Florida 2024 2024 Regular Session

Florida Senate Bill S1112 Analysis / Analysis

Filed 01/29/2024

                    The Florida Senate 
BILL ANALYSIS AND FISCAL IMPACT STATEMENT 
(This document is based on the provisions contained in the legislation as of the latest date listed below.) 
Prepared By: The Professional Staff of the Committee on Health Policy  
 
BILL: SB 1112 
INTRODUCER:  Senator Harrell 
SUBJECT:  Health Care Practitioner Titles and Designations 
DATE: January 29, 2024 
 
 ANALYST STAFF DIRECTOR  REFERENCE  	ACTION 
1. Brown Brown HP Pre-meeting 
2.     RC  
 
I. Summary: 
SB 1112 creates s. 456.0651, F.S., to provide regulations for the use of health care practitioner 
titles and designations. The bill defines “advertisement,” “educational degree,” “misleading, 
deceptive, or fraudulent representation,” and “profession.” 
 
The bill provides that if someone other than an allopathic or osteopathic physician attaches to his 
or her name any of the titles or designations listed in the bill, in an advertisement or in a manner 
that is misleading, deceptive, or fraudulent, the person is practicing medicine or osteopathic 
medicine without a license and is subject to the provisions of s. 456.065, F.S., relating to the 
unlicensed practice of a health care profession. The bill provides exceptions for certain 
professions and certain titles and provides that practitioners may use titles and specialty 
designations authorized under their respective practice acts. 
 
The bill amends s. 456.072(1)(t), F.S., to provide that a practitioner’s failure to wear a name tag, 
which must include his or her name and profession, when treating or consulting with a patient, is 
grounds for discipline unless he or she is providing services in his or her own office where the 
practitioner’s license is prominently displayed in a conspicuous area. If the practitioner chooses 
not to where a name tag under those latter conditions, the practitioner must verbally identify 
himself or herself to all new patients by name and profession in a manner that does not constitute 
the unlicensed practice of medicine or osteopathic medicine. 
 
The bill further amends s. 456.072(1)(t), F.S., to provide that any advertisement naming a 
practitioner must include the practitioner’s profession and educational degree and to require 
practitioner regulatory boards,
1
 or the Department of Health (DOH) if there is no board, to adopt 
rules to determine how practitioners must comply with this paragraph of statute. 
                                                
1
 Under s. 456.001(1), F.S., the term “board” is defined as any board, commission, or other statutorily created entity, to the 
extent such entity is authorized to exercise regulatory or rulemaking functions within DOH or, in some cases, within DOH’s 
Division of Medical Quality Assurance (MQA). 
REVISED:   BILL: SB 1112   	Page 2 
 
 
The bill provides an effective date of July 1, 2024. 
II. Present Situation: 
Licensure and Regulation of Health Care Practitioners 
The Division of Medical Quality Assurance (MQA), within the DOH, has general regulatory 
authority over health care practitioners.
2
 The MQA works in conjunction with 22 regulatory 
boards and four councils to license and regulate 364 health care professions.
3
 Professions are 
generally regulated by individual practice acts and by ch. 456, F.S., which provides regulatory 
and licensure authority for the MQA. The MQA is statutorily responsible for the following 
boards and professions established within the division:
4
 
