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2005 Legislative Report
The 2005 Legislative Session began with 2657 filed bills out of which only 394 ultimately passed during the 60 days of session. The major issues that passed dealt with Medicaid Reform, Growth Management and the implementation of most of the Constitutional Amendments, although they were not as the Governor proposed. The major education package known as A++ failed totally because the House insisted on the inclusion of additional vouchers and laws to implement the Constitutional Amendment on slot machines also didn’t pass.
At one point, Senator Peaden, stated in committee that Physician Assistants were included in the amendment. We met immediately with staff on this issue and went over the original amendment language which clearly spoke to physicians. After reviewing the issue, they admitted they had made a mistake. They corrected the staff analysis and took PAs out of the language.. SB 940 Known as Three Strikes
Medicaid Reform Package Passed 2005 Session Earlier this year, the Governor outlined a framework to reform the state's Medicaid program. The Legislature created Select Committees on Medicaid Reform that traveled around the state and listened to public testimony from interested stakeholders. As a result, the House and Senate finally agreed upon legislation that would start the reform process in motion with all details being approved by the Legislature before implementation. CS/CS/SB 838 by Sen. Durell Peaden, R-Crestview, encompasses many areas of the Medicaid program. The bill requires the Agency for Health Care Administration (AHCA) to have two pilot sites for the demonstration project. One pilot will be in Broward County. The other pilot will start in Duval County and will expand to Baker, Clay and Nassau Counties within one-year after the Duval County program becomes operational. The Legislature directs AHCA to make their federal waiver application available on the website 30 days before submitting it to the Centers for Medicare and Medicaid Services (CMS). Additionally, the application must be submitted to the appropriate House and Senate committees 10 days before submission to CMS. AHCA must submit a timeline for implementation of any waiver and budget projections. Basically, AHCA does not have authority to implement any waivers without the Legislature's approval. The bill requires AHCA to develop an encounter data-information system that collects and reports utilization information. Medicaid recipients will be given the option to purchase health care coverage through an employer-sponsored health insurance plan instead of a Medicaid-certified plan, also known as the opt-out option. After 24 months of implementation, the Office of Program Policy Analysis and Governmental Accountability, in consultation with the Auditor General, must evaluate the two managed care pilot programs and present their report by June 30, 2008. By April 1, 2006, AHCA must contract with an entity to design a database of clinical utilization information or electronic medical records for Medicaid providers. The bill repeals all language that was adopted in SB 404 that would have allowed AHCA to set Medicaid rates without complying with chapter 120, reinstates the judicial review process and removes the language that allows for AHCA to set Medicaid rates retroactively. The bill directs the Senate Select Committee on Medicaid Reform to study how provider rates are established and modified, how provider agreements and administrative rulemaking affect those rates, the discretion allowed by federal law for setting of rates by the state, and the impact of litigation on provider rates. The study must be done by March 1, 2006. As it relates to long-term care services, AHCA is authorized to seek a waiver to integrate all long-term care services under a fixed-payment delivery system. There will be two pilots for this proposal. One will be on a voluntary basis and the other will be mandatory. The pilot sites were not specifically identified in the legislation. Before implementation of this new system, AHCA must receive approval from the Legislature. The bill addresses many other issues and concerns pertaining to the Medicaid program. As the Legislature requires AHCA to engage in a transparent waiver process before implementation, it should provide many interested stakeholders the opportunity to contribute to the ultimate proposal that will be submitted to CMS for final approval. We all owe a big "thank you" to the Board of the Florida Academy of Physician Assistants for their tireless efforts on behalf of their Profession. We also owe a great deal of thanks to, Jack Foard the President of FAPA, for his leadership this session and to Mary Ettari, the LGA Chairman along with her committee members: Ron Pace, Angela Fronz, Jeff Hulley and John Byrnes. They spent countless hours reading bills in an effort to determine how the language would impact the PAs in Florida. Finally, we want to extend a special “Thank You” to all those members of FAPA who took the time this session to write or meet with your Legislator, and to those supervising physicians who also took part. It takes a commitment from each and everyone one of you to make a difference and this session you did! At the beginning of Session, the FAPA learned that the Foreign Medical Graduates hired Luis Morse, a former Legislator from Miami, to help pass legislation that would establish a special pathway to be PAs or physicians. Morse was the Representative who years ago helped write the law to give FMG’s a special pathway to be PAs. That option is no longer available. We met with Rep. Morse on a number of occasions during the session and he agreed not to pass that type of legislation this year. The FMA and the FAPA have offered to work with him in finding a solution that will not hurt other professions. HB 1041, The Women’s Safety Act, has added requirements for abortion clinics to have a physician, registered nurse, ARNP or PA on the premises for all follow-up care for the patient for postoperative monitoring and care until the patient is discharged. In addition, they must give training to surgical assistants in patient advocacy and counseling. It also states that one of these professionals must go over ultrasound reports at the request of the patient. SB 366 gives the Board of Medicine additional grounds for discipline for practitioners who fail to complete PRN programs. Listing of all the health care related bills with a brief summary (Adobe PDF) Juhan and Pat Mixon Special Note from the LGAC Mixon and Associates, namely Pat and Juhan Mixon and their staff in Tallahassee, have been our contracted legislative consultants for over ten years now. Their relationship with FAPA goes much deeper than that however. Pat and Juhan are truly committed to this Academy and our profession. They are one of our two best assets, Kautter Management Group being the other major asset. Their dedication, zest and zeal in the performance of their work for us is unsurpassed. We know of no other chapter that is as fortunate as FAPA is in having such dedicated professionals as our friends. They work year round in our behalf, going to every Board of Medicine meeting and FAPA Board meetings, legislative committee meetings and hearings, fund raising events for legislators, acting as our liaison with countless other medical and health care groups, and answering countless emails and phone calls from PAs, both FAPA members and non-members. During the sixty day legislative session each and every year, they work ten to twelve hours a day, six to seven days a week for the entire session, making sure that the PA profession is protected from those who might do things less than favorable to our profession. We cannot even begin to repay them for their hard work and friendship. So make sure that when you see them at a FAPA meeting or in your area that you tell them thank you for being there for us. |
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