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Prescribing, Insurance Changes Get Last-Minute Approval

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

Florida lawmakers Friday approved measures that would expand the drug-prescribing powers of advanced registered nurse practitioners and address a controversial health-insurance issue known as "balance billing."

In a flurry of maneuvering at the end of the annual legislative session, lawmakers also approved an insurance change that will benefit people with Down syndrome --- an issue dear to Senate President Andy Gardiner, whose son has Down syndrome. Gardiner has made helping people with developmental disabilities his signature issue while serving as president.

The drug-prescribing and insurance bills (HB 423 and HB 221) were among the final measures passed during the 60-day session, which ended at 6:45 p.m. Friday.

Advanced registered nurse practitioners have long lobbied for the authority to prescribe controlled substances. But the idea ran into the lobbying might of physician groups, which have opposed the proposals.

This year's bill, spearheaded by Rep. Cary Pigman, R-Avon Park, and Sen. Denise Grimsley, R-Sebring, also would grant the power to prescribe controlled substances to physician assistants. The measure now goes to Gov. Rick Scott.

"It's been a long battle, and well worth the fight," Florida Nurses Association Executive Director Willa Fuller said in a prepared statement. "The passage of this bill is a huge victory for nurses and patients."

The balance-billing issue also drew intense lobbying during the session, as it affects health insurers, doctors and hospitals.

The issue centers on patients who have preferred provider organization, or PPO, insurance coverage and go to hospitals for emergency treatment. Supporters of the legislation say those patients sometimes get unexpected bills because doctors in the hospitals are not part of the insurance plans' networks.

The legislation, at least in part, would set up a dispute-resolution process that backers say would help shield patients from unexpected bills and leave it to health-care providers and insurers to work out payment issues. State Chief Financial Officer Jeff Atwater and the Florida Association of Health Plans pushed for the proposed changes, sponsored by Rep. Carlos Trujillo, R-Miami, and Sen. Rene Garcia, R-Hialeah.

But the Senate added a late twist to the balance-billing measure when it approved an amendment Friday to require insurance plans to cover such services as speech therapy, occupational therapy and physical therapy for people with Down syndrome. The change expands part of a law that took effect in 2009 for people with autism spectrum disorder.