STORAGE NAME: h1553e.HHS
DATE: 4/7/2025
1
FLORIDA HOUSE OF REPRESENTATIVES
BILL ANALYSIS
This bill analysis was prepared by nonpartisan committee staff and does not constitute an official statement of legislative intent.
BILL #: CS/HB 1553
TITLE: Uterine Fibroid Research Database
SPONSOR(S): Dunkley and Valdés
COMPANION BILL: SB 1728 (Rodriguez)
LINKED BILLS: None
RELATED BILLS: None
Committee References
Health Professions & Programs
15 Y, 0 N
Health Care Budget
12 Y, 0 N, As CS
Health & Human Services
24 Y, 0 N
SUMMARY
Effect of the Bill:
CS/HB 1553 requires health care providers to submit identified information to the Department of Health (DOH) for
inclusion in the Uterine Fibroid Research Database. The bill also adds uterine fibroids to the list of infectious or
noninfectious diseases of public health significance, which requires health care providers to submit identified
uterine fibroid data to DOH for epidemiological research purposes.
Fiscal or Economic Impact:
The bill has a $1 million fiscal impact on the Department of Health, which is accounted for in the House proposed
budget for Fiscal year 2025-2026. See Fiscal or Economic Impact.
JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
ANALYSIS
EFFECT OF THE BILL:
Uterine Fibroids Research Database
Current law requires health care providers to submit deidentified information relating to the diagnosis and
treatment of patients with uterine fibroids to the Department of Health (DOH) for inclusion in the Uterine Fibroid
Research Database.
1 DOH is unable to determine if the submitted deidentified information is related to a unique
individual or related to the same individual whose information has been reported multiple times by various health
care providers. Due to the lack of fidelity in the deidentified data it would receive under the current law, DOH has
not yet implemented the Uterine Fibroid Research Database.
The bill requires health care providers to submit identified information to DOH for inclusion in the Uterine Fibroid
Research Database. This will allow DOH to successfully implement the database. (Section 1)
The bill also adds uterine fibroids to the list of infectious or noninfectious diseases of public health significance
under s. 381.0031, F.S. This requires health care providers to submit identified uterine fibroid data to DOH for
epidemiological research in addition to the reporting requirement for the Uterine Fibroid Research Database.
(Section 1)
The bill provides an effective date of July 1, 2025. (Section 2)
1
S. 381.9312, F.S. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
2
FISCAL OR ECONOMIC IMPACT:
STATE GOVERNMENT:
The bill will have a $1 million nonrecurring fiscal impact on the Department of Health (DOH), which is accounted
for in the House proposed budget for Fiscal Year 2025-2026.
2
DOH will use the funds for the development and licensing of the Uterine Fibroid Research Database; to ensure the
cloud-storage and maintenance operation of the database; and to provide for one OPS Data Scientist to support the
development, monitoring, and analysis of data for a comprehensive uterine fibroid disease registry.
3
RELEVANT INFORMATION
SUBJECT OVERVIEW:
Uterine Fibroids
Uterine fibroids, which are tumors that grow in a woman's uterus,
4 place significant financial burdens on the
United States health care system and economy, with an estimated $34 billion in associated annual health care
costs.
5 These growths are typically benign (noncancerous) and are the most common benign tumor affecting
women.
6 Uterine fibroids are rare before puberty, increase in prevalence during the reproductive years, and
decrease in size after menopause. As many as one in five women have fibroids during their childbearing years and
half of all women have them by age 50. Fibroids are also more common in Black women, women with high blood
pressure, obesity, early onset of periods, late age of menopause, older women, and women with a family history of
fibroids.
7
Although the exact cause of fibroids is unknown, they are thought to be caused by hormones in the body and family
history or genes.
8 In addition to age, race and ethnic origin, and family history, other known risk factors include:
9
Obesity: Overweight or obese women are two or three times more likely to get fibroids than normal
weight women.
Eating habits: Eating a lot of red meat and ham is linked with higher risk of fibroids.
Vitamin D deficiency: Vitamin D inhibits fibroid growth, but studies indicate only 10 percent of Black
women have adequate levels.
10
Diagnosis of Fibroids
Fibroids vary in size and weight
11 and can grow in different parts of the uterus.
12 Although it is possible for just one
fibroid to develop, most often there are multiple. Fibroids are not always easy to diagnose, as some women have no
2
Fiscal Year 2025-2026, HB 5001, House Proposed General Appropriations Act, line 512,
https://www.flhouse.gov/Sections/Documents/loaddoc.aspx?FileName=HB+5001+As+Introduced.pdf&DocumentType=Bill&
BillNumber=5001&Session=2025 (last visited Apr. 4, 2025).
3
Department of Health, Agency Bill Analysis HB 1553 (2025), p. 3, on file with the Health Care Budget Subcommittee.
4
The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy. University of Florida Health
(UFHealth), Hysterectomy, https://ufhealth.org/hysterectomy (last visited Feb. 13, 2025).
