Christine Jordan Sexton
- Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.
—Tick tock—
Any day now, Gov. Ron DeSantis is expected to sign the big health care package approved by the Legislature.
Senate President Kathleen Passidomo’s health care priority bills (SB 1758/SB 7016/SB 7018) were sent to DeSantis on March 12. The Governor has until March 27 to sign them into law, veto them, or allow them to become law without his signature.
No other health care-related bills have been sent to DeSantis since the end of the 2024 Session.
The main thing to watch regarding these bills is whether the Governor allows all the spending included in the legislation to proceed.
The bills include more than $1.2 billion in appropriations that are outside the stand-alone budget approved by lawmakers on the final day of the Session. DeSantis has line-item veto power for budget items and that includes spending authorizations included in any bill, not just the General Appropriations Act (GAA).
DeSantis, during a news conference held shortly after the 2024 Session concluded, said it was likely he would veto budget items approved by legislators. He was referring specifically to the 2024-25 budget act but it’s important to remember he could use it in other places as well.
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— Meet the COVID Class —
Passidomo was adamant that expanding Medicaid would not improve access to health care and that Florida needed to grow a future health care workforce large enough to meet the state’s growing demand.
As her legislation to do just that sat in DeSantis’ office, graduating medical students who began their careers amid the COVID-19 pandemic found out March 15 where they are headed to continue their medical education.
After months of applications and interviews, medical student graduates in Florida, the United States, and across the world learned on the same day (known as Match Day) where and in what facilities they will spend the next three to seven years completing the training needed to become board-certified.
Medical colleges in Florida held Match Day events, where students were given the envelopes containing their acceptances. The envelopes cannot be opened until noon.
At the Morsani College of Medicine at the University of South Florida, 180 medical students were matched, 31 of whom matched to USF Health. Six others matched to Lehigh Valley Health Network and two matched through the military. In a press release, the college said 33% of the students will train in Florida and 39% will enter primary care.
A total of 109 students from the FSU College of Medicine were matched with residencies. Roughly 45% of those who matched will stay in Florida to begin their residency training according to the Tallahassee Democrat.
The University of Central Florida College of Medicine had all of its 117 seniors matched with residency programs including a record high 16 who are pursuing residencies in psychiatry.
The 128 medical school seniors at the University of Florida College of Medicine were matched with residency programs in 26 different states and Washington, D.C. Thirty-four graduating seniors were matched at UF (including UF Health Jacksonville and UF Health Halifax Health) and another 20 students were matched at other programs in Florida.
All 196 graduating seniors from the Miller School of Medicine at the University of Miami were matched with residencies. According to UM, the students will complete residency programs in 30 states. Fifty-three of its students are staying in Florida, including 35 who will intern at the University of Miami/Jackson Health System. Twenty-seven students will attend residency programs in California, 17 in New York and 11 in Texas.
All 113 graduating seniors at Florida International University College of Medicine matched. According to the university, 42% of the class will continue their medical training in Florida, and nearly a third will stay in South Florida.
Florida Atlantic University announced that 48% of the class of 2024 will conduct their residency in Florida, and 41% will specialize in primary care, including internal medicine, family medicine and pediatrics. The class of 2024 also matched in some of the most competitive specialties, including psychiatry, orthopedic surgery, dermatology, plastic surgery, urology and a triple board specialty in pediatrics/psychiatry/child psychiatry, among others.
The Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine and the Nova Southeastern Dr. Kiran C. Patel College of Allopathic Medicine also graduated medical students as did the Lake Erie College of Osteopathic Medicine Bradenton Campus
According to the NRMP, there was a 4.7% increase in the number of applicants for residencies. A total of 50,413 applicants registered in the 2024 Main Residency Match.
The rise in applicants was driven largely by an increase of nearly 2,000 non-U.S. citizen international medical graduates and more than 600 osteopathic seniors over last year.
This year’s Match included 44,853 applicants who certified a rank order list (“active applicants”) and 41,503 certified positions in 6,395 residency training programs.
—ACA celebrations scheduled—
The re-election campaign of President Joe Biden plans to highlight the 14th anniversary of the Affordable Care Act, also known as Obamacare, over the next few days.
The Biden campaign announced on Wednesday that it would hold 20 in-person events across eight states with “local elected officials and people impacted by the Affordable Care Act.” On Saturday, Biden, former President Barack Obama, and former House Speaker Nancy Pelosi will hold a “national organizing call to mobilize supporters and volunteers around protecting the ACA.”
