Diagnosis: Checking The Pulse Of Florida Healthcare News And Policy

Health plan practices that delay hospital discharges put patients at risk and drive up healthcare costs, prompting Florida hospital leaders to call for reforms.

The Florida Hospital Association (FHA), representing more than 260 hospitals and health systems statewide, is urging state and federal lawmakers to overhaul prior authorization requirements that leave patients hospitalized while insurers review post-acute care requests.

In a recent letter to Florida lawmakers, FHA cited survey findings showing that 243,000 patients experienced discharge delays between July 2024 and June 2025, resulting in 781,000 additional hospital days. Another 158,000 emergency department patients waited more than 12 hours for a bed.

FHA estimates the delays generated $2.5 billion in preventable healthcare spending.

“An unnecessary hospital day is not simply an administrative inconvenience,” said Mary Mayhew, FHA president and CEO. “The delay keeps a patient in a setting that no longer aligns with their medical needs and prevents the hospital bed from serving another Floridian who needs it.”

Waiting for health plan authorization was the leading cause of delayed discharges, accounting for 40% of affected patients.

Those delays can also undermine recovery. A stroke patient who is medically ready to leave the hospital, for example, may still need inpatient rehabilitation to regain mobility or speech. Waiting for an insurer to approve that care can prolong hospitalization and potentially compromise recovery.

Mayhew warned that unreimbursed costs associated with those delays ultimately contribute to higher healthcare costs for employers and families.

FHA is backing state legislation establishing clearer prior authorization standards for Medicaid managed care plans and commercial insurers. The proposal would:

— Eliminate prior authorization requirements for physician-ordered post-acute care at discharge.

— Require decisions within 24 hours for urgent requests and 72 hours for nonurgent requests.

— Mandate timely peer-to-peer reviews of denials by physicians practicing in the same specialty as the requesting physician.

— Require annual reporting of prior authorization metrics to help regulators identify delays and hold insurers accountable.

FHA argues the changes would move patients into appropriate, lower-cost care settings sooner while freeing hospital beds for those requiring acute care.

The push extends to Washington, where Centers for Medicare & Medicaid Services Administrator Mehmet Oz has also criticized cumbersome authorization procedures.

“It is way past time to ax the fax, kill the clipboard, and put patients over paperwork,” Oz wrote, calling for an end to outdated, paper-based processes that delay treatment and burden providers.

FHA also urged Florida’s congressional delegation to support three bipartisan measures targeting Medicare Advantage practices: the Improving Seniors’ Timely Access to Care Act (HR 3514/S 1816), the Medicare Advantage Prompt Pay Act (HR 5454/S 2879) and the Medicare Advantage Improvement Act (HR 8375/S 4384).

According to FHA, Florida Medicare Advantage patients remain hospitalized an average of 3.7 additional days after being medically cleared for discharge.

Mayhew said reform would improve patient care, preserve hospital capacity and reduce avoidable spending.

“When information can be shared in seconds, there is no justification for requiring clinicians to fax documentation or wait days for a request for additional information,” Mayhew said. “If health plans are going to insist on putting prior authorization between patients and the care they need, then the plans should be prepared to make those authorization decisions in a timely fashion.”

— Candid camera —

PhRMA is turning patients’ frustrations at the pharmacy counter into material for a new digital campaign aimed at pharmacy benefit managers.

The drugmakers’ trade group describes a humorous premise: What would PBMs say if they answered patients’ questions candidly? The campaign takes on prior authorization, rebate practices and decisions about which medicines health plans cover.

PBMs administer prescription drug benefits, negotiate discounts with manufacturers and manage pharmacy networks. Their decisions help determine which drugs patients can obtain through their insurance and what they pay out of pocket.

On its campaign page, PhRMA argues that consolidation among insurers, PBMs and pharmacies has concentrated too much influence over treatment options. It also contends that discounts negotiated in the drug supply chain do not consistently reach patients at the counter.

To watch the ad, please click the image below:

Those concerns have drawn regulatory scrutiny. In a July 2024 interim report, Federal Trade Commission staff examined the industry’s concentration and raised concerns about PBMs steering patients toward affiliated pharmacies and away from independent competitors.

PhRMA has its own stake in that fight: It represents the manufacturers on the other side of those negotiations. The latest campaign makes its case through familiar patient questions about coverage, approvals and the cost of filling a prescription.

— OK, BrO₃ —

Attorney General James Uthmeier has issued an investigative subpoena to a food group that uses potassium bromate in its food products.

Uthmeier issued the subpoena Friday to Performance Food Group Inc. The move expands Uthmeier’s civil investigation into the company’s use of the chemical and other possible cancer-causing agents in Florida’s food supply.

“We are following this additive from the bag of flour to the kitchen that serves Florida families,” Uthmeier said in a news release.

“Performance Food Group is one of the largest buyers in this chain. Floridians have a right to know what was sold, who bought it, and whether anyone was told that these products contain a chemical much of the world has already banned.”

