Florida Senate - 2025 SB 932 By Senator Jones 34-00613-25 2025932__ 1 A bill to be entitled 2 An act relating to the Health Care Freedom Act; 3 providing a short title; repealing ss. 286.31, 4 286.311, and 381.00321, F.S., relating to the 5 prohibited use of state funds for travel to another 6 state for purpose of abortion services, the prohibited 7 use of state funds for sex-reassignment prescriptions 8 or procedures, and the right of medical conscience of 9 health care providers and health care payors, 10 respectively; creating s. 381.027, F.S.; providing a 11 short title; defining terms; requiring a covered 12 entity to, by a specified date, adopt a policy 13 relating to providing written notice of a complete 14 list of its refused services to patients; providing 15 requirements for such notice; requiring a covered 16 entity to submit a complete list of its refused 17 services to the Department of Health by a specified 18 date; requiring a covered entity to notify the 19 department within a specified timeframe after a change 20 is made to such list; requiring a covered entity to 21 submit the list, along with its application, if 22 applying for certain state grants or contracts; 23 providing a civil penalty; requiring the department to 24 adopt rules; requiring the department to publish and 25 maintain on its website a current list of covered 26 entities and their refused services by a specified 27 date; requiring the department to develop and 28 administer a certain public education and awareness 29 program; providing construction; providing for 30 severability; amending s. 381.96, F.S.; revising the 31 definition of the term eligible client and 32 redefining the term pregnancy and parenting support 33 services as pregnancy support services,; revising 34 department duties and contract requirements to conform 35 to changes made by the act; amending s. 390.011, F.S.; 36 deleting the definition of the term fatal fetal 37 abnormality; amending s. 390.0111, F.S.; revising the 38 timeframe in which a physician may perform a 39 termination of pregnancy; revising exceptions; 40 deleting the prohibition against the use of telehealth 41 to perform abortions, the requirement that medications 42 intended for use in a medical abortion be dispensed in 43 person by a physician, and the prohibition against 44 dispensing such medication through the United States 45 Postal Service or any other courier or shipping 46 service; amending s. 390.012, F.S.; revising rules the 47 Agency for Health Care Administration may develop and 48 enforce to regulate abortion clinics; repealing s. 49 395.3027, F.S., relating to patient immigration status 50 data collection in hospitals; amending s. 409.905, 51 F.S.; defining the terms gender identity and 52 transgender individual; requiring the agency to 53 provide Medicaid reimbursement for medically necessary 54 treatment for or related to gender dysphoria or a 55 comparable or equivalent diagnosis; prohibiting the 56 agency from discriminating in its reimbursement on the 57 basis of a recipients gender identity or that the 58 recipient is a transgender individual; amending s. 59 456.001, F.S.; deleting the definition of the terms 60 sex and sex-reassignment prescriptions or 61 procedures; amending s. 456.47, F.S.; deleting the 62 prohibition against the use of telehealth to perform 63 abortions, including medical abortions; repealing ss. 64 456.52 and 766.318, F.S., relating to sex-reassignment 65 prescriptions and procedures and civil liability for 66 provision of sex-reassignment prescriptions or 67 procedures to minors, respectively; amending ss. 68 61.517, 61.534, 409.908, 409.913, 456.074, and 69 636.0145, F.S.; conforming provisions and cross 70 references to changes made by the act; providing an 71 effective date. 72 73 Be It Enacted by the Legislature of the State of Florida: 74 75 Section 1.This act may be cited as the Health Care 76 Freedom Act. 77 Section 2.Section 286.31, Florida Statutes, is repealed. 78 Section 3.Section 286.311, Florida Statutes, is repealed. 79 Section 4.Section 381.00321, Florida Statutes, is 80 repealed. 81 Section 5.Section 381.027, Florida Statutes, is created to 82 read: 83 381.027Requirements for covered entities; notice of 84 refused services; department duties. 85 (1)SHORT TITLE.This section may be cited as the Health 86 Care Transparency and Accessibility Act. 87 (2)DEFINITIONS.As used in this section, the term: 88 (a)Covered entity means any health care facility that 89 uses, plans to use, or relies upon a denial of care provision to 90 refuse to provide a health care service, or referral for a 91 health care service, for any reason. The term does not include a 92 health care practitioner. 