| 9 | 9 | | Page 1 of 11 |
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| 10 | 10 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 11 | 11 | | |
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| 12 | 12 | | |
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| 13 | 13 | | |
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| 14 | 14 | | A bill to be entitled 1 |
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| 15 | 15 | | An act relating to health care practitioner 2 |
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| 16 | 16 | | identification; amending s. 456.003, F.S.; revising 3 |
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| 17 | 17 | | legislative findings; creating s. 456.65, F.S.; 4 |
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| 18 | 18 | | prohibiting the use of specified titles and 5 |
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| 19 | 19 | | designations by health care practitioners not licensed 6 |
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| 20 | 20 | | as physicians or osteopathic physicians, as 7 |
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| 21 | 21 | | applicable, with an exception; providing that the use 8 |
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| 22 | 22 | | of such titles and designations constitutes the 9 |
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| 23 | 23 | | unlicensed practice of medicine or osteopathic 10 |
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| 24 | 24 | | medicine, as applicable; authorizing the department to 11 |
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| 25 | 25 | | pursue specified reme dies for such violations; 12 |
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| 26 | 26 | | authorizing health care practitioners to use names and 13 |
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| 27 | 27 | | titles, and their corresponding designations and 14 |
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| 28 | 28 | | initials, authorized by their respective practice 15 |
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| 29 | 29 | | acts; specifying the manner in which health care 16 |
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| 30 | 30 | | practitioners may represent their specialty practice 17 |
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| 31 | 31 | | areas; specifying titles and abbreviations certain 18 |
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| 32 | 32 | | health care practitioners may use; providing 19 |
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| 33 | 33 | | construction; amending ss. 458.3312 and 459.0152, 20 |
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| 34 | 34 | | F.S.; specifying specialist titles and designations 21 |
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| 35 | 35 | | that physicians and osteopathic physicians, 22 |
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| 36 | 36 | | respectively, are prohibited from using unless they 23 |
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| 37 | 37 | | have received formal recognition by the appropriate 24 |
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| 38 | 38 | | recognizing agency for such specialty certifications; 25 |
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| 39 | 39 | | |
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| 46 | 46 | | Page 2 of 11 |
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| 47 | 47 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 48 | 48 | | |
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| 49 | 49 | | |
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| 50 | 50 | | |
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| 51 | 51 | | authorizing the Board of Medicine and the Board of 26 |
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| 52 | 52 | | Osteopathic Medicine, as applicable , to adopt certain 27 |
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| 53 | 53 | | rules; amending s. 641.51, F.S.; revising written 28 |
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| 54 | 54 | | notification requirements for adverse determinations 29 |
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| 55 | 55 | | made by a health maintenance organization; providing 30 |
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| 56 | 56 | | an effective date. 31 |
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| 57 | 57 | | 32 |
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| 58 | 58 | | Be It Enacted by the Legislature of the State of Florida: 33 |
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| 59 | 59 | | 34 |
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| 60 | 60 | | Section 1. Subsection (2) of section 456.003, Florida 35 |
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| 61 | 61 | | Statutes, is amended to read: 36 |
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| 62 | 62 | | 456.003 Legislative intent; requirements. — 37 |
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| 63 | 63 | | (2) The Legislature further finds believes that such 38 |
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| 64 | 64 | | professions must shall be regulated only for the preservation of 39 |
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| 65 | 65 | | the health, safety, and welfare of the public under the police 40 |
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| 66 | 66 | | powers of the state, and that the health, safety, and welfare of 41 |
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| 67 | 67 | | the public may be harmed or endangered by the unlawful practice 42 |
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| 68 | 68 | | of a profession; by a misleading, deceptive, or fraudulent 43 |
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| 69 | 69 | | representation relating to a person's authority to practice a 44 |
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| 70 | 70 | | profession lawfully; or when patients are uninformed about the 45 |
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| 71 | 71 | | profession under which a health care practitioner is practicing 46 |
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| 72 | 72 | | before receiving professional consultation or services from the 47 |
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| 73 | 73 | | practitioner. As a matter of great public importance, such 48 |
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| 74 | 74 | | professions must shall be regulated when: 49 |
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| 75 | 75 | | (a) Their unregulated practice can harm or endanger the 50 |
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| 76 | 76 | | |
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| 83 | 83 | | Page 3 of 11 |