 The Board of Acupuncture, created under ch. 457, F.S.; 
 The Board of Medicine, created under ch. 458, F.S.; 
 The Board of Osteopathic Medicine, created under ch. 459, F.S.; 
 The Board of Chiropractic Medicine, created under ch. 460, F.S.; 
 The Board of Podiatric Medicine, created under ch. 461, F.S.; 
 Naturopathy, as provided under ch. 462, F.S.; 
 The Board of Optometry, created under ch. 463, F.S.; 
 The Board of Nursing, created under part I of ch. 464, F.S.; 
 Nursing assistants, as provided under part II of ch. 464, F.S.; 
 The Board of Pharmacy, created under ch. 465, F.S.; 
 The Board of Dentistry, created under ch. 466, F.S.; 
 Midwifery, as provided under ch. 467, F.S.; 
 The Board of Speech-Language Pathology and Audiology, created under part I of ch. 468, 
F.S.; 
 The Board of Nursing Home Administrators, created under part II of ch. 468, F.S.; 
 The Board of Occupational Therapy, created under part III of ch. 468, F.S.; 
 Respiratory therapy, as provided under part V of ch. 468, F.S.; 
 Dietetics and nutrition practice, as provided under part X of ch. 468, F.S.; 
 The Board of Athletic Training, created under part XIII of ch. 468, F.S.; 
 The Board of Orthotists and Prosthetists, created under part XIV of ch. 468, F.S.; 
 Electrolysis, as provided under ch. 478, F.S.; 
 The Board of Massage Therapy, created under ch. 480, F.S.; 
 The Board of Clinical Laboratory Personnel, created under part I of ch. 483, F.S.; 
 Medical physicists, as provided under part II of ch. 483, F.S.; 
                                                
2
 Pursuant to s. 456.001(4), F.S., health care practitioners are defined to include acupuncturists, physicians, physician 
assistants, chiropractors, podiatrists, naturopaths, dentists, dental hygienists, optometrists, nurses, nursing assistants, 
pharmacists, midwives, speech language pathologists, nursing home administrators, occupational therapists, respiratory 
therapists, dieticians, athletic trainers, orthotists, prosthetists, electrologists, massage therapists, clinical laboratory personnel, 
medical physicists, genic counselors, dispensers of optical devices or hearing aids, physical therapists, psychologists, social 
workers, counselors, and psychotherapists, among others.  
3
 Florida Department of Health, Division of Medical Quality Assurance, Annual Report and Long-Range Plan, Fiscal Year 
2022-2023, p. 4, https://www.floridahealth.gov/licensing-and-regulation/reports-and-publications/annual-reports.html (last 
visited Jan. 24, 2024). 
4
 Section 456.001(4), F.S.  BILL: SB 1112   	Page 3 
 
 Genetic Councilors as provided under part III of ch. 483, F.S.; 
 The Board of Opticianry, created under part I of ch. 484, F.S.; 
 The Board of Hearing Aid Specialists, created under part II of ch. 484, F.S.; 
 The Board of Physical Therapy Practice, created under ch. 486, F.S.; 
 The Board of Psychology, created under ch. 490, F.S.; 
 School psychologists, as provided under ch. 490, F.S.; 
 The Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health 
Counseling, created under ch. 491, F.S.; and 
 Emergency medical technicians and paramedics, as provided under part III of ch. 401, F.S. 
 
The DOH and the practitioner boards have different roles in the regulatory system. Boards 
establish practice standards by rule, pursuant to statutory authority and directives. The DOH 
receives and investigates complaints about practitioners and prosecutes cases for disciplinary 
action against practitioners. 
 
The DOH, on behalf of the professional boards, investigates complaints against practitioners.
5
 
Once an investigation is complete, the DOH presents the investigatory findings to the boards. 
The DOH recommends a course of action to the appropriate board’s probable cause panel which 
may include:
6
 
 Issuing an Emergency Order; 
 Having the file reviewed by an expert; 
 Issuing a closing order; or 
 Filing an administrative complaint. 
 
The boards determine the course of action and any disciplinary action to take against a 
practitioner under the respective practice act.
7
 For professions for which there is no board, the 
DOH determines the action and discipline to take against a practitioner and issues the final 
orders.
8
 The DOH is responsible for ensuring that licensees comply with the terms and penalties 
imposed by the boards.
9
 If a case is appealed, DOH attorneys defend the final actions of the 
boards before the appropriate appellate court.
10
 
 
The DOH and board rules apply to all statutory grounds for discipline against a practitioner. 
Under current law, the DOH takes on the disciplinary functions of a board relating to violations 
of a practice act only for practitioner types that do not have a board. The DOH itself takes no 
final disciplinary action against practitioners for which there is a board. 
 
