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From FAHU Lobbyist, Rhett O'Doski
2016 Week 6 Legislative Update
It’s been a busy two weeks in Tallahassee for FAHU priorities. With the 2016 legislative session set to expire on March 11, all major issues are still up in the air as is the state budget, which per the constitution, must be passed.
Agent Fees – We have been working in collaboration with NAIFA-FL and FAIA on a joint operation that if successful will allow agents to charge a fee in the individual market. Last week we successfully amended SB 1386 by Senator Richter and HB 1303 by Representative Jones with our legislative proposal. Senate bill 1386 passed the Senate floor yesterday on a unanimous vote and will now go to the House for final passage in the next two weeks.
Public Health Adjusters?? – Earlier this year an issue came to our attention from the CFO’s office and Representative Travis Cummings (FAHU member). Due to a long unforeseen glitch in the public adjuster statute, health care agents acting on behalf of their customers could inadvertently be acting as unlicensed public adjusters and consequently could be subject to penalties. FAHU worked with the CFO’s office to successfully amend both SB 992 by Brandes and HB 651 by Beshears to clarify that the public adjuster statute does not apply to licensed health agents. Both bills are positioned for chamber floor votes.
Out of Network/Balance billing – One of the more contentious issues of the session has been legislation prohibiting the practice of balance billing by hospitals and providers. This week we engaged along with a carrier trade group to defeat amendments aimed to gut the effectiveness of the legislation. SB 1442 by Garcia and HB 221 by Trujillo are both poised for floor votes and are sure to draw more adverse amendments.
Family Glitch – Another FAHU priority is poised to pass the House of Representatives. That’s the good news. HB 543 by FAHU’s own Representative Rick Stark has passed three committees and is ready for a floor vote by the entire House. The bad news is, we are still stuck in Neutral in the Senate with no movement. This legislation, aimed at keeping private capital in the small group market is something that we will continue to pursue this session and beyond if that’s what’s required.
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Other Issues of Interest
Direct Primary Care Moves to the Floor
The Senate Fiscal Policy Committee agreed to a bill on Feb. 17 outlining agreements for doctors and patients to contract directly for health services.
SB 132, by Sen. Denise Grimsley, R-Sebring, was amended to include the 30 day advance notice provision to terminate agreements and immediate termination for breach of contract contained in the House bill.
Both SB 132 and the House counterpart HB 37 are now awaiting action by their respective chambers.
Medical Marijuana
Senate leaders Feb. 24 sent a medical marijuana bill ready for consideration by the chamber back to the Rules Committee for another hearing, reports The Times/Herald Tallahassee Bureau.
Rules chairman Sen. David Simmons, R-Altamonte Springs, moved that the bill (SB 460) have another hearing, which is unusual after a piece of legislation has been put on the agenda for a floor session. The Rules Committee is scheduled to meet next Monday afternoon.
Simmons did not give a reason, but the bill drew more than 30 proposed amendments, including one by sponsor Sen. Rob Bradley, R-Fleming Island, that would turn it from a two-page bill into a 27-page bill.
The bill was intended to expand medical marijuana laws to make the full-strength drug available to terminal patients.
Senate Passes Mental Health Services
The Florida Senate passed a bill Wednesday by Sen. Rene Garcia, R-Hialeah, aimed at improving the delivery of mental health and substance abuse services.
“Mental health is a serious issue facing communities across our state and this important legislation will set forth a more proactive and comprehensive approach to improving services available to Floridians,” said Senate President Andy Gardiner, R-Orlando, in a prepared statement.
SB 12 would, among several changes, create a "no wrong door" policy so that people who need treatment would get it, no matter how they enter the system. The bill would require the managing entities contracted with the Department of Children and Families to coordinate care “among a full array of behavior health services.”
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KidCare expansion passes final house committee
The House Health & Human Services Committee passed a bill Feb. 4 to remove the five-year waiting period for children of legal immigrants in Florida to be eligible for health care coverage through the Florida Kidcare Program.
HB 89, which has the vocal support of House Speaker Steve Crisafulli, now heads to the chamber floor.
A child of parents who legally immigrated to the United States from Cuba, Rep. Jose Felix Diaz became emotional during his closing remarks on the bill, reports Christine Sexton of Politico.