The subpoena comes after Uthmeier opened a civil investigation into Performance Food Group in July. He acknowledged that no law bans the chemical compound in foods, at least in the Sunshine State. But there’s a growing body of evidence that potassium bromate may be a threat to health and could contribute to cancer, according to some researchers.

The subpoena seeks records involving Pillsbury Potentate High Gluten Flour, Pillsbury Best Bakers Patent Flour, Gold Medal All Aces Bakery Flour, and Gold Medal Superlative Bakers Flour — each a bleached, bromated, enriched bakery flour — as sold or used through Performance Foodservice Miami and Performance Foodservice Orlando.

The response to the subpoena must be submitted to Uthmeier’s Office of Consumer Protection Division in Tampa by Nov. 6.

— TGH SRC thumbs-up —

Tampa General Hospital’s (TGH) Neuro Spine Program has become the first in the world to earn a Center of Excellence in Neuro Spine Surgery designation from the Surgical Review Corporation (SRC), according to the hospital.

SRC also named four TGH surgeons Master Surgeons in Neuro Spine Surgery: Puya Alikhani, Patrick Kim, Erik Hayman and Alexander Haas. According to SRC, the title recognizes sustained dedication and the highest levels of surgical skill, clinical outcomes and patient care.

“These achievements reflect the dedication of the entire TGH spine team and a shared commitment to delivering the highest standard of care to every patient,” said Alikhani, Director of TGH’s Division of Spine Surgery, Chief of neurosurgery at the hospital and a Professor at the University of South Florida Morsani College of Medicine.

“Leading with excellence and advancing spine surgery has always been at the heart of what we do, and we are proud to set that standard for the world.”

The accreditation involved a detailed review and comparison of the TGH surgical team’s performance against national and international benchmarks, including on-site evaluations at the hospital.

“This designation provides patients and families with added confidence that they are choosing a spine program that meets the highest standards of quality, safety and outcomes,” said Luke Straus, Vice President of TGH’s Neurosciences and Orthopedic Institutes.

— Wolfson’s gets top national honors —

Wolfson Children’s Hospital in Jacksonville ranks among the nation’s top 50 children’s hospitals in four pediatric specialties, according to U.S. News & World Report’s 2026-27 Best Children’s Hospitals.

The rankings recognized Wolfson in diabetes and endocrinology, neurology and neurosurgery, orthopedics and urology. This is the ninth consecutive year Wolfson has appeared in the U.S. News rankings.

“Being recognized among the nation’s best in four pediatric specialties by U.S. News & World Report is a reflection of the expertise and specialized care available at Wolfson Children’s Hospital,” said Allegra C. Jaros, President of Wolfson Children’s Hospital.

“Our continued recognition celebrates the dedication of our clinical teams and the strength of our collaboration with Nemours Children’s Health (Wolfson’s partner facility in Jacksonville). Most importantly, it reinforces our commitment to the children and families we serve and to providing exceptional, top-quality pediatric care close to home.”

— Grants awarded —

Four nonprofit healthcare organizations serving children in Florida will receive grants of $25,000 each.

Sunshine Health, a subsidiary of Centene Corp., is providing $100,000 in grants divided among caregivers who support children and youth facing behavioral health needs and additional challenges. The money will help fund programs for foster, adoptive, and kinship parents and caregivers.

The funding will help caregivers develop skills to create supportive and healing-centered home environments and provide more stability.

“We are honored to support these grant winners’ innovative programs that will strengthen families and improve the lives of vulnerable children,” said Charlene Zein, president and CEO of Sunshine Health.

The Citrus Family Care Network in Miami, the Family Initiative in Cape Coral, Florida 1.27 in Tampa and Kids First of Florida are the four organizations that will receive the $25,000 grants.

“The grant will strengthen caregiver resilience, promote placement stability, and expand access to early mental health advocacy and intervention for hundreds of children and families across our community,” said Leigh Ann Drew, Statewide Director of Child Welfare for Family Initiative. “We are honored to advance this critical work and grateful for Sunshine Health’s partnership in building stronger, more resilient families.”

— Robin —

Patients checking into Palm Beach Children’s Hospital can now interact with the hospital’s newest hire: an AI-enhanced therapeutic robot named Robin.

The 4-foot-tall robot was designed by Expper Technologies to provide emotional support and ease patients’ anxiety and fear about being in the hospital. Patients can talk to Robin, play games with it, or ask it to play songs and videos.

The Palm Beach Ray of Hope Foundation donated the robot. The group’s president, Janet Levy, told WPBF that Robin’s goal is to make children forget where they are.

“Just for a moment, if you could just take away that they’re ill or that they’re in a hospital, that makes a meaningful difference. And that is very important to us,” Levy said.

Robin is already at 40 other facilities around the country, but Palm Beach Children’s Hospital is the first in Florida to use the therapeutic robot.

