.

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

Court Allows Recklessness and Punitive Damages Claims to Proceed After Work‑Zone Crash

In a case where a defendant filed preliminary objections against allegations of recklessness and punitive damages, the Susquehanna County Court of Common Pleas denied these preliminary objections. This case stems from a motor vehicle accident, where the defendants car struck the plaintiffs car after the defendant allegedly fell asleep at the wheel, going at a high rate of speed, through a construction work zone. Defendant first objected to the general allegations throughout the plaintiff’s complaint pertaining to “reckless” conduct contending that there were insufficient factual allegations to support the claim of reckless conduct. Defendant next objected to the plaintiffs claim for punitive damages, as punitive damages may only be assessed against a motorist for falling asleep while driving if there is further evidence to prove driver was aware of their drowsiness and risk of falling asleep. Lastly, defendant objected to plaintiffs complaint, claiming it lacked specificity. The court here found that the plaintiff had included in the complaint specific allegations related to the defendant’s alleged recklessness, including allegations regarding speeding in a work zone, almost striking the flagger, falling asleep at the wheel, and striking the plaintiffs vehicle which was stopped. Additionally, the court noted that falling asleep does not come without warning. The court found that these allegations were sufficient to support an allegation of recklessness at the pleadings stage.

Thought Leadership

New Jersey Appellate Division Affirms Exclusion of Legal Malpractice Expert as Impermissible Net Opinion

Jack Slimm and Jeremy Zacharias obtained a favorable decision on behalf of their client in a case centering on the admissibility of expert testimony in legal malpractice actions. In Martin v. Loury, the New Jersey Appellate Division affirmed the exclusion of a plaintiff's legal malpractice expert, holding that the expert's opinions on causation and damages were too speculative to support the malpractice claim. The legal malpractice action arose from an underlying employment dispute involving claims for damages stemming from the breach of an employment agreement. The plaintiff alleged that defense counsel committed malpractice during a second trial by failing to recall the plaintiff as a rebuttal witness after the employer's CEO testified. According to the plaintiff's expert, additional rebuttal testimony would have bolstered the plaintiff's damages claims and led to a more favorable result. Both the trial court and the Appellate Division rejected that theory. The courts found that the expert could not explain how the proposed rebuttal testimony would have altered the outcome of the underlying case or resulted in any additional recoverable damages. Notably, the trial judge in the underlying employment matter had already rejected the CEO's testimony as not credible and had accepted the damages analysis advanced by the plaintiff. The court had also determined that the amount of damages was not genuinely disputed. As a result, the expert's opinion that additional rebuttal testimony would have produced a better outcome was unsupported by the record and based on speculation rather than evidence. The Appellate Division agreed that neither the plaintiff nor the expert could identify any actual damages attributable to the alleged malpractice or demonstrate the required element of proximate causation. The court further upheld the trial court's application of New Jersey's net opinion doctrine, finding that the expert failed to provide the necessary "why and wherefore" supporting his conclusion that the attorney's conduct caused a compensable loss. Because the opinions rested on unquantified possibilities rather than demonstrable facts, they were inadmissible. Key Takeaway for Legal Malpractice Defendants For attorneys and firms defending legal malpractice claims, Martin v. Loury underscores the importance of closely scrutinizing an opponent's expert report on the critical elements of proximate causation and damages. The decision demonstrates that a malpractice claim cannot survive where an expert merely speculates that different litigation tactics might have produced a better result. Instead, the plaintiff must present admissible expert testimony grounded in the record that explains how the alleged attorney error probably changed the outcome of the underlying matter and resulted in measurable damages.

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

Supreme Court of Pennsylvania Holds That Public Policy Does Not Prevent Insurance Coverage for Sex Trafficking Claims

