Press release https://atapadvocates.com

[Washington, DC] [April 21, 2026] -- The Alliance for Transparent and Affordable Prescriptions (ATAP), a coalition of more than 20 patient advocacy, medical professional, and healthcare organizations dedicated to improving prescription drug affordability, will convene on Capitol Hill April 21–22 for its 2026 Hill Day.

Bringing together physicians, patient advocates, and healthcare leaders from across the country, ATAP’s annual fly-in comes at a pivotal moment as momentum continues to build in Congress for meaningful pharmacy benefit manager (PBM) reform. Participants will meet with lawmakers and key congressional staff to advocate for policies that lower out-of-pocket costs and ensure patients have access to the medications they need.

“Patients remain stuck in a system where rising drug prices benefit middlemen rather than the people who rely on these medications,” said Dr. Robert Levin, President of ATAP. “Our message to Congress is simple: the time for incremental change has passed. We need structural reforms that prioritize patients, not profits.”

During this year’s Hill Day, ATAP members will focus on advancing bipartisan solutions that address the misaligned incentives embedded in the PBM business model. Chief among these is ending the practice of tying PBM compensation to a drug’s list price, which can encourage the selection of higher-cost treatments over more affordable options.

In addition, advocates will continue to push for policies that ensure negotiated discounts and rebates are delivered directly to patients at the pharmacy counter, reducing their immediate financial burden rather than being retained within the system.

ATAP’s delegation is scheduled to meet with a broad range of congressional offices, including members of key committees with jurisdiction over healthcare policy, as well as leadership offices in both chambers. These conversations will highlight real-world experiences from patients and providers navigating a system that too often delays care, limits treatment options, and increases costs.

ATAP’s Hill Day will also feature a congressional briefing focused on the growing challenges associated with prior authorization requirements and the role PBMs play in exacerbating delays in patient care. The briefing will take place on April 21 at 12:00 PM in the Cannon House Office Building Room 240 and will bring together policymakers, staff, and healthcare stakeholders to examine how current practices impact timely access to treatment.

Dr. Harry Gewanter, a leading physician voice within ATAP and representative of the Coalition of State Rheumatology Organizations, will participate in the discussion, highlighting how burdensome prior authorization requirements, often driven or administered by PBMs, can delay critical care, disrupt treatment plans, and increase administrative strain on providers.

Coinciding with its Hill Day activities, ATAP also announced it has become a member of the PBM Accountability Project, a growing national coalition focused on increasing transparency and oversight of PBM practices.

“This collaboration strengthens our ability to advocate for long-overdue accountability in the prescription drug marketplace,” Dr. Levin said. “By working alongside a diverse group of stakeholders, we are amplifying the call for reforms that bring transparency to a system that has operated without sufficient scrutiny for far too long.”

The PBM Accountability Project unites employers, unions, pharmacists, and consumer advocates in a coordinated effort to expose practices such as spread pricing, rebate retention, and restrictive formularies that can drive up costs and limit access to care. ATAP’s physician-led perspective brings an important clinical voice to the coalition’s efforts, underscoring the direct impact these practices have on patient outcomes.

“Frontline providers see every day how barriers created by PBMs interfere with treatment decisions and patient care,” Dr. Levin added. “Joining this effort allows us to more effectively advocate for policies that restore transparency, strengthen the doctor-patient relationship, and ensure savings reach the people who need them most.”

As Congress continues to evaluate proposals to reform the prescription drug supply chain, ATAP leaders emphasized that sustained engagement from patients and providers is critical to achieving meaningful change.

“We are encouraged by the growing bipartisan interest in PBM reform,” said Dr. Levin. “But encouragement must translate into action. Patients across the country cannot afford further delay.”

To learn more about ATAP and its mission, visit https://atapadvocates.com. For more information about the PBM Accountability Project, visit https://www.pbmaccountability.org/.

“I don’t think a corporation … should be telling people what they can and can’t do,” said the retiree, who suffers from arthritis. "My doctors know me. I know my doctors. and when I'm in pain—which is every morning, waking up to two fists that can barely open—I need something to take care of the pain.”

What’s the role of AI in insurance?

The use of AI in insurance promises that all the rules governing insurance will be followed at a much quicker pace, industry representatives say. V7 Labs, for example, a London-based company that automates document-heavy tasks using AI agents, promises on its website to dispatch tasks that would take 30 to 60 minutes in a traditional claims process to two to three minutes.

Already, 84 percent of the nation’s health insurers are using AI for sensitive processes, like prior authorization for medical care and detecting fraud, the National Association of Insurance Commissioners found in a 2024-25 survey. NAIC is the industry’s standard-setting and support organization.

In 2023, the same organization found that 70% of property insurance companies in the U.S. were using AI or were interested in using it, and 88% of auto insurers were using or planning to use it. How well it can be relied on to interpret the nuances of human needs and evaluate individual circumstances, however, is at the forefront of political debate.

What is the AI law in Florida?

A state bill that would have required all denials to involve a human being garnered bipartisan support in the last legislative session.

“While these tools can improve speed and efficiency, no Floridian should ever have a claim denied based solely on an automated output,” said state Rep. Hillary Cassel, R-Dania Beach, who sponsored the bill that passed the House but failed to advance to the Senate.

The bill, she said, “establishes a clear and reasonable safeguard. It requires that any decision to deny a claim or portion of a claim must be made by a qualified human professional who independently reviews the facts, verifies any AI generated information and documents the basis for that decision.”

Industry representatives lined up against the bill that died. It would also seem to conflict with President Donald Trump’s executive order that no state law should regulate AI. The advancement of AI should not be hamstrung by a “patchwork of 50 different regulatory regimes,” that would put it at a competitive disadvantage with other countries’ AI development, the Dec. 11 executive order says.

Property and auto insurance regulations vary state by state, however, and it’s likely the one area that a case could be made that AI’s application to insurance should be regulated on the state level, said Gabriel Carrillo, program director for the Center for Risk Management and Insurance Education at the University of Central Florida College of Business.

“When you talk about property and casualty insurance, when you talk about life insurance, it’s almost completely regulated at the state level,” Carrillo said.

Does my insurance company use AI?

Industry representatives came before a state House committee to assure lawmakers that AI in insurance has guardrails. Although it’s a machine deciding, those decisions must comply with state rules for settling claims. They also made the case that AI’s speed and efficiency in processing claims could mean lower costs will be passed onto policyholders.

AI’s faster processing will make no difference, according to industry representatives.

“At the end of the day, who is responsible if there is a mistake in the claims-handling process? If it's an AI platform, if it's a human platform, the insurance company is always responsible, and we think that is the consistent piece here,” said Thomas Koval, a retired insurance company executive and current board member of FCCI Insurance Group, a commercial insurer out of Sarasota.