                                                
5
 Department of Health, Investigative Services, http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-
complaint-process/isu.html (last visited Jan. 24, 2024). 
6
 Department of Health, Prosecution Services, http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-
complaint-process/psu.html (last visited Jan. 24, 2024). 
7
 Section 456.072(2), F.S. 
8
 Professions which do not have a board include naturopathy, nursing assistants, midwifery, respiratory therapy, dietetics and 
nutrition, electrolysis, medical physicists, genetic counselors, and school psychologists. 
9
 Supra, note 6. 
10
 Id.  BILL: SB 1112   	Page 4 
 
The Unlicensed Activity Unit 
The Unlicensed Activity (ULA) Unit protects Florida residents and visitors from the potentially 
serious and dangerous consequences of receiving medical and health care services from an 
unlicensed person. The ULA unit investigates and refers for prosecution all unlicensed health 
care activity complaints and allegations. 
 
The ULA unit works in conjunction with law enforcement and the state attorney’s offices to 
prosecute individuals practicing without a license. In many instances, unlicensed activity is a 
felony level criminal offense. More importantly, receiving health care from unlicensed persons is 
dangerous and could result in further injury, disease or even death.
11
 
 
The Unlicensed Activity Investigation Process 
The DOH assigns all ULA complaints a computer-generated complaint number for tracking 
purposes. If the allegations are determined to be legally sufficient, the matter will be forwarded 
to a ULA investigator whose office is geographically closest to the location where the alleged 
unlicensed activity is occurring. In cases where the person making the allegation has provided 
their identifying information, a ULA investigator will contact him or her to verify the allegations. 
The investigator may also ask for more detailed information concerning certain aspects of the 
complaint. He or she may also ask to meet with the complainant in person for a formal interview. 
All ULA investigators are empowered to take sworn statements. 
 
After discussing the allegations with the complainant, the ULA investigator will pursue all 
appropriate investigative steps (gather documents, conduct surveillance, question witnesses, etc.) 
in order to make a determination concerning the likelihood that the offense(s) took place in the 
manner described by the complainant. In the event that a licensed health care provider is alleged 
to be somehow involved with the unlicensed activity, the ULA investigator will also coordinate 
his/her investigation with the Investigative Services Unit (ISU) regulatory investigator assigned 
to investigate the licensee. 
 
If the complainant’s allegations can be substantiated, the ULA investigation will conclude with 
one or more of the following outcomes: 
 The subject(s) will be issued a Cease and Desist Agreement. 
 The subject(s) will be issued a Uniform Unlicensed Activity Citation (fine). 
 The subject(s) will be arrested by law enforcement. 
 
If the investigation determines that the alleged acts either did not take place or if they did occur 
but all actions were lawful and proper, the investigation will be closed as unfounded. In the event 
that the allegation(s) cannot be clearly proved or disproved, the matter will be closed as 
unsubstantiated. In any case, a detailed investigative report will be prepared by the ULA 
investigator supporting the conclusions reached by the investigation. 
 
                                                
11
 The Department of Health, Licensing and Regulation, enforcement, Unlicensed Activity, Reporting Unlicensed Activity, 
available at https://www.floridahealth.gov/licensing-and-regulation/enforcement/report-unlicensed-activity/index.html (last 
visited Jan. 24, 2024).  BILL: SB 1112   	Page 5 
 
Under s. 456.065, F.S., investigations involving the unlicensed practice of a health care 
profession are criminal investigations that require the development of sufficient evidence 
(probable cause) to present to law enforcement or file charges with the State Attorney’s Office in 
the county of occurrence. While ULA investigators are non-sworn, many have law enforcement 
experience gained from prior careers as police officers and detectives. ULA investigators work 
cooperatively with many law enforcement agencies in joint investigations that are either initiated 
by the DOH or the agency concerned.
12
 
 
Health Care Specialties and Florida Licensure 
The DOH does not license health care practitioners by specialty or subspecialty. A health care 
practitioner’s specialty area of practice is acquired through the practitioner’s additional 
education, training, or experience in a particular area of health care practice. Practitioners who 
have acquired additional education, training, or experience in a particular area may also elect to 
become board-certified in that specialty by private, national specialty boards, such as the 
American Board of Medical Specialties (ABMS), the Accreditation Board for Specialty Nursing 
Certification, and the American Board of Dental Specialties.
13
 Board certification is not required 
to practice a medical or osteopathic specialty. 
 
