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 768
INTRODUCER: Senator Calatayud
SUBJECT: Controlling Business Interests by Persons with Ties to Foreign Countries of Concern
DATE: March 17, 2025
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Smith Brown HP Pre-meeting
2. JU
3. RC
I. Summary:
SB 768 revises health care providers’ minimum licensure requirements to require licensees to
make reasonable efforts to ensure that a person who holds a direct controlling interest in the
licensee does not also hold, either directly or indirectly, regardless of ownership structure, an
interest in an entity that has a business relationship with a foreign country of concern or that is
subject to the statute prohibiting contracting with scrutinized companies. The bill also removes
“any other entity of significant control” (of such foreign country of concern) from the definition
of foreign country of concern, for purposes of that requirement.
These changes would ease heightened requirements, relating to business interests by persons
with ties to foreign countries of concern, for licensees who may not have access to the
information that they need to ensure that they satisfy those current minimum licensure
requirements.
The bill provides an effective date of July 1, 2025.
II. Present Situation:
Health Care Licensing Procedures Act
As of February 21, 2025, the Florida Agency for Health Care Administration (AHCA) regulates
49,823 health care providers.
1
The Health Care Licensing Procedures Act
2
provides a
streamlined and consistent set of basic licensing requirements for health care providers that are
1
Agency for Health Care Administration, Senate Bill 786 Legislative Analysis (Feb. 19, 2025) (on file with the Senate
Committee on Health Policy).
2
Chapter 408, Part II, F.S. See also s. 408.801(1), F.S.
REVISED: BILL: SB 768 Page 2
licensed, registered, or certified by the AHCA.
3
The Act is intended to minimize confusion,
standardize terminology, and include issues that are not otherwise addressed in state law
pertaining to specific providers.
4
Among other things, it provides certain minimum licensure
requirements with which applicants and licensees must comply in order to obtain and maintain a
license.
5
The issuance of a license is not a contract or an agreement between the state and the
licensee.
6
A license is a privilege that is granted by the state based upon the licensee complying
with licensure requirements.
7
Minimum Licensure Requirements; An Act Relating to the Interests of Foreign Countries
On July 1, 2023, Senate Bill 264 (2023), relating to the Interests of Foreign Countries, became
effective, creating additional minimum licensure requirements for health care providers.
8
One such additional requirement is subsection (15) of s. 408.810, F.S., which requires a licensee
to ensure that a person or entity who possesses a controlling interest in the licensee does not also
hold, either directly or indirectly, regardless of ownership structure, an interest in an entity that
has a business relationship with a foreign country of concern or that is subject to the statute
prohibiting contracting with scrutinized companies.
9
The term “controlling interest” is defined for the Act (part II of ch. 408, F.S.) in s. 408.803(7),
F.S.:
• “Controlling interest” means:
o (a) The applicant or licensee;
o (b) A person or entity that serves as an officer of, is on the board of directors of, or has a
5-percent or greater ownership interest in the applicant or licensee; or
o (c) A person or entity that serves as an officer of, is on the board of directors of, or has a
5-percent or greater ownership interest in the management company or other entity,
related or unrelated, with which the applicant or licensee contracts to manage the
provider.
The term does not include a voluntary board member.
3
Section 408.801(2), F.S. The act applies to following providers: laboratories authorized to perform testing under the Drug-
Free Workplace Act, birth centers, abortion clinics, crisis stabilization units, short-term residential treatment facilities,
residential treatment facilities, residential treatment centers for children and adolescents, hospitals, ambulatory surgical
centers, nursing homes, assisted living facilities, home health agencies, nurse registries, companion services or homemaker
services providers, adult day care centers, hospices, adult family-care homes, homes for special services, transitional living
facilities, prescribed pediatric extended care centers, home medical equipment providers, intermediate care facilities for
persons with developmental disabilities, health care services pools, health care clinics, organ tissue and eye procurement
organizations.
4
Id.
5
See generally s. 408.810, F.S.
6
Supra note 1.
7
Supra note 1.
8
Ch. 2023-22, s. 10, Laws of Fla.
9
Section 287.135, F.S. BILL: SB 768 Page 3
For purposes of s. 408.810(15), F.S., the following terms are defined:
• “Business relationship” means engaging in commerce in any form, including, but not limited
to, acquiring, developing, maintaining, owning, selling, possessing, leasing, or operating
equipment, facilities, personnel, products, services, personal property, real property, military
equipment, or any other apparatus of business or commerce.
• “Foreign country of concern” has the same meaning as in s. 692.201(3), F.S., as that term is
defined for purposes of the conveyance of property.
o “Foreign country of concern” means the People’s Republic of China, the Russian
Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the
Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab
Republic, including any agency of or any other entity of significant control of such
foreign country of concern.