— LOBBYISTS —

Jorge Altuna, Shawn Foster, Sunrise Consulting Group: Hope Services

Slater Bayliss, The Advocacy Partners: Catalyst Pharmaceuticals

Angela Bonds: Better Together Strengthening Families

Robert Holroyd, TSE Consulting: Dwelling of Pompano

Robert Holroyd, Tripp Scott: Dwelling of Pompano

— ICYMI —

“U.S. cuts Obamacare subsidies for 189,000 with duplicate coverage” via Ahmed Aboulenein and Amina Niasse of Reuters — The Trump administration is ending Affordable Care Act subsidies for roughly 189,000 enrollees identified as having duplicate government coverage or being deceased. Health Secretary Robert F. Kennedy Jr. says the move will save approximately $738 million this year and more than $1.5 billion annually. Federal officials identified about 120,000 people also enrolled in Medicaid, 58,000 with Medicare coverage and approximately 11,000 deceased beneficiaries. Affected individuals or their estates have 30 days to challenge the findings before subsidies stop. Officials say people with overlapping coverage retained insurance through another program. The announcement follows a separate September initiative targeting allegedly fraudulent marketplace enrollment. The Centers for Medicare & Medicaid Services also plans stronger interstate Medicaid address verification beginning in January 2027.

“In Florida, immigrant Medicaid crackdown ensnares eligible families” via Sharmila Venkatasubban of the Florida Trib — The law layers a new set of criteria onto Medicaid eligibility. In Florida, those new, complicated requirements have been handed to a beleaguered and understaffed state agency that a federal judge found this year could not reliably get far simpler eligibility decisions and notices right. Critics say people who still qualify are getting pulled into a bureaucratic vortex along with those the law meant to remove, leaving already overburdened DCF front-line workers ill-equipped to handle complex cases the new immigration rules are creating. The new complications build on a years-long pattern of dysfunction within DCF, said Lynn Hearn, legal director of the Florida Health Justice Project. Of the termination notices the FHJP has seen, none say what immigration status the state has on file or what status would let someone keep coverage. Some families get no notice at all.

“UF Jacksonville explores how AI can improve patient care and medical research” via Kristian Thomas of the University of Florida College of Medicine — Jacksonville — University of Florida medical leaders in Jacksonville are exploring how artificial intelligence can improve patient care, research and training without replacing physicians’ judgment. The UF Health Science Center – Jacksonville hosted its inaugural AI Scholar Days, highlighting emerging medical tools and the safeguards needed for responsible adoption. Interim regional campus dean Tirbod Fattahi described the moment as an opportunity for medical professionals to help shape the technology’s future. Organizer Jessica O’Leary emphasized using AI to strengthen human expertise, improve learning and support better health outcomes. The discussions also examined patient privacy, oversight and established protocols. The initiative reflects growing interest in practical healthcare applications as academic medical centers evaluate how AI can assist clinicians and researchers.

“Heidi Overton crafted early justification for shrinking vaccine schedule” via David Lim of Semafor — Overton, Trump’s nominee to run the Food and Drug Administration, played a larger role in driving the process to reduce the number of vaccines the government recommends to children than emerged during her Senate confirmation last month, when Republican Senators asked her whether she’d stand up to anti-vaccine voices in the administration. An aide on the President’s Domestic Policy Council, Overton helped edit and craft a scientific justification that was used to underpin cutting the Centers for Disease Control and Prevention recommendations from 17 to 11 vaccines in January. “I would give him my best advice,” Overton replied.

— RULES —

The Board of Podiatric Medicine’s final rule (64B18-16.006) regarding Registration Requirements of Podiatric Residents goes into effect today. More here.

The Board of Podiatric Medicine’s final rule (64B18-17.001) regarding Continuing Education Required for License Renewal goes into effect today. More here.

The Board of Pharmacy’s final rule (64B16-26.304) regarding Subject Matter for Nuclear Pharmacist License Renewal Continuing Education Programs (Repealed) takes effect Oct. 25. More here.

The Board of Dentistry’s final rule (64B5-16.001) regarding Definitions of Remediable Tasks and Supervision Levels takes effect Oct. 26. More here.

The Board of Dentistry’s final rule (64B5-16.0051) regarding Delegation of Remediable Restorative Functions to Dental Assistants; Supervision Level; and Training and Experience Requirements takes effect Oct. 26. More here.

The Board of Dentistry’s final rule (64B5-16.006) regarding Remediable Tasks Delegable to a Dental Hygienist takes effect Oct. 26. More here.

The Board of Dentistry’s final rule (64B5-16.0061) regarding Delegation of Remediable Restorative Functions to Dental Hygienists; Supervision Level; and Training and Experience Requirements takes effect Oct. 26. More here.

The Agency for Health Care Administration’s final rule (59G-4.002) regarding Medicaid Provider Reimbursement Schedules and Billing Codes takes effect on Oct. 26. More here.

The Board of Optometry’s final rule (64B13-18.002) regarding Formulary of Topical Ocular Pharmaceutical Agents takes effect Oct. 30. More here.

— PENCIL IT IN —

Oct. 19

Happy birthday to Alexis Maria Calatayud and Hillary Cassel!

Oct. 21

Happy birthday to Christine Hunschofsky!

Oct. 22

Happy birthday to Jim Boyd and Mitch Rosenwald!

Oct. 27

Happy birthday to Mike Giallombardo!

Nov. 1

Happy birthday to Bruce Antone!

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