The Florida state legislature’s stain on the Florida Statutes reflects an apparent determination on the part of lawmakers to undermine public health in Florida.
The MOBILE Act was sold to the press and the public as a reform that would greatly streamline the process of out-of-state licensed healthcare providers obtaining licensure in Florida. The most optimistic sound bites even dared to dream that it would make improvements to Florida’s healthcare system. Which, as the nation’s premier retirement destination and being approximately three times the national average population for its land area, does indeed badly need it.
The reality of this legislative misfire is as grim as the public face of the act was hopeful.
Traditionally, healthcare providers looking to get licensed in Florida would (often with the assistance of counsel) submit an application to the Florida Department of Health (DOH), together with whatever documentation was needed to prove their satisfaction of a complete set of licensure requirements set forth by Florida law. If the applicant was unquestionably qualified, they would be issued a license as soon as the DOH verified their satisfaction of these requirements. This is known as a routine application. If the licensee’s documentation or background was defective or ambiguous in any way that cast even the smallest amount of doubt as to whether they qualify under Florida law, they would be summoned to a hearing before their professional licensing board (such as the Florida Board of Medicine, Nursing, Pharmacy, or Respiratory Care, etc.) to provide testimony and any additional information that would alleviate or address the board’s concerns and enable them to reach an ultimate decision.
The licensing boards were invested with this responsibility due to their experience in the applicants’ sought field of work, and of the standard of care that attaches to the work itself. Though serving a quasi-judicial function, most of the members of each licensing board are selected from among the very same professional communities they regulate. A minority of members are drawn from related or unrelated fields to offer outside viewpoints and round out the board’s collective perspective. Thus, as a whole, each licensing board is uniquely qualified to grant entry into their profession in Florida.
Although board members are experts in their fields, they are in the end human. While the licensure process is thoughtfully designed, it can be unforgiving to those who are denied licensure or faced with additional conditions and hurdles.
However, despite offering little comfort to those negatively affected, these decisions have always been rational; at least as far as being based on reasons, and reasons that are, at least arguably, connected to patient care and the demands of the profession. Importantly, these reasons are openly stated during board hearings, debated, and weighed against other factors.
Because these hearings are publicly noticed, recorded, and published, the process is meaningfully subject to review, study, and appeal, reflecting Florida’s strong tradition of transparency.
The MOBILE Act, for many out-of-state applicants, effectively eliminates the traditional licensure review process. Under the act, applicants who still qualify for licensure by endorsement (meaning they are already licensed in another state) are entitled to a decision within seven days of submitting a complete application. If it were not impossible, this accelerated timeline could reasonably be seen as a “streamlining” of the endorsement process and may even enhance access to care, provided there is a limitless supply of well-qualified, out-of-state applicants with spotless records.
However, it’s also roughly equivalent to luring healthcare providers to Florida with the promise of a pet unicorn and a thirty-second line at the DMV. The act is silent as to how the Department of Health will meet this obligation in the event of a shortage of unicorns, or in the event that the realities of time, administrative workload, and available manpower make it impossible to process even the routine license applications in seven days.
It should also be noted that for the majority of licenses, anyone who meets the strict criteria for licensure by endorsement already did so under the traditional requirements. In fact, these applications were already classified as “routine” and processed as quickly as possible, even before the MOBILE Act was enacted. In that light, the act’s one supposed benefit appears to be little more than an illusion: a mirage sold to the public.
Yet when it comes to the MOBILE Act’s real and attainable effects, they are not streamlined or efficient but rather highly damaging for Florida’s healthcare landscape in terms of the availability of care.
The MOBILE Act also attempts to bind each and every endorsement applicant to a set of licensure requirements that are not only demanding (in terms of the former experience required before relocation to Florida) but which, in many cases, blanketly exclude vast portions of formerly qualified endorsement candidates. These exclusions are based on facially legitimate and relevant considerations, such as former convictions, prior discipline, and civil litigation — all of which would (even under the old rules) have warranted review and consideration by the applicable Board.
The MOBILE Act also seeks to impose a rigid set of licensure requirements on all endorsement applicants, requirements that are not only stringent in terms of prior experience before relocating to Florida, but that, in many cases, categorically disqualify large groups of candidates who were previously eligible. These exclusions are based on facially legitimate factors, such as past convictions, prior disciplinary actions, or involvement in civil litigation all of which, under the previous rules, would have triggered individualized review by the relevant licensing board, rather than automatic rejection.
The trouble is that these considerations are no longer to be considered, but rather, according to the strictest reading of the MOBILE Act, simply present an absolute bar to licensure in Florida.
It’s appealing to assume these changes are protective in the sense that any much-needed caregiver denied licensure in Florida must have been rejected for good reason. And before the act’s passage, that assumption would have been largely accurate. However, closer examination reveals otherwise; while the new standards are more burdensome, they aren’t actually higher in the sense of requiring better qualified applicants. In many cases, the new restrictions are so arbitrary as to exclude even the best.
