Legislative Articles and Issues2013 Florida Legislative Session
May 7, 2013
Dear Physicians - The 2013 legislative session concluded on Friday, May 3, 2013. Of the nearly 1,850 bills filed, only 286 of them passed. Below are the highlights of some of our key legislative issues. DCMA key contact physicians, leadership and staff played an important role meeting with and/or contacting legislators to educate them on our issues. A big thank you to FMA leadership, legislative staff and lobbyists for all their hard work. Patricia
KEY BILLS THAT PASSED
MEDICAL LIABILITY REFORM (Supported)
SB 1792 (Judiciary), sponsored by Senator Lee and Representative Gaetz, contains three important provisions designed to help improve Florida’s medical liability climate for Florida physicians.
- Ensure a Physician’s Constitutional Right to Counsel
A recent Florida Supreme Court decision has the effect of limiting and even prohibiting non-defendant physicians from speaking to their attorney about non-privileged information. The bill ensures that a health care practitioner has the right to consult with an attorney for the purposes of obtaining legal services if the practitioner is scheduled for a deposition, is called as a witness or receives formal or informal discovery requests.
- Give Parties Equal Access to Medical Fact Witnesses
Florida law prohibits a nonparty physician from disclosing a malpractice plaintiff’s medical history and condition to a defendant in a medical malpractice case without the plaintiff’s consent. The bill addresses this unfairness by permitting prospective defendants or their counsel, after receiving a claimant’s notice of intent to initiate a medical malpractice lawsuit, to interview the claimant’s treating health care providers without the presence of the claimant or the claimant’s attorney after providing notice. The bill requires 15 days' notice to the plaintiff during the presuit process of such interviews and requires the plaintiff to set the interview time, date and location. After the suit is filed, the bill allows the defendant to interview the treating providers without notice to or the presence of the plaintiff or the plaintiff’s attorney.
- Require Fairness in the Use of Medical Experts
Florida law does not require that an expert witness be of a same or similar specialty as the defendant physician. What constitutes a “similar” specialty is undefined and has led to situations where physicians in one specialty have been allowed to testify against a physician in an entirely different specialty. The bill corrects this problem by restricting the categories of experts who are qualified to testify against health care provider specialists by permitting only those providers in the same specialty as the provider against whom the testimony is offered.
Effective July 2013
- CAT FUND MALPRACTICE ASSESSMENT EXEMPTION (Supported)
SB 468 by Senator Hukill and Representative Boyd, and SB 1770 (Banking & Insurance Committee), provide a 3-year extension of the medical malpractice insurance exemption from assessments levied by the Florida Hurricane Catastrophe Fund (CAT Fund). Effective July 2013.
EPINEPHRINE AUTO-INJECTORS / SCHOOLS (Supported)
SB 284, by Senator Negron and Representative LaRosa, gives private and public schools the authority to purchase and store epinephrine auto-injectors, also known as “epi-pens,” on school grounds. The legislation requires schools that possess such auto-injectors to adopt a protocol developed by a licensed physician for the purpose of training school personnel to administer the device in the event of an allergic reaction. Effective July 2013.
TEXTING WHILE DRIVING (Supported)
SB 52 by Senator Detert and Representative Holder, provides penalties for texting while driving. First-time violators would be subject to a $30 fine plus court costs. The offense is classified as a secondary non-moving violation, which means drivers could only be charged if they are stopped for another reason. The bill was amended to allow law enforcement officers to access a driver’s cell phone records only in cases where accidents caused a death or injury. Effective October 2013.
PHYSICIAN DISPENSING/WORKERS COMP (Supported)
SB 662 by Senator Hays and Representative Hudson, revises provisions relating to reimbursement for prescription medications under the Workers’ Compensation Law. The bill is a negotiated compromise between employer/business interests, dispensing physicians and drug repackagers. Importantly, the bill will not impede or prohibit physicians from dispensing medication to workers’ comp patients. It provides that the reimbursement rate for repackaged or relabeled drugs dispensed by a dispensing practitioner will be capped at 112.5 percent of the average wholesale price (AWP) plus $8.00 for the dispensing fee. It specifies how the AWP is to be calculated. The bill provides an exception to the reimbursement schedule if the employer or carrier directly contracts with a provider seeking reimbursement at a lower rate. In addition, it prohibits a dispensing practitioner from possessing such medications unless payment has been made to the supplying distributor or repackager within 60 days of the practitioner taking possession of the medication. Effective July 2013.
