The Florida Current: Summary of 2011 Florida Health Care State Legislation
The Florida Current, known for its timely news about state politics, issues and the Florida Legislature, posted this excellent summary of health care legislation in the 2011 State Legislative Session:
2011 session summary: Health Care
Christine Jordan Sexton, 05/11/2011 - 09:37 AM
When it comes to health care and health insurance, the 2011 session will be remembered for what lawmakers did, as well as what they didn't do.
Lawmakers passed a far-reaching overhaul of the $22 billion Medicaid program, requiring most Medicaid patients to enroll in managed care plans over the next four years. It also passed a spate of lawsuit protections for doctors and hospitals that treat Medicaid patients and agreed to require out-of-state doctors to register with the state before they can testify as expert witnesses in lawsuits.
But other high-profile health issues -- such as requiring medical loss ratios for health insurance carriers as mandated by federal law, or making changes to state employee health insurance -- didn't pass. There were different reasons for inaction on those issues: While there was no support for changing state insurance law to bring the MLR requirement in line with federal law, there was support to trim state administrative overhead. Many embraced the idea of making state employee health insurance policies more reflective of the commercial market.
But at the end of the day, the chambers started to bicker, and the issue was dropped, a victim of the session's last dysfunctional hours.
KEY ISSUES
MEDICAID: Arguably this was the No. 1 issue of the 2011 session, after the chambers couldn’t reach a compromise on the issue last year. The final bills approved by legislators, HB 7107 and 7109, require Medicaid patients to enroll in managed care plans beginning October 2013 for long-term care and 2014 for traditional health care generally provided for women and children. Under the revised Medicaid program, the state would be divided into 11 regions and competitively bid among interested managed care plans. The bill dictates a minimum and maximum number of plans for each region, and requires at least one provider service network in each.
The revised Medicaid program would allow the state to assess premiums for participation, and also would allow for co-payments for inappropriate use of emergency rooms. The changes require Florida to submit a new waiver to the federal government for approval before any changes can be made. Before submitting the waiver, the state must hold a handful of meetings across the state to get input from Floridians.
One of the overhaul measures, HB 7109, includes limits on lawsuits against Medicaid providers. The measure limits non-economic damages for personal injury or wrongful death to $300,000 per claimant. The cap can be pierced if the plaintiff can prove by clear and convincing evidence that the provider acted wrongfully. Hospitals include ambulatory surgical centers and mobile surgical facilities licensed under a hospital. No practitioner is liable for more than $200,000 in non economic damages unless the injured patient can prove by clear and convincing evidence that the practitioner acted wrongfully,
LIABILITY PROTECTIONS: There were a number of lawsuit protections passed this year to the benefit of Florida hospitals and doctors. The Legislature gave the nod to HB 395, which makes operational changes to Shands hospitals in Gainesville and Jacksonville, and gives the hospitals and their affiliated physicians and clinics sovereign immunity. The Legislature also approved a bill, SB 1676, that will give the University of Miami and its employees sovereign immunity when working at Jackson Memorial Hospital.
The Florida Medical Association pushed its tort agenda separately from Medicaid legislation, focusing on HB 479. Doctors pushed measures that would allow them to buy insurance policies giving them the right to veto any offer for admission of liability, as well as the right to arbitrate any offer that is within policy limits.
FMA President Madelyn Butler, M.D., said in a statement that the organization was “extremely pleased” with the bill. “For over a decade (the FMA has considered) the passage of this legislation to be major step forward in making Florida a more friendly place to practice medicine.”
But lawmakers rejected proposals that would have limited lawsuits against Florida nursing homes. Senate Rules Chairman Sen. John Thrasher said simply that they'd hit their limit on lawsuit protections.
HEALTH CARE BUDGET: The overall health care budget included in SB 2000 appropriates nearly $30 billion for health care and human services, or a 5 percent increase. The final budget includes funding for the Medically Needy and MEDS-AD program, while also providing a $36.2 million increase for Florida KidCare and a reimbursement rate increase for dentists who serve children. But there are also plenty of cuts in the final budget. Hospitals will have their Medicaid reimbursement rates cut by 12 percent, county health departments’ rates will be cut 10 percent, nursing home rates will be cut by 6.5 percent and development disabled providers will receive a 3 percent rate cut. The budget also cuts money set aside for biomedical research from $50 million to $30 million.
