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Medical board protests 2 bills

By Carol Gentry
6/9/2009 © Health News Florida

The Florida Board of Medicine “strongly" opposes two bills pending the governor's signature, saying their unintended consequences could hurt thousands of health professionals and the Department of Health. The board voted unanimously on both actions Saturday at a meeting in Fort Lauderdale. 

One of the bills, SB 1986, is the so-called Medicaid "train," which includes measures to crack down on Medicaid fraud, study a "medical home" project and other health issues. It has drawn little opposition since the "medical home" pilot was changed from a real project to a study and has not yet reached the office of Gov. Charlie Crist for final action.

The other bill, which the governor's office received on Monday, has received little attention. SB 2188 requires agencies to put documents online seven days before holding a public meeting so that it’s clear what the meeting is about and those who may want to come can prepare for it.

Both sound unobjectionable, said Assistant Attorney General Ed Tellechea, who serves as general counsel to the Board of Medicine, and he conceded both are expected to be signed. But they contain clauses that could create a “nightmare” for health professionals and boards that regulate them, he said.

Gov. Charlie Crist said Tuesday morning he has not not finished reviewing the issues the board voted on. 

Here are details:

Posting documents

The public-documents requirement, which would affect all health-licensure boards and committees, would overwhelm certain boards -- including Medicine and Nursing -- whose members must plow through thousands of pages of patient medical records in deciding what action to take against professionals charged with misconduct. Those documents would have to be redacted for any patient-identifying information before they could be posted, but the agenda for meetings doesn't gel until a couple of weeks before a meeting, leaving little time for redaction.

The medical board's office staff has to work long hours already to provide the documents to board members in time to review them for their meetings and to redact those that will be made public, said Larry McPherson, executive director of the medical board. Given that the Legislature provided no extra funding for staff to accomplish the job, he said, he doesn't know how it can be done. 

Medicaid fraud

The Medicaid bill, Tellechea said, would require DOH to refuse licensure to all health professionals -- including certified nurse assistants and massage therapists -- who are “affiliated with” a person convicted of a felony in the last 15 years.  The bill also bars DOH from renewing licenses for those who have such relationships, he said.

Because the term “affiliated” is so vague, Tellechea warned, it's possible that doctors who have a practice partner, relative or even an office assistant who gets convicted of a felony could be denied relicensure in the state. The proposed statute doesn't define the term, he said, and doesn't authorize DOH to do so.

"If I have privileges at a hospital and the hospital gets banged for Medicaid fraud, do I have a problem?" he asked.

The pending law also treats Florida residents differently from out-of-state residents who apply for licensure in Florida because it doesn't apply to those affiliated with persons convicted of a felony in another state, Tellechea said. 

Sen. Don Gaetz, a co-sponsor of the bill, told Health News Florida that he thinks the medical board is "over-reacting." He notes that the Florida Medical Association signed off on it.

The bill would change language in Florida statute 456.0635 (2) to state:

"Each board within the jurisdiction of the (Department of Health),  
or the department if there is no board, shall refuse to admit a 
candidate to any examination and refuse to issue or renew a 
license, certificate, or registration to any applicant if the 
candidate or applicant or any principle, officer, agent, 
managing employee, or affiliated person of the applicant, has 
been: 
(a) Convicted of, or entered a plea of guilty or nolo 
contendere to, regardless of adjudication, a felony under 
chapter 409, chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or 
42 U.S.C. ss. 1395-1396, unless the sentence and any subsequent 
period of probation for such conviction or pleas ended more than 
fifteen years prior to the date of the application." 

--Contact Carol Gentry at 727-410-3266 or by e-mail.