They're headed into overtime in Tallahassee
Thursday, May 2, 2019
Posted by: Bryan Campbell, DCMS Chief Executive Officer
No, this has nothing to do with the Florida St. Seminoles or even sports for that matter.
The Florida Legislature will NOT be ending session tomorrow as scheduled, and that’s because the House and Senate were unable to come to a resolution on the state budget in time. By Florida Law, that means they will head into an extra day of session on Saturday to finalize the budget and last minute issues. Many of those issues, including the budget, have a direct impact on healthcare here in Northeast Florida
This is an area that has some of the greatest impact here in Northeast Florida. The $91.1 billion state budget will likely be approved on Saturday, and will change a part of the formula that funds safety net hospitals such as UF Health Jacksonville. The budget removes $9.5 million from the “automatic rate enhancements” fund, which supplements Medicaid reimbursements for these hospitals. The Senate originally proposed to redistribute the entire $318 million in the fund, but settled on the 3% reduction as a compromise.
Scope of Practice
Several bills were considered this year which would have dramatically changed Scope of Practice in Florida. HB 111 would have given pharmacists the ability to diagnose and treat flu and strep throat. That bill passed the House but was not heard in the Senate. Another bill that passed in the House but stalled in the Senate was HB 821 which allowed for Nurse Practitioners and Physicians Assistants to practice without the supervision of a physician. Other bills sought to give pharmacists prescribing and consulting rights, and prescribing authority to psychologists. All of these bills were defeated.
Put away those prescription pads and make sure your EMR skills are up to date. HB 831 requires that all prescriptions be submitted electronically. The exception would be in the case of an outage or technical problem with your e-prescribing software, and noted in the patient’s file.
Certificate of Need
HB 21 greatly modifies the Certificate of Need process for approval of new medical facilities in the state. This means fewer barriers to the opening of many types of medical facilities.
HB 23 established some official rules for Telehealth in Florida. Primarily, it established the definition of telehealth as “the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.”
While this definition is important, the two primary issues concerning telehealth we have been monitoring have been out-of-state licensure and reimbursement. A registration has been established that an out-of-state provider with an active medical license in good standing in their state may pay an annual fee to practice medicine in Florida. They will be subject to the prevailing Board in their licensing state, but must comply with several Florida-specific regulations.
In terms of reimbursement, the law states that insurance companies and physicians must voluntarily agree to enter a contract which covers telehealth, and that any provision in the contract which differentiates in the reimbursement rate between telehealth and the same services provided without telehealth MUST be initialed by the provider in the contract.
This is a brief summary of the actions of the 2019 Florida Legislature, and as of the time of this writing (1:45pm, Thursday May 2, 2019) there are still at least two days of session, so things may yet change. Next week, we will provide to you a more comprehensive breakdown of the session, including response from local hospitals and representatives to the Legislature. Keep in mind, all of the passed bills still require the Governor's signature.