Diagnosis for 10.23.21: Checking the pulse of Florida health care news and policy

diagnosis art
Time again to check your pulse — of Florida health care policy and politics.

Welcome to the second edition of Diagnosis. This is Peter Schorsch, thanking you for your readership of yet another email from Florida Politics. Fortunately, this one is quarterbacked by Christine Sexton, so it will always be a must-read.

Two notes: First, the subsequent editions of Diagnosis will publish the Fridays of the legislative committee weeks in November and December. The plan is to publish weekly after the holidays.

Second, as you can see, there are open slots for advertising in this essential email. The masthead is also available for sponsorship. We have already secured two annual advertisers. We are looking for three more strategic partners, but only three more. We intend to keep the number of advertisers in this space limited.

If you are interested in advertising in this email, don’t hesitate to contact me at [email protected].

Again, thank you for your readership and support.

— WHY SO HUSH-HUSH? —

Gov Ron DeSantis‘ administration refuses to say when the state received approval from the federal government to get an additional $1.1 billion in Medicaid dollars or provide the approval letter to the press or the public.

According to correspondence obtained by Florida Politics, the Department of Health and Human Services told Medicaid Director Tom Wallace on Sept. 28 that the state’s plan to tap into the additional federal Medicaid dollars had gotten conditional approval.

The Sept. 28 letter contains information regarding how the money can be used to increase payments to direct care providers, whether they work with Medicaid beneficiaries in the iBudget waiver program or with beneficiaries in the Medicaid-managed long-term care program, which is a managed care model.

Why so mum on Medicaid money? Image via The Governor’s Office.

The letter lays out the rules regarding payments to providers that offer home and community-based services both through a managed care and non-managed care delivery system. The letter makes clear that regardless of the delivery model, the state needs to provide the federal government with the proposed payment rates, and the methodologies used to set those rates,

The reimbursement methodology must be based upon actual historical utilization and actual trend factors. Additionally, the letter notes that home and community-based services delivered through managed care must be actuarially sound and approved by the federal government before they can take effect.

AHCA Secretary Simone Marstiller told members of the House Health Care Appropriations Subcommittee earlier this month the state had received “conditional approval” of its request for $1.1 billion in increased federal Medicaid match. It was the first time the agency had publicly acknowledged the approval.

Florida Politics made repeated requests for a copy of the approval letter, but AHCA did not provide the correspondence.

And while the agency has posted different iterations of its proposal to spend the $1.1 billion on its webpage, it has not posted the federal approval letter to its site.

Meanwhile, those that provide the services continue to press lawmakers about the urgency of the situation.

— MASKING MAYHEM —

Florida’s top public health official was asked to leave a state Senator’s office this week after refusing to don a mask in her office.

Sen. Tina Polsky, who was diagnosed with stage 1 breast cancer in August, asked state Surgeon General Joseph Ladapo and his two legislative aides to leave her office after Ladapo refused to comply with her request to put on a mask.

“I told him I had a serious medical condition,” said Polsky, who will begin radiation therapy treatment for cancer next week.

Tina Polsky, facing breast cancer, boots the Surgeon General for going maskless.

Polsky said that Ladapo had requested to meet with her in Tallahassee this week; he was making the rounds visiting several Senators who will be asked in the upcoming Session to confirm him.

Polsky said he offered to go outside when she asked him to put the mask on, but she declined.

“I don’t want to go outside,” Polsky said she told Ladapo after he made the offer. “I want you to sit in my office and talk to you.”

Polsky said there was a brief back-and-forth, and then she finally asked whether there was a reason he couldn’t wear a mask.

“He just smiles and doesn’t answer. He’s very smug,” Polsky recalled. “And I told him several times, `I have this very serious medical condition.’ And he said, ‘that’s OK,’ like it basically has nothing to do with what we are talking about.”

Eventually, Polsky said she asked Ladapo to leave her office, which he agreed to do, she said. But the Senator said before going, Ladapo remarked, “sometimes I try to reason with unreasonable people for fun.”

Weesam Khoury, a Department of Health spokesperson, confirmed Ladapo’s comment, but said it was not directed to the Senator.