93 (b)Denial of care provision means any federal or state 94 law that purports or is asserted to allow a health care facility 95 to opt out of providing a health care service, or referral for a 96 health care service, including, but not limited to, ss. 97 381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss. 98 18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n; 99 42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of 100 Labor, Health and Human Services, and Education, and Related 101 Agencies Appropriations Act of 2019, Division B of Pub. L. No. 102 115-245; and 45 C.F.R. part 88. 103 (c)Department means the Department of Health. 104 (d)Health care facility has the same meaning as in s. 105 381.026(2). 106 (e)Health care practitioner has the same meaning as in 107 s. 456.001. 108 (f)Health care services has the same meaning as in s. 109 624.27(1). 110 (g)Referral has the same meaning as in s. 456.053(3). 111 (h)Refused service means a health care service that a 112 covered entity chooses not to provide, or not to provide a 113 referral for, based on one or more denials of care provisions. 114 The term includes health care services that the covered entity 115 selectively provides to some, but not all, patients based on 116 their identity, objections to a health care service, or other 117 nonmedical reasons. 118 (3)REQUIREMENTS FOR COVERED ENTITIES; PENALTY. 119 (a)By October 1, 2025, each covered entity shall adopt a 120 policy for providing patients with a complete list of its 121 refused services. A covered entity shall: 122 1.Provide written notice to the patient or the patients 123 representative which includes the complete list of its refused 124 services before any health care service is initiated. 125 a.In the case of an emergency, the covered entity must 126 promptly provide written notice after the patient is capable of 127 receiving such notice or when the patients representative is 128 available. 129 b.The patient or patients representative shall 130 acknowledge receipt of the written notice of refused services. 131 2.Retain all acknowledgments of receipt of the written 132 notice of refused services for a period of at least 3 years. 133 3.Provide a complete list of its refused services to any 134 person upon request. 135 (b)By October 1, 2025, a covered entity shall submit to 136 the department a complete list of its refused services. If any 137 change is made to the list, the covered entity must notify the 138 department within 30 days after making the change. 139 (c)If applying for any state grant or contract related to 140 providing a health care service, a covered entity must submit, 141 along with its application, a complete list of its refused 142 services. 143 (d)A covered entity that fails to comply with this 144 subsection is subject to a fine not to exceed $5,000 for each 145 day the covered entity is not in compliance. 146 (4)DEPARTMENT DUTIES. 147 (a)The department shall adopt rules to implement this 148 section which must include a process for receiving and 149 investigating complaints regarding covered entities not in 150 compliance with this section. 151 (b)By January 1, 2026, the department shall publish and 152 maintain on its website a current list of covered entities and 153 the refused services for each covered entity. 154 (c)The department shall develop and administer a public 155 education and awareness program regarding the denial of health 156 care services, including how the denial of health care services 157 can negatively impact health care access and quality, how the 158 denial of health care services may be avoided, and how the 159 denial of health care services affects vulnerable people and 160 communities. 161 (5)CONSTRUCTION. 162 (a)This section does not authorize denials of health care 163 services or discrimination in the provision of health care 164 services. 165 (b)This section does not limit any cause of action under 166 state or federal law, or limit any remedy in law or equity, 167 against a health care facility or health care practitioner. 168 (c)Compliance with this section does not reduce or limit 169 any potential liability for covered entities associated with the 170 refused services or any violations of state or federal law. 171 (d)Section 761.03 does not provide a claim relating to, or 172 a defense to a claim under, this section, or provide a basis for 173 challenging the application or enforcement of this section or 174 the use of funds associated with the application or enforcement 175 of this section. 