Week in Review | Session Week 7 (February 24-28, 2020)
The Florida House of Representatives this week passed bills to improve health care for Floridians across the state. On Wednesday, lawmakers voted to end powerful monopolies caused by hospitals buying physicians’ offices; other patient-centered bills included one to expand e-prescribing and another to ensure that patients have easy access to medical records.
"The market will drive down costs if we empower patients with the information they need to make informed and responsible medical decisions," House Speaker Jose Oliva said. "That means holding health care providers and insurance companies accountable for predatory billing practices and responsible for making medical records and pricing information available. Floridians deserve better health care, and the Florida House is working hard to make sure they get it."
House members continued to hear other bills in committees, including one to expand Advanced Practice Registered Nurses' scope of practice and improve access to primary care. Other measures on tap included lawsuit reform (to ensure that lawyers don't get higher payouts than they deserve) and tax cuts (to keep more money in the pockets of those who earn it). Additional highlights from the week are detailed in the briefs below.
House Public Integrity & Ethics Committee takes testimony from subpoenaed FCADV board members
House lawmakers this week began taking sworn testimony from subpoenaed board members of the taxpayer-funded domestic violence organization under fire for financial mismanagement, including paying its chief executive $7.5 million over three years. On Monday and Thursday, lawmakers on the Public Integrity & Ethics Committee asked board members, under oath, why the CEO of the Florida Coalition Against Domestic Violence was given a total of more than 1,000 paid days off in memos dated 2016, 2017, and 2019.
FCADV Board Chairman Melody Keeth, who signed the memos and was first to be questioned, suggested the excessive paid time off was "a typo." Other board members claimed ignorance regarding the CEO's compensation package. In addition to Keeth, the committee questioned Laurel Lynch, FCADV director from Bradenton; Angela Diaz-Vidaillet, FCADV vice president from Miami; Patricia Duarte, chief financial officer of FCADV in Tallahassee; and Sandra Barnett, chief operating officer of FCADV in Tallahassee.
In 2018 and 2019, CEO Tiffany Carr cashed out her banked paid time off and left FCADV while blocking ongoing requests from the Department of Children and Families for the group's spending records. In mid-February, the Florida House obtained several of those records and issued subpoenas to Carr and all board members. On Thursday, Gov. Ron DeSantis signed HB 1087, freeing DCF from the sole-source contract with FCADV.
As the Florida House continues its ongoing investigation into FCADV, individuals with knowledge of the FCADV’s financial mismanagement and corporate corruption may provide information and, if an FCADV employee or another qualified person, be protected by calling The Whistleblowers Hotline at 1-800-543-5353 or sending mail to P.O. Box 151, Tallahassee, FL 32302, c/o Melinda M. Miguel, Chief Inspector General.
Florida House votes to make medical records more accessible
The Florida House passed a bill Wednesday to ensure that Floridians gain access to their medical records in a standardized, timely manner. HB 1147 sets the timeframe that health care providers and facilities must produce or allow inspection of records and empowers patients to control their records in the form most convenient for them.
Requesting medical records should be a straightforward process; however, it is often inconsistent, confusing, and subject to repeated delays. HB 1147 ensures that, regardless of provider type, each practitioner and facility must produce all requested records in their possession within 14 working days and allow inspection of all records in their possession within 10 working days. Furthermore, providers and facilities must produce the records in the form the patient selects.
Patients will receive treatment from many health care providers throughout their lives, and each provider will create and maintain a record of that treatment. It is crucial that patients and their providers have prior treatment records for the patient to receive the best care. HB 1147 is headed to the Senate for its consideration.
Florida House votes to prevent prescription fraud and abuse
Most Floridians conduct business electronically — it’s instant, efficient, and secure. It is time now for the health care industry to catch up. On Wednesday, the Florida House passed HB 1103, which eliminates paper prescriptions and moves to an electronic format to help combat fraud, medical errors, and the opioid crisis.
HB 1103 would require all prescriptions to be electronically or telephonically transmitted by July 1, 2021, with some exceptions. Written prescriptions exacerbate the opioid crisis because they can be altered, and prescription pads may be lost or stolen and used illegally. Written prescriptions can also cause medical errors when handwriting is misread.
HB 1103 provides exceptions for written prescriptions provided to patients receiving services in a free clinic, in a hospital’s emergency department, from a health care practitioner providing free services, or when there is a temporary electrical or technological failure that prevents electronic prescribing.
Many providers already e-prescribe medications. At least 15 other states require e-prescribing in some manner, and federal law will require it for all controlled substances beginning January 1, 2021. HB 1103 is headed to the Senate for its consideration.
Florida House votes for open, transparent access to health care information
Health care providers have some flexibility in discussing costs with patients, but there may be cases when a provider’s contract with an insurer limits communication related to costs of care. Florida House members passed a bill Wednesday to ensure open communication.
HB 1205 prohibits a health insurer or Health Maintenance Organization (HMO) from limiting the ability of any provider to discuss pricing information with a patient, ensures that insured patients do not pay more than an uninsured patient for a health care service, and safeguards a patient’s right to open communication with providers regarding costs of care. The bill’s provisions apply to all state-regulated health plans, including health insurance policies, small and large group policies, and HMO coverage contracts.