HB 239 by Representative Caldwell and Senator Richter, expands optometric scope of practice by authorizing optometrists to prescribe oral medications under specified conditions. In order to obtain this authority, an optometrist must undertake a 20-hour course and an examination on general and ocular pharmaceutical agents. The bill establishes a statutory formulary of 14 different oral pharmaceutical agents in four categories: analgesics; antibiotics; antivirals; and anti-glaucoma agents. Analgesics may not be prescribed for more than 72 hours without consultation by an ophthalmologist. Anti-glaucoma agents may not be prescribed for more than 72 hours. Schedule III, IV and V controlled substances may not be prescribed except for agents on the formulary for the relief of pain due to ocular conditions. Controlled substances may not be prescribed for the treatment of chronic non-malignant pain. The bill defines “surgery” and prohibits optometrists from performing surgery. The final bill is a compromise supported by the Florida Optometric Association and the Florida Society for Ophthalmology. Effective July 2013. Chapter No. 213-26, Laws of Florida.
DAUBERT/SCIENTIFIC TESTIMONY (Supported)
HB 7015 (Judiciary Committee) changes the legal standard under which courts consider whether expert testimony will be admitted in a particular case. Previously, Florida and many other states used the “Frye” standard for determining admissibility, which considered whether the testimony was “generally accepted within the scientific community”. Federal courts and some states have moved to a stricter standard known as “Daubert” for determining admissibility. The “Daubert” standard requires a court to determine if: the testimony is based on sufficient facts and data; the testimony is the product of reliable principles and methods; and the witness has applied the principles and methods reliably to the facts of the case. HB 7015 rejects the old “Frye” standard and adopts the “Daubert” standard for use in Florida courts. Effective July 2013.
HB 365 by Representative Hudson and Senator Grimsley, establishes requirements and conditions under which pharmacists may make substitutions of a prescribed biologic drug. A biosimilar is a highly similar version of a biologic product, but it is not an exact copy. In 2010 Congress passed a law authorizing FDA to approve biosimilars. The FDA may designate a biosimilar as interchangeable with a reference biologic drug. HB 365provides that a pharmacist may make a substitution of a biosimilar for a prescribed biological product if: the FDA has been licensed and determined the biosimilar to be “interchangeable” for the prescribed biologic product; the prescribing provider does not express a preference against substitution; the pharmacist notifies the patient and the patient consents; and the pharmacists retains a record of the substitution for at least 2 years. A provision that would have required pharmacists to notify the prescribing provider within 5 days of any substitution was removed from the bill prior to final passage. Effective July 2013.
CANCER DRUG PARITY/PDMP Funding (Supported)
HB 1159 by Representative O’Toole and Senator Hays began as a bill creating an exception to CON laws for skilled nursing facilities within specified areas of the state. It was subsequently amended in the final days of session to only streamline the CON review process for such facilities. In the final hours of the legislative session the bill was amended to incorporate several issues from other bills. First, it was amended to incorporate provisions of SB 422 by Senator Benacquisto and HB 301 by Representative Mayfield. The provisions create the “Cancer Treatment Fairness Act” to require certain individual and group health insurance policies or HMO contracts that provide coverage for cancer treatment medications to provide coverage for oral medications in a manner no less favorable than those provided for other cancer treatments, such as injectable or intravenous medications. These provisions become effective July 2014. Second, it was amended to appropriate $500,000 for the administration of the Prescription Drug Monitoring Program (PDMP). Third, the bill was amended to authorize the Department of Health to designate a hospital meeting specified criteria as a Level II trauma center. Finally, it was amended to authorize the Miami Children’s Hospital to add 10 beds for labor and delivery care and treatment of pregnant women meeting specified criteria. Effective upon becoming law.
IMPAIRED PRACTITIONERS (Supported)
SB 248 by Senator Thrasher and Representative Renuart implements changes for impaired practitioner services provided by PRN/IPN. It clarifies that PRN/IPN is authorized to assist students enrolled in a school or program to become licensed as health care practitioners as defined in ch. 456, F.S. In addition, the bill provides that each board or profession within the Division of Medical Quality Assurance has the authority to ask any license applicant to undergo an evaluation for impairment. The bill also subjects radiologic technologists to the impaired practitioner provisions in Florida law. Effective July 2013.
