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2017 Legislative Session Report

United to Advance Health Care and Pharmacy Practice

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2017 Legislative Session Report
by
Michael Jackson, BPharm, EVP & CEO FPA
Claudia Davant, Adams Street Advocates


L to R: Michael Jackson (FPA), Robert Beck (ASA), Claudia Davant (ASA), Governor Rick Scott and Rebecca Roman (ASA) receive the American Pharmacist Month Proclamation

We are pleased to report another great advocacy year in the books of the FPA’s efforts to shape public policy for the profession and business of pharmacy.  FPA leadership, staff our lobby and legal team worked many hours over the 60 day session to build on the successes of the previous years.  Each year is unique with reoccurring and emerging health care issues that need to be addressed and this year was no exception.

 

The work of health policy advocacy is resource intensive and includes a lot of coordination of our political army, involvement by our political committee volunteers and the hundreds of member pharmacists, pharmacy students and technicians that took time from their busy schedules to be an active participant in the fighting for pharmacy.  The FPA is pleased to have been working with our lobby team of Adams Street Advocates for this year’s campaign.  They are well respected on the hill and knowledgeable of process as well as our issues.  Working with Adams Street Advocates is the legal team at the Lockwood law firm.  Together with support from the FPA staff and the Governmental Affairs Committee we have worked to support good public health policy for Florida and for our profession.

 

FPA Governmental Affairs Committee

Norman Tomaka – Chair

Tim Rogers - Board Chair

Scott Tomerlin - President

Carol Motycka – Speaker

David Mackarey – Vice Speaker

Alexander Pytlarz – Treasurer

Suzanne Wise – President Elect

Claudia Davant – FPA Lobbyist

Gary Dalin – FSHP Liaison

Daniel Buffington – At Large Member

Christina Laird – At Large Member

Aneesh Lakhani – At Large Member

Mario Pedraza – At Large Member

Eric Alvarez – At Large Member

William Garst – Past Chair

S. Mark Hobbs – FPPC Chair

Michael Jackson – FPA EVP

James Wright

Angela Garcia

Ashley Huff

John Lockwood – FPA Legal Council

Rebecca Roman – FPA Lobbyist

Robert Beck – FPA Lobbyist

Dave Ericks – FPA Lobbyist

 

Theresa Tolle – FPPC Treasurer

 

 

2017 LEGISLATIVE CHALLENGES


For the past 5 years, the average percentage of bills passed has been about 14%. This year, 3,052 bills were filed by the House and Senate. Of those filed, only 249 passed both chambers, which means that only about 8% of all bills filed passed both chambers. This is the lowest percentage of bills passed in the last decade. This was largely due to the House and Senate having very different priorities in both policy and budget, which made for a historically challenging session to pass legislation.

 

BUDGET CRISIS

 

Lawmakers had to return to the Capitol past the planned session end date of May 5th in order to debate and pass an $82.4 billion state budget as well as a series of sweeping policy bills disclosed publicly at the end of the regularly scheduled session.  Much of this extension was triggered by disagreements on healthcare spending which delayed an on-time budget deal.  Passing the state’s budget is the one thing the Constitution requires the Legislature to do which means that lawmakers were forced to extend their annual session.

 

As expected, lawmakers overwhelmingly passed the budget, but their approval alone isn’t enough. It then goes to Gov. Rick Scott who can veto individual line items or the entire plan.

 

That possibility has some in the Legislature bracing to return to Tallahassee to override Scott’s vetoes, a move that requires two-thirds of the House and Senate to agree. At least some Democrats would have to join with Republican leaders to do that.

 

“My advice to you is not to take any summer vacations out of the country,” House Minority Leader Janet Cruz, D-Tampa, told Democrats this week.  This year’s session marks the second time in three years that the Legislature has needed extra days to write a budget.

 

FPA ADVOCACY PLAN

 

There is no shortage of issues that need the attention of the FPA.  This includes monitoring and fighting for and against issues that could benefit or harm the profession and or business of pharmacy.  Ideally in a perfect world with ample resources we have a desire to take on all things that need to be addressed however the reality of limited resources mean that there needs to be a priority list created.  While political giving to the Florida Pharmacist Political Committee has been healthy over the past year or so, we are still competing in the policy arena with groups that are significantly more engaged in supporting candidates and campaigns.  With that comes the need to create a task list of issues to focus our efforts on.  The generation of that advocacy plan began in August of 2016.

 

On August 5th the FPA Governmental Affairs Committee (GAC) met on August 5th to review issues discussed during the annual convention and also assess other health care policy that is still considered active.  The Committee elected to create three categories of issues that determine where our efforts should concentrate.  Those priorities include proactively advocating for legislation, advocate for issues if there is an opportunity and finally monitoring of emerging pharmacy related health care policy.  Consider the following chart:

 

Advocate for Legislation – High Priority

 

  • Access to Pharmacist Services Act - Advocate for legislation that supports proposed changes to the pharmacy practice act.  This is a continued advocacy effort from the 2015-2016 legislative session. Bill sponsors are to be identified.  This is a high priority issue.
  • MAC Pricing Enforcement – Advocacy includes implementing laws or rules that require PBMs to comply with updating MAC pricing.
  •  PBM Transparency – This includes legislation that seeks to provide regulatory control of PBMs within the Florida Board of Pharmacy and Florida Insurance Commissioner.  Such proposal needs to take into consideration the issues surrounding the closure of pharmacy networks.
  • Federal Provider Status – Continue to support efforts to have pharmacists recognized as health care providers in the Social Security act.