Florida currently leads the nation in people who are getting health insurance through the marketplace established by Obamacare. More than 4.2 million signed up for coverage during the most recent open enrollment period that ended in January. But Florida Republicans have also resisted expanding Medicaid eligibility, which was also allowed under the ACA.
At one point, DeSantis — when he was running for President — said he planned to roll out this Spring a “big proposal” as an alternative to Obamacare. But DeSantis ended his campaign for President in early January and has been focused on such issues as immigration in recent weeks.
Eden Giagnorio, communications director for the Florida Democratic Party, said that the party is hosting a press event linked to the Affordable Care Act but said that more details on the location and time will go out later this week.
— CVS Caremark’s recs for weight loss Rx —
Roughly 70% of CVS Caremark’s plan members include coverage for weight loss medications.
With the number of prescriptions written for GLP-1s soaring from roughly 230,000 in 2019 to more than 9 million in 2022, CVS issued “considerations” for its plan members to consider to balance the benefits of the coverage with the costs.
“CVS Caremark recommends an evidence-based approach in which plan sponsors evaluate the health needs of their respective covered populations.”
The document also contains some more fine-tuned recommendations. It advises that plans can consider the coverage on the “nature of their employee population.”
For example, those in industries that experience high turnover may opt for a more restrictive approach, while health plans that value the health outcomes and total cost-of-care impact that weight management can have in preventing chronic condition onset or progression may opt for thoughtful coverage paired with a care management program.
GLP-1s are a novel class of medications that impact the brain signaling around appetite, hunger, and satiety.
On average, GLP-1s reduce body weight by 21%. GLP-1 sales are projected to hit $46.1 billion in 2028.
— Walgreens to lay off 324 employees —
Walgreens notified state officials this week of its plans to close an Orlando distribution center and lay off 324 employees.
Rebecca Biller, Senior Counsel of Employment Law for Walgreens, said the layoffs are a result of the company’s efforts to help build business momentum and improve the efficiency of its operations. Biller said that the “separations are expected to commence on or about May 17, 2024.
“We anticipate that these changes, when finalized, would be permanent, and they would involve the entire facility. In total, 324 employees will be affected by this site closure,” she wrote in the letter to the state.
“All affected employees will remain employed and receive their full compensation and benefits for the entire 60-day period or until they resign, whichever occurs first.
“We expect these reductions in force to be permanent, and we will provide all affected employees with the opportunity to participate in on-site career fairs and/or outplacement services to assist with their transition to other employment.“
—The final countdown? —
The Agency for Health Care Administration anticipates posting the names of the managed care plans and provider-sponsored networks (PSNs) it wants to sign multi-year, multi-billion contracts to provide health care services to the poor, elderly and disabled.
AHCA issued the Invitation to Negotiate (ITN) for the state’s Medicaid managed care program in April 2023. Initially, AHCA hoped to conclude the procurement by Dec. 11, 2023.
Florida’s existing managed care contracts expire Dec. 31, 2024. This is the third time the state has put the Medicaid program out for competitive bid.
“The agency’s overall objectives are for Medicaid enrollees to receive all medically necessary services in a timely manner and in the most appropriate setting, thereby achieving high-quality outcomes while containing costs,” the ITN states.
AHCA released three Medicaid ITNs in 2023, one for its Statewide Medicaid managed care program, which includes long term care; one to test whether managed care can help integrate traditional health care with home- and community-based services; and a third for dental services.
Earlier this year AHCA awarded a six-year contract to Florida Community Care.
AHCA anticipates announcing the names of the managed care plans it intends to enter multi-year dental contracts with on March 29.
— RULES —
AHCA announced it is withdrawing proposed changes to Rule 59G-4.250. More here.
— LOBBYISTS —
— Erica Chanti, Rubin Turnbull & Associates: Hospital for Special Surgery
— Christopher Dudley, David Hagan, Karis Lockhart, The Southern Group: Youth Crisis Center
— ETC —
— PruittHealth Ponte Vedra submitted an expedited CON application to transfer CON #10721 from PruittHealth – 4-3, LLC to PruittHealth Ponte Vedra to establish a new 120-bed community nursing home. More here.
— TBO Holdings’ CON applications to transfer CON #10724 from RSBRM FL LLC to itself to establish a 60-bed community nursing home was approved. More here.
— The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary model that empowers primary care providers in eligible Accountable Care Organizations (ACOs) to treat people with Medicare using innovative, team-based, person-centered proactive care. Dubbed the ACO Primary Care Flex Model, it will provide a one-time advanced shared savings payment and monthly prospective primary care payments (PPCPs) to ACOs. The advanced shared savings payments provide ACOs with needed resources and flexibility to cover costs associated with forming an ACO (where relevant) and administrative costs for required model activities.
