HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 583 Health Care Practitioner Titles and Abbreviations
SPONSOR(S): Healthcare Regulation Subcommittee, Massullo
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Healthcare Regulation Subcommittee 17 Y, 0 N, As CS Osborne McElroy
2) Health & Human Services Committee 15 Y, 3 N Osborne Calamas
SUMMARY ANALYSIS
The Division of Medical Quality Assurance (MQA), within the Department of Health (DOH), has general
regulatory authority over health care practitioners. The MQA works in conjunction with 22 boards and four
councils to license and regulate seven types of health care facilities and more than 40 health care professions.
An unlicensed individual may be subject to administrative action or criminal penalties if the individual states or
otherwise implies that he or she is a licensed medical professional. This may include the use of certain terms
or titles that the public generally associates with a specific medical profession. DOH does not license
specialties or sub-specialties based upon board certification, but current law does limit who can hold
themselves out as board-certified specialists.
Current law authorizes regulatory boards (or DOH) to discipline health care practitioners for violations related
to how they represent their professional identities, including:
Making misleading, deceptive, or fraudulent representations in or related to the practice of the
licensee’s profession; or
Failing to identify to a patient the type of license under which the practitioner is practicing.
CS/HB 583 further regulates the way in which health care practitioners represent their professions. The bill
specifies the titles and abbreviations that health care practitioners may use in advertisements,
communications, and personal identification. Any unauthorized use of a title, abbreviation, or educational
degree constitutes a misleading, deceptive, or fraudulent representation by the health care practitioner.
CS/HB 583 requires any advertisement for health care services naming a practitioner to identify the profession
under which the practitioner is practicing and the practitioner’s educational degree. The bill also requires health
care practitioners to wear name badges, establishes requirements for name badges, and provides exemptions.
The bill directs each board, or DOH if there is no regulatory board, to establish rules determining how
practitioners must comply with this requirement.
The bill authorizes DOH or the boards, as applicable, to discipline any health care practitioner who violates the
provisions of the bill.
The bill has an insignificant, negative fiscal impact on DOH, and no fiscal impact on local governments.
The bill provides an effective date of July 1, 2023.
FULL ANALYSIS
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
STORAGE NAME: h0583c.HHS
DATE: 4/18/2023
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Health Care Practitioners Licensure and Regulation
The Division of Medical Quality Assurance (MQA), within the Department of Health (DOH), has general
regulatory authority over health care practitioners.1 The MQA works in conjunction with 22 boards and
four councils to license and regulate seven types of health care facilities and more than 40 health care
professions.2 Each profession is regulated by an individual practice act and by ch. 456, F.S., which
provides general regulatory and licensure authority for the MQA. MQA is statutorily responsible for the
following boards and professions established within the division:3
The Board of Acupuncture, created under ch. 457, F.S.;
The Board of Medicine, created under ch. 458, F.S.;
The Board of Osteopathic Medicine, created under ch. 459, F.S.;
The Board of Chiropractic Medicine, created under ch. 460, F.S.;
The Board of Podiatric Medicine, created under ch. 461, F.S.;
Naturopathy, as authorized under ch. 462, F.S.;
The Board of Optometry, created under ch. 463, F.S.;
The Board of Nursing, created under part I of ch. 464, F.S.;
Nursing assistants, as authorized under part II of ch. 464, F.S.;
The Board of Pharmacy, created under ch. 465, F.S.;
The Board of Dentistry, created under ch. 466, F.S.;
Midwifery, as authorized under ch. 467, F.S.;
The Board of Speech-Language Pathology and Audiology, created under part I of ch. 468, F.S.;
The Board of Nursing Home Administrators, created under part II of ch. 468, F.S.;
The Board of Occupational Therapy, created under part III of ch. 468, F.S.;
Respiratory therapy, as authorized under part V of ch. 468, F.S.;
Dietetics and nutrition practice, as authorized under part X of ch. 468, F.S.;
The Board of Athletic Training, created under part XIII of ch. 468, F.S.;
The Board of Orthotists and Prosthetists, created under part XIV of ch. 468, F.S.;
Electrolysis, as authorized under ch. 478, F.S.;
The Board of Massage Therapy, created under ch. 480, F.S.;
The Board of Clinical Laboratory Personnel, created under part III of ch. 483, F.S.;
Medical physicists, as authorized under part IV of ch. 483, F.S.;
The Board of Opticianry, created under part I of ch. 484, F.S.;
The Board of Hearing Aid Specialists, created under part II of ch. 484, F.S.;
The Board of Physical Therapy Practice, created under ch. 486, F.S.;
The Board of Psychology, created under ch. 490, F.S.;
School psychologists, as authorized under ch. 490, F.S.;
The Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health
Counseling, created under ch. 491, F.S.; and
Emergency medical technicians and paramedics, as authorized under part III of ch. 401, F.S.