Still, an insurer’s use of AI was among the sticking points that could have meant tens of thousands of Floridians lost access to a hospital network. It was cited as health care giant Tenet Healthcare, which operates five Florida hospitals, went to the last day of its contract with Cigna, another national company, before an agreement was struck.

The contract was inked before deadline, but it was the first time AI has been a matter of contention between a health care entity as big as Tenet and an insurer as large as Cigna. Tenet said the insurance company was denying claims without human review, but Cigna publicly denied it.

Traditional Medicare piloting AI review

A pilot launched in six states this January has raised the alarm on two fronts: Traditional, fee-for-service Medicare enrollees’ procedures will be subject to more prior authorization and that authorization will be done by AI, along with human clinical review, according to federal officials.

The pilot seeks to end the waste in health care that studies have found adds up to about a quarter of the spending in U.S. health care.

Nearly half of the country’s 69.7 million Medicare enrollees get the traditional, fee-for-service public insurance. Traditional Medicare recipients have largely not been subject to denials that enrollees in its more recent evolution, Medicare Advantage plans, have been subject to.

KFF, a national health policy research organization, found that 53 million prior authorization requests were processed by Medicare Advantage plan insurers in 2024, resulting in 4.1 million denials. That compares with traditional Medicare. Their enrollees underwent 625,000 prior authorization reviews in 2024 and 143,705 resulted in denials—a fraction of those conducted through Medicare Advantage plans.

But that could be changing because of the pilot program called the Wasteful and Inappropriate Service Reduction Model (WISeR).

“The WISeR Model helps reduce clinically unsupported care by working with companies experienced in using enhanced technologies to expedite and improve the review process for a pre-selected set of services that are vulnerable to fraud, waste and abuse,” reads the press release from the Centers for Medicare and Medicare.

Evan Saltzman, a Florida State University professor in the Department of Risk Management/Insurance, Real Estate and Legal Studies, sees the pilot as part of an inevitable pull.

“It's moving traditional Medicare toward what's already done in the private sector and Medicare Advantage,” Saltzman said.

But U.S. Rep. Lois Frankel said she’s going to fight against any expansion of the effort, now being tested in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington.

“We believe Medicare was based on a promise that if your doctor says you need care, if you're hurt and you need care, Medicare will be there for you, not AI,” Frankel said.

The Federal Trade Commission secured a landmark settlement with one of the nation’s largest pharmacy benefit managers (“PBMs”), Express Scripts, Inc., and its affiliated entities (collectively “ESI”). The settlement requires ESI to adopt fundamental changes to its business practices that increase transparency, are expected to drive down patients’ out-of-pocket costs for drugs like insulin by up to $7 billion over 10 years, bring millions of dollars in new revenue to community pharmacies each year, and advance the Trump Administration’s key healthcare priorities.

The FTC’s settlement resolves the Commission’s lawsuit against ESI, which alleges that ESI artificially inflated the list price of insulin drugs by using anticompetitive and unfair rebating practices, and impaired patients’ access to lower list price products, ultimately shifting the cost of high insulin list prices to vulnerable patients.

“The FTC’s settlement with Express Scripts is a clear testament to the Trump-Vance FTC’s focus on lowering healthcare costs for American patients,” said FTC Chairman Andrew N. Ferguson. “The FTC’s settlement with ESI will end its business practices that have kept drug prices high, ultimately providing meaningful financial relief to American patients who depend on ESI to access life-sustaining prescription drugs as well as community pharmacies who will see new revenues each year and relief from being squeezed. It also delivers significant wins for the broader Trump-Vance healthcare agenda, including reshoring major portions of ESI’s business, ensuring regulatory compliance with price transparency laws, requiring disclosures of kickbacks to brokers, and paving the way for Americans to participate fully in TrumpRx.”

The FTC’s enforcement action against ESI, as well as Caremark Rx and OptumRx, alleges that the PBMs created a system that artificially drove up the list prices of drugs by preferencing rebates. The complaint alleges that this system pushed insulin manufacturers, among others, to compete for preferred formulary coverage based on the size of rebates off the list price rather than net price, which ultimately benefitted the PBMs, including ESI, which keep a portion of the inflated rebates. According to the FTC’s complaint, the inflated list prices hurt patients whose out-of-pocket payments like copays and coinsurance are tied to the list price of the drug.

ESI, under the FTC’s proposed consent order, has agreed to:

• Stop preferring on its standard formularies high wholesale acquisition cost versions of a drug over identical low wholesale acquisition cost versions;
• Provide a standard offering to its plan sponsors that ensures that members’ out-of-pocket expenses will be based on the drug’s net cost, rather than its artificially inflated list price;
• Provide covered access to TrumpRx as part of its standard offering upon relevant legal and regulatory changes;
  Provide full access to its Patient Assurance Program’s insulin benefits to all members when a plan sponsor adopts a formulary that includes an insulin product covered by the Patient Assurance Program unless the plan sponsor opts out in writing;
  Provide a standard offering to all plan sponsors that allows the plan sponsor to transition off rebate guarantees and spread pricing;
• Delink drug manufacturers’ compensation to ESI from list prices as part of its standard offering;
  Increase transparency for plan sponsors, including with mandatory, drug-level reporting, providing data to permit compliance with the Transparency in Coverage regulations, and disclosing payments to brokers representing plan sponsors;
• Transition its standard offering to retail community pharmacies to a more transparent and fairer model based on the actual acquisition cost for a drug product plus a dispensing fee and additional compensation for non-dispensing services;
• Promote the standard offerings to plan sponsors and retail community pharmacies; and
  
• Reshore its group purchasing organization Ascent from Switzerland to the United States, which will bring back to the United States more than $750 billion in purchasing activity over the duration of the order.

The Commission vote to accept the consent agreement for public comment was 1-0, with Commissioner Meador recused.

The public will have 30 days to submit comments on the proposed consent agreement package. Instructions for filing comments appear on the docket. Once processed, they will be posted on Regulations.gov.

NOTE: When the Commission issues a consent order on a final basis, it carries the force of law with respect to future actions.

The Federal Trade Commission works to promote competition, and to protect and educate consumers. The FTC will never demand money, make threats, tell you to transfer money, or promise you a prize. You can learn more about how competition benefits consumers, file an antitrust complaint, or comment on a proposed merger. For the latest news and resources, follow the FTC on social media, subscribe to press releases, and read our blog.

Manufacturers that advertise vaccines in Florida that cause injury or harm could be sued under a bill sponsored by Fort Pierce Republican Erin Grall.

Over objections by lobbyists representing organized medicine and business interests, the Senate Committee on Regulated Industries voted, 5-3, Tuesday to pass the proposal, SB 408.