 

Advocate for if opportunity presented

 

  • Emergency Refill Services – FPA should work to make changes allowing pharmacists to provide up to a 30 day supply of life sustaining maintenance medications when the prescriber is unable to be contacted.
  • Dispensing of Oral Contraceptives – FPA should support legislation that allows for the pharmacist to initiate dispensing of oral contraceptive drugs.
  • Consultant Pharmacist Review in ALF’s, Surgery Centers, etc – FPA should support this legislation if filed as a bill.
  •  Population Based Board of Pharmacy Appointments – FPA should support legislation that is filed that requires the Governor to make Board of Pharmacy appointments based upon population density of stakeholders.

                       

Monitor

 

  • Equality of Pharmacists – FPA will monitor and object to legislation that may treat PharmD pharmacists differently than pharmacists who hold the Bachelor of Science degrees.  The monitoring should include a review of the proposed legislation that may have an impact on reimbursement or payment of services.  The exception would be for the services provided by the different types of pharmacist licenses such as nuclear, consultant, or immunization registrations.
  • Medical Marijuana Laws – The FPA will continue to monitor and provide input on efforts to change or implement Florida laws and rules on Medical Marijuana.

 

The above plan formulated by the GAC was presented to the FPA Board of Directors at their August 2016 meeting and was approved.  This sets in motion the work of our policy team.  During the legislative session the GAC met via web conference call on a weekly basis to receive status reports on the work plan approved by the Board.  Included in this report is the outcome of this year’s session.

 

BILLS THAT PASSED

 

PHARMACIST ADMINISTRATION OF LONG-ACTING ANTIPSYCHOTIC MEDICATION

 

Senator Grimsley and Representative Pigman both filed bills dealing with Nursing Regulation.  Senator Grimsley filed SB 328 Relating to Regulation of Nursing and Representative Pigman filed HB 543 Relating to Regulation of Health Care Practitioners.  House bill 543 ultimately passed and is on its way to the Governor’s desk. There was a last minute amendment that would have allowed Pharmacists to administer Antipsychotic medication but with the requirement that pharmacists take 8 hours of training exclusively from a statewide association of physicians offering AMA PRA Category I CME.  We successfully amended that language so that the Florida physician associations and Florida pharmacy associations must work together to provide the content and training.  This was a significant win for the FPA as it is a foot in the door to stop the creation of restricted sole source provider of continuing education for pharmacists.  Other provisions in HB543 include the following:

 

  • Removes the requirement that ARNP protocols be submitted to the Board for review.  Protocols with physicians must now be maintained at the site or sites where the ARNP practices.
  • Pharmacists may administer long-acting antipsychotic medications approved by the FDA by injection to a patient under the following conditions:

o   Authorized by protocol with Florida licensed physicians and osteopathic physicians.

o   Pharmacist practices at a facility that accommodates privacy for nondeltoid injections and conforms with state rules and regulations regarding the appropriate and safe disposal of medication and medical waste

o   Has completed the CE course provided by a collaborative of state pharmacy and physician associations.  This CE could be live or offered via distance learning.  The course content must include content related to the safe and effective administration of behavioral health and antipsychotic medications by injection.  This should include but not be limited to potential allergic reactions to these medications.

o   Has received a prescription from a physician for each injection administered

 

MEDICATION SYNCHRONIZATION

 

Medication synchronization is a service provided by pharmacists that coordinates prescription refills such that they can be picked up from a pharmacy at the same time rather than staggered throughout a given month.  This service has shown where patients become more compliant with their prescription medications.  On occasion a consumer may attempt to self synchronize their meds by skipping doses which negatively affects their adherence to therapy.  Also pharmacists that attempt to coordinate prescription refills accomplish this through early or short refills to align prescription medications.  Partial dispensing of prescription medications may come at an increased cost to consumers by their health plans.  SB800 passed both the House and Senate and is headed to the Governor’s desk.  This bill allows for certain medication refills to be synchronized or aligned once annually at in-network pharmacies with a few exceptions.  It prohibits a partial fill to align refill dates for the following prescription drugs:

 

  • Controlled substances;
  • Prescription drugs dispensed in unbreakable packages; and
  • Multi-dose units of prescription drugs.

 

Additionally, the bill requires a health insurer or HMO to pay the pharmacy a full dispensing fee for each prescription dispensed, unless otherwise agreed to at the time an insured or subscriber requests medication synchronization. Health insurers and HMOs may have to update their contracts with pharmacies or PBMs for how they reimburse for partial prescription refills to allow the pharmacy to get a full dispensing fee when the partial refill is for medication synchronization.

 

REPORTING OF CONTROLLED SUBSTANCE DISPENSING TO PDMP

 

In House bill 557 Florida Statutes 893.055 was changed to require the reporting of dispensed controlled substances to the prescription drug monitoring program.  Current law requires the reporting to be done within 7 days of dispensing.  This change will require the reporting of data by the next business day and must be done exclusively by the electronic means approved by the Department of Health.  Other forms of reporting such as by disk or by US Mail are no longer allowed.  This bill passed by the House and Senate also grants employees of the VA system to access the Florida PDMP database.

 

REPORTING OF IMPAIRED PRACTITIONER

 

Current Florida laws under 456.072 create grounds for discipline for failing to report violations by other practitioners to the Department of Health.  Added to this law in House bill 229 was additional language that provides an option to report impaired practitioners to a consultant operating an impaired practitioner program under F.S. 456.076 rather than to the Department of Health.  Similar language was added to the pharmacy practice act under F.S. 465.016.  This was likely done to create an option for an impaired practitioner to get help instead of immediately going to discipline.  Practitioners who are not successful in working with the impaired practitioner consultant may be referred to the Department for discipline.  This legislation passed both the House and Senate and is headed to the Governor’s desk.

