Heading into Week 7
2022 Legislative Session
Large Strategies'
Capitol Health Care Summary
Click on bill to review Legislative Staff Analysis.
PASSED 1 CHAMBER this Week
By Senator Harrell
Under current law, Medicaid requires prior authorization and step therapy for drugs not listed on the PDL. Step therapy requires recipients to first try a PDL-listed drug before obtaining a non-PDL drug, subject to a list of clinical exceptions, which must be documented by the prescriber to obtain prior authorization. SB 534 adds additional exceptions to the Medicaid step therapy policy for drugs to treat schizophrenia, schizotypal or delusional disorders, where:
  • Prior authorization was granted previously for the same drug; and
  • The medication was dispensed to the patient in the last 12 months.
SB 534 PASSED SENATE this week and in Messages to House (38-0)
Senator Perry
CS/SB 806 creates section 381.825, Florida Statutes, to establish the “Ramping up Education of Alzheimer’s Disease and Dementia for You (READY) Act.” The bill requires the Department of Health (DOH) to use existing, relevant public health and community outreach programs to educate health care practitioners on Alzheimer’s disease and dementia-related disorders (ADRD).
  • SB 806 PASSED the Senate this week and in Messages to House (39-0)
By Senator Gruters
CS/SB 1260 creates s. 189.0762, F.S., which provides a procedure for an independent hospital district to convert into a private non-profit entity by following the steps that are specified in the bill. The governing body of the district may vote to evaluate the benefits of conversion for residents of the district. If the governing body of the district determines conversion is in the best interests of the district’s residents, the governing body may negotiate an agreement with the governing body of each county in which any part of the district’s boundary is located. This agreement must be in writing and include the terms and conditions necessary for both disposing of the assets and liabilities of the system and ensuring health care services are provided to the district’s residents. After completing the negotiation, the governing body of the district and each county that is a party to the agreement may elect to approve the conversion of the district to a private non-profit entity, subject to providing documentation to the public before the vote to approve of the conversion. If the district levies ad valorem taxes, the conversion must be approved by the electors of the district voting in a referendum held during the next general election.
  • SB 1260 PASSED SENATE this week and in Messages to House (39-0)
  • HB 897 has one committee stop remaining
On Special Order THIS WEEK
Rep Massullo
The bill authorizes physicians licensed under chapters 458 or 459, F.S., to provide emergency medical care or treatment to a minor without parental consent. This allows physicians to provide such care in prehospital settings, similar to EMTs and paramedics, or in hospital settings. 
  • Placed on House Special Order
  • SB 114 to be heard in its last committee of reference this week
by Rep Latvala
The bill prohibits insurers of life insurance policies, industrial life insurance policies, group life insurance policies, credit life and credit disability insurance policies, and long-term care insurance policies from discriminating against living organ donors, or prospective donors, in coverage or eligibility solely on their status as a living organ donor. The bill makes such discrimination a violation of the Unfair Insurance Trade Practices Act, subject to existing penalties within the Act. 
  • Placed on House Special Order
  • SB 1026 has 1 committee stop remaining, Senate Rules
Senator Gruters
CS/CS/SB 224 amends the “Florida Clean Indoor Air Act,” which regulates vaping and tobacco smoking in Florida. The bill allows counties and municipalities to restrict smoking within the boundaries of any of the public beaches and public parks they own, except with regard to the smoking of cigars that do not contain a filter or a plastic tip or the smoking of pipe tobacco in a pipe. Currently, the regulation of smoking is preempted to the state, and counties and municipalities are prohibited from regulating smoking. “Smoking” is defined in ch. 386, F.S., as “inhaling, exhaling, burning, carrying, or possessing any lighted tobacco product, including cigarettes, cigars, pipe tobacco, and any other lighted tobacco product.” The bill changes the title of the “Florida Clean Indoor Air Act” to the “Florida Clean Air Act” to account for the broader application of the act proposed in the bill.