Specifically, the bill would amend Florida law regulating drugs and cosmetics to allow an individual to file a lawsuit within three years following an alleged vaccine-related injury. The bill would provide one-way attorney fees, allowing any claimant who wins to recover “reasonable attorney fees” but not allow winning defendants to do the same.

Traditionally in Florida, one-way fees have been intended to balance the interests of ordinary people against deep-pocketed interests.

The bill defines “advertise” as “a media communication, including, but not limited to, television, radio, print, the Internet, digital or electronic media, product placement, promotion by an influencer in exchange for compensation, or any other manner of paid promotion, that a vaccine manufacturer purchases to promote the manufacturer’s vaccine.”

Discussions between health care providers and their patients or written or promotional materials regarding vaccines, or any promotional materials concerning vaccines displayed in health care facilities, would be specifically exempt from the definition of advertise.

According to a staff analysis of the bill, healthcare and pharmaceutical digital ad spending for 2025 was estimated at $24.8 billion, with traditional ad spending at about $7.9 billion.

Bill sponsor Grall said she thinks the measure would help increase vaccine rates in Florida, which have been plummeting. Statewide, the percentage of fully immunized two-year-olds dropped from about 85% a decade ago to roughly 75%, Grall said.

“Public trust regarding vaccines has diminished. I would argue that increased knowledge of the virtual immunity that manufactures have with regards to vaccine-related injuries has contributed to this declining trust,” Grall told members of the committee Tuesday morning.

“Vaccines have served an important public health service to eradicate disease, and this bill, I believe, is s step in rebuilding public trust of proven vaccines by holding manufacturers accountable.”

Florida Justice Reform Institute President William Large said the bill most likely would run afoul of federal laws that limit vaccine manufacturer liability in certain respects and establish compensation for injuries related to vaccines.

He touched on the National Childhood Vaccine Injury Act of 1986, which established the National Vaccine Injury Compensation Program (VICP), a no-fault program funded by vaccine manufacturers through an excise tax on each vaccine dose. The VICP covers most vaccines routinely given in the United States. Benefits include rehabilitation costs, pain and suffering, attorney fees, and, in the case of death, $250,000.

Another federal law Large referenced is the Public Readiness and Emergency Preparedness Act of 2005 (PREP), which authorizes the Department of Health and Human Services secretary to issue a so-called PREP Act declaration. The declaration allows the government to limit the liability of manufacturers, distributors, health care providers, and others for losses related to the administration or use of vaccines other other countermeasures to blunt any threat.

The PREP law also authorizes HHS to establish the Countermeasure Injury Compensation Program (CICP) to compensate claimants for serious physical injuries and death caused by certain vaccines.

CICP recoveries may include medical expenses, a portion of lost employment income, and a survivor death benefit.

Lastly, there’s the federal Food and Drug Cosmetics Act, which deals with labeling and failure to warn.

Preemption

“Most of this area of law is preempted by three federal acts,” Large said. “I’m also concerned it violates the First Amendment. And it’s also our position it’s bad public policy.”

Health and Human Services Secretary Robert F. Kennedy Jr. has criticized the VICP, calling it “biased” and “corrupt.” Kennedy, who owns a financial stake in a lawsuit against Merck over claims the pharmaceutical company failed to properly warn consumers about risks from its HPV vaccine, Gardasil, has said the protections remove incentives for vaccines to be safe.

Grall’s bill provides that an injured individual may bring an action within three years following accrual of the cause of action. Finally, the bill provides that a court can award a claimant who prevails in an action actual damages, court costs, and reasonable attorney fees.

There’s an identical proposal (HB 339) in the House filed by Rep. Monique Miller, a Republican from Palm Bay.

Committee Chair Sen. Jennifer Bradley, a Fleming Island Republican, thanked Grall for the bill, saying that in the aftermath of the COVID pandemic it’s an important conversation for the Legislature to have.

She said the United States is one of two countries that allow vaccine manufacturers to directly advertise to patients. While she stressed she’s no “anti-vaxer” Bradley said today’s environment is vastly differently than 40 years ago when the federal government agreed to pass the vaccine injury compensation fund in order to help ensure an adequate supply of childhood vaccines.

The environment today, Bradley said, is an “atmosphere of distrust.”

“I think this is an important conversation as we see the rise of a lot of diseases and a lot of cases with an uptick. I think we really need to take a hard look at the public trust we have in these big systems,” she said.

“Is this bill perfect? I don’t think so. Can it get better? Can we talk about it? We can put our head in the sand, but public trust in our health system is weak right now. And I think there are things we can do and conversations we can have to remedy that and to build that back. And I think this is a great first conversation.”

Gov. Ron DeSantis announced more than $20 million in LINE (Linking Industry to Nursing Education) funding to support nursing education, including scholarships, and workforce needs during a press conference at St. Petersburg College's Caruth Health Education Center this week.

Specifically, the funding includes $14.5 million to state colleges and private postsecondary institutions and $6 million to state universities.

"These investments are directly addressing the nationwide nursing shortage by supporting scholarships for nursing students and expanding access to state-of-the-art simulation and instructional equipment," DeSantis wrote.

Under Gov. DeSantis, Florida has awarded $85 million through the LINE program, including $61.5 million to state colleges and private postsecondary institutions, and $24 million to State University System institutions since 2022.

Along with LINE, the state has also awarded $400 million in PIPELINE (Prepping Institutions, Programs, Employers, and Learners through Incentives for Nursing Education) funds to postsecondary institutions, including $240 million for state colleges and districts and $160 million for state universities.

Overall, both initiatives have totaled $485 million since their inception.

"If you look at what we've done in both of these programs, we're now producing a thousand-plus additional nurses than we were before those every year between our state colleges and our state universities," DeSantis said at the press conference. "That's a meaningful increase."

Florida Commissioner of Education Stasi Kamoutsas also praised the new investment for state nurses at the announcement.

"I'm so thankful that this investment is going specifically towards the nursing programs, to be able to beef up those programs to be able to give those students an opportunity not just to see value in themselves, but to give back to their communities," Kamoustas said. "This investment is going to specifically impact 20 of our 28 state colleges, who will receive funding that will reinforce the critical role that our state colleges play as the backbone of our workforce education here in the state," he added.

Inflation is affecting everything these days, including malpractice verdicts. Jury awards are increasing, not only as the result of economic inflation, but because social inflation is changing the way that juries think about awards in malpractice cases.

“In the last four to five years, attitudes have changed in the ways that juries see large companies and corporations and how they respond to malpractice cases—there are public trust issues,” explained Tom Murphy, SVP National Healthcare Practice, Risk Strategies, part of the Brown & Brown team.

“A lot more physicians have become employed by corporations or private equity groups with fewer going into private practice, and that has put a strain on the doctor/patient relationship,” he said. “Physicians are also getting lower reimbursements, so they have to see more patients—in the same amount of time—to make up for lost income.”