176 (6)SEVERABILITY.If any provision of this section or its 177 application to any person or circumstance is held invalid, the 178 invalidity does not affect other provisions or applications of 179 this section which can be given effect without the invalid 180 provision or application, and to this end the provisions of this 181 section are severable. 182 Section 6.Section 381.96, Florida Statutes, is amended to 183 read: 184 381.96Pregnancy support and wellness services. 185 (1)DEFINITIONS.As used in this section, the term: 186 (a)Department means the Department of Health. 187 (b)Eligible client means any of the following: 188 1.a pregnant woman or a woman who suspects she is 189 pregnant, and the family of such woman, who voluntarily seeks 190 pregnancy support services and any woman who voluntarily seeks 191 wellness services. 192 2.A woman who has given birth in the previous 12 months 193 and her family. 194 3.A parent or parents or a legal guardian or legal 195 guardians, and the families of such parents and legal guardians, 196 for up to 12 months after the birth of a child or the adoption 197 of a child younger than 3 years of age. 198 (c)Florida Pregnancy Care Network, Inc., or network 199 means the not-for-profit statewide alliance of pregnancy support 200 organizations that provide pregnancy support and wellness 201 services through a comprehensive system of care to women and 202 their families. 203 (d)Pregnancy and parenting support services means 204 services that promote and encourage childbirth, including, but 205 not limited to: 206 1.Direct client services, such as pregnancy testing, 207 counseling, referral, training, and education for pregnant women 208 and their families. A woman and her family remain eligible to 209 receive direct client services for up to 12 months after the 210 birth of the child. 211 2.Nonmedical material assistance that improves the 212 pregnancy or parenting situation of families, including, but not 213 limited to, clothing, car seats, cribs, formula, and diapers. 214 3.Counseling or mentoring, education materials, and 215 classes regarding pregnancy, parenting, adoption, life skills, 216 and employment readiness. 217 4.Network awareness activities, including a promotional 218 campaign to educate the public about the pregnancy support 219 services offered by the network and a website that provides 220 information on the location of providers in the users area and 221 other available community resources. 222 3.5.Communication activities, including the operation and 223 maintenance of a hotline or call center with a single statewide 224 toll-free number that is available 24 hours a day for an 225 eligible client to obtain the location and contact information 226 for a pregnancy center located in the clients area. 227 (e)Wellness services means services or activities 228 intended to maintain and improve health or prevent illness and 229 injury, including, but not limited to, high blood pressure 230 screening, anemia testing, thyroid screening, cholesterol 231 screening, diabetes screening, and assistance with smoking 232 cessation. 233 (2)DEPARTMENT DUTIES.The department shall contract with 234 the network for the management and delivery of pregnancy and 235 parenting support services and wellness services to eligible 236 clients. 237 (3)CONTRACT REQUIREMENTS.The department contract must 238 shall specify the contract deliverables, including financial 239 reports and other reports due to the department, timeframes for 240 achieving contractual obligations, and any other requirements 241 the department determines are necessary, such as staffing and 242 location requirements. The contract must shall require the 243 network to: 244 (a)Establish, implement, and monitor a comprehensive 245 system of care through subcontractors to meet the pregnancy and 246 parenting support and wellness needs of eligible clients. 247 (b)Establish and manage subcontracts with a sufficient 248 number of providers to ensure the availability of pregnancy and 249 parenting support services and wellness services for eligible 250 clients, and maintain and manage the delivery of such services 251 throughout the contract period. 252 (c)Spend at least 90 85 percent of the contract funds on 253 pregnancy and parenting support services, excluding services 254 specified in subparagraph (1)(d)4., and wellness services. 