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| 84 | 84 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 85 | 85 | | |
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| 86 | 86 | | |
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| 87 | 87 | | |
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| 88 | 88 | | health, safety, and welfare of the public, and when the 51 |
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| 89 | 89 | | potential for such harm is recognizable and clearl y outweighs 52 |
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| 90 | 90 | | any anticompetitive impact which may result from regulation. 53 |
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| 91 | 91 | | (b) The public is not effectively protected by other 54 |
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| 92 | 92 | | means, including, but not limited to, other state statutes, 55 |
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| 93 | 93 | | local ordinances, or federal legislation. 56 |
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| 94 | 94 | | (c) Less restrictive mea ns of regulation are not 57 |
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| 95 | 95 | | available. 58 |
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| 96 | 96 | | Section 2. Section 456.65, Florida Statutes, is created to 59 |
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| 97 | 97 | | read: 60 |
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| 98 | 98 | | 456.65 Specialties. — 61 |
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| 99 | 99 | | (1)(a) A health care practitioner not licensed as a 62 |
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| 100 | 100 | | physician under chapter 458 may not hold himself or herself out 63 |
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| 101 | 101 | | to a patient or the public at large as a specialist by 64 |
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| 102 | 102 | | describing himself or herself or his or her practice through the 65 |
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| 103 | 103 | | use of any specialist title or designation specifically listed 66 |
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| 104 | 104 | | under s. 458.3312(2), either alone or in combination, or in 67 |
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| 105 | 105 | | connection with other w ords, unless the practitioner is 68 |
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| 106 | 106 | | authorized to use such specialist title or designation under 69 |
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| 107 | 107 | | subsection (2). 70 |
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| 108 | 108 | | (b) A health care practitioner not licensed as a physician 71 |
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| 109 | 109 | | under chapter 459 may not hold himself or herself out to a 72 |
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| 110 | 110 | | patient or the public at l arge as a specialist by describing 73 |
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| 111 | 111 | | himself or herself or his or her practice through the use of any 74 |
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| 112 | 112 | | specialist title or designation specifically listed under s. 75 |
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| 113 | 113 | | |
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| 120 | 120 | | Page 4 of 11 |
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| 121 | 121 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 122 | 122 | | |
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| 123 | 123 | | |
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| 124 | 124 | | |
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| 125 | 125 | | 459.0152(2), either alone or in combination, or in connection 76 |
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| 126 | 126 | | with other words, unless the prac titioner is authorized to use 77 |
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| 127 | 127 | | such specialist title or designation under subsection (2). 78 |
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| 128 | 128 | | (c) A violation of paragraph (a) or paragraph (b) 79 |
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| 129 | 129 | | constitutes the unlicensed practice of medicine or osteopathic 80 |
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| 130 | 130 | | medicine, as applicable, and the department may purs ue remedies 81 |
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| 131 | 131 | | under s. 456.065 for such violation. 82 |
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| 132 | 132 | | (2) Notwithstanding subsection (1): 83 |
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| 133 | 133 | | (a) A licensed health care practitioner may use the name 84 |
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| 134 | 134 | | or title of his or her profession which is authorized under his 85 |
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| 135 | 135 | | or her practice act, and any corresponding des ignations or 86 |
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| 136 | 136 | | initials so authorized, to describe himself or herself and his 87 |
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| 137 | 137 | | or her practice. 88 |
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| 138 | 138 | | (b) A licensed health care practitioner who has a 89 |
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| 139 | 139 | | specialty area of practice authorized under his or her practice 90 |
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| 140 | 140 | | act may use the following format to identify himself or herself 91 |
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| 141 | 141 | | or describe his or her practice: "...(name or title of the 92 |
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| 142 | 142 | | practitioner's profession)..., specializing in ...(name of the 93 |
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| 143 | 143 | | practitioner's specialty)...." 94 |
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| 144 | 144 | | (c) A chiropractic physician licensed under chapter 460 95 |
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| 145 | 145 | | may use the title "chiropr actic radiologist" and other titles, 96 |
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| 146 | 146 | | abbreviations, or designations authorized under his or her 97 |
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| 147 | 147 | | practice act reflecting those chiropractic specialty areas in 98 |
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| 148 | 148 | | which the chiropractic physician has attained diplomate status 99 |
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| 149 | 149 | | as recognized by the American Chiro practic Association, the 100 |
