THE CAPITAL, TALLAHASSEE, March 2, 2016.......... Some of the issues have been around for years. Others are relatively new.
But with House Republican leaders itching to rework health-care regulations, the House overwhelmingly passed a series of bills Wednesday that touch on everything from drug prescribing to high-tech "telehealth."
With a little more than a week left in the annual legislative session, it remains unclear whether the House will be able to convince the Senate to go along with many of the proposals. The House, for example, pushed several of the same issues last year but couldn't get agreement.
Nevertheless, the House has continued to hammer away at the ideas, with Republican leaders arguing that they are taking more of a free-market approach that would provide choices to patients and provide greater transparency about health-care costs.
Perhaps the longest-running proposal approved Wednesday was a measure (HB 423), sponsored by Rep. Cary Pigman, R-Avon Park, that would allow advanced registered nurse practitioners and physician assistants to prescribe controlled substances. Nurse practitioners, in particular, have sought the authority for years but have often run into opposition from physician groups such as the influential Florida Medical Association. The bill passed the House in a 117-2 vote, with only Tampa Democrat Janet Cruz and Fort Walton Beach Republican Matt Gaetz opposed.
Another proposal that that has bounced around during the past few years is a bill (HB 7087) aimed at opening up the state to greater use of "telehealth." Broadly, telehealth involves doctors and other health-care providers using technology to remotely provide care to patients.
But the issue raises a variety of regulatory issues, including how to oversee out-of-state physicians who provide care to Florida patients. Rep. Julio Gonzalez, a Venice Republican who is a physician, criticized the bill Wednesday because he said out-of-state physicians should face discipline by the Florida Board of Medicine and Department of Health, like in-state doctors do.
Supporters of the bill, however, said Florida needs to encourage telehealth, which is billed in part as being able to help provide care in areas such as rural communities that lack physicians and specialists. The bill, sponsored by Rep. Chris Sprowls, R-Palm Harbor, passed in a 114-3 vote, with opposition from Gonzalez, Coconut Creek Democrat Kristin Jacobs and Winter Haven Republican John Wood.
"Technology is where we're going --- it's where we are,'' said Rep. Mia Jones, a Jacksonville Democrat who has helped lead efforts to pass a telehealth bill.
Other bills approved Wednesday included a measure (HB 37) that would seek to clear the way for what are known as "direct primary care" agreements between doctors and patients; a measure (HB 85) that would allow patients to stay overnight at ambulatory-surgical centers and create a new type of facility known as "recovery care centers;" a measure (HB 1061) that calls for Florida to enter into an agreement that would allow multi-state nurse licensure; and a measure (HB 1175) aimed at increasing transparency about health-care prices.
Perhaps the bill that has drawn the most-intense lobbying during the legislative session is a measure (HB 221), filed by Rep. Carlos Trujillo, R-Miami, aimed at a health-care practice known as "balance billing."
The issue centers on patients who have preferred provider organization, or PPO, insurance coverage and go to hospitals for emergency treatment. Supporters of the bill say those patients sometimes get unexpected bills because doctors in the hospitals are not part of the insurance plans' networks.
The bill has been shadowed throughout the legislative session by lobbying battles involving health insurers, doctors and hospitals. Supporters say the bill, which includes such things as a dispute-resolution process, would shield patients from unexpected bills and leave it to health-care providers and insurers to work out payment issues.
"This is one of the greatest consumer protections that we are going to be able to pass this year,'' said Wood, chairman of the House Insurance & Banking Subcommittee.
But Gonzalez blasted the proposal, saying it would hamper the ability of doctors to negotiate contracts with insurers. He described the bill as providing a "solution that will help Goliath against David."
House members voted 116-1 to approve the bill, with only Gonzalez opposed.