255 (d)Offer wellness services through vouchers or other 256 appropriate arrangements that allow the purchase of services 257 from qualified health care providers. 258 (e)Require a background screening under s. 943.0542 for 259 all paid staff and volunteers of a subcontractor if such staff 260 or volunteers provide direct client services to an eligible 261 client who is a minor or an elderly person or who has a 262 disability. 263 (f)Annually Monitor its subcontractors annually and 264 specify the sanctions that will shall be imposed for 265 noncompliance with the terms of a subcontract. 266 (g)Subcontract only with providers that exclusively 267 promote and support childbirth. 268 (h)Ensure that informational materials provided to an 269 eligible client by a provider are current and accurate and cite 270 the reference source of any medical statement included in such 271 materials. 272 (i)Ensure that the department is provided with all 273 information necessary for the report required under subsection 274 (5). 275 (4)SERVICES.Services provided pursuant to this section 276 must be provided in a noncoercive manner and may not include any 277 religious content. 278 (5)REPORT.By July 1, 2024, and each year thereafter, the 279 department shall report to the Governor, the President of the 280 Senate, and the Speaker of the House of Representatives on the 281 amount and types of services provided by the network; the 282 expenditures for such services; and the number of, and 283 demographic information for, women, parents, and families served 284 by the network. 285 Section 7.Subsection (6) of section 390.011, Florida 286 Statutes, is amended to read: 287 390.011Definitions.As used in this chapter, the term: 288 (6)Fatal fetal abnormality means a terminal condition 289 that, in reasonable medical judgment, regardless of the 290 provision of life-saving medical treatment, is incompatible with 291 life outside the womb and will result in death upon birth or 292 imminently thereafter. 293 Section 8.Subsections (1) and (2) of section 390.0111, 294 Florida Statutes, are amended to read: 295 390.0111Termination of pregnancies. 296 (1)TERMINATION IN THIRD TRIMESTER AFTER GESTATIONAL AGE OF 297 6 WEEKS; WHEN ALLOWED.A physician may not knowingly perform or 298 induce a termination of pregnancy on any person in the third 299 trimester of pregnancy if the physician determines the 300 gestational age of the fetus is more than 6 weeks unless one of 301 the following conditions is met: 302 (a)Two physicians certify in writing that, in reasonable 303 medical judgment, the termination of the pregnancy is necessary 304 to save the pregnant womans life or avert a serious risk of 305 substantial and irreversible physical impairment of a major 306 bodily function of the pregnant woman other than a psychological 307 condition. 308 (b)The physician certifies in writing that, in reasonable 309 medical judgment, there is a medical necessity for legitimate 310 emergency medical procedures for termination of the pregnancy to 311 save the pregnant womans life or avert a serious risk of 312 imminent substantial and irreversible physical impairment of a 313 major bodily function of the pregnant woman other than a 314 psychological condition, and another physician is not available 315 for consultation. 316 (c)The pregnancy has not progressed to the third trimester 317 and two physicians certify in writing that, in reasonable 318 medical judgment, the fetus has a fatal fetal abnormality. 319 (d)The pregnancy is the result of rape, incest, or human 320 trafficking and the gestational age of the fetus is not more 321 than 15 weeks as determined by the physician. At the time the 322 woman schedules or arrives for her appointment to obtain the 323 abortion, she must provide a copy of a restraining order, police 324 report, medical record, or other court order or documentation 325 providing evidence that she is obtaining the termination of 326 pregnancy because she is a victim of rape, incest, or human 327 trafficking. If the woman is 18 years of age or older, the 328 physician must report any known or suspected human trafficking 329 to a local law enforcement agency. If the woman is a minor, the 330 physician must report the incident of rape, incest, or human 331 trafficking to the central abuse hotline as required by s. 332 39.201. 333 (2)IN-PERSON PERFORMANCE BY PHYSICIAN REQUIRED.Only a 334 physician may perform or induce a termination of pregnancy. A 335 physician may not use telehealth as defined in s. 456.47 to 336 perform an abortion, including, but not limited to, medical 337 abortions. Any medications intended for use in a medical 338 abortion must be dispensed in person by a physician and may not 339 be dispensed through the United States Postal Service or by any 340 other courier or shipping service. 