Diagnosis for 6.19.24: Checking the pulse of Florida health care news and policy

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It's time again to check the pulse — of Florida's health care policy and politics.

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

— Veto watch —

State health care regulators, lobbyists, and at least one powerful Republican Senator are closely watching the fate of so-called interstate mobility legislation and whether a push to have it vetoed is successful.

SB 1600, championed by Sen. Jay Collins, was sent to Gov. Ron DeSantis’ office on June 17. The bill has an effective date of July 1, but the Governor has until July 2 to officially act on it.

The bill addresses licenses by endorsement for professions regulated by the Florida Department of Business and Professional Regulation as well as the Florida Department of Health.

SB 1600 eliminates a statute regarding medical licensure by endorsement and creates a new universal endorsement statute that applies to medical doctors and a dozen-plus other medical professionals.

Jay Collins is waiting to see whether his bill will survive a veto push. Image via Colin Hackley.

Moreover, the bill makes clear that the Board of Medicine cannot approve by endorsement any physicians who have a complaint, an allegation or an investigation pending before a licensing entity in another state or territory; have been convicted of or pled nolo contendere to, regardless of adjudication, any felony or misdemeanor related to the practice of a health care profession; have had a health care provider license revoked or suspended by another state; have voluntarily surrendered any license in lieu of having disciplinary action taken against the license; or have been reported to the National Practitioner Data Bank, which includes medical malpractice settlements.

While SB 1600 puts a hard stop on domestically trained physicians, SB 7016 — which was signed by the Governor — makes it easier for internationally trained physicians to get licensed in Florida.

The centerpiece of Senate President Kathleen Passidono’s Live Healthy initiative, SB 7016 allows internationally trained physicians to be licensed by endorsement so long as they graduate from World Health Organization-recognized medical schools and complete international medical residencies that are “substantially similar” to those endorsed by the Accreditation Council for Graduate Medical Education.

SB 1600 has been looming large over the last two Board of Medicine meetings, and some members wanted the regulatory panel to press the Governor for a veto.

A spokesperson for Collins said the Senator’s office is aware of the health care sector’s efforts to get the legislation vetoed.

I welcome your feedback, questions and especially your tips. You can email me at [email protected] or call me at 850-251-2317.

— Negotiated rule-making —

Former House Speaker Jose Oliva pushed to eliminate the certificate of need program (CON) for hospitals, arguing that it was litigious and contentious, among other things.

Oliva maintained that CON could be eliminated, and the state could maintain control over the quality of medically complex services through rules and regulations. But it turns out that getting those rules passed is equally as controversial as obtaining the CON itself.

AHCA hopes to hammer out industry-acceptable rules next month when a 14-member negotiated rule-making panel meets. AHCA did not provide the names of the people who have been appointed to the panel that is scheduled to meet July 24 and July 25.

Two meetings are set for next month, but the call is still out for panel members. Stock image via Adobe.

AHCA first announced plans to appoint a committee in March and gave people interested in serving on the panel 30 days to notify the state of their interest in serving on the panel, which will be comprised of a surgeon specializing in heart transplants; a surgeon specializing in kidney transplants; a surgeon specializing in liver transplants; a surgeon specializing in lung transplants; a medical director or program coordinator for a heart transplant program; a medical director or program coordinator for a kidney transplant program; a medical director or program coordinator for a liver transplant program; a medical director or program coordinator for a lung transplant program; a medical director or program coordinator for a hospital that only has a bone marrow program; asocial worker specializing in organ transplant services that is employed by a hospital; an administrator from a hospital currently providing transplant services; an administrator from a hospital not currently providing transplant services in a metropolitan area with a population of greater than 200,000 persons; an administrator from a hospital not currently providing transplant services in a metropolitan area with a population between 100,000 and 200,000 persons; and an AHCA representative.

This week’s announcement publishing the dates for the meetings reiterated the membership of the 14-member council and gave interested parties another 20 days to notify the state if they want to serve on the panel.

— Abortion wrangling —

The legal battle over a description that will appear alongside the abortion access amendment on the November ballot won’t be resolved until July at the earliest.