“Dr. Ladapo is committed to meeting with members of the Legislature regardless of their party affiliation to discuss policy, even when they do not agree on the subject at hand,” Khoury said in an email. “Meetings between highly regarded and intelligent, elected and appointed officials happen all the time, and it is disappointing you don’t hear about them more — but it is probably because the only time they get reported is when a genuine meeting turns into a media headline expected from a gossip column.”

Khoury added, misspelling Polsky’s name, that she and Ladapo “are saddened to hear about Sen. Polsky’s recent diagnosis and wish her well.”

Polsky said she is taking all precautions she can to protect herself from getting infected with COVID-19. A positive test means a delay in her treatment, and she doesn’t want to take any risks.

“I really wanted to interview him. I had a lot of good questions,” Polsky said. “So that was unfortunate that I didn’t do it. But I felt really uncomfortable.”

— PARTICIPATION AWARD —

Nearly 100 hospitals in three Medicaid Regions across Florida won’t participate in a new direct payment program to improve health care quality at Florida facilities.

Rep. Bryan Avila, the chair of the House Health Care Appropriations subcommittee, said this week hospitals in Medicaid Regions 5, 6, and 10 wouldn’t be able to participate in the program established by the Legislature last year. The Directed Payment Program, or DPP, is federally authorized for states, like Florida, which deliver Medicaid services through managed-care plans.

The program is specifically designed to help make up for low Medicaid reimbursement rates, also known as “Medicaid shortfall,” or the differences between the money hospitals receive for providing Medicaid services and the costs of those services.

Bryan Avila says some Florida hospitals are sitting out on the federally backed Medicaid program.

Approved by the Florida Legislature during the 2021 Session, Florida’s DPP provides a financial incentive for all hospitals to engage in quality initiatives with the Medicaid managed-care plans in their region. These quality initiatives include reducing preventable emergency department utilization and improving birth outcomes, among others. Hospitals that participate in a DPP receive their DPP funding via their local Medicaid managed-care plans.

The DPP does not cost the state any money. That’s because the required state match comes from a uniform hospital assessment on all hospitals in a Medicaid region that agree to be assessed.

Hospitals in eight of the 11 Medicaid Regions agreed to participate in the DPP program. But there wasn’t an agreement among the hospitals in Medicaid Regions 5, 6, and 10.

Pasco and Pinellas comprise Medicaid Region 5. According to the state Health Finder website, there are 28 hospitals in those two counties.

Medicaid Region 6 includes Hardee, Highlands, Hillsborough, Manatee and Polk counties. There are 35 hospitals in those counties.

Medicaid Region 10 is the only region in the state comprising just one county, Broward. There are 34 hospitals in the county, according to the state website. However, a spate of public hospitals affiliated with the North and South Broward Hospital district may join the DPP because they are publicly owned and could agree to partner together and join the program.

— POLL PRESSURE —

With a vote upcoming on President Joe Biden’s new spending package, a new survey puts pressure on Democratic Rep. Stephanie Murphy to say yes to the proposals.

Protect Our Care, a group advocating for lower drug costs, promotes the new survey showing constituents in Florida’s 7th Congressional District back multiple proposals in the plan relating to Medicare and Medicaid.

Murphy, a moderate Democrat, has expressed concern with the size of Biden’s Build Back Better spending proposal. The survey, conducted by Public Policy Polling (PPP), shows constituents in Murphy’s district support the plan’s proposals relating to health care costs. The poll showed 87% of CD 7 voters say the price of prescription drugs is too high, and 80% back proposed provisions to allow Medicare the ability to negotiate lower drug prices.

“In the past, Congresswoman Stephanie Murphy has been a consistent fighter for more affordable health care in her district,” said Protect Our Care Florida Director William Miller.

“We hope that with the upcoming Build Back Better legislation, she will stand again and vote for what the overwhelming majority of her constituents want: lower prescription drug prices, expanded Medicare to cover hearing, vision, and dental, and lower insurance premiums.”

Proponents argue allowing Medicare to negotiate and lower drug prices will provide significant savings to the government. The PPP survey showed that 85% of voters support using those potential savings to cover dental, hearing, and vision for those eligible for Medicare. Biden’s bill contains provisions doing just that, but those could be cut as well.

