Legislative Report
Week 3
March 20, 2021

Paul D. Seltzer, DO, Legislative Chair
Stephen R. Winn, ED
Michelle W. Larson, Assoc. ED
Jason D. Winn, Esq.
Summary
The third week of the 2021 Legislative Session proved to be another busy week regarding healthcare, as the legislature passed bills relating to COVID liability protections, PBM regulation and scope-of-practice expansion.

On Wednesday March 17, 2021, Dr. Richard Thacker testified on behalf of the FOMA, FMA, FAFP, and the FSACOFP, speaking against SB 894 relating to physician assistants. Although Dr. Thacker thanked Senator Diaz for his amendment removing language allowing PAs to practice autonomously, Dr. Thacker cautioned against eliminating caps on the number of PAs a physician could supervise.  

"To allow one physician to supervise a thousand PAs is neither true supervision nor is it true collaboration, and in fact; it's a threat to patient safety. In this particular case there is not safety in numbers. While the autonomous practice provision has been taken out of this bill, the deletion of the four PA limit would essentially allow the functional equivalent of practicing autonomously.”  
Richard Thacker, DO
Aimee Diaz Lyon, FAFP
Richard Thacker, DO
Jeff Scott, FMA
Concluding his remarks regarding the bill’s supervision policy, Dr. Thacker stated: 

“We understand the PAs desire to compete with APRNs and we have agreed to work with them – all of the entities I represent today. But we just can’t support a position that is inherently unsafe and ill-advised.”  
SB 894 passed the Senate Health Policy Committee by a vote of 7 to 3. In an attempt to eliminate much of the controversy surrounding independent practice for PAs, the sponsor, who also chairs the committee, submitted an amendment eliminating the PA autonomy provision.

The bill significantly expands PA scope-of-practice to include provisions such as the authentication of death certificates and the prescribing of psychiatric mental health-controlled substance for a minor. As amended, the bill also eliminates the maximum number of PAs a physician may supervise. Presently, physicians may only supervise four.

The Senate moved forward with its version of the COVID-19 liability protections bill. SB 72 as amended provides certain protections from liability for businesses and healthcare providers with regard to the ongoing pandemic. The bill was amended to include negotiated language between House and Senate leadership. SB 72 passed the Senate 24 to 15 and has been placed on the House Special Order Calendar for March 25, 2021.  

With regard to the bill, Speaker Sprowls stated, “we anticipate picking up that bill, passing it, and getting it to the Governor’s desk as soon as possible.” 

Speaking on the bill, Senator Brandes, the sponsor, stated:

"Our local businesses have suffered enough from the COVID pandemic. They shouldn’t have to worry about frivolous COVID-related lawsuits just for trying to keep their doors open. That’s exactly why I filed SB 72, which was recently approved by the full Florida Senate. This legislation shields businesses, healthcare workers, and places of worship from being sued based on COVID-19 related claims and will greatly accelerate the economic recovery already underway in our state. I look forward to sending this bill to the Governor’s desk!"

We continue monitoring legislation to ensure your interests are represented. This week, the FOMA was successful in amending SB 368 and HB 441 to include physicians licensed under Chapter 459, which was inadvertently left out in the bill drafting process. We thank the sponsors, Senator Baxley and Representative Hage, for their assistance to resolve our concern. As amended, the bills create an alternative dispute resolution process for persons 60 years of age and older who are involved in certain legal proceedings, such as guardianships.   

Along with our patient advocacy partners, the FOMA publicly supported SB 390 relating to prescription-drug coverage by Senator Wright. As drafted, the bill revises provisions of the Florida Insurance Code relating to the oversight of pharmacy benefit managers by the Office of Insurance Regulation. SB 390 was passed unanimously by the Senate Banking and Insurance Committee on March 16, 2021.   
2021 Legislative Session
Doctor of the Day Program
The Florida Office of Legislative Services is seeking physician volunteers for Session which began Tuesday, March 2 and runs through Friday, April 30, 2021. A physician volunteer is needed for both House and Senate Chambers each day. Each physician will need a House of Representatives or Senate member for sponsorship.

