The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Health Policy
BILL: SB 780
INTRODUCER: Senator Gainer
SUBJECT: Health Care Licensure Requirements
DATE: February 16, 2021 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Brown Brown HP Favorable
2. MS
3. RC
I. Summary:
SB 780 creates s. 456.0231, F.S., to require the Department of Health (DOH) to grant physicians,
as defined under the bill, who are employees of the U.S. Department of Veterans Affairs (VA) an
exemption from Florida’s physician licensure requirements if such physicians submit proof of
out-of-state licensure, proof of VA employment, and an attestation that they will only treat
veterans in Florida-licensed hospitals or pursuant to their employment with the VA.
The bill provides an effective date of July 1, 2021.
II. Present Situation:
Regulation of Health Care Practitioners in Florida
The DOH is responsible for the regulation of health care practitioners and certain health care
facilities in Florida for the preservation of the health, safety, and welfare of the public. The
Division of Medical Quality Assurance (MQA), working in conjunction with 22 boards1 and four
councils, licenses and regulates seven types of health care facilities, and more than 200 license
types, in more than 40 health care professions.2 Any person desiring to be a licensed health care
professional in Florida must apply to the MQA in writing.3 Most health care professions are
regulated by a board or council in conjunction with the DOH, and all professions have different
requirements for initial licensure and licensure renewal.4
1
Under s. 456.001(1), F.S., the term “board” is defined as any board, commission, or other statutorily created entity, to the
extent such entity is authorized to exercise regulatory or rulemaking functions within the DOH or, in some cases, within the
MQA.
2 Florida Department of Health, Medical Quality Assurance, Annual Report and Long Range Plan, 2019-2020, available at
http://www.floridahealth.gov/licensing-and-regulation/reports-and-publications/documents/2019-2020-annual-report.pdf (last
visited Feb. 3, 2021).
3 Section 456.013, F.S.
4 See chs. 401, 456-468, 478, 480, 483, 484, 486, 490, and 491, F.S.
BILL: SB 780 Page 2
Licensing of Florida Physicians
Statutes regulating the practices of medicine and osteopathic medicine fall under chapters 458
and 459, F.S., respectively. The practice acts for both professions establish the regulatory boards,
a variety of licenses, the application process with eligibility requirements, and financial
responsibilities for the practicing physicians. The respective board for each practice has the
authority to establish, by rule, standards of practice and standards of care for particular settings. 5
Such standards may include education and training, medication including anesthetics, assistance
of and delegation to other personnel, sterilization, performance of complex or multiple
procedures, records, informed consent, and policy and procedures manuals.6
The current licensure application fee for a medical doctor7 is $350 and is non-refundable.
Applications must be completed within one year. If a license is approved, the initial license fee is
$355. The entire process may take from two to six months from the time the application is
received.8
For osteopathic physicians, the current application fee is a non-refundable $200, and if approved,
the initial licensure fee is $305.9 Applications must be completed within one year. The entire
process may take from two to six months from the time the application is received. If an
applicant is licensed in another state, the applicant may seek Florida licensure by requesting the
Board of Osteopathic Medicine (BOOM) to “endorse” the exam scores of the others state’s
licensing exam. The applicant must demonstrate that the out-of-state license was issued based on
those exam scores. The applicant must also show that the exam was substantially similar to any
exam that Florida allows for licensure.10
The general requirements for licensure under both practice acts are very similar with the obvious
differences found in the educational backgrounds of the applicants. However, the practice acts
are not identical in their licensure offerings as shown in the table below. Where the practice acts
share the most similarities are the qualifications for licensure. Both the Board of Medicine
(BOM) and the BOOM require their respective applicants to:
 Complete an application form as designated by the appropriate regulatory board.
 Be at least 21 years of age.
 Be of good moral character.
 Have completed at least two years (medical) or three years (osteopathic) of pre-professional
post-secondary education.
 Have not previously committed any act that would constitute a violation of this chapter or
lead to regulatory discipline.
5
Sections 458.331(1)(v) and 459.015(1)(z), F.S.
6
Id.
7
Medical doctors are also known as allopathic physicians.
8
Florida Board of Medicine, Medical Doctor Unrestricted – Process, available at
https://flboardofmedicine.gov/licensing/medical-doctor-unrestricted (last visited Feb. 3, 2021).
