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The Quarterly Dose

New Rules, New Risks: Florida’s Latest Health Care Legislation Explained

The Quarterly Dose – August 2025

August 1, 2025

by Megan J. Nelson

On July 1, 2025, the following laws were enacted and may affect health care providers in Florida. These legislative changes introduce updates to regulatory compliance, patient care protocols and provider responsibilities. This overview highlights key provisions and their practical implications for providers across the state.

HB 519 — Administration of Controlled Substances by Paramedics
The Florida Comprehensive Drug Abuse Prevention and Control Act (Chapter 893, Fla. Stat.) allowed for specific licensed practitioners to authorize the administration of a controlled substance by a licensed nurse or an intern practitioner. It did not expressly include paramedics. Under federal law, the Protecting Patient Access to Emergency Medications Act of 2017 (PPAEMA) created specific rules relevant to the EMS setting, allowing for a paramedic to administer controlled substances outside the physical presence of a medical director if the EMS agency was authorized to do so by state law, was registered with the DEA, and had a standing order or verbal order from a medical director.

What the changes mean:
A licensed practitioner may now authorize a certified paramedic to administer controlled substances in the course of providing emergency services.

HB 647 —Advanced Practice Registered Nurse Services (APRN)
Advanced practice registered nurses were not authorized to file a death certificate or complete a medical certification of cause of death, unless they were registered for autonomous practice.

What the changes mean:
An advanced practice registered nurse providing hospice care may certify the cause of death and file the certificate of death.

SB 958 — Type 1 Diabetes Early Detection Program
This bill created § 381.992, Fla. Stat., and requires the Department of Health, in collaboration with school districts throughout the state, to develop Type 1 diabetes information material related to early detection for the parents and guardians of students. The material must include a description of Type 1 diabetes, the risk factors and warning signs associated with Type 1 diabetes, the process for screening students using a blood autoantibody test, and recommendations for further evaluation for students displaying warning signs or positive early detection screening results.

What the new law means:
Medical providers may see an increase in concerned parents wanting to discuss Type 1 diabetes. However, some parents may not be able to seek medical care due to financial and insurance reasons.

It may be beneficial for pediatricians to reach out to their local school districts and assist with providing additional education and/or workshops for parents.

HB 791 - Surrendered Infants
Section 383.50, Fla. Stat., allows parents to safely surrender infants up to 30 days of life at an emergency medical services station, fire station, or hospital without civil or criminal liability. Existing provisions related to the presumption that the parent intended to surrender the infant, consented to appropriate medical treatment and care, and to the termination of parental rights; the care and custodial processing of an infant upon lawful surrender; and the parent’s anonymity upon surrender remain in effect.

New additions to the law:
The new law extends the previous law to include the surrender of an infant using an infant safety device. An infant safety device is a device that is installed in a supporting wall of a hospital, an emergency medical services station, or a fire station and that has an exterior point of access allowing an individual to place an infant inside and an interior point of access allowing individuals inside the building to safely retrieve the infant.

The infant safety device must be:

  • Physically part of the hospital, emergency medical services station, or fire station and be in a conspicuous and visible area to employees;
  • Temperature controlled and ventilated;
  • Equipped with a dual alarm system which automatically triggers an alarm inside the building when an infant is placed in the device, and the alarm must be tested at least once a week;
  • Equipped with a surveillance system that allows for monitoring the inside of the device 24 hours a day; and 
  • Physically checked at least twice a day.

If the infant safety device is located at an emergency medical services station or fire station, the alarm must also immediately alert 911, and dispatch must send the nearest first responder to retrieve the infant.

HB 1089 — Newborn Screenings
Newborn screening is a preventive public health service provided in every state to identify, diagnose and manage newborns at risk for selected disorders that, without detection and treatment, can lead to permanent development and physical damage or death. The Florida Newborn Screening Program serves to promote the screening of all newborns for metabolic, hereditary and congenital disorders known to result in significant impairment of health or intellect. The program currently screens for 37 core conditions and 23 secondary conditions, nearly all of which are screened for through the collection and testing of blood spots. Hearing screening, critical congenital heart disease and targeted testing for congenital cytomegalovirus are completed at the birthing facility through point of care testing.