Title Prohibitions Under Current Florida Law 
Current law limits which health care practitioners may hold themselves out as board-certified 
specialists. An allopathic physician may not hold himself or herself out as a board-certified 
specialist unless he or she has received formal recognition as a specialist from a specialty board 
of the ABMS or other recognizing agency
14
 approved by the Board of Medicine.
15
 Similarly, an 
osteopathic physician may not hold himself or herself out as a board-certified specialist unless he 
or she has successfully completed the requirements for certification by the American Osteopathic 
Association (AOA) or the Accreditation Council on Graduate Medical Education (ACGME) and 
is certified as a specialist by a certifying agency
16
 approved by the board.
17
 In addition, an 
allopathic physician may not hold himself or herself out as a board-certified specialist in 
dermatology unless the recognizing agency, whether authorized in statute or by rule, is 
triennially reviewed and reauthorized by the Board of Medicine.
18
 
 
A podiatric physician also may not advertise that he or she is board certified unless the 
organization is approved by the Board of Podiatric Medicine (BPM) for the purposes of 
advertising only and the name of the organization is identified in full in the advertisement. In 
                                                
12
 The Department of Health, Licensing and Regulation, enforcement, Unlicensed Activity, Investigate Complaints, available 
at https://www.floridahealth.gov/licensing-and-regulation/enforcement/report-unlicensed-activity/investigate-complaints.html 
(last visited Jan. 24, 2024). 
13
 Examples of specialties include dermatology, emergency medicine, ophthalmology, pediatric medicine, certified registered 
nurse anesthetist, clinical nurse specialist, cardiac nurse, nurse practitioner, endodontics, orthodontics, and pediatric dentistry. 
14
 The Board of Medicine has approved the specialty boards of the ABMS as recognizing agencies. See Fla. Admin. Code. R. 
64B8-11.001(1)(f),(2022). 
15
 Section 458.3312, F.S. 
16
 The osteopathic board has approved the specialty boards of the ABMS and AOA as recognizing agencies. Fla. Admin. 
Code R. 64B15-14.001(h),(2022). 
17
 Section 459.0152, F.S. 
18
 Id.  BILL: SB 1112   	Page 6 
 
order for an organization to obtain the BPM approval it must be the American Podiatric Medical 
Association, the National Council of Competency Assurance, or an organization that must: 
 Be composed of podiatric physicians interested in a special area of practice demonstrated 
through successful completion of examinations or case reports; 
 Subscribe to a code of ethics; 
 Have rules and procedures for maintaining a high level of professional conduct and discipline 
among its membership; 
 Have an active membership of at least seventy-five (75); 
 Sponsor annual meeting and courses in Board approved continuing education; and 
 Be a national organization in scope and give a certification examination at least once a year 
before the podiatric physician can advertise possession of the certification.
19
 
 
A dentist may not hold himself or herself out as a specialist, or advertise membership in or 
specialty recognition by an accrediting organization, unless the dentist has completed a specialty 
education program approved by the American Dental Association and the Commission on Dental 
Accreditation and the dentist is:
20
 
 Eligible for examination by a national specialty board recognized by the American Dental 
Association; or 
 Is a diplomate of a national specialty board recognized by the American Dental Association. 
 
