
  297  to save the pregnant woman’s life or avert a serious risk of
  298  substantial and irreversible physical impairment of a major
  299  bodily function of the pregnant woman other than a psychological
  300  condition.
  301         (b) The physician certifies in writing that, in reasonable
  302  medical judgment, there is a medical necessity for legitimate
  303  emergency medical procedures for termination of the pregnancy to
  304  save the pregnant woman’s life or avert a serious risk of
  305  imminent substantial and irreversible physical impairment of a
  306  major bodily function of the pregnant woman other than a
  307  psychological condition, and another physician is not available
  308  for consultation.
  309         (c) The fetus has not achieved viability under s. 390.01112
  310  and two physicians certify in writing that, in reasonable
  311  medical judgment, the fetus has a fatal fetal abnormality.
  312         Section 10. Section 395.3027, Florida Statutes, is
  313  repealed.
  314         Section 11. Present subsections (4) through (12) of section
  315  409.905, Florida Statutes, are redesignated as subsections (5)
  316  through (13), respectively, and a new subsection (4) is added to
  317  that section, to read:
  318         409.905 Mandatory Medicaid services.—The agency may make
  319  payments for the following services, which are required of the
  320  state by Title XIX of the Social Security Act, furnished by
  321  Medicaid providers to recipients who are determined to be
  322  eligible on the dates on which the services were provided. Any
  323  service under this section shall be provided only when medically
  324  necessary and in accordance with state and federal law.
  325  Mandatory services rendered by providers in mobile units to
  326  Medicaid recipients may be restricted by the agency. Nothing in
  327  this section shall be construed to prevent or limit the agency
  328  from adjusting fees, reimbursement rates, lengths of stay,
  329  number of visits, number of services, or any other adjustments
  330  necessary to comply with the availability of moneys and any
  331  limitations or directions provided for in the General
  332  Appropriations Act or chapter 216.
  333         (4) GENDER-AFFIRMING CARE.—
  334         (a)Definitions.As used in this section, the term:
  335         1.“Gender identity” means an individual’s internal sense
  336  of that individual’s gender, regardless of the sex assigned to
  337  that individual at birth.
  338         2.“Transgender individual” means an individual who
  339  identifies as a gender different from the sex assigned to that
  340  individual at birth.
  341         (b)Reimbursement.The agency shall provide reimbursement
  342  for medically necessary treatment for or related to gender
  343  dysphoria as defined by the Diagnostic and Statistical Manual of
  344  Mental Disorders, Fifth Edition, published by the American
  345  Psychiatric Association or a comparable or equivalent diagnosis.
  346         (c)Discrimination prohibited.The agency may not
  347  discriminate in its reimbursement of medically necessary
  348  treatment on the basis of the recipient’s gender identity or on
  349  the basis that the recipient is a transgender individual.
  350         Section 12. Subsections (8) and (9) of section 456.001,
  351  Florida Statutes, are amended to read:
  352         456.001 Definitions.—As used in this chapter, the term:
  353         (8) “Sex” means the classification of a person as either
  354  male or female based on the organization of the human body of
  355  such person for a specific reproductive role, as indicated by
  356  the person’s sex chromosomes, naturally occurring sex hormones,
  357  and internal and external genitalia present at birth.
  358         (9)(a) “Sex-reassignment prescriptions or procedures”
  359  means:
  360         1. The prescription or administration of puberty blockers
  361  for the purpose of attempting to stop or delay normal puberty in
  362  order to affirm a person’s perception of his or her sex if that
  363  perception is inconsistent with the person’s sex as defined in
  364  subsection (8).
  365         2. The prescription or administration of hormones or
  366  hormone antagonists to affirm a person’s perception of his or
  367  her sex if that perception is inconsistent with the person’s sex
  368  as defined in subsection (8).
  369         3. Any medical procedure, including a surgical procedure,
  370  to affirm a person’s perception of his or her sex if that
  371  perception is inconsistent with the person’s sex as defined in
  372  subsection (8).
