This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0725.HRS
DATE: 4/4/2023
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 725 Intravenous Vitamin Treatment
SPONSOR(S): Healthcare Regulation Subcommittee, Garcia
TIED BILLS: IDEN./SIM. BILLS: SB 754
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Healthcare Regulation Subcommittee 17 Y, 0 N, As CS Osborne McElroy
2) Health Care Appropriations Subcommittee
3) Health & Human Services Committee
SUMMARY ANALYSIS
Intravenous Vitamin Therapy (IVVT) is a relatively recent medical trend that involves administering a high dose
mixture of vitamins, minerals, electrolytes, and other fluids directly into a patient’s bloodstream. IVVT differs
from traditional applications of IV therapy in that it is frequently used among otherwise healthy individuals, with
unconventional goals such as achieving a general feeling of wellness, obtaining clearer skin, fighting a cold, or
curing a hangover. IVVT is not regulated by the U.S. Food and Drug Administration (FDA). IVVT is an elective
treatment that does not require physician referral.
IVVT may pose a variety of risks depending on an individual’s health status. It is especially dangerous for
individuals with heart disease and kidney problems whose bodies are not capable processing the salts and
fluids that are being rapidly added to the body. Some ingredients could cause an allergic reaction or interact
with other medications that a patient is taking. There are additional risks associated with administering IVVT
without a reviewing a patient’s current bloodwork; for example, sudden changes in electrolyte balances can
cause fatal cardiac arrythmias and other complications that must be responded to immediately.
CS/ HB 725 creates s. 456.0302, F.S., relating to administering intravenous vitamin treatment. The bill defines
intravenous vitamin treatments, requires patients complete a self-screening risk assessment questionnaire
prior to receiving IVVT, and prohibits health care providers from administering IVVT to patients for whom it
would be unsafe based on their answers to the questionnaire.
The bill requires patients be provided information regarding potential side effects and risks of IVVT, instructions
on when to seek medical attention, and a visit summary. The bill requires health care providers to notify a
patient’s designated physician if IVVT was administered. The bill also requires that health care providers
administering IVVT maintain a written plan for emergency care.
The bill directs the Board of Medicine, Board of Osteopathic Medicine, and the Board of Nursing to adopt rules
to implement the provisions of the bil.
The bill has an insignificant, negative fiscal impact on the Department of Health, and no fiscal impact on local
government.
CS/HB 725 provides an effective date of July 1, 2023. STORAGE NAME: h0725.HRS PAGE: 2
DATE: 4/4/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Intravenous Vitamin Treatment
Intravenous Vitamin Therapy (IVVT) is a relatively recent medical trend that involves administering a
high dose mixture of vitamins, minerals, electrolytes, and other fluids directly into a patient’s
bloodstream.
1
Traditionally, intravenous (IV) therapy is used in conventional medial settings for the
management of fluids and electrolytes for patients who cannot swallow, are dehydrated, or have other
conditions that requires timely correction of fluid or electrolyte imbalance.
2
In these settings, there are
clinical guidelines to direct the medical professional in the type of fluid, rate, and volume, at which the
fluid should be administered based on the needs of the patient.
3
IVVT differs from traditional applications of IV therapy in that it is frequently used among otherwise
healthy individuals, with unconventional goals such as achieving a general feeling of wellness,
obtaining clearer skin, fighting a cold, or curing a hangover.
4
There is very little evidence of the benefit
of IVVT for healthy individuals and it is not regulated by the U.S. Food and Drug Administration (FDA).
5
IVVT may be administered in primary care or integrative medical centers, or found in stand-alone retail
locations known as drip bars or medical spas and mobile units
6
that administer IVVT to patients in their
own homes.
7
IVVT infusion products are not regulated or based on evidence-based practice guidelines. Retail
venues administering IVVT commonly advertise “menus” from which a patient can choose their
treatment.
8
IVVT contents may include saline, amino acids, B-12, vitamin C, “anti-nausea medicines,”
and zinc, among other micronutrients, vitamins, and “medicinal treatments.”
