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 Rules
BILL: CS/CS/SB 768
INTRODUCER: Judiciary Committee; Health Policy Committee and Senator Calatayud
SUBJECT: Controlling Business Interests by Persons with Ties to Foreign Countries of Concern
DATE: April 7, 2025
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Smith Brown HP Fav/CS
2. Collazo Cibula JU Fav/CS
3. Smith Yeatman RC Favorable
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/CS/SB 768 requires health care providers, as a condition of licensure, to ensure that a person
or entity that possesses a direct controlling interest in the health care provider does not directly
hold 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. Foreign
countries of concern include China, Russia, Iran, North Korea, Cuba, the Venezuelan regime of
Nicolas Maduro, and Syria. Scrutinized companies may include those that boycott Israel or have
prohibited operations in Cuba, Iran, Sudan, or Syria.
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. These changes would ease heightened requirements for licensees
who may not have access to the information that they need to ensure that they satisfy those
current licensure requirements.
The bill provides an effective date of July 1, 2025.
REVISED: BILL: CS/CS/SB 768 Page 2
II. Present Situation:
Health Care Licensing Procedures Act
The Health Care Licensing Procedures Act
1
provides a streamlined and consistent set of basic
licensing requirements for health care providers, including the 49,823 health care providers that
are currently licensed, registered, or certified by the Florida Agency for Health Care
Administration (AHCA) as of February 21, 2025.
2
The Act is intended to minimize confusion, standardize terminology, and include issues that are
not otherwise addressed in state law pertaining to specific providers.
3
Among other things, it
provides certain minimum licensure requirements that applicants must satisfy to obtain and
maintain a license.
4
The issuance of a license is not a contract or an agreement between the state
and the licensee,
5
but rather a privilege that is granted by the state based upon the licensee
complying with licensure and certification requirements.
6
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.
7
One such additional requirement
8
requires a licensee to ensure that a person or entity possessing
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
In connection with this additional requirement, the term “controlling interest” means:
• The applicant or licensee;
• 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
1
Chapter 408, Part II, F.S.; see also s. 408.801(1), F.S. (providing the short title).
2
Section 408.801(2), F.S.; Agency for Health Care Administration (AHCA), Senate Bill 768 Legislative Analysis (Feb. 19,
2025) (on file with the Senate Committee on Health Policy). 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. Section 408.802, F.S.
3
Section 408.801(2), F.S.
4
See generally s. 408.810, F.S. (specifying minimum licensure requirements).
5
Senate Bill 768 Legislative Analysis, supra note 3, at 2.
6
Id.
7
Chapter 2023-22, s. 10, Laws of Fla.
8
Section 408.810(15), F.S.
9
Section 287.135, F.S. BILL: CS/CS/SB 768 Page 3
• 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.
10
Additionally:
• “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.
11
• “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.
12
• “Interest” 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.
13
According to AHCA, 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.
14
Pursuant to the statute outlining the license application process for the
Act, proof of compliance with the controlling interest requirement must be submitted with any
application for licensure or licensure renewal.
15
In practice, AHCA verifies the background screening of individuals possessing a controlling
interest (generally 5 percent or more) in the licensee if their names are listed on the application.
16
However, some business entities having a controlling interest in a licensee have chosen to not
name or disclose individuals. AHCA reports that aside from the application process, there is no
mechanism by which its staff can verify whether the controlling interest requirement has been
satisfied.
17
AHCA also notes that it is a registered user of the SAVE Program of the U.S.
Department of Homeland Security
18
and can determine the status of nonimmigrant aliens
10
Section 408.803(7), F.S. The term does not include a voluntary board member. Id.
11
Section 408.810(15)(b)1., F.S.
12
Section 408.810(15)(b)2., F.S. (incorporating by reference the definition of same in s. 692.201(3), F.S).
13
Section 408.810(15)(b)3., F.S. (incorporating by reference the definition of same in s. 286.101(1)(g), F.S.).
14
Senate Bill 768 Legislative Analysis, supra note 3, at 2.
15
Section 408.806(5), F.S.
16
Section 408.809(1)(d), F.S.
17
Senate Bill 768 Legislative Analysis, supra note 3, at 2.
18
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 visited Mar. 21, 2025). BILL: CS/CS/SB 768 Page 4
possessing controlling interests in home health agencies, home medical equipment providers, and
health care clinics.
19
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.
20
The bill adds
the words “direct” and “directly” to subsection (15), so that a licensee would be required to
ensure that a person or entity who possesses a direct controlling interest in the licensee does not
also directly hold, 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.
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.
The bill removes the concept of engaging in “any other apparatus of business or commerce”
from the definition of “business relationship”, for purposes of this requirement.
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.
21
, 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.
19
Senate Bill 768 Legislative Analysis, supra note 3, at 2.
20
Section 408.802, F.S. (listing regulated providers).
21
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: CS/CS/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 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.
22
VI. Technical Deficiencies:
None.
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill substantially amends section 408.810 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Substantial Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
CS/CS by Judiciary on April 1, 2025:
The committee substitute restores the requirement that licensees “ensure,” not just “make
reasonable efforts to ensure,” that a specified business relationship does not exist.
CS by Health Policy on March 18, 2025:
The committee substitute revises the application of the requirement in the underlying bill
that a licensee must make a reasonable effort to ensure that a person or entity that
22
Senate Bill 768 Legislative Analysis, supra note 3, at 3-4. BILL: CS/CS/SB 768 Page 6
possesses a “controlling interest” (as defined in the underlying bill) does not have a
specified business relationship. Instead, the CS requires the licensee to ensure that a
person or entity that possesses a direct controlling interest does not have such a
relationship. It also deletes the definition of “controlling interest” which is already
defined for the chapter in current law.
The underlying bill required the licensee to ensure that such a person or entity does not
directly or indirectly hold a specified business relationship. The CS removes “indirectly”
and requires the licensee to ensure that such a person or entity does not directly hold such
a relationship.
The CS removes the concept of engaging in “any other apparatus of business or
commerce” from the definition of “business relationship,” for purposes of the bill’s
overall requirement.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.