  373         (b) The term does not include:
  374         1. Treatment provided by a physician who, in his or her
  375  good faith clinical judgment, performs procedures upon or
  376  provides therapies to a minor born with a medically verifiable
  377  genetic disorder of sexual development, including any of the
  378  following:
  379         a. External biological sex characteristics that are
  380  unresolvably ambiguous.
  381         b. A disorder of sexual development in which the physician
  382  has determined through genetic or biochemical testing that the
  383  patient does not have a normal sex chromosome structure, sex
  384  steroid hormone production, or sex steroid hormone action for a
  385  male or female, as applicable.
  386         2. Prescriptions or procedures to treat an infection, an
  387  injury, a disease, or a disorder that has been caused or
  388  exacerbated by the performance of any sex-reassignment
  389  prescription or procedure, regardless of whether such
  390  prescription or procedure was performed in accordance with state
  391  or federal law.
  392         3. Prescriptions or procedures provided to a patient for
  393  the treatment of a physical disorder, physical injury, or
  394  physical illness that would, as certified by a physician
  395  licensed under chapter 458 or chapter 459, place the individual
  396  in imminent danger of death or impairment of a major bodily
  397  function without the prescription or procedure.
  398         Section 13. Section 456.52, Florida Statutes, is repealed.
  399         Section 14. Section 766.318, Florida Statutes, is repealed.
  400         Section 15. Subsection (1) of section 61.517, Florida
  401  Statutes, is amended to read:
  402         61.517 Temporary emergency jurisdiction.—
  403         (1) A court of this state has temporary emergency
  404  jurisdiction if the child is present in this state and:
  405         (a) The child has been abandoned; or
  406         (b) It is necessary in an emergency to protect the child
  407  because the child, or a sibling or parent of the child, is
  408  subjected to or threatened with mistreatment or abuse; or
  409         (c) It is necessary in an emergency to protect the child
  410  because the child has been subjected to or is threatened with
  411  being subjected to sex-reassignment prescriptions or procedures,
  412  as defined in s. 456.001.
  413         Section 16. Subsection (1) of section 61.534, Florida
  414  Statutes, is amended to read:
  415         61.534 Warrant to take physical custody of child.—
  416         (1) Upon the filing of a petition seeking enforcement of a
  417  child custody determination, the petitioner may file a verified
  418  application for the issuance of a warrant to take physical
  419  custody of the child if the child is likely to imminently suffer
  420  serious physical harm or removal from this state. Serious
  421  physical harm includes, but is not limited to, being subjected
  422  to sex-reassignment prescriptions or procedures as defined in s.
  423  456.001.
  424         Section 17. Paragraph (a) of subsection (1) of section
  425  409.908, Florida Statutes, is amended to read:
  426         409.908 Reimbursement of Medicaid providers.—Subject to
  427  specific appropriations, the agency shall reimburse Medicaid
  428  providers, in accordance with state and federal law, according
  429  to methodologies set forth in the rules of the agency and in
  430  policy manuals and handbooks incorporated by reference therein.
  431  These methodologies may include fee schedules, reimbursement
  432  methods based on cost reporting, negotiated fees, competitive
  433  bidding pursuant to s. 287.057, and other mechanisms the agency
  434  considers efficient and effective for purchasing services or
  435  goods on behalf of recipients. If a provider is reimbursed based
  436  on cost reporting and submits a cost report late and that cost
  437  report would have been used to set a lower reimbursement rate
  438  for a rate semester, then the provider’s rate for that semester
  439  shall be retroactively calculated using the new cost report, and
  440  full payment at the recalculated rate shall be effected
  441  retroactively. Medicare-granted extensions for filing cost
  442  reports, if applicable, shall also apply to Medicaid cost
  443  reports. Payment for Medicaid compensable services made on
  444  behalf of Medicaid-eligible persons is subject to the
  445  availability of moneys and any limitations or directions
  446  provided for in the General Appropriations Act or chapter 216.