 

PRESCRIPTION DRUG PRICE TRANSPARENCY

 

Current Florida law requires the state to list the 100 most frequently prescribed drugs on the www.MyFloridaRx.com web site although there are currently about 150 drugs listed there.  Included in this web site are the usual and customary retail prices of those drugs.  This web site is a joint effort between the Florida Office of the Attorney General and the AHCA. The web site has the ability to identify the usual and customary prices of these drugs by pharmacy in a particular market area.  This pricing information is provided to the Agency for Health Care Administration by pharmacies transmitting their usual and customary price for Medicaid prescription drug claims. Current law also requires the prices in that web site to be updated on a quarterly basis though the FPA understands that the updates are done monthly.  House bill 589 approved by the Florida legislature and signed into law by Governor Scott increases the number of drugs that must be on this list from 100 to 300 and also requires the list to be updated monthly.

 

BILLS THAT DID NOT PASS

 

NETWORK ACCESS

 

Earlier in 2016 the FPA members had been affected by Medicaid managed care plans that began excluding pharmacies from their networks.  On numerous occasions EVP Michael Jackson met with the Agency for Health Care Administration (AHCA) raising concerns over this issue and how it would harm patient access.  This year, FPA had support for legislation that would have required the managed care plans to include any pharmacy in their networks that met credentialing and quality standards set by AHCA and also agreed to the same price reimbursements as current network contracts provided.

 

HB 625 filed by Representative Fitzenhagen and SB 670 sponsored by Senator Bean was designed to help correct the problems with restricted networks in the Medicaid program.  HB 625 unfortunately was not heard in the house due to strong opposition to "any willing provider" concepts.  The House leadership opposes this philosophy on the grounds that it completely undermines the foundation of Managed Care.  However we made significant progress in the Senate.  SB 670 passed its first two of three committees with high favorability.

 

FPA members Marianne Glorius and James Wright as well as Michael Jackson testified to the crisis created in the industry by the arbitrary time and distance standards adopted by AHCA.  Many senators expressed serious concern over their local pharmacies inability to provide services to their constituents.  AHCA was grilled over these standards in committee and we believe as a result made significant changes to these standards through their contract negotiations with the plans.  On March 9, they removed the rural standard of 60 minutes or 45 miles and an urban standard of 45 minutes or 30 miles and adopted standards that cut time and distance down to 30 minutes or 20 miles.   AHCA also gave assurances to us and to the Senate to cut these in half again in June to 15 minutes or 10 miles for network adequacy provisions.  These changes are a significant move in the right direction with assurances that even this lower standard will be reviewed later in the summer for impact.  See AHCA's announcement below.


 

While HB625 and SB670 will not get to the governor’s desk this session, we are pleased that AHCA is listening to our concerns and taking action.  Much of this action again came from the filing of these bills.

 

REVISIONS TO FLORIDA’S MEDICAL MARIJUANA LAWS

 

The use of medical marijuana has become available in Florida however it remains illegal under federal law.  In 2014 Florida statutes 381.986 was created that allowed for compassionate use of low tetrahydrocannabinol and medical cannabis.  This allowed for the very limited use of medical marijuana by a restricted supplier network created by the Office of Compassionate Use (OCU).  This office is housed within the Florida Department of Health and is charged with the regulation of our state’s medical marijuana production, security patient verification and dispensing.  This law was amended during the 2016 legislative session that expanded slightly the conditions that medical marijuana could be used for.  During the fall 2016 general election amendment 2 was placed onto the ballot that expanded the use of marijuana to the following conditions:

  • cancer
  • epilepsy
  • glaucoma
  • HIV
  • AIDS
  • post-traumatic stress disorder (PTSD)
  •  amyotrophic lateral sclerosis (ALS)
  • Crohn's disease
  • Parkinson's disease
  • multiple sclerosis

Amendment 2 was also designed to allow licensed physicians to certify patients for medical marijuana use after diagnosing them with some other debilitating medical conditions of the same kind or class as those diseases mentioned above.  With the passage of amendment 2 by over 71% of Florida voters the measure was adopted as a change to the Florida constitution.  This gave the Florida legislature an opportunity to make adjustments to Florida law to align it with constitutional language.  Several bills were filed during the 2017 session for the purpose of giving the state legislature an opportunity to create the standards for medical marijuana rulemaking but none of these bills passed this session.  There will likely be a special session as the passage of amendment 2 requires the Department of Health to have rules in place by July 3, 2017.  Amendment 2 as does the Department of Health rules and Florida statutes 381.986 do not have a role for pharmacists or pharmacies in medical marijuana dispensing.

 

RESTRICTION ON MANDATORY MAIL ORDER SERVICES

 

HB1185 sponsored by Representative Richardson and SB1336 sponsored by Senator Garcia were filed to provide consumers the freedom to restrict the ability for health insurance policies to require mandatory mail order for prescription drugs used to treat chronic illnesses.  These bills also were written to level the market place by making the copay the same whether the patient chooses a community pharmacy or mail order pharmacy.  It was clear early in the session that these bills were not going to be heard in any committee on the House or Senate side.  The House especially was very resistant to interfere with managed care contracts within provider networks.