A stand-alone health care budget conforming bill -- SB 2144 -- diminishes the impact of the nursing home cuts by decreasing staffing requirements to 3.6 hours per resident each day.
FEDERAL HEALTH CARE REFORM: While the state moves through the courts with its challenge of federal health care reform, the Florida Legislature also took steps to blunt the impact of the overhaul. SJR 2, filed by Senate President Mike Haridopolos, R-Merritt Island, is a proposed constitutional amendment that would thwart the effect of the federal law by making clear that mandates don’t apply to Floridians. It is one of at least 7 amendments that could appear before voters in November 2012.
The Legislature also passed HB 1193, which further attempts to ensure that any effort to implement federal health reform is weakened by creating a new section of insurance law, a prohibition against requiring the purchase of health insurance. There are exceptions in the law for driving workers compensation and any “activity between private persons.”
Also, the state didn’t move ahead with implementing any changes to insurance laws to reflect the numerous health insurance reforms that went into effect September 23. And it made no effort to begin rate review of large group or out-of-state health insurance plans. Both issues appeared on an Office of Insurance Regulation 2011 list of legislative priorities.
ABORTION: With an anti-abortion governor at the helm, the Legislature passed a number of bills that, if signed into law, could slow down the process for women wanting to obtain abortions. The Legislature passed five abortion-related bills, the most high-profile being HB 1127, which requires a woman seeking an abortion in the first trimester to get an ultrasound. Gov. Charlie Crist vetoed a similar bill last year. Sen. Nancy Detert, R-Venice, voted against the bill, saying she “personally resent(s) a Legislature that acts like I am too stupid to make decisions about my own body.”
The Legislature also passed HB 1247, which makes it more difficult for minors to get court waivers from Florida’s parental notification law by adding time delays. Another measure, HB 1179, will ask voters to weigh in on public funding of abortions -- which already is prohibited by federal law -- and exempt abortion from the right to privacy in Florida’s constitution.
While Florida opposes the federal health reform act -- a central part of which is the establishment of insurance exchanges in 2014 -- legislators took steps to ensure that no health plan sold through an exchange can include abortion as part of the policy. Under HB 97, abortion coverage effectively will have to be sold separately through an insurance rider, which many pro-choice advocates say just won't happen in practice.
The Legislature also gave the nod to HB 501, which transfers responsibility of allocating the funds generated by sales of license plates from counties to the entity Choose Life Inc. The bill also authorizes Choose Life, Inc. to use 15 percent of the money collected through the sale of the license plates for administration and promotion.
PRESCRIPTION DRUGS: A resolution was brokered in the waning hours of the legislative session by Gov. Rick Scott, Attorney General Pam Bondi, and Haridopolos, who was counseled by his physician/wife, Stephanie, and House leaders. The end product keeps intact pain management clinic regulations and provides enhanced criminal and administrative penalties targeting doctors and clinics engaged in prescription drug trafficking. HB 7095 also bans dispensing of most abused narcotics, but makes exceptions for doctors who dispense the drugs for surgical purposes.
Moreover, the Legislature gave the nod to HB 1039, which permanently bans the sale and use of so called “bath salts.” Bondi nixed the sale of methylenedioxypyrovalerone after being elected in January via an emergency rule. The bill codifies the emergency rule.
AGENCY MERGER: Speculation heading into the 2011 session centered around folding the state’s health care agencies into a single entity. There were several bills filed that would have done just that, but in the end nothing occurred. Fueling the anticipation of consolidation was the creation in the House of a Select Committee on Government Reorganization. In the end, though, there were no changes, and the state’s social and health care agencies remain distinct.
Indeed, Scott appointed former Florida Medial Association President Frank Farmer to head the Florida Department of Health and Liz Dudek, who had been acting AHCA Secretary, to fill the position full-time. David Wilkins, a member of the transition team, has been named Secretary of the Department of Children and Families.
