The Legislature had an abbreviated schedule last week in order to take advantage of the Passover and Easter holidays.  The bulk of Senate and House Session time was spent debating their respective budgets.  The process kicks into high gear this week, as we enter the final four weeks of the 2010 Legislative Session. 

- Senate and House budgets approved last week
          The Senate and House approved their respective 2010-2011 budgets last week.  This is likely the earliest during the sixty day legislative session that the Senate and House have ever approved their budgets.  The Senate budget is nearly $2 billion more than the House budget, as the Senate's budget relies on the passage of a gaming compact with the Seminole Indian Tribe of Florida and the six-month extension of federal assistance for Medicaid matching funds (FMAP).

          The Senate budget includes additional funds to eliminate reductions to the Medically Needy Program and Medicaid Aged and Disabled Program (Meds AD) that were originally proposed.  The House budget eliminates coverage for pregnant women with incomes between 150-185 percent of the federal poverty level as well the optional coverage for chiropractic care.  For major institutional reductions, the Senate reduces hospital inpatient and outpatient rate payments by six percent as a major cost reduction measure, while the House cuts those payments by 4.3 percent.  The Senate and House both adopted reductions in reimbursement rates to managed care organizations, as well as nursing homes. 

           The timeline for the budget conference process has yet to be announced.  Since the Senate's budget is based on two issues which have yet to be determined, the gaming compact and the FMAP extension, it could be several weeks before Senate and House budget negotiations commence.

           The Senate approved its budget last week, which establishes two medical home projects in Service Areas 1 and 2 (from Pensacola to Tallahassee regions), as well as a request for Federal approval of a voucher alternative to Medicaid Reform.  The House also approved its budget, however at this time has not made a decision about Medicaid reform.  The House will release its Medicaid reform plan in the next few days. 

- No Change
          HB 7183 by the House Health Care Regulation Committee aims to refocus the mission of the Department of Health (DOH) by streamlining and prioritizing public health functions in order to create greater efficiency and accountability while increasing the quality of care for Floridians.  HB 7183 is awaiting a vote by the full House.  (Note: additional detail in the March 29 Capitol Update.)

- HB 5309 approved by the full House
          HB 5309 by the House Health Care Appropriations Committee makes numerous changes to the Statewide Tobacco Education and Use Prevention Program (Program).  HB 5309 was approved by the full House last week.  HB 5309updates terminology and changes statutory references from "smoking" to "tobacco use," and expands the Program's media campaign component to include innovative communication strategies. The bill provides $10 million for Area Health Education Centers (AHECs), subject to appropriation, and deletes language requiring the AHECs to compete for future funding. Additionally, the bill authorizes community mental health providers under contract with the Department of Children and Families to receive annual funding to provide intervention and tobacco use cessation treatment for persons with mental illness.   The Senate does not have a similar companion bill at this time, but this bill will be discussed as part of the budget conference negotiations.

- No Change
          SB 2504 by Senator Al Lawson (D-Tallahassee) prohibits a licensed facility from employing a hospital-based physician or group of hospital-based physicians, or entering into a contract with such physicians unless those physicians are under contract with same health insurers as the licensed facility.  SB 2504 has yet to receive a hearing and there is no House companion bill.

- No Change
           SB 2034 by Senator Steve Wise (R-Jacksonville) and HB 1529 by Representative Nick Thompson (R-Ft. Myers) place requirements on pre-dispute and post-dispute arbitration agreements used in medical negligence and nursing home cases.  The bills state that the provider may not refuse to provide services solely because the consumer refused to sign the agreement or exercised the right of rescission.  The bills also limit the use of arbitrations in emergency medical situations.  SB 2034 has three more committee hearings before a vote by the full Senate.  HB 1529 received three references, and has yet to receive a hearing.

- No Change
           SB 2272 by Senator Mike Fasano (R-New Port Richey), SB 2722 by Senator Andy Gardiner (R-Orlando) and HB 225 by Representatives John Legg (R-Port Richey) and Joseph Abruzzo (D-Wellington) further regulate the dispensing of controlled substances in Florida in an effort to curb prescription drug abuse. 

