Legislative News

 AmyYoung   Amy Young-Governmental Consultant
   

2015 Legislative Session Recap

The Florida Legislature recently adjourned sine die in a historic way. Due to a bitter impasse between House Republicans and the Senate over Medicaid expansion, the House packed up their bags and went home three days early before the official May 1 adjournment. This was an unprecedented and historic end to a contentious session. As a result of the surprise shut-down, every piece of legislation relating to healthcare, with the exception of the 24-hour waiting period for abortions, failed passage. We worked hard on so many issues for more than six months including scope of practice for nurse midwives, prohibition against balance billing, and prohibition on retroactive denials, step therapy provisions, direct primary care contracts, telemedicine, and many others. Some issues were very good for ACOG and others were not. However, we will certainly be back at the table over the summer when a special session is called to deal with the failed budget negotiations and other related matters.

More specifically, these are the bills that failed passage this session that ACOG District XII worked on throughout the session. Stay tuned for more activity after the session this June!!

SB 516 by Bean

BALANCED BILLING

General Health Insurance Coverage for Emergency Services; Prohibiting coverage for emergency services from requiring a prior authorization determination; requiring such coverage to be provided regardless of whether the service is furnished by a participating or nonparticipating provider; specifying coinsurance, copayment, limitation of benefits, and reimbursement requirements for nonparticipating providers; prohibiting a nonparticipating provider from collecting or attempting to collect an amount in excess of specified amounts, etc. Effective date: October 1, 2015

 

HB 681 by Trujillo

BALANCED BILLING

General Health Insurance Coverage for Emergency Services: Prohibits coverage for emergency services from requiring prior authorization determination; requires such coverage to be provided regardless of whether service is furnished by participating or nonparticipating provider; specifies coinsurance, copayment, limitation of benefits, and reimbursement requirements for nonparticipating providers; prohibits nonparticipating provider from collecting or attempting to collect amount in excess of specified amounts; revises methodology for determining HMO reimbursement amounts for certain services. Effective date: October 1, 2015

SB 784 by Gaetz, D.

MANAGED CARE/PRESCRIPTION DRUGS

General Healthcare; Providing that this act shall be known as the “Right Medicine, Right Time Act”; creating the Clinical Practices Review Commission; requiring a managed care plan that establishes a prescribed drug formulary or preferred drug list to provide a broad range of therapeutic options to the patient; requiring sufficient clinical evidence to support a proposed coverage limitation at the point of service; requiring the commission to evaluate the sufficiency of the evidence and the Office of Insurance Regulation to approve coverage limitations on the basis of the commission’s evaluation, etc. Effective date: October 1, 2015

HB 863 by Harrison

MANAGED CARE/PRESCRIPTION DRUGS

General Health Insurance: Designates act as "Florida Patient Protection Act"; revises prescription drug coverage requirements for managed care plans; provides for appeal of certain healthcare coverage decisions made by managed care plans, health insurers, and HMOs; authorizes OIR to hold certain public hearings; requires OIR to issue certain reports annually; prohibits discriminatory benefit plans; provides penalties for use of discriminatory treatment criteria; provides requirements for certain civil actions brought against insurer or HMO; provides penalties and attorney fees. Effective date: July 1, 2015

SB 634 by Stargel

OBSTETRICAL SERVICES

General Responsibilities of Healthcare Facilities; Repealing provisions relating to practice parameters for physicians performing Caesarean section deliveries in provider hospitals; requiring a hospital to notify certain obstetrical physicians within a specified timeframe before the hospital closes its obstetrical department or ceases to provide obstetrical services, etc. Effective date: July 1, 2015

HB 161 by Burton

OBSTETRICAL SERVICES

General Responsibilities of Healthcare Facilities: Repeals provisions relating to provider hospitals; requires hospital to notify obstetrical physicians before closing its obstetrical department or ceasing to provide obstetrical services. Effective date: July 1, 2015

HB 7047 by Health Innovation

DIRECT PRIMARY CARE AGREEMENTS

General Bundled Healthcare Services: Requires analysis of medical tourism for bundled healthcare services in Economic Development Programs Evaluation; requires EFI to collaborate with DEO to market state as healthcare destination; requires Division of Tourism Marketing to include in four-year plan discussion of promotion of medical tourism for bundled healthcare services; provides plan requirements; specifies that direct primary care agreement does not constitute insurance and is not subject to Florida Insurance Code; specifies that entering into such agreement does not constitute business of insurance and is not subject to code; provides that certificate of authority is not required to market, sell, or offer to sell such agreement; specifies criteria for such agreement. Effective date: July 1, 2015

SB 478 by Bean

TELEHEALTH

General Telehealth; Providing certain practice standards for telehealth providers; authorizing telehealth providers to use telehealth to prescribe controlled substances, with an exception; prohibiting the use of telehealth or specified computer-controlled devices to prescribe optical devices, etc. Effective date: July 1, 2016

HB 545 by Cummings

TELEHEALTH

General Telehealth: Defines "telehealth" & "telehealth provider"; provides for certain practice standards for telehealth providers; authorizes telehealth providers to use telehealth to prescribe certain controlled substances; provides recordkeeping requirements and standards; excludes telehealth products from definition of "discount medical plan". Effective date: July 1, 2015