A circuit court judge earlier this month ordered state economists to draw up new wording for the financial impact statement that will be published next to the initiative. But the state has appealed that decision and the 1st District Court of Appeal this week agreed to place a hold on Circuit Judge John C. Cooper’s ruling.

The appeals court also refused to expedite the case to the Florida Supreme Court. The court did say it would not hold oral arguments in the litigation and laid out a schedule that calls for lawyers for Floridians Protecting Freedom and the state to have all legal arguments filed by July 1.

1DCA set a July 1 deadline for legal arguments.

Floridians Protecting Freedom, the group sponsoring the amendment, challenged the wording of the financial impact statement because it had been drawn up late last year. That was months before the Florida Supreme Court ruled in a legal challenge to Florida’s ban on abortions after 15 weeks. The April 1 court ruling triggered a ban on abortion after six weeks that went into effect one month later.

Cooper ruled that the currently worded financial impact statement is “misleading” and that it needs to be redone.

But lawyers working on behalf of Attorney General Ashley Moody assert that Cooper had no legal authority to make his ruling and that the circuit court “unlawfully injected itself” into the process.

Voters will decide this November whether to approve an amendment that guarantees access to abortion up to the point of viability, which is generally around 24 weeks. State law requires economists working for the Legislature and the state to draft a financial impact statement for proposed initiatives.

Amid the litigation, the Financial Impact Estimating Conference has scheduled two meetings in July to consider revisions to the proposed financial impact statement. They are still on tap as of Wednesday.

— Wait and see —

Zephyrhills resident Benny Blanchard has been certified medical marijuana eligible, but he hasn’t had any orders filled because he refuses to sign the patient consent form.

 Now, he’s looking to the Board of Medicine for help.

Blanchard sent a petition to the Board asking it for a declaratory statement that he isn’t required to sign the form. If the BOM doesn’t issue a statement, he’s asking it to reconsider the BOM-approved form Florida medical marijuana patients are required to sign.

Blanchard sent the petition to the Board on May 23. The BOM noticed the request this week.

The request centers on whether adult medical marijuana patients must sign the patient consent form.

Blanchard argues that the Florida Constitution only requires written consent from a parent or legal guardian when a minor is seeking a physician certification for medical marijuana and that written consent doesn’t apply to adults.

Moreover, the petition argues that statutes refer to the BOM-developed consent forms as “voluntary.”

“Petitioner respectfully submits that he has an actual, present, and practical need to receive the requested declaratory statement. Petitioner has applied and paid for renewal for his MMJ card to keep it concurrent, but is unable to acquire medicine without the required authorization of his Doctor,” he wrote in his petition.

Jacksonville health care attorney and lobbyist Christoper Nuland follows the board and its meetings. Nuland told Florida Politics the BOM regulates Florida’s physicians and is reluctant to issue statements on requests not submitted by physicians.

Stay tuned …

— Marijuana meeting —

There is great potential for new marijuana licenses if the recreational use amendment succeeds in November.

To ensure equity in what is expected to be a growing and lucrative market, Black CannaBusiness (BCB) Mastermind is hosting a free program, dubbed BCB Mastermind CeO Intensive, for minority cannabis entrepreneurs and executives in Tampa this week.

BCB Mastermind co-founder Todd Hughes described the two-day event to Florida Politics as an “immersive MBA-like experience that gives the participants from the Florida markets and southern markets the opportunity to build new networks, to understand sustainability, and to promote social equity.”

Parallel, the parent company of Surterra Wellness, is hosting the workshop, which has attracted more than 250 students nationwide who are affiliated with plant-touching or ancillary businesses.

BCB Mastermind wants to educate minority cannabis entrepreneurs before a potential post-Amendment 3 boom in business.

“So, this is a success primer for those individuals looking into the Florida market who are in the Florida market, or southern markets like Alabama. There’s a two-day intensive part and then we do six weeks online where they’ll go through a variety of topics for two days a week,” Hughes said.

Hughes, a disabled veteran, said the seminar focuses in part on educating legislators.