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| 150 | 150 | | |
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| 157 | 157 | | Page 5 of 11 |
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| 158 | 158 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 159 | 159 | | |
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| 160 | 160 | | |
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| 161 | 161 | | |
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| 162 | 162 | | International Chiropractors Association, the International 101 |
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| 163 | 163 | | Academy of Clinical Neurology, or the International Chiropractic 102 |
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| 164 | 164 | | Pediatric Association. 103 |
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| 165 | 165 | | (d) A podiatric physician licensed under chapter 461 may 104 |
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| 166 | 166 | | use the following titles and abbreviations as applicable to his 105 |
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| 167 | 167 | | or her license, specialty, and certification: "podiatric 106 |
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| 168 | 168 | | surgeon," "Fellow in the American College of Foot and Ankle 107 |
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| 169 | 169 | | Surgeons," and any other titles or abbreviations authorized 108 |
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| 170 | 170 | | under his or her practice act. 109 |
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| 171 | 171 | | (e) A dentist licensed under chapter 466 may use the 110 |
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| 172 | 172 | | following titles and abbreviations as applicable to his or her 111 |
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| 173 | 173 | | license, specialty, and certification: "doctor of dental 112 |
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| 174 | 174 | | surgery," "D.D.S.," "oral surgeon," "maxillofacial surgeon," 113 |
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| 175 | 175 | | "oral and maxillofacial surge on," "O.M.S.," "dental 114 |
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| 176 | 176 | | anesthesiologist," "oral pathologist," "oral radiologist," and 115 |
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| 177 | 177 | | any other titles or abbreviations authorized under his or her 116 |
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| 178 | 178 | | practice act. 117 |
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| 179 | 179 | | (f) An anesthesiologist assistant licensed under chapter 118 |
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| 180 | 180 | | 458 or chapter 459 may use only the titles "anesthesiologist 119 |
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| 181 | 181 | | assistant" or "certified anesthesiologist assistant" and the 120 |
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| 182 | 182 | | abbreviation "C.A.A." 121 |
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| 183 | 183 | | (3) This section may not be construed to prohibit or 122 |
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| 184 | 184 | | interfere with a licensed practitioner's ability to bill 123 |
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| 185 | 185 | | lawfully the Medicare program or ot her federal health care 124 |
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| 186 | 186 | | program using definitions or terminology provided under 125 |
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| 187 | 187 | | |
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| 194 | 194 | | Page 6 of 11 |
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| 195 | 195 | | F L O R I D A H O U S E O F R E P R E S E N T A T I V E S |
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| 196 | 196 | | |
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| 197 | 197 | | |
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| 198 | 198 | | |
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| 199 | 199 | | applicable federal law or regulations for services rendered to a 126 |
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| 200 | 200 | | patient enrolled in such program. 127 |
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| 201 | 201 | | Section 3. Section 458.3312, Florida Statutes, is amended 128 |
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| 202 | 202 | | to read: 129 |
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| 203 | 203 | | 458.3312 Specialties.— 130 |
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| 204 | 204 | | (1) A physician licensed under this chapter may not hold 131 |
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| 205 | 205 | | himself or herself out as a board -certified specialist unless 132 |
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| 206 | 206 | | the physician has received formal recognition as a specialist 133 |
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| 207 | 207 | | from a specialty board of the American Board of Medica l 134 |
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| 208 | 208 | | Specialties or other recognizing agency that has been approved 135 |
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| 209 | 209 | | by the board. However, a physician may indicate the services 136 |
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| 210 | 210 | | offered and may state that his or her practice is limited to one 137 |
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| 211 | 211 | | or more types of services when this accurately reflects the 138 |
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| 212 | 212 | | scope of practice of the physician. 139 |
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| 213 | 213 | | (2) Specialist titles and designations that are subject to 140 |
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| 214 | 214 | | subsection (1) include: 141 |
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| 215 | 215 | | (a) Surgeon. 142 |
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| 216 | 216 | | (b) Neurosurgeon. 143 |
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| 217 | 217 | | (c) General surgeon. 144 |
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| 218 | 218 | | (d) Anesthesiologist. 145 |
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| 219 | 219 | | (e) Cardiologist. 146 |
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| 220 | 220 | | (f) Dermatologist. 147 |
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| 273 | | - | (3) The board may adopt by rule additional specialist 176 |
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| 274 | | - | titles and designations that are subject to subsection (1). 177 |
