Florida Gastroenterological Society
Florida Gastroenterological Society

2017 Legislative Session Updates

April 28, 2017 - Legislative Report
by Christopher L. Nuland, Esq., JD
Lobbyist and General Counsel

One week to go.

With only one week remaining in the 2017 Legislative Session, scores of bills remain in play, with the House and Senate playing a high-stakes game of  “chicken” with regard to the their respective health care priorities.

For instance, the Florida House has passed legislation on Direct Primary Care, Recovery Care Centers, Cardiovascular Rules, and Ratification of Board of Medicine Rules.  The Senate, for this part, has deferred on addressing these issues, waiting instead for the House to address Senate priorities such as limits on step therapy and retroactive denials.  While a “Grand Deal” is still possible, time is getting short.

With that being said, several initiatives appear to be in good position for final passage.  Enhanced newborn screening requirements should receive final passage from the House today, and legislation increasing access to stroke centers has passed the House and is on Special Order in the Senate today.  Likewise, legislation allowing for private funding of the Prescription Database has passed the House and is on the Senate Floor.

Much of the last few days has been spent in budget negotiations.  With four days left before a budget must officially be delivered to all legislators, agreement has finally been made on the major issues, including the House agreeing to raises for all state workers.  The resolution of this issue should allow legislators to begin deliberations on a final health care bill.

Stay tuned for what is bound to be a bumpy ride over the next few days.

 

April 9, 2017 - Legislative Update
by Christopher L. Nuland, Esq., JD
Lobbyist and General Counsel

Happy Passover and Easter.

The 2017 Legislative Session has passed its midpoint, and with very little activity planned this coming week due to the Passover and Easter holidays, only three full weeks of full legislative activity remain.

That being said, this past week was an eventful one for Medicine both at the Legislature and in a marathon Board of Medicine Meeting in Ft. Lauderdale.  In Tallahassee, the House Ways and Means Committee passed its reform package, complete with ARNP Independent Practice, Telemedicine, and other reforms.  Fortunately, the bill must still pass the Health and Human Services Committee and then the full House.  The Senate, for its part, has shown little interest in the House approach.

Likewise, the Optometric Scope of Practice Expansion Bill has slowed, in no small part due to our efforts.  It also must still pass the House Health and Human Services Committee and the full House, and intense lobbying has made the Senate reluctant to take up the companion bill.  While the battle here is not over, I am happy with the progress (or lack thereof) so far.

In the Senate, the House Banking and Insurance Committee passed legislation that would eliminate retroactive denials, while the Senate Banking Committee advanced Maintenance of Certification (“MOC”) Reform legislation.   While the current Senate MOC language is far from perfect, it is still alive, and we will be working over the next few weeks to advance the superior House version.

Meanwhile, the Florida Board of Medicine held a series of meetings on Thursday and Friday, where the Board and its committees focused on the prevention of wrong site surgeries, heavily disciplining those who practice outside the scope of their ACGME training, and receiving updates from its staff and us on the current status of pending legislation.

As mentioned above, this likely will be a light week, so the next legislative update will be on April 21.

 

March 31, 2017 - Legislative Update
by Christopher L. Nuland, Esq. JD
Lobbyist and General Counsel

March is in the books, but not before the Legislature had its most productive week of the 2017 Session, with more fireworks set for this week.

The tone for the week was set Monday, when the Senate Health Policy met a day earlier than usual to address a host of issues, including Newborn Screening Requirements, expanded access to Stroke Centers, elimination of duplicative regulation of Clinical Labs, and Overdose Reporting Requirements (which was amended to eliminate such reporting for non-EMS providers).

However, those developments paled in comparison to the House, where the Health Innovation Committee passed a proposed deregulation of the Trauma System and virtual ban on managed care Retroactive Denials (both bills still have more committee stops).  The highlight of the week, however, was the full House passing its “Priority Package” of health-related issues Friday afternoon, including Direct Primary Care and Recovery Care Clinics.

All of THAT, however, pales in comparison to what the Senate will address on Monday, when the Senate Health Policy takes on MOC and Physician Assistant Regulation at the same time that the Banking and Insurance Committee addresses Workers Compensation, PIP, and Board of Medicine Office Surgery Rules.

 

March 17, 2017 - Legislative Report
Christopher L. Nuland, JD
Lobbyist and General Counsel

Happy St. Patrick’s Day.

If you have been following along over the last few weeks, you know that I have been using military analogies, saying that battle lines had formed.  This week, they engaged.

The fight of the week was the Optometrists’ effort in the Health Quality Committee to be allowed to perform surgeries.  Medicine was united in opposition, and we spoke at length on the difference between medical residency training and the “course” that optometrists would have to take.  Despite our efforts, the Optometrists won this vote by a 8-7 count when one opponent was called out of the room and his proxy was disallowed.  While it would have been nice to put that issue aside for the rest of the Session, the fierceness of the debate and closeness of the vote give me great hope that we can defeat these efforts in the Senate.

In other notable news, that same Health Quality Committee overwhelmingly approved a measure that would prohibit insurance companies and hospitals from requiring that panel physicians maintain MOC certification.  Even if this legislation does not ultimately pass, a clear message has been sent to ABMS, which was in attendance and opposes the measure, that it must become more responsive to its physicians.

Thursday was less combative, as the House Health and Human Services Committee moved Direct Primary Care one step closer to passage (the Senate version has a vote next week),  voted to ratify pending Board of Medicine rules for which we have fought for over two years, and pushed for the establishment of Recovery Care Centers.