MAC PRICING UPDATES

 

As you know, two years ago we successfully lobbied to obtain support and passage of legislation that would require the PBMs to update their MAC lists every 7 days (F.S. 465.1862).  But because PBMs are unregulated there was no enforcement mechanism to ensure this occurred and no penalty if they defaulted on this duty.  Legislation in both the House and Senate was filed to require the Office of Insurance Regulation (OIR) to audit the PBMs for compliance quarterly.

HB 617 was sponsored by Representative Beshears and SB 580 was filed by Senator Garcia.

HB 617 passed its first of three committees on a favorable vote of 12 Yeas, 0 Nays. 

Senator Garcia’s SB580 passed its first of three committees with 9 Yeas, and 0 Nays.

These bills caused quite a stir among the Insurance industry!  We worked with them and the Governor’s office to change the focus of the legislation to prevent PBM discrimination and to put them under the Florida Unfair Trade and Deceptive Practices Act with significant penalties for not being in compliance.  Unfortunately, these bills and subsequent amendments that we attempted to file on other bills did not pass, but again the debate was heated and we raised this issue as well as the existence of vertical integration in ways we have been unable to do to date.  AHCA has agreed in public that this is a potential problem and will work with us over the summer on potential changes to their contracts to prevent monopolistic behavior.  We have significant support from leadership to fix this in both chambers next session.

 

BAIT AND SWITCH LEGISLATION

 

SB182 by Senator Mayfield and HB95 by Representative Massullo were filed to prohibit individual or group insurance plans from removing a covered prescription drug from their formularies in the middle of a plan year.  These bills also would have stopped an insurer or HMO from reclassifying a drug to a more restrictive tier increasing the out-of-pocket expenses to patients.  There were a few exceptions where this removal would be necessary such as safety notices about the drugs from the FDA or if the manufacturer provided notice to the FDA of the drug being discontinued.  In many cases a patient may select a health plan based upon the type of prescription drug coverage only to find that coverage will change half way through a plan year.  The Senate version of the bill passed al 4 of its committees while HB95 only passed the Health Innovation Subcommittee which means that the bill will not get to the Governor’s desk this year.

 

90 DAY SUPPLY NETWORKS

 

SB 2508 (Appropriation) Relating to Division of State Group Insurance and HB 993 (Magar) Relating to State Employees' Prescription Drug Program contained language that would allow PBMs to set up a new network called a ‘90-Day Supply Network’. We met with Senate committee staff to explain that the language took away patient choice and would cause local pharmacies and pharmacies not associated with a PBM 90-day supply network to be excluded from filling state employee prescriptions for a 90 day prescription period, further eroding independent pharmacy business/revenue. We also met with legislators to let them know that this would be taking away their choice.

 

We were able to get the language removed from SB 2508 in the budget conference process and the House bill (HB 993) died in committee. This was a major win to protect FPA members from once again being shut out of services by pharmacy mail order competitors.

 

LEGISLATIVE APPROVAL FOR MEDICAID STATE PLAN AMENDMENTS

 

An amendment was filed to SB916 late during the 2017 session that would have required the legislature to approve efforts by AHCA to submit or implement state plan amendments or requesting certain waivers or extensions or expansions for existing waivers.  Anytime that the state’s Medicaid manager proposes to change the program a state plan has to be filed with the Center for Medicare and Medicaid services.  The good in this is that AHCA could not proceed on any changes to Medicaid without legislative approval.  The bad is that there could be Medicaid programs in place that are creating significant problems for providers or patients and before AHCA could act on those issues a bill has to pass the House and Senate and be signed by the Governor.  The ugly is such an amendment would have ground to a halt our efforts to continue to work with AHCA to fix the Medicaid network restrictions and other issues that we have brought to the attention of that state agency.  We were successful in working to get that amendment withdrawn.  SB916 was eventually substituted with HB7117 that addressed the Statewide Medicaid Managed Care Program.  As luck would have it HB7117 ultimately did not pass anyway.  This preserves our ability to proactively work with AHCA this summer to fix the pharmacy issues in the Medicaid managed care program.

 

PHARMACIST COLLABORATIVE PRACTICE

 

The majority of states have included in their pharmacy practice acts provisions that allow pharmacists to initiate, modify or discontinue prescription drug therapy under a collaborative agreement or protocol.  Florida for example allows pharmacists to provide immunization on a protocol as well as providing certain narcotic antagonists under a standing order.  SB1180 was filed to clarify that pharmacists can not only provide these services but also order and evaluate clinical testing in settings beyond what is currently restricted in Florida laws.  Pharmacy and medical association groups met continuously at the close of the 2016 legislative session on through the end of this session to find consensus on the language that would enable these services to be provided by pharmacists.  SB1180 was filed by Senator Rodriguez at the request of the FPA however there was no House companion bill and the issue did not move forward.  SB1180 included language that would include consultation with patients regarding certain preparations, health care products, and services, authorizing consultant pharmacists to provide additional services such as initiating, modifying or discontinuing medications when authorized by a medical director or within the context of a patient-specific order or treatment protocol, or at the request of or referral from a patient’s treating health care provider.  This bill would have also authorized qualified pharmacists to provide certain services related to the treatment of influenza within the framework of an established protocol under a supervising physician.  Since there was no House sponsor this bill was not heard and will not go to the Governor for his approval.  There was strong interest though as the merits of the proposal was discussed with members of the House and Senate.  The FPA would like to thank member Dan Buffington in his efforts to bridge the gap of understanding within our medical association colleagues.

