Regulatory recap: 2025 highlights and updates

By Mary Thomas, Esq.
Special to the FMA

As 2025 comes to a close, Florida’s regulatory and legislative landscape continues to evolve in ways that directly affect physicians across all practice settings.The following recap highlights key regulatory developments from the past year, as well as updates on issues previously reported, to help physicians stay informed and compliant as they look ahead to the coming year.

Board of Medicine Appointments

On Nov. 14, 2025, Gov. Ron DeSantis announced the appointment of Gobivenkata Balaji, MD, Lee Gross, MD, John Littell, MD, and Deborah Sargeant to the Board of Medicine, along with the reappointment of Amy Derick, MD (Chair), David Diamond, MD, Patrick Hunter, MD, and Nicole Justice.  

The FMA congratulates the new appointees. We also thank former Board members Michael Wasylik, MD, Zachariah Zachariah, MD, and Wael Barsoum, MD, for their service and dedication to protecting the health and safety of Florida patients.   

Scope of Practice for Medical Assistants – Declaratory Statement

At its December meeting, the Board of Medicine considered a petition for declaratory statement asking whether a Florida licensed physician may “employ medical assistants to provide IV infusion therapy containing only saline (no vitamins or medications) to early post-operative patients under the physician’s direct supervision and responsibility.”

After discussion, the Board determined that intravenous administration falls outside the statutory scope of practice for medical assistants, pursuant to Section 458.3485(2), F.S. While declaratory statements apply only to the individual petitioner, they provide important guidance for physicians seeking to remain compliant with Florida law.

Disciplinary Guidelines – Refund of Overpayments and Stem Cell Therapy

At its August meeting, the Board of Medicine updated its disciplinary guidelines to reflect the passage of SB 1808 (2025) addressing refunds of patient overpayments and SB 1768 (2025) relating to stem cell therapy.

Refund of Overpayments 

SB 1808 (2025) requires any physician, healthcare practitioner, or licensed healthcare facility that bills the patient’s insurer to refund to the patient any overpayment within 30 days of determining that an overpayment occurred. During discussion, the Board acknowledged the practical challenges physicians may face in controlling billing operations in many practice settings.

To address these concerns, the Board added first-time violations of Section 456.072(1)(tt), F.S., as a citation offense rather than an immediate disciplinary action. For a first violation, the penalty consists of a $100 administrative fine and refund to the patient. 

If the violation recurs, the Board may pursue formal disciplinary action. For a first disciplinary offense, penalties range from reimbursement to the patient and a letter of concern to up to one year of suspension followed by probation, along with an administrative fine ranging from $250 to $5,000. For a second disciplinary offense, penalties range from reimbursement and a reprimand to up to one year of suspension followed by probation, with an administrative fine ranging from $5,000 to $10,000¹.  The Board emphasized that penalties at the higher end of these ranges would be reserved for the most egregious violations.

The FMA appreciated the Board’s recognition of the operational realities physicians face.

Stem Cell Therapy

SB 1768 (2025) authorizes physicians to perform stem cell therapies that have not been approved by the FDA for orthopedics, wound care, and pain management, subject to specific statutory safeguards. Physicians must obtain signed consent from patients and must advertise that the therapies have not yet been approved by the FDA. Treatments that use fetal or embryo-derived cells from abortions are prohibited.  Violations of this law may result in both criminal penalties and disciplinary actions by the appropriate board.

To align with the statute, the Board updated its disciplinary guidelines to impose, for a first offense, a penalty ranging from one year of probation to license revocation, along with an administrative fine of $2,500 to $10,000. For a second offense, penalties range from two years of probation to license revocation or denial, with an administrative fine of $5,000 to $10,000. A Stem Cell Therapy Workgroup is scheduled to meet on Jan. 8, 2026, to adopt rules implementing this legislation. 

Office Surgery Inspections – Repeat Deficiencies

At its April and June meetings, the Surgical Care and Quality Assurance Committee examined concerns related to repeat deficiencies identified during office surgery inspections. In many cases, registrants corrected deficiencies, such as incomplete crash cart supplies, only to be cited for the same issue during subsequent inspections. These recurring problems raised questions about accountability and the effectiveness of the current enforcement process.

The Committee discussed the possibility of a joint meeting with the Board of Osteopathic Medicine to ensure regulatory consistency between allopathic and osteopathic standards. This issue has not been raised or revisited by the Committee since the June meeting, and the FMA will continue to monitor any future developments.

Graduate Assistant Physician

The Live Healthy Act (2024) created the Graduate Assistant Physician (GAP) limited license for unmatched medical school graduates who have passed all parts of the USMLE or the COMLEX. As a brief overview, GAPs may provide healthcare services only under the direct supervision of an approved physician, who may supervise no more than two GAPs and is professionally liable for their actions. The license is time-limited, valid for two years with a one-time, one-year renewal, to encourage transition into residency training rather than allowing long-term practice as a GAP. 

To implement the statute, the boards adopted Rule 64B8-7.005, F.A.C., effective Nov. 14, 2024. More than one year after adoption of the rule, only one GAP license has been issued as of this update.

For any questions on the regulatory activities impacting the practice of medicine, please contact legal@flmedical.org or call (850) 224-6496. 



Mary Thomas, Esq., is the Executive Director of the Council of Florida Medical School Deans. Previously, she served for over a decade as the Assistant General Counsel for the FMA. Ms. Thomas continues to represent the FMA in matters before the state's regulatory boards.