Hits & Misses on Orlando Medical News

Hits & Misses

By: By LYNNE JETER

Posted: Tuesday, June 7, 2011 4:52 pm

Bruce Rueben

FHA Reports More Victories than Setbacks during 2011 Legislative Session

TALLAHASSEE—At the start of the 2011 legislative session, state lawmakers faced a $4 billion shortfall in general revenue and double digit unemployment rates, while also housing one of the nation’s largest foreclosure markets. Swirling at the heart of the funding tug-of-war was the multi-million dollar price tag and overhaul options for the state Medicaid system serving 3 million Floridians.

A proposed solution involved essentially eliminating state programs for the Medicaid medically needy and aged/disabled population, significant Medicaid hospital payment cuts, and statewide expansion of Medicaid managed care.

“At the outset of the 2011 legislative session, we faced giant obstacles, including a Senate proposal to eliminate coverage for hospital services in the Medicaid Medically Needy and Aged/Disabled Programs,” said Bruce Rueben, president of the Florida Hospital Association (FHA). “Through united and effective grassroots strategies, we successfully fought for the restoration of these programs.”

Other FHA legislative priorities included the defeat of managed care mandatory contracting provisions, the protection of current and future Provider Service Networks (PSNs) and accountability controls to guarantee the maximum amount of state tax dollars spent on patient care.

“After intense negotiations, much deliberation and extraordinary pressure from FHA members, the legislature provided full funding to both the Medicaid Medically Needy Program and Aged/Disabled Programs,” said Rueben. “The funding allows nearly 225,000 individuals to continue Medicaid coverage for their chronic illnesses. Initial Senate proposals would have eliminated coverage for all adults in the Medically Needy Program, leaving them without critical coverage for their conditions. The legislature committed over $372 million to allow the continuation of these programs.”

House Bill 7109 approves a PSN to serve as a managing entity for the Medically Needy Program and for MediPass Programs operating in counties with fewer than two prepaid plans.

“These contractors will have similar responsibilities in both programs and will focus on case and utilization management,” said Rueben. “This concept will continue until full implementation of the managed medical assistance program or October 1, 2014, whichever is sooner.”

FHA-supported bills that state lawmakers passed include medical liability caps on damages that limit the non-economic damages a Medicaid recipient may recover against hospital and physician providers (HB 7109); medical liability procedural safeguards legislation that provides several litigation protections for providers in medical liability actions (HB 479); a bill extending sovereign immunity of the University of Florida to Shands Health and the sovereign immunity of public teaching hospitals to non-profit university medical schools (SB 1676, HB 395); and milestone “pill mill” legislation concerning controlled substances that sets further requirements on pain clinics and physicians ordering controlled substances (HB 7095).

FHA-opposed bills that failed include prisoner payment legislation that would have limited hospital payments for medical services provided to arrestees and pre-trial detainees (SB 490, HB 257); legislation concerning the sale or lease of county, district, or municipal hospitals that would have required public hospitals to seek court approval or a local referendum before it was sold or leased to a private organization (SB 1448, HB 619); mandated nurse-to-patient ratios legislation that would have mandated pre-set ratios that do not take into account the patient’s needs or provide the flexibility to adjust for complexities inherent in patient care staffing (SB 454, HB 305); and a bill that would have repealed the 2010 legislation authorizing the use of red light camera technology for the enforcement of failure to stop on red at traffic lights and eliminated designation of a portion of fines collected for Florida’s trauma centers (SB 672, HB 4087).

A few misses included state lawmakers passing legislation reducing Medicaid payments to hospitals by 12 percent, and reducing Medicaid payments to rural hospitals by 3 percent (SB 2000, HB 5001).

FHA-supported legislation that died included a bill that would have allowed Advanced Registered Nurse Practitioners (ARNPs) to prescribe controlled substances as designated through individual protocols developed with a supervising physician (SB 454, HB 305).

Two nursing workforce bills (SB 1118, HB 919) that would have required hospitals to establish Nurse Staffing Collaborative Councils to involve direct care nurses in the development and evaluation of the hospital staffing plan also failed. FHA did not oppose either bill.

FHA supported some provisions but not others of hospital licensure bills (SB 1736, HB 119) that proposed to amend licensure statutes of Agency for Health Care Administration (AHCA)-regulated facilities, including several related to hospital operations such as 340B drugs, infection control procedures and health professions licensure. Both bills failed.

FHA leaders plan to discuss the 2012 legislative agenda at the FHA Annual Meeting to be held Oct. 12-14 at Hilton Orlando Bonnet Creek. For more information, visit www.fhaannualmeeting.org.