As health care costs continue to rise, many health insurers are asking consumers to take on a greater share of their costs by increasing premiums and out-of-pocket expenses. Patients should have the information they need to be able to choose less expensive health care services – or even pay for a service themselves, rather than using insurance, if it’s less expensive. HB 1205 is headed to the Senate for its consideration.
Florida House votes to prevent anti-competitive practices by hospitals
Hospital control of many health care providers in one area reduces competition and raises costs. That is why House lawmakers passed a measure Wednesday that would monitor hospital mergers and acquisitions.
HB 711 requires the Attorney General’s Office to review hospital acquisitions of physician practices and other health care provider entities for anti-competitive behavior. Any hospital planning to acquire a physician practice must report it to the Attorney General at least 90 days prior to completion. The bill authorizes the Attorney General’s Anti-Trust division to look out for anti-competitive practices and act accordingly to prevent harmful monopolies.
One studyfound that, on average, prices increase by over 14% when a hospital acquires a physician’s practice. For specialty physician practice acquisitions, prices rise by 15% to 33.5%.
HB 711 is a positive step toward ensuring that hospitals and doctors compete with each other to provide high-quality health care services at low prices. The bill is headed to the Senate for its consideration.
Florida House votes to increase local government transparency
The Florida House passed a bill Wednesday to ensure that local governments are responsible and transparent stewards of taxpayer dollars.
HB 1149 requires additional fiscal transparency from local governments. The bill focuses on helping residents gain access to important information, including voting records related to tax increases and the issuance of tax-supported debt. The bill also enhances access to tax history and property tax information, expands public meetings and notice requirements, and requires local governments to conduct and consider a debt affordability analysis prior to approving the issuance of new long-term, tax-supported debt.
Under current law, most local governments are required to have an annual financial audit. HB 1149 requires the auditor to report whether the local government is in compliance with the provisions of the new act created by the bill. Local governments not in compliance must provide evidence that corrective action has been initiated within 45 days and completed within 180 days. The Auditor General must report local governments that do not take corrective action to the Legislative Auditing Committee.
HB 1149 ensures that Floridians have open, easy access to the information they need to be more engaged with their local government. The bill is headed to the Senate for its consideration.
Florida House Committee votes for free-market health care reform
Floridians deserve options when it comes to meeting their health care needs. Florida House Health & Human Services Committee members approved a bill Wednesday that frees up more choices for patients who need specialty care.
HB 6059 removes provisions prohibiting licensure of hospitals that serve specific populations. Florida bans hospitals that specialize in cardiac, orthopedic, surgical, or oncology care. That means hospitals can’t specialize and become a center of innovation in any of those areas.
HB 6059 removes outdated regulatory barriers that hinder competition. Repealing the ban should increase competition and ultimately lead to more high-quality, cost-effective options for patients.
House Health & Human Services Committee votes to break down health care barriers
Florida House Health & Human Services Committee members approved a bill Wednesday that would free advanced practice registered nurses (APRNs) to help patients to the full extent of their education and training.
Florida has a shortage of health care providers, which means some patients don’t have quick access to the primary care they need. However, there are 32,877 APRNs actively licensed to practice in Florida but can only do so under the supervision of a physician.
These APRNs have graduate degrees – many doctoral – and are trained to diagnose and treat illness and disease. Yet, they are stifled in their ability to help patients. Many experienced APRNs are “supervised” by physicians who never see the APRN’s patients, never review a chart, and never do a patient consultation.
Treatment by an APRN is just as safe as a treatment by a physician. In fact, states that allow independent practice see increases in health care utilization and quality of care, which can lead to improved health outcomes. HB 607 brings Florida in line with 30 other states that already allow APRNs to practice independently.
Florida House Health & Human Services Committee votes for more options for patients
Floridians deserve options when it comes to meeting their health care needs. That is why House lawmakers on the Health & Human Services Committee approved a measure Wednesday that would allow pharmacists to work to the full extent of their education and training – which means more choices for patients who need quick and simple care.
HB 389 allows pharmacists to provide health care services to patients with minor illnesses, including strep and flu, or chronic conditions, under varying levels of physician supervision. Florida, like much of the nation, is experiencing a shortage of physicians, especially primary care physicians. As the population of Florida ages, more patients will need health care services to manage chronic conditions, as well as diagnose and treat common, minor illnesses.
Physicians currently rely on other health care practitioners, such as APRNs and PAs. However, pharmacists can also help meet this need, since they are usually the most accessible and most frequently visited health care practitioner.
Current law allows pharmacists to provide medication management services and administer immunizations and antipsychotic medication via injection. HB 389 is the logical next best step to make it easier for patients to manage their chronic health conditions and to find relief from minor health issues quickly, safely, and affordably.
House Appropriations Committee approves tax cut
People – not the government – should have the most control over their hard-earned money. To this end, the House Appropriations Committee approved a tax package Tuesday that offers $162.7 million in tax cuts to Floridians.