  • SB 224 & its companion, HB 105 both on Special Order this week
Senator Bean
CS/CS/SB 1222 authorizes paramedics and Class III institutional pharmacies, a type of hospital pharmacy, to serve hospital patients at their homes. Under the bill, a paramedic, under the supervision of a physician or acting under other standing orders, may provide basic life support services and advanced life support services to a patient receiving acute and post-acute hospital care at his or her permanent residence through a program approved by the Centers for Medicare and Medicaid Services and the Agency for Health Care Administration. A Class III institutional pharmacy may dispense, distribute, compound, and fill prescriptions for medicinal drugs for these same patients.
  • On Senate Special Order
  • House bill, HB 37, has passed all committees of reference in the House
By Rep Trasbulsy
The bill requires a 911 PST to complete biennial telecommunicator CPR training in order to have their certification renewed. The bill also authorizes certain public safety agencies to enter into a reciprocal agreement with another public safety agency to provide telephonic assistance in administering CPR, including a fire department, law enforcement department, or other emergency medical service that receives or dispatches calls for emergency medical conditions.
  • Placed on House Special Order
  • SB 890 has 1 committee of reference remaining, Senate Appropriations
Rep Toledo
Since January 1, 2019, PBMs operating in the state are required to register with the Office of Insurance Regulation (OIR) by submitting a completed application form and fee for registration. Effective July 1, 2018, the Legislature also prohibited the use of “gag clauses” that prevent pharmacies from providing drugs to patients at the lowest applicable prices.
The bill transfers the audit provisions of the Florida Pharmacy Act to the Florida Insurance Code. This change gives OIR the authority to enforce these provisions and respond to potential violations. In addition, the bill expressly authorizes pharmacies to appeal audit findings made by health plans and PBMs using the existing dispute resolution program available through the Agency for Health Care Administration (AHCA). The bill establishes a financial penalty for PBMs that fail to register with OIR in accordance with current law. To date, OIR has lacked the authority to actively enforce the registration requirement adopted by the Legislature in 2018. Accordingly, the bill establishes a $10,000 fine for any PBM failing to register with OIR. The bill also expressly makes a health insurer or HMO responsible for violations of the pharmacy audit provisions, even if a PBM is contracted to manage pharmacy benefits on behalf of the insurer or HMO.
  • Placed on House Special Order
  • SB 1476, has 1 committee stop remaining, Senate Appropriations
By Burgess
CS/SB 1066 expands compensability of first responders, as it relates to workers’ compensation, by revising the deadline for first responders to file a notice of injury with their carrier or employer. The bill provides that the time of notice of injury is measured from one of the qualifying events or diagnosis of the disorder, whichever is later. Further, the bill provides that a claim is barred if the notice is not filed within 52 weeks after the qualifying event or the diagnosis of the disorder, whichever is later. Current law provides the time for notice of injury or death is measured from one of the qualifying events or the manifestation of the disorder, whichever is later. A claim must be noticed within 52 weeks after the qualifying event. The bill would eliminate the 52-week deadline for filing a claim. 
  • Placed on Senate Special Order
  • House bill, HB 689, it its last House committee of reference
Senator Boyd
This bill amends s. 381.887, F.S., to:
  • Include the prescribing, ordering and dispensing of emergency opioid antagonists within the purpose of the section, which is to provide for the emergency treatment for suspected opioid overdose;
  • Authorize a pharmacist to order, and dispense pursuant to that order, an emergency opioid antagonist with an auto injection delivery system or intranasal application delivery system to a patient or caregiver;
  • Add personnel of a law enforcement agency or other agencies to the list of persons authorized to possess, store, and administer emergency opioid antagonists under the section. The bill specifies that such personnel includes, but is not limited to, correctional probation officers and child protective investigators who, while acting within the scope or course of employment, come into contact with controlled substances or persons at risk of experiencing an opioid overdose; and
  • Provide immunity from any civil or criminal liability to the listed persons authorized to possess, store, and administer emergency opioid antagonists under the section for the administering of emergency opioid antagonists.
