2024 version of ‘eyeball wars’ going down to the wire

Senate President Kathleen Passidomo said she had no intention of giving trans-stifling ID bills play in the chamber. Image via Florida Politics.

In another round of “eyeball wars,” the Senate is refusing to budge on a top priority of Senate President Kathleen Passidomo that deals with health care providers and who can use the titles “physician” and “doctor.”

The Senate has refused to go along with an amendment the House tagged on to SB 1112, a priority bill for Passidomo, whose late father was an ophthalmologist.

In refusing to concur with the amendment, the Senate sent the bill back to the House for consideration. With the 2024 Session set to end Friday, the future of the bill is up in the air.

As initially filed, the Senate bill would create a new law regarding the regulation of health care titles and designations. It would enumerate in law a lengthy list of titles that can only be used by allopathic physicians or osteopathic physicians — MDs and DOs, respectively. The bill also allows health care providers to use in their advertising the names or titles that are authorized in their respective practice acts, or the laws that govern their professions.

Chiropractors, podiatrists and dentists are referred to in their respective practice acts as physicians. While the word “physician” doesn’t appear in the optometrist’s practice act it, is on the degree they are bestowed when they graduate and is used in federal reimbursement rules.

The House earlier this week amended the bill to allow optometrists to use the term “optometric physician” in their public advertisements, a move that SB 1112 sponsor Sen. Gayle Harrell criticized on Thursday.

“The proper way to grant the authority for a health care practitioner to use additional titles is to have those specific titles added to their practice act,” she said Thursday. “If the House wishes to do that, and have optometrists call themselves optometric physicians, they should file that bill next year.”

This is the second year that the Legislature has tackled the issue because Gov. Ron DeSantis vetoed a similar proposal last year, but offered no explanation.

Passidomo in 2023 denied that the proposal was the latest chapter in the long-standing eyeball wars, and instead referred to the measure as the “ology” bill, a reference to the many protected titles enumerated in the bill that only MDs and DOs could use. But earlier this week, Passidomo dropped all pretenses.

“This is a continuation of the eyeball wars. And the optometrists objected to the bill last year. We passed it; it was vetoed. They lobbied hard. They are wrong,” Passidomo said.

“So what this bill does, it basically provides in your advertising, if you will, in the information you put out, what you wear, how you talk, you should tell your patients what your degree is. I think it’s wrong to infer or leave it silent that you have a degree you don’t have.”

Florida Optometric Association lobbyist David Ramba said the legislation “isolates” optometrists and treats them differently than other professions. Ramba said the term “physician” doesn’t dictate what they can or can’t do under the law.

“Across the country and in Washington, the ophthalmologists would like to restrict our ability to provide services. And one way they are doing that is having us reimbursed as a technician and not a physician.”

While SB 1112 contains a provision designed to ensure that the proposed law does not interfere with Florida optometrist’s Medicare participation, Ramba isn’t convinced.

“It’s great that the state law would say something about how the Centers for Medicare & Medicaid Services CMS is going to reimburse us, as we all know, the feds and CMS don’t really care what we write in our statutes about your terms here,” he said, adding that the provision was included in the Senate bill to offset the optometrists’ arguments. “But the state doesn’t control those reimbursements, the feds do.”