5
Yang Q, Ciebiera M, Bariani M, Ali M, Elkafas H, Boyer T, and Al-Hendy A, Endocrine Society Oxford, Endocrine Reviews, 2022,
Vol. XX, No. XX, 1–43 Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment, (Nov.
2021) available at https://academic.oup.com/edrv/advance-article/doi/10.1210/endrev/bnab039/6422392 (last visited Feb.
13, 2025).
6
National Center for Biotechnology Information (NCBI), Uterine Leiomymomata,
https://www.ncbi.nlm.nih.gov/books/NBK546680/ (last visited Feb. 13, 2025).
7
UFHealth, Uterine Fibroids, https://ufhealth.org/uterine-fibroids (last visited Feb. 13, 2025).
8
Id.
9
Florida Department of Health (DOH) Hernando County, Uterine Fibroids, 2021 Florida Data Report,
https://hernando.floridahealth.gov/_files/FibroidsReport_2021.pdf (last visited Feb. 13, 2025).
10
Id. Sunlight in moderation, supplements, and certain food sources can help improve Vitamin D levels.
11
Supra note 7. Some fibroids are microscopic, while others fill the entire uterus and weigh several pounds. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
3
symptoms. However, common symptoms are bleeding between periods, heavy bleeding during periods, periods
that last longer than normal, urinary frequency and urgency, pelvic cramping or pain with periods, feeling fullness
or pressure in the lower belly, and painful intercourse.
13
Fibroids can also be diagnosed through a pelvic exam, which may show a change in the shape of a woman’s uterus,
or through the following tests:
14
Ultrasound, which uses sound waves to create a picture of the uterus.
Magnetic resonance imaging, which uses powerful magnets and radio waves to create a picture.
Saline infusion sonogram, where saline is injected into the uterus to make it easier to see the uterus
using ultrasound.
Hysteroscopy, which uses a long, thin tube inserted through the vagina and into the uterus to examine
the inside of the uterus.
Endometrial biopsy, which removes a small piece of the lining of the uterus to check for cancer if a
woman has unusual bleeding.
Treatment of Fibroids
Treatment of fibroids depends on a woman’s age, general health, symptoms, type of fibroids, whether she is
pregnant, and her desire to have children in the future. Treatment ranges from minimally invasive hormonal and
medical treatments to major surgical interventions, such as hysterectomy.
15
Non-Surgical Treatment
There are various treatments for the symptoms of fibroids, such as intrauterine devices (IUDs) that release
hormones to help reduce heavy bleeding and pain and tranexamic acid to reduce the amount of blood flow.
16 There
are also medical or hormonal therapies to shrink fibroids,
17 including a type of IUD that releases a low dose of the
hormone progestin into the uterus each day.
18 Medical procedures used to directly treat fibroids include:
19
Endometrial ablation, a procedure used to treat heavy bleeding associated with fibroids; and
Uterine artery embolization, a procedure that stops the blood supply to the fibroid, causing it to shrink
and die.
Surgical Treatments
Surgical procedures used to treat fibroids include:
20
Hysteroscopy, a procedure that removes fibroids growing inside the uterus;
Myomectomy, a procedure that removes fibroids from the uterus, but does not prevent new fibroids
from growing; and
Hysterectomy.
12
Supra note 7. Fibroids can grow in the muscle wall of the uterus (myometrial); just under the surface of the uterine lining
(submucosal); just under the outside lining of the uterus (subserosal); or on a long stalk on the outside the uterus or inside the
uterus (pedunculated).
13
Supra, note 7.
14
Id.
15
Supra, note 6.
16
Other examples include iron supplements to prevent or treat anemia due to heavy periods; and pain relievers, such as
ibuprofen or naproxen, for cramps or pain.
17
Other examples include birth control pills to help control heavy periods and hormone shots to help shrink fibroids by
stopping ovulation.
18
Supra, note 7.
19
Id.
20
Id. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
4
Hysterectomy is a major surgery to remove all or part of a woman’s uterus. The fallopian tubes and ovaries may
also be removed during the surgery.
21 Hysterectomy is the second most frequently performed surgical procedure,
after cesarean section, for women of reproductive age in the United States. Between 2012-2020, one in five women,
and half of the women aged 70 years or older, reported undergoing a hysterectomy in the United States;
22 fibroids
are the number one reason for hysterectomies in the United States.
23
In addition to the general risks of surgery,
24 hysterectomy specific risks include:
25
Injury to the bladder or ureters;
Pain during sexual intercourse;
Early menopause if the ovaries are removed;
Decreased interest in sex; and
Increased risk of heart disease if the ovaries are removed before menopause.
Uterine Fibroid Research Database
In 2022, the Legislature required the Department of Health (DOH) to establish a Uterine Fibroid Research
Database, which includes, but is not limited to:
26
Incidence and Prevalence of women diagnosed with fibroids in Florida;
Demographic attributes of women diagnosed with fibroids in Florida; and
Treatments and procedures for fibroids in the state.
