|
FOMA 2023 Legislative Update - Week 9
May 5, 2023
Paul D. Seltzer, DO, Legislative Chair
Stephen R. Winn, ED
Michelle W. Larson, Assoc. ED
Jason D. Winn, Esq.
| |
On May 5, 2023, the Florida Legislature concluded its business for the 2023 Legislative Session, adjourning Sini Die. With the dropping of the handkerchief, the FOMA is pleased to report that our legislative team successfully passed several legislative priorities and prevented specific policies from becoming law to ensure Florida patients have access to high-quality health care services. Such priorities include:
- Ensuring patient access to affordable medications through pharmacy benefit manager (PBM) reform;
- Obtaining enhanced funding for graduate medical education;
- Increasing funding for the Florida Reimbursement Assistance for Medical Education (FRAME) Program;
- Passing title protections to provide greater transparency to patients;
- Preventing the expansion of scope-of-practice, reducing potential harm to patients concerning unqualified health care practitioners.
| |
Governor DeSantis Signs PBM Reform Bill Into Law |
Steve Winn, Sente President Kathleen Passidomo &
Jason D. Winn, Esq
| |
FOMA Successfully Supports Increases in Medical Loan Reimbursement Funding for the FRAME Program:
The FY 2023-24 General Appropriations Act provides a $10 million increase in recurring funds for the Florida Reimbursement Assistance for Medical Education (FRAME) Program. Total recurring funding for FRAME for FY 2023-24 is now $16 million. The FOMA thanks Chair Harrell and others for their persistence on this priority budget item.
The FOMA is also pleased to announce our legislative team's work to provide additional opportunities to fund loan forgiveness applicants for this year's application cycle has paid off. Due to the overwhelming response, the legislature allocated an additional $10 million to support applications for FY 2022-23, bringing this year's total to $16 million.
The FRAME Program provides medical loan repayment opportunities for qualifying healthcare practitioners in Florida.
| |
Senator Gayle Harrell,
Chair of the Senate Appropriations Committee
on Health & Human Services
& FOMA President Brett Scotch, DO
| |
FOMA Successfully Supports Funding for New GME Program
"Slots for Doctors"
The FOMA and its partners successfully supported the establishment of the Slots for Doctors Program, a $30 million recurring appropriation to address the physician workforce shortage in the state. This graduate medical education program creates 300 resident positions in specialties facing a supply-and-demand deficit. The program offers $100,000 annually for residency positions in accredited programs, with hospitals and Federally Qualified Health Centers being eligible for funding. These positions also qualify for the one-time Graduate Medical Education Startup Bonus Program.
The program covers a wide range of adult and pediatric specialties, including 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.
| |
Robust Funding for Graduate Medical Education:
The Florida legislature approved a robust funding package of $430.1 million for graduate medical education (GME) in the fiscal year 2023-24. Of the total funding, $291 million is allocated toward the Statewide Medicaid Residency Program and the Graduate Medical Education Startup Bonus Program. Funding for these programs is distributed as follows:
- $191 million for the Statewide Medicaid Residency Program;
- $42.2 million for two hospitals with the largest number of graduate medical residents in a statewide supply/demand deficit
- $55.7 million for the Graduate Medical Education Startup Bonus Program
This year’s allocation for GME also funds the Slots for Doctors program described earlier. A total of $30 million is set aside for the program to address the physician workforce shortage in the state.
The legislature allocates $18 million to support full-time equivalents (FTEs) in primary care training within Medicaid regions where the demand for primary care exceeds supply by 85% or more, as identified in the IHS Markit Florida Statewide and Regional Physician Workforce Analysis. An initial distribution of $4.5 million will be proportionally allocated per FTE to hospitals with a Medicaid utilization rate of 14% or higher, based on 2021 Florida Hospital Uniform Reporting System data. Payments to providers are contingent upon approval of the nonfederal share provided through intergovernmental transfers. Primary care programs in Medicaid Regions 1 and 2 will receive over $20 million to fund full-time equivalents (FTEs) and training.
High tertiary statutory teaching hospitals will receive a total of $66 million. These funds support highly specialized tertiary care services and additional Graduate Medical Education resident-FTE allocations.
