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Diagnosis for 9.22.22: 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.

— Back-to-Back —

Less than one week after the members of the Boards of Medicine and Osteopathic Medicine meet jointly in Tallahassee to discuss the headline-grabbing issue of gender-affirming care the members of the Joint Rules/Legislative Committee will have the proposed language to consider for approval when they meet in Tampa Oct. 6.

Members of the joint committee will hear from experts for two of those hours, but the 1,000-plus page recently released public book doesn’t identify the names of the “subject experts” or how many experts will present testimony.

If approved by the joint committee the Board of Medicine could agree to publish “proposed rules” as early as Oct. 7 and the Board of Osteopathic Medicine could agree to publish a proposed rule at its Nov. 4 meeting.

Once designated a proposed rule, the state has 21 days to finalize the proposal. That time is tolled, however, if someone requests a rule hearing. The clock also is stopped if someone requests a formal challenge to the proposed rule. Proposed rules cannot take effect if they have been challenged at the state Division of Administrative Hearings.

The medical boards agreed to develop a state-specific standard of care guidelines for the treatment of gender dysphoria in August. Though the board had not previously delved into the issue they agreed to do so at the behest of state Surgeon General Joseph Ladapo.

He petitioned the board to consider amending its standard-of-care rules to prohibit patients under the age of 18 from receiving sex-reassignment surgery and puberty-blocking hormone and hormone antagonist treatments. The proposal also would have the board change the standard of care rules to require older patients to sign a consent form and to wait 24 hours before starting such treatments.

While he has not been shy about pushing proposals through the Legislature that the LGBTQ+ community says target them, Gov. Ron DeSantis has been able to limit access to gender-affirming health care through his administrative power by having his health care agencies pass regulations addressing the issue.

Florida Medicaid, housed in the Agency for Health Care Administration (AHCA), banned reimbursement for general affirming care, a move that affects the poor, elderly and disabled who rely on the program. The ban was challenged in a Tallahassee federal court by the Southern Regional Office of Lambda Legal.

Meanwhile, by getting the medical boards, housed in the Florida Department of Health (DOH), to adopt state-specific standards-of-care the regulations would apply to all doctors providing health care and their patients, regardless of payer. The medical boards would have the authority to sanction doctors who violate the rules.

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

— Cash Flow —

As a mandated $15 minimum wage requirement nears, calls for DeSantis to insert himself into a tussle between Medicaid managed care plans and the home- and community-based providers they contract with continues.

Home Care Association of Florida Executive Director Bobby Lolley sent a letter to DeSantis last week asking him to consider delaying the wage increase by a month in hopes that the Medicaid long-term care plans they contract with to provide health care services will have increased their payments. The Florida Assisted Living Association also sent a letter to the Governor’s office requesting DeSantis’ help.

Effective Oct. 1 the rates the state pays contracted Medicaid managed care long-term care plans should increase by 8.4%. Most of that rate increase is the result of a $136 million bump lawmakers included in the budget to raise the minimum wage paid to “direct caregivers” who treat the poor, elderly and disabled in Medicaid managed care plans.

Lolley said the association, which represents 2,200 home health care agencies, has been in regular contact with Medicaid officials about health plans not increasing home- and community-based providers’ reimbursements rates in time to coincide with the mandated pay increase.

In May, the association asked AHCA and Medicaid to begin working in advance in hopes of preventing a potential cash flow issue for its members.

“The minimum wage mandate will take effect in less than three weeks, and we have not yet heard from any provider who has had their contract amended by a health plan to cover the minimum wage requirement,” Lolley wrote in the letter.

The cash-flow problems among contracted home- and community-based providers was caused when lawmakers gave the managed care plans until Jan. 1, 2023, to pass the increased wages on to their contracted providers but required employers to begin paying direct care staff a $15 minimum wage Oct. 1.

Senate President Wilton Simpson championed the $15 minimum wage and in a prepared statement said his office is watching the implementation.

“I know AHCA is working diligently to ensure as smooth of an implementation as possible and my team will continue to closely monitor the implementation in advance of the Oct. 1 deadline,” Simpson said. He added, “we got to where we are today because the Legislature and Gov. DeSantis place great value on the contributions of those workers who care for our most vulnerable. We are going to see this across the finish line and make sure these workers get this important raise.”

 


The post Diagnosis for 9.22.22: Checking the pulse of Florida health care news and policy appeared first on Florida Politics – Campaigns & Elections. Lobbying & Government..

FloridaPolitics, excerpt posted on  SouthFloridaReporter.com

Republished with permission 

This article originally appeared here and was republished with permission.

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