  447  Further, nothing in this section shall be construed to prevent
  448  or limit the agency from adjusting fees, reimbursement rates,
  449  lengths of stay, number of visits, or number of services, or
  450  making any other adjustments necessary to comply with the
  451  availability of moneys and any limitations or directions
  452  provided for in the General Appropriations Act, provided the
  453  adjustment is consistent with legislative intent.
  454         (1) Reimbursement to hospitals licensed under part I of
  455  chapter 395 must be made prospectively or on the basis of
  456  negotiation.
  457         (a) Reimbursement for inpatient care is limited as provided
  458  in s. 409.905(6) s. 409.905(5), except as otherwise provided in
  459  this subsection.
  460         1. If authorized by the General Appropriations Act, the
  461  agency may modify reimbursement for specific types of services
  462  or diagnoses, recipient ages, and hospital provider types.
  463         2. The agency may establish an alternative methodology to
  464  the DRG-based prospective payment system to set reimbursement
  465  rates for:
  466         a. State-owned psychiatric hospitals.
  467         b. Newborn hearing screening services.
  468         c. Transplant services for which the agency has established
  469  a global fee.
  470         d. Recipients who have tuberculosis that is resistant to
  471  therapy who are in need of long-term, hospital-based treatment
  472  pursuant to s. 392.62.
  473         3. The agency shall modify reimbursement according to other
  474  methodologies recognized in the General Appropriations Act.
  476  The agency may receive funds from state entities, including, but
  477  not limited to, the Department of Health, local governments, and
  478  other local political subdivisions, for the purpose of making
  479  special exception payments, including federal matching funds,
  480  through the Medicaid inpatient reimbursement methodologies.
  481  Funds received for this purpose shall be separately accounted
  482  for and may not be commingled with other state or local funds in
  483  any manner. The agency may certify all local governmental funds
  484  used as state match under Title XIX of the Social Security Act,
  485  to the extent and in the manner authorized under the General
  486  Appropriations Act and pursuant to an agreement between the
  487  agency and the local governmental entity. In order for the
  488  agency to certify such local governmental funds, a local
  489  governmental entity must submit a final, executed letter of
  490  agreement to the agency, which must be received by October 1 of
  491  each fiscal year and provide the total amount of local
  492  governmental funds authorized by the entity for that fiscal year
  493  under this paragraph, paragraph (b), or the General
  494  Appropriations Act. The local governmental entity shall use a
  495  certification form prescribed by the agency. At a minimum, the
  496  certification form must identify the amount being certified and
  497  describe the relationship between the certifying local
  498  governmental entity and the local health care provider. The
  499  agency shall prepare an annual statement of impact which
  500  documents the specific activities undertaken during the previous
  501  fiscal year pursuant to this paragraph, to be submitted to the
  502  Legislature annually by January 1.
  503         Section 18. Subsection (36) of section 409.913, Florida
  504  Statutes, is amended to read:
  505         409.913 Oversight of the integrity of the Medicaid
  506  program.—The agency shall operate a program to oversee the
  507  activities of Florida Medicaid recipients, and providers and
  508  their representatives, to ensure that fraudulent and abusive
  509  behavior and neglect of recipients occur to the minimum extent
  510  possible, and to recover overpayments and impose sanctions as
  511  appropriate. Each January 15, the agency and the Medicaid Fraud
  512  Control Unit of the Department of Legal Affairs shall submit a
  513  report to the Legislature documenting the effectiveness of the
  514  state’s efforts to control Medicaid fraud and abuse and to
  515  recover Medicaid overpayments during the previous fiscal year.