IMPAIRED PRACTITIONERS (Supported)
SB 604 by Senator Bean and Representative Harrell modify provisions of current law regarding impaired practitioners. The bill redirects fees collected for certification of EMTs and paramedics into the Medical Quality Assurance Trust Fund, providing necessary clarification and funding for including EMTs and paramedics within the scope of impaired practitioner services. In addition, the bill clarifies the Department of Financial Services must defend any action for injunctive, affirmative or declaratory relief against PRN/IPN involving emergency interventions on behalf of practitioners or students. Effective July 2013.
MEDICAID FRAUD (Monitored)
HB 939 by Representative Pigman and Senator Grimsley contains provisions intended to help prevent Medicaid fraud and abuse, primarily by modifying existing statutes relating to provider controls, reporting and accountability. The FMA was able to obtain amendments to the bill to protect provider rights to administrative hearings, prevent the state from excluding consideration of addenda or modifications made to medical records in an audit process, and to remove provisions that would have extended the timeframe in which providers are required to retain Medicaid records. Effective July 2013.
Included in the $74.3 billion budget for fiscal year 2013-2014 are allocations for the Statewide Medicaid Residency Program, funding for the federally required increase in Medicaid reimbursement rates for primary care providers as mandated by PPACA, funding for the development of Florida Diagnostic Related Groups (DRG) for Medicaid hospital inpatient services, and funding for the inclusion of critical congenital heart disease testing within the Newborn Screening Program.
The budget provides $80 million in graduate medical education funding to pay for additional residency training positions for new physicians in the state. This allocation will provide for approximately 700 new residency slots. In addition, the budget includes $5.2 million in funding for specific residency positions at the Florida State University College of Medicine and the University of Florida College of Medicine. Preference for these residency slots (13 at each medical school) will be given to underserved rural areas that are determined by the Department of Health to have a primary care physician shortage. The budget also allocates $2.5 million to Lakeland Regional Medical Center to initiate the planning, design and construction of facilities that support graduate medical education in Polk County.
PATIENT PROTECTION AND AFFORDABLE CARE ACT (Monitored)
The House and Senate failed to agree on a plan for extending health care coverage to Floridians between 100 and 138 percent of the Federal Poverty Level pursuant PPACA. The Senate proposal, SB 7038 by Senator Negron, would have made Florida eligible for about $55B in federal subsidies over a 10-year period by providing coverage to persons with incomes of up to 138 percent of the federal poverty level. SB 7038 would have amended the existing Florida KidCare Act to implement the expanded coverage program. Those in the program would pay small premiums for private insurance, copays for doctor visits and hospital stays (as little as $2) and would qualify for health reimbursement accounts. The House proposal, HB 7129, was spearheaded by Representative Corcoran. House leadership opposed using any federal dollars for expanding care. HB 7129 would have used $237M in state general revenue to provide 115,000 Floridians with insurance coverage. Participants would have received up to $2,000 a year for the purchase of insurance but would have been required to provide a $25 monthly premium payment.
PATIENT COMPENSATION SYSTEM (Monitored)
HB 897 (Brodeur) and SB 1134 (Hays) would have created a “no fault” administrative process for compensating patients for medical injuries as an alternative to the current judicial process for medical liability claims.
CONTROLLED SUBSTANCE PRESCRIBING (Supported)
SB 1192 (Grimsley) exempted from pain management regulations physicians who write less than a 30-day supply of a scheduled drug over a 6-month period; required all physicians in a registered pain management clinic to consult the PDMP on a patient’s first visit if a Schedule II/III drug is prescribed; preempted adoption of local ordinances that regulate specified clinics; required owners of pain management clinics be licensed physicians; and authorized the PDMP to be funded by state funds or corporate donations. HB 831 (Fasano) would require all physicians to consult the PDMP if a Schedule II – IV drug is prescribed and would have authorized the PDMP to be funded by state funds and removing a prohibition on funding by prescription drug manufacturers. The FMA opposed HB 831.
MEDICAL LIABILITY/PRESUIT NOTICE (Opposed)
SB 228 (Flores) and HB 1387 (Gonzalez) would have imposed additional restrictions on the ability of a defendant physician in a medical liability action to gain access to medical records during the presuit notice period.