 

SUMMARY

 

This has been an active public policy campaign for the 2016-2017 leadership year.  Under the guidance from President Scott Tomerlin the FPA engaged in a number of issues within the legislature, Congress, various state agencies as well as the Board of Pharmacy.  Given the toxic environment we are pleased to report that we have seen a lot of progress and success of our issues.  A number of bad policy decisions were put to bed by our lobbyists with sincere commitment by the members of the Florida House and Senate as well as AHCA leadership to correct problems in the pharmacy services domain.

 

We are also pleased to report on the successful legislative day event at the Florida Capitol on March 14th and 15th.  Well over 400 pharmacists and pharmacy students participated with a number of life saving interventions conducted by our volunteers.  A full report has been published in the April issue of Florida Pharmacy Today available on the Pharmview.com web site.  Our advocacy efforts were also well coordinated with the Florida Independent Pharmacy Network as well as the Florida Society of Health-System Pharmacists.  SPECIAL NOTE: The 2018 legislative session will begin on January 9th and will run for 60 days.  This will contract our advocacy window for next year so work is already begun on the preparation of an advocacy plan.

 

FEDERAL ISSUES

 FPA Advocates visit with former Florida Governor and now Congressman Charlie Crist

Florida is not the only place on the planet where advocacy is necessary.  FPA leadership traveled to Washington DC to visit with members of Congress on several issues including but not limited to DIR fees, closed networks, collaborative practice and PBM transparency.  In particular the discussions on pharmacist provider status are beginning to get traction with members of the 115th Congressional House and Senate signing on as cosponsors.  For the first time we now have a Florida Senator that has agreed to cosponsor the SB109.  SB109 and the House companion HR 592 are designed to recognize pharmacists as health care providers in underserved areas.  The versions of these bills filed during the 114 Congressional session had 296 cosponsors in the House and 51 cosponsors in the Senate.  We are optimistic that these bills should get a hearing in the 115th.

 

 


 

The Florida Pharmacist Political Committee (FPPC) has been hard at work bringing awareness to the importance of supporting political campaigns.  Since July of 2016 the FPPC has raised over $62,000 with 94% of what we spend going directly to political campaigns that are friendly to our issues.  Our support of these campaigns has been helpful in our advocacy efforts and will open doors for future opportunities.  We would like to thank all of our contributing members and especially our major donors including but not limited to Kenneth Jackson, Mark Hobbs, Theresa Tolle and Bill Eley.  President Tomerlin will be extending an invitation for them to participate in a special reception event at the 127th annual meeting and convention.

 

COMPREHENSIVE LIST OF LEGISLATION MONITORED BY FPA
Detailed Information on Bills Available at this Link
 

Sorted by Bill Number

HB 7

Relating to Certificates of Need for Hospitals

Miller (A)

Certificates of Need for Hospitals: Eliminates certificates of need for hospitals; provides licensure requirements. Effective Date: July 1, 2017

 

HB 61

Relating to Emergency Services for an Unintentional Drug Overdose

Lee Jr. (L)

Emergency Services for an Unintentional Drug Overdose: Requires hospital emergency department to develop best practices policy to promote prevention of unintentional drug overdoses; authorizes policy to include certain processes, guidelines, & protocols. Effective Date: July 1, 2017

 

HB 95

Relating to Consumer Protection from Nonmedical Changes to Prescription Drug Formularies

Massullo, Jr.

Consumer Protection from Nonmedical Changes to Prescription Drug Formularies: Provides that changes to prescription drug formularies during health insurance policy or HMO contract year do not apply to state group insurance program; limits changes to health insurance policy prescription drug formulary during policy year; requires small employer carriers to provide continuity of care with respect to prescription drug coverage. Effective Date: January 1, 2018

 

SB 102

Relating to Payment of Health Care Claims

Steube

Payment of Health Care Claims; Prohibiting a health insurer from retroactively denying a claim under specified circumstances, etc. Effective Date: 7/1/2017

 

SB 114

Relating to Cosmetic Product Registration

Brandes

Cosmetic Product Registration; Deleting the requirement that a person who manufactures, packages, repackages, labels, or relabels a cosmetic in this state register such cosmetic biennially with the Department of Business and Professional Regulation, etc. APPROPRIATION: $222,564.00 Effective Date: 7/1/2017

 

HB 129

Relating to Health Care Practitioner Regulation

Plasencia

Health Care Practitioner Regulation: Revises definition of term "medical director" to include certain physician assistants & advanced registered nurse practitioners; authorizes physician assistants & advanced registered nurse practitioners to sign, certify, stamp, verify, or endorse document that requires signature, certification, stamp, verification, or endorsement of physician; provides exception. Effective Date: July 1, 2017

 

HB 145

Relating to Recovery Care Services

Fitzenhagen

Recovery Care Services: Includes recovery care centers as facilities licensed under ch. 395, F.S.; provides admission criteria for recovery care center; requires emergency care, transfer, & discharge protocols; authorizes AHCA to establish separate standards for recovery care centers for care & treatment of patients; directs agency to enforce special-occupancy provisions of Florida Building Code applicable to recovery care centers; provides applicability of Health Care Licensing Procedures Act; exempts recovery care centers from specified minimum licensure requirements. Effective Date: July 1, 2017

 

SB 150

Relating to Controlled Substances

Steube

Controlled Substances; Providing that certain emergency responders and crime laboratory personnel may possess, store, and administer emergency opioid antagonists; adding certain synthetic opioid substitute compounds to the list of Schedule I controlled substances; revising the substances that constitute the offenses of trafficking and capital trafficking in, and capital importation of, hydrocodone and oxycodone; revising the mitigating circumstances under which a departure from the lowest permissible sentence is reasonably justified, etc. Effective Date: 10/1/2017