Murphy added that many people, especially those under age 35, no longer understand the true value of a dollar as a result of many factors including social media.

“As the younger generation grows up with social media and reality TV, there has been a change in the valuation of money,” he said. “They see athletes and celebrities making crazy amounts. For example, Dodgers player Shohei Ohtani signed a contract for $700 million.

“The playing field has also changed because for many years you could determine what juries would be like in different regions of the country,” he added. “But because of social media and cellphones, it doesn’t matter if you’re in a town of 200 people in Oklahoma or New York City. They’re all seeing what everyone else is seeing.”

Not only has social inflation affected claims and legal costs in the malpractice world, but it has caused rates to rise as well. Between 2014-2024, economic and social inflation have added $4 billion in costs to insurance companies. Malpractice rates are up 20 percent for all carriers across the board, causing physicians to pay higher premiums. As economic and social inflation continue to have an effect, they are also at higher risk of being sued and paying higher damages if they lose.

According to Murphy, the average claim payment has increased by 60 percent in the last 20 years, with the average claim payment now equaling $485,000.

“I remember 20 years ago doing a presentation when the average claim payment was $250,000,” said Murphy. “Insurance companies are now pondering what to do as costs are spiraling; they are out of control.”

Nuclear verdicts of $10 million or more have also increased. Between 2013-15, there were 85 such judgements across the country. Between 2022-24, that amount doubled to 160 judgements nationwide.

“In a recent Hospital of the University of Pennsylvania birth injury trial, for example, the jury awarded $207 million to the plaintiff,” said Murphy, noting that it was the largest medical malpractice award in Pennsylvania’s history. “While there is never justification for the malpractice death or injury of a newborn, how did they come up with this number? In this case, it is mainly punitive—to make an example of the hospital and the insurance company.”

In a recent case between Phoebe Putney Memorial Hospital in Albany, GA and a double amputee, the jury awarded $70 million to the plaintiff.

“As a result of physician negligence, the hospital had to amputate the patient’s legs below the knees as the result of a medication overdose during treatment for sepsis,” said Murphy. “Fifteen or 20 years ago, that patient would have been awarded $5 million to $10 million. But now, even if a patient signs a surgical consent form, it’s like it doesn’t matter.”

He noted that while most judges in appeals court will lower these awards because they are so out of line, these verdicts cause other problems.

“Numbers like this cause carriers to settle more cases—even if they are defensible—because they are afraid of huge nuclear verdicts,” he said.

For more information, contact Tom Murphy at tmurphy@risk-strategies.com or call (800) 966-2120.

In 2024, the Florida Senate debated SB 1276, the “Litigation Investment Safeguards and Transparency Act.” The act would require a court’s consideration of potential conflicts of interest that could arise from the existence of a litigation financing agreement in specified circumstances as well as prohibit specified acts by litigation financiers and require certain disclosures related to litigation financing agreements.

While the bill died on the calendar, increased interest in investing in law firms by third parties, such as private equity firms, may soon bring this issue to the forefront again.

Third-Party Litigation Funding (TPLF) takes place when an external investor funds a lawsuit in exchange for a portion of the potential payout. Third-Party Investment in Law Firms is when outside investors gain ownership or a share of ownership in a law firm itself.

Currently, the only states that have passed laws to regulate third-party litigation funding are Colorado, Arizona, New York, Oklahoma, and Montana. Arizona is the only state that allows direct ownership of law firms by non-attorneys.

“While there is currently a rule in place that technically prohibits third-party litigation funding at this time, that may change in the future,” explained Kyla Murphy, AVP National Healthcare Practice, Risk Strategies.

Florida Bar Rule 4-1.8(f) states that a lawyer cannot accept compensation for representing a client from a third party unless the client gives informed consent; the arrangement doesn’t interfere with the lawyer’s professional judgment or the client-lawyer relationship, and the lawyer protects client information under Rule 4-1.6. This rule prevents conflicts of interest by ensuring the lawyer’s primary loyalty remains with the client, not the third-party payer.

According to Murphy, if third-parties are allowed to fund litigation or gain ownership shares in law firms, it will not only affect those involved in a lawsuit, but every single commercial insurer, including those who provide malpractice insurance.

“Essentially, there will be a trickle-down effect: because most private equity firms look to make high revenue quickly, their focus may be on the bottom line and could potentially interfere with the way lawsuits are handled moving forward,” Murphy said.

“This will also put extreme pressure on plaintiff’s attorneys,” she added. “Third-party investors will expect them to win big, because they have a lot of money invested in the case. This may result in nuclear verdicts, which will trickle down to affect insurance rates because the insurers have to pay these settlements. That means physicians will be paying more for premiums.”

According to a recent article in The Insurance Journal, the five-year cost to commercial insurers due to third-party litigation investments is estimated to exceed $25 billion.

“If settlements start to exceed $10 million or $25 million, insurers are going to raise premiums to offset these losses, which means that physicians will pay more,” said Murphy. “In the long run, these verdicts may contribute to shortages in healthcare because physicians will stop practicing because they can’t afford insurance, and new physicians may decide not to enter the field.”

For more information, contact Kyla Murphy at Kyla.murphy@risk-strategies.com or call (800) 966-2120.

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the 2026 Medicare physician fee schedule (MPFS). 

The AMA submitted detailed comments to CMS regarding its proposals on Sept. 11, 2025.

While the AMA staff analyze and develop a detailed summary of the more than 2,000-page rule, we want to bring a handful of key issues to your immediate attention, in the attached document. 

2026 MPFS Final Rule Topline Summary

“CMS instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service of October 1, 2025, and later for certain services impacted by select expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025 (Pub. L. 119-4, Mar. 15, 2025).  This includes claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and Federally Qualified Health Center (FQHC) claims.  This includes telehealth claims that CMS can confirm are definitively for behavioral and mental health services.  CMS has directed all MACs to continue to temporarily hold claims for other telehealth services (i.e. those that CMS cannot confirm are definitively for behavioral and mental health services) and for acute Hospital Care at Home claims. 

Beginning October 1, 2025, for services that are not behavioral health services, many of the statutory limitations on payment for Medicare telehealth services that were, in response to the COVID-19 Public Health Emergency, lifted, and subsequently extended, through legislation again took effect. These include prohibition of many services provided to beneficiaries in their homes and outside of rural areas, and hospice recertifications that require a face-to-face encounter. In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage (ABN). Further information on use of the ABN, including ABN forms and form instructions can be found here: https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn. Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are currently not payable by Medicare in the absence of Congressional action. For further information: https://www.cms.gov/medicare/coverage/telehealth.

