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FOMA 2023 Legislative Update - Week 3

March 29, 2023

Paul D. Seltzer, DO, Legislative Chair

Stephen R. Winn, ED

Michelle W. Larson, Assoc. ED

Jason D. Winn, Esq.

Summary

The House and Senate continue accelerating the pace of the 2023 Legislative Session, sending HB 837 concerning civil remedies to the Governor, and chairs in both chambers released their 2023 initial Health and Human Services budget proposal. Governor DeSantis signed HB 837 into law on Friday, March 24, 2023.

On Tuesday, March 28, the Senate Appropriations Committee amended and passed its initial budget proposal, positioning the bill for consideration by the Senate. The House also released its initial budget, referring HB 5001 to the House Calendar. Rumor has it that legislators may complete their work early for the 2023 Legislative Session, tackling their only constitutional duty sooner.

Jason D. Winn, Esq.

Rep. Mike Beltran &

Steve Winn

HB 837, Civil Remedies Signed by the Governor

HB 0837 Civil Remedies by Gregory

On March 23, 2023, the Senate adopted the House version of HB 837, civil remedies, with a vote of 23 Yeas and 15 Nays. The bill proposes changes to civil remedies in Florida, including modifying the comparative negligence system from a "pure" to a "modified" system, limiting a plaintiff's ability to recover damages if they are more at fault than the defendant. It also provides uniform standards to calculate the value of medical damages in personal injury or wrongful death cases and modifies the "bad faith" framework. Additionally, the bill limits contingency fee multipliers for attorney fee awards to rare circumstances and repeals Florida's one-way attorney fee provisions for insurance cases.

Governor DeSantis signed the bill into law on on 03/24/23.

Increase in Graduate Medical Education Funding

Senate Plan:

Florida Senate’s proposed budget prioritizes training new physicians in the state, allocating $349.9 million in funding for graduate medical education (GME) programs, $123.8 million above the current year. Of the total allocated the plan funds the Graduate Medical Education Statewide Medicaid Residency Program at $93.8 million, the Graduate Medical Education Certified Addiction Medicine Physician Program at $4 million, the Graduate Medical Education Program at $15.4 million, and the new Graduate Medical Education Slots for Doctors Program at $30 million.

The following physician specialties and subspecialties, both adult and pediatric, in statewide supply/demand deficit for the Slots for Doctors and Graduate Medical Education Startup Bonus Programs are as follows: allergy or immunology; anesthesiology; cardiology; colon and rectal surgery; emergency medicine; endocrinology; family medicine; gastroenterology; general internal medicine; geriatric medicine; hematology; oncology; infectious diseases; neonatology; nephrology; neurological surgery; obstetrics/gynecology; ophthalmology; orthopedic surgery; pediatrics; physical medicine and rehabilitation; plastic surgery/reconstructive surgery; psychiatry; pulmonary/critical care; radiation oncology; rheumatology; thoracic surgery; urology; and vascular surgery.

House Plan

The Florida House's healthcare budget allocates $322 million in funding for graduate medical education (GME) programs, $95.9 million above the current year. Of the total allocated, the plan funds the Graduate Medical Education Statewide Medicaid Residency Program at $97.3 million, the Graduate Medical Education Startup Bonus Program at 58.2 million, and the Graduate Medical Education Slots for Doctors Program at $30 million.

The physician specialties and subspecialties, both adult and pediatric, that are in statewide supply/demand deficit for the Slots for Doctors and Graduate Medical Education Startup Bonus Programs are as follows: allergy or immunology; anesthesiology; cardiology; colon and rectal surgery; emergency medicine; endocrinology; family medicine; gastroenterology; general internal medicine; geriatric medicine; hematology; oncology; infectious diseases; neonatology; nephrology; neurological surgery; obstetrics/gynecology; ophthalmology; orthopedic surgery; pediatrics; physical medicine and rehabilitation; plastic surgery/reconstructive surgery; psychiatry; pulmonary/critical care; radiation oncology; rheumatology; thoracic surgery; urology; and vascular surgery.

Health Care Education Reimbursement & Loan Repayment Program

Funding for the Health Care Education Reimbursement & Loan Repayment Program will be a conference issue as the plans differ by $12 million. Under the Senate plan, the program is funded at $18 million, $12 million above the current-year. The House proposal maintains funding at 6 million.

The FOMA and FMA are working to adopt the Senate plan to ensure the program is adequately funded.

Advanced Nursing Bill Passes First Committee in the House

HB 1067 Autonomous Practice by an Advanced Practice Registered Nurse by Giallombardo

On March 22, the House Healthcare Regulation Committee passed HB 1067, the autonomous practice of advanced practice registered nurses, by a vote of 11 yeas to 5 nays. The bill has on committee stop remaining in the House. SB 1058, the companion measure, has yet to be heard in committee and has three committees of reference.

HB 1067 removes the requirement that autonomous APRNs practice exclusively in primary care. The bill authorizes registered autonomous APRNs to perform their general functions as an APRN and any specific functions related to their specialty area without physician supervision.

The FOMA and FMA oppose this legislation in its current form and continue educating legislators concerning its impact on patient safety and the unintended consequences surrounding the bills.

Bill Tracking Report

In the News

Florida House panel advances a measure to block gender-affirming care for minors

A Florida House panel on Wednesday approved a sweeping measure that would prohibit doctors from providing gender-affirming care to minors, including children already receiving treatment such as puberty blockers or hormone therapy. The proposal (HB 1421), approved in a 12-5 vote by the House Healthcare Regulatory Subcommittee, also would ban health insurance companies from covering gender-affirming surgeries for transgender people.

Lawmakers say CNA medication training is one way to address nursing home shortage

In an effort to address the ongoing worker shortage at Florida's nursing homes, lawmakers are considering a measure that would let certified nursing assistants get trained as "qualified medication aides." Supporters say the plan would free up nurses and create a glide path for CNAs to get more training.

Medicaid renewals are starting. Those who don't reenroll could get kicked off

Dominique Jackson has been on Medicaid for seven years. But the Columbus, Ohio, resident didn't realize he'd have to verify his eligibility every year to keep his coverage. Then, he sprained his ankle. "I found that I had to re-enroll because I went to the emergency room and I still had my old Medicaid card.

Diagnosis for 3.22.23: Checking the pulse of Florida health care news and policy

PDLs and PBMs - While things appear to be moving at lightning speed, a high priority for Gov. Ron DeSantis, cracking down on pharmacy benefit managers (PBMs) won't be heard in the House or Senate until next week.