What the changes mean:
Duchenne Muscular Dystrophy (DMD) will be added to the Newborn Screening beginning January 1, 2027. DMD is a rare genetic condition, but it is also the most common childhood-onset form of muscular dystrophy. It affects approximately one in every 3,300—5,000 live male births. DMD is an X-linked inherited neuromuscular disorder that can be carried by females, but typically only presents symptomatically in boys. DMD is considered a lethal condition for which there is no curative treatment. However, early diagnoses and a multidisciplinary approach can slow the progression of the disease, prolong the survival rate and maintain a quality of life.

SB 1156 — Home Health Aide for Medically Fragile Children Program
The Home Health Aide for Medically Fragile Children (HHAMFC) Program was created in 2023 in response to the national health care provider shortage and its impact on medically fragile children and their family caregivers to provide an opportunity for family caregivers to receive training and gainful employment. Other Medicaid programs exist that pay a family member to provide home health services to a Medicaid enrollee, but the HHAMFC Program is the only one that pays a family member who is not a licensed nurse for the provision of home health services to a medically fragile child. The program allows a family caregiver to be reimbursed by Medicaid as an HHAMFC once they have completed an approved training program or graduated from an accredited pre-licensure nursing education program and are waiting to take the state licensing exam.

What the changes mean:
The HHAMFC must complete an approved training program, and the employing home health agency must provide validation of the HHAMFC prior to the aide providing services to an eligible relative. The employing home health agency must also provide training on HIV/AIDS and ensure that the HHAMFC holds and maintains a CPR certification.

The training program must consist of at least 76 total hours of training with at least 40 hours of home health aide training, 20 hours of skills training tailored to the needs of the child, 16 hours of clinical training related to the child’s needs, and training on HIV infections and CPR.

Increased the Medicaid utilization cap from eight hours per day to 12 hours per day.

Requires the home health agency to report an adverse incident within 48 hours of the incident.

HB 1195 — Fentanyl Testing
The bill created § 395.1042, Fla. Stat., and requires a hospital or hospital-based off-campus emergency department treating patients for possible drug overdose or poisoning to include testing for fentanyl in the urine drug screening. If the urine test is positive for fentanyl, a second analytical confirmation test must be performed. The results of the urine drug test and confirmation test must be retained as part of the patient’s medical record for the period of time required by the hospital’s current practice.

What the new law means:
Providers must include testing for fentanyl when a patient is suspected of a possible drug overdose or poisoning.

The addition of testing for fentanyl should not be limited to patients who are suspected of a possible drug overdose or poisoning. As fentanyl overdoses are becoming more common in patients who unknowingly take a substance that contains fentanyl, emergency medical providers should include testing for fentanyl when ordering any urine drug screening, including for patients who are disoriented or unconscious for unknown reasons.

HB 1353 — Home Health Care Services
What the changes mean:
An administrator may now manage up to five home health agencies that have the same controlling interest, regardless of where they are located in the state.

The initial admission visit, all service evaluation visits, and the discharge visit that a home health agency must provide may now be performed by a registered nurse who is contracted but not a direct employee of the home health agency.

HB 1421 — Improving Screening for and Treatment of Blood Clots
This bill aims to improve the screening for and treatment of venous thromboembolism or deep vein thrombosis (blood clots).

New additions to the law:
Every hospital with an emergency department and every ambulatory surgical center must develop and implement policies and procedures for the rendering of appropriate medical attention for patients at risk of forming blood clots.

All non-physician personnel must be trained on the policies and procedures annually. A certified nursing assistant (CNA) employed by a nursing home must undergo in-service training which includes recognizing the signs and symptoms of a blood clot and techniques for providing an emergency response.

A CNA wishing to administer medication, as delegated by a registered nurse, must complete training on identifying signs and symptoms of a blood clot and response protocols to assist a patient with a blood clot as part of the 34-hour training course on medication administration.