If a dentist announces or advertises a specialty practice for which there is not an approved 
accrediting organization, the dentist must clearly state that the specialty is not recognized or that 
the accrediting organization has not been approved by the American Dental Association or the 
Florida Board of Dentistry.
21
 
 
The Board of Chiropractic Medicine (BCM) permits a chiropractor to advertise that he or she has 
attained diplomate status in a chiropractic specialty area recognized by the BCM. BCM 
specialties include those which are recognized by the Councils of the American Chiropractic 
Association, the International Chiropractic Association, the International Academy of Clinical 
Neurology, or the International Chiropractic Pediatric Association.
22
 
 
Practitioner Discipline 
Section 456.072, F.S., authorizes a regulatory board, or the DOH if there is no board, to 
discipline a health care practitioner’s licensure for a number of offenses, including but not 
limited to: 
 Making misleading, deceptive, or fraudulent representations in or related to the practice of 
the licensee’s profession; or 
 Failing to identify through writing or orally to a patient the type of license under which the 
practitioner is practicing. 
                                                
19
 Fla. Admin. Code R. 64B18-14.004 (2022). 
20
 Section 466.0282, F.S. A dentist may also hold himself or herself out as a specialist if the dentist has continuously held 
himself or herself out as a specialist since December 31, 1964, in a specialty recognized by the American Dental Association. 
21
 Section 466.0282(3), F.S. 
22
 Fla. Admin. Code R. 64B2-15.001(2)(e), (2022). Examples of chiropractic specialties include chiropractic acupuncture, 
chiropractic internist, chiropractic and clinical nutrition, radiology chiropractic, and pediatric chiropractors.  BILL: SB 1112   	Page 7 
 
 
If a board or the DOH finds that a licensee committed a violation of a statute or rule, the board or 
the DOH may:
23
 
 Refuse to certify, or to certify with restrictions, an application for a license; 
 Suspend or permanently revoke a license; 
 Place a restriction on the licensee’s practice or license; 
 Impose an administrative fine not to exceed $10,000 for each count or separate offense; if the 
violation is for fraud or making a false representation, a fine of $10,000 must be imposed for 
each count or separate offense; 
 Issue a reprimand or letter of concern; 
 Place the licensee on probation; 
 Require a corrective action plan; 
 Refund fees billed and collected from the patient or third party on behalf of the patient; or 
 Require the licensee to undergo remedial education. 
 
State Versus Federal Practitioner Licensure 
The federal government does not license health care practitioners, nor does it regulate 
practitioner behavior in terms of scope of practice, standards of practice, or practitioner 
discipline. Instead, the federal government relies on state governments to fulfill those functions. 
 
Conditions of Participation in Federal Health Care Programs 
In addition to state licensure requirements, Medicare, Medicaid, and other government 
reimbursement programs
24
 rely on the power of the purse to manage practitioners and facilities in 
the provision of health care services to persons enrolled in such programs. These programs 
impose “conditions of participation” and “conditions of payment,” which essentially mandate 
compliance with specified standards. Certification under a federal health care program is a right 
to participate in government payment systems. It is distinct from licensure by a state government 
or accreditation by a nationally-recognized board.
25
 
 
Examples of Federal Deference to State Regulatory Authority 
For example, under federal labor law found in 29 CFR s. 825.125, the definition of “health care 
provider” includes, in part, a doctor of medicine or osteopathy who is authorized to practice 
medicine or surgery by the state in which the doctor practices. 
 
That section of federal law goes on to reference other practitioners, including podiatrists, 
dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse midwives, 
clinical social workers, and physician assistants who are authorized to practice in their state and 
performing within the scope of their practice as defined under state law. 
 
                                                
23
 Section 456.072(2), F.S. 
24
 Such as the federal workers’ compensation program for longshoremen and harbor workers found under 20 CFR Subchapter 
A, available at: https://www.law.cornell.edu/cfr/text/20/chapter-VI/subchapter-A (last visited Jan. 24, 2024). 
25
 The Healthcare Law Review: USA, Spotlight: The Regulation of Healthcare Providers and Professionals in the USA, Sept. 
7, 2020, available at: https://www.lexology.com/library/detail.aspx?g=c3c193d0-753e-4244-914a-fd943e70ec8e (last visited 
Jan. 24, 2024).  BILL: SB 1112   	Page 8 
 