Murphy’s support could affect the final shape of the package and whether it moves forward. The survey sampled 516 voters in CD 7. It ran Oct. 15-16 and has a margin of error of 4.3 percentage points.

To watch the Protect Our Care ad, click on the image below:

— FILED —

COVID-19-related bills may be scant, but not health care ones. This week saw a handful of proposals trickle in, led off by a return of legislation to bring more oversight to pharmacy benefit managers.

The issue has been a focus for Tampa Bay Republican Rep. Jackie Toledo for a few Legislative Sessions now, and a slimmed-down version passed the House last year before dying in the Senate. The latest vehicle is HB 357, which would continue where the 2021 effort left off.

Jackie Toledo will once again push greater oversight for pharmacy benefit managers.

Sen. Gayle Harrell, a Stuart Republican, also pitched a new bill (SB 564) that would prohibit insurers from requiring patients to progress through step therapy — also known as “fail first” therapy — before covering medications used to treat stage 4 metastatic cancer as well as “all medically necessary services associated with the administration of the drug.”

Rep. Yvonne Hinson, a Gainesville Democrat, is also taking aim at the denial of health care services with legislation (HB 373) that would require health care facilities have a denial of care provision in place to provide patients and the state Department of Health with a complete list of its refused services. Those that fail to turn in a list by Oct. 1, 2022, would face a $5,000 per day fine.

Meanwhile, Tampa Democratic Sen. Janet Cruz wants to save disabled veterans a few dollars with a bill (SB 556) that would waive the Medical Marijuana Identification Cards fee. Under current law, medical cannabis cards carry a $75 fee payable to the Office of Medical Marijuana Use.

And finally, Tampa Republican Rep. Traci Koster filed a proposal (HB 343) that would edit the educational requirements for marriage and family therapist licenses to include master’s degrees with a “major emphasis in marriage and family therapy or a closely related field” earned from an accredited school before Sept. 1, 2027. Currently, the state requires degrees from programs approved by the Commission on Accreditation for Marriage and Family Therapy Education or the Council for Accreditation of Counseling and 39 Related Educational Programs.

— ROSTER —

It has a new name, and now it has new leadershipMembers of the Florida Association of Nurse Anesthesiology (formerly Florida Association of Nurse Anesthetists) have elected Dr. William Self and Dr. Michelle Canale to serve as president and incoming president of the Association, respectively. They will hold the posts through the 2022 Legislative Session. Self, who lives in Ormond Beach, is a partner with Affirmed Health Centers, which provides ketamine infusion therapy for patients with depression and complex regional pain syndrome. Canale currently serves as the USF Director of its CRNA Program and a Graduate Programs Assistant Professor in the school’s College of Nursing.

Going national — The American Dental Association has selected Dr. Cesar Sabates of Coral Gables as its next president. Sabates, the first Cuban American dentist to lead ADA, previously served as the 17th District trustee for the ADA Board of Trustees from 2016-2020, and as a delegate in the ADA House of Delegates from 2000-2016. He also was the past president of the Florida Dental Association (FDA) and the South Florida District Dental Association (SFDDA). “The opportunity to serve as president of the ADA is a milestone I don’t take lightly,” Sabates said. “Getting to follow in the footsteps of the many who have come before me, is a huge honor, and I look forward to continuing the work that has such a strong impact in the field of dentistry.”

Congratulations to Cesar Sabates, Installed as American Dental Association President, the first Cuban American dentist to hold the position.

— ICYMI —

The ones to blame — The state spent $5.5 million to build a website allowing Floridians to comparison shop prices for medical care, but almost nobody uses it. House Speaker Chris Sprowls, who sponsored the legislation in 2016 necessary to create the website, told Florida Politics he blames the low traffic on the media, at least in part. “I have had a hell of a time getting the media to cover this in any substantive way,” Sprowls told Florida Politics, referring to the Florida Health PriceFinder website. “I think people don’t know that this is an option for them to check. And that is partially on the government for making sure there is a reasonable amount of resources to utilize to get the word out there.”