 

HB 161

Relating to Direct Primary Care Agreements

Burgess

Direct Primary Care Agreements: Specifies that direct primary care agreement does not constitute insurance & provides requirements for such agreement. Effective Date: July 1, 2017

 

SB 182

Relating to Consumer Protection from Nonmedical Changes to Prescription Drug Formularies

Mayfield

Consumer Protection from Nonmedical Changes to Prescription Drug Formularies; Limiting changes to a health insurance policy prescription drug formulary during a policy year; requiring small employer carriers to provide continuity of care for certain patients with respect to prescription drug coverage, etc. Effective Date: 1/1/2018

 

HB 183

Relating to Controlled Substances

Jacobs

Controlled Substances: Schedules Mitragynine & 7-Hydroxymitragynine, constituents of Kratom, in schedule of controlled substances; provides exception from scheduling for drug product approved by USDA which contains Mitragynine or 7-Hydroxymitragynine; reenacts related provisions. Effective Date: October 1, 2017

 

HB 211

Relating to Cosmetic Product Registration

Latvala (C)

Cosmetic Product Registration: Deletes requirement that person who manufactures, packages, repackages, labels, or relabels cosmetic in this state register such cosmetic biennially with DBPR; revises annual fee for cosmetic manufacturing permit. Effective Date: July 1, 2017

 

SB 222

Relating to Length of Time a Patient May Stay at an Ambulatory Surgical Center or Mobile Surgical Center

Steube

Length of Time a Patient May Stay at an Ambulatory Surgical Center or Mobile Surgical Center; Revising the definition of ambulatory surgical center and mobile surgical facility, etc. Effective Date: 7/1/2017

 

SB 228

Relating to Physician Orders for Life-sustaining Treatment

Brandes

Physician Orders for Life-sustaining Treatment; Establishing the Physician Orders for Life-Sustaining Treatment (POLST) Program within the Department of Health; providing limited immunity for legal representatives and specified health care providers acting in good faith in reliance on POLST forms; authorizing emergency medical transportation providers to withhold or withdraw cardiopulmonary resuscitation or other medical interventions if presented with POLST forms that contain an order not to resuscitate, etc. Effective Date: 7/1/2017

 

HB 229

Relating to Health Care Practitioner Licensure

Byrd

Health Care Practitioner Licensure: Revises provisions related to impaired practitioner programs; requires DOH to establish terms & conditions of program by contract; provides contract terms; requires DOH to refer practitioners to consultants; revises grounds for refusing to issue or renew license, certificate, or registration in health care profession. Effective Date: upon becoming a law

 

SB 240

Relating to Direct Primary Care

Lee (T)

Direct Primary Care; Requiring the Agency for Health Care Administration to provide specified financial assistance to certain Medicaid recipients; authorizing primary care providers or their agents to enter into direct primary care agreements for providing primary care services; providing construction and applicability of the Florida Insurance Code as to direct primary care agreements, etc. Effective Date: 7/1/2017

 

HB 249

Relating to Drug Overdoses

Rommel

Drug Overdoses: Permitting certain entities to report controlled substance overdoses to the Department of Health; providing immunity for persons who make reports in good faith; requiring a hospital with an emergency department to develop a best practices policy to promote the prevention of unintentional drug overdoses, etc. Effective Date: October 1, 2017

 

SB 262

Relating to Health Insurance

Steube

Health Insurance; Deleting a provision that provides that health maintenance organizations are not vicariously liable for certain medical negligence except under certain circumstances; authorizing specified persons to bring a civil action against a health maintenance organization for certain violations; specifying a health maintenance organization’s liability for such violations, etc. Effective Date: 10/1/2017

 

SB 326

Relating to Alternative Treatment Options for Veterans

Steube

Alternative Treatment Options for Veterans; Providing definitions; authorizing the Department of Veterans’ Affairs to contract with certain individuals and entities to provide alternative treatment options for certain veterans; requiring direction and supervision by certain licensed providers; authorizing the department to adopt rules, etc. Effective Date: 7/1/2017

 

SB 328

Relating to Regulation of Nursing

Grimsley

Regulation of Nursing; Removing an obsolete qualification no longer sufficient to satisfy certain certification requirements; requiring certain continuing education courses to be approved by the Board of Nursing; removing a requirement that certain nursing program graduates complete a specific preparatory course; providing that accredited and nonaccredited nursing education programs must disclose probationary status, etc. Effective Date: Except as otherwise expressly provided in this act, this act shall take effect July 1, 2017

 

SB 348

Relating to Termination of Pregnancy

Steube

Termination of Pregnancy; Citing this act as the “Florida Pain-Capable Unborn Child Protection Act”; prohibiting the attempted or actual performance or induction of an abortion in certain circumstances; requiring a physician to make a specified determination before performing or inducing or attempting to perform or induce an abortion; requiring a physician to use an abortion method that provides the best opportunity for the unborn child to survive the abortion in specified circumstances, etc. Effective Date: 7/1/2017

 

HB 359

Relating to Insurance

Santiago

Insurance: Removes provision repealing exemption from emergency assessment for medical malpractice insurance premiums; revises definition of asset; revises requirements for medical malpractice insurers to provide rate filing; permits insurers to charge insufficient funds fees; provides conditions under which an electronically delivered document meets formatting requirements; authorizes insurer to exclude certain individuals from private passenger motor vehicle insurance coverage under specified circumstances; provides exceptions. Effective Date: upon becoming a law

