Diagnosis For 5.16.22: Checking The Pulse Of Florida Health Care News And Policy

This week, an ongoing legal tussle over Florida’s ban on “vaccine passports” will go before an appellate court.

Pushed on by Gov. Ron DeSantis, state legislators a year ago passed a law that codified an executive order from the Governor that blocked businesses or government entities from requiring proof of vaccination.

Norwegian Cruise Line Holdings challenged the law in federal court and won a preliminary injunction last August that allowed it to require guests to be vaccinated before boarding. U.S. District Judge Kathleen Williams, appointed by former President Barack Obama, blocked the law on several grounds. She said Florida had not provided factual or legal reasons for the law and said that “documentary proof of vaccination will expedite passengers’ entry into virtually every single country.”

Florida appealed the ruling, and although the judge’s ruling only applied to Norwegian, state officials said they would not enforce the vaccine passport ban for all cruise lines until a decision was reached on the injunction.

Months later, the case will finally be heard Wednesday in Miami by a panel of judges from the 11th Circuit Court of Appeals.

The landscape over COVID-19 has changed since the lawsuit was first filed, including that the Centers for Disease Control & Prevention has dropped its restrictions (which came after Florida successfully challenged them) and its risk advisories about cruises.

Charles Cooper, a Washington D.C. attorney representing State Surgeon General Joseph Ladapo, noted in a court filing earlier this month that Norwegian has dropped its vaccination requirement for children under 12 and that some destinations are allowing negative test results in place of shots.

Derek Shaffer, a lawyer for Norwegian, responded last week by saying that the changing nature of testing and quarantining requirements is precisely why the cruise lines should be allowed to require proof of vaccinations. He added that Norwegian dropped the vaccine requirement for children based on recent data but noted that the cruise line still maintains a standard that 95% of those on the ship are vaccinated.

During an earnings call last week, Norwegian CEO Frank Del Rio acknowledged the line planned to drop its vaccination requirement to 90% for one brand operated by the cruise line due to a change in CDC recommendations. But Del Rio contended that the approach used by the company had resulted in a lower incidence of COVID-19 compared to the population at large. A transcript from the call quotes Del Rio saying, “we do not prioritize short-term gains at the expense of jeopardizing our long-term brand equity and industry-leading pricing in the process” and that the company “prioritized the health, safety and well-being of our guests, crew and the communities we visit above all else.”

The expense of jeopardizing our long-term brand equity and industry-leading pricing in the process” and that the company “prioritized the health, safety and well-being of our guests, crew and the communities we visit above all else.”

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— Six of one —

The Agency for Health Care Administration has extended for another six months a ban on new applied behavior analysis group providers from enrolling in the Medicaid program in Miami Dade and Broward counties.

In its announcement Friday afternoon, the AHCA said it is the “final extension” and that the moratorium on the providers of ABA services used to treat children with autism expires Nov. 13.

The ban does not allow any new provider group to enroll in those two counties, even if the group is an existing Medicaid ABA provider in other areas across the state.

The provider enrollment ban in Miami Dade and Broward does not prevent an applied behavior analysis provider working independently from joining a Medicaid ABA group provider already operating in those two counties.

Applied behavior analysis is a therapy based on the science of learning and behavior, according to Autism Speaks. Medicaid costs for applied behavior analysis therapy doubled between 2016 and 2018, with state officials blaming unqualified providers who render unnecessary services. Centers for Medicare & Medicaid Services (CMS) granted Florida a “temporary moratorium” on new ABA provider enrollment in Miami-Dade and Broward counties.

In the meantime, the state has taken steps to ferret out potential fraud and has required ABA professionals to be credentialed by the Behavior Analyst Certification Board. There has also been a move afoot to change the Medicaid reimbursement rules, including requiring the parent or guardian of an autistic child to participate in every ABA treatment session. Representatives from the Florida Association for Behavior Analysis, who attended a workshop the state held on the proposed changes in April, have criticized the suggested changes.

— Survey says … —

Residents who are 50 years and older accounted for 64% of Florida voters in 2018, making them a powerful voting bloc in the upcoming elections. A recent AARP survey shows that more than half (56%) are worried about their retirement plan solvency and having enough money to retire (50%). Forty-eight percent worry about the availability of public assistance benefits.

The concerns may not be surprising given that 28% of survey respondents reported a reduction in income and 24% reported a decline in savings in the last two years.

Meanwhile, Medicare benefits and staying mentally sharp were the top health concerns noted by 79% of survey respondents. Health insurance (71%), health care expenses (68%), and declining physical health (64%) were also reported among their top concerns.

Again, the findings underscore their firsthand experiences.

Declines in physical health (25%), vision or hearing (19%), and mobility (16%) were reported to have occurred in survey respondents in the last two years, as was memory loss (8%).

Meanwhile, 64% of Florida AARP members say they worry about staying in their homes and continuing to drive, while 62% worry about the availability of long-term care.

“Floridians 50+ made up 64% of Florida voters in 2018. It’s clear that they have significant influence in the Sunshine State. The 50+ will be the deciders in the 2022 midterm elections. It’s time to recognize and better understand what matters most to them,” AARP Florida State Director Jeff Johnson said in a prepared statement announcing the survey findings.

AARP contacted 171,805 members from across the United States and the District of Columbia, asking them to participate in the survey either by mail or online between May 20 and Aug. 18, 2021. A total of 20,116 members completed and returned surveys for a response rate of 12%. In Florida, 9,865 members were contacted, with 1081 completing and returning surveys. The overall response rate for Florida was 11%.