341 Section 9.Subsection (1) of section 390.012, Florida 342 Statutes, is amended to read: 343 390.012Powers of agency; rules; disposal of fetal 344 remains. 345 (1)The agency may develop and enforce rules pursuant to 346 ss. 390.011-390.018 and part II of chapter 408 for the health, 347 care, and treatment of persons in abortion clinics and for the 348 safe operation of such clinics. The rules must be reasonably 349 related to the preservation of maternal health of the clients, 350 must be in accordance with s. 797.03, may not impose an 351 unconstitutional burden on a womans freedom to decide whether 352 to terminate her pregnancy, and must provide for all of the 353 following: 354 (a)The performance of pregnancy termination procedures 355 only by a licensed physician. 356 (b)The making, protection, and preservation of patient 357 records, which must be treated as medical records under chapter 358 458. When performing a license inspection of a clinic, the 359 agency shall inspect at least 50 percent of patient records 360 generated since the clinics last license inspection. 361 (c)Annual inspections by the agency of all clinics 362 licensed under this chapter to ensure that such clinics are in 363 compliance with this chapter and agency rules. 364 (d)The prompt investigation of credible allegations of 365 abortions being performed at a clinic that is not licensed to 366 perform such procedures. 367 Section 10.Section 395.3027, Florida Statutes, is 368 repealed. 369 Section 11.Present subsections (4) through (12) of section 370 409.905, Florida Statutes, are redesignated as subsections (5) 371 through (13), respectively, and a new subsection (4) is added to 372 that section, to read: 373 409.905Mandatory Medicaid services.The agency may make 374 payments for the following services, which are required of the 375 state by Title XIX of the Social Security Act, furnished by 376 Medicaid providers to recipients who are determined to be 377 eligible on the dates on which the services were provided. Any 378 service under this section shall be provided only when medically 379 necessary and in accordance with state and federal law. 380 Mandatory services rendered by providers in mobile units to 381 Medicaid recipients may be restricted by the agency. Nothing in 382 this section shall be construed to prevent or limit the agency 383 from adjusting fees, reimbursement rates, lengths of stay, 384 number of visits, number of services, or any other adjustments 385 necessary to comply with the availability of moneys and any 386 limitations or directions provided for in the General 387 Appropriations Act or chapter 216. 388 (4)GENDER-AFFIRMING CARE. 389 (a)Definitions.As used in this section, the term: 390 1.Gender identity means an individuals internal sense 391 of that individuals gender, regardless of the sex assigned to 392 that individual at birth. 393 2.Transgender individual means an individual who 394 identifies as a gender different from the sex assigned to that 395 individual at birth. 396 (b)Reimbursement.The agency shall provide reimbursement 397 for medically necessary treatment for or related to gender 398 dysphoria as defined by the Diagnostic and Statistical Manual of 399 Mental Disorders, Fifth Edition, published by the American 400 Psychiatric Association or a comparable or equivalent diagnosis. 401 (c)Discrimination prohibited.The agency may not 402 discriminate in its reimbursement of medically necessary 403 treatment on the basis of the recipients gender identity or on 404 the basis that the recipient is a transgender individual. 405 Section 12.Subsections (8) and (9) of section 456.001, 406 Florida Statutes, are amended to read: 407 456.001Definitions.As used in this chapter, the term: 408 (8)Sex means the classification of a person as either 409 male or female based on the organization of the human body of 410 such person for a specific reproductive role, as indicated by 411 the persons sex chromosomes, naturally occurring sex hormones, 412 and internal and external genitalia present at birth. 413 (9)(a)Sex-reassignment prescriptions or procedures 414 means: 415 1.The prescription or administration of puberty blockers 416 for the purpose of attempting to stop or delay normal puberty in 417 order to affirm a persons perception of his or her sex if that 418 perception is inconsistent with the persons sex as defined in 419 subsection (8). 