Scott has had less success finding a secretary for the Agency for Persons with Disabilities. Scott named former legislator Carl Littlefield to head the agency, but Littlefield resigned just one day before he was scheduled to appear before a Senate committee, where he was expected to field some tough questions regarding his handling of allegations that a group home for developmentally disabled adults allowed sex between residents. Littlefield was the area administrator for APD that oversaw Human Development Center in Seffner.
There still is no secretary at APD.
Health Care Legislation Passed During Florida's 2011 Regular Session:
SB 2 - Relating to Health Care Services, by HaridopolosHB 97 - Relating to Health Insurance, by Gaetz (M)HB 137 - Relating to Prostate Cancer Awareness Program, by RenuartHB 155 - Relating to Privacy of Firearms Owners, by BrodeurHB 395 - Relating to University of Florida J. Hillis Miller Health Center, by O’TooleHB 445 - Relating to Wellness or Health Improvement Programs, by IngramHB 479 - Relating to Medical Malpractice, by Horner and CampbellSB 702 - Relating to Umbilical Cord Blood Banking, by FloresHB 843 - Relating to Teaching Agency for Home and Community-Based Care, by DiazHB 935 - Relating to Health Care Price Transparency, by CorcoranHB 1037 - Relating to Continuing Care Retirement Communities, by Bembry and PassidomoHB 1039 - Relating to Controlled Substances, by PatronisHB 1085 - Relating to Women's Health, by PlakonHB 1125 - Relating to Health and Human Services, by CorcoranHB 1127 - Relating to Abortions, by PorterHB 1179 - Relating to Abortion/Public Funding/Construction of RightsHB 1193 - Relating to Health Insurance, by HudsonHB 1247 - Relating to Parental Notice of Abortion, by StargelHB 1319 - Relating to Certificates and Licenses for Certain Health Care Practitioners, by HarrellSB 1366 - Relating to Child Welfare/Mental Health/Substance Abuse, by StormsSB 1676 - Relating to Sovereign Immunity, ThrasherSB 2144 - Relating to Medicaid, by BudgetHB 4027 - Relating to Obsolete Health Care Provisions, by HornerHB 7095 - Relating to Controlled Substances, by Health & Human ServicesHB 7107 - Relating to Medicaid Managed Care, by Health & Human Services CommitteeHB 7109 - Relating to Medicaid, by Health & Human Services Committee
2011 session summary: Health Care
Christine Jordan Sexton, 05/11/2011 - 09:37 AM
When it comes to health care and health insurance, the 2011 session will be remembered for what lawmakers did, as well as what they didn't do.
Lawmakers passed a far-reaching overhaul of the $22 billion Medicaid program, requiring most Medicaid patients to enroll in managed care plans over the next four years. It also passed a spate of lawsuit protections for doctors and hospitals that treat Medicaid patients and agreed to require out-of-state doctors to register with the state before they can testify as expert witnesses in lawsuits.
But other high-profile health issues -- such as requiring medical loss ratios for health insurance carriers as mandated by federal law, or making changes to state employee health insurance -- didn't pass. There were different reasons for inaction on those issues: While there was no support for changing state insurance law to bring the MLR requirement in line with federal law, there was support to trim state administrative overhead. Many embraced the idea of making state employee health insurance policies more reflective of the commercial market.
But at the end of the day, the chambers started to bicker, and the issue was dropped, a victim of the session's last dysfunctional hours.
KEY ISSUES
MEDICAID: Arguably this was the No. 1 issue of the 2011 session, after the chambers couldn’t reach a compromise on the issue last year. The final bills approved by legislators, HB 7107 and 7109, require Medicaid patients to enroll in managed care plans beginning October 2013 for long-term care and 2014 for traditional health care generally provided for women and children. Under the revised Medicaid program, the state would be divided into 11 regions and competitively bid among interested managed care plans. The bill dictates a minimum and maximum number of plans for each region, and requires at least one provider service network in each.
The revised Medicaid program would allow the state to assess premiums for participation, and also would allow for co-payments for inappropriate use of emergency rooms. The changes require Florida to submit a new waiver to the federal government for approval before any changes can be made. Before submitting the waiver, the state must hold a handful of meetings across the state to get input from Floridians.
