The Legislature completed week six of nine, and ended last week at a frantic pace.  The House debated education reform bills until almost 3:00 a.m. on Friday morning.  Legislative committees continue to meet with packed agendas and hundreds of amendments.  The Senate and House budget conference process has yet to begin and the April 30th session conclusion date is looming large, as the pressure on the Legislature to complete its work on time increases.

          Last week the House Select Policy Council on Strategic and Economic Planning unveiled its Medicaid reform proposal.  The House's proposal ends MediPass and fee for service in Medicaid, and replaces those programs with the Managed Medical Assistance Program. Under the new program, a vast majority of Medicaid patients will be placed in a managed care plan. Only a small, select group of Medicaid patients will be exempt from mandatory managed care enrollment.  The program's implementation is to begin by January 1, 2012, and will be operational statewide by October 1, 2013.
 
           All care in the Managed Medical Assistance Program will be provided by a "qualified plan." Qualified plans are limited to health insurance companies, exclusive provider organizations, health maintenance organizations and provider service networks. Qualified plans will be paid on a capitated, per-member per-month basis.  Florida will be divided into six districts, and the number of qualified plans allowed to operate in each district will be limited. Under the program, the Children's Medical Services Network is considered a qualified plan and may participate statewide. 
 
           Additionally the proposal allows qualified plans to be designated as medical homes. The plans that choose to become an accredited medical home agree to pay primary care physicians at least eighty percent of the Medicare rate. Designation as a medical home gives plans certain priorities in the plan selection process for a particular region. Prior to full implementation of this managed care plan in October 2013, the managed care pilot project will continue and will expand to include Miami-Dade County by June 30, 2011.

- HB 225 amended and approved by House Health Care Appropriations; SB 2272 and SB 2722 will receive a hearing by the Senate Criminal Justice on April 13.
          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 was amended and received approval by the House Health Care Appropriations Committee last week. The amendment removed the seventy-two hour dispensing prohibition for physicians, a provision organized medicine adamantly opposed. The amendment requires physicians to register with the Board of Pharmacy to dispense controlled substances and pay a $100 registration fee. SB 2722 was recently 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.
 
           SB 2272 and SB 2722 will receive a hearing by Senate Criminal Justice on April 13. HB 225 is awaiting a vote by the full House.    

- HB 107 approved by House Government Operations
          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 an "appropriate specialist" for autism spectrum disorder screening if the screening is requested.  The insurance lobby strongly opposes the direct referral provision. 
 
           HB 107 received approval by the House Government Operations Committee last week. The committee discussed two amendments to the bill during the hearing. The first amendment, sponsored by the bill's sponsor Representative Coley, included individuals licensed under Chapter 491, clinical social workers, marriage and family therapists and mental health counselors, to the list of "appropriate specialists." Representative Coley ultimately withdrew the amendment amid concerns expressed by organized medicine. The second amendment was introduced by Representative John Wood (R-Haines City), and it removed coverage of developmental disabilities from the bill. The amendment was defeated.  HB 107 has one more committee hearing before a vote by the full House. SB 214 has two more committee hearings before a vote by the full Senate. 

- SB 316 approved by Senate Transportation and Economic Development Appropriations
          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 received unanimous approval by the Senate Transportation and Economic Development Appropriations Committee last week. The bill is awaiting a vote by the full Senate. HB 387 received three committee references, and has yet to receive a hearing.

           SB 2596 by Senator Victor Crist (R-Tampa) and HB 1141 by 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 received unanimous approval by the Senate Transportation Committee last week. Student members of the "Ought to be a Law" program presented the bill, and explained the health risks to children associated with second hand smoke exposure.  Several weeks ago, HB 1141 was discussed during a workshop by the House Roads, Bridges and Ports Policy Committee; however, the committee did not vote on the bill. 
 
No action was taken on these bills last week.  For further information, please refer to the April 6 Capitol Update.