420 2.The prescription or administration of hormones or 421 hormone antagonists to affirm a persons perception of his or 422 her sex if that perception is inconsistent with the persons sex 423 as defined in subsection (8). 424 3.Any medical procedure, including a surgical procedure, 425 to affirm a persons perception of his or her sex if that 426 perception is inconsistent with the persons sex as defined in 427 subsection (8). 428 (b)The term does not include: 429 1.Treatment provided by a physician who, in his or her 430 good faith clinical judgment, performs procedures upon or 431 provides therapies to a minor born with a medically verifiable 432 genetic disorder of sexual development, including any of the 433 following: 434 a.External biological sex characteristics that are 435 unresolvably ambiguous. 436 b.A disorder of sexual development in which the physician 437 has determined through genetic or biochemical testing that the 438 patient does not have a normal sex chromosome structure, sex 439 steroid hormone production, or sex steroid hormone action for a 440 male or female, as applicable. 441 2.Prescriptions or procedures to treat an infection, an 442 injury, a disease, or a disorder that has been caused or 443 exacerbated by the performance of any sex-reassignment 444 prescription or procedure, regardless of whether such 445 prescription or procedure was performed in accordance with state 446 or federal law. 447 3.Prescriptions or procedures provided to a patient for 448 the treatment of a physical disorder, physical injury, or 449 physical illness that would, as certified by a physician 450 licensed under chapter 458 or chapter 459, place the individual 451 in imminent danger of death or impairment of a major bodily 452 function without the prescription or procedure. 453 Section 13.Paragraph (f) of subsection (2) of section 454 456.47, Florida Statutes, is amended to read: 455 456.47Use of telehealth to provide services. 456 (2)PRACTICE STANDARDS. 457 (f)A telehealth provider may not use telehealth to perform 458 an abortion, including, but not limited to, medical abortions as 459 defined in s. 390.011. 460 Section 14.Section 456.52, Florida Statutes, is repealed. 461 Section 15.Section 766.318, Florida Statutes, is repealed. 462 Section 16.Subsection (1) of section 61.517, Florida 463 Statutes, is amended to read: 464 61.517Temporary emergency jurisdiction. 465 (1)A court of this state has temporary emergency 466 jurisdiction if the child is present in this state and: 467 (a)The child has been abandoned; or 468 (b)It is necessary in an emergency to protect the child 469 because the child, or a sibling or parent of the child, is 470 subjected to or threatened with mistreatment or abuse; or 471 (c)It is necessary in an emergency to protect the child 472 because the child has been subjected to or is threatened with 473 being subjected to sex-reassignment prescriptions or procedures, 474 as defined in s. 456.001. 475 Section 17.Subsection (1) of section 61.534, Florida 476 Statutes, is amended to read: 477 61.534Warrant to take physical custody of child. 478 (1)Upon the filing of a petition seeking enforcement of a 479 child custody determination, the petitioner may file a verified 480 application for the issuance of a warrant to take physical 481 custody of the child if the child is likely to imminently suffer 482 serious physical harm or removal from this state. Serious 483 physical harm includes, but is not limited to, being subjected 484 to sex-reassignment prescriptions or procedures as defined in s. 485 456.001. 486 Section 18.Paragraph (a) of subsection (1) of section 487 409.908, Florida Statutes, is amended to read: 488 409.908Reimbursement of Medicaid providers.Subject to 489 specific appropriations, the agency shall reimburse Medicaid 490 providers, in accordance with state and federal law, according 491 to methodologies set forth in the rules of the agency and in 492 policy manuals and handbooks incorporated by reference therein. 493 These methodologies may include fee schedules, reimbursement 494 methods based on cost reporting, negotiated fees, competitive 495 bidding pursuant to s. 287.057, and other mechanisms the agency 496 considers efficient and effective for purchasing services or 497 goods on behalf of recipients. If a provider is reimbursed based 498 on cost reporting and submits a cost report late and that cost 499 report would have been used to set a lower reimbursement rate 500 for a rate semester, then the providers rate for that semester 501 shall be retroactively calculated using the new cost report, and 502 full payment at the recalculated rate shall be effected 503 retroactively. Medicare-granted extensions for filing cost 504 reports, if applicable, shall also apply to Medicaid cost 505 reports. Payment for Medicaid compensable services made on 506 behalf of Medicaid-eligible persons is subject to the 507 availability of moneys and any limitations or directions 508 provided for in the General Appropriations Act or chapter 216. 