Please contact the FOMA Governmental Relations office for assistance at govaffairs@foma.org or call 850-878-7364. The Florida Legislature has implemented COVID-19 protocols so please review this memo for details and instructions on how to register. 
Legislative Spotlight
SB 0072 Civil Liability for Damages Relating to COVID-19 by Brandes

Read Second Time; Amendments Failed (273472, 433794, 735608, 645490, 504394, 930780, 261298); Amendment Adopted (549168); Amendment Withdrawn (435730); Passed (Vote: 24 Yeas/15 Nays)

SB 72 limits civil claims against businesses related to the COVID-19 pandemic. The bill was amended to include health care providers.
SB 0894 Physician Assistants by Diaz

Favorable with CS by Health Policy; 7 Yeas, 3 Nays

CS/SB 894 revises the practice acts for physician assistants (PAs) in chs. 458 and 459, F.S., and expands the scope of practice for PAs. The bill:

  • Repeals the current-law restriction on the number of PAs that a physician may supervise at any one time;
  • Repeals the current-law requirement that a PA must inform a patient that the patient has the right to see a physician before a prescription is prescribed or dispensed by the PA;
  • Authorizes a fully licensed PA to procure medical devices and drugs unless he or she is prohibited from prescribing the drug under the negative formulary process in effect under current law;
  • Repeals the authority of the Department of Health (DOH) to issue a prescriber number to a PA upon the PA’s completion of certain requirements;
  • Repeals the provision in current law that prohibits a PA from prescribing a psychiatric mental health controlled substance for a minor;
  • Provides that a PA may authenticate any document with his or her signature that a physician may authenticate, including, but not limited to the date of maximum medical improvement for a workers' compensation medical evaluation as defined in ch. 440, F.S., and a list of other orders and documents; 
  • Authorizes a PA to supervise medical assistants as that term is defined in chs. 458 and 459, F.S.;
  • Provides the following relating to third-party payors: Payment for services within a PA’s scope of practice must be made when ordered or performed by a PA if the same service would have been covered if ordered or performed by a physician;
  • PAs are authorized to bill for and receive direct payment for the services they deliver. 
  • Repeals the current-law requirement for the Board of Medicine (BOM) and Board of Osteopathic Medicine (BOOM) to publish standards to ensure that PA educational programs operate in a manner that does not endanger the health or welfare of patients who receive services within the scope of the programs and repeals the boards’ responsibility to review the quality of the curricula, faculties, and facilities of such programs and take whatever other action is necessary to determine that the purposes of the PA practice acts are being met; 
  • Limits the boards’ authority to approve PA programs to those in the United States and its territories or possessions and to those accredited by specific entities; 
  • Amends various requirements for PA licensure; 
  • Repeals the requirement for a licensed PA to notify the DOH in writing within 30 days of employment or after any change in his or her supervising physician.
SB 0390 Prescription Drug Coverage by Wright

Favorable with CS by Banking and Insurance; 12 Yeas, 0 Nays

CS/SB 390 revises provisions of the Florida Insurance Code (code) relating to the oversight of pharmacy benefit managers (PBMs) by the Office of Insurance Regulation (OIR). Specifically, the bill:

  • Authorizes OIR to conduct market conduction examinations of PBMs to determine compliance with applicable provisions of the code;
  • Requires a health insurer or Health Maintenance Organizations (HMO), and any entity acting on their behalf, including a PBM, to comply with the pharmacy audit provisions;
  • Provides that a health insurer or HMO may only contract with a PBM that complies with specified statutory requirements;
  • Authorizes an audited pharmacy to appeal certain pharmacy audit findings made by health insurers or HMO; and
  • Clarifies that an insurer or HMO remains responsible for any violations of the pharmacy audit requirements and the prompt pay law by a PBM acting on its behalf.
Bills Heard in Committee
SB 0058 Hospitals’ Community Benefit Reporting by Rodriguez (A)