The bill amends s. 381.981, F.S., requiring the Florida Public Health Institute, Inc., to include emergency opioid antagonists as part of substance abuses in their statutorily required health awareness campaigns.
The bill also amends s. 395.1041, F.S., to require a hospital emergency department or urgent care center to report the treatment of a person in response to an actual or suspected overdose to the department if the patient was not transported to the hospital by a BLS or ALS provider and to require a BLS or ALS provider to report when it treats and releases or transports to a medical facility a person in response to an emergency call for a suspected or actual overdose of a controlled substance.
The provider must use an appropriate reporting method with secure access, including, but not limited to, the Washington/Baltimore High Intensity Drug Trafficking Overdose Detection Mapping Application Program or other program identified by the department rule and must use its best effort to report such incidents within 120 hours of discovering the incident.
Rep Fetterhoff
The bill amends statutes governing peer specialists. Specifically, the bill:  Requires DCF to develop a training program for peer specialists, giving preference to trainers who are certified peer specialists, and issue a competency examination that coincides with such training;  Requires DCF to certify peer specialists either directly or through a credentialing entity;  Requires peer specialists providing recovery support services to be certified;  Revises background screening requirements by adding offenses for which individuals seeking certification as a peer specialist may seek an exemption from eligibility disqualification, and grants an exemption from the updated background screening requirements to individuals certified as peer specialists as of July 1, 2022; and  Allows peer specialists to work with adults with mental health disorders, in addition to adults with SUD or co-occurring disorders, while an exemption request is pending, and extends the time limit for such work to 180 days. 
  • Placed on House Special Order
  • SB 282 also on Senate Special Order
By Rep Willhite
The bill defines “step therapy protocol” as a protocol or program that establishes the specific sequence in which prescription drugs, medical procedures, or courses of treatment must be used to treat a health condition. The bill also requires a process to receive a “protocol exemption”, which is a determination by an insurer or HMO to exempt an insured patient from an existing step therapy protocol. The bill requires an insurer or HMO to publish on its website, and provide to an insured in writing, a procedure for an insured patient and health care provider to request a protocol exemption. The procedure must include:  The manner in which an insured patient or health care provider may request a protocol exemption;  The manner and timeframe in which the health insurer or HMO is required to authorize or deny a protocol exemption request; and,  The manner and timeframe in which an insured patient may appeal the denial of a request. The bill requires an insurer or HMO granting a protocol exemption to specify the prescription drug, medical procedure, or course of treatment approved. Alternatively, an insurer or HMO denying a protocol exemption request must provide a written explanation of the denial, including the clinical rationale supporting the denial. The written explanation must also describe the procedure for appealing the determination by the insurer or HMO.
  • Placed on House Special Order
  • SB 730 on agenda in last committee of reference this week
Waiting on Special Order Spot
By Rep Tuck
A pharmacist or a pharmacy intern may administer:  Immunizations or vaccines listed on the U.S. Centers for Disease Control and Prevention (CDC) Adult Immunization Schedule as of April 20, 2021;  Vaccines recommended by the CDC for international travel as of April 30, 2021;  Immunizations or vaccines licensed for use in the United States by the U.S. Food and Drug Administration (FDA) as of April 30, 2021;  Immunizations or vaccines authorized for emergency use by the FDA as of April 30, 2021;  Immunizations or vaccines approved by the Board of Pharmacy (Board) in rule; and  Immunizations or vaccines approved by the Board of Pharmacy in response to a state of emergency declared by the Governor. Pharmacy technicians are not currently authorized by law to administer immunizations or vaccines. CS/HB 1209 authorizes qualified Florida-registered pharmacy technicians to administer to adults the abovereferenced immunizations or vaccines under the supervision of a certified pharmacist. The bill requires pharmacy technicians to become certified to administer such immunizations and vaccines. To become certified, a registered pharmacy technician must complete a certification program approved by the Board, in consultation with the Board of Medicine and the Board of Osteopathic Medicine. The training curriculum must have at least 6 hours of training that, at a minimum, includes instruction on the safe and effective administration of vaccines and potential allergic reactions to such vaccines. Upon registration renewal, pharmacy technicians must have completed at least two hours of additional continuing education. The bill updates the authorized immunizations or vaccines that may be administered from those listed in the CDC Recommended Immunization Schedule for adults, the CDC’s Health Information for International Travel, and those licensed or authorized for emergency use by the FDA as of April 30, 2021 to those listed or approved as of March 31, 2022.