9
Florida Board of Osteopathic Medicine, Osteopathic Medicine Full Licensure - Fees, available at
https://floridasosteopathicmedicine.gov/licensing/osteopathic-medicine-full-licensure/#tab-fees (last visited Feb. 3, 2021).
10
Florida Board of Osteopathic Medicine, Osteopathic Medicine Full Licensure – Requirements, available at
https://floridasosteopathicmedicine.gov/licensing/osteopathic-medicine-full-licensure (last visited Feb. 3, 2021).
BILL: SB 780 Page 3
 Have not had an application for a license to practice medicine or osteopathic medicine denied
or a license revoked, suspended or otherwise acted upon in another jurisdiction by another
licensing authority.
 Submit a set of fingerprints to the DOH for a criminal background check.
 Demonstrate that he or she is a graduate of a medical college recognized and approved by the
applicant’s respective professional association.
 Demonstrate that she or he has successfully completed a resident internship (osteopathic
medicine) or supervised clinical training (medical) of not less than 12 months in a hospital
approved for this purpose by the applicant’s respective professional association.
 Demonstrate that he or she has obtained a passing score, as established by the applicant’s
appropriate regulatory board, on all parts of the designated professional examination
conducted by the regulatory board’s approved medical examiners no more than five years
before making application to this state; or, if holding a valid active license in another state,
that the initial licensure in the other state occurred no more than five years after the applicant
obtained a passing score on the required examination.11
Statutory References for Practice Acts – Licensure of
Medical Doctors and Osteopathic Physicians: Chapters 458 and 459, F.S.
Issue Medical Doctors Osteopathic Physicians
Regulatory Board Board of Medicine Board of Osteopathic
s. 458.307, F.S. Medicine
s. 459.004, F.S.
Rulemaking Authority s. 458.309., F.S. s. 459.005, F.S.
General Requirements for s. 458.311, F.S. s. 459.0055, F.S.
Licensure
Licensure Types:
Restricted License s. 458.310, F.S. No provision
Restricted License s. 458.3115, F.S. No provision
Certain foreign physicians
Licensure by Endorsement s. 458.313, F.S. No provision
Temporary Certificate s. 458.3135, F.S. No provision
(Approved Cancer Centers)
Temporary Certificate s. 458.3137, F.S. No provision
(Training Programs)
Medical Faculty Certificate s. 458.3145, F.S. s. 459.0077, F.S.
Temporary Certificate s. 458.315, F.S. s. 459.0076, F.S.
Areas of Critical Need
Temporary Certificate s. 458.3151, F.S. s. 459.00761, F.S.
Areas of Critical Need –
Active Duty Military &
Veterans
Public Health Certificate s. 458.316, F.S. No provision
Public Psychiatry s. 458.3165, F.S. No provision
Certificate
11
See ss. 458.311, F.S. and 459.0055, F.S.
BILL: SB 780 Page 4
Statutory References for Practice Acts – Licensure of
Medical Doctors and Osteopathic Physicians: Chapters 458 and 459, F.S.
Issue Medical Doctors Osteopathic Physicians
Limited Licenses s. 458.317, F.S. s. 459.0075, F.S.
Expert Witness s. 458.3175, F.S. s. 459.0066, F.S.
License Renewal s. 458.319, F.S. s. 459.008, F.S.
$500/max/biennial renewal
Financial Responsibility s. 458.320, F.S. s. 459.0085, F.S.
Condition of Licensure
Penalty for Violations s. 458.327, F.S. s. 459.013, F.S.
To practice medicine as an allopathic physician12 in Florida, an individual must become a
licensed medical doctor through licensure by examination13 or licensure by endorsement.14
Florida does not automatically recognize another state’s medical license or provide licensure
reciprocity. Licensure by endorsement requires the medical physician to meet one of the
following requirements:
 Be a graduate of an allopathic United States medical school recognized and approved by the
United States Department of Education and completed at least one year of residency training;
 Be a graduate of an allopathic international medical school and have a valid Educational
Commission for Foreign Medical Graduates (ECFMG) certificate and completed an
approved residency of at least two years in one specialty area; or
 Be a graduate who has completed the formal requirements of an international medical school
except the internship or social service requirements, passed parts I and II of the National
Board of Medical Examiners (NBME) or ECFMG equivalent examination, and completed an
academic year of supervised clinical training (5th pathway) and completed an approved
residency of at least two years in one specialty area.