IT trouble — AHCA Secretary Marstiller on Monday pressed lawmakers to set aside nearly $118 million next year to complete a mammoth technological overhaul of the state’s Medicaid program. But Rep. Avila, the chair of the House budget committee responsible for health care spending, questioned whether AHCA’s request was a “little excessive” because her agency expects legislators to trim back the request. The ask comes after lawmakers put $158 million into the overhaul over the past five years. Still, Marstiller said the top-line was justified. “The request we have is as conservative as we could make it,” she said. “It is necessary to do what we know we need to do to be successful.”

Simone Marstiller tried to keep her latest ask as conservative as possible.

Eyeball Wars — Optometrists and ophthalmologists are gearing up for another battle in the ongoing ‘Eyeball Wars.’ Members of the Florida Society of Ophthalmology turned up for a Wednesday meeting of the House Professions & Public Health Subcommittee to warn of potential dangers if lawmakers expand optometrists’ scope of practice. Ophthalmologists, who are medical doctors, are once again arguing that optometrists do not have the education and training needed to perform surgery or prescribe particular controlled substances. Yet Palm Beach Gardens optometrist Mark T. Marciano told panel members that optometrists provide 72% of the eye care in the state. “That’s a lot,” he said.

Premium prices — State employees haven’t had an increase in their health insurance premiums in more than 15 years, but that could change as a Senate panel begins to take a deep dive into costs associated with the state group health insurance plan. As reported by Florida Politics, Division of State Group Insurance Director Ryan Stokes told panel members family premiums for health insurance coverage on June 30, 2005, were $10,004. The employee’s contribution was $2,160, and the state contributed the remainder. As of July 1, the annual family premium for the state group health insurance plan was $21,973, of which the employee is still responsible for $2,160. Committee Chair Jeff Brandes seemed dismayed by the information. Florida’s state group health insurance is estimated to have cost $2.8 billion this past year. As of June 30, the state’s group health insurance plan covered 362,290 people (175,046 state employees).

Billable hours — Tampa Bay area law firm Zinober, Diana & Monteverde submitted a $10,091 invoice for mediation services and travel expenses for helping negotiate new rules governing the operation of neonatal intensive care units that DeSantis‘ administration is pushing over the objections of some of the state’s largest hospitals, including one run by his former Chief of Staff, Shane Strum. The mediation services were related to the negotiated rule-making panel appointed by the Agency for Health Care Administration earlier this month. The panel was appointed to craft new rules for the units that care for the state’s sickest newborns. The rules are necessary after the Florida Legislature agreed in 2019 to exempt hospitals from the regulatory program called “certificate of need.” The law firm is charging the state a “discounted” rate of $375, according to the information posted on a state website maintained by Chief Financial Officer Jimmy Patronis.

Get well soon — Sen. Polsky, a lawyer and rising star among Democrats, has been diagnosed with stage 1 breast cancer and will begin treatment next week at Boca Raton Regional Hospital Lynn Cancer Institute. Polsky, 53, self-detected a suspicious mass about a month and a half ago. She is awaiting the results of one more test, but for now, she is scheduled to treat the cancer with radiation. She decided to publicize her diagnosis and treatment plan to underscore the importance of self-examinations and annual mammograms and how they improve breast cancer health outcomes, Polsky told Florida Politics on Thursday. Polsky says she was given a good prognosis because she caught it early. “And I had a mammogram last year. Mine is completely treatable,” she said. “I want to make sure that other people take good care of themselves.”

— SECOND OPINIONS —

Florida kids still lead all ages in positivity as COVID-19 cases fall” via Ian Hodgson of the Tampa Bay Times — Florida children 11 and under remain the highest-risk and least-protected age group from infection. Case positivity for the youngest Floridians was 5.3%, according to the latest state data. That is down from the peak positivity rate of 23% on Aug. 19, but it’s still higher than the current positivity rate of any other age group. But the majority of every other age group has been vaccinated, while no vaccine has been approved for children 11 and under. According to the Florida Department of Health, nearly 3,000 children in that age range tested positive for COVID-19 from Oct. 8-14. That’s nearly 90% lower than the peak weekly cases of 26,475, among all ages, over the seven days reported on Aug. 27.