Assisted living facilities must provide a pamphlet to residents upon admission which contains information about risk factors for, and recognizing signs and symptoms of, a blood clot.

SB 1768 - Stem Cell Therapy
The new law, §§ 458.3245 and 459.0127, Fla. Stat., authorizes physicians to perform stem cell therapies that have not been approved by the FDA when used for orthopedic conditions, wound care or pain management. It sets forth standards for the retrieval, manufacture, storage and use of stem cells, ensuring the stem cells used are obtained from facilities that meet rigorous regulatory and accreditation requirements. Before administering any stem cell therapy, a physician must provide written notice to the patient that the therapy is not approved by the FDA and must obtain signed informed consent clearly informing the patient of the nature and purpose of the proposed treatment prior to initiation of therapy. Any advertisements must include clearly legible writing indicating the stem cell therapy is not approved by the FDA.

Who does the law not apply to:
Physicians who have obtained FDA approval for an investigational new drug or device for the use of human cells, tissues, or cellular or tissue-based products.

Physicians who perform stem cell therapy under an employment or other contract on behalf of an institution that is certified to perform stem cell therapy or has expertise in stem cell therapy as determined by the Department of Health.

Violations of the law:
A violation may subject the physician to disciplinary action by their regulating board.

A physician who willfully performs, or actively participates in, treatment or research using human cells or tissues derived from a fetus or embryo after abortion commits a felony of the third degree.

A physician who willfully performs, or actively participates in, the sale, manufacture or distribution of computer products created using human cells, tissues or cellular tissue-based products commits a felony of the third degree.

SB 1808 — Refund of Overpayments Made by Patients
This bill requires anyone who accepts payment from a patient’s insurance for services rendered by a health care practitioner and determines that a patient has overpaid for said services to refund the overpayment within 30 days. If a health care practitioner fails to timely refund the overpayment, the failure will constitute grounds for disciplinary action. If a facility or provider licensed by the Agency for Health Care Administration fails to timely refund an overpayment, the agency may impose an administrative penalty of up to $500 on the license.

HB 597 — Diabetes Management in Schools
Public schools may acquire and maintain a supply of undesignated glucagon for use on students with diabetes experiencing hypoglycemic emergencies. Public schools are authorized to obtain the glucagon through a prescription from a county health department or authorized healthcare practitioner, or through arrangements with manufacturers or suppliers. This will help decrease the delay in treatment as students with diabetes experiencing a hypoglycemic emergency can now be treated with glucagon even if they don’t have their own medication at school.

SB 1514 —Anaphylaxis in Public and Charter Schools
Schools may maintain a supply of epinephrine auto-injectors (epi-pens), accessible to trained school personnel or authorized students. They must adopt a physician-developed protocol for school personnel, medical and non-medical, who are trained to recognize an anaphylactic reaction and to administer an injection of epinephrine via auto-injection during emergencies. This will help decrease the delay in treatment as students who are experiencing an anaphylactic emergency can receive an injection of epinephrine via an auto-injector by a school nurse or other trained school employee, even if they don’t have their own epi-pen with them. 


 

The Quarterly Dose – August 2025, has been prepared for our readers by Marshall Dennehey. It is solely intended to provide information on recent legal developments and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note to tamontemuro@mdwcg.com. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2025 Marshall Dennehey. All Rights Reserved.

Firm Highlights

Thought Leadership

Featured Conversations... Key Takeaways from A.M. Best’s Webinar on the Misuse Defense in Product Liability Claims, Featuring Michael Salvati

