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Will FL Close Clinic Loophole?

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The Health Care Clinic Act, which would close a gap in health-care regulation, passed all four of its Senate committees by a unanimous vote and is poised for passage on the Senate floor. And yet its companion bill in the House was never heard at all.

With just three days left in the session, SB 746 would ordinarily be considered dead. And yet, its sponsor isn't giving up. Sen. Eleanor Sobel hopes to attach it to an issue considered a must-pass in the House. 

“We have to find a way to stop all these scam artists,” said Sobel, D-Hollywood.

Chris Nuland, the only lobbyist who cares enough about the issue to track and push the bill, credits Sobel’s persistence. “With her as sponsor,” he said, “we can still do it.”

Florida law currently requires clinics to be licensed and inspected only if they accept insurance.  So clinics that want to avoid scrutiny do so by taking only cash.

The sponsor of the House bill, Rep. Elaine Schwartz, said she tried to get it heard in the Health Innovation Subcommittee, where it was assigned. But Rep. Jason Brodeur, the chairman, didn’t like the bill, she said, so he didn't put it on the agenda.

Brodeur, R-Sanford, told Health News Florida he objected to only part of the bill, and expected Schwartz to redraft it and bring it back. But Schwartz says that’s not the message she got. If she misunderstood, she said, she’s embarrassed and will apologize.

Sobel says she doubts Schwartz dropped the ball, calling Brodeur's excuse “baloney.”  "

If he wanted to hear it, he would have put it up,” she said.

Many of the clinics exploiting the loophole prescribe or sell drugs that are legal but being used for purposes that were never intended and may be risky.  An example: HCG Weight-Loss Clinics, which use a pregnancy hormone as part of an extreme low-calorie diet. The Food and Drug Administration issued a warning on that regimen last year.

Other clinics push male and female hormones for “anti-aging” or general malaise; the safety of such treatment over time has not been proven.  Still others specialize in steroids and other performance-enhancing drugs for body-builders and athletes.

It’s no accident that last year’s Major League Baseball scandal featured an unlicensed Miami clinic as the source of drugs for players, including star Alex Rodriguez. He drew a lengthy suspension after the truth came out; a grand jury in Miami is reportedly still at work.

It wasn’t just rich ballplayers who used the clinic and were placed at risk. Customers included high-school athletes and weekend warriors who got their steroid shots from a clinic manager, who had no health-care training or license.

The Biogenesis scandal made headlines all over the country and beyond. But it didn’t translate into  a push to close the cash-only clinic loophole.

Though the clinics targeted by the bill have been described as a risk to public health, it has received no sign of support from state health officials, nor from the Florida Medical Association.

It’s not unusual for public-health measures to be ignored, to fall through the cracks.

Last year, in an embarrassing lapse, the bill to give Department of Health authority over out-of-state compounding clinics was never drafted because the agency forgot to send the language it wanted to the committee, as Health News Florida reported in June.

So out-of-state drug makers like New England Compounding Center, the now-defunct facility that caused a multistate fungal meningitis epidemic in 2012, have remained free to ship into Florida for an extra year.

Soon, that gap may be resolved. A bill that regulates out-of-state compounders has passed in the House and is on the calendar in the Senate today.