The mask mandate for Miami-Dade Schools could soon be eased” via The Associated Press — Miami-Dade School Superintendent Alberto Carvalho says the number of students being quarantined has dropped significantly since school started. He says a decision will be based on the latest data and advice from a task force comprised of local doctors. An easing of the policy would give parents an opt-out provision. Masks were mandated when the delta variant caused a spike in cases, hospitalizations and deaths. The district joined a handful of others defying an executive order and the Department of Health rule to let parents decide whether children wear masks. An administrative law judge is slated to hear a challenge to the rule by Miami-Dade and the other counties beginning Thursday.

Alberto Carvalho brings good news about Miami-Dade quarantines.

Florida school orders students who get COVID-19 vaccine to stay home 30 days” via the Miami Herald — Administrators at the Centner Academy, a nearly 300-student school serving pre-K to eighth grade with three campuses in the Miami Design District and Wynwood, notified parents they’d have to keep their children home for 30 days if they receive the vaccination — or preferably wait until the summer. In the letter to parents, the school says the 30-day period will allow time so that a vaccinated student couldn’t transmit anything to other children, promoting false claims about COVID-19 vaccines. The story has outraged public-health experts battling the coronavirus. “It is very dangerous, I think, to be broadcasting something that is not based on any fact,” said Mary Jo Trepka, an infectious disease epidemiologist and professor at Florida International University.

Parents of brain-injured kids tell Florida: Thanks for reforms, but we need more help” via Carol Marbin Miller and Daniel Chang of the Miami Herald — Florida parents steered into a controversial compensation program for children with severe brain injuries told state investigators they often were treated like “liars” and “fraudsters” for whom administrators needed “to protect themselves.” One parent told investigators the program administrators “react to any request as if we are trying to commit fraud. It’s very disheartening to need something for your child, ask for that thing, and then be treated as if you’re a liar or worse for asking.” The remarks were made as part of a survey of parents whose children’s health care is managed by the Birth-Related Neurological Injury Compensation Association, or NICA, created to protect obstetricians from the financial consequences of birth injuries that leave children severely disabled.

‘They treat me like I’m old and stupid’: Seniors decry health providers’ age bias” via Judith Graham of KHN — Ageism occurs when people face stereotypes, prejudice or discrimination due to their age. The assumption that all older people are frail and helpless is a common, incorrect stereotype. Prejudice can consist of feelings such as “older people are unpleasant and difficult to deal with.” Discrimination is evident when older adults’ needs aren’t recognized and respected or treated less favorably than younger people. In health care settings, ageism can be explicit. An example: plans for rationing medical care (“crisis standards of care”) that specify treating younger adults before older adults. Embedded in these standards is a value judgment: Young peoples’ lives are worth more because they presumably have more years left to live.

Nurses with burnout: ‘Many … have gotten sick, some have died, and all of us are exhausted’” via Issac Morgan of Florida Phoenix — A panel of health care leaders told lawmakers the pandemic has triggered burnout among workers at hospitals, nursing homes, and community health centers. Nurses, in particular, have chosen early retirement or left for other industries, health experts said. In Florida, nurses and others have dealt with COVID-19 surges, new variants, and deaths over at least 18 months. The Florida Hospital Association warned the state could see a nurse shortage by 2035 if retention and recruitment aren’t addressed. In a joint report from FHA and the Safety Net Hospital Alliance of Florida, the state is projected to see a shortage of 59,100 nurses by 2035 — including 37,400 R. N.s and 21,700 licensed practical nurses (LPNs).

Tampa General Hospital marks 700th lung transplant” via Melissa Eichman of Bay News 9 — “Probably a total of 15 or 20 programs across the country that have been able to meet this milestone, it’s a milestone that we provide for our community, to provide advanced care,” said Dr. Kapil Patel, with Tampa General Hospital and the University of South Florida. Vez Hang, 40, recently had a bilateral lung transplant, the first COVID-19 transplant patient at TGH. “We’re seeing more patients, younger patients with advanced lung disease developed in a short period from COVID and is nonreversible,” said Patel, director of the Center for Advanced Lung Disease and Lung Transplant Center. “These patients are now confined to the hospital requiring high-oxygen requirements, (and they) will not be able to go home without a lung transplant.”