Michael Salvati, shareholder in our Philadelphia office, was a panelist for the April A.M. Best webinar, “The Misuse Defense: Strategic Approaches to Defending Product Liability Claims for Insurers.” During the program, Michael and his fellow panelists offered practical, jurisdiction‑specific guidance on how misuse and failure‑to‑warn theories intersect in modern product liability litigation. Michael emphasized the unique challenges these claims present—particularly in states like Pennsylvania, where evidentiary rules diverge sharply from those applied in many other jurisdictions. Failure to Warn as the “Flip Side” of Misuse Salvati explained that failure‑to‑warn allegations often arise as a direct counter to a misuse defense. As he noted, “If our misuse defense is that the plaintiff didn't use a product properly or safely, then the failure to warn claim is that we didn't tell them how to use it properly.” He emphasized that these claims can stem from either the absence of warnings or criticisms of existing warnings, such as insufficient specificity or lack of clarity about risks. Pennsylvania’s Unique Evidentiary Landscape One of Salvati’s most notable points was the stark difference in how Pennsylvania treats evidence of compliance with industry standards. He highlighted that Pennsylvania is “one of the only states…where that evidence is not admissible” in strict liability cases. Manufacturers cannot rely on compliance with ANSI, UL, ISO, or even federal safety standards to defend the product against a strict liability claim—because the focus is solely on the product itself, not the manufacturer’s conduct. Salvati acknowledged the challenge this creates for defense counsel and clients who expect such compliance to carry weight. Understanding the Three Defect Theories Salvati also walked through the three primary defect theories recognized in many jurisdictions: - Design defect – a flaw in the product’s intended design - Manufacturing defect – a deviation affecting a specific unit - Failure to warn – inadequate instructions or warnings He noted that warnings claims are increasingly significant and sometimes stand alone when design or manufacturing theories are weak. As he put it, plaintiffs often default to warnings claims because “the default position seems to be, ‘If I got hurt, there must be something wrong.’” Warranties and State‑by‑State Variations Salvati addressed how breach‑of‑warranty claims fit into the broader framework, explaining that implied warranties—such as merchantability—often overlap with strict liability in Pennsylvania. He emphasized the importance of understanding local nuances, as warranty law and admissibility rules vary widely across states. Looking Ahead: The Growing Importance of Warnings In his closing remarks, Salvati stressed that warnings should never be treated as an afterthought in product liability defense. He observed that warnings‑only claims are becoming more common and urged manufacturers and insurers to continually evaluate the clarity and completeness of their instructions and warnings. His takeaway: “We should always be talking about what are the instructions that come with our products…to bolster a misuse defense.” Listen to the complete webinar here: https://www3.ambest.com/conferences/events/eventregister.aspx?event_id=WEB1074.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict. 

Thought Leadership

The Enforceability of Online Arbitration Agreements Remains Unresolved in Pennsylvania, But the Pennsylvania Superior Court has Provided Substantive Guidance on the Issue

