Dec 31 / Stephen Choate, MHA, MT-BC

Breaking Down The Music Therapy Licensure Act: What Florida’s New Bill Does (and Doesn’t) Do

Music therapy licensure is once again on the table in Florida.

In December 2025, companion bills were officially filed in both chambers of the Florida Legislature, proposing the establishment of professional licensure for music therapists. The filing comes on the heels of recent Medicaid-related disruptions that temporarily halted access to music therapy services for families across the state.

This article breaks down what the proposed Music Therapy Licensure Act actually does, how it would need to move through the legislative process, why earlier efforts failed, and why advocates believe this attempt presents the strongest case for licensure Florida has yet seen.

What Was Filed

For the 2026 Regular Session, Representative Anna Eskamani and Senator Carlos Guillermo Smith introduced companion bills in the Florida House and Senate that would establish a formal licensure pathway for music therapists under the Florida Department of Health (DOH). Together, the bills propose incorporating music therapy into Florida’s existing professional regulatory framework rather than creating a standalone board or regulatory body.

If enacted, the legislation would authorize DOH to license and oversee professional music therapists. The bills also establish a Music Therapy Advisory Committee within DOH to support implementation and set timelines to guide the transition.

By situating oversight within DOH, the legislation aligns music therapy with the regulatory structure used for many other allied health professions in Florida, reflecting a model the state already employs.

What the Bill Aims to Do

  • Establish state licensure for music therapists in Florida
  • Implement title protection, limiting use of the term music therapist to authorized individuals
  • Define the statutory scope of music therapy
  • Place regulatory authority with the Florida Department of Health
  • Authorize investigation and discipline of licensed practitioners
  • Create a Music Therapy Advisory Committee to advise the Department of Health
  • Set minimum licensure qualifications and application requirements
  • Provide a transition period for current practitioners to obtain licensure
  • Clarify exemptions for other professionals, students, and supervised practice
  • Standardize professional oversight for public protection

From Bill to Law

For the Music Therapy Licensure Act to become law, it must move through Florida’s legislative process, which is structured to subject proposed regulations - particularly those affecting professional practice - to multiple layers of review.

After filing, a bill is referred to one or more committees in both the House and Senate, typically including policy committees related to health care and professional regulation, as well as fiscal committees if the proposal has budgetary implications. Each committee may hold hearings, receive public testimony, and vote on whether to advance the bill. A bill must pass every committee to which it is assigned before it can be considered by the full chamber.

If approved by committee, the bill proceeds to the House or Senate floor for debate and a vote. Both chambers must pass the bill in identical form. If differences exist between the House and Senate versions, those differences must be reconciled before final passage.

Once both chambers approve the same version, the bill is sent to the Governor, who may sign it into law or veto it. If signed, the law takes effect on the date specified in the legislation, which for most professional regulation bills is July 1, following passage.

Additionally, Florida’s process differs from that of some other states in its heightened scrutiny of occupational regulation. Proposals that create new licensure requirements are often assigned to multiple committees and evaluated closely for necessity, scope, and potential economic impact. As a result, bills establishing professional licensure in Florida typically face a longer and more robust review than in states less reluctant to impose these regulatory requirements. We will discuss this in greater detail in subsequent sections of this article.

Previous Attempts

Florida has considered regulating the practice of music therapy before, but prior efforts failed to advance beyond the committee stage.

During the 2017 legislative session, lawmakers introduced CS/HB 729, a bill that proposed mandatory state registration - not full licensure - for music therapists under the Florida Department of Health. The bill would have prohibited individuals from practicing music therapy or representing themselves as music therapists unless registered with the state, while providing exemptions for certain licensed professionals, students, and supervised practice arrangements.

The 2017 proposal did receive a favorable vote in its first committee of reference, the Health Quality Subcommittee, which adopted the bill unanimously as a committee substitute. However, the bill ultimately died in the Health Care Appropriations Subcommittee and never reached the House or Senate floor for a vote.

The staff analysis accompanying the bill makes clear why it stalled. Under Florida’s Sunrise Act (Florida Statute § 11.62), the Legislature may not regulate a previously unregulated profession unless that regulation is:

  • necessary to protect the public from “significant and discernible harm,” and
  • narrowly tailored so as not to unnecessarily restrict entry into the profession or reduce access to services.

Although proponents argued that unqualified individuals could potentially cause harm through improper use of music-based interventions, the analysis concluded that the evidence presented was largely anecdotal. No clinical or scientific studies were offered demonstrating that the unregulated practice of music therapy had resulted in widespread, measurable harm to the public.

In fact, the staff analysis explicitly noted that while there is research supporting the benefits of music therapy, there were no studies comparing outcomes between board-certified music therapists and non-credentialed providers, nor clear evidence that unregulated practice posed a recognizable threat to public health or safety. Similar findings from other states’ Sunrise reviews were cited in support of this conclusion.

This outcome was consistent with broader patterns in Florida policymaking. The state has long taken a cautious approach to occupational regulation, particularly where new requirements may function as barriers to entry or restrictions on trade. Florida law places the burden on proponents to demonstrate that existing mechanisms - such as professional certification, employer oversight, or contractual requirements - are insufficient to protect the public.