One of the overhaul measures, HB 7109, includes limits on lawsuits against Medicaid providers. The measure limits non-economic damages for personal injury or wrongful death to $300,000 per claimant. The cap can be pierced if the plaintiff can prove by clear and convincing evidence that the provider acted wrongfully. Hospitals include ambulatory surgical centers and mobile surgical facilities licensed under a hospital. No practitioner is liable for more than $200,000 in non economic damages unless the injured patient can prove by clear and convincing evidence that the practitioner acted wrongfully,
LIABILITY PROTECTIONS: There were a number of lawsuit protections passed this year to the benefit of Florida hospitals and doctors. The Legislature gave the nod to HB 395, which makes operational changes to Shands hospitals in Gainesville and Jacksonville, and gives the hospitals and their affiliated physicians and clinics sovereign immunity. The Legislature also approved a bill, SB 1676, that will give the University of Miami and its employees sovereign immunity when working at Jackson Memorial Hospital.
The Florida Medical Association pushed its tort agenda separately from Medicaid legislation, focusing on HB 479. Doctors pushed measures that would allow them to buy insurance policies giving them the right to veto any offer for admission of liability, as well as the right to arbitrate any offer that is within policy limits.
FMA President Madelyn Butler, M.D., said in a statement that the organization was “extremely pleased” with the bill. “For over a decade (the FMA has considered) the passage of this legislation to be major step forward in making Florida a more friendly place to practice medicine.”
But lawmakers rejected proposals that would have limited lawsuits against Florida nursing homes. Senate Rules Chairman Sen. John Thrasher said simply that they'd hit their limit on lawsuit protections.
HEALTH CARE BUDGET: The overall health care budget included in SB 2000 appropriates nearly $30 billion for health care and human services, or a 5 percent increase. The final budget includes funding for the Medically Needy and MEDS-AD program, while also providing a $36.2 million increase for Florida KidCare and a reimbursement rate increase for dentists who serve children. But there are also plenty of cuts in the final budget. Hospitals will have their Medicaid reimbursement rates cut by 12 percent, county health departments’ rates will be cut 10 percent, nursing home rates will be cut by 6.5 percent and development disabled providers will receive a 3 percent rate cut. The budget also cuts money set aside for biomedical research from $50 million to $30 million.
A stand-alone health care budget conforming bill -- SB 2144 -- diminishes the impact of the nursing home cuts by decreasing staffing requirements to 3.6 hours per resident each day.
FEDERAL HEALTH CARE REFORM: While the state moves through the courts with its challenge of federal health care reform, the Florida Legislature also took steps to blunt the impact of the overhaul. SJR 2, filed by Senate President Mike Haridopolos, R-Merritt Island, is a proposed constitutional amendment that would thwart the effect of the federal law by making clear that mandates don’t apply to Floridians. It is one of at least 7 amendments that could appear before voters in November 2012.
The Legislature also passed HB 1193, which further attempts to ensure that any effort to implement federal health reform is weakened by creating a new section of insurance law, a prohibition against requiring the purchase of health insurance. There are exceptions in the law for driving workers compensation and any “activity between private persons.”
Also, the state didn’t move ahead with implementing any changes to insurance laws to reflect the numerous health insurance reforms that went into effect September 23. And it made no effort to begin rate review of large group or out-of-state health insurance plans. Both issues appeared on an Office of Insurance Regulation 2011 list of legislative priorities.
ABORTION: With an anti-abortion governor at the helm, the Legislature passed a number of bills that, if signed into law, could slow down the process for women wanting to obtain abortions. The Legislature passed five abortion-related bills, the most high-profile being HB 1127, which requires a woman seeking an abortion in the first trimester to get an ultrasound. Gov. Charlie Crist vetoed a similar bill last year. Sen. Nancy Detert, R-Venice, voted against the bill, saying she “personally resent(s) a Legislature that acts like I am too stupid to make decisions about my own body.”
The Legislature also passed HB 1247, which makes it more difficult for minors to get court waivers from Florida’s parental notification law by adding time delays. Another measure, HB 1179, will ask voters to weigh in on public funding of abortions -- which already is prohibited by federal law -- and exempt abortion from the right to privacy in Florida’s constitution.