SB 532 by Grimsley

ARNP PRESCRIBING AUTHORITY

General Healthcare Services; Directing the Department of Veterans’ Affairs to contract for a study to determine the need and location for additional state veterans’ nursing homes; revising the authority of a licensed physician assistant to order medication under the direction of a supervisory physician for a specified patient; specifying that a direct primary care agreement does not constitute insurance and is not subject to the Florida Insurance Code; authorizing a licensed practitioner to authorize a licensed physician assistant or advanced registered nurse practitioner to order controlled substances for a specified patient under certain circumstances, etc. Effective Date: July 1, 2015

HB 281 by Pigman

ARNP PRESCRIBING AUTHORITY

General Drug Prescription by Advanced Registered Nurse Practitioners and Physician Assistants: Expands categories of persons who may prescribe brand drugs under prescription drug program when medically necessary; exempts controlled substances prescribed by ARNP or physician assistant from disqualifications for certification or licensure as deputy or state pilot; applies certain existing penalties to ARNP; requires advanced registered nurse practitioners and physician assistants who prescribe controlled substances to make certain designation, comply with registration requirements, and follow specified standards of practice; redefines term "practitioner" to include ARNPs and physician assistants under Florida Comprehensive Drug Abuse Prevention and Control Act. Effective Date: July 1, 2015

SB 614 by Grimsley

ARNP – APRN AUTHORIZATION

General Healthcare; Expanding the categories of persons who may prescribe brand drugs under the prescription drug program when medically necessary; exempting controlled substances prescribed by an advanced registered nurse practitioner or a physician assistant from the disqualifications for certification or licensure, and for continued certification or licensure, as a deputy pilot or state pilot; applying existing penalties for violations relating to the prescribing or dispensing of controlled substances to an advanced registered nurse practitioner, etc. Effective Date: Except as otherwise expressly provided in this act, this act shall take effect upon becoming a law

HB 547 by Pigman

ARNP – APRN AUTHORIZATION

General Scope of Practice of Advanced Practice Registered Nurses and Physician Assistants: Re-designates ARNPs as advanced registered practice nurses (APRNs); provides for independent APRNs (IAPRNs) to practice advanced or specialized nursing; exempts IAPRNs and physician assistants (PAs) from requirement that certain medical acts be supervised by physician; revises APRN certification requirements; authorizes APRNs and PAs to administer, dispense, and prescribe medicinal drugs pursuant to protocol; provides for registration of IAPRNs who meet certain requirements; specifies acts that IAPRNs and physician assistants are authorized to perform without physician supervision or protocol; provides for eligibility of IAPRNs for clinical privileges; requires IAPRNs to maintain medical malpractice insurance or provide proof of financial responsibility. Effective date: July 1, 2015

SB 1200 by Brandes

PERSONAL INJURY/WRONGFUL DEATH COMPENSATION

General Compensation for Personal Injury or Wrongful Death Arising From a Medical Injury; Creating the Patient Compensation System; providing a process for filing applications for compensation under the system; requiring individuals with relevant clinical expertise to determine whether the facts stated in the application, prima facie, rise to a claim for medical injury; providing for review of awards by an administrative law judge, etc. Effective date: July 1, 2016

HB 1109 by Pigman

PERSONAL INJURY/WRONGFUL DEATH COMPENSATION

General Compensation for Personal Injury or Wrongful Death Arising from a Medical Injury: Provides exclusive remedy for personal injury or wrongful death arising from medical injury; provides exceptions; creates Patient Compensation System; provides for various offices and committees; provides for independent medical review panels; prohibits certain conflicts of interest; provides process for filing application; provides for disposition of application; provides for determination of compensation when there is sufficient proof of medical injury; provides that compensation shall be offset by past & future collateral source payments; provides for determinations of malpractice for purposes of specified constitutional provision; provides for review of appeals by administrative law judge; requires annual contributions from specified providers; provides for provider opt out; requires annual report. Effective date: July 1, 2015

SB 1240 by Richter

MEDICAL/HEALTHCARE – DAMAGES RECOVERABLE

General Damages Recoverable For Cost Of Medical Or Healthcare Services; Providing for the calculation of an award of damages for certain medical or healthcare services paid or owed by a claimant or a governmental or commercial insurance payor, subject to certain restrictions; providing that the amount of a lien or subrogation claim asserted by Medicaid, Medicare, or a payor regulated under the Florida Insurance Code for certain past medical expenses, in addition to the amount of copayments or deductibles payable by the claimant, is the maximum amount recoverable and admissible into evidence under certain circumstances, etc. Effective date: Upon becoming a law

HB 1199 by Metz

DAMAGES IN PERSONAL INJURY ACTIONS

General Damages in Personal Injury Actions: Provides for calculation of damages; specifies that certain evidence may not be used for certain purposes; provides that difference between amount originally billed by healthcare provider who has provided medical or healthcare services to claimant & actual amount remitted to provider is not recoverable; limits amount of damages in certain actions involving liens or subrogation claims by certain payors. Effective date: Upon becoming a law.


Contact:

Colleen Filbert
Project Manager
cfilbert@acogdistrict12fl.org

ACOG District XII:
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American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998