A recent survey found that minorities account for less than 19% of those with an ownership stake in cannabis businesses.

“Florida’s new ballot initiative for recreational cannabis is set to create a $4 billion to $6 billion market, and it’s crucial that this new market is inclusive,” Hughes said. “At BCB Mastermind, we are committed to ensuring that minorities have a fighting chance to participate in generational wealth creation. Joining our program means joining over 250 students nationwide who are leading plant-touching and ancillary businesses.

The meeting comes shortly after the Governor signed legislation that will help at least three Black farmers who are part of the Pigford class obtain medical marijuana licenses.

The meeting is June 20-21.

— RULES —

AHCA announced its holding a rule development workshop on amending Rule 59G-4.215 regarding Medicaid payments for personal care services. More here.

The Division of Children’s Medical Services announced its altering the proposed changes to Rule 64C-7.002 regarding the collection procedures for newborn screening. More here.

The Board of Podiatric Medicine proposes amending Rule 64B18-24.001 to update the application for initial certification for podiatric X-ray assistants. More here.

— LOBBYISTS —

Tori Deal, Jonathan Paul Steverson, Holland & Knight: American Kratom

Tobey Bree Gable: The Children’s Home Society of Florida

Amanda Stewart, Anita Berry, Johnston & Stewart Government Strategies: Astellas Pharma U.S.

— ETC —

— Simply Healthcare Plans announced the launch of the Florida Self-Sufficiency Council, a forum dedicated to elevating best practices that support Floridians on a journey to wellness and prosperity.

Simply Healthcare has partnered with the Florida Workforce Development Association, comprised of Florida’s 24 local workforce development boards, and the Better Health Better Pay Collaborative to advance the Council’s mission.

“Simply Healthcare is proud to establish the first-of-its-kind Florida Self-Sufficiency Council in partnership with Florida Workforce Development Association and the Better Health Better Pay Collaborative,” said Simply Healthcare Plans President Dana Gryniuk. “By elevating best practices for individuals to access education, career opportunities and health care services, we can uplift Florida families today and over the long term.”

Key elements of the initiative include its comprehensive approach to whole health and focus on collaborative engagement with Florida Medicaid members and key stakeholders. The initiative will also work to determine best practices that improve Floridians’ access to health, career, and social services in their communities.

— Community Blood Center in Collier County is looking for O-negative blood donors. The blood center, an affiliate of Naples Comprehensive Health, announced in a news release it needs help to boost what it described as critically low supplies.

“The local shortage is the result of a sudden increase in usage by area patients. The only way to obtain adequate levels of transfusible blood is through lifesaving donations from our community members, the center said in a news release.

O-negative blood is the universal blood type needed for emergency transfusions and for immune-deficient infants. Donations can be made at 100 Immokalee Road, Naples 34110, on the first floor of the NCH Business Center.

— ROSTER —

Cleveland Clinic picked Sarah Vogler, MD, as its Chief of Staff for the Florida market. She has served as its interim secretary since February. As Chief of Staff, Vogler is responsible for the Office of Professional Staff Affairs in Florida and will be responsible for overall clinical performance.

— ICYMI —

In case you missed them, here is a recap of other critical health care policy stories covered in Florida Politics this past week.

New law gives at least 3 Black farmers a shot at marijuana licenses” by Christine Jordan Sexton of Florida Politics — Gov. DeSantis has agreed to change the law to abate legal wrangling over medical marijuana licenses for Black farmers. It’s the second time in as many years the Governor approved changes to the state’s medical marijuana licensure laws for Black farmers. At least three Black farmers tied to what is known as the “Pigford” litigation will benefit from the changes. That’s according to Sen. Tracie Davis, a Jacksonville Democrat who helped champion the 2024 changes included in SB 1582, an omnibus bill related to the Department of Health (DOH).