 

HB 375

Relating to Patient Safety Culture Surveys

Grant (M)

Patient Safety Culture Surveys: Requires AHCA to develop surveys to assess patient safety culture in certain health care facilities; requires submission of patient safety culture survey data as condition of licensure; provides appropriation.APPROPRIATION: $352,919.00 Effective Date: July 1, 2017

 

SB 394

Relating to Advanced Registered Nurse Practitioners

Steube

Advanced Registered Nurse Practitioners; Providing that certified registered nurse anesthetists, to the extent authorized by a protocol established in collaboration with the medical staff of a facility in which the anesthetic service is performed, may determine, in collaboration with the responsible physician, the appropriate type of anesthesia, etc. Effective Date: 7/1/2017

 

SB 406

Relating to Compassionate Use of Low-THC Cannabis and Marijuana

Bradley

Compassionate Use of Low-THC Cannabis and Marijuana; Authorizing physicians to issue physician certifications to specified patients who meet certain conditions; requiring written consent of a parent or legal guardian for the treatment of minors; requiring that certain physicians annually reexamine and reassess patients and update patient information in the compassionate use registry; requiring the Department of Health to register caregivers meeting certain requirements on the compassionate use registry; Effective Date: Upon becoming a law

 

SB 424

Relating to Controlled Substances

Rouson

Controlled Substances; Scheduling Mitragynine and 7-Hydroxymitragynine, constituents of Kratom, in a schedule of controlled substances; providing an exception from scheduling for any drug product approved by the United States Food and Drug Administration which contains Mitragynine or 7-Hydroxymitragynine, etc. Effective Date: 10/1/2017

 

SB 430

Relating to Discount Plan Organizations

Bean

Discount Plan Organizations; Requiring third-party entities that contract with providers to administer or provide platforms for discount plans to be licensed as discount plan organizations; specifying periodic charge reimbursement and other requirements for discount plan organizations following membership cancellation requests; requiring discount plan organizations and marketers to provide specified disclosures to prospective members before enrollment, etc. Effective Date: Upon becoming a law

 

HB 449

Relating to Health Insurance

Renner

Health Insurance: Creates Patient Savings Act; requires health insurers to provide shared savings incentive program in which insureds receive cash payment as incentive to save on certain nonemergency health care services; provides appropriation.APPROPRIATION: $75,000.00 Effective Date: upon becoming a law

 

SB 452

Relating to Health Insurance Coverage for Enteral Formulas

Powell

Health Insurance Coverage for Enteral Formulas; Deleting the annual coverage limit and age limit for coverage of certain food products for the treatment of certain diseases, etc. Effective Date: 7/1/2017

 

SB 454

Relating to Regulation of Insurance Companies

Brandes

Regulation of Insurance Companies; Deleting a future repeal of an exemption of medical malpractice insurance premiums from certain emergency assessments by the State Board of Administration relating to the Florida Hurricane Catastrophe Fund; revising the allowable assets of insurers relating to specified levied assessments; providing that an electronically delivered document in an insurance policy meets formatting requirements for printed documents under certain conditions, etc. Effective Date: Upon becoming a law

 

HB 477

Relating to Controlled Substances

Boyd

Controlled Substances: Provides that certain crime laboratory personnel may possess, store, & administer emergency opioid antagonists; provides that unlawful distribution of specified controlled substances & analogs or mixtures thereof which proximately cause death is murder; adds certain synthetic opioid substitute compounds to Schedule I; prohibits possession of more than 10 grams of specified substances; revises substances that constitute certain trafficking offenses; creates certain trafficking offenses; provides specified minimum terms of imprisonment & fines based on quantity involved in for certain offenses. Effective Date: October 1, 2017

 

SB 502

Relating to Florida Statutes

Benacquisto

Florida Statutes; Deleting provisions that have expired, have become obsolete, have had their effect, have served their purpose, or have been impliedly repealed or superseded, etc. Effective Date: Except as otherwise provided by this act, this act shall take effect on the 60th day after adjournment sine die of the session of the Legislature in which enacted

 

SB 504

Relating to Florida Statutes

Benacquisto

Florida Statutes; Deleting provisions which have become inoperative by noncurrent repeal or expiration and, pursuant to s. 11.242(5)(b) and (i), F.S., may be omitted from the 2017 Florida Statutes only through a reviser’s bill duly enacted by the Legislature, etc. Effective Date: On the 60th day after adjournment sine die of the session of the Legislature in which enacted

 

HB 505

Relating to Florida Comprehensive Drug Abuse Prevention and Control Act

Trumbull

Florida Comprehensive Drug Abuse Prevention and Control Act: Specifies that ioflupane I 123 is not included in Schedule II; provides that reference to ch. 893, F.S., or to any section or portion thereof, includes all subsequent amendments. Effective Date: July 1, 2017

 

SB 526

Relating to Mammography Reports

Steube

Mammography Reports; Requiring that mammography reports include a specified notice regarding breast density, etc. Effective Date: 10/1/2017

 

SB 528

Relating to Health Insurance

Steube

Health Insurance; Creating the "Patient Savings Act"; providing a civil remedy for a health insurer who violates the Patient Savings Act; requiring an insurer to provide good faith estimates of costs for certain health care services upon request by an insured, etc. Effective Date: Upon becoming a law

 

SB 530

Relating to Health Insurer Authorization

Steube

Health Insurer Authorization; Requiring health insurers and pharmacy benefits managers on behalf of health insurers to provide certain information relating to prior authorization in a specified manner; requiring health insurers to publish on their websites and provide in writing to insureds a specified procedure to obtain protocol exceptions, etc. Effective Date: 7/1/2017