  • Favorable by all committees of reference
  • SB 1892 to be heard in its last committee of reference this week
By Senator Jones
SB 1258 statutorily requires managed care plans contracting with the Agency for Health Care Administration (AHCA) under the Statewide Medicaid Managed Care (SMMC) program to collect and annually report an expanded set of performance measures, including Healthcare Effectiveness Data and Information Set (HEDIS) measures, the federal Core Set of Children’s Health Care Quality measures, and the federal Core Set of Adult Health Care Quality performance measures, as specified by the AHCA. For calendar year 2020, the plans were required to report 27 HEDIS measures related to medical care and nine measures related to Child and Adult Core Set measures. Beginning in calendar year 2025, the bill requires each managed care plan to collect and report all of the Adult Core Set behavioral health measures, which are not currently required to be reported. Beginning in calendar year 2026, the bill requires each managed care plan to stratify all performance measure data by recipient age, race, ethnicity, primary language, sex, and disability status.
  • Both SB 1258 & HB 855 reported favorable by all committees of reference
By Rep McClure
CS/HB 931 exempts registered nurses who perform alternate-site testing within a hospital or a hospital-based off-campus emergency department from clinical laboratory personnel licensure requirements. This allows registered nurses to perform alternate-site testing within a FED.
  • Favorable by all committees of reference
  • SB 1374 to be heard in its last committee of reference this week
By Senator Harrell
SB 1240 requires charter schools to report the removal of a student from school, school transportation, or a school-sponsored activity for an involuntary mental health examination. The bill provides that the Department of Education (the DOE) must share data comprised of both public and charter school reporting with the Department of Children and Families (the DCF) by July 1 of each year. The bill also provides specific data the DCF is required to analyze when preparing its biannual report on the involuntary examinations of minors. The bill modifies requirements for annual mental health assistance allocation plans prepared by school districts by requiring districts to:  Provide parents of students receiving mental health services with information regarding other services available through the student’s school or local community-based mental health providers; and  Provide other individuals living in the same household as a student receiving mental health services with information about other services the student may qualify for that would contribute to the student’s improved well-being.
  • Favorable by all committees of reference
  • HB 899 also favorable by all committees of reference
One Committee Stop Remaining
By Senator Rodriguez
CS/SB 768 addresses numerous health care-related issues regulated by the Department of Health (DOH). The bill:  Updates the “Targeted Outreach for Pregnant Women Act of 1998”;  Amends section 381.0303, Florida Statutes., to specify that for pediatric special needs shelters, the DOH is the lead agency to coordinate local medical and health care providers for the staffing and management of the shelters and is the decision-making authority for determining the medical supervision in each special needs shelter;  Allows the DOH to collect samples of marijuana and marijuana delivery devices, in general, from a medical marijuana treatment center (MMTC) for specified testing, rather than only samples of edibles;  Expands MMTC recall requirements to all marijuana products and delivery devices, rather than only edibles;  Provides an exception from criminal laws for the DOH employees to acquire, possess, test, transport, and lawfully dispose of marijuana and marijuana delivery devices;  Amends statutes regulating several types of health care professions, including allopathic and osteopathic physicians, nurses, midwives, psychologists, orthotists, prosthetists, clinical lab personnel, chiropractors, mental health counselors, clinical social workers, and marriage and family therapists;  Amends sections 460.406, 468.803, 483.824, and 490.005, Florida Statutes, to delete references to the term “regional” and replace it with the term “institutional” to conform withthe U.S. Department of Education accreditation nomenclature for approving health carerelated educational institutions; and  Amends section 766.314, Florida Statutes, authorizing the Florida Birth-Related Neurological Injury Compensation Association (NICA) to collect and enforce physician assessments in circuit court, if necessary, and requires the NICA to notify the DOH and the appropriate board of any unpaid final judgments against a physician within a specific timeframe.