1 Pursuant to s. 456.001(4), F.S., health care practitioners are defined to include acupuncturists, physicians, physician assis tants,
chiropractors, podiatrists, naturopaths, dentists, dental hygienists, optometrists, nurses, nursing assistants, pharmacists , midwives,
speech language pathologists, nursing home administrators, occupational therapists, respiratory therapists, dieticians, athle tic trainers,
orthotists, prosthetists, electrologists, massage therapists, clinical laboratory personnel, medical phys icists, dispensers of optical
devices or hearing aids, physical therapists, psychologists, social workers, counselors, and psychotherapists, among others.
2 Florida Department of Health, Division of Medical Quality Assurance, Annual Report and Long-Range Plan, Fiscal Year 2021-2022, p.
5. Available at https://www.floridahealth.gov/licensing-and-regulation/reports -and-publications/_documents/annual-report-2122.pdf (last
visited March 28, 2023).
3 S. 456.001(4), F.S; Id.
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DOH and the practitioner boards have different roles in the regulatory system. Boards act as the
governing body of a specified profession; they establish practice standards by rule, pursuant to
statutory authority and directives, and determine disciplinary action against practitioners who have
violated the practice standards. DOH receives and investigates complaints against practitioners and
facilitates the legal response when necessary.
DOH, on behalf of the professional boards, investigates legally sufficient complaints against
practitioners.4 Once an investigation is complete, DOH presents the investigatory findings to the
boards. DOH recommends a course of action to the appropriate board’s probable cause panel5 which
may include:6
Having the file reviewed by an expert;
Issuing a closing order; or
Filing an administrative complaint.
The boards determine the course of action and any disciplinary action to take against a practitioner.7
For professions in which there is no board, DOH determines the action and discipline to take against a
practitioner and issues the final orders.8 DOH is responsible for ensuring that licensees comply with the
terms and penalties imposed by the boards.9 If a case is appealed, DOH attorneys defend the final
actions of the boards before the appropriate appellate court. 10
Board Certification and Florida Licensure
DOH licenses health care practitioners by profession according to the requirements established in
statute and rule. DOH does not, however, license health care practitioners by specialty or subspecialty;
rather, private national specialty boards grant board certification to practitioners. 11 Examples of such
boards include the American Board of Medical Specialties (ABMS), the Accreditation Board for
Specialty Nursing Certification, and the American Board of Dental Specialties. 12
Current law limits which health care practitioners may hold themselves out as board-certified
specialists. An allopathic physician may not hold himself or herself out as a board-certified specialist
unless he or she has received formal recognition as a specialist from a specialty board of the ABMS or
other recognizing agency13 approved by the allopathic board.14 Similarly, an osteopathic physician may
not hold himself or herself out as a board-certified specialist unless he or she has successfully
completed the requirements for certification by the American Osteopathic Association (AOA) or the
Accreditation Council on Graduate Medical Education (ACGME) and is certified as a specialist by a
certifying agency15 approved by the board.16
4 Department of Health, Investigative Services. Available at http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-
complaint-process/isu.html (last visited March 28, 2023).
5 See also, Department of Health, A Quick Guide to the MQA Disciplinary Process: Prob ab le Cause Panels. Available at
https://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-complaint-process/_documents/a-quick-guide-to-the-mqa-
disciplinary-process.pdf
6 Department of Health, Prosecution Services. Available at http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-
complaint-process/psu.html (last visited March 28, 2023).
7 S. 456.072(2), F.S.
8 Id. Professions which do not have a board include naturopathy, nursing assistants, midwifery, respiratory therapy, dietetics an d
nutrition, electrolysis, medical physicists, and school psychologists.
9 Supra, note 6.
10 Id.
11 Examples of specialties include dermatology, emergency medicine , ophthalmology, pediatric medicine, certified registered nurse
anesthetist, clinical nurse specialist, cardiac nurse, nurse practitioner, endodontics, orthodontics, and pediatric dentistry.
12 See also, The American Board of Medical Specialties website ava ilable at https://www.abms.org/ (last visited April 15, 2023). The
Accreditation Board for Specialty Nursing Certification website available at https://absnc.org/ (last visited April 15, 2023). The American
Board of Dental Specialties website available at https://dentalspecialties.org/ (last visited April 15, 2023).
