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Diagnosis for 5.23.22: Checking the pulse of Florida health care news and policy

Memorial Day is just around the corner. It’s the kickoff of the Summer and the start of the countdown to a new fiscal year … and some budget vetoes.

It’s been more than two months since Florida legislators passed a $112 billion budget, but they still haven’t officially sent it to Gov. Ron DeSantis.

During that time, DeSantis has held numerous events around the state where he has announced his support for various hometown projects included in the spending plan as well as major items he recommended, like a $37 million boost in cancer research.

The state will now spend $100 million annually on cancer research, which will benefit facilities such as Moffitt Cancer Center (above), the UM Sylvester Comprehensive Cancer Center and the UF Health Cancer Center.

It’s not surprising that legislative leaders have held off sending the budget to DeSantis since the Governor has called not one, but two Special Sessions. Holding off on what budget items he will veto gives the Governor a chance to see which legislators back his agenda.

But the start of the fiscal year, July 1, is coming up fast. Most Governors usually sign the budget — and hand out their line-item budget vetoes — around Memorial Day. The Governor’s budget office has had plenty of time to go through the Appropriations Act, so it wouldn’t be surprising to see DeSantis act quickly once this week’s Special Session on property insurance is wrapped up.

Legislators as well as health care lobbyists, hospitals and other providers will soon know whether or not their budget priorities will make it to the finish line.

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

— Extended again? —

It looks like the Joe Biden administration is prepared to extend the public health emergency associated with the COVID-19 pandemic for another 90 days — a move that means Florida will continue to receive extra money from the federal government.

The current public health emergency is scheduled to end in July, but the administration also promised to give states 60 days notice if it planned to end the emergency. That notice deadline passed last week. CNN and Bloomberg reported last week that administration officials plan to extend the emergency declaration because COVID-19 cases have been rising.

An extension to the COVID-19 public health emergency means more money for Florida health care providers.

The extension of the public health emergency means people can continue to receive free tests, vaccines and treatments for COVID-19.

But for state legislators and budget analysts, another extension means the state will continue to receive an additional 6.2% increase in the amount of federal Medicaid dollars to help pay the costs of the health care safety net program for the poor, elderly and disabled. If the administration does go ahead with an extension, extra money will continue to flow to Florida for both the first and second quarters of the 2022-23 fiscal year.

But that additional federal assistance comes with a requirement that Florida cannot remove anyone from the Medicaid program so long as the public health emergency is in effect. As of April 30, Florida’s Medicaid enrollment topped 5.2 million people. Florida normally requires children ages 5-19 and certain adults to be determined eligible for Medicaid every six months.

— Abortion action? —

As anti-abortion groups in Florida begin to push for the Republican-controlled Legislature to enact more restrictions due to a looming U.S. Supreme Court decision, state health care regulators issued an emergency order shutting one of the few Panhandle abortion clinics following the facility’s alleged failure to comply with state laws.

The Agency for Health Care Administration issued the emergency order May 20 and alleges, among other things, that Integrity Medical Care, which operates as American Family Planning, did not report to the state that three of its patients were transferred to hospitals because they required advanced care.

AHCA’s order shuts down Pensacola’s American Family Planning. Image via Google Maps.

AHCA alleges in the complaint that following an alleged second trimester abortion on March 23, one patient was transferred to a nearby hospital for emergency surgery. The patient required a total abdominal hysterectomy with bilateral salpingectomy and received ten units of blood.

A second patient need resuscitation and a transaction to replace “egregious loss of blood” following a May 5 abortion. The physician didn’t complete the abortion, with the surgeon noting cervical laceration and possible uterine rupture.

The state alleges that the physician performing the abortion directed the patient’s spouse to drive her to a hospital in Alabama even though care was available at a nearby hospital that the clinic had a transfer agreement with. The state alleges that it created an unnecessary delay in the patient receiving emergency care.

The clinic also got cited for failing to report the transfer of a patient to a hospital in 2021. Ultimately, the patient required repair of a uterine perforation, a colon resection, a colostomy, a sigmoidectomy, and a cystoscopy.

The U.S. Supreme Court appears poised to reverse Roe vs. Wade, the decision that struck down many state abortion laws, according to a draft opinion that was leaked earlier this month.

Florida recently passed a new law that bans all abortions after 15 weeks of pregnancy in anticipation that the high court would uphold a similar law enacted by Mississippi.

But the release of the draft opinion has led some anti-abortion leaders to advocate that Florida go further. Some have advocated for a measure that would block abortions after six weeks, or when a fetal heartbeat can be detected.

— Asked and (sometimes) answered — 

Memorial Day is just around the corner, and the official start of summer is underway. But the days aren’t going to be lazy anytime soon for vendors planning on responding to the request for information (RFI) published May 6 by the Agency for Health Care Administration regarding Florida’s multi-billion dollar Medicaid managed care contracts. Responses are due by 5 p.m. on June 3.

To that end, AHCA provided answers to some of the 19 questions interested parties and health plans had timely submitted to the state regarding the RFI.

The agency said it “prefers” responses to have a minimum 11-point font and that it will not accept Adobe files. And, AHCA said, responding to the RFI doesn’t get vendors extra credit points that can be applied to their responses to the statewide Medicaid Managed Care re-procurement.

Submit a Word doc at your peril. Stock image via Adobe.

But not all questions sent to the state were answered. And sometimes AHCA’s responses didn’t answer the questions that were asked.

AHCA would not say whether it would be “reviewing” the performance bond contracts or whether it would be providing “transparency” into how administrative load costs are determined, which were from questions submitted by Molina Healthcare.

AHCA said the questions did “not address the subject matter” of the request for information and that they “will not be answered.”

The agency avoided directly answering some of the other questions.

Simply Healthcare Plans, Inc., for instance, said it was aware responses to the request for information were public record. The health plan asked AHCA about the timing of the release of the information. It wanted to know whether the agency would release the responses to the RFI prior to the upcoming procurement of the Statewide Medicaid Managed Care (SMMC) Program, or release responses after the reprocurement is finalized.

AHCA didn’t answer the question, responding instead, that “all RFI responses will be subject to public records request, in accordance with Chapter 119, Florida Statutes.” It then referred to RFI for additional details.

West Cocoa Pharmacy and Compounding asked AHCA whether it was “taking comments from the general public, providers and recipients“ on the RFI.

AHCA responded, “Yes, all providers, or interested providers, are welcome to reply.”

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