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Upcoming special session almost as much about health care as budget

The 2015 Special Session is being referred to as a budget session but it could just as easily be described as the Special Session on health care.

Thirty-two bills have been filed for consideration in the 2015A session and 40 percent of them involve health care, either through substantive policy changes, financing, or both. They include a bill that would eliminate certificates of need for general hospitals, long term care hospitals and “tertiary services” such as pediatric open heart surgery, organ transplantation and neonatal intensive care units, among other things.

In addition to being listed in “the call” or the list of issues the Legislature will address, the regulatory program was included in the list of issues Gov. Rick Scott asked the freshly created Commission on Healthcare and Hospital Funding to examine.

In the executive order noted that “restricting competition and limiting the marketplace for healthcare services while increasing the demand for healthcare services harms the affordability, access and quality of services for Florida families.”

Although Scott and House Republican leaders have advocated for a free market approach, HB 31 A eliminates certificate of need for hospitals, long-term care hospitals and tertiary services, it keeps the requirements intact in the high-growth areas of  nursing homes and hospice facilities. The agency received 106 applications for new nursing home and hospice facilities in 2014. Of those, three were withdrawn, 67 were initially denied and 33 initially approved. There was a keen interest from developers and investors because it was the first time the state allowed new nursing home facilities to be built and beds offered in more than a decade.

In contrast, the agency received 13 applications in 2014 for new hospital facilities. Of those, one was withdrawn, four were denied and eight were initially approved.

Fourteen states have no CON regulation at all, including Texas and California.

Agency for Health Care Administration Secretary Liz Dudek likes to say she “grew up” in the CON regulation unit, referring to her early career in health care facility and regulation. Her institutional knowledge of Florida’s certificate of need program is second to none.

At a commission meeting this week Dudek offered her wisdom to the commission members, who asked how they should handle CON at its meetings since it’s  included in the call and ripe for legislative changes. Dudek said she didn’t expect the issue to have much momentum during the Regular Session, but that it would be more “critical” in the 2016 session.

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