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Senate Positions Health Care Priorities For Passage

Jose Oliva addressing a room.
Florida House of Representatives
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

In a sign that top Republicans have reached agreement on significant health-care legislation, a Senate panel on Thursday revised three high-profile proposals to more closely mirror House bills. 

The Senate Appropriations Committee changed proposals on the “certificate of need” regulatory process, telehealth and prescription-drug importation programs --- all issues that are priorities of House Speaker Jose Oliva.  Some of the changes surprised Republican senators, who complained about the sudden revisions.

The moves came after Oliva, R-Miami Lakes, told reporters late Wednesday night that his health-care priorities would pass this session.

“I’ve been very encouraged by the movement that there’s been over there (in the Senate). I’ve been encouraged by the kind of support we’ve got here in the House,” Oliva said.

“This is an idea whose time has come. People understand what’s happening to them and their health care bills,” he added. “This is a comprehensive approach, and I’m confident we’ll get it done.”

While the chambers aren’t completely aligned on the issues, the Senate Appropriations Committee revamped bills to get closer to the House.

For instance, senators changed a bill (SB 1712) to repeal the certificate of need process for new general hospitals beginning July 1, 2021. Certificate of need for all hospitals and “tertiary care” services would be eliminated on July 1, 2024 under the amendment.

The revised bill would maintain the certificate of need process for nursing homes, hospices and intermediate care facilities for the developmentally disabled.

The House passed a bill last month that would eliminate certificate of need programs for hospitals, nursing homes and hospices effective July 1.

Known in the industry as CON, the certificate of need process requires hospitals, nursing homes and hospices to get approval from the state before they can build facilities or add certain services.

Oliva and other House leaders argue getting rid of the regulatory process would reduce costs and expand access to care. But opponents of the move contend, in part, it would lead to new hospitals and other facilities popping up in affluent areas, leaving older facilities to serve lower-income and uninsured patients.

Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach, opposed the amendment approved Thursday and said a prior Senate CON bill had protections needed to ensure existing hospitals wouldn’t be hurt by investors who want to open specialty, boutique facilities..

“We have really just thrown that away,” Bean said. “So my first question is, what happened?”

Senate Health Policy Chairwoman Gayle Harrell, a Stuart Republican sponsoring the bill, said the changes would mean CON wouldn’t be eliminated for another two years for hospitals and that she would work to ensure the Agency for Health Care Administration addresses some of the concerns through rules.

While Bean was dismayed with the CON changes, he championed an amendment to the Senate’s version of a proposal (SB 1528) that could allow Florida to begin importing drugs from Canada.  With the amendment, the Senate’s bill nearly mirrors the House plan.

Pointing to the possibility of lower costs, Gov. Ron DeSantis announced his support of drug importation programs at the start of the legislative session while making an appearance at The Villages. DeSantis was flanked by Oliva and Agency for Health Care Administration Secretary Mary Mayhew when he made the announcement.

In addition to needing to pass the Legislature, the Canadian drug importation programs would need approval from the U.S. Department of Health and Human Services, and part of the proposal would require a change in federal law. The pharmaceutical industry has been lobbying heavily against allowing importation.

Nevertheless, Bean predicted that importation programs could be up and running in two years.

The Senate committee Thursday also gave the nod to a telehealth bill (SB 1526) that has drawn criticism from health-care providers and the insurance industry.

Doctors and other providers are irked that the bill would allow insurance companies and HMOs to use out-of-state providers who register with the state for telehealth purposes.

Also, insurers do not like part of the bill dealing with what is known as payment “parity,” which would prevent them from paying less to providers for telehealth services than if the services were delivered in person.

Audrey Brown Bridges, president and chief executive officer of the Florida Association of Health Plans, said inclusion of payment parity in the bill is problematic.

“The inclusion of the payment parity provision in the latest version of SB 1526 is good for 9 a.m. to 5 p.m. doctors and emergency departments who fear competition,” she said in a statement. “This provision interferes with a health plan’s ability to negotiate and contract, which only adds to the cost of health care for Florida families and employers and ultimately undermines the goal of real-time patient access and availability of quality telehealth services.”