— Baptist Health Foundation received its largest single donation this week, a $50 million gift from Ken Griffin, founder and CEO of Miami-based hedge fund Citadel and founder of Griffin Catalyst.
— Nine HCA Healthcare East Florida Division hospitals have been honored with the prestigious 2024 Patient Safety Excellence Award 2024 by Healthgrades. Those receiving honors include HCA Florida Aventura Hospital; HCA Florida JFK Hospital; HCA Florida Kendall Hospital; HCA Florida Northwest Hospital; HCA Florida Palms West Hospital; HCA Florida Raulerson Hospital; HCA Florida St. Lucie Hospital; HCA Florida Westside Hospital; and HCA Florida Woodmont Hospital.
— ROSTER —
— Stacey Brandt, executive vice president and Chief Administrative Officer of Tampa General Hospital (TGH), was recognized as part of Modern Healthcare’s 2024 class of Women Leaders.
— University of Miami Miller School of Medicine alumnus Jeffrey Jacobs, was honored with Hall of Fame recognition at the Miller School’s Medical Alumni Association (MAA) award ceremony this month.
— Ambuj Kumar, M.D., MPH, Director of research methodology and biostatistics, and associate professor in the Department of Internal Medicine at the USF Health Morsani College of Medicine, recently received the Practice Guidelines Distinguished Service Award from the American Society for Transplantation and Cellular Therapy
— ICYMI —
In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.
“Pressure to expand Medicaid in Florida keeps slowly rising” via Christine Jordan Sexton of Florida Politics — The effort to bring Medicaid expansion to Florida will have to wait at least another year — even though many other southern states that resisted the expansion offered under Obamacare have had second thoughts and changed direction. The question is whether Florida will be one of the last states in the nation to enact expansion — similar to how it was among the last states to enact the initial Medicaid program that was first authorized in 1965. Florida did not come on board until five years later.
“Rare disease grant program to ‘push the boundaries of science and medicine’ awaits Gov. DeSantis’ signature” via Janelle Irwin Taylor of Florida Politics — More than 7,000 known rare diseases that affect approximately 350 million people across the globe — including some 30 million Americans. Now, Florida may be offering those individuals some much-needed hope. The Legislature passed a bill (SB 1582) that would create a grant program to fund scientific and clinical research on rare diseases. It awaits DeSantis’ signature.
“Legislature sends ‘Live Healthy’ bills to Gov. DeSantis” via Christine Jordan Sexton of Florida Politics — Senate President Passidomo’s proposal to fortify a network of providers, including dental hygienists and physicians, to prepare for the aging Baby Boomers who call the Sunshine State home has been sent to DeSantis. The Governor will have 15 days to sign the bill, veto it, or allow it to become law without his signature. However, in recent years, the Governor has had bills sent to him shortly before he acts.
“This is human behavior’: Sheriff candidate wants to legalize prostitution in Miami-Dade” by Jesse Scheckner of Florida Politics — Former Miami Dade College Police Chief Jeff Giordano just unveiled a titillating policy proposal in his bid to become Miami-Dade County’s first Sheriff in decades: He wants to legalize prostitution. The world’s oldest profession isn’t going anywhere, he said, so it should be safe, legal, and regulated to help eliminate “street-corner prostitution rackets” and increase testing for sexually transmitted diseases.
— FOR YOUR RADAR —
Aside from coverage by Florida Politics, these stories are worth your time.
“DCF call center has second-longest wait times in the country; $12M might help” via Jackie Llanos of the Florida Phoenix — Floridians calling the Department of Children and Families (DCF) for help with Medicaid and other programs face the second-longest wait times in the country, according to a February report from the Centers for Medicare and Medicaid Services (CMS). On average, people have to wait 42 minutes to talk to an agent, and 44% of calls get abandoned.
“VP Harris calls for marijuana rescheduling, leniency” via The Associated Press — Vice President Kamala Harris and rapper Fat Joe led a White House discussion Friday on easing marijuana penalties, with Harris saying it’s “absurd” that the federal government classifies marijuana as more dangerous than fentanyl, the synthetic opioid blamed for tens of thousands of deaths annually the United States. Harris, a former state prosecutor in California, also criticized the federal classification of cannabis as “patently unfair.” The government currently is reviewing how it classifies marijuana, and Harris urged that the process be wrapped up as quickly as possible.
— PENCIL IT IN —
Thursday
Happy birthday to House Speaker Paul Renner!
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Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.