"We run for office. We make a lot of promises and this process is tough. And a lot of good bills die, but you can’t relent,” Diaz said, choking back tears. “You have to do things you believe in without fears of consequence. Handling a bill that deals with immigration is not easy. ”
There are about 17,000 children who could benefit if the ban is lifted. HB 89 includes an appropriation of nearly $300,000 which will draw down more than $28.5 million in federal funds to provide the care.
A similar Senate counterpart (SB 248) has one more committee stop.
Senate bill boosts rural hospitals
A Senate committee Tuesday approved a bill that could help boost efforts to build new or replacement hospitals in rural counties, according to The News Service of Florida.
Approved by the Senate Health Policy Committee, SB 236 would expand an exemption to the state's "certificate of need" regulatory process for hospital construction or expansion projects. The state currently has a narrow exemption that applies to hospitals in counties with populations of 15,000 to 18,000 people and densities of fewer than 30 people per square mile.
House and Senate Differ on Medicaid Spending
Overall the two chambers are nearly $400 million apart in Medicaid funding, including the Senate suggesting hundreds of millions to increase rates hospitals can bill Medicaid for inpatient hospital stays, Arek Sarkissian of The Naples Daily News reported earlier this month.
The Florida Senate is proposing $75 million for children's programs at hospitals that serve the poor, reports Health News Florida, and the Safety Net Hospital Alliance of Florida supports the proposal.
In recent years, Florida hospitals have depended on the low-income pool fund, also known as “LIP,” to help treat low-income and uninsured patients.
With the arrival of the Affordable Care Act, the federal government stopped funding the pool, encouraging states to expand Medicaid instead.
Florida chose not to expand Medicaid and Gov. Rick Scott sued the federal government. The compromise was a gradual phase out of LIP funding.
The issue also brought the 2015 Legislative session to a halt.
Scott – Revenue Sufficient to Deliver $1 Billion Tax Cut
Despite a nearly $400 million haircut to state revenue projections, Gov. Rick Scott is holding firm in his belief that lawmakers can include $1 billion in tax cuts in this year's budget, according to Matt Dixon of Politico.
"There is plenty of money in the budget," Scott told reporters Wednesday.
Legislative economists last month slashed by $388 million the amount they estimate budget-writers will have to work with as they craft the 2016-17 state budget.
"I've seen the spreadsheets and the dollars and cents that are there," said House Speaker Steve Crisafulli. "There is a reality to this."
His chamber has already passed a $1 billion tax cut package, but much of it is a one-year, rather than permanent. Crisafulli says Scott's plan uses upwards of 130 percent of the available discretionary revenue, which can’t happen.
On Tuesday, Senate budget chief Tom Lee said it was his impression Scott has accepted the idea that his tax cut proposal would need to be trimmed.
"Oh yeah. I think they've moved away from that," he said. "I think they've even said that publicly. I think they were talking about $600 million a couple of weeks ago."
When asked about Lee’s comments Wednesday, Scott denied the claim. "There is enough revenue," he said.
The Senate has not yet put forward a formal tax package but rather has moved several pieces of legislation that carry separate tax cuts. It will likely assemble a final tax cut plan once all that legislation reaches the Senate Appropriations Committee.
OIR Commissioner Replacement Screening
Only two of 25 applicants for the soon to be vacated top job in the Office of Insurance Regulation successfully met the qualifications laid out in the state’s two question pre-screening, reports Jim Rosica of FloridaPolitics.com.
The questions are: “Do you have five or more years of responsible private sector experience working full-time in areas within the scope of subject matter jurisdiction of the Office of Insurance Regulation within the last 10 years?” and “Do you have five or more years of experience as a senior examiner or other senior employee of a state or federal agency having regulatory responsibilities over insurers or insurance agencies within the last 10 years?”
Kirk Schmidt and Jeffrey Bragg were the only applicants to answer “yes” to both questions.
Bragg of Palm Harbor retired from the U.S. Department of Treasury in 2014 after serving as head of its Terrorism Risk Insurance Program. He also was in senior management for Zurich Risk Management, according to his application.
Schmidt, of Jefferson City, Missouri, is president and CFO of an insurance company after having been chief financial examiner for the Missouri Department of Insurance, he said in his application.
Also, absent from the list of applicants are former state Rep. Tom Grady and current state Rep. Bill Hager. Both have been said to be on Gov. Rick Scott‘s short list. But according to Rosica, Grady said he has no plans to apply for the position.
“I haven’t applied. I don’t expect to apply,” he told FloridaPolitics.com. “It was flattering to hear my name batted about as a leading contender.”
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