While Florida opposes the federal health reform act -- a central part of which is the establishment of insurance exchanges in 2014 -- legislators took steps to ensure that no health plan sold through an exchange can include abortion as part of the policy. Under HB 97, abortion coverage effectively will have to be sold separately through an insurance rider, which many pro-choice advocates say just won't happen in practice.
The Legislature also gave the nod to HB 501, which transfers responsibility of allocating the funds generated by sales of license plates from counties to the entity Choose Life Inc. The bill also authorizes Choose Life, Inc. to use 15 percent of the money collected through the sale of the license plates for administration and promotion.
PRESCRIPTION DRUGS: A resolution was brokered in the waning hours of the legislative session by Gov. Rick Scott, Attorney General Pam Bondi, and Haridopolos, who was counseled by his physician/wife, Stephanie, and House leaders. The end product keeps intact pain management clinic regulations and provides enhanced criminal and administrative penalties targeting doctors and clinics engaged in prescription drug trafficking. HB 7095 also bans dispensing of most abused narcotics, but makes exceptions for doctors who dispense the drugs for surgical purposes.
Moreover, the Legislature gave the nod to HB 1039, which permanently bans the sale and use of so called “bath salts.” Bondi nixed the sale of methylenedioxypyrovalerone after being elected in January via an emergency rule. The bill codifies the emergency rule.
AGENCY MERGER: Speculation heading into the 2011 session centered around folding the state’s health care agencies into a single entity. There were several bills filed that would have done just that, but in the end nothing occurred. Fueling the anticipation of consolidation was the creation in the House of a Select Committee on Government Reorganization. In the end, though, there were no changes, and the state’s social and health care agencies remain distinct.
Indeed, Scott appointed former Florida Medial Association President Frank Farmer to head the Florida Department of Health and Liz Dudek, who had been acting AHCA Secretary, to fill the position full-time. David Wilkins, a member of the transition team, has been named Secretary of the Department of Children and Families.
Scott has had less success finding a secretary for the Agency for Persons with Disabilities. Scott named former legislator Carl Littlefield to head the agency, but Littlefield resigned just one day before he was scheduled to appear before a Senate committee, where he was expected to field some tough questions regarding his handling of allegations that a group home for developmentally disabled adults allowed sex between residents. Littlefield was the area administrator for APD that oversaw Human Development Center in Seffner.
There still is no secretary at APD.
Health Care Legislation Passed During Florida's 2011 Regular Session:
SB 2 - Relating to Health Care Services, by HaridopolosHB 97 - Relating to Health Insurance, by Gaetz (M)HB 137 - Relating to Prostate Cancer Awareness Program, by RenuartHB 155 - Relating to Privacy of Firearms Owners, by BrodeurHB 395 - Relating to University of Florida J. Hillis Miller Health Center, by O’TooleHB 445 - Relating to Wellness or Health Improvement Programs, by IngramHB 479 - Relating to Medical Malpractice, by Horner and CampbellSB 702 - Relating to Umbilical Cord Blood Banking, by FloresHB 843 - Relating to Teaching Agency for Home and Community-Based Care, by DiazHB 935 - Relating to Health Care Price Transparency, by CorcoranHB 1037 - Relating to Continuing Care Retirement Communities, by Bembry and PassidomoHB 1039 - Relating to Controlled Substances, by PatronisHB 1085 - Relating to Women's Health, by PlakonHB 1125 - Relating to Health and Human Services, by CorcoranHB 1127 - Relating to Abortions, by PorterHB 1179 - Relating to Abortion/Public Funding/Construction of RightsHB 1193 - Relating to Health Insurance, by HudsonHB 1247 - Relating to Parental Notice of Abortion, by StargelHB 1319 - Relating to Certificates and Licenses for Certain Health Care Practitioners, by HarrellSB 1366 - Relating to Child Welfare/Mental Health/Substance Abuse, by StormsSB 1676 - Relating to Sovereign Immunity, ThrasherSB 2144 - Relating to Medicaid, by BudgetHB 4027 - Relating to Obsolete Health Care Provisions, by HornerHB 7095 - Relating to Controlled Substances, by Health & Human ServicesHB 7107 - Relating to Medicaid Managed Care, by Health & Human Services CommitteeHB 7109 - Relating to Medicaid, by Health & Human Services Committee
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