Diagnosis For 2.21.22: Checking The Pulse Of Florida Health Care News And Policy

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

This Session, more than 1,800 bills and constitutional amendments have been filed, and with just three weeks left, many of them are essentially dead. Yes, there’s still time, but with many House and Senate “substantive” committees winding down their work, it is unlikely that bills that are not moving or have not moved are unlikely to make it to the finish line.

And there is plenty of legislation in the health care arena that looks doomed, ranging from revamping medical malpractice laws to altering medical marijuana rules for physicians and changing the scope of practice for health care providers.

The Senate, for example, effectively killed a bill that would have changed current law to allow parents with adult children who never married or had children to sue for noneconomic damages (pain and suffering) stemming from incidents of medical malpractice.

The move has support in the House, and Rep. Spencer Roach, a North Fort Myers Republican, persuaded members of the House Judiciary Committee to pass the bill 13-5.

But the Senate dislikes the proposal. The Senate Judiciary Committee was slated to vote on the proposal, but committee Chair Danny Burgess temporarily postponed it, saying it wasn’t ready for “prime time.” He did not reschedule the bill for a vote before the panel’s last meeting — essentially killing it.

Three different types of health care providers are authorized to administer anesthesia in Florida: anesthesiologist assistants, certified registered nurse anesthetists, and anesthesiologists. The groups came into the Session seeking licensure changes.

CRNAs wanted the authority to practice independently without being directly supervised by a physician. But the bills, which would have required CRNAs to have written collaborative agreements with physicians, have not been moving. Sen. Manny Diaz Jr. sponsored SB 986, and its first committee of reference was the Senate Health Policy Committee, which Diaz chairs.

Anesthesiologists oppose the bills the CRNA supports; they are medical doctors and don’t want to see the nurses’ scope of practice expanded.

Anesthesiologists are on board, though, with a move by anesthesiologist assistants to have regulatory statutes changed to broaden the type of work they can perform.

To that end, lawmakers introduced SB 1366 and HB 1101 for consideration this Session. While no Senate committee heard the former, the latter cleared two House health care panels and is now available for consideration by the full House.

I welcome your feedback, questions, and, especially, your tips. You can email me at SextonHealthNewsletter@gmail.com or call me at 850-251-2317.

— ANOTHER PHE EXTENSION —

On Friday, President Joe Biden gave notice to Congress that there is a need to continue the national Public Health Emergency (PHE) because of COVID-19, but a question remains on how long into 2022 it will remain. Various vaccines and treatments are allowed because of the emergency declaration, but it also has a significant effect on the amount of funding the federal government contributes to Florida’s $35 billion safety net program. That additional funding has helped fuel budget surpluses.

Biden told congressional leaders in a letter: “There remains a need to continue this national emergency. The COVID-19 pandemic continues to cause significant risks to the public health and safety of the nation. More than 900,000 people in this nation have perished from the disease, and it is essential to continue to combat and respond to COVID-19 with the full capacity and capability of the federal government.”

Congress in 2020 agreed to bump federal Medicaid funding by 6.2% with the caveat that states cannot disenroll beneficiaries so long as they tap into the enhanced funding. The latest extension means the Medicaid bump will continue to flow into the state’s coffers through Sept. 30.

More than 70 members of Congress sent a letter to the Biden administration Feb. 10 calling on it to allow the PHE to expire, noting that COVID-19 is now endemic. Seven GOP members from Florida signed the letter: Reps. Gus Bilirakis, Kat Cammack, Neil Dunn, Brian Mast, Bill Posey, Greg Steube, and Michael Waltz.

“We recognize that the PHE cannot end overnight and that certain actions must be taken to avoid significant disruption to patients and health care providers, including working with Congress to extend certain policies like maintaining access to telehealth services for our nation’s seniors,” states the letter.

— AND WHEN THE PHE EXPIRES —

Florida’s Medicaid program has never been larger. As of Jan. 31, it had 5.1 million enrolled, more than 20% of the state’s population. So long as the PHE is in effect and Florida continues to tap into the funds, the state cannot disqualify anyone from the program. When the public health emergency expires — and the additional 6.2% bump in federal Medicaid funding is eliminated — there will be pressure to begin redeterminations quickly and to eliminate people who no longer qualify because they earn too much money or they do not meet eligibility requirements, such as pregnant women reaching the end of postpartum coverage requirements.

Adults deemed no longer eligible for Medicaid may qualify for subsidized coverage through the health insurance exchange. Children who lose Medicaid coverage may be eligible for the state children’s health insurance program (Florida KidCare). Though it is also a Medicaid-funded program, it provides children access to Medicaid-funded health insurance products. Families also are charged premiums. Florida’s Medicaid program is administered chiefly through contracts with Medicaid-managed care plans. The Department of Children and Families is responsible for initial Medicaid redetermination.

Florida Politics attempts to interview DCF Secretary Shevaun Harris were not successful.