All in all, it was a productive, if rough week, and both the House and Senate rewarded themselves by allowing an extra long weekend, but we all will be back at it on Monday when new battles will surely be fought.

 

March 10, 2017 - Legislative Update
by Christopher L. Nuland, JD
Lobbyist and General Counsel

As usual, the first week of the legislative session was dominated by the pageantry of the Opening Day, complete with flowers, the Governor’s annual State of the State address, and the last-second introduction of scores of new legislative proposals.  Nevertheless, a few bills did make some advances in committees, with SB 144 (Texting and Driving) passing its first Senate Committee of Reference, HB 145 (Recovery Care Centers) and HB 59 (Adult Cardiovascular Training Standards) both passing the House Health Appropriations Committee.

All of that, however, is a mere appetizer for what promises to be a momentous week.  Not only will the Senate Health Policy Committee take on insurance issues, nursing regulations and Recovery Care Centers, while the Senate Judiciary Committee will discuss HMO Liability for Medical Malpractice, but the House Health Appropriations, Health Innovation, and Health Quality Committees have each scheduled marathon five hour meetings in order to move legislation (the agendas for the House meetings have not been set at press time).

Stay tuned for progress reports, as it looks like next week will be a bumpy ride!!

 

February 17, 2017 - Advocacy Matters – Legislative Update
by Christopher L. Nuland, JD
Lobbyist and General Counsel

This past week was a momentous one for the Florida Medicine, both in the courts and in the legislature.

Florida House Moves Major Legislation

While the Florida Senate this week addressed only budgetary items, the House was busy working on several pieces of major legislation.

In the House Quality Committee, the Committee voted to move forward with a bill that would allow certain ARNPs to practice without physician supervision and would allow out-of-state Telemedicine providers to practice without being held accountable to the Florida Board of Medicine.  We opposed both such provisions but continues to work with the sponsor on the legislation.

In better news, the same Committee advanced Chapter-supported legislation that would allow the responsible use of a single opiate during Level I office procedures if (and only if) emergency medications were available.  The Senate Health Policy Committee will address the same issue next Tuesday.

Meanwhile, the House Innovation Subcommittee passed legislation to allow for the establishment of physician-owned Recovery Care Centers.

All in all, it has been quite a week, and next week promises to be just as exciting, as both the House and Senate will address legislation banning mid-year formulary changes, while the Senate will tackle legislation that would make HMOs liable for medical malpractice to the extent that they dictate care and other legislation that would ban retroactive denials.

11th Circuit Rules Ban on Physician Free Speech re Guns Unconstitutional

In a major decision for all professional free speech, the full 11th Circuit Court of Appeals yesterday ruled that Florida’s ban on physician’s speaking to their patients regarding guns was a violation of the physician’s First Amendment Right to Free Speech.  While the Court did uphold a portion of the law that prohibits discrimination based upon a patient’s gun ownership (a point that was not disputed by the plaintiffs), all but one judge agreed that restrictions on what a physician and patients discuss are a violation of the First Amendment.

As of press time, the Scott administration is considering whether to appeal the ruling to the U.S. Supreme Court.


Week 2 Legislative Update
by Christopher L. Nuland, Esq.
Lobbyist and General Counsel

As usual, the first week of the legislative session was dominated by the pageantry of the Opening Day, complete with flowers, the Governor's annual State of the State address, and the last-second introduction of scores of new legislative proposals.  Nevertheless, a few bills did make some advances in committees, with SB 144 (Texting and Driving) passing its first Senate Committee of Reference, HB 145 (Recovery Care Centers) and HB 59 (Adult Cardiovascular Training Standards) both passing the House Health Appropriations Committee.

 

All of that, however, is a mere appetizer for what promises to be a momentous week.  Not only will the Senate Health Policy Committee take on insurance issues, nursing regulations and Recovery Care Centers, while the Senate Judiciary Committee will discuss HMO Liability for Medical Malpractice, but the House Health Appropriations, Health Innovation, and Health Quality Committees have each scheduled marathon five hour meetings in order to move legislation (the agendas for the House meetings have not been set at press time).

Stay tuned for progress reports, as it looks like next week will be a bumpy ride!!
 
Week 1 Legislative Report
by Christopher L. Nuland, Esq.
Lobbyist and General Counsel

The 2017 Legislative Season is in full swing, with both the House and Senate completing the second week of Committee hearings last week.  While few bills were actually acted upon, battle lines have begun to form on numerous issues of interest to physicians.

For instance, FGS priority bills have already been filed that would prohibit insurers from removing drugs from a formulary in the middle of a contract year (HB 95 and SB 182) and place strict limits on any retroactive denials (SB 102).  While Scope of Practice bills have yet to be filed, intelligence suggests that ARNPs and optometrists both will be seeking significant expansions in the coming Session.

I am pleased to report that Recovery Care Center legislation has already been filed in the House (HB 145) and Senate (SB 222).  Your lobbying team has already met with the Speaker's Office and the Chair of the Senate Health Policy Committee, and we look
forward to working with both to advance this legislation.  This legislation would allow GIs to perform more advanced procedures in their ASCs and allow patients to recover in affiliated recovery units for up to 72 hours, thereby eliminating the need for a hospital stay.

The Legislature will not meet this week, as many members will be headed to Washington, DC for Inaugural activities, but both Chambers will hold hearings three weeks in February in preparation for the March 7 opening of the official 2017 Legislative Session.