The Strongest Case Yet

What distinguishes the current licensure effort from previous attempts is the emergence of a concrete, statewide disruption to services. In recent months, families across Florida experienced abrupt interruptions in access to music therapy through Medicaid managed care - services that some parents described as a “lifeline” for their children. Unlike earlier debates, which centered largely on hypothetical or potential risks, the current discussion is grounded in observable consequences affecting constituents in real time.

For advocates of licensure, these disruptions may constitute the type of evidence of harm that was previously found lacking. Whether lawmakers agree and ultimately determine that licensure is the appropriate response remains uncertain, but the factual and political context surrounding the issue poses an opportunity previous efforts did not have.

Timing

The timing of the bill is highly consequential. At the time of publication, families across Florida remain in limbo following the suspension of music therapy services through Medicaid managed care. Many are still awaiting clarity on whether - and when - services will resume under their managed care provider.

Unlike earlier licensure proposals, which were introduced in relatively stable service environments, the current legislation arrives amid active disruption. The issue is no longer hypothetical; it is unfolding in real time, affecting constituents who are directly engaged with the healthcare system and seeking immediate resolution. This urgency changes how lawmakers encounter the issue and increases pressure to consider structural changes.

Evidence of Harm

It could (and likely will) be argued that the service disruptions themselves substantiate harm to the public. For families who relied on music therapy as part of ongoing care - particularly for children with complex needs - the sudden loss of services was not merely inconvenient, but destabilizing. Whether legislators will agree that halting these services is inherently harmful is yet to be revealed.

In tandem with these disruptions, the Florida Music Therapy Task Force initiated a statewide Risk Assessment: Evaluation of Harm survey aimed at gathering practitioner-reported information about the effects of the absence of state regulation. The survey seeks to document how the lack of licensure and formal state recognition may have affected public protection, quality of care, continuity and expansion of services, and access to funding or reimbursement opportunities.

Under Florida’s Sunrise Act, this distinction is critical. Anecdotal and self-reported data, standing alone, have historically been insufficient to justify new occupational regulation (such as in 2017). However, when presented alongside statewide disruptions to Medicaid services in real-time, it may have more teeth.

Causation

Perhaps the most disputable aspect of the argument is causation.

Some advocates for licensure maintain that the large number of non-credentialed providers delivering services through Sunshine Health contributed to the termination of the contract with its intermediary who managed these services. In their view, the lack of licensure allowed inconsistent credentialing practices to persist, which in turn, destabilized service delivery. A recent report by the Tampa Bay Times highlighted the scale of the issue, claiming more than a thousand providers lacked standard credentials.

While utilizing non-credentialed providers raises questions, opponents of licensure are likely to frame the issue differently. They may argue that the harm was not caused by the absence of licensure itself, but by failures to comply with existing requirements. Providers rendering services must be properly enrolled and possess Medicaid provider identification numbers - a step that could be met without state licensure. 

Ultimately, what led to the disruption of services was the sudden enforcement of this Medicaid ID requirement.

When Sunshine announced in mid-October that its contract would be terminated on December 31, providers with Medicaid IDs were permitted to continue providing services through the end of the year. The problem, since it was not required in credentialing, was that most providers never obtained these. This sudden drop in the supply of eligible providers resulted in the interruption of services for so many families - not because they weren’t approved to be seen - but because so few of the providers now met the requirement to serve them.

From this perspective, the issue was not regulatory insufficiency, but operational noncompliance. Had the credentialing process been followed correctly, the resulting service disruptions would have been avoided entirely. Under this analysis, licensure would not address the root cause of the failure; it would simply add an additional layer of regulation to a system that already has compliance mechanisms in place.

This distinction matters greatly in Florida’s political context. The state’s long-standing reluctance to introduce new barriers to professional practice means lawmakers will scrutinize whether licensure is necessary to prevent future harm, or whether improved enforcement of existing processes would be sufficient. Resolving that question - whether licensure addresses a structural gap or merely responds to administrative breakdown - will likely be the greatest hurdle facing the bill.

Beyond Licensure

Regardless of whether Florida ultimately implements music therapy licensure - through the proposed Music Therapy Licensure Act or a future legislative effort - the profession will still face significant structural challenges. Licensure, while foundational, is not a comprehensive solution to the issues that determine whether a field can thrive sustainably within modern healthcare systems.

State licensure alone does not guarantee insurance reimbursement, establish viable reimbursement rates, or ensure consistent access to payer contracts. It does not, by itself, resolve administrative barriers within Medicaid managed care, nor does it ensure that services will be funded at levels that reflect the training, scope, and clinical expertise of board-certified music therapists. These challenges persist even in states where licensure is already in place.

What licensure can do is serve as a starting point. It can ensure professional standards, clarify minimum qualifications, and help legitimize the field in the eyes of the public. In regulatory environments that prioritize credentialing and risk management, licensure often serves as a prerequisite for broader recognition - but it is only the first step.

Building a thriving and sustainable field will require continued work beyond regulation - engaging payers, educating policymakers, strengthening data on outcomes and cost-effectiveness, and addressing workforce and reimbursement realities head-on.

MusicMED’s upcoming article will explore this distinction in greater depth, examining licensure not as an endgame, but as a starting point - and outlining what must follow if music therapy is to achieve durable access, fair compensation, and long-term viability in Florida and beyond.
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