CMS notes that the Bipartisan Budget Act of 2018 (Pub. L. 115-123, Feb. 9, 2018), which added section 1899(l) to the Social Security Act, allows clinicians in applicable Medicare Shared Savings Program Accountable Care Organizations (ACOs) to provide and receive payment for covered telehealth services to certain Medicare beneficiaries without geographic restrictions and in the beneficiary’s home. Separate from requirements to participate in the Medicare Shared Savings Program, there is no special application or approval process for applicable ACOs or their ACO participants or ACO providers/suppliers to offer these covered telehealth services. Clinicians in applicable ACOs can furnish and receive payment for covered telehealth services under these special telehealth flexibilities. For clinicians in applicable ACOs, telehealth claims that CMS can confirm are definitively for behavioral and mental health services will be paid. At this time, claims for some telehealth services will continue to be held.  For more information, including information on to which ACOs these flexibilities apply: https://www.cms.gov/files/document/shared-savings-program-telehealth-fact-sheet.pdf (PDF).”

A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished in 2026. The AMA encourages physicians to review their final score as soon as possible as the deadline to file a Targeted Review is only open until November 14, 2025.

The AMA has sought clarification from CMS and they are still accepting and reviewing Targeted Reviews during the government shutdown. However, some decisions may be delayed due to the need for broader CMS staff review, and some staff are furloughed. There are no plans currently to extend the targeted review period.

For more information, please see the email from CMS below.

Now Available: 2026 MIPS Payment Adjustment Information

The Centers for Medicare & Medicare Services (CMS) has released Merit-based Incentive Payment System (MIPS) payment adjustment information for the 2024 performance period/2026 MIPS payment year.

• Your 2024 MIPS final score determines the MIPS payment adjustment you’ll receive in 2026.
• A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished in 2026.

 Access Your MIPS Payment Adjustment

• Sign in  to the Quality Payment Program (QPP) website using the same credentials that allowed you to submit your 2024 MIPS data and check your 2024 MIPS final score. Refer to the QPP Access User Guide (ZIP, 4MB)  for more information.
• Click “View Feedback” on the home page and select your organization (Practice, Alternative Payment Model (APM) Entity, Virtual Group).
  • Practice representatives can access individual, subgroup, and group performance feedback (final scores and payment adjustments).
  • APM Entity representatives can access APM Entity-level performance feedback (final scores and payment adjustments).
  • Virtual group representatives can access virtual group-level performance feedback (final scores and payment adjustments).
  • Third party representatives can’t access final feedback or payment adjustment information.

If you don’t have a HARP account or QPP role, please refer to the Register for a HARP Account (re: HARP account) and Connect to an Organization (re: QPP role) documents in the QPP Access User Guide (ZIP, 4MB)  and start the process now.

Medicare Shared Savings Program Accountable Care Organizations (ACOs)

Medicare Shared Savings Program ACOs are encouraged to identify at least one individual within your ACO who can obtain a HARP account with the Security Official role; additional individuals may request the Staff User role. ACO individuals can create and manage their HARP account and QPP access in the ACO Management System (ACO-MS) .

Contact your ACO to find out how you can obtain a HARP account via ACO-MS. If you have any questions, please contact the ACO Information Center at SharedSavingsProgram@cms.hhs.gov  or 1-888-734-6433 (Option 1).

• REMINDER: Representatives of Shared Savings Program ACO Participant Taxpayer Identification Numbers (TINs) and practices with clinicians receiving their APM Entity’s final score won’t be able to access the APM Entity’s performance feedback unless they’ve been granted the “staff user” QPP role for the APM Entity.

Payment Adjustment and Performance Feedback Resources:

• 2026 MIPS Payment Year Payment Adjustment User Guide (PDF, 2MB)  – Reviews information about the calculation and application of MIPS payment adjustments, and answers frequently asked questions.
• 2024 MIPS Performance Feedback FAQs (PDF, 2MB) – Reviews the information available in performance feedback and how to access it. (We’re in the process of updating this resource with the Targeted Review deadline.)
• 2024 MIPS Performance Feedback Supplemental Reports Guide (PDF, 833KB) – Reviews the downloadable supplemental and patient-level reports for administrative claims quality and cost measures.
• 2024 Quality and Cost Benchmarks  – Links to quality and cost measure benchmarks and supporting documentation. (Benchmarks determine measure scores.)

2024 Targeted Review Request Period Open Until November 14, 2025[1]

Beginning with the 2024 performance period/2026 MIPS payment year, the targeted review period closes 30 days following the release of MIPS payment adjustments (refer to 42 CFR 414.1385(a)(2) ).

Who Can Request a Targeted Review?

Individual clinicians, groups, subgroups, virtual groups, APM Entities (including Shared Savings Program ACOs), designated support staff and authorized third party intermediaries may request that CMS review their MIPS final score and MIPS payment adjustment factor through a process called targeted review.

When to Request a Targeted Review

Review your MIPS performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website . If you believe there’s an error in the calculation of your MIPS final score or MIPS payment adjustment factor, you can request a targeted review now until November 14, 2025, at 8 p.m. ET. Be advised that our ability to respond to inquiries and resolve requests will be delayed in most cases until normal government operations resume.

Examples of circumstances that could prompt a Targeted Review:

• Data were submitted under the wrong TIN or National Provider Identifier (NPI).
• You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
• Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

Note: This isn’t a comprehensive list of circumstances.

How to Request a Targeted Review

To access your MIPS final score, performance feedback and request a targeted review:

• Sign in  using your HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed you to submit your 2024 MIPS data and check your 2024 final score.
• Click “Targeted Review” on the left-hand navigation.

CMS may require documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required.

• 2024 Targeted Review User Guide (PDF, 2MB)  – Reviews the process for requesting a targeted review and examples for when you would or wouldn’t request a targeted review. (We’re in the process of updating this resource with the Targeted Review deadline.)

[1]  Note: The federal government shutdown doesn’t affect your ability to submit a targeted review request by the above deadline, however it may affect our response time to resolve your request.

Claims Hold Update

In anticipation of possible Congressional action, CMS has instructed all Medicare Administrative Contractors (MACs) to continue to temporarily hold claims with dates of service of October 1, 2025, and later for services impacted by the expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025. This includes all claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and all Federally Qualified Health Center claims. Providers may continue to submit these claims, but payment will not be released until the hold is lifted.

Absent Congressional action, beginning October 1, 2025, many of the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 Public Health Emergency took effect again for services that are not behavioral health services. These include prohibition of many services provided to beneficiaries in their homes and outside of rural areas, and hospice recertifications that require a face-to-face encounter. In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage (ABN). Further information on use of the ABN, including ABN forms and form instructions: https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn. Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action. For further information: https://www.cms.gov/medicare/coverage/telehealth.