On July 21, 2026, the Supreme Court of Pennsylvania issued an opinion emphasizing the limited circumstances in which courts may invoke public policy to bar insurance coverage, holding in Samsung Fire & Marine Insurance Co., Ltd. (U.S. Branch) v. RI Settlement Trust that Pennsylvania public policy does not preclude coverage for claims alleging that insureds enabled or profited from human sex trafficking. The decision rejects a line of federal district court decisions predicting otherwise and reinforces that Pennsylvania courts will invoke the public policy doctrine only in the clearest of circumstances. RI Settlement is particularly significant because it arose on certified questions from the United States Court of Appeals for the Third Circuit, giving the Supreme Court the opportunity to resolve an issue on which federal courts had predicted Pennsylvania law differently. RI Settlement arose out of four separate civil complaints in which the underlying plaintiffs alleged that, as minors, they were the victims of human sex trafficking at various hotels in Philadelphia. The plaintiffs claimed that the hotel owners were negligent in failing to stop the sex trafficking from happening at their hotels. After the filing of the lawsuits, the hotel owners sought coverage under their Commercial General Liability policies. The insurers initially defended the hotels under Reservation of Rights letters, though the carriers later filed Declaratory Judgment actions seeking declarations that they did not owe a duty to defend or indemnify. In short, the insurers argued in the alternative that they did not owe any obligation to provide coverage based upon Pennsylvania public policy (because the claims violated the Human Trafficking Law – 18 Pa.C.S. § 3011) and the terms and conditions of the policy. On motions for judgment on the pleadings, the District Court found for the insurers on the basis of public policy: There is no duty to defend or indemnify against actions arising out of an insured's criminal conduct related to the sex trafficking of minors. The Court appreciates that it may make public policy the basis of a judicial decision only in “the clearest of cases.” See Minnesota Fire & Cas. Co. v. Greenfield, 589 A.2d 854, 868 (Pa. 2004) (quoting Hall v. Amica Mut. Ins. Co., 648 A.2d 755, 760 (Pa. 1994)). Yet, the Court strains to imagine a clearer case than the one presented here in which the facts alleged indicate that Policyholders engaged in criminal conduct in violation of Pennsylvania's Human Trafficking Law. The hotel owners appealed the matter to the Third Circuit, which petitioned the Supreme Court of Pennsylvania to grant review of two certified questions of law: (1) whether Pennsylvania law had an “overriding public policy” against sex trafficking, such that an insurer’s duty to defend and/or indemnify is abrogated when an insured is alleged to have enabled or profited from such trafficking; and (2) if yes, is that duty abrogated whenever the insured’s alleged conduct would constitute a violation of the Pennsylvania Human Trafficking statute. Importantly, the certified questions did not ask the Supreme Court to determine whether the policies afforded coverage under their terms. Rather, the court was asked only whether Pennsylvania public policy independently barred coverage. As a result, the court assumed for purposes of answering the certified questions that the insurers otherwise owed a duty to defend and addressed only the public policy issue, leaving all policy-based coverage defenses for further proceedings. Because the court concluded that the answer to the first certified question was “no”, it did not reach the second issue. In reaching its determination that Pennsylvania public policy does not prohibit insurance coverage for sex trafficking claims, the court limited the impact of its decision in Minnesota Fire & Cas. Co. v. Greenfield, 855 A. 2d 854, 855 (Pa. 2004), which the RI Settlement opinion emphasized as having been an “Opinion Announcing Judgment of the Court” – or a plurality opinion. In Greenfield, the insured homeowner was sued by the estate of his houseguest who overdosed from heroin that he sold to her. The matter wound its way to the Supreme Court, which determined that the insurer did not owe a duty to defend or indemnify based upon Pennsylvania public policy, which criminalized the sale and use of heroin as a Schedule I narcotic. In RI Settlement, the court “decline[d] the invitation” to extend the rationale of the three-justice plurality in Greenfield beyond cases involving Schedule I controlled substances. In so holding, the justices in RI Settlement refused to “divine an overriding public policy pronouncement by the General Assembly by virtue of its enactment of the Human Trafficking Law.” The opinion further states that it is not “within the purview of this Court to rank the magnitude of the public policy underlying the various crimes defined in the Crimes Code. It is sufficient for the work of the courts to know that the General Assembly has identified conduct it deems harmful and dangerous to the maintenance of an orderly society and criminalized it.” While the court declined to declare that Pennsylvania public policy prohibits coverage for sex trafficking claims, the opinion in RI Settlement expressly states that insurers are free to include appropriate exclusionary language for such causes of actions in their policies if they desire to do so. It will certainly be interesting to see whether the insurance industry accepts the court’s invitation, or perhaps whether the Pennsylvania legislature steps in to clarify that sex trafficking claims are indeed of the type or magnitude that they should not be covered by insurance. In any event, we will, of course, continue to monitor this and other insurance coverage issues that arise before courts in Pennsylvania, New Jersey and throughout our firm’s geographic footprint and around the country.