Budget GME funding also allocates $4.4 million to address the shortage of physicians trained in mental and behavioral health specialties. This funding will support accredited mental and behavioral health programs, providing up to $200,000 per filled resident, fellow, or intern position that rotates through licensed mental health and behavioral health facilities. This initiative aims to improve mental health care in the state. Payments to providers are contingent upon the nonfederal share provided through intergovernmental transfers.
| |
Legislature Funds Increase for Pediatric Medicaid Services
The FOMA is pleased to announce that this year's budget includes $76 million to increase reimbursements for pediatric services provided to Medicaid patients in Florida. Beginning on October 1, 2023, this significant payment boost will elevate reimbursement rates to at least the Medicare level. The additional funding covers both primary and specialty care, providing better support for physicians attending to the pediatric needs of Florida's Medicaid population.
| |
FOMA Priority Legislation Passed | |
SB 1550 Prescription Drugs
This legislation addresses the transparency of a manufacturer’s prescription drug price increases above certain thresholds. It also establishes regulations concerning the relationships between pharmacy benefit managers, pharmacy benefits plans and programs, and pharmacy providers for delivering pharmacy services to covered persons.
Governor DeSantis signed the bill into law on May 3, 2023.
| |
HB 0267 - Telehealth Practice Standards
This legislation revises the definition of “telehealth” to include health care services provided through audio-only means.
| |
SB 0230 Health Care Practitioner Titles and Designations
This legislation specifies which titles and abbreviations health care practitioners may use for advertisements, communications, and personal identification.
| |
HB 0825 Assault or Battery on Hospital Personnel
This legislation provides that an assault or battery on hospital personnel is reclassified to the next highest level when the offense is committed against hospital personnel while they are engaged in the lawful performance of a duty.
| |
HB 1387 Department of Health
This legislation makes numerous changes to programs under the Department of Health (DOH) and health care professions regulated by the Division of Medical Quality Assurance within the DOH. The FOMA successfully amended the bill to allow physicians specializing in family medicine to certify brain death with the concurrence of one other physician, as is required under current law, who is a board-eligible or board-certified neurologist, neurosurgeon, internist, family medicine physician, pediatrician, surgeon, or anesthesiologist. HB 1387 also authorizes autonomous advanced practice registered nurse practitioners to certify brain death if they are the patient’s treating health care practitioner and two physicians agree with the practitioner’s determination.
The legislation also provides for the following:
- Prohibits specific research in this state relating to enhanced potential pandemic pathogens;
- Prohibits medical marijuana treatment centers from producing marijuana products that are attractive to children or manufactured in specified manners;
- Requires local registrars to electronically file all live birth, death, and fetal death records in their respective jurisdictions in the department’s electronic registration system;
- Extends the timeframe for the confidentiality of certain birth records;
- Amends statute to align with the requirements of the US Food & Drug Administration rule establishing a new category for over-the-counter (OTC) hearing aids and specifying what constitutes an OTC hearing aid.
| |
SB 1580 Protections of Medical Conscience
This legislation prohibits discrimination against providers or payors based on conscience-based objections outlined in the bill, providing civil immunity and whistleblower protection.
| |
Advanced Practice Registered Nurse Legislation Dies in Committee | |
SB 1058 Autonomous Practice by Advanced Practice Registered Nurses
HB 1067 Autonomous Practice by an Advanced Practice Registered Nurse
The FOMA and its partners successfully opposed a measure that would have deleted the restriction that an autonomous advanced practice registered nurse (APRN) practice only in primary care, opening the door to specialty practice. After an extensive campaign to educate legislators concerning the risks to patient safety, the measure failed to gain traction in committee.
| |
Senate Confirms Appointees
Florida Board of Osteopathic Medicine
| |
The FOMA congratulates the following newly confirmed appointees to the Florida Board of Osteopathic Medicine: | |
Stay Tuned
FOMA 2023 Know the Issues
Mark your calendars for the release of the FOMA's final report, which will be published shortly after the session concludes on May 5, 2023. This comprehensive document will offer a complete analysis of the legislation passed during this session, detailing its impact on the osteopathic profession and outlining any actionable items for our members.
| |
DeSantis signs a bill placing restrictions on pharmacy benefit managers | After lawmakers passed the changes Tuesday, Gov. Ron DeSantis moved quickly to sign a bill that will place restrictions on pharmacy benefit managers. | | | |
Florida Senate confirms reappointment of Ladapo as surgeon general | The Florida Senate confirmed the reappointment of state Surgeon General Dr. Josepth Ladapo on Thursday. The Republican-controlled Senate voted 27-12 along party lines to confirm Ladapo. The position also leads the state Department of Health. | | | |
A KidCare expansion plan is heading to DeSantis | The Florida Senate on Thursday unanimously approved a plan to expand eligibility for the KidCare subsidized health insurance program, readying the issue to go to Gov. Ron DeSantis. The Senate vote came after the House unanimously passed the bill (HB 121) last month. | | | |
Florida lawmakers advance measure to boost hospital worker protections | A measure that ratchets up the consequences for assault or battery of hospital personnel was passed Tuesday by the Florida Senate. The measure, sponsored by Sen. Ana Maria Rodriguez, R-Doral, advanced by a 38-1 vote. The House unanimously passed the measure last month. | | | | | | |