  • SB 768 1277 has 1 committee stop remaining, Senate Appropriations
  • HB has 1 committee stop remaining, House Health & Human Services
By Rep Melo
The bill reduces the number of hours of required CNA direct care from 2.5 hours to 2 hours per resident per day. The bill retains current law requiring 1 hour of licensed nurse direct care per resident per day. In total, at least 3 hours of direct care per resident per day must be provided by CNAs and licensed nurses. For the remaining 0.6 hours of the required 3.6 weekly average of total hours of direct care, the bill allows nursing homes to count care provided by any combination of the following categories of disciplines and professions: physicians; nursing; pharmacy; dietary; therapeutic; dental; podiatry; mental health; and paid feeding assistants. The bill requires nursing homes to maintain records documenting compliance with minimum staffing requirements for at least five years. Legal proceedings for noncompliance with federal staffing requirements are often rebutted by nursing homes with proof of compliance with state staffing requirements as evidence of federal staffing requirements compliance. The bill provides that evidence of a facility’s compliance with state minimum staffing requirements is not admissible as evidence of compliance with federal staffing requirements. 
  • HB 1239 has 1 committee stop remaining, House HHS
  • SB 804 has 1 committee stop remaining
In 2019, the Legislature enacted the Patient Savings Act (Act), which allows health insurers to create a shared savings incentive program (program) to encourage insureds to choose lower cost, high quality nonemergency health care services and share any savings realized as a result of their choice. Health insurers are not required to establish a program under the Act, and an insured’s participation in a program is voluntary and optional. A program may offer shared savings incentives as, for example, premium reduction or return; flexible spending account, health savings account, or health reimbursement account credit; and cash or cash equivalent including, but not limited to, merchandise, a gift card, or a debit card. Incentives under a program must be distributed at least quarterly to participating insureds. Under the Act, services within and outside Florida for which incentives may be offered include, but are not limited to:  Clinical laboratory services;  Infusion therapy;  Inpatient and outpatient surgical procedures;  Obstetrical and gynecological services;  Inpatient and outpatient nonsurgical diagnostic tests and procedures;  Physical and occupational therapy services;  Radiology and imaging services;  Prescription drugs;  Services provided through telehealth; and  Any additional services published by the Agency for Health Care Administration that have the most significant price variation both statewide and regionally pursuant to s. 408.05(3)(m), F.S. CS/HB 1325 authorizes, but does not require, an individual health insurer, group health insurer, or health maintenance organization that offers a shared savings incentive program to include items and services listed in federal law, the Table 1-500 Items and Services List (List), as shoppable health care services for which the shared savings incentive is available. The List is added to the group of shoppable health care services from which a health insurer can select certain items and services for its program. The bill also makes clear that these changes are effective for the 2023 plan year, not the current plan year.