509 Further, nothing in this section shall be construed to prevent 510 or limit the agency from adjusting fees, reimbursement rates, 511 lengths of stay, number of visits, or number of services, or 512 making any other adjustments necessary to comply with the 513 availability of moneys and any limitations or directions 514 provided for in the General Appropriations Act, provided the 515 adjustment is consistent with legislative intent. 516 (1)Reimbursement to hospitals licensed under part I of 517 chapter 395 must be made prospectively or on the basis of 518 negotiation. 519 (a)Reimbursement for inpatient care is limited as provided 520 in s. 409.905(6) s. 409.905(5), except as otherwise provided in 521 this subsection. 522 1.If authorized by the General Appropriations Act, the 523 agency may modify reimbursement for specific types of services 524 or diagnoses, recipient ages, and hospital provider types. 525 2.The agency may establish an alternative methodology to 526 the DRG-based prospective payment system to set reimbursement 527 rates for: 528 a.State-owned psychiatric hospitals. 529 b.Newborn hearing screening services. 530 c.Transplant services for which the agency has established 531 a global fee. 532 d.Recipients who have tuberculosis that is resistant to 533 therapy who are in need of long-term, hospital-based treatment 534 pursuant to s. 392.62. 535 3.The agency shall modify reimbursement according to other 536 methodologies recognized in the General Appropriations Act. 537 538 The agency may receive funds from state entities, including, but 539 not limited to, the Department of Health, local governments, and 540 other local political subdivisions, for the purpose of making 541 special exception payments, including federal matching funds, 542 through the Medicaid inpatient reimbursement methodologies. 543 Funds received for this purpose shall be separately accounted 544 for and may not be commingled with other state or local funds in 545 any manner. The agency may certify all local governmental funds 546 used as state match under Title XIX of the Social Security Act, 547 to the extent and in the manner authorized under the General 548 Appropriations Act and pursuant to an agreement between the 549 agency and the local governmental entity. In order for the 550 agency to certify such local governmental funds, a local 551 governmental entity must submit a final, executed letter of 552 agreement to the agency, which must be received by October 1 of 553 each fiscal year and provide the total amount of local 554 governmental funds authorized by the entity for that fiscal year 555 under this paragraph, paragraph (b), or the General 556 Appropriations Act. The local governmental entity shall use a 557 certification form prescribed by the agency. At a minimum, the 558 certification form must identify the amount being certified and 559 describe the relationship between the certifying local 560 governmental entity and the local health care provider. The 561 agency shall prepare an annual statement of impact which 562 documents the specific activities undertaken during the previous 563 fiscal year pursuant to this paragraph, to be submitted to the 564 Legislature annually by January 1. 565 Section 19.Subsection (36) of section 409.913, Florida 566 Statutes, is amended to read: 567 409.913Oversight of the integrity of the Medicaid 568 program.The agency shall operate a program to oversee the 569 activities of Florida Medicaid recipients, and providers and 570 their representatives, to ensure that fraudulent and abusive 571 behavior and neglect of recipients occur to the minimum extent 572 possible, and to recover overpayments and impose sanctions as 573 appropriate. Each January 15, the agency and the Medicaid Fraud 574 Control Unit of the Department of Legal Affairs shall submit a 575 report to the Legislature documenting the effectiveness of the 576 states efforts to control Medicaid fraud and abuse and to 577 recover Medicaid overpayments during the previous fiscal year. 578 The report must describe the number of cases opened and 579 