DOCTOR OF NURSING PRACTICE/TITLE (Supported)
HB 805 (Fitzenhagen) and SB 612 (Galvano) would have made it grounds for disciplinary action for a nurse to use the title of “Doctor” when rendering patient care without clarifying that he or she was not an MD or DO.
BALANCE BILLING (Opposed)
HB 1153 (Stark) and SB 1692 (Gibson) would have limited the ability of an out-of-network physician to balance bill patients for services rendered in a hospital that was in the patient’s PPO network.
NEEDLE & SYRINGE EXCHANGE PILOT PROGRAM (Supported)
SB 808 (Margolis) and HB 735 (Pafford) would have required the Department of Health to establish a needle & syringe exchange pilot program in Miami-Dade County. The pilot program would offer free, clean, and unused needles and hypodermic syringes in exchange for the return of used needles and syringes as a means to prevent the transmission of HIV/AIDS and other blood-borne diseases among intravenous drug users and their partners. The bill was amended to ensure that no state funds would be used to administer the program and to provide for a 5-year sunset of the pilot program.
CRNAs/Physician Supervision (Opposed)
HB 305 (Fresen) and SB 1450 (Smith) would have modified physician supervision standards for CRNAs.
HB 429 (Caldwell) and SB 470 (Altman) would have changed the membership and directives governing the NICA Board to favor trial attorneys.
HB 499 (M. Jones) and SB 898 (Joyner) would have required insurers and HMOs to provide coverage for telemedicine services under certain types of policies or contracts. The bills would have prohibited an insurer or HMO from excluding coverage for a service solely because it was delivered through telemedicine services, and would have required telemedicine services to be reimbursed on the same basis as face-to-face treatment. The bills would have required the Department of Health to lead an interagency study to evaluate options for telemedicine with respect to certain services. Finally, the bills would have provided the Department of Health rulemaking authority to implement provisions of the bill.
Surgical Assistants (Monitored)
SB 360 (Garcia) and HB 281 (Gaetz) created definitions for surgical technologists and surgical assistants, and would have prohibited a health care facility from employing or contracting with any person to perform the duties of a surgical assistant or surgical technologist unless the person was “certified” to do so as provided in the bills.
HMO “Bait and Switch” (Supported)
HB 409 (Baxley) and SB 510 (Legg) would have required insurers and HMOs to continue to use the services of a preferred provider or network provider listed on a provider or network panel at the time of an insured’s enrollment for a specified period of time.
May 3, 2013
Dear Physicians –
No, the legislative session isn’t over until later today, and it will probably be quite a while before we ‘know’ everything that happened. I thought I’d write you with preliminary information.
The biggest news to share with you is the passage of Senate Bill 1792 which was a victory for the DCMA, FMA and other medical groups that have lobbied for years for changes to help shield physicians from costly lawsuits.
The DCMA played a pivotal role in securing the passage of this legislation and acted in good faith to ensure medical liability reform during the 2013 Florida Legislative Session. A big thank you to DCMA Key Contact Physicians, and other physicians who made calls or sent emails to Miami-Dade legislators to effect this victory.
The DCMA also played a key role in supporting and helping medical students’ efforts to establish a Needle and Syringe Exchange Program. Starting as a statewide effort, it was changed to a pilot program for Miami-Dade County; however as of this writing it is still stalled in the Florida House Judiciary Committee. The bill, introduced in the Florida Senate by Senator Gwen Margolis, stands a good chance of passing next year.
FMA was able to broker a compromise between ophthalmologists and optometrists allowing optometrists to prescribe certain medications.
Please remember that the DCMA and FMA represent all specialties and as is evidenced by the passage of medical liability reform a cohesive organization does get results.
Be on the lookout for more updates as they become available. Patricia
2013 Florida Legislative Session
NOW IS THE TIME. . .
To contact Miami-Dade County legislators, request an appointment to meet, and discuss issues that are important to you and your patients.
The 2013 Florida Legislative Session
March 5, 2013 - May 3, 2013
The February 2013 issue of Miami Medicine includes contact information for the Miami-Dade County Legislative Delegation. You will find tips on speaking and meeting with legislators. Also included is the DCMA/FMA 2013 Legislative Agenda.