 And both of the following:
o Passed all parts of a national examination (the NBME; the Federation Licensing
Examination offered by the Federation of State Medical Boards of the United States, Inc.;
or the United States Medical Licensing Exam); and
o Be licensed in another jurisdiction and actively practiced medicine in another jurisdiction
for at least two of the immediately preceding four years; or passed a board-approved
clinical competency examination within the year preceding filing of the application or;
successfully completed a board approved postgraduate training program within two years
preceding filing of the application.15
Financial Responsibility
As a condition of licensure, all Florida-licensed allopathic physicians are required to maintain
professional liability insurance or other financial responsibility to cover potential claims for
medical malpractice as a condition of licensure, with specified exemptions.16 Physicians who
12
Supra, note 7.
13
Section 458.311, F.S.
14
Section 458.313, F.S.
15
Florida Board of Medicine, Medical Doctor-Unrestricted; Licensure by Endorsement, available at
https://flboardofmedicine.gov/licensing/medical-doctor-unrestricted (last visited Feb. 3, 2021).
16
Section 458.320, F.S.
BILL: SB 780 Page 5
perform surgeries in a certain setting or have hospital privileges must maintain professional
liability insurance or other financial responsibility to cover an amount not less than $250,000 per
claim.17 Physicians without hospital privileges must carry sufficient insurance or other financial
responsibility in coverage amounts of not less than $100,000 per claim.18 Certain physicians who
are exempt from the requirement to carry professional liability insurance or other financial
responsibility must provide notice to their patients.19
Florida-licensed osteopathic physicians have similar financial responsibility requirements as
allopathic physicians.20 With specified exceptions, the DOH must suspend, on an emergency
basis, any licensed allopathic or osteopathic physician who fails to satisfy a medical malpractice
claim against him or her within specified time frames.21
Disciplinary Process: Fines and Sanctions
Chapter 456, F.S., contains the general regulatory provisions for health care professions and
occupations under the MQA. Section 456.072, F.S., specifies 40 acts that constitute grounds for
which disciplinary actions may be taken against a health care practitioner. Section 458.331, F.S.,
identifies 43 acts that constitute grounds for which disciplinary actions may be taken against a
medical physician, and s. 459.015, F.S., identifies those acts which are specific to an osteopathic
physician. Some parts of the review process are public and some are confidential.22
Complaints and allegations are received by the MQA unit for determination of legal sufficiency
and investigation. A determination of legal sufficiency is made if the ultimate facts show that a
violation has occurred.23 The complainant is notified by letter as to the whether the complaint
will be investigated and if any additional information is needed. Complaints that involve an
immediate threat to public safety are given the highest priority.
The DOH is responsible for reviewing each report to determine if discipline against the provider
is warranted.24 Authorization for the discipline of allopathic and osteopathic physicians can be
found in state law and administrative rule.25 If held liable for one of the offenses, the fines and
sanctions by category and by offense are based on whether the offense is the physician’s first,
second, or third offense.26 The boards may issue a written notice of noncompliance for the first
17
Section 458.320(2), F.S.
18
Section 458.320(1), F.S.
19
Section 458.320(5)(f) and (g), F.S.
20
Section 459.0085, F.S.
21
Sections 458.320(8) and 459.0085(9), F.S.
22
Florida Department of Health, Division of Medical Quality Assurance, Enforcement Process, available at
http://www.floridahealth.gov/licensing-and-regulation/enforcement/documents/enforcement-process-chart.pdf (last updated
Nov. 2019) (last visited Feb. 3, 2021).
23
Florida Department of Health, Consumer Services – Administrative Complaint Process, available at
http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-complaint-process/consumer-services.html (last
visited Feb. 3, 2021).
24
See ss. 458.351(5) and 459.026(5), F.S.
25
See ss. 458.307 and 459.004, F.S., for the regulatory boards, and Florida Admin. Code R. ss. 64B8-8 and 64B15-19, for
administrative rules relating to disciplinary procedures.
26
Id.
BILL: SB 780 Page 6
occurrence of a single minor violation.27 The amount of fines assessed can vary depending on the
severity of the situation, such as improper use of a substance to concealment of a material fact. A
penalty may come in the form of a reprimand, a licensure suspension, or revocation followed by
some designated period of probation if there is an opportunity for licensure reinstatement. Other
sanctions may include supplemental continuing education requirements, which require proof of