  • HB 1325 has 1 committee stop remaining, House Health & Human Services
  • SB 252 has 1 committee stop remaining, Senate Appropriations
By Senator Brodeur
PCS/CS/SB 1950 makes changes to the Statewide Medicaid Managed Care (SMMC) program in anticipation of the next competitive procurement for the 2025 plan year. The bill:  Requires provider service networks (PSNs) to be reimbursed on a prepaid basis.  Authorizes the Agency for Health Care Administration (AHCA) to select eligible managed care plans to provide services through a single statewide procurement and deletes the requirement that the AHCA conduct separate and simultaneous procurements for each Medicaid region.  Authorizes the AHCA to award contracts to managed care plans on a regional or statewide basis.  Outlines a new regional structure for plan selection under the SMMC program’s Managed Medical Assistance (MMA) and Long-Term Care (LTC) programs with a minimum and maximum number of plans designated for each region. The bill provides for eight regions named by letters (Regions A-H), rather than the 11 regions named by numbers (Regions 1- 11) in current law.  Requires the AHCA to award a contract to at least one PSN in each of the eight regions under the MMA program and under the LTC program.  Requires managed care plans to include Florida cancer hospitals that meet specified federal criteria in their networks as essential providers. Revises MMA plan healthy behaviors program requirements to include tobacco cessation programs, rather than smoking cessation programs, and to clarify that substance abuse programs must include opioid abuse recovery.  Authorizes an MMA Child Welfare Specialty Plan to serve a child in a permanent guardianship situation whose parents receive payments through the Guardianship Assistance Program. 
  • SB 1950 has 1 committee stop remaining, Senate Appropriations
  • HB 7047 has 1 committee stop remaining, House Health & Human Services
Senator Broxson
CS/SB 1184 prohibits regulatory boards within the Department of Health from reprimanding, sanctioning, revoking or threatening to revoke a license, certificate, or registration of a health care practitioner for exercising his or her constitutional right of free speech, including speech through the use of a social media platform.
The bill requires a regulatory board, or DOH to prove beyond a reasonable doubt that the use of free speech by a health care practitioner led to the direct physical harm of a person with whom the health care practitioner had a practitioner-patient relationship within the three years immediately preceding the incident of physical harm in order to reprimand, sanction, or revoke or threaten to revoke, a license, certificate, or registration of the health care practitioner for his or her speech.
The bill specifies that if the board or DOH fails to meet such burden of proof and reprimands, sanctions, or revokes or threatens to revoke, a license, certificate, or registration of the health care practitioner for his or her speech, the board or DOH is liable for a sum of up to $1.5 million per occurrence for direct or indirect damages to the health care practitioner.
The bill requires such regulatory board, or DOH to provide the health care practitioner with any complaint it has received that may result in revocation of licensure, certification, or registration, within seven days after receiving the complaint. If the board or the DOH fails to provide such a complaint, it must pay the practitioner an administrative penalty of $500 each day the complaint is not provided to the practitioner.
  • 1 committee stops remaining, Senate Appropriations
  • House bill, HB 687, also has 1 committee stop remaining
By Rep Massullo
The bill makes several changes to Baker Act involuntary examination procedures. The bill:  Amends the basis for which a qualified professional makes certain patient communication and patient access determinations;  Requires a qualified professional to document patient communication restrictions within a specified timeframe;  Creates discharge planning and procedures that must be followed if a patient’s 72-hour examination period ends on a weekend or holiday;  Allows psychiatric nurses to release patients from involuntary exams when practicing in nationally accredited community mental health centers, under certain conditions;  Revises certain provisions relating to the Commission on Mental Health and Substance Abuse; and  Requires DCF to receive and maintain reports related to patient transportation to receiving facilities. The bill revises conditions under which a Baker Act patient's communication may be restricted and requires a facility to review any restrictions on a patient’s communication every three days, instead of weekly as required under current law. The bill requires a receiving facility to notify specified emergency contacts of a person being held for an involuntary examination under the Baker Act. The bill makes changes to certain procedures in the Baker Act and Marchman Act. Specifically, the bill provides requirements for the release of clinical records from a receiving facility or service provider and requires law enforcement officers to notify emergency contacts of a person in protective custody and include such contact information in an incident report. The bill provides an emergency notification exception under the Marchman Act that is not available to involuntary examination patients under the Baker Act.
  • HB 1277 has 1 committee stop remaining, House Health & Human Services
  • SB 1262 has 1 committee stop remaining, Senate Appropriations
Archived Weekly Session Wrap-Ups