SB 0072 Civil Liability for Damages Relating to COVID-19 by Brandes

SB 0080 Child Welfare by Brodeur

SB 0130 Mental Health and Substance Use Disorders by Rouson

HB 0133 Surrendered Newborn Infants by Harding

HB 0149 Students with Disabilities in Public Schools by DuBose

SB 0170 Podiatric Medicine by Hooper

HB 0239 Regulation of Smoking by Counties and Municipalities by Altman

HB 0241 Parents' Bill of Rights by Grall

HB 0245 Massage Therapy by Chaney

SB 0272 Rare Disease Advisory Council by Baxley

HB 0309 Dementia-related Staff Training by Byrd

SB 0348 Medicaid by Rodriguez (A)

SB 0368 Elder-focused Dispute Resolution Process by Baxley

SB 0380 Child Restraint Requirements by Perry

SB 0390 Prescription Drug Coverage by Wright

SB 0404 Office of Minority Health and Health Equity by Rouson

HB 0441 Elder-focused Dispute Resolution Process by Hage

HB 0461 Medicare Transportation Services by Trabulsy

SB 0468 Expunction of Criminal History Records Relating to Certain Cannabis Offenses by Bracy

HB 0485 Personal Care Attendants by Garrison

HB 0519 Required Health Education Instruction by Yarborough

SB 0530 Nonopioid Alternatives by Perry

SB 0532 Workforce Education by Burgess

HB 0541 Veterans' Preference in Employment by Buchanan

HB 0543 Occupational Therapy by Koster

SB 0614 Assault or Battery on Hospital Personnel by Rodriguez (A)

HB 0701 Behavior Health Care Services Coverage and Access by Stevenson

SB 0716 Consent for Pelvic Examinations by Book
SB 0764 Veterans Treatment Courts by Burgess

SB 0818 Mental Health Professionals by Burgess

SB 0852 Medicaid Modernization by Brodeur

SB 0864 Telehealth by Brodeur

SB 0874Alzheimer’s Disease Awareness by Brodeur

SB 0894 Physician Assistants by Diaz

SB 0948 Child Welfare by Book

HB 1009 Organ Donation and Transplantation by Latvala

HB 1055 Pub. Rec./Trade Secrets by Gregory

HB 1057 Agency for Health Care Administration by Garrison

HB 1063 Administration of Vaccines by Fernandez-Barquin

HB 1097 Health Care Licensure Requirements by Learned

SB 1132 Personal Care Attendants by Bean

SB 1142 Prohibited Acts by Health Care Practitioners by Rodrigues (R)

HB 1157 Freestanding Emergency Departments by Koster

SB 1192 Mental Illness Training for Law Enforcement Officers by Powell

HB 1345 Pharmaceutical Products Containing Cannabis by Persons-Mulicka

HB 1353 Personal Protective Equipment by Yarborough

SB 1442 Substance Abuse Prevention by Boyd

HB 1455 Regulation of Medical Marijuana by Roach

HB 1483 Solicitation of Non-medical Services by Yarborough

HB 1565 Department of Health by Drake

SB 1608 Protecting Consumers Against Pandemic-related Fraud by Bean

SB 1686 Definition of Developmental Disability by Torres, Jr.

SB 1760 Personal Protective Equipment by Albritton

SB 1786 Payments for Birth-related Neurological Injuries by Burgess

SB 1934 Health Care Practitioner Discipline by Book

SB 2006 Emergency Management by Burgess

HB 6095 Scheduling of Drug Products Containing Cannabidiol by Fischer

SB 7000 OGSR/Nurse Licensure Compact by Health Policy
Governor's Executive Order 03/19/2021
Bill Tracking
Please see the link below containing a list of all legislation filed to date. Let us know if you have any specific areas of interest or concern.

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