2016 Legislative Session Wrap Up Report

It’s in the books.  The Legislature made the joint motion to “Sine Die” just after 6:30 PM on Friday evening bringing an end to the 2016 session.  This year ended up being a big year for health care as several FAHU priorities passed the full legislature and others made significant advancement.  We were successful in once again fending off measures that would increase the cost of health care and we made a big statement about the important role of the agent. 
 
What Passed?
 
Balance Billing - For several years now a FAHU priority has been to address the surprise balance billing issue for out of network services.  HB 221 by Trujillo, prohibits out-of-network providers from balance billing members of a PPO or EPO for emergency services or for non-emergency services when the non-emergency services are provided in a network hospital and the patient had no ability or opportunity to choose a network provider. Hospitals, ambulatory surgical centers and urgent care centers are also prohibited from balance billing. 

This was one of the most controversial bills to pass this year and one of the final two bills to pass before the session ended.  As often times happens, a compromise had to be struck.  A priority of Senate President Andy Gardiner has long been coverage for Down Syndrome.  In order to pass HB 221, the House accepted an amendment that expended the current autism mandate to include Down Syndrome.

Agent Fee’s – There has been no shortage of debate surrounding the declining or complete evaporation of agent commissions.  This year we were able to pass legislation that will allow an agent to charge a fee for your services in lieu of the commission.  SB 1386 by Richter passed the House on a 116-0 vote.  This was also a recognition by the Legislature of the agents role in the health care system and Representative Rick Stark made comments on the House floor to that effect.  This change will become effective upon becoming law and we will provide guidance for agents who wish to avail themselves of this new tool.
 
Telehealth – We have long advocated for responsible telehealth laws that will modernize the patient care experience.  Each year we run into the powerful doctor lobby who oppose using out of state doctors to provide care via telehealth.  This year the Legislature passed a study proposal that will hopefully get this issue across the goal line.  HB 7087 by Sprowls, creates a 15-person advisory council made up of health care representatives across several industries to study the issue and report to state lawmakers by October 2017.

Transparency – Another FAHU mainstay has been transparency of costs.  HB 1175 by Sprowls, requires the Agency for Health Care Administration to contract with a vendor for an all-payer claims database (APCD), which provides an online, searchable method for consumers to compare provider price and quality, and a Florida-specific data set for price and quality research purposes. The bill requires insurers and HMO's to submit data to the APCD, under certain conditions.
 
Scope of Practice – Food fights between doctors, nurses, ARNP's and other providers are typically quite controversial and usually results in nothing passing.  This year the legislature opened up prescribing capabilities for ARNP’s and Physician Assistants (PA’s).  HB 423 by Pigman authorizes ARNP's to prescribe, dispense, order, and administer controlled substances, but only to the extent authorized under a supervising physician’s protocol. The bill also authorizes PA's to prescribe controlled substances that are not listed on the formulary established by the Council on Physician Assistants, under current supervisory standards.

KidCare Expansion - HB 89 removes the 5-year waiting period for lawfully present children in Florida, which makes those children immediately eligible for health care coverage through Kidcare. The bill clearly states that eligibility is not being extended to undocumented immigrants.

What Didn’t Pass
 
Family Glitch – HB 543 by Representative Stark passes all three of it’s referenced committees but unfortunately the Senate companion, SB 910 by Braynon failed to launch.  Representative Stark did a masterful job navigating the House bill and the upside is we were able to have good public discussions about the small group market and why this measure would help slow the erosion.  We will continue to push and develop this issue over the summer and hope for a better result next year.

Step Therapy – Once again we were able to defeat cost driver type measures like this one.  SB 212 by Gaetz would have put an end to prior authorization and step therapy protocols that insurers and PBM’s utilize to keep costs down. 

Certificate of Need - The Senate stopped SB 1144 by Gaetz, this bill provided exemptions to the review process for health providers to construct or expand hospital facilities.

Surgical Centers - HB 85 by Fitzenhagen, would have made ambulatory surgical centers more competitive by allowing patients to stay 24 hours. The House version would have also created recovery care centers to keep patients for 72 hours. The Senate turned this into an omnibus bill with some of its controversial priorities that ultimately caused it to sink under its own weight.

Direct Primary Care - HB 85 also carried frameworks for direct primary care agreements. This would have allowed patients to pay for services from their primary care provider directly rather than through insurance.