CMS notes that the Bipartisan Budget Act of 2018 allows clinicians in applicable Medicare Shared Savings Program Accountable Care Organizations (ACOs) to provide and receive payment for covered telehealth services to certain Medicare beneficiaries without geographic restriction and in the beneficiary’s home. There is no special application or approval process for applicable ACOs or their ACO participants or ACO providers/suppliers. Clinicians in applicable ACOs can furnish and receive payment for covered telehealth services under these special telehealth flexibilities. For more information: https://www.cms.gov/files/document/shared-savings-program-telehealth-fact-sheet.pdf (PDF).

After a similar proposal died this spring in the Senate, a House Republican on Friday renewed a push to pass a bill that would lead to cities, counties and other government agencies paying more in lawsuits over people getting injured. Rep. Fiona McFarland, R-Sarasota, filed a bill (HB 145) that would revamp the state’s sovereign-immunity laws, which help shield government agencies from costly lawsuits. Under a law passed in 2010, government agencies’ liability in such cases is capped at $200,000 for payments to a single person and $300,000 if multiple people are involved in an incident, though the caps can be exceeded if lawmakers pass a special type of measure known as a “claim” bill. Under McFarland’s proposal, those limits would go to $500,000 and $1 million for injuries that occur on or after Oct. 1, 2026, and $600,000 and $1.2 million for injuries that occur on or after Oct. 1, 2031. The bill could lead to higher costs for government agencies, but McFarland has long argued that changes are needed to sovereign-immunity laws to help victims get justice for injuries. The House voted 103-11 to pass the similar bill during the 2025 legislative session, but the Senate did not take up the issue. McFarland’s new bill will be considered during the 2026 session, which will start in January.

Source: https://www.newsserviceflorida.com/latest/briefs/higher-liability-limits-sought/article_f8bb9c40-316f-4089-a5c0-1ecb134cc3b9.html

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Those programs collectively receive about $9 billion, but funding will shrink to $5.2 billion by fiscal year 2034-35. The Hospital Directed Payment Program, which accounts for the largest share at $8.1 billion this year, will see a $3.5 billion reduction by 2034. Other affected initiatives include the Physician Supplemental Payment Program, down $234 million, the Public Hospital Physician Program, down $9 million, and two Florida Cancer Hospital Programs, down $56 million and $17 million. Meyer said the cuts will be phased in gradually. "What this provision does is any state-directed payments that are above 110% of Medicare beginning in 2028 will start stepping down annually 10% a year until you get to the 110% of Medicare threshold," he said. "We currently have five state-directed payment programs that are above 110% that will need to be stepped out. Depending upon where they are with respect to the percent of Medicare, some will get to that 110% cap sooner," he added. "Others will take more years to get there at a 10% annual reduction." The discussion came as House lawmakers met for the first committee week ahead of the 2026 legislative session scheduled to begin on Jan. 13, focusing on health care access and affordability — issues likely to dominate debate as Florida braces for the long-term fiscal impact of the federal reforms.

Source: Florida Politics

State Launches $50M Health Innovation Loan Program: The state Department of Health last week rolled out its Florida Health Care Innovation Loan Program, a new initiative to boost inventive solutions across the state's health care system. The program, backed by $50 million annually in state funding, aims to finance proposals that improve care delivery, reduce costs, strengthen the health care workforce, expand access, and enhance patient outcomes. The initiative, created under 2024's SB 7018, which was part of a priority legislative package called the "Live Healthy" initiative, established the Health Care Innovation Council and enshrined the loan program in state law. Under the legislation, the state will appropriate $50 million per year through 2034-35, creating a revolving loan fund that supports eligible health care entities implementing innovative models and technologies. The Health Care Innovation Council, chaired by the lieutenant governor and composed of health, technology, finance, and advocacy experts, will review applications and advise on project prioritization. Eligible applicants include entities licensed by the Agency for Health Care Administration — such as hospitals, nursing homes, ambulatory surgery centers — and educational or clinical training providers collaborating with these facilities. The program gives priority to rural hospitals and nonprofit Medicaid-serving entities, especially those in medically underserved regions. 

Read the Press release

The Florida House next week could start a renewed effort to change state law to clear the way for some people to pursue medical-malpractice lawsuits over the deaths of family members. The House Civil Justice & Claims Subcommittee is scheduled Oct. 15 to take up the proposal (HB 6003).

The bill, sponsored by Rep. Dana Trabulsy, R-Fort Pierce, is filed for consideration during the 2026 legislative session, which will start in January.

Lawmakers passed such a proposal during the 2025 session, but Gov. Ron DeSantis vetoed it.

The proposal would repeal a 1990 law that prevents people ages 25 and older from seeking what are known as “non-economic” damages in medical-malpractice cases involving deaths of their parents.

Also, under the law, parents cannot seek such damages in malpractice cases involving the deaths of their children who are 25 or older.

People who allege their family members were killed by malpractice supported the proposal throughout the 2025 session, arguing that doctors and other health providers are not being held accountable.

But health-care and business groups lobbied against the change, contending it would drive up malpractice insurance costs and lead to doctors deciding not to practice in Florida. In vetoing the proposal, DeSantis said it could open “floodgates” for litigation.

When certain legislative payment provisions (“extenders”) are scheduled to expire, CMS directs all Medicare Administrative Contractors (MACs) to implement a temporary claims hold. This standard practice is typically up to 10 business days and ensures that Medicare payments are accurate and consistent with statutory requirements. The hold prevents the need for reprocessing large volumes of claims should Congress act after the statutory expiration date and should have a minimal impact on providers due to the 14-day payment floor. Providers may continue to submit claims during this period, but payment will not be released until the hold is lifted.

Absent Congressional action, beginning October 1, 2025, many of the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 Public Health Emergency will take effect again for services that are not behavioral and mental health services. These include prohibition of many services provided to beneficiaries in their homes and outside of rural areas and hospice recertifications that require a face-to-face encounter. In some cases, these restrictions can impact requirements for meeting continued eligibility for other Medicare benefits. In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage. Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action. Additionally, Medicare would not be able to pay some kinds of practitioners for telehealth services.

For further information: https://www.cms.gov/medicare/coverage/telehealth.

CMS notes that the Bipartisan Budget Act of 2018 allows clinicians in applicable Medicare Shared Savings Program Accountable Care Organizations (ACOs) to provide and receive payment for covered telehealth services to certain Medicare beneficiaries without geographic restriction and in the beneficiary’s home. There is no special application or approval process for applicable ACOs or their ACO participants or ACO providers/suppliers. Clinicians in applicable ACOs can provide these covered telehealth services and bill Medicare for the telehealth services that are permissible under Medicare rules during CY 2025, irrespective of further Congressional action.

For more information:

https://www.cms.gov/files/document/shared-savings-program-telehealth-fact-sheet.pdf.

MACs will continue to perform all functions related to Medicare Fee-for-Service claims processing and payment.