13 The allopathic board has approved the specialty boards of the ABMS as recognizing agencies. See, Rule 64B8-11.001(1)(f), F.A.C.
14 S. 458.3312, F.S.
15 The osteopathic board has approved the specialty boards of the ABMS and AOA as recognizing agencies. See, Rule 64B15-
14.001(h), F.A.C.
16 S. 459.0152, F.S.
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A dentist may not hold himself or herself out as a specialist, or advertise membership in or specialty
recognition by an accrediting organization, unless the dentist has completed a specialty education
program approved by the American Dental Association and the Commission on Dental Accreditation
and the dentist is:17
Eligible for examination by a national specialty board recognized by the American Dental
Association; or
A diplomate of a national specialty board recognized by the American Dental Association.
If a dentist announces or advertises a specialty practice for which there is not an approved accrediting
organization, the dentist must clearly state that the specialty is not recognized or that the accrediting
organization has not been approved by the American Dental Association or the Florida Board of
Dentistry.18
Additionally, an advanced practice registered nurse may not advertise or hold himself or herself out as
a specialist for which he or she has not received certification. 19
By rule, the Board of Chiropractic Medicine (BCM) prohibits chiropractors from using deceptive,
fraudulent, and misleading advertising. The BCM permits chiropractors to advertise that they have
attained Diplomate status in a chiropractic specialty area recognized by the BCM. BCM-recognized
specialties include those which are recognized by the Councils of the American Chiropractic
Association, the International Chiropractic Association, the International Academy of Clinical Neurology,
or the International Chiropractic Pediatric Association.20
Professional Specialty Designations
Section 456.072, F.S., authorizes a regulatory board or DOH, if there is no board, to discipline a health
care practitioner’s licensure for a number of offenses, including but not limited to:
Making misleading, deceptive, or fraudulent representations in or related to the practice of the
licensee’s profession; or
Failing to identify to a patient the type of license under which the practitioner is practicing.
Using a term designating a medical specialty for which a non-physician practitioner has not completed
a residency or fellowship program accredited or recognized by the ACGME or the AOA in such
specialty is not expressly grounds for discipline under current law. 21
If the board or DOH finds that a licensee committed a violation, the board or DOH may: 22
Refuse to certify, or to certify with restrictions, an application for a license;
Suspend or permanently revoke a license;
Place a restriction on the licensee’s practice or license;
Impose an administrative fine not to exceed $10,000 for each count or separate offense; if the
violation is for fraud or making a false representation, a fine of $10,000 must be imposed for
each count or separate offense;
Issue a reprimand or letter of concern;
Place the licensee on probation;
Require a corrective action plan;
17 S. 466.0282, F.S. A dentist may also hold himself or herself out as a specialist if the dentist has continuously held himself or herself
out as a specialist since December 31, 1964, in a specialty recogni zed by the American Dental Association.
18 S. 466.0282(3), F.S.
19 S. 464.018(1)(s), F.S.
20 Rule 64B-15.001(2)(e), F.A.C. Examples of chiropractic specialties include chiropractic acupuncture, chiropractic internist,
chiropractic and clinical nutrition, radiology chiropractic, and pediatric chiropractors.
21 See also, ss. 458.331(1)(ll) and 459.015(1)(nn), F.S., wherein allopathic and osteopathic physicians may be subject to discipline for
advertising a board-certified specialty for which they are not qualified.
22 S. 456.073(1), F.S.
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Refund fees billed and collected from the patient or third party on behalf of the patient; or
Require the licensee to undergo remedial education.
Effect of the Bill
CS/HB 583 further regulates the way in which health care practitioners represent their professions.
Professional Designations
CS/HB 583 specifies the specific titles and abbreviations that may be used by allopathic and
osteopathic physicians, chiropractic physicians, podiatric physicians, dentists, anesthesiologist
assistants, and optometrists. The bill specifies that health care practitioners, regardless of whether they
are specified in the bill, may also use the titles and abbreviations used in their respective practice acts.
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Current law authorizes licensure discipline for “deceptive or misleading terms or false representation.”
The bill further specifies what constitutes misleading, deceptive, or fraudulent representation and
incorporates a misrepresentation of a practitioner’s educational degree into qualifying offenses.
CS/HB 583 requires any advertisement for health care services naming a practitioner to identify the
profession and educational degree as related to the services featured in the advertisement.
For the purposes of the bill, an advertisement means any printed, electronic, or oral statement that:
Is communicated or disseminated to the general public.
Is intended to encourage a person to us