Key Points: The Pennsylvania Supreme Court confirms that an order compelling arbitration is not immediately appealable as collateral orders. The outcome of Chilutti II has generally left the substantive enforceability issues with browsewrap agreements unresolved in Pennsylvania. Until this issue is resolved by the Pennsylvania courts, companies operating in the Commonwealth should strive to ensure that their registration websites and/or application screens conspicuously present arbitration agreements in manners which ensure their users and consumers assent to the terms of the agreements by following the standards set forth in Chilutti I. Browsewrap agreements have been defined as agreements “‘in which a website offers terms that are disclosed only through a hyperlink and the user supposedly manifests assent to those terms simply by continuing to use the website,’ and typically do not require an electronic signature.” See, Cobb v. Tesla, Inc., 2026 WL 458470, at *1 n. 2 (Pa. Super. Feb. 18, 2026) (citation omitted). They are largely regarded as the “if you keep using this, you agree to everything buried in this link” terms embedded into almost every online agreement consumers and users sign before proceeding with purchases of goods and/or services. While consumers are generally aware of them, many almost never click on the link, nor read them in their entirety. This leaves many consumers and users ignorant of the terms and impact of such agreements. However, one’s ignorance of the otherwise neatly-tucked-away terms rarely renders them unenforceable. The issue of the enforceability of browsewrap agreements has been up for debate for some time in many jurisdictions, including Pennsylvania. Indeed, Pennsylvania had a brief grip on this issue for a period in time. Specifically, in 2023, an en banc Superior Court set forth heightened standards for companies to meet in order to secure assent and enforce browsewrap arbitration agreements. See Chilutti v. Uber Techs., Inc., 300 A.3d 430 (Pa.Super. 2023) (en banc) (“Chilutti I”) Chilutti I involved a husband and wife who sued Uber and its subsidiaries after the wife, a wheelchair bound passenger using Uber’s rideshare service, fell, struck her head, and lost consciousness due to her uber driver failing to provide a seatbelt and making an aggressive turn during the trip. The Chilutti’s filed a negligence lawsuit against Uber and its subsidiaries. In response, the defendants moved to compel arbitration, arguing that “the couple’s conduct on the company’s website and application — when they registered for the ridesharing service — signified that they agreed to be bound by the mandatory arbitration provision found in the hyperlinked terms and conditions.” The trial court granted the defendants’ petition and stayed the proceedings pending the results of arbitration, and the Chilutti’s appealed. On appeal, the Superior Court addressed two issues. First, it addressed the issue of whether it had jurisdiction to hear the appeal. A divided Superior Court determined that it did, with its basis for the holding being that the order from which the Chilutti’s appealed was a collateral order. Next, the Superior Court set out to address the merits of the Chilutti’s substantive claim. The Superior Court concluded that the parties lacked a valid agreement to arbitrate. Its rationale was that Uber’s website and application did not provide reasonably conspicuous notice of the terms to the Chiluttis. In reaching this decision, the en banc Superior Court held that browsewrap arbitration agreements are enforceable in Pennsylvania only if the registration website and application screens explicitly inform consumers that they are waiving the right to a jury trial, the registration process cannot be completed until the consumer is fully informed of this waiver, and, when the agreement is available via hyperlink, the waiver appears at the top of the first page of the terms in bold, capitalized text. Since the ruling, Pennsylvania courts have applied Chilutti I to determine if browsewrap agreements are enforceable.  For instance, the Allegheny County Court of Common Pleas invoked Chilutti I to reject an agreement that lacked an express jury-trial waiver on the assent screen.  See Miller v. Festival Fun Parks, LLC, 92 WDA 2025 (C.P. Alleg. Cnty. Mar. 24, 2025). Similarly, the Superior Court has held that notice which failed to explicitly state the consumer was waiving a jury-trial right did not “me[e]t the strict burden set forth by our en banc Court in Chilutti I.” Pierce v. FloatMe Corp., 348 A.3d 1077, 1088 (Pa. Super. 2025). While the issue of enforceability of browsewrap agreements appeared to have been resolved by Chilutti I, Pennsylvania courts’ grip on this issue has been slackened by the Pennsylvania Supreme Court’s January 21, 2026, opinion in Chilutti II. See Chilutti v. Uber Techs., Inc., 349 A.3d 826 (Pa. 2026) (“Chilutti II”). Therein, the Supreme Court did not address the merits of the Chiluttis’ substantive claim, but rather the issue of whether the Superior Court had appellate jurisdiction to immediately review the orders staying litigation pending arbitration. The Court ultimately vacated the en banc opinion on jurisdictional grounds, holding that the Superior Court did not have appellate jurisdiction because the trial court’s order from which the Chiluttis appealed did not qualify as a collateral order and, thus, the Superior Court erred in holding to the contrary and lacked jurisdiction to entertain the merits” of the Chiluttis’ substantive claim. As such, Chilutti II has rendered Chilutti I nonbinding, and the issue of enforceability of online arbitration agreements remains unresolved. However, in light of the fact the Supreme Court did not address or comment on the merits of the Chiluttis’ appeal, Chilutti I is still meaningful. Specifically, it provides guidance as to the standards a company should strive to meet to ensure they have obtained users’ assent so that they are able to enforce online arbitration agreements. Additionally, it may serve as persuasive authority in judges’ evaluations of petitions and/or motions to compel browsewrap arbitration agreements until this particular issue is properly put before our appellate courts. Keanna works in our Pittsburgh, PA office. She can be reached at (412) 803-1174 or KASeabrooks@MDWCG.com.