           HB 225 prohibits physicians from dispensing more than a seventy-two hour supply of controlled substances listed in Schedules II and III.  SB 2722 was amended to require that physicians document a legitimate reason for dispensing more than a seventy-two hour prescription for a controlled substance in the patient's medical record.  SB 2272 by Senator Fasano is expected to merge with SB 2722 in the next few weeks.  SB 2272 does not include the seventy-two hour dispensing limitation for physicians. The FAFP continues to work with its colleagues at the Florida Medical Association to address organized medicine's concerns with the bills, and expect a sensible resolution. 

           SB 2722 has two more committee hearings before a vote by the full Senate and HB 225 has one more committee hearing before a vote by the full House.  

- SB 2596 will receive a hearing by Senate Transportation on April 7
         Bills by Senator Victor Crist (R-Tampa) and Representative Kevin Ambler (R-Tampa) were inspired and written by a group of high school students from the legislators' districts through the, "Ought to be a Law" program.  SB 2596 and HB 1141 create a second degree offense for a person who is smoking while driving or in control of a motor vehicle when a minor under the age of sixteen is in the vehicle, regardless of whether vehicle is in operation or is parked.  If found in violation of the secondary offense, law enforcement may either issue a warning, or assess a $100 noncriminal moving or nonmoving violation in addition to issuing a penalty for the primary offense.

           SB 2596 will receive its first committee hearing this week by the Senate Transportation Committee.  Last week HB 1141 was discussed in a workshop by the House Roads, Bridges and Ports Policy Committee; however, the committee did not vote on the bill. 

- SB 214 will receive a hearing by Senate Governmental Oversight and Productivity on April 6
           SB 214 by Senator Jeremy Ring (D-Margate) and HB 107 by Representative Marti Coley (R-Marianna) allow physicians to decide whether it is "medically necessary" to refer a minor patient to an "appropriate specialist" for screening for autism spectrum disorder.  If the physician does not believe a screening is "medically necessary," the parent or legal guardian is permitted under the bill to seek a second opinion from an "appropriate specialist" without obtaining a referral to see the "appropriate specialist."  Insurers are required to provide direct access to "appropriate specialists" for autism spectrum disorder screening if the screening is requested.  The insurance lobby strongly opposes the direct referral provision.  SB 214 will receive a hearing by the Senate Governmental Oversight and Productivity Committee this week.  HB 107 has three more committee hearings before a vote by the full House.  

- No Change
           SB 330 by Senator Mike Bennett (R-Bradenton) and HB 135 by Representative Ron Reagan (R-Sarasota) allow optometrists to prescribe thirteen different oral medications, some of which are controlled substances.  SB 330 was approved by the Senate Health Regulation Committee, and has one more committee hearing before a vote by the full Senate.  HB 135 by Representative Reagan has yet to receive a committee hearing in the House. 

- SB 316 will receive a hearing by Senate Transportation and Economic Development Appropriations on April 6
           SB 316 by Senator Thad Altman (R-Melbourne) and HB 387 by Representative Rich Glorioso (R-Plant City) revise child restraint requirements for children who are passengers in motor vehicles.  SB 316 bases the restraint requirement on a child's height rather than age. 
 
            SB 316 will receive its last committee hearing this week by the Senate Transportation and Economic Development Appropriations Committee before a vote by the full Senate.  HB 387 received three committee references, and has yet to receive a hearing.

- No Change
           SB 516 by Senator Mike Fasano (R-New Port Richey) and HB 275 by Representative Denise Grimsley (R-Sebring) prohibit health insurance policies or medical service plan contracts from limiting, reducing or denying coverage for prescription drugs if the insured person is currently using the drug, if the insured person is covered under their policy/contract or if the prescription drug was covered under the policy or contract.  These bills aim to promote patient safety and ensure quality care.         SB 516 received three committee references and HB 275 received four committee references.   The bills have yet to receive a committee hearing.

- No Change
         SB 1474 by Senator John Thrasher (R-Jacksonville) and HB 791 by Representative Ron Renuart (R-Ponte Vedra Beach) extend sovereign immunity to emergency health care providers who provide emergency care in hospitals.  SB 1474 has three more committee hearings before a vote by the full Senate.   HB 791 received four committee references, and has yet to receive a committee hearing.