9
Cost of treatment ranges
widely from $90
10
to over $300
11
for treatments lasting between 45 and 90 minutes.
Under current law, IVVT may be administered by any licensed health care professional who may
administer intravenous therapies within their scope of practice and possesses the appropriate
certifications and training. This includes physicians,
12
physician assistants,
13
registered nurses and
advanced practice registered nurses,
14
anesthesiologist assistants under the direct supervision of an
1
WebMD, IV Vitamin Therapy: Does It Work? Available at https://www.webmd.com/vitamins-and-supplements/iv-vitamin-therapy-does-
it-work (last visited March 27, 2023).
2
Dayal, S. & Kolasa, K. (2021). Consumer Intravenous Vitamin Therapy: Wellness Boost or Toxicity Threat? Nutrition Today, 56:5.
Available at
https://www.researchgate.net/publication/354838784_Consumer_Intravenous_Vitamin_Therapy_Wellness_Boost_or_Toxicity_Threat
(last visited March 27, 2023).
3
See, American Academy of Pediatrics, Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Available at
https://publications.aap.org/pediatrics/article/142/6/e20183083/37529/Clinical-Practice-Guideline-
Maintenance?autologincheck=redirected (last visited March 27, 2023).
4
Supra, note 2.
5
AARP. The Truth Behind Trendy IV Therapy. Available at https://www.aarp.org/health/drugs-supplements/info-2022/iv-vitamin-
therapy.html (last visited March 27, 2023).
6
Jones Health Law, Establishing a Mobile IV Therapy Clinic in Florida. Available at https://www.joneshealthlaw.com/establishing-a-
mobile-iv-therapy-clinic-in-florida/ (last visited March 27, 2023).
7
Id.
8
Supra, note 2.
9
See Bounce Hydration, Our IV Drip Menu. Available at https://www.bouncehydration.com/our-iv-drips (last visited March 27, 2023).
Restore Hyper Wellness, IV Drip Therapy. Available at https://www.restore.com/services/iv-drip-therapy (last visited March 27, 2023).
Florida Mind Health Center, IV Vitamin Therapy. Available at https://www.flmindhealth.com/iv-therapy/ (last visited March 27, 2023).
10
The IV-Suite, IV Pushes. Available at https://www.iv-suite.com/iv-pushes/ (last visited March 27, 2023).
11
Mobile IV Medics, Mobile IV Hydration Therapy in Florida. Available at https://mobileivmedics.com/service-areas/florida/ (last visited
March 27, 2023).
12
See, chs. 458 and 459, F.S.
13
See, chs. 458 and 459, F.S.
14
See, Ch. 464, F.S. STORAGE NAME: h0725.HRS PAGE: 3
DATE: 4/4/2023
anesthesiologist,
15
medical assistants under the direct supervision of a physician,
16
and licensed
practical nurses under the direction of a registered nurse.
17
IVVT is an elective treatment that does not require physician referral. Procedures vary widely between
facilities; some suggest patients to consult with their physician prior to receiving treatment,
18
others
require a telehealth consultation with their own “medical professionals” at their first visit,
19
and most
require a medical questionnaire and liability waiver or consent form be completed prior to treatment.
20
Some facilities require that patients over 65 years of age provide a recent basic metabolic panel lab
21
prior to receiving IVVT.
22
IVVT may pose a variety of risks depending on an individual’s health status. It is especially dangerous
for individuals with heart disease and kidney problems whose bodies are not capable processing the
salts and fluids that are being rapidly added to the body.
23
Some ingredients could cause an allergic
reaction or interact with other medications that a patient is taking.
24
There are additional risks
associated with administering IVVT without a reviewing a patient’s current bloodwork; for example,
sudden changes in electrolyte balances can cause fatal cardiac arrythmias other complications that
must be responded to immediately.
25
Effect of the Bill
CS/HB 725 creates s. 456.0302, F.S., relating to administering intravenous vitamin treatment. The bill
defines intravenous vitamin treatment (IVVT) as a procedure in which high concentrations of vitamins
and minerals are administered directly into a person's bloodstream, allowing rapid absorption of higher
doses of the vitamins and minerals than if received through food or supplements. The requirements of
the bill apply to health care providers licensed under chs. 458, 459, and 464, F.S.
