Imagine a hypothetical: a Florida worker falls at a construction site and is rushed to the ER. The surgeon who operates on the worker has no idea that six months later, they’ll still be fighting to get paid, caught in a bureaucratic standoff between an employer claiming ignorance and an insurer denying the claim.

That's the future Florida physicians may face if two Republican-backed bills moving through the state legislature become law.

Senate Bill 1380 and House Bill 1307, introduced by Senator Jonathan Martin and Representative Berny Jacques, take direct aim at employers who hire undocumented workers, rewriting state law to exclude "unauthorized aliens" from the legal definition of "employee."

Among other things, the legislation makes employers "personally and fully liable" for all medical costs when an undocumented worker is injured on the job and explicitly bars employers from shifting those costs to any other party, including a workers’ comp insurer.

The political intent is clear: punish businesses that hire workers without legal status. But the practical fallout may land squarely on healthcare providers, who would be forced to navigate a potential billing nightmare.

For physicians already stretched thin by the administrative burdens of workers' comp, these bills may bring uncertainty into every claim. At the point of care, doctors will not know whether the patient is covered, who's responsible for payment, or whether they'll ever receive reimbursement.

Florida Legislature Comes for Employers

Under the proposed legislation, employers must run an E-Verify check on an injured employee before submitting a workers' comp claim, and maintain documentation proving they did so. If they can't produce that verification, the employer becomes liable for all treatment costs.

Section 10 of both bills creates a new section of Florida Statutes, Section 440.1001, which would state (emphases ours):

“An employer who knowingly hires or employs an individual who is not authorized to work in the United States under federal law is personally and fully liable for all medical and treatment costs and related expenses resulting from an injury sustained by the unauthorized alien during his or her employment…

…An employer may not transfer or otherwise shift financial responsibility for medical and treatment costs and related expenses resulting from an injury to any third party, including an insurance company, a state agency, or any other entity.”

The intent is to make hiring undocumented workers financially risky for employers. However, the language creates a different problem entirely, ending the guarantee of coverage for injured workers and leaving providers to furnish care and then figure out whether anyone will pay.

The Provider’s Puzzle: Who Pays?

The proposed legislation creates a problem for healthcare providers: they have no way of knowing who is financially responsible for treatment.

When an injured worker arrives at a clinic or emergency room, the treating physician faces an impossible situation, unable to independently verify:

• Whether the patient is authorized to work in the United States
• Whether the employer conducted an E-Verify check before submitting the claim
• Whether the workers' compensation insurer will accept or deny the claim

Under current law, the answer is straightforward: workers' comp coverage applies, and the insurer is responsible. Under this legislation, the answer would depend entirely on compliance steps taken (or not taken) by the employer, potentially months or years before the injury occurred.

This might leave providers in limbo.

If providers bill the workers' comp carrier, will the carrier deny the claim, asserting that the employer failed to E-Verify and is therefore personally liable? If they bill the employer directly, does the employer dispute liability, claiming they did verify or that the employee presented fraudulent documents?

Meanwhile, the provider has already rendered care and faces the prospect of protracted disputes or outright non-payment.

The legislation explicitly prohibits employers from "transfer[ring] or otherwise shift[ing] financial responsibility...to any third party, including an insurance company." But how is a physician supposed to know, at the moment a worker with an injury walks through the door, whether that prohibition applies?

The practical result will likely be that providers must deliver care first and untangle the liability web later, if they can untangle it at all.

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