FOR YOUR PROFESSION
Email, write, call, or schedule an appointment to meet your legislators today.
Don’t know who your legislator is? Want additional information on legislators?
Or call the DCMA for a list of legislators and contact information – 305 324-8717
The Dade County Medical Association…Keeping you Informed
DCMA/FMA Legislative Agenda 2013
DCMA/FMA 2013 LEGISLATIVE AGENDA
ISSUES TO SUPPORT:
Support legislation that will permit defendant providers in a medical liability suit to discuss the case with the plaintiff’s other treating providers and that will increase the burden of proof for negligence in cases involving supplemental diagnostic testing in order to reduce costly and unnecessary testing for defensive purposes.
MEDICAID TO MEDICARE
Increase the reimbursement rate for Medicaid to that of Medicare. At the very least seek to ensure that physicians have the opportunity to control the disbursement of Medicaid funds in any type of capitated system.
GRADUATE MEDICAL EDUCATION
Increase state funding for graduate medical education programs in order to preserve access to care in Florida.
Support a PRN revisers bill that would: allow PRN to provide services to all health care professionals, ensure sovereign immunity coverage for all types of actions, clarify that licensure from DCF as a “treatment center” is not required, address the discoverability of PRN work product, and add first responders to PRN’s scope of service.
Seek permanent exemption for medical malpractice insurance from any assessments levied on premiums for property and casualty insurance by the Florida Hurricane Catastrophe Fund.
HOSPITAL DEPARTMENT CLOSURE
Give the Agency for Health Care Administration the power to investigate decisions by a hospital to close a particular department and to take action to ensure patients are not left without needed medical care.
TRANSPARENCY IN HEALTH INSURANCE CPT REIMBURSEMENT SCHEDULES
Support legislation that would require all health insurance companies licensed in Florida to give all physicians access, on the company’s website, to the participating physician’s current complete fee schedule.
PROHIBIT ARTIFICIAL PRICE CONTROLS OF NON-COVERED SERVICES
Support legislation that would prohibit Florida insurance companies from forcing contract provisions on health care providers for services not covered by the plan.
PREAUTHORIZATION FOR MEDICAL TESTING
Support legislation making it unlawful for an insurance company or other third party payer to interfere with a licensed MD/DO’s valid order for a medical test or procedure.
DETERMINATION OF MEDICAL BENEFITS
Seek legislation that would require managed care organizations to provide “real time” eligibility for their subscribers and reimburse physicians for any patient services rendered whereby subscriber eligibility has been confirmed prior to the delivery of care.
USE OF THE TERM “PHYSICIAN”
Support legislation that would prohibit the use of the term “physician” by any person other than an M.D. or D.O.
IMPLEMENTATION OF FEDERAL AFFORDABLE CARE ACT
Support state implementation of a rate increase to Medicaid primary care providers pursuant to the Affordable Care Act in a manner that implements the increase uniformly and which ensures that primary care physicians receive the full increase, and continue to support an increase for all physicians.
Support legislation which ensures that the governing body of any Health Insurance Exchange contains adequate physician representation and which prohibits restrictions on the ability of a physician to bill patients directly for the costs of care not fully covered by their insurance policy, and which does not weaken any existing physician protections in chapters 641 or 627, F.S.
BOOSTER SEATS / CHILDREN
Support legislation that requires all children 4 to 7 years of age and 4’9” in height or less to be placed in a properly restrained booster seat when riding in an automobile.
Support legislation that would prohibit minors from using tanning beds.
NERVE CONDUCTION / EMG
Seek legislation that would limit the performance of nerve conduction studies and needle EMGs in outpatient facilities to situations where the licensed allopathic or osteopathic physician who is
interpreting the study is onsite at the time the study is performed.
TEXTING WHILE DRIVING
Support legislation banning drivers from manually texting or emailing while operating a motorized vehicle.
APPROPRIATE PAYMENTS FOR VACCINES/VACCINE ADMINISTRATION
Seek legislation to ensure commercial insurance payment for all vaccines is not less than 25% above the vaccine cost on the CDC Vaccine Price List and that payment for each billed age-specific and non-age specific vaccine administration CPT code is not less than Medicare rates.
TRUTH IN MEDICAL EDUCATION
Seek legislation to make it unlawful for a nurse to represent him or herself as a physician (MD/DO), and include such activity under the definition of the unlicensed practice of medicine with felony-level penalties for such representation.
