Week four has come to an end and the Legislature will turn its sights next week to the budget.  Per the constitution, the budget is actually the only bill that the legislature must pass annually.  In years such as this, that does not seem like such a bad idea!
 
There has been talk this week of the state’s beleaguered PIP auto insurance system as bills start to move that would “repeal and replace” (Thank you President Ken Stevenson for that) PIP insurance.  I think the overall concern is that if there is a straight up repeal of PIP, drivers who are otherwise uninsured will have no medical coverage at all.  Both pieces of legislation currently being considered would repeal PIP and replace it with varying levels of BI and in the Senate version, mandatory medical payments coverage.  We will keep an eye on this as it moves through the system. 
 
 
Florida House again passes direct primary care agreements -
 
The Florida House Thursday passed legislation allowing patients to directly contract for basic health services with their doctor -- an idea the lower chamber has championed as a cost saving measure for the past few sessions.
 
But HB 161 does not include a provision from the similar SB 240 that directs the Agency for Health Care Administration to submit a Medicaid waiver to the federal government to allow recipients to choose direct primary care agreements within the state’s Medicaid managed care program.
 
 
HMO retroactivity bill starts to move in lower chamber -
 
The House plan to prevent insurers from retroactively denying a claim under certain conditions started to move in the lower chamber.
 
HB 579, like the SB 102 companion bill, prohibits health insurers and HMOs from retroactively denying a claim if they verified the eligibility of a subscriber at the time of treatment and provided an authorization number.
 
An adopted amendment makes the provision apply only to contracts in 2018 and after and does not apply to Medicaid managed care.
 
Having passed the House Health Innovation Subcommittee, it has two more committee stops before heading to the floor.
 
 
House passes surgery center bill -
 
The Florida House Thursday passed a bill allowing patients to stay up to 24 hours at ambulatory surgical centers. HB 145 also contains a provision creating recovery care centers to treat patients for up to 72 hours post-surgery, but that component was removed from the comparable SB 222.
 
 
Senate health panel passes managed care nursing home exemption -
 
The Senate Health Policy Committee passed legislation (SB 682) Monday to carve out nursing home residents from the Medicaid managed care system.
 
With some exceptions, Medicaid recipients who have resided in a nursing facility for 60 or more consecutive days would be exempted from the Long-Term Care component of the statewide managed care program. An exemption would also apply to those receiving hospice care while residing in a nursing facility.
 
Under the bill, nursing homes and hospices would instead be paid on a fee-for-service basis from the Agency for Health Care Administration for these Medicaid recipients rather than receiving payment from the managed care plans.
 
Generally, fee-for-service means medical staff is paid for each service provided. Managed care organizations provide for bulk buying services for lower prices, but some choices of providers or drugs are limited.
 
 
Judge tosses out trauma system plan -
 
As lawmakers debate revamping the trauma-care system, a judge Tuesday rejected a plan by the Florida Department of Health that likely would have led to an increase in trauma centers across the state, reports The News Service of Florida.
 
Administrative Law Judge Garnett Chisenhall, in a 70-page ruling, tossed out proposed rules that the department planned to use in determining whether trauma centers should be allowed to open. Chisenhall said the department's position "contravenes" at least two state laws.
 
The ruling was a victory for five major hospitals -- UF Health Jacksonville, Tampa General Hospital, Lee Memorial Hospital in Fort Myers, Bayfront Health-St. Petersburg and St. Joseph's Hospital in Tampa -- that have long run trauma centers and filed challenges after the department proposed the rule last year.
 
It also was the latest development in six years of legal and regulatory battling about efforts to open new trauma centers in various parts of the state. Those battles have focused heavily on a law that limits the number of trauma centers statewide to 44 and also caps the numbers in 19 different regions of the state.