  516  The report must describe the number of cases opened and
  517  investigated each year; the sources of the cases opened; the
  518  disposition of the cases closed each year; the amount of
  519  overpayments alleged in preliminary and final audit letters; the
  520  number and amount of fines or penalties imposed; any reductions
  521  in overpayment amounts negotiated in settlement agreements or by
  522  other means; the amount of final agency determinations of
  523  overpayments; the amount deducted from federal claiming as a
  524  result of overpayments; the amount of overpayments recovered
  525  each year; the amount of cost of investigation recovered each
  526  year; the average length of time to collect from the time the
  527  case was opened until the overpayment is paid in full; the
  528  amount determined as uncollectible and the portion of the
  529  uncollectible amount subsequently reclaimed from the Federal
  530  Government; the number of providers, by type, that are
  531  terminated from participation in the Medicaid program as a
  532  result of fraud and abuse; and all costs associated with
  533  discovering and prosecuting cases of Medicaid overpayments and
  534  making recoveries in such cases. The report must also document
  535  actions taken to prevent overpayments and the number of
  536  providers prevented from enrolling in or reenrolling in the
  537  Medicaid program as a result of documented Medicaid fraud and
  538  abuse and must include policy recommendations necessary to
  539  prevent or recover overpayments and changes necessary to prevent
  540  and detect Medicaid fraud. All policy recommendations in the
  541  report must include a detailed fiscal analysis, including, but
  542  not limited to, implementation costs, estimated savings to the
  543  Medicaid program, and the return on investment. The agency must
  544  submit the policy recommendations and fiscal analyses in the
  545  report to the appropriate estimating conference, pursuant to s.
  546  216.137, by February 15 of each year. The agency and the
  547  Medicaid Fraud Control Unit of the Department of Legal Affairs
  548  each must include detailed unit-specific performance standards,
  549  benchmarks, and metrics in the report, including projected cost
  550  savings to the state Medicaid program during the following
  551  fiscal year.
  552         (36) The agency may provide to a sample of Medicaid
  553  recipients or their representatives through the distribution of
  554  explanations of benefits information about services reimbursed
  555  by the Medicaid program for goods and services to such
  556  recipients, including information on how to report inappropriate
  557  or incorrect billing to the agency or other law enforcement
  558  entities for review or investigation, information on how to
  559  report criminal Medicaid fraud to the Medicaid Fraud Control
  560  Unit’s toll-free hotline number, and information about the
  561  rewards available under s. 409.9203. The explanation of benefits
  562  may not be mailed for Medicaid independent laboratory services
  563  as described in s. 409.905(8) s. 409.905(7) or for Medicaid
  564  certified match services as described in ss. 409.9071 and
  565  1011.70.
  566         Section 19. Paragraph (c) of subsection (5) of section
  567  456.074, Florida Statutes, is amended to read:
  568         456.074 Certain health care practitioners; immediate
  569  suspension of license.—
  570         (5) The department shall issue an emergency order
  571  suspending the license of any health care practitioner who is
  572  arrested for committing or attempting, soliciting, or conspiring
  573  to commit any act that would constitute a violation of any of
  574  the following criminal offenses in this state or similar
  575  offenses in another jurisdiction:
  576         (c) Section 456.52(5)(b), relating to prescribing,
  577  administering, or performing sex-reassignment prescriptions or
  578  procedures for a patient younger than 18 years of age.
  579         Section 20. Section 636.0145, Florida Statutes, is amended
  580  to read:
  581         636.0145 Certain entities contracting with Medicaid.—An
  582  entity that is providing comprehensive inpatient and outpatient
  583  mental health care services to certain Medicaid recipients in
  584  Hillsborough, Highlands, Hardee, Manatee, and Polk Counties
  585  through a capitated, prepaid arrangement pursuant to the federal
  586  waiver provided for in s. 409.905(6) s. 409.905(5) must become
  587  licensed under this chapter by December 31, 1998. Any entity
  588  licensed under this chapter which provides services solely to
  589  Medicaid recipients under a contract with Medicaid is exempt
  590  from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and
  591  636.066(1).
  592         Section 21. This act shall take effect July 1, 2024.