Another example is found in federal law creating a workers’ compensation program for 
longshoremen and harbor workers.
26
 Under that federal program, for the purpose of establishing 
who may be paid for providing services to persons enrolled in the program, the term “physician” 
includes doctors of medicine, surgeons, podiatrists, dentists, clinical psychologists, optometrists, 
chiropractors, and osteopathic practitioners within the scope of their practice as defined by state 
law.
27
 
 
This federal workers’ compensation program that reimburses health care providers as described 
above will also reimburse for treatment based on prayer or spiritual means alone if provided by 
an accredited practitioner of a church or religious denomination that is recognized by the federal 
government in certain ways.
28
 
 
Federal Distinctions Between Physicians and Other Providers 
Other federal programs draw specific distinctions between “physicians” and non-physicians who 
are included in the “physician” payment provisions above. For example, federal Medicaid law 
requires that state Medicaid programs “must provide for payment of optometric services as 
physician services, whether furnished by an optometrist or a physician,” thereby differentiating 
between optometrists and physicians instead of classifying them jointly.
29
 
 
These federal laws do not license or regulate such practitioners the way state laws do. They also 
do not define practitioner credentials, titles, or scopes of practice outside the provisions of state 
law and regulations that provide for such designations. 
 
Florida Requirements for Billing Medicare Patients 
In 1992, the Legislature created s. 456.056, F.S., relating to how Florida-licensed practitioners 
may bill patients enrolled in Medicare. The sole purpose of this section of statute is to prohibit 
Florida-based practitioners who participate in Medicare from directly invoicing Medicare 
patients in excess of the amounts that patients owe, according to Medicare payment 
methodologies. 
 
Section 456.056, F.S., provides that the term “physician” is defined in a manner consistent with 
federal law that governs Medicare billing. As the term is used in that section of the Florida 
Statutes, “physician” means: 
 A physician licensed under ch. 458, F.S., 
 An osteopathic physician licensed under ch. 459, F.S., 
 A chiropractic physician licensed under ch. 460, F.S., 
 A podiatric physician licensed under ch. 461, F.S., or 
 An optometrist licensed under ch. 463, F.S.
30
 
 
                                                
26
 Supra note 25. 
27
 See 20 CFR s. 702.404. 
28
 See 20 CFR s. 702.401(b). 
29
 See 42 CFR s. 441.30. 
30
 See s. 456.056(1)(a), F.S.  BILL: SB 1112   	Page 9 
 
This definition of “physician,” which was written to apply only to Medicare billing issues, is 
comparable to Medicare’s definition of “physician services” found in 42 CFR Part 414, which is 
entitled “Payment for Part B Medical and Other Health Services.” This portion of Medicare 
law
31
 provides that, for payment purposes, “physician services” includes the following services, 
to the extent they are covered by Medicare: professional services of doctors of medicine and 
osteopathy, doctors of optometry, doctors of podiatry, doctors of dental surgery and dental 
medicine,
32
 and chiropractors. 
 
Section 456.056, F.S., goes on to provide that any attempt by a Florida-licensed “physician,” as 
defined above, to collect from a Medicare beneficiary any amount of charges in excess of an 
unmet deductible or the 20 percent of charges that Medicare does not pay, is deemed null, void, 
and of no merit.
33
 
 
As such, the only purpose of s. 456.056, F.S., is to regulate the dollar amounts that specified 
practitioners may attempt to collect from their patients as payment for Medicare services, 
consistent with Medicare’s terminology for billing. This Florida statute does not provide 
authority for any health care practitioner to use certain titles. 
III. Effect of Proposed Changes: 
Section 1 of the bill creates s. 456.0651, F.S., and defines the following terms as used in that 
section of statute: 
 “Advertisement” means any printed, electronic, or oral, statement that: 
o Is communicated or disseminated to the general public; 
o Is prepared, communicated, or disseminated under the control of the practitioner or with 
the practitioner’s consent; and 
o Is intended to encourage a person to use a practitioner’s professional services or to 
promote those services or the practitioner in general; or, for commercial purposes, names 
a practitioner in connection with the practice, profession, or institution in which the 
practitioner is employed, volunteers, or provides health care services. 
 “Educational degree” means a degree awarded to a practitioner by a college or university 
relating to the practitioner’s profession or specialty designation, which degree may be 
referenced in an advertisement by name or acronym. 
 “Misleading, deceptive, or fraudulent representation” means any information that 
misrepresents or falsely describes a practitioner’s profession, skills, training, expertise, 
educational degree, board certification, or licensure. 
 “Profession” means, in addition to the meaning provided in s. 456.001, the name or title of a 
practitioner’s profession that is regulated by the DOH’s Division of Medical Quality 
Assurance and which name or title is allowed to be used by an individual due to his or her 
license, license by endorsement, certification, or registration issued by a board or the DOH. 
The term does not include a practitioner’s license or educational degree. 
 