CS/HB 725 requires that patients complete a self-screening risk assessment questionnaire prior to
receiving IVVT. A health care provider may not administer IVVT to a patient if it would be unsafe to do
so based upon the patient’s answers to the questionnaire.
The bill requires patients be provided information regarding potential side effects and risks of IVVT,
instructions on when to seek medical attention, and a visit summary. The bill requires health care
providers to notify a patient’s designated physician that IVVT was administered.
CS/HB 725 also requires that health care providers maintain a written plan for emergency care. The
plan must include the following:
The name and address of hospital closest to the location at which the intravenous vitamin
treatment is being performed;
Reasons for which an emergency transfer of a patient may be required; and
15
S. 458.3475(3), F.S.
16
Board of Medicine, Final Order On Petition for Declaratory Statement. Available at https://www.floridahealth.gov/licensing-and-
regulation/declaratory/_documents/medical/doh-09-0320.pdf (last visited March 27, 2023).
17
Rule 64B9-12.004, F.A.C.
18
Midtown Movement and Medicine, IV Vitamin Therapy Provides Full Body Rejuvenation. Available at
https://midtownmovementtlh.com/our-services/iv-infusion-therapy/ (last visited March 28, 2023).
19
Restore Hyper Wellness, FAQs: Learn More about IV Drip Therapy. Available at https://www.restore.com/services/iv-drip-therapy
(last visited March 28, 2023).
20
See Bounce Hydration, Our IV Drip Menu. Available at https://www.bouncehydration.com/our-iv-drips (last visited March 27, 2023).
Restore Hyper Wellness, IV Drip Therapy. Available at https://www.restore.com/services/iv-drip-therapy (last visited March 27, 2023).
Florida Mind Health Center, IV Vitamin Therapy. Available at https://www.flmindhealth.com/iv-therapy/ (last visited March 27, 2023).
21
A basic metabolic panel is a common blood test measuring the glucose, calcium, blood urea nitrogen, creatine, sodium, potassium,
bicarbonate, and chloride in a person’s blood. See also, Cleveland Clinic, Basic Metabolic Panel (BMP). Available at
https://my.clevelandclinic.org/health/diagnostics/22020-basic-metabolic-panel-bmp (last visited March 28, 2023).
22
Supra, note 19.
23
Supra, note 5.
24
Id.
25
Supra, note 2. STORAGE NAME: h0725.HRS PAGE: 4
DATE: 4/4/2023
Medical services to be used in the event of a health emergency.
The bill directs the Board of Nursing, Board of Medicine, and Board of Osteopathic Medicine to develop
rules implementing the provisions of the bill. This includes the adoption of a self-screening risk
assessment questionnaire, information that must be provided to patients prior to receiving IVVT,
notification to be provided to a patient’s designated physician, procedures for safely administering
IVVT, and protocols to follow in a health emergency. The Boards must also develop requirements for
education and training requirements for health care providers authorized to administer IVVT, as well as,
administrative and documentation requirements regarding the administration of IVVT.
Violation of the provisions of the bill constitute grounds for disciplinary action by DOH and the
practitioner’s respective regulatory board.
The bill provides an effective date of July 1, 2023.
B. SECTION DIRECTORY:
Section 1: Provides a name for the act: “Stephanie Balais Act.”
Section 2: Creates s. 456.0302, F.S., relating to administering intravenous vitamin treatment.
Section 3: Provides an effective date of July 1, 2023.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
DOH will incur insignificant negative expenditures related to rulemaking which current resources are
able to absorb.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. The bill does not appear to affect county or municipal governments.
2. Other: STORAGE NAME: h0725.HRS PAGE: 5
DATE: 4/4/2023
None.
B. RULE-MAKING AUTHORITY:
The bill provides sufficient rulemaking authority to implement the provisions of the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES