Florida’s New Immigration Law: What Physician Employers Should Know
By Jeff Scott, Esq., FMA General Counsel | June 29, 2023

While not normally an issue that affects the practice of medicine, this year’s immigration bill does contain provisions that many physician practices should be aware of.

SB 1718, signed into law by Gov. Ron DeSantis on May 10, 2023, amends various state statutes to address provisions related to individuals in Florida who may be unauthorized aliens. Key for physician employers is the requirement, beginning on July 1, 2023, for private employers with 25 or more employees to use the E-Verify system to verify a new employee’s employment eligibility within three business days after the first day that the new employee begins working for pay.

If the E-Verify system is unavailable for three business days after the first day that a new employee begins work, the employer must use the Employment Eligibility Verification form (Form I-9) to verify employment eligibility. The employer must document the unavailability of the E-Verify system.

Employers may not continue to employ an unauthorized alien after obtaining knowledge that a person is or has become an unauthorized alien and must keep documentation of any official verification generated for at least three years.

An employer that is required to use the E-Verify system must certify that it is in compliance with the verification requirements on its first return each calendar year to the tax service provider when making contributions to or reimbursing the state’s unemployment compensation or reemployment assistance system.

Beginning July 1, 2024, the Department of Economic Opportunity (DEO) must notify employers of any noncompliance and provide 30 days to cure the noncompliance. If the employer failed to use the E-Verify system as required three times during any 24-month period, the DEO must impose a fine of $1,000 per day until the employer provides sufficient proof that the noncompliance is cured.

Notably, noncompliance constitutes grounds for suspension of all licenses by a licensing agency subject to chapter 120 of the Florida Statutes until the noncompliance is cured.

While the verification requirements apply to all private employers, the section that received the most attention during the Legislative Session only applies to hospitals. Section 5 of SB 1718 provides that each hospital that accepts Medicaid must include a space on its patient admission form for the patient to indicate whether they are a U.S. citizen, lawfully present in the U.S., or not lawfully present in the U.S.

There must be a follow-up statement on the form that the response will not affect patient care or result in a report to immigration authorities.

Rather, the hospital is required to submit a quarterly report to the Agency for Health Care Administration on the number of admissions of patients who indicated U.S. citizenship or lawful presence in U.S., those who indicated not lawfully present in U.S., and those who declined to answer.

The Agency is required to take this information and report to the legislative and executive branches on total hospital admissions and a breakdown of patients’ self-reported status, and to describe information relating to the costs of uncompensated care for aliens not lawfully present in the United States.

There are other state and federal laws governing employment eligibility that physician practices should be knowledgeable of. The FMA encourages physician employers to consult with legal counsel to ensure compliance, and we will present a webinar on the changes made by SB 1718 in the coming months.