investigated each year; the sources of the cases opened; the 580 disposition of the cases closed each year; the amount of 581 overpayments alleged in preliminary and final audit letters; the 582 number and amount of fines or penalties imposed; any reductions 583 in overpayment amounts negotiated in settlement agreements or by 584 other means; the amount of final agency determinations of 585 overpayments; the amount deducted from federal claiming as a 586 result of overpayments; the amount of overpayments recovered 587 each year; the amount of cost of investigation recovered each 588 year; the average length of time to collect from the time the 589 case was opened until the overpayment is paid in full; the 590 amount determined as uncollectible and the portion of the 591 uncollectible amount subsequently reclaimed from the Federal 592 Government; the number of providers, by type, that are 593 terminated from participation in the Medicaid program as a 594 result of fraud and abuse; and all costs associated with 595 discovering and prosecuting cases of Medicaid overpayments and 596 making recoveries in such cases. The report must also document 597 actions taken to prevent overpayments and the number of 598 providers prevented from enrolling in or reenrolling in the 599 Medicaid program as a result of documented Medicaid fraud and 600 abuse and must include policy recommendations necessary to 601 prevent or recover overpayments and changes necessary to prevent 602 and detect Medicaid fraud. All policy recommendations in the 603 report must include a detailed fiscal analysis, including, but 604 not limited to, implementation costs, estimated savings to the 605 Medicaid program, and the return on investment. The agency must 606 submit the policy recommendations and fiscal analyses in the 607 report to the appropriate estimating conference, pursuant to s. 608 216.137, by February 15 of each year. The agency and the 609 Medicaid Fraud Control Unit of the Department of Legal Affairs 610 each must include detailed unit-specific performance standards, 611 benchmarks, and metrics in the report, including projected cost 612 savings to the state Medicaid program during the following 613 fiscal year. 614 (36)The agency may provide to a sample of Medicaid 615 recipients or their representatives through the distribution of 616 explanations of benefits information about services reimbursed 617 by the Medicaid program for goods and services to such 618 recipients, including information on how to report inappropriate 619 or incorrect billing to the agency or other law enforcement 620 entities for review or investigation, information on how to 621 report criminal Medicaid fraud to the Medicaid Fraud Control 622 Units toll-free hotline number, and information about the 623 rewards available under s. 409.9203. The explanation of benefits 624 may not be mailed for Medicaid independent laboratory services 625 as described in s. 409.905(8) s. 409.905(7) or for Medicaid 626 certified match services as described in ss. 409.9071 and 627 1011.70. 628 Section 20.Paragraph (c) of subsection (5) of section 629 456.074, Florida Statutes, is amended to read: 630 456.074Certain health care practitioners; immediate 631 suspension of license. 632 (5)The department shall issue an emergency order 633 suspending the license of any health care practitioner who is 634 arrested for committing or attempting, soliciting, or conspiring 635 to commit any act that would constitute a violation of any of 636 the following criminal offenses in this state or similar 637 offenses in another jurisdiction: 638 (c)Section 456.52(5)(b), relating to prescribing, 639 administering, or performing sex-reassignment prescriptions or 640 procedures for a patient younger than 18 years of age. 641 Section 21.Section 636.0145, Florida Statutes, is amended 642 to read: 643 636.0145Certain entities contracting with Medicaid.An 644 entity that is providing comprehensive inpatient and outpatient 645 mental health care services to certain Medicaid recipients in 646 Hillsborough, Highlands, Hardee, Manatee, and Polk Counties 647 through a capitated, prepaid arrangement pursuant to the federal 648 waiver provided for in s. 409.905(6) s. 409.905(5) must become 649 licensed under this chapter by December 31, 1998. Any entity 650 licensed under this chapter which provides services solely to 651 Medicaid recipients under a contract with Medicaid is exempt 652 from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and 653 636.066(1). 654 Section 22.This act shall take effect July 1, 2025.