USF researchers hope electrochemical nose will ‘sniff’ out COVID-19” via Christopher O’Donnell of the Tampa Bay Times — Known as the Electrochemical-Nose — or the Echem-Nose — the device is being developed at the university’s Department of Electrical Engineering. Potential uses include sounding an alert when the virus is detected in indoor spaces, or as a quick way to screen passengers boarding an aircraft. Echem-Nose detects and identifies odors through the presence of chemicals in gases that come into contact with the thin mucus lining within the nose. The device uses a photovoltaic sensor, which can detect the signature of chemical elements in the air. But in an unusual marriage of chemistry, engineering, and biomolecular engineering, the sensor is covered with biomaterial — in this case, a thin, artificial layer of mucus that will contain copies of the COVID-19 antibody protein.

The nose knows: USF Engineering’s Tiffany Miller is part of the team developing the Bull Nose COVID-19 testing system. Image via USF.

Encompass Health and Baptist Health South Florida announce expansion of home health joint venture in Miami” via Yahoo Finance — The transaction is expected to close in the fourth quarter of 2021 and is subject to certain customary closing conditions and regulatory approvals. The joint venture expansion will add Encompass Health’s home health services to Miami-Dade and Monroe counties, complementing the existing inpatient rehabilitation services in the market. Encompass Health is currently the fourth largest provider of Medicare-certified skilled home health services and a Top 10 hospice provider in the country based on Medicare reimbursements. Baptist Health South Florida is the largest health care organization in the region, with 11 hospitals, more than 23,000 employees, 4,000 physicians, and 100 outpatient centers, urgent care facilities, and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties.

New FIU college of medicine elective focuses on LGBTQ health” via Ileana Varela of FIU News — “The LGBTQ community faces many health disparities and is often not included in medical education,” said Juan Oves, a fourth-year medical student at the FIU Herbert Wertheim College of Medicine (HWCOM). “Many studies have shown that physicians are often not prepared to provide adequate care to LGBTQ patients.” HWCOM launched a new elective course on LGBTQ health. Students can choose to rotate for two to four weeks at a clinical site or community partner to develop the skills and knowledge to provide care for the LGBTQ community. And the students can further expand their expertise through online resources from the Fenway Institute’s LGBTQIA+ National Health Education Center.

Editor of European medical journal sued after allegations of false advertising” via Erin Page of Law Street — On Tuesday, a case was filed in the Southern District of Florida by Exegi Pharma against Camillo Ricordi as editor-in-chief of the European Review for Medical and Pharmacological Services. The lawsuit alleges false advertising and support of a fraudulent product. The Review published an article titled “The safety profile of probiotic VSL#3. A meta-analysis of safety data from double-blind, randomized, placebo-controlled clinical trials.” The VSL#3 article relies upon several clinical studies; however, these studies’ integrity is questioned as having been authorized with data obtained under a different formulation than the final product.

— STATUTORY RULE CHANGES —

Diagnosis sifts through the latest statutory and technical rule changes, so you don’t have to.

— The Board of Speech-Language Pathology and Audiology proposes amending Rule 64B20-2.003 to allow the Board to approve a subsequent provisional license if good cause is shown by the person whose provisional license has or will expire before completion of all requirements of Rule 64B20-2.001. More here.

— The Board of Osteopathic Medicine proposes amending Rule 64B15-12.0031 to update the rules regarding physician assistants. More here.

Moving the goalposts, again?

— The Board of Chiropractic Medicine proposes amending Rule 64B2-13.007 to update provisions relating to out-of-state practitioners and update them with new language. More here.

— The Board of Chiropractic Medicine proposes amending Rule 64B2-16.0075 to update days required on an address change and Florida Statues in rule text. More here.

— The Board of Chiropractic Medicine proposes amending Rule 64B2-16.003 to update and revise the Boards’ disciplinary guidelines to add penalties for newly enacted disciplinary violations. More here.