• “Interest” has the same meaning as in s. 286.101(1), F.S., as that term is defined for purposes
of foreign gifts and contracts in business.
o “Interest” in an entity means any direct or indirect investment in or loan to the entity
valued at 5 percent or more of the entity’s net worth or any form of direct or indirect
control exerting similar or greater influence on the governance of the entity.
The onus is on the licensee to ensure that no business relationship exists with foreign countries of
concern or that is subject to the statute prohibiting contracting with scrutinized companies.
10
Pursuant to s. 408.806(5), F.S., which outlines the license application process for the Act, proof
of compliance with s. 408.810, F.S., including subsection (15) of that section, must be submitted
with an application for licensure and licensure renewal.
11
In practice, the AHCA processes the background screenings of individual people with a
controlling interest (generally 5 percent or more) in the licensee when their names are listed on
an application.
12
Licensees may have controlling interests that are business entities with no
individual people having been named or disclosed. The AHCA reports that aside from the
application process, there is no mechanism by which its staff can verify whether the
requirements of subsection (15) are met.
13
The AHCA notes that it is a registered user of the
SAVE Program of the U.S. Department of Homeland Security
14
and can determine the status of
nonimmigrant aliens with controlling interest in home health agencies, home medical equipment
providers, and health care clinics.
15
10
Supra note 1.
11
Section 408.806(5), F.S.
12
Section 408.809(1)(d), F.S.
13
Supra note 1.
14
SAVE is an online service for registered federal, state, territorial, tribal, and local government agencies to verify
immigration status and naturalized/acquired U.S. citizenship of applicants seeking benefits or licenses. United States
Department of Homeland Security, SAVE, available at https://www.uscis.gov/save (last accessed Mar. 15, 2025).
15
Supra note 1. BILL: SB 768 Page 4
III. Effect of Proposed Changes:
Section 1 of the bill amends s. 408.810(15), F.S., which provides certain minimum licensure
requirements for health care providers relating to foreign countries of concern.
16
The bill adds
the phrase “make reasonable efforts to” to subsection (15), so that a licensee would be required
to make reasonable efforts to ensure, rather than to absolutely ensure, that a person or entity who
possesses a controlling interest in the licensee does not also hold, either directly or indirectly,
regardless of ownership structure, an interest in an entity that has a business relationship with a
foreign country of concern or that is subject to the statute prohibiting contracting with scrutinized
companies.
The bill creates a competing definition
17
of the term “controlling interest” within the Health Care
Licensing Procedures Act, for purposes of subsection (15), to limit a controlling interest to
persons or entities that have a direct controlling interest in the licensee. Functionally speaking,
the addition of this definition would have the same effect as adding the word “direct” before the
words “controlling interest” in subsection (15). Under the bill, a licensee would no longer have
to ensure that a person or entity who possesses an indirect controlling interest does not have an
interest in an entity that has an otherwise forbidden business relationship.
Additionally, the bill defines the term “foreign country of concern” in a similar manner to how it
is currently defined in s. 692.201, F.S.
18
, but removes the phrase “or any other entity of
significant control of” such foreign country of concern.
These changes would ease the heightened requirements on licensees who may not have access to
the information they need to ensure that they meet the current requirements of subsection (15).
Section 2 of the bill provides an effective date of July 1, 2025.
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None.
C. Trust Funds Restrictions:
None.
16
Section 408.802, F.S. (listing regulated providers).
17
See “Present Situation” in this analysis relating to the definition of “controlling interest” in 408.803(7), F.S.
18
Pursuant to s. 692.201, F.S., “Foreign country of concern” means the People’s Republic of China, the Russian Federation,
the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of
Nicolás Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such
foreign country of concern. BILL: SB 768 Page 5
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:
It is objectively easier to “make reasonable efforts to ensure” rather than “ensure” that
certain business relationships do not exist. It is possible that changes made by the bill
which ease minimum licensure requirements could encourage additional health care
providers to seek licensure and provide health care services in this state.
C. Government Sector Impact:
The AHCA expects this bill to have no fiscal impact on the agency.
19
VI. Technical Deficiencies:
None.
VII. Related Issues:
The AHCA has noted a lack of clarity as to what it means to make a “reasonable effort” as
required by the bill on line 21.
20
Additionally, it may be unclear what the word “direct” means on
line 36.
VIII. Statutes Affected:
This bill substantially amends section 408.810 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
None.
19
Supra note 1.
20
Supra note 1. BILL: SB 768 Page 6
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.