Medical professionals await implementation of major changes to state’s healthcare policies

With major changes to Florida’s healthcare policies awaiting implementation from last year’s session and significant legislation on the wish list this year – redistricting and personal injury protection reform – state lawmakers passed a moderate number of healthcare bills in 2012.
Florida is yet to implement the sweeping Medicaid reform bill from 2011 and is awaiting word from the U.S. Supreme Court on whether the Patient Protection and Affordable Care Act is constitutional. 
“Given the inherent responsibilities of the state legislature and the ‘waiting game’ being played with the federal government, it’s not surprising that other issues rose to the top of the priority list for (Republican) Gov. Rick Scott and Florida lawmakers,” said Alonso, PA-C, president of the Florida Academy of Physician Assistants (FAPA).

Despite the distraction, FAPA was among clear winners this session in the healthcare realm. The statewide association successfully lobbied for one of the only scope-of-practice, or rather, streamlining of licensure, bills to be approved this year.  
The bill deletes a duplicative second license that is currently required of a PA to gain prescribing authority – a requirement shared by no other prescribing practitioner. The bill further deletes a requirement for an unnecessary three-hour prescribing course, and also stipulates that the Board of Medicine may establish rules relating to the cost of a prescriber number, which may be the same as the PA license number.

“This bill should put physician assistants on more equal footing with other prescribing practitioners,” said Alonso.
Another scope-of-practice winner was the Florida Pharmacy Association, whose members saw passage of a bill that expanded their scope by allowing them to administer epinephrine.
Most profession-centric scope of practice bills did not pass. Incoming Senate President Don Gaetz, a Republican from Destin, touted the end of a decades-long fight between optometrists and ophthalmologists as he moved to pass a bill that would allow optometrists to prescribe oral medications, rather than just ocular. Gaetz had secured Florida Medical Association (FMA) support to not oppose any move to expand the role of optometrists, by combining the idea with one the FMA supported: sovereign immunity. Even with broad industry support, the bill withered in the House.

Another priority bill that seemed poised for passage, but fell short in the waning hours of the 2012 session: the Advanced Registered Nurse Practitioner (ARNP) bill, which would have expanded the ARNP practice by permitting ARNPs to Baker Act patients. FAPA lobbied for inclusion in the bill; PAs were amended into the language. By virtue of the opinions of Attorney General Pam Bondi and the Florida Board of Medicine, PAs already Baker Act; however, this language would have clarified this authority in statute. “Failure of this bill’s passage doesn’t change the ability of a PA to Baker Act,” said Alonso. “However, FAPA will continue to work alongside the ARNPs on this bill in the future, as the partnership was seen as a sensible collaboration between three allied professional groups – FMA, ARNPs and FAPA.”

Before the 2012 session, copious discussion prevailed concerning an overhaul of assisted living facility regulations in the wake of a Miami Herald investigation that exposed abuses at these facilities. Senate sponsors crafted sweeping bills to tackle the problem, but these efforts dissipated when lawmakers couldn’t reach an agreement.

Other controversial legislative coups included:
    An overhaul of personal injury protection (PIP). Since Senate and House committees first began meeting in preparation for the 2012 legislative session, PIP had been a priority not only for the legislators, but also for Gov. Scott and Florida CFO Jeff Atwater. After rigorous debate on areas ranging from provider coverage to attorney’s fees, the PIP overhaul passed in the session’s late hours. The bill turns PIP into a somewhat “emergent care” system by requiring that a person seek treatment at a hospital within 14 days of an accident and secure follow-up care by only specified professionals. If a condition is a non-emergency medical condition, coverage is capped at $2,500. Initially, the bill didn’t include PA services, but FAPA successfully lobbied for inclusion via an amendment to the bill before its last stop. Two modalities are expressively excluded from billable coverage: massage therapy and acupuncture.
    State Rep. Matt Hudson, a Republican from Naples, had pushed for changes to the Florida Department of Health. An early version of the health reorganization bill would have required counties to apply for block grants to run county health departments. Faced with overwhelming opposition to the measure, Hudson scaled back and pushed a trimmed-down version of the plan via House Bill 1263, requiring the state department to reduce the length of time to process licensure applications. The bill also closes A.G. Holley State Hospital in Lantana, which specializes in tuberculosis treatment.
    Bowing to public pressure, a hotly contested bill dealing with youth athlete concussions finally passed in this year’s legislative session. The bill requires the Florida High School Athletic Association (FHSAA) to create policies for returning a youth athlete to play after sustaining a traumatic head injury. It also limits the membership of the sports medicine advisory committee of the FHSAA to eight doctors, a chiropractor, a dentist, a podiatrist, a retired coach, and three athletic trainers. Lobbyists for Florida chiropractors unsuccessfully fought to amend the bill so they would be authorized to clear athletes to return to play.

In a move to help the needy, the Florida Academy of Physician Assistants (FAPA) will begin distributing discount drug cards to Florida residents. The free program will provide savings up to 75 percent on prescription drugs at more than 56,000 regional and national pharmacies.
“This program has no restrictions to membership, no income requirements, no age limitations and there are no applications to fill out,” said FAPA president Dayne Alonso, PA-C. “The goal of the new program is to provide additional card distribution channels and create awareness so that all Florida residents will have access to this prescription assistance program.”
FAPA’s 2,500-plus members have enthusiastically embraced the physician/PA team model of healthcare delivery, with the goal of improving access to quality healthcare for all patients, Alonso said.

“The FAPA Board of Directors unanimously voted to institute this program to benefit all the patients we serve,” she said. “As PAs in Florida, we put patients first and this was a way to provide a valuable service to those who need it most.”
Even though the FAPA prescription assistance program was launched to help uninsured and underinsured residents afford their prescription medications, the program may also be used by people who have health insurance coverage with no prescription benefits, a common problem with many health savings accounts (HSA) and high deductible health plans. Also, patients who have prescription coverage may use this program for non-covered drugs.
For more information to share with patients, visit www.FAPAonline.org.  

 

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