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Senate signs off on health care changes

Posted at 5:53 PM, Apr 29, 2019
and last updated 2019-04-29 17:53:50-04

TALLAHASSEE, Fla. — Three high-priority health care bills cleared the Senate on Monday, likely setting the stage for House Speaker Jose Oliva to claim a victory in his effort to revamp the health system.

All three measures must go back to the House for final approval before the legislative session is scheduled to end Friday.

The Senate voted 23-17 to pass a bill (HB 21) that would eliminate the long-controversial “certificate of need” regulatory program for hospitals.

As amended by the Senate, the bill would eliminate the certificate-of-need requirement for new general hospitals and “tertiary services” on July 1. It would repeal a certificate-of-need requirement in 2021 for specialty hospitals, such as children’s hospitals.

Tertiary services include such things as organ transplants and pediatric open-heart surgery and neonatal intensive-care units.

Under longstanding law, hospitals have needed to seek certificates of need from the state Agency for Health Care Administration to build facilities or to add certain services.

The bill is a top priority for Oliva, a Miami Lakes Republican who argues that a more free-market approach would lead to lower costs and greater access to care. The bill, as approved by the Senate, would not eliminate the so-called CON program for nursing homes, hospices or intermediate-care facilities for the developmentally disabled.

The Senate on Monday also voted 27-13 to approve a bill (HB 19) that could lead to importing lower-cost prescription drugs from Canada.

The bill authorizes the Canadian Prescription Drug Importation Program in the Agency for Health Care Administration and the International Prescription Drug Importation Program in the Department of Business and Professional Regulation. The Canadian Prescription Drug Importation Program would be for state health-care programs, while the international program would be for all state residents.

Neither program can be established without approval from the federal government.

The bill has been a priority for Oliva and Gov. Ron DeSantis. The programs would be prohibited from including importation of controlled substances; biological products; intravenously injected drugs; or drugs that are inhaled during surgery.

The Canadian Prescription Drug Importation Program would be designed to import drugs for people in the Medicaid program, people in the corrections system or people who are treated at county health departments.

Noting that the program is established for people who are poor or incarcerated, Sen. Perry Thurston, D-Fort Lauderdale, said while the measure may be a good concept, he didn’t think it was ready to be launched.

Thurston said the program would be limited to the state’s “most vulnerable population,” and he recalled the “Tuskegee experiments” During those 40-year, unethical experiments, public-health doctors withheld penicillin treatment from men with syphilis, with most of the men poor sharecroppers.

But Senate sponsor Aaron Bean R-Fernandina Beach, said the measure would reduce costs for the state and for residents who pay too much for drugs.

“We’re sitting back just enjoying the highest drug prices on the planet. But today we have a chance to say, ‘no.’ We have a chance to say, ‘Enough is enough,’” Bean said. “What this bill will do is simply ask permission from the federal government to launch this program. “

The Senate also voted 30-9 to approve a bill (HB 23) that would establish a regulatory framework for “telehealth.”

Telehealth, which is also known as telemedicine, involves using the internet and other technology to provide services to patients remotely. Telehealth is not a type of health-care service but rather is a mode to deliver services.

The bill allows licensed out-of-state health care providers who register with the state to offer telehealth to Florida residents. There are registration exceptions, though. For instance, health-care providers who are responding to emergency medical conditions wouldn’t be required to register.

Nor would providers who work in consultation with Florida health-care professionals who would have ultimate authority over diagnoses and care of patients.

The bill would modify the state’s current insurance laws to make clear that contracts signed by HMOs and insurers with telehealth providers are “voluntary.”

The contracts would have to establish mutually acceptable payment rates or payment methodologies for services provided through telehealth. It’s not a mandate, though, that providers be paid the same amount. The bill allows for contracts to reimburse providers differently, but those contracts must be initialed by the providers to signify that they understand the reimbursement policies.