HB 7097 includes a three-day Back-to-School sales tax holiday from August 7 to 9, 2020, and a seven-day Disaster Preparedness sales tax holiday from May 29 to June 4, 2020. Other highlights include a reduction of the business rent tax; a reduction in the communications services tax, which will help cut costs for anyone paying for a cellphone plan; and a reduction of the aviation fuel tax rate – cost-savings that can be passed on to consumers.
The bill also updates Florida’s property taxes by limiting the value of a nonprofit hospital’s charity tax exemption to no more than the value of charitable services it provides to the community, expanding the list of military operations that qualify for the deployed service-member tax exemption, and allowing condominium associations to jointly represent condo owners in certain judicial appeals.
The tax package also requires that future School Capital Outlay Sales Surtaxes be proportionately shared with charter schools. It expands allowable uses for tourist development tax proceeds in all counties to include public parks, trails, and water quality improvement projects – making Florida the first state to tie water quality to tourism.
Florida House committee supports legislation to help Floridians compare local governments
Information about local government spending, debt, and more should be published in a manner that is timely, understandable, and accessible to Floridians. On Tuesday, the Appropriations Committee approved two bills that offer a policy solution to ensure this practice is the norm.
Together, the bills require local governments to submit annually financial information to the Department of Financial Services. The Department will then be required to publish this data, along with other information related to community conditions, on an interactive website and on printed reports to be mailed to each household in Florida with a registered voter.
The mailed report cards will present an earned grade of “A” through “D” based on the comparison of data, or an “F” if a local government refused to submit their data completely and on time. The grades are awarded in the following categories: government spending, debt and cost, and public safety and education. These tools will allow Floridians to compare their local governments against others.
When Floridians have this knowledge, they can make better decisions about where they choose to live, who they choose to vote for, and how they choose to get involved in their communities.
Committee unanimously approves Intellectual Diversity in Higher Education bill
State university and college students should feel free to express their viewpoints in a marketplace of diverse ideas. On Wednesday, Florida House lawmakers on the Education Committee unanimously voted to support this concept by approving HB 613.
HB 613, Higher Education, requires all state universities and colleges to survey students and faculty, and publish a report on the status of intellectual diversity at their institutions. The legislation also revises provisions related to performance funding, among other changes.
A study by UCLA’s Higher Education Research Institute found a dramatic leftward shift in the composition of faculty today with progressives at 60% and conservatives at only 13%. Given this dire lack of political diversity, conservative students may have real fears about expressing their opinions.
HB 613 reinforces the protections of the First Amendment by helping expose suppression of diverse speech and opinions at Florida’s higher education institutions.
School Choice bill receives Republican support in House Appropriations
Florida is at the forefront of the school choice movement, giving parents the power to select what is best for their child’s education. On Tuesday, the House Appropriations Committee approved HB 7067 that expands and improves the state’s school choice scholarship programs, and it streamlines standardized testing for public school students.
The legislation makes changes to four of the state’s five school choice scholarships to give more families the opportunity to choose the education that best meets their child’s needs. Among the revisions, the bill increases the enrollment cap for the Family Empowerment Scholarship from 18,000 students to about 28,000. It also provides continuity of school choice by making Florida Tax Credit Scholarship (FTC) students eligible for Family Empowerment Scholarship and allowing FTC students to remain eligible by eliminating annual income verification.
The bill also phases out the statewide Geometry and 9th grade ELA end-of-course assessments by replacing them with district-wide ACT or SAT test that 11thgrade public school students already take.
Florida House votes to strengthen conflict of interest law for public officials
Florida’s government officials should be held to the highest ethical standards. To that end, the Florida House unanimously voted to pass a bill enacting reforms to conflict of interest laws so that government employees and elected officials do not use their positions for private gain.
HB 1185 would help weed out conflicts of interest by banning some actions and requiring that public servants report new information. Among many reforms included in the bill, statewide elected officials are prohibited from taking a job offered as a result of their official duties or political status. Additionally, state workers cannot seek a job at an organization regulated by their employer agency, and statewide elected officials must report salary increases or new posts if they work for an organization that receives state dollars.
HB 1185 advances the Florida House’s commitment to eliminating corruption, fraud, and abuse in government. The bill is now headed to the Senate for consideration.
House Judiciary Committee votes to improve accuracy in damages
Health insurance prices are skyrocketing. A broken court system that awards inflated amounts of medical expenses in personal injury and wrongful death cases could be one reason why. Medical bills that do not accurately reflect the typical amount paid for that medical service should not be considered by a jury. Florida House Judiciary Committee members approved a bill on Wednesday to address this problem.
HB 9 ensures that the amount of medical expenses awarded in personal injury or wrongful death cases reflects the usual and customary amounts that a service provider in the community would receive and not the amount the medical provider billed. It also deals with rising insurance costs by establishing logical guidelines for medical damages payouts in personal injury or wrongful death cases.
HB 9 aims to limit any confusion a jury may have about what amount of damages should be awarded.