Florida Gastroenterological Society
Florida Gastroenterological Society

2019 Legislative Wrap-Up

FGS Legislative Update

Talk about suspense! This legislative session brought with it several high-profile issues that remained active right to the end! And, I am happy to report that our lobbyist, Chris Nuland, has provided an extraordinary final report to share with you.

On defense, we stopped all attempts at Scope of Practice expansion, including pharmacists, nurse practitioners, and physician assistants. While Scope Expansion remains a fundamental part of the House Health Care package, the steadfast support of the Senate Leadership and Governor Desantis was successful in stopping the expansion efforts in the Senate.

We also worked hard to ensure that any Telehealth Bill would require out-of-state physicians to procure a full Florida license. While the Legislature ultimately did not require full licensing, it did include in its bill a requirement that such physicians remain accountable to both the Florida courts and Board of Medicine, and the bill also included requirements to maintain the in-person standard of care and a prohibition on insurers requiring the use of telemedicine.

Offensively, we had the most successful session in recent memory! While we certainly did not get everything we wanted, HB 843 (which passed during the last week of Session) addressed many of our most important issues, such as:

  • A requirement that a patient’s physician would be notified of any hospital admission
  • The ability of ambulatory surgery centers to keep patients for up to 24 hours
  • The expansion of last year’s Direct Primary Care agreements to all specialties
  • A prohibition on redundant step therapy
  • Ceremonial resolutions from the House, Senate and Governor’s Office raising awareness of Colorectal Cancer

Thank you to everybody who visited Tallahassee, contacted a legislator, or emailed us and/or Chris, with an insightful comment. Your work was instrumental in our success! Your profession, patients, and the FGS greatly thank you for your advocacy.

Sincerely,

Justin Bouck
FGS Executive Director

P.S. – Don’t forget!! Registration for the 2019 FGS Annual Meeting is now Open! September 13-15, 2019 at the Hilton Bonnet Creek in Orlando, FL. Use the links below to register and book your room.
Register for the course | Book your room

Legislative Updates – Week 6

When An Irresistible Force Meets an Unmovable Object…

As we write this, we are completing the sixth of the nine weeks of Florida Legislative Session, during which Medical Office Regulation and Scope of Practice issues have taken center stage.

In the wake of several death in office surgeries, we teamed with Senator Anitere Flores and Representative Anthony Rodriguez to introduce SB 732 and HB 933, respectively, to address shortcomings in the Florida law.  As amended (with our input and support), the bills would, for the first time, make the office facilities, owners, operators, and physicians all susceptible to discipline for violations of the State’s Office Surgery Rule.  Current Law only allows the Board of Medicine to discipline the surgeon, and it has been discovered that several unscrupulous practices, owned by non-physicians, have escaped responsibility for substandard care.  The bills have each passed two committees in each chamber, and it is anticipated that each will pass its Appropriations  stop next week.  Finally, passage is then expected in the final two weeks of Session.  It is important to note that this new law, as amended, will NOT affect the most common minor procedures performed in physician offices or procedures performed in ASCs or hospitals.

On Scope of Practice matters, HB 821, which would allow independent practice of Nurse Practitioners and PAs, on Wednesday passed its last House committee over our objections and is expected to be passed by the House.  Moreover, the whole House has moved legislation that would allow pharmacists to diagnose and prescribe. We have, however, secured support in the Senate to stop the bill, and we  expect that support to prevent final passage of the bill.

Not all of the legislation passing the House is bad.  For instance, the House is moving legislation that would require hospitals to notify a patient’s treating physician(s) when a patient is admitted and allow such physicians, even if not on staff, to at least participate in the patient’s care.

We hope that the above is useful.  Should you have any questions, please feel free to contact Chris Nuland at nulandlaw@aol.com.

Florida Senate Passes Proclamation Recognizing Colorectal Cancer Awareness Month

Today, the Senate passed our proclamation request recognizing March as Colorectal Cancer Awareness Month. We want to thank Sen. Lori Berman for her continued support of our colorectal awareness efforts in Florida.

Dr. Gerardo Lanes, FGS Past President, with DigestiveCARE also played a vital role in helping Florida Legislature recognize the importance of Colorectal Cancer screenings.

If you are over 45 years old or have a family history of colorectal cancer please schedule a consultation with your gastroenterologist. Despite colorectal cancer being the 2nd leading cause of cancer, it can also have over a 90% survival rate if caught early. Don’t wait, get screened now.