The MOBILE Act disqualifies out-of-state doctors from licensure in Florida if they have ever faced professional discipline, even for the most minor infractions. As a result, a well-represented Florida licensee may return to practice after serious violations and sanctions, while an out-of-state physician could be permanently barred for a far less serious offense under their home state’s laws.
Penalizing a healthcare professional for having been already licensed in another state, while extending due process and sound discretion to identically situated applicants in Florida is unmistakably bad for the consumer public, as well as most likely unconstitutional under the commerce clause and full faith and credit clause of the Federal Constitution. Even so, if one accepts as valid a certain amount of protectionism towards Florida’s healthcare industry, this double standard could be seen as rational. Except that in Florida, even being denied licensure (for any profession, in any state) is considered discipline, and could therefore forever bar a licensee from Florida under this section, despite never having violated the professional regulations of any state.
Because a person is not generally entitled to professional licensure, and when they are, they are often responsible under state law for proving it, a person can be denied licensure in Florida for an offense as mild as missing a letter from the California Department of Health. Previously, the Florida licensing Board in question may have considered this infraction in light of the applicant’s qualifications and their all too human capacity for reason. Now, the unyielding machinery of the MOBILE Act robs them of that opportunity, and thereby robs the rest of us of a qualified healthcare provider. One would be forgiven for assuming that this is an extreme, or even hypothetical example. It’s not. It’s a real and regular occurrence.
The National Practitioner Data Bank collects information on every medical malpractice settlement. As a result, under the most stringent reading of the MOBILE Act as it currently exists, every practitioner who has been ever settled a malpractice claim (or had one settled on their behalf) is now in danger of exclusion from obtaining Florida licensure. Notwithstanding the details or underlying facts behind a former malpractice settlement, the exclusion of so many qualified providers is not a loss the people of Florida can afford. To illustrate just one example of why: According to the American Medical Association, the typical OB/GYN is sued an average of 1.52 times in their career. And these claims are so frequently settled that the average malpractice insurance premium for OB/GYNs is higher than any other medical specialty, and has been seen to measurably contribute to a trend of exodus from that already underserved specialty. What this means, put simply, is that a critically underserved medical field, at least in Florida, is about to become far more so.
While OB/GYNs face the highest malpractice insurance premiums, they rank second nationally in terms of the number of lawsuits defended.
The number one spot? Surgeons. With an astonishing 193 malpractice suits per 100 general surgeons, the MOBILE Act, if interpreted and enforced according to its strictest and most far-reaching terms, stands to exclude surgeons from practicing in Florida at a higher rate than any other profession or medical specialty.
Disciplinary actions are based on specific allegations of professional misconduct. Malpractice claims, whether meritorious or not, at least rest on accusations of error. But among the most arbitrary reasons a healthcare professional can be reported to the National Practitioner Data Bank (NPDB)involves no requirement of actual wrongdoing and offers little to no meaningful opportunity for appeal or redress. This is in reference to peer review proceedings.
The function, structure, and best practices surrounding peer reviews are discussed in greater detail in Staff Privileges, Credentialing and Peer Review. For present purposes, it is critical to understand the following: peer review proceedings may be initiated entirely at a hospital’s discretion, the procedures vary significantly by institution, and the reporting requirements emphasize transparency over fairness or outcome (NPDB reporting requirements).
With the passage of House Bill 1299, effective July 1, 2025, the following language was added to the MOBILE Act under section (2)(c)4:
“If the reported adverse action was a result of conduct that would not constitute a violation of any law or rule in this state, the board, or the department if there is no board, may:
This means that an applicant who was reported to the NPDB may now still qualify for Florida licensure, if the conduct that triggered the report would not have violated Florida law. This discretion is restored to the licensing boards who can now again weigh context, review facts, and impose safeguards where needed, rather than issuing automatic denials.
That said, this is not as simple as it sounds and appealing to counsel who specializes in medical licensing defense becomes an apparent necessity as a layperson. For one, this exception only applies to the section otherwise barring people for NPDB reports, not the whole thing. Separate bases for MOBILE exclusion, like former discipline or convictions, are still very much in effect for automatic denials. The return of the licensing Boards’ proper discretion (while indeed cause for much rejoicing) only applies if there’s no other reason the Board has to deny someone under the Act, AND if the NPDB report wasn’t for conduct that would violate Florida law.
If you’re a healthcare professional considering a move to Florida and plan to apply for licensure, consulting with an experienced healthcare defense attorney can be invaluable in navigating the state’s complex licensure process. While the MOBILE Act has seen some improvements, Florida’s licensing standards remain highly restrictive. Determining your eligibility requires a careful, individualized review of your professional and legal history.
Chapman Law Group’s Professional Licensing and Regulatory Affairs attorneys are here to guide that process. If you’re an out-of-state health care provider navigating Florida licensure, contact us today. We understand the rules, the boards, and complex legislation like the MOBILE Act and we know how to fight for your healthcare license.
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