SB 212-Relating to Ambulatory Surgical Centers
On Thursday, February 25th, SB 212, relating to Ambulatory Surgical Centers, by Senator Don Gaetz (R-Destin) was heard by the Senate Appropriations Committee and unanimously passed.

The bill in its original form only addressed regulations for ambulatory surgical centers. However, at this committee, Senator Gaetz added language encompassing a wide array of health care topics, including the prohibitions on step therapy and authorization protocols that insurers use to control costs of treatment.

AIF stood in opposition to this lengthy health care amendment that was added today to SB 212 by Senator Gaetz.

SB 212 now requires Medicaid managed care plans, health maintenance organizations (HMOs), and insurers that restrict medications by a step-therapy or fail-first protocol to have a clear and convenient process to request an override of the protocol. The bill requires these entities to grant an override of the protocol within 24 hours if, based on sound clinical evidence or medical and scientific evidence, the prescribing provider:

• Concludes that the preferred treatment required under the fail-first protocol has been ineffective in the treatment of the enrollee’s disease or medical condition; or
• Believes that the preferred treatment required under the fail-first protocol is likely to be ineffective given the known relevant physical or mental characteristics and medical history of the enrollee and the known characteristics of the drug regimen or will cause or is likely to cause an adverse reaction or other physical harm to the enrollee.

AIF believes this action to be redundant and unnecessary given that insurers already have a protocol in place if incidents, such as ineffective treatment of the enrollee’s disease or medical condition, occurs.

SB 212 will now go to the Senate floor for final consideration.

AIF opposes legislation that will negatively impact the standards of care that are currently in place based on real-time protocols that are centered on evidence-based research.

SB 1442-Relating to Out-of-network Health Insurance Coverage
On Thursday, February 25th, SB 1442, relating to Out-of-network Health Insurance Coverage, by Senator Rene Garcia (R-Hialeah) was heard by the Senate Appropriations Committee and passed 17 yeas to 0 nays.

The intent of this bill is to protect consumers from balance billing when that situation occurs in an emergency setting; the balance bill is the difference between the provider's charges and the amount the provider has received in reimbursement from the consumer's insurance plan. Provider charges in Florida are often 100 times more than Medicaid charges, so this legislation should cap a significant cost driver in today's health care system. 

In today’s committee there was some debate over an amendment filed to the bill which would have prohibited insurance companies from denying coverage for procedures incurred once premiums are not paid by a policy holder.  AIF’s General Counsel Tammy Perdue testified against the amendment and cautioned the committee about the consequences that prohibition could have on employers if those charges were passed onto them by the insurer.  The amendment was not adopted. AIF will remain vigilant throughout the closing weeks of this session to guard against legislation with unintended but expensive consequences for Florida’s employers.

SB 1442 will now go to the Senate floor for consideration. 

AIF supports legislation that requires a patient to be presented with documentation regarding any charges for out-of-network services.

SB 1686- Relating to Telehealth
On Thursday, February 25th, SB 1686, relating to Telehealth, sponsored by Senator Aaron Bean (R-Jacksonville) was heard by Senate Appropriations Committee. and passed with 17 yeas to 0 nays. AIF’s General Counsel, Tammy Perdue, stood in support of this bill.

SB 1686 creates a Telehealth Task Force within the Agency for Health Care Administration (AHCA), authorizes healthcare practitioners in Florida to provide telehealth services, and defines telehealth. The task force is chaired by the Secretary of the AHCA or his or her designee, the State Surgeon General and 21 other members, including other health care practitioners, providers, telehealth services providers and sellers, and facilities. *(Amendment 419202 changed the previous amount of members on the task force from 17 to 21).

The bill requires the task force to compile data and submit a report by June 30, 2017, to the Governor, the President of the Senate, and the Speaker of the House of Representatives that analyzes:

• Frequency and extent of the use of telehealth nationally and in this state;
• Costs and cost savings associated with using telehealth;
• Types of telehealth services available;
• Extent of available health insurance coverage available for telehealth services; and
• Barriers to implementing the use of, using, or accessing telehealth services.

The bill also requires the task force to hold its first meeting by September 1, 2016, and to meet as frequently as necessary to complete its work.

SB 1686 will now go to the Senate floor for consideration.

AIF supports legislation that permits an unfettered role for telehealth services that will allow our citizens access to better quality care at lower costs.