                                                
31
 See 42 CFR s. 414.2. 
32
 Dentistry is omitted from s. 456.056, F.S., since traditional Medicare does not cover most dental care apart from 
emergencies or dental services provided in a hospital setting. See: https://www.medicare.gov/coverage/dental-services (last 
visited Jan. 24, 2024). 
33
 See s. 456.056(5), F.S.  BILL: SB 1112   	Page 10 
 
The bill provides that, for purposes of s. 456.065, F.S., relating to the unlicensed practice of a 
health care profession, in addition to the definitions of the “practice of medicine”
34
 and the 
“practice of osteopathic medicine”
35
 found in their corresponding practice acts, those terms also 
include attaching to one’s name, alone or in combination, or in connection with other words, any 
of the following titles or designations in an advertisement or in a manner that constitutes a 
misleading, deceptive, or fraudulent representation: 
 Doctor of medicine. 
 M.D. 
 Doctor of osteopathy. 
 D.O. 
 Emergency physician. 
 Family physician. 
 Interventional pain physician. 
 Medical doctor. 
 Osteopath. 
 Osteopathic physician. 
 Doctor of osteopathic medicine. 
 Surgeon. 
 Neurosurgeon. 
 General surgeon. 
 Resident physician. 
 Medical resident. 
 Medical intern. 
 Anesthesiologist. 
 Cardiologist. 
 Dermatologist. 
 Endocrinologist. 
 Gastroenterologist. 
 Gynecologist. 
 Hematologist. 
 Hospitalist. 
 Intensivist. 
 Internist. 
 Laryngologist. 
 Nephrologist. 
 Neurologist. 
 Obstetrician. 
 Oncologist. 
 Ophthalmologist. 
 Orthopedic surgeon. 
 Orthopedist. 
 Otologist. 
                                                
34
 See s. 458.305, F.S.  
35
 See s. 459.003, F.S.  BILL: SB 1112   	Page 11 
 
 Otolaryngologist. 
 Otorhinolaryngologist. 
 Pathologist. 
 Pediatrician. 
 Primary care physician. 
 Proctologist. 
 Psychiatrist. 
 Radiologist. 
 Rheumatologist. 
 Rhinologist. 
 Urologist. 
 
Exceptions 
Notwithstanding the provisions above, the bill authorizes all of the following. 
 
A licensed practitioner may use any name or title of his or her profession, and any corresponding 
designation or initials, authorized under his or her practice act to describe himself or herself and 
his or her practice. 
 
If the licensed practitioner has a specialty area of practice authorized under his or her practice 
act, he or she may use the following format to identify himself or herself or describe his or her 
practice: “...(name or title of the practitioner’s profession)..., specializing in ...(name of the 
practitioner’s specialty)....” 
 
A chiropractic physician
36
 licensed under ch. 460, F.S., may use the titles “doctor of chiropractic 
medicine,” “chiropractic radiologist,” and other titles, abbreviations, or designations authorized 
under his or her practice act or reflecting those chiropractic specialty areas in which the 
chiropractic physician has attained diplomate status as recognized by the American Chiropractic 
Association, the International Chiropractors Association, the International Academy of Clinical 
Neurology, or the International Chiropractic Pediatric Association. 
 