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| 275 | | - | Section 4. Section 459.0152, Florida Statutes, is amended 178 |
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| 276 | | - | to read: 179 |
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| 277 | | - | 459.0152 Specialties. — 180 |
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| 278 | | - | (1) An osteopathic physician licensed under this chapter 181 |
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| 279 | | - | may not hold himself or herself out as a board -certified 182 |
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| 280 | | - | specialist unless the osteopathic physician has successfully 183 |
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| 281 | | - | completed the requirements for certification by the American 184 |
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| 282 | | - | Osteopathic Association or the Accreditation Council on Graduate 185 |
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| 283 | | - | Medical Education and is certified as a specialist by a 186 |
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| 284 | | - | certifying agency approved by the board. However, an osteopathic 187 |
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| 285 | | - | physician may indicate the services offered and may st ate that 188 |
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| 286 | | - | his or her practice is limited to one or more types of services 189 |
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| 287 | | - | when this accurately reflects the scope of practice of the 190 |
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| 288 | | - | osteopathic physician. 191 |
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| 289 | | - | (2) Specialist titles and designations that are subject to 192 |
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| 290 | | - | subsection (1) include: 193 |
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| 291 | | - | (a) Surgeon. 194 |
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| 292 | | - | (b) Neurosurgeon. 195 |
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| 293 | | - | (c) General surgeon. 196 |
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| 294 | | - | (d) Anesthesiologist. 197 |
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| 295 | | - | (e) Cardiologist. 198 |
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| 296 | | - | (f) Dermatologist. 199 |
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| 297 | | - | (g) Endocrinologist. 200 |
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| 273 | + | Section 4. Section 459.0152, Florida Statutes, is amended 176 |
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| 274 | + | to read: 177 |
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| 275 | + | 459.0152 Specialties. — 178 |
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| 276 | + | (1) An osteopathic physicia n licensed under this chapter 179 |
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| 277 | + | may not hold himself or herself out as a board -certified 180 |
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| 278 | + | specialist unless the osteopathic physician has successfully 181 |
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| 279 | + | completed the requirements for certification by the American 182 |
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| 280 | + | Osteopathic Association or the Accreditation Co uncil on Graduate 183 |
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| 281 | + | Medical Education and is certified as a specialist by a 184 |
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| 282 | + | certifying agency approved by the board. However, an osteopathic 185 |
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| 283 | + | physician may indicate the services offered and may state that 186 |
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| 284 | + | his or her practice is limited to one or more types of services 187 |
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| 285 | + | when this accurately reflects the scope of practice of the 188 |
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| 286 | + | osteopathic physician. 189 |
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| 287 | + | (2) Specialist titles and designations that are subject to 190 |
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| 288 | + | subsection (1) include: 191 |
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| 289 | + | (a) Surgeon. 192 |
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| 290 | + | (b) Neurosurgeon. 193 |
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| 291 | + | (c) General surgeon. 194 |
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| 292 | + | (d) Anesthesiologis t. 195 |
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| 293 | + | (e) Cardiologist. 196 |
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| 294 | + | (f) Dermatologist. 197 |
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| 295 | + | (g) Endocrinologist. 198 |
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| 296 | + | (h) Gastroenterologist. 199 |
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| 297 | + | (i) Gynecologist. 200 |
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| 347 | | - | (3) The board may adopt by rule additional specialist 226 |
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| 348 | | - | titles and designations that are subject to subsection (1). 227 |
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| 349 | | - | Section 5. Subsection (4) of section 641.51, Florida 228 |
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| 350 | | - | Statutes, is amended to read: 229 |
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| 351 | | - | 641.51 Quality assurance program; second medical opinion 230 |
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| 352 | | - | requirement.— 231 |
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| 353 | | - | (4) The organization shall ensure that only a physician 232 |
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| 354 | | - | holding an active, unencumbered license i ssued under chapter 458 233 |
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| 355 | | - | or chapter 459 may render an adverse determination regarding a 234 |
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| 356 | | - | service provided by a physician licensed in this state. The 235 |
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| 357 | | - | organization shall submit to the treating provider and the 236 |
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| 358 | | - | subscriber written notification regarding the orga nization's 237 |