Effective July 1, 2025, HB 975 removes this exception and requires all physicians to complete electronic fingerprinting prior to their next license renewal.

Read the FMA’s report to learn what you need to know about completing the process.

https://dcjournal.com/dont-let-middlemen-off-the-hook-in-the-drug-pricing-debate/ 

President Trump’s recent directive to 17 pharmaceutical manufacturers demanding that U.S. drug prices align with the lowest prices in other developed countries has thrust the issue of prescription drug affordability into the spotlight. The goal, making medications accessible for American patients, is one we all share. The path to achieving it matters, and the current approach risks missing the mark by overlooking a critical player in the crisis, pharmacy benefit managers (PBMs).

Physicians and patient advocates have long warned about PBMs’ role in increasing costs. We applaud efforts to lower drug prices, but we urge policymakers to confront the root causes of the broken system, starting with the practices of PBMs.

Unlike other developed nations, the United States relies heavily on PBMs to negotiate rebates, manage formularies and control pharmacy reimbursements. The three largest PBMs dominate the market, often prioritizing profits over patients. Studies and income statements reveal the PBM industry pockets billions by exploiting the gap between a drug’s acquisition costs and its reimbursement rates, funds that could reduce out-of-pocket costs or expand access to treatments.

The president’s most-favored-nation pricing model aims to cap U.S. drug prices at levels seen in Switzerland, Norway and Ireland, extending this framework across Medicaid, Medicare and commercial markets. It also proposes distribution models that bypass traditional middlemen. While bold, this plan fails to address a uniquely American problem: the unchecked power of PBMs, the intermediaries that inflate costs and distort the drug supply chain. A significant concern with this model is the unintended consequences, one that could result in artificially low reimbursements tied to MFN pricing that may push physician practices and independent infusion centers to close their doors, affecting patients who rely on access to treatments.

Trump’s focus on affordability is commendable, but MFN pricing is a half-measure. Without tackling PBMs, price reductions will be illusory, absorbed by middlemen while patients see little relief. Congress and the administration must pair reforms with PBM accountability, prohibiting spread pricing, mandating rebate pass-throughs, delinking PBM fees from the drug list price, and enforcing transparency in formulary decisions.

Some have pointed to direct-to-consumer or direct-to-business drug distribution models as an innovative workaround to the PBM-dominated supply chain. While these models can offer faster access and price transparency, they often come at a hidden cost to patients. Because these arrangements typically bypass insurance, patients are left paying out-of-pocket for medications in addition to the pricey premiums they already pay for health coverage. Worse still, these payments frequently fail to count toward deductibles or out-of-pocket maximums, meaning patients shoulder more of the financial burden without moving any closer to relief under their insurance plans.

Rather than alleviating systemic cost pressures, this shift risks creating a dangerous two-tiered system, one where patients must choose between affordability and insurance coverage. It’s a patchwork solution that treats a symptom but ignores the underlying problem that remains, a profit-driven intermediary system that forces patients to pay more, one way or another.

Instead of regulating these middlemen, the MFN model targets manufacturers, leaving PBMs’ profits untouched.

This distinction is critical. Other countries with lower drug prices don’t contend with PBM-driven price inflation. Imposing foreign price ceilings without dismantling this architecture risks misdirecting reform. Worse, it threatens to cripple physician-administered care settings, like independent infusion centers that operate on slim margins and could collapse under artificially low reimbursements. These centers are lifelines for patients with chronic conditions, and their loss would devastate access to care.

The evidence proves that PBMs often incentivize higher list prices to maximize rebates, which they retain rather than pass on to patients. The practices of PBMs aren’t efficient; they are exploitative. By focusing solely on manufacturer prices, we’re treating symptoms while ignoring the disease.

There’s a better way. We support robust PBM reform, like measures in the House-passed reconciliation package that would bar PBMs from tying revenue to a drug’s list price in Medicare Part D. Replacing percentage-based rebates with flat, fair-market service fees would eliminate the perverse incentive to favor high-cost drugs over equally effective, lower-cost alternatives. This would restore transparency and accountability, ensuring savings reach patients.

Our infusion clinics, patients and country cannot afford another misstep in the drug pricing crisis. PBMs have operated in the shadows for too long, profiting at the expense of those they claim to serve. It’s time to hold them accountable and treat the real disease. Only then can we build a system that works for patients, not profits.

The report shows that physicians deliver care to patients in practices that are increasingly owned by hospitals or other organizations and not by physicians, larger, and increasingly likely to include physicians in a variety of specialties, not just one.

The report also explores the reasons that private practices are sold to hospitals, private equity firms, or insurers and finds that inadequate payment rates, costly resources, and burdensome regulatory and administrative requirements are longstanding and important drivers of this change.

Other reports based on the Benchmark Survey can be found here. 

HB 1195 Fentanyl Testing

Rep Harris

Establish Gage's Law requiring hospitals to include a fentanyl test whenever a urine drug test is conducted for suspected overdose

Directs hospitals to retain the test results in the patient’s clinical record.

Approved by Governor; Chapter No. 2025-19

SB 68 Health Facilities

Senator Martin

Expand the definition of health facility to include additional not-for-profit entities and associations, authorize new loan powers for health facilities authorities, and make confirmation fentanyl testing optional for hospitals.

Approved by Governor; Chapter No. 2025-179

HB 1545 Parkinson's Disease

Rep Busatta

Creates a consortium and an institute dedicated to Parkinson's disease research and care within the University of South Florida.

Approved by Governor; Chapter No. 2025-188

SB 2514 Health and Human Services

Appropriations

Among other things, requires coverage of blood-based biomarker tests for colorectal cancer screening as specified in federal Medicare determinations.

SB 1768 Stem Cell Therapy

Senator Trumbull

Establish requirements for Florida-licensed physicians to offer certain FDA-unapproved stem cell therapies, including ethical sourcing, facility accreditation, and patient disclosures, while prohibiting stem cells derived from aborted fetuses and providing penalties for violations.

Approved by Governor; Chapter No. 2025-185

HB 1255 Education

Rep Trabulsy

Modernize Florida's K-12 and teacher-related statutes but specific to health care:

Expands the definition of emergency opioid antagonists in public schools and clarifies liability protections and parental consent requirements for corporal punishment.

Approved by Governor; Chapter No. 2025-110

HB 647 Advanced Practice Registered Nurse Services

Rep Trabulsy

l authorizes advanced practice registered nurses providing hospice care and acting within an established protocol with a licensed physician to file a certificate of death or fetal death and certify the cause of a person’s death.

Approved by Governor; Chapter No. 2025-50

HB 677 State Group Insurance Coverage of Standard Fertility Preservation Services

Rep Trabulsy

Require the state group health insurance plan to cover standard fertility preservation services for individuals who may face iatrogenic infertility due to cancer treatments.

