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Diagnosis For 3.14.22: 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.

Well, it won’t be quite an on-time departure for the Florida Legislature, but Lawmakers expect to vote on a new $112 billion budget Monday and then head to the exits and the 2022 campaign trail.

Lawmakers agreed to extend Session by three days after failing to finalize negotiations on the budget in time to meet the deadline required under Florida law. The state requires the budget to be delivered to legislators 72 hours before a final vote.

Sine Die will be fashionably late this year.

The central drama Monday is whether lawmakers adopt the spending plans with a unanimous or near-unanimous vote. Many Democrats said during Friday’s debate ahead of the vote that they did not agree with everything in the new budget, but they also praised vast portions of it.

Session’s end also drops the curtain on significant health care policy changes for the year, although there were a few surprises at the very end.

Medicaid managed care bill? Yes.

The free-speech protections for doctors championed by Gov. Ron DeSantis? Nope. (Maybe Rep. Brad Drake shouldn’t have voted against the redistricting maps …)

telehealth bill? You betcha.

Requiring insurers to offer hearing aid coverage for certain children? Nope.

Many other proposals crashed and burned along the way to the end, including a bid to change the state’s medical malpractice laws and an overhaul of Florida’s auto insurance health coverage.

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

— State, not private, investment —

A bill requiring insurers in the state to provide hearing aid coverage for children sailed through the Senate without a single vote in opposition — but it never made it to the House floor, despite a similar piece of legislation clearing three committees in that chamber.

Yet …

In the closing round of budget negotiations, the House and Senate settled on a final amount of $5 million to create a new children’s hearing aid program that will help children diagnosed with hearing loss but are not enrolled in Medicaid or the children’s health insurance program.

The money can purchase several items to assist children, including hearing aids, assistive learning devices and hearing aid batteries. The program will be open to families whose income is 400% of the federal poverty level or less (That’s $106,000 for a family of four according to 2021 poverty guidelines.)

While it won’t be required, Chris Sprowls is for funding hearing aids for Florida children.

As House Speaker Chris Sprowls explained when asked why the Legislature did not pass the insurance bill (SB 498) yet agreed to pay for the new program: “I think the issue is we’ve historically not done insurance mandates in the Florida House. We don’t usually think it’s good for the market. However, we do lots of investments that we think are good for kids.”

Sprowls added that the sponsors of the insurance bill — Rep. Chuck Brannan and Adrian Zika — had been working on the issue all Session, and he noted Brannan had talked publicly about his own son, who was ultimately diagnosed as profoundly deaf and could get cochlear implants when he was five.

Sprowls said that Brannan and Zika “just candidly won our hearts.”

“We wanted to help, and we thought this was a good way to do it,” he said.

Last month Brannan got emotional when he discussed his son, Chase, who has graduated from the University of Florida and is closing in on his master’s degree.

“This child only got to hear his mother’s voice for about seven years because he lost his mother when he was 12 years old. That’s my child,” Brannan said. “I don’t know where Chase would be. He certainly would be deaf. He may not be able to speak. But he’s not going to be a burden on the government or society. He makes his own way. He’s never had any special accommodations except for those devices.”

— No. 9 —

Senate President Wilton Simpson sent the message early in Session saying he was comfortable with the proposed Medicaid managed care rewrite his chamber produced. Other top Senators — Aaron Bean and Jason Brodeur — reiterated the message as the weeks went on.

Wilton Simpson and the Senate got most of their wish list in the Medicaid-managed care revamp.

And in the end, the Legislature passed a bill that enshrined much of the Senate’s positions, including reducing the number of Medicaid-managed care regions from 11 to nine and renaming the regions from numbers to letters.

Medicaid managed care contracts are worth tens of billions of dollars, and the number of plans that the state can contract within each region affects the value of the contracts.

AHCA wanted Lawmakers to update the statutes to allow the agency to issue a single statewide contract for managed care plans to bid on. Currently, the law requires the state to bid in 11 different regions.

SB 1950 also changes the number of plans in each region that can sign contracts with the state, including altering the number of minimum and maximum plans the state can contract within most regions.

Only Medicaid Regions: 6, 7 and 11 remain unchanged under the bill, which was pushed by Agency for Health Care Administration Secretary Simone Marstiller and lobbied by Chief of Staff Cody Farrill.

Medicaid Region 6 (renamed Region D under the bill) comprises Hardee, Highlands, Hillsborough, Manatee and Polk counties. Region 7 (renamed Region E under the bill) includes Brevard, Orange, Osceola and Seminole counties. Region 11 (renamed Region I under the bill) is Miami Dade and Monroe counties.

Meanwhile, the bill also affects Medicaid managed care contracts for long-term care coverage and changes the number of minimum and maximum plans allowed to be contracted with for every region except for what used to be known as Region 11.

AHCA initially proposed legislation that would have shrunk the number of Medicaid regions across the state from 11 to eight. AHCA’s plan would have trimmed three districts by merging six existing regions into just three. While the Legislature signed off on merging current Regions 1 and 2 into the new Region A and Regions 3 and 4 into a Region B, Lawmakers rejected the idea of combining current Medicaid Region 5 and 6 into Medicaid Region C, choosing to keep them separate instead.

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