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| 359 | | - | adverse determination within 2 working days after the subscriber 238 |
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| 360 | | - | or provider is notified of the adverse determination. The 239 |
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| 361 | | - | written notification must include the utilization review 240 |
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| 362 | | - | criteria or benefits provisions used in the adverse 241 |
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| 363 | | - | determination, identify the physician who rendered the adverse 242 |
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| 364 | | - | determination, and be signed by an authorized representative of 243 |
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| 365 | | - | the organization or the physician who rendered the adverse 244 |
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| 366 | | - | determination. The organization must include with the 245 |
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| 367 | | - | notification of an adverse de termination information concerning 246 |
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| 368 | | - | the appeal process for adverse determinations. The written 247 |
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| 369 | | - | notification must include a written disclosure stating that the 248 |
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| 370 | | - | determination was made by a physician holding an active, 249 |
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| 371 | | - | unencumbered license issued under chapter 458 or chapter 459. 250 |
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| 347 | + | Section 5. Subsection (4) of section 641.51, Florida 226 |
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| 348 | + | Statutes, is amended to read: 227 |
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| 349 | + | 641.51 Quality assurance program; second medical opinion 228 |
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| 350 | + | requirement.— 229 |
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| 351 | + | (4) The organization shall ensure that only a physician 230 |
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| 352 | + | holding an active, unencumbered license issued under chapter 458 231 |
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| 353 | + | or chapter 459 may render an adverse determination regarding a 232 |
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| 354 | + | service provided by a physician licensed in this state. The 233 |
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| 355 | + | organization shall submit to the treating provider and the 234 |
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| 356 | + | subscriber written notification regarding the organization's 235 |
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| 357 | + | adverse determination within 2 working days after the subscriber 236 |
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| 358 | + | or provider is notified of the adverse determination. The 237 |
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| 359 | + | written notification must include the utilization review 238 |
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| 360 | + | criteria or benefits provisions used in the adverse 239 |
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| 361 | + | determination, identify the physician who rendered the adverse 240 |
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| 362 | + | determination, and be signed by an authorized representative of 241 |
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| 363 | + | the organization or the physician who rendered the adverse 242 |
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| 364 | + | determination. The organization must include with the 243 |
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| 365 | + | notification of an adverse determination information concerning 244 |
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| 366 | + | the appeal process for adv erse determinations. The written 245 |
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| 367 | + | notification must include a written disclosure stating that the 246 |
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| 368 | + | determination was made by a physician holding an active, 247 |
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| 369 | + | unencumbered license issued under chapter 458 or chapter 459. 248 |
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| 370 | + | The organization shall maintain a record of each adverse 249 |
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| 371 | + | determination and identify in those records the physician who 250 |
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| 384 | | - | The organization shall maintain a record of each adverse 251 |
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| 385 | | - | determination and identify in those records the physician who 252 |
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| 386 | | - | rendered the adverse determination. This subsection provision 253 |
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| 387 | | - | does not create authority for the Board of Medicine or the Board 254 |
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| 388 | | - | of Osteopathic Medicine to regulate the organization; however, 255 |
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| 389 | | - | the Board of Medicine and the Board of Osteopathic Medicine each 256 |
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| 390 | | - | continue to have jurisdiction over licensees of their respective 257 |
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| 391 | | - | boards. 258 |
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| 392 | | - | Section 6. This act shall take effect July 1, 2025. 259 |
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| 384 | + | rendered the adverse determination. This subsection provision 251 |
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| 385 | + | does not create authority for the Board of Medicine or the Board 252 |
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| 386 | + | of Osteopathic Medicine to regulate the organizati on; however, 253 |
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| 387 | + | the Board of Medicine and the Board of Osteopathic Medicine each 254 |
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| 388 | + | continue to have jurisdiction over licensees of their respective 255 |
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| 389 | + | boards. 256 |
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| 390 | + | Section 6. This act shall take effect July 1, 2025. 257 |
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