To populate the database, physicians and physician assistants licensed under chapters 458
27 and 459,
28 F.S., and
advanced practice registered nurses licensed under ch. 464,
29 F.S., must submit to DOH deidentified information
relating to their diagnoses and treatments of women with fibroids to DOH, for inclusion in the database.
30 DOH is
prohibited from including any personal identifying information of women diagnosed with or treated with uterine
fibroids in the database.
31
As a result of not being able to include any personal identifying information in the database, DOH has not been able
to implement it. A woman may see many doctors before receiving a diagnosis and treatment for uterine fibroids.
Without collecting personal identifying information, DOH is unable to deduplicate the data. If DOH were to add the
information to the database, it can lead to an over or under representation of the public health issue.
32
In 2022, the Legislature appropriated $802,900, including $681,048 in nonrecurring funds and $121,852 in
recurring funds to procure, develop, and implement the database, as well as train health care providers on the
21
UFHealth, Hysterectomy, https://ufhealth.org/hysterectomy (last visited Feb. 13, 2025).
22
Sameer V. Gopalani, Sabitha R. Dasari, Emily E. Adam, Trevor D. Thompson, Mary C. White, and Mona Saraiya, Variation in
Hysterectomy Prevalence and Trends Among U.S. States and Territories—Behavioral Risk Factor Surveillance System, 2012-2020,
(Oct. 2023), available at https://stacks.cdc.gov/view/cdc/135504 (last visited Feb. 13, 2025).
23
Johns Hopkins Medicine, Fibroids, https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-
fibroids#:~:text=Hysterectomy%20for%20Fibroids,eliminates%20the%20possibility%20of%20recurrence (last visited Mar.
3, 2025).
24
Risks include blood clots, which may cause death if they travel to the lungs, allergic reactions to medicines, breathing
problems, bleeding, infection, and injury to nearby body areas.
25
Supra, note 21.
26
Id.
27
Ch. 458, F.S., governs licensure and regulation of allopathic physicians (medical doctors) and physician assistants by the
Florida Board of Medicine, in conjunction with DOH.
28
Ch. 459, F.S., governs licensure and regulation of osteopathic physicians and physician assistants by the Florida Board of
Osteopathic Medicine, in conjunction with DOH.
29
Ch. 464, F.S., governs licensure and regulation of APRNs by the Board of Nursing, in conjunction with DOH.
30
Supra, note 1.
31
Id.
32
Supra, note 3. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
5
reporting requirement.
33 DOH has since reverted back $646,998 of the appropriated funds since they were unable
to implement the database.
Public Health Reporting
DOH is required to periodically issue a list of infectious or noninfectious diseases of public health significance for
purposes of epidemiological monitoring and research.
34 Current law requires any licensed physician, chiropractic
physician, nurse, midwife, or veterinarian licensed in this state to immediately report the diagnosis or suspected
diagnosis of a disease of public health significance to DOH.
35 The practitioner must report the disease or condition
on a form developed by DOH, which includes information such as the patient’s name, demographic information,
diagnosis, test procedure used, and treatment given.
36 The practitioner must make the patient’s medical records
for such diseases available for onsite inspection by DOH.
37
Uterine Fibroids Data
Currently, the main uterine fibroids data source in the state is through a data-sharing agreement between DOH and
the Agency for Health Care Administration (AHCA). If a woman has a hospitalization related to fibroids, this
information is captured via the hospital discharge record. Current law requires hospitals to submit hospital
discharge data to AHCA,
38 which AHCA then transmits to DOH per the data-sharing agreement.
In 2023, there were 17,589 hospitalizations related to uterine fibroids among Florida women ages 15-54 years.
39
RECENT LEGISLATION:
YEAR BILL # HOUSE SPONSOR(S) SENATE SPONSOR OTHER INFORMATION
2022 CS/CS/CS/HB
543
McClure Gibson The bill was enacted, but it has
not been fully implemented.
BILL HISTORY
COMMITTEE REFERENCE ACTION DATE
STAFF
DIRECTOR/
POLICY CHIEF
ANALYSIS
PREPARED BY
Health Professions & Programs
Subcommittee
15 Y, 0 N 3/13/2025 McElroy Clenord
Health Care Budget Subcommittee 12 Y, 0 N, As CS 3/26/2025 Clark Day
THE CHANGES ADOPTED BY THE
COMMITTEE:
Removed the appropriation on the bill.
Health & Human Services
Committee
24 Y, 0 N 4/7/2025 Calamas Clenord
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33
Ch. 2022-50, Laws of Florida.
34
S. 381.0031, F.S.
35
Id.
36
Rule 64D-3.030, F.A.C.
37
Id.
38
S. 408.061, F.S.
39
FLHealthCharts, Hospitalization from Uterine Fibroids,
https://www.flhealthcharts.gov/ChartsDashboards/rdPage.aspx?rdReport=UterineFibroids.Dataviewer&cid=0901 (last
visited Mar. 1, 2025). JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
6
THIS BILL ANALYSIS HAS BEEN UPDATED TO INCORPORATE ALL OF THE CHANGES DESCRIBED ABOVE.
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