 

HB 543

Relating to Regulation of Health Care Practitioners

Pigman

Regulation of Health Care Practitioners: Requires DOH to follow federal requirements in implementation of specified program; exempting certain pain-management clinics from specified requirements and rules; requires advanced registered nurse practitioner supervisory protocol to be maintained at specified location; revises provisions relating to nursing education programs; requires pharmacy or outsourcing facility to obtain permit before engaging in specified activities relating to sterile compounding; revises provisions relating to orthotics & prosthetics, massage therapy, physical therapy assistants, marriage & family therapy, & master social workers. Effective Date: July 1, 2017

 

HB 557

Relating to Controlled Substance Prescribing

Duran

Controlled Substance Prescribing: Defines "acute pain"; limits prescribing of opioids for acute pain in certain circumstances; revises requirements for reporting dispensing of controlled substances; limits exception to reporting requirements for certain facilities dispensing controlled substances; authorizes certain employees of U.S. Department of Veterans Affairs to access certain information in program's database; specifies when revised reporting requirement takes effect. Effective Date: July 1, 2017

 

SB 558

Relating to Emergency Services for an Unintentional Drug Overdose

Passidomo

Emergency Services for an Unintentional Drug Overdose; Requiring a hospital providing emergency services to a person suffering from an unintentional drug overdose to provide certain services and information; providing conditions for transfer of a patient to a licensed detoxification or addictions receiving facility, etc. Effective Date: 7/1/2017

 

HB 579

Relating to Payment of Health Care Claims

Hager

Payment of Health Care Claims: Prohibits health insurers & health maintenance organizations from retroactively denying claim under specified circumstances; provides applicability; exempts certain Medicaid managed care plans. Effective Date: July 1, 2017

 

SB 580

Relating to Insurance Administrators

Garcia

Insurance Administrators; Requiring the Office of Insurance Regulation to conduct quarterly audits, for a certain purpose, of pharmacy benefits managers that hold certificates of authority to act as administrators; adding violations of certain provisions of the Florida Pharmacy Act as grounds for the office’s suspension or revocation of an administrator’s certificate of authority or imposition of a fine, respectively, etc. Effective Date: Upon becoming a law

 

SB 588

Relating to Drug Overdoses

Passidomo

Drug Overdoses; Requiring a hospital with an emergency department to develop a best practices policy to promote the prevention of unintentional drug overdoses; authorizing certain entities to report controlled substance overdoses to the Department of Health; providing immunity for persons who make reports in good faith; providing that a failure to report is not a basis for licensure discipline, etc. Effective Date: 10/1/2017

 

HB 589

Relating to Prescription Drug Price Transparency

Yarborough

Prescription Drug Price Transparency: Requires AHCA to collect data on retail prices charged by pharmacies for 300 most frequently prescribed medicines; requires agency to update website monthly. Effective Date: upon becoming a law

 

SB 614

Relating to Medical Marijuana

Brandes

Medical Marijuana; Creating the "Florida Medical Marijuana Act"; authorizing a qualifying patient or his or her caregiver to purchase, acquire, and possess up to the allowed amount of marijuana, medical marijuana products, and associated paraphernalia for a qualifying patient’s medical use; providing that a physician must certify, on a specified form, that a patient is suffering from a debilitating medical condition and that the benefits to the patient of using marijuana outweigh the potential health risks before a patient may register with the department and obtain a registry identification card; requiring that the department create a secure, online, electronic medical marijuana patient registry containing a file containing specified information for each qualifying patient, caregiver, and certifying physician, etc. Effective Date: Upon becoming a law

 

HB 617

Relating to Insurance Administrators

Beshears

Insurance Administrators: Redefines "administrator" to include pharmacy benefits manager; requires OIR to conduct quarterly audits of pharmacy benefits managers; adds certain violations of Florida Pharmacy Act as grounds for office's suspension or revocation of administrator's certificate of authority or imposition of fine; prohibits office from penalizing pharmacy benefits manager within specified timeframe & under certain conditions. Effective Date: upon becoming a law

 

HB 619

Relating to Consolidation of Medicaid Waiver Programs

Pigman

Consolidation of Medicaid Waiver Programs: Authorizes AHCA to consolidate specified Medicaid waiver programs; provides for transition of certain home & community-based services waiver participants into long-term care managed care programs. Effective Date: July 1, 2017

 

HB 625

Relating to Managed Care Plan Provider Networks

Fitzenhagen

Managed Care Plan Provider Networks: Prohibits managed care plan from excluding pharmacy that meets credentialing requirements & standards established by AHCA & that accepts terms of plan; requires managed care plan to offer same rate of reimbursement to all pharmacies in plan network.Effective Date: July 1, 2017

 

SB 634

Relating to Involuntary Examinations Under the Baker Act

Campbell

Involuntary Examinations Under the Baker Act; Authorizing physician assistants and advanced registered nurse practitioners to execute a certificate under certain conditions stating that he or she has examined a person and finds the person appears to meet the criteria for involuntary examination, etc. Effective Date: 7/1/2017

 

HB 645

Relating to Involuntary Examinations Under the Baker Act

Lee Jr. (L)

Involuntary Examinations Under the Baker Act: Authorizes physician assistants & advanced registered nurse practitioners to execute certificate under certain conditions. Effective Date: July 1, 2017

 

SB 670

Relating to Managed Care Plan

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