COVID LOBBYING —

The culture-editing, society-changing impacts of COVID-19 are touching every part of life. But when it comes to public health policy, “change” is an insufficient word: COVID-19 has created an entirely new category of discourse.

In Florida’s 2019 and 2020 Legislative Sessions, zero bills were filed mentioning the word “pandemic.” Predictably, in 2021 as the globe was enveloped in the virus’ wrath, 50 bills were filed relating to pandemics generally, and 74 mentioned COVID-19 specifically. The 2022 Legislative Session will only amplify these dynamics.

It’s clear that “COVID policy” extends beyond health care — with implications for the economy, education, insurance, infrastructure, federal relations, and the judiciary. And nowhere are the tensions of these challenges as evident as in Florida, placing our policymakers in a very real, very consequential spotlight.

‘Pandemic’ is the hot keyword with lawmakers. Image via AP.

Consider the following: while just seven bills of the 546 filed so far mention COVID-19, accounting for about 1% of all bills filed, based on the House lobbying appearance database, a whopping 18% of all lobbying activity on health care issues have related to COVID-19. This doesn’t even count lobbying relating to “telehealth,” which is undoubtedly interconnected, or on more broadly health care access.

Through a different lens, just 45% of all bills filed to date have had at least one lobbyist appearance reported, while 85% of the bills related to COVID-19 have been actively lobbied so far.

These lobbying appearances touch on the following COVID-19-specific issues: liability or immunity protections (47%), insurance coverage, including for home test kits (20%), vaccination policy (6%), PreK-12 education policy and relief funds (4%), air quality issues (2%), and contact tracing and testing (2%). Another 20% of appearances mention COVID-19 broadly.

The single-most lobbied COVID-19-related bill so far is HB 129, on insurance coverage for at-home test kits, with teams lobbying the issue on behalf of at least 14 different principals, including Anthem, Novartis, CVS, MedArrive, Centene, and the Florida Association of Health Plans.

These may not be the most publicly salient debates — there probably won’t be many people escorted out of public meetings because of heated feelings about insurance coverage — but they do reveal where Florida insiders may end up placing or feeling the most significant pressure in the months to come.

— PENCIL IT IN —

Monday

8 a.m.A state-appointed panel of interested parties meets to set rules on regulation of neonatal intensive care units.

Place: Agency for Health Care Administration, Building 3, Conference Rooms A, B and C, 2727 Mahan Drive, Tallahassee.

Or call (888) 585-9008; participant code: 476211242.

Tuesday

9 a.m.A state-appointed panel of interested parties meets to set negotiated rules on regulation of neonatal intensive care units.

Place: Agency for Health Care Administration, Building 3, Conference Rooms A, B and C, 2727 Mahan Drive, Tallahassee.

Or, call (888) 585-9008; participant code: 476211242.

You can borrow one of mine.

Wednesday

10 a.m. — Florida Chamber Annual Meeting & Future of Florida Forum.

Place: Hyatt Regency Grand Cypress 1 Grand Cypress Boulevard, Orlando.

Thursday

8 a.m. — Florida Chamber Annual Meeting & Future of Florida Forum.

Place: Hyatt Regency Grand Cypress, 1 Grand Cypress Boulevard, Orlando.

2:30 p.m. — AHCA hosts a workshop on proposed Rule 9G-4.251 Prescribed Drugs Reimbursement Methodology.

Place: Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee.

Or, register at: https://attendee.gotowebinar.com/register/8178491

Friday

9:30 a.m. — Governor’s Panel on Excellence in Long-Term Care meets.

Call: 1 (888) 585-9008; participant code: 998518088

2 p.m. — AHCA holds a workshop on proposed Rule 59A-4.1081 personal care attendant training program

Place: Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee.

Or, call (888) 585-9008; participant code: 476211242#.

Peter Schorsch

Peter Schorsch is the President of Extensive Enterprises Media and is the publisher of FloridaPolitics.com, INFLUENCE Magazine, and Sunburn, the morning read of what’s hot in Florida politics. Previous to his publishing efforts, Peter was a political consultant to dozens of congressional and state campaigns, as well as several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella. Follow Peter on Twitter @PeterSchorschFL.



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