Seek legislation that allows state law regarding the standards of practice and registration of pain clinics to supersede any local ordinances and explicitly prohibits counties and municipalities from passing such laws.
AUTOMATIC SUBSTITUTION OF BIOSIMILARS
Support legislation that would enact statewide guidelines on the substitution of “biosimilars.”
DEFINING EXPERT TESTIMONY
Support legislation that would require Florida courts to interpret and apply principles of expert testimony in conformity with the Daubert standard, as set forth by the United States Supreme Court.
ENSURING PAYMENT FOR NEWBORN CARE
Support legislation so that a newborn's medical care is covered under the mother's health insurance for the first 30 days of life and that the newborn's insurance be active at the time of birth with no additional costs for the policyholder during the first 30 days and regardless of whether or not the child is registered.
Seek legislation that would require the following: any physician who makes health insurance coverage recommendations regarding approval or disapproval of any patient care decisions be licensed in the state of Florida and be a member of the same specialty as the ordering physician; all benefits managers to be considered as “practicing medicine” when taking action to approve or disapprove a benefit for a patient; benefits managers to disclose, upon request, the guidelines used to make a negative recommendation; and that ordering physicians be compensated for their time at market value when interacting with benefits managers hired or engaged by any third party.
PAYMENT FOR PREVENTATIVE SERVICES
Seek or support legislation so that comprehensive preventive medicine CPT codes (99381-99387, 99391-99397) are paid at least at “Medicare” rates, as calculated by using RVU’s obtained from the Centers of Medicare and Medicaid Services (CMS); and also seek or support legislation so that vision screening, hearing screening, VEP (visual evoked potential), and recommended age-appropriate laboratory procedures and tests are required to be paid independently when performed along with a comprehensive preventive medicine CPT code (99381-99387, 99391-99397).
APPROPRIATE PAYMENTS BY AHCA FOR VACCINES / ADMINISTRATION
Work with the Agency for Healthcare Administration (AHCA) or seek legislation to increase vaccine payments to at least 25% above the vaccine cost, as listed on the CDC Vaccine Price List, for patients
with MediKids or Healthy Kids insurance; encourage AHCA to update its vaccine fee schedule for MediKids and Healthy Kids patients on the first day of every quarter on their website; and work with AHCA or seek legislation to increase vaccine administration payments for all patients covered by Florida KidCare (Medicaid, MediKids, Healthy Kids, Children's Medical Services) to the Maximum Regional Charges for Florida ($24.01) as established by the US Department of Health and Human Services.
TIMELY AND APPROPRIATE PAYMENTS FOR NEW CPT CODES
Seek or support legislation to ensure that, beginning January 1st of each year, health insurance companies recognize and pay physicians for all current-year CPT codes billed.
APPROPRIATE PAYMENT FOR VACCINE PRICE INCREASES
Seek or support legislation so that health insurance companies increase vaccine payments by an amount at least equal to the manufacturer vaccine price increase(s) beginning on the day the price increase(s) goes into effect.
CMS VERBAL ORDER AUTHENTICATION REQUIREMENT
Collaborate with the Florida Hospital Association and the Florida Society of Hospital Physician Executives to effect legislative change to FS 395.3025(12) as follows, “Verbal or telephone orders for hospital services must be authenticated within 30 days from the date of patient discharge. The hospital must maintain the written authentication or documentation of the efforts made to obtain such authentication as part of the medical record.”
IDENTIFY INTERVENTIONAL PAIN MEDICINE AS THE PRACTICE OF MEDICINE
Support legislation that identifies interventional pain medicine as the practice of medicine by medical and osteopathic physicians and specifies that only physicians licensed under Chapter 458 or Chapter 459 may perform interventional pain medicine techniques.
HMO’S BAIT AND SWITCH
Support legislation that would require HMOs to allow any policyholder to continue to utilize the services of any physician who was on the list of preferred providers as of the date of the policyholder’s enrollment for no less than one year from the date of enrollment.
LEGALIZING SYRINGE EXCHANGE PROGRAMS IN FLORIDA
Seek legislation to amend Chapter 893, Florida Statutes, to legalize Syringe Exchange Programs in the state of Florida.