Governor DeSantis Supports Colon Cancer Awareness

Thanks to Joni Brown of DigestiveCARE, we have received the official proclamation from the Florida Governor Ron DeSantis’s office, recognizing March as Colon Cancer Awareness Month in Florida.

We are excited to see the newly-installed Governor waste no time recognizing the threat of this disease and the importance of colon cancer screening.

As one of the leading causes of cancer-related deaths in the United States, we must stress the importance of early screening. According to a letter from the American College of Gastroenterology, the 5-year survival rate is over 90%, but because of poor screening, less than 40% of colon cancer cases are detected early.

If you or your organization would like to get involved in raising awareness for this deadly, yet preventable disease please email us at info@flgastro.org.

Legislative Update: Debate Begin…

Especially in the House of Representatives, Scope of Practice Expansion and Telemedicine are two of the key issues of the 2019 Legislative Session, and both were placed in the limelight before a packed Health Quality Committee Room this past week. 

Committee members heard presentations on both issues, with Telemedicine taking the lead. While panel members touted the virtues of telemedicine, we continued to lobby that physicians have the final say as to whether telemedicine is appropriate and that out-of-state physicians be held accountable to both the Board of Medicine and Florida courts. While the final bill has yet to be introduced, legislators in both chambers (and on both sides of the aisle) appear to support our position. 

APRN Independent Practice was a more contentious issue, as proponents argued that independence would allow APRNs to treat more patients, while opponents such as us argued that independent practice would not increase the number of APRNs but would remove the physician from the health care team. While no vote was taken, Re. Cary Pigman, M.D. filed an APRN Independent Practice Bill (HB 821) almost immediately, which we will have to fight throughput the Session. 

In the Senate, we have been working behind the scenes on SB 732, which, as written, would require any office that performed invasive procedures of any type to be registered and inspected. We are, however, working in good faith with the sponsor, Anitere Flores, to amend the bill to allow regulation of Level II and III offices and owners, as well as physicians. It is hoped that this approach will help curb many of the abuses cited in a recent USA Today article without disrupting currently effective regulations. 

Finally, we are lobbying both chambers to enact legislation that would prohibit redundant Step Therapy, as requiring patients who have tried and failed with lesser treatments should not be required to repeat those failed therapies if they change health plans. As you can see, it will be a hectic Session, but we are currently well positioned to protect our doctors and patients, and we look forward to a successful sixty days.

2019 Legislative Update: Committee Meetings – Week 3

FGS Legislative Update


🔥🔥 2019 Legislative Season Heats Up 🔥🔥

With the third of six legislative committee weeks in the books, battle lines have already formed for the 2019 Legislative Session.

It has become painfully obvious that the House of Representatives will propose several Scope of Practice Expansion bills, such as Independent Practice for APRNs and PAs, Pharmacist Diagnosis and Prescribing Authority, and Psychologist Prescribing, while the Florida Senate has thus far indicated that it will resist such legislation.

Conversely, initiatives such as the elimination of Redundant Step Therapy and the Recognition of Prior Authorizations are likely to advance in the Senate but face a far more hostile reception in the House of Representatives.

Legislators in both chambers, however, have indicated that changes to the 2018 Opioid Law are unlikely.

What does remain to be seen is the inevitable “Wild Card” issue that nobody yet sees, but which will come out of nowhere to dominate the news cycle.

With a new Governor and scores of new legislators, ideas are percolating on all fronts, and February is destined to be a better harbinger of things to come.

2018 4th Quarter Legislative Update

Despite the holiday season, the FGS has been busy over the past few weeks at both the Legislature and the Board of Medicine.

In the Legislature, FGS received a commitments from Rep. Cary Pigman, M.D. and Sen. Lori Berman to sponsor our Cancer Awareness bill, and our lobbyist has an opportunity to meet with session leadership. While the House is expected to again introduce Independent Practice Bills for APRNs and PAs, we will oppose these measures and have received commitments from Senate members to protect our interests.

On the regulatory front, the news if even better. FGS and other secured a favorable ruling from the Department of Health that eliminates the need of gastroenterologists from checking the PDMP before administering drugs, even if those drugs are administered in an office or ASC setting. Moreover, the Board of Medicine has drastically reduced the administrative requirements pertaining to the prescription of acute pain medications, which will ease the administrative burdens of our doctors.

Please follow our updates throughout the legislative session, which is expected to be one of the more contentious in recent memory, as we fight to protect the business and profession of gastroenterology.