Gov. DeSantis touts cancer funding accomplishments, hints at future changes” via Christine Jordan Sexton of Florida Politics — The Governor signed a trio of health care related bills related to cancer and rare diseases in Miami and hinted that he expects more changes to how the state funds cancer research in the future. SB 7072, a health care bill that appeared late in the 2024 Session, was the center of a $127 million-plus health care industry tussle between the National Cancer Institute recognized programs in the state and other cancer providers. The measure codified a “Cancer Connect Collaborative,” which was first announced by the DeSantis administration in 2023. The Legislature did not, though, give the collaborative control over how the state allocates $127.5 million in recurring cancer research funds, named in honor of First Lady Casey DeSantis.

Budget vetoes: No transparency on health care transparency?” via Christine Jordan Sexton of Florida Politics — Florida has invested millions of dollars to promote health care prices and transparency. However, DeSantis vetoed $750,000 lawmakers included in AHCA’s budget to competitively procure an independent study to evaluate the utility of the data now being collected. The proviso language attached to the spending item had a long set of requirements for the study, including looking at the state’s claims database and evaluating how it compares to what’s happening in the health insurance market and how the information collected inform health care decisions by consumers, the public sector, employers and researchers; and provide a trend analysis of the website engagement metrics including top data comparisons and searches.

State college staff can access group health plan, but Gov. DeSantis vetoes $80M to offset increased costs” via Christine Jordan Sexton of Florida Politics — Faculty and staff working at the state’s 28 colleges can now access the state group health insurance plan. But the increased costs of expanding access to those employees will have to come somewhere out of the existing budgets of the colleges. DeSantis signed legislation (HB 5101) allowing state college staff to enroll in the health insurance plan. But DeSantis vetoed the $80 million lawmakers agreed to put in the budget to offset the increased costs associated with potential new enrollment.

Health care providers thank the Legislature, Governor for upcoming Medicaid increases” via Christine Jordan Sexton of Florida Politics — Money flowed to many health care providers this year, and they were quick to thank DeSantis for signing the Fiscal Year 2024-25 budget. The budget, along with the ambitious Live Healthy proposal, will bring increases in funding for those who provide care to the poor, elderly and disabled and help fortify the state’s health care delivery system.

— FOR YOUR RADAR —

Aside from coverage by Florida Politics, these stories are worth your time.

Women bypass Florida’s six-week abortion ban through telehealth, mail, travel” via Caroline Catherman of the Orlando Sentinel — In the month since Florida imposed a six-week abortion ban, Lana’e Hernandez has helped nearly 200 women figure out how to end later pregnancies, work that sometimes means securing airfare, hotel rooms and money to pay clinics in places as far away as Illinois. Her clients have included a first-time mother who terminated a pregnancy due to serious fetal health defects and a single mother of five unable to support another baby. She said some of her clients have never left the state before or flown on a plane.

Surgeon General calls for warning labels on social media platforms” via Ellen Barry and Cecilia Kang of The New York Times — The U.S. Surgeon General, Dr. Vivek Murthy, announced on Monday that he would push for a warning label on social media platforms advising parents that using the platforms might damage adolescents’ mental health. Warning labels are one of the most powerful tools available to the nation’s top health officials, but Dr. Murthy cannot unilaterally require them; the action requires approval by Congress. The proposal builds on several years of escalating warnings from the Surgeon General. In a May 2023 advisory, he recommended that parents immediately set limits on phone use and urged Congress to swiftly develop health and safety standards for technology platforms.

— PENCIL IT IN —

Friday

Happy birthday to Reps. Chuck Clemons and Linda Chaney!

Saturday

Happy birthday to House Speaker-Designate Daniel Perez!

Tuesday

Happy birthday to Sen. Bryan Avila!

Wednesday

Happy birthday to First Lady Casey DeSantis and Reps. Dianne “Ms Dee” Hart, Lawrence McClure and Mike Beltran!

10 a.m. — The Blood Clot and Pulmonary Embolism Workgroup meets. Register for the meeting here.

Noon — The ARC of Florida hosts a webinar with the U.S. DOL Office of Federal Contract Compliance Programs (OFCCP) and the U.S. Equal Employment Opportunity Commission (EEOC) on workplace rights and the differences between the agencies. Register here.

Diagnosis is written by Christine Jordan Sexton and edited by Drew Wilson.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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