A podiatric physician
37
 licensed under ch. 461, F.S., may use the titles “podiatric surgeon,” 
“Fellow in the American College of Foot and Ankle Surgeons,” and other titles or abbreviations 
authorized under his or her practice act. 
 
A dentist licensed under ch. 466, F.S., may use the following titles and abbreviations as 
applicable to his or her license, specialty, and certification, and any other titles or abbreviations 
authorized under his or her practice act: 
 Doctor of medicine in dentistry. 
 Doctor of dental medicine. 
 D.M.D. 
                                                
36
 Under s. 460.403(5), F.S., “chiropractic physician” means any person licensed to practice chiropractic medicine pursuant to 
ch. 460, F.S. 
37
 Under s. 461.003(4), F.S., “podiatric physician” means any person licensed to practice podiatric medicine pursuant to 
ch. 461, F.S.  BILL: SB 1112   	Page 12 
 
 Doctor of dental surgery. 
 D.D.S. 
 Oral surgeon. 
 Maxillofacial surgeon. 
 Oral and maxillofacial surgeon. 
 O.M.S. 
 Oral radiologist. 
 Dental anesthesiologist. 
 Oral pathologist 
 
An anesthesiologist assistant licensed under ch. 458 or 459, F.S., may use only the titles 
“anesthesiologist assistant” or “certified anesthesiologist assistant” and the abbreviation 
“C.A.A.” 
 
Grounds for Discipline 
Section 2 of the bill amends the grounds for discipline in s. 456.072(1)(t), F.S., to specify that 
the following acts constitute grounds for disciplinary actions: 
 A practitioner’s failure, when treating or consulting with a patient, to identify through the 
wearing of a name tag the practitioner’s name and profession, as defined in s. 456.0651, F.S. 
The information on the name tag must be consistent with the specifications of s. 456.0651(2), 
F.S., such that it does not constitute the unlicensed practice of medicine or osteopathic 
medicine. 
 The failure of any advertisement for health care services naming a practitioner to identify the 
profession under which the practitioner is practicing and the practitioner’s educational degree 
in relation to the services featured in the advertisement. 
 
The name tag requirement does not apply if the practitioner is providing services in his or her 
own office that houses his or her practice or group practice. In such a case: 
 In lieu of a name tag, the practitioner must prominently display a copy of his or her license in 
a conspicuous area of the practice so that it is easily visible to patients. The copy of the 
license must be no smaller than the original license. 
 The practitioner must also verbally identify himself or herself to a new patient by name and 
profession, and such identification must be consistent with the specifications of 
s. 456.0651(2), F.S., so that it does not constitute the unlicensed practice of medicine or 
osteopathic medicine. 
 
The bill requires each board, or the DOH if there is no board, to adopt rules to determine how 
practitioners must comply with s. 456.072(1)(t), F.S., as amended by the bill. 
 
Section 3 of the bill provides an effective date of July 1, 2024. 
IV. Constitutional Issues: 
A. Municipality/County Mandates Restrictions: 
None.  BILL: SB 1112   	Page 13 
 
B. Public Records/Open Meetings Issues: 
None. 
C. Trust Funds Restrictions: 
None. 
D. State Tax or Fee Increases: 
None. 
E. Other Constitutional Issues: 
None. 
V. Fiscal Impact Statement: 
A. Tax/Fee Issues: 
None. 
B. Private Sector Impact: 
None. 
C. Government Sector Impact: 
To the extent persons violate the bill’s provisions, the bill could have a potential 
workload increase and an increase in costs for the DOH’s ULA Unit of an indeterminate 
amount. 
VI. Technical Deficiencies: 
None. 
VII. Related Issues: 
None. 
VIII. Statutes Affected: 
This bill substantially amends section 456.072 of the Florida Statutes. 
 
This bill creates section 456.0651 of the Florida Statutes.  BILL: SB 1112   	Page 14 
 
IX. Additional Information: 
A. Committee Substitute – Statement of Substantial Changes: 
(Summarizing differences between the Committee Substitute and the prior version of the bill.) 
None. 
B. Amendments: 
None. 
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.