Awaiting Governor's Action

HB 907 Florida Institute for Pediatric Rare Diseases

Rep Anderson

Establishes the Florida Institute for Pediatric Rare Diseases at the Florida State University College of Medicine and implements a pilot program and consortium to enhance newborn genetic screening, research, and collaboration on pediatric rare diseases.

Approved by Governor; Chapter No. 2025-187

SB 994 Driver License Education Requirements

Senator Collins

Specify that applicants 18 years of age or older must complete a traffic law and substance abuse education course and require a department-approved driver education course for obtaining a learner’s license.

Approved by Governor; Chapter No. 2025-104

HB 0597 Diabetes Management in Schools

Rep Smith

Authorizing school districts or public schools to acquire and maintain a supply of undesignated glucagon for use on students with diabetes experiencing hypoglycemic emergencies.

Approved by Governor; Chapter No. 2025-15

SB 958 Type 1 Diabetes Early Detection Program

Rep Bernard

Establishes a Type 1 diabetes early detection program and ensures parents and guardians receive relevant information.

Approved by Governor; Chapter No. 2025-46

SB 1514 Anaphylaxis in Public Schools

Senator Smith

Requires public schools serving K–8 students to provide anaphylaxis training and maintain effective emergency plans for allergic reactions, including the administration of an epinephrine delivery device.

Approved by Governor; Chapter No. 2025-47

HB 1607 Cardiac Emergencies

Rep Yarkosky

Require public schools to expand first aid and cardiac emergency training while mandating the development of urgent life-saving emergency plans and placement of automated external defibrillators.

Approved by Governor; Chapter No. 2025-67

SB 1286 Harming or Neglecting Children

Senator Grall

The bill amends the definition of harm and neglect of a child in both dependency and criminal law to allow caregivers to let a sufficiently mature child partake in independent, unsupervised activities without considering these actions as harm or neglect of a child.

Approved by Governor; Chapter No. 2025-167

HB 1299 Department of Health

Rep Yarkosky

Extend the repeal date for the definition of 'messenger ribonucleic acid vaccine,' refine medical marijuana treatment center requirements, modify licensure endorsements and certifications for various health practitioners, update references to recognized physician specialty boards, and revise the Physical Therapy Licensure Compact definitions. READ MORE

HB 711 Spectrum Alert

Rep Borrero

Establishes a statewide Spectrum Alert system to rapidly locate missing children with autism spectrum disorder and enhance the effectiveness of law enforcement responses.

Approved by Governor; Chapter No. 2025-123

HB 0791 Surrendered Infants

Rep Cobb

The bill authorizes hospitals, EMS stations, and fire stations that are staffed 24 hours per day to use infant safety devices to accept surrendered infants, and establishes criteria for their use.

Approved by Governor; Chapter No. 2025-17

SB 480 Nonprofit Agricultural Organization Medical Benefit Plans

Senator DiCeglie

Authorize nonprofit agricultural organizations to offer medical benefit plans not regulated as insurance.

Approved by Governor; Chapter No. 2025-54

HB 547 Medical Debt

Rep Partington

Broadens the definition of extraordinary collection actions by facilities and allows facilities to sell certain medical debt under strict conditions.

Approved by Governor; Chapter No. 2025-98

HB 1091 Substance Abuse and Mental Health Care

Rep Gonzalez Pittman

Enhance crisis services through a new 988 suicide and crisis lifeline call center, revise procedures for involuntary treatment and outpatient services, and update training requirements for mental health professionals.

Approved by Governor; Chapter No. 2025-143

HB 1099 - Arrest/ Detention Individuals with Significant Medical Conditions

Rep Canady

A law enforcement officer may use their discretion based on the totality of the circumstances when determining whether to make an immediate arrest of a person who has a significant medical condition, including an arrest for an offense committed against an elderly person or a disabled adult.

Approved by Governor; Chapter No. 2025-64

SB 1620 Mental Health & Substance Use Disorders

Senator Rousson

Require use of standardized functional assessment tools, strengthen treatment plan and discharge requirements, expand telehealth for school-based services, promote person-first language, and enhance statewide mental health workforce and facility reviews. READ MORE

Approved by Governor; Chapter No. 2025-184

HB 961 Department of Highway Safety and Motor Vehicles

Rep Maney

Among other things, the bill creates a lifetime disabled parking permit for certain permanently disabled persons, extend renewal periods for disabled parking permits, and allow broad use of previously issued disability certificates for replacements.

Approved by Governor; Chapter No. 2025-125

SB 768 Controlling Business Interests by Persons with Ties to Foreign Countries of Concern

Senator Calatayud

Prohibit genetic sequencing software from foreign countries of concern in state laboratories and clarify licensure requirements regarding controlling interests from those countries.

Approved by Governor; Chapter No. 2025-96

SB 108 Administrative Procedures

Senator Grall

Modernize and streamline Florida's administrative rulemaking process by establishing stricter requirements, new deadlines, and enhanced oversight for agencies adopting, reviewing, and amending rules.

Approved by Governor

HB 797 Veteran and Spouse Nursing Home Beds

Rep LaMarca

Authorize certain nonprofit skilled nursing facilities to designate or reclassify beds for veterans and spouses and exempt them from certain certificate-of-need requirements.

Approved by Governor; Chapter No. 2025-17

HB 1353 Home Health Care Services

Rep Franklin

Removes certain geographic restrictions on home health agency administration, allows contract staff to perform key nursing visits, and revises criteria for the Excellence in Home Health Program.

Approved by Governor; Chapter No. 2025-127

HB 0421 Peer Support for First Responders

Rep Maggard

Adds law enforcement personnel who are involved in investigating a crime scene or collecting or processing evidence to the definition of a “first responder,” receiving the same benefit of confidentiality with respect to peer support communications

Approved by Governor; Chapter No. 2025-9

HB 929 Firefighter Health and Safety

Rep Booth

Enhance firefighter health and safety by expanding the Division of State Fire Marshal’s authority to address chemical hazards, mental health best practices, and stricter enforcement measures.

Approved by Governor; Chapter No. 2025-124 

Vetoed By The Governor

HB 6017 Recovery of Damages for Medical Negligence Resulting in Death

Rep Trabulsy

Removes statutory barriers preventing certain individuals from recovering damages in wrongful death cases involving medical negligence (adult children and by parents of adult children) and updates related provisions.

Awaiting Governor's Action 

HB 1421 Improving Screening for and Treatment of Blood Clots

Rep Black

Establishes new statewide requirements for screening, training, and reporting to improve venous thromboembolism prevention and care in healthcare and assisted living facilities.

HB 1427 Health Care

Rep Griffitts Jr.

Amends program application, approval, and regulation requirements for nursing education programs in Florida.