PENALTIES FOR CARETAKERS WHO WITHHOLD INFORMATION
Support legislation that would make it a crime for caretakers to purposely withhold information and/or provide false or misleading information to treating physicians/health care professionals regarding the true nature of a child’s injury or condition.
NEONATAL PULSE OXIMETRY HEART DISEASE
Support legislation to require that all Florida newborns be screened for critical congenital heart disease using pulse oximetry and that newborn pulse oximetry be added to list of mandated newborn screening tests. Such legislation will also direct Children’s Medical Services to develop and implement a screening program for critical congenital heart disease (CCHD) and track the results in all newborns.
Support legislation that transfers Somatropin (HGH), Sermolelin, Chorionic Ganodotropin (hCG), and other muscle-building drugs, as necessary, to the list of Schedule III drugs.
COMMERCIAL WEIGHT LOSS PROGRAMS AND UNLICENSED DIETETIC ACTIVITY
Support legislation to amend the Florida Commercial Weight-Loss Practices Act (s. 501.073, F.S.) to require public disclosure of the name and license number of any licensee who reviews and approves a weight-loss program.
RECOGNITION AND TREATMENT OF ANAPHYLAXIS
Seek legislation to require that school personnel, including but not limited to teachers and nurses, be instructed to recognize and treat an individual experiencing an anaphylactic emergency, particularly through the administration of an epinephrine auto-injection, and also require all schools to have a non-student specific epinephrine auto-injector available on site for treatment purposes.
PHYSICIAN ASSISTANTS ORDERING MEDICATIONS
Support legislation that clarifies the authority of physician assistants to order medications for their supervising physician’s patient in a hospital setting.
ISSUES TO OPPOSE:
Oppose the statewide expansion of the Medicaid Pilot Project that would effectively move almost every Medicaid patient into a Medicaid HMO. Oppose any effort to mandate Medicaid participation as a condition of physician licensure.
MANDATORY PARTICIPATION IN HEALTH NETWORKS
Oppose legislation that requires the linkage of physician licensure to the acceptance of any government or private insurance, public health care system, forced public service initiatives or mandatory ER coverage.
PRESCRIPTION DRUG MONITORING DATABASE
Oppose mandates on physicians to check Florida’s prescription drug monitoring database before issuing a prescription.
Oppose the imposition of any new restrictions on the ability of a physician to bill patients directly for the costs of care not fully covered by their insurance policy.
SCOPE OF PRACTICE EXPANSIONS
Continue to oppose all scope of practice expansions including naturopaths, ARNPs, pharmacists, optometrists, psychologists, podiatrists, direct access to physical therapists, audiologists and speech language pathologists.
AUTONOMY IN MEDICAL DECISION MAKING
Oppose any legislation that would infringe on physician practice autonomy and the doctor/patient relationship.
PROTECT ABILITY TO SELF INSURE
Oppose legislation that will take away a physician’s ability to self insure or that will make it more difficult for a physician to meet the financial responsibility requirements for licensure.
Oppose any expansion of Florida’s Wrongful Death Act.
Oppose any vaccine legislation that would deviate from evidence-based recommendations and guidelines of the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American Academy of Pediatrics.
Oppose any legislation that imposes additional costs on physicians or their practices without remuneration or other mechanisms to offset the additional costs.
Oppose any legislation changing current law relating to the Fabre doctrine.
PHYSICIAN SUPERVISION ISSUES
Protect advances we have made relating to physician supervision of nurses and PAs.
Oppose any changes to the statutes/rules governing arbitration that would jeopardize the effectiveness of the FMA created physician-patient arbitration form.
MANDATORY PARTICIPATION IN HEALTH NETWORKS
Oppose legislation that would tie physician licensure to mandated participation in any health care network, insurance plan or public health care system, forced public service initiatives, mandated emergency room coverage, or affiliation with any public or private third party payor organization.
LIMITS ON PHYSICIAN / PATIENT CONVERSATIONS
Oppose any legislation that would seek to interfere with the scope of conversations a physician can have with their patients or patient’s guardian.
Oppose legislation that would restrict, directly or indirectly, the ability of physicians to dispense repackaged medications and that would restrict the level of reimbursement necessary for physicians to continue point-of-care dispensing to workers compensation patients.
DCMA & FMA - Your Organizations Working For YOU DCMA-FMA-Powerpoint-11-8-12.pdf