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Healthcare train doesn’t make it out of station before House calls it quits

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Heath care was the divisive issue of the 2015 regular legislative session with healthcare financing and Medicaid expansion proving to be issues too large to bridge differences.

When the House of Representatives abruptly called it quits on Tuesday, several healthcare issues outside of Medicaid went down in a fiery crash.

Longtime healthcare lobbyist Christopher Nuland said when House Speaker Steve Crisafulli addressed the chamber and House Appropriations Committee Chairman Richard Corcoran announced Sine Die, he was “dumbfounded. Every lobbyist had the same mouth-open expression,” Nuland said.

Issues that appeared to be alive and in play headed into the last three days of session included:

  • Developing a site selection process for a new Veteran’s Administration nursing home;
  • Allowing physicians to participate in direct primary care;
  • Allowing advanced registered nurse practitioners and physician assistants to prescribe and order controlled substances in a hospital;
  • Clarifying in statute that free clinics can receive an appropriation, or grant from an appropriation, to provide services to the uninsured while preserving their sovereign immunity protection; and
  • Authorizing direct primary care contracts between doctors and patients without violating the state insurance code.

Nuland said that he was in a meeting with two lawmakers who had told him that there was an agreement on a healthcare bill just 20 minutes before the House adjourned, sine die.

“They were saying we had a bill and then this happened and that’s what’s frustrating,” Nuland said. “Everyone had done the work.”

Tallahassee lobbyist Alisa LaPolt represents nurses in the Capitol. She has lobbied for 11 years and was a Capitol Press Corps reporter before that. LaPolt said that in her 17 years of Capitol watching Tuesday’s events caught her by surprise.

“Typically, we all sit back and observe the House and Senate dynamics,” the last week of session she said. “This year the impasse was so great from Day 1 that we all were wondering how it would pay out May 1. Well, we didn’t even get to May 1.”

One bill that passed after the House called it quits was CS/CS/HB 269, which allows manufacturers of investigational drugs, biologic products, and devices to provide such drugs, products, and devices to patients with a terminal condition without the approval of the FDA. The bill has been dubbed the Right to Try Act.

Two other bills that cleared on Tuesday despite the dysfunction include:

CS/HB 751–The bill allows patients and caregivers to administer an emergency opioid antagonist to a person experiencing an opioid overdose. The bill also grants healthcare practitioners and pharmacists immunity from civil and criminal liability and professional discipline, related to prescribing and dispensing an opioid antagonist. The immunities provided by the bill do not limit any existing statutory immunities that are otherwise applicable

CS/HB 1049–The bill was amended to include a pharmacy benefits manager issue that has been pushed by pharmacies over the last several years but HMOs and managed care companies have expressed concerns with. The language was included in HB 1049 and under the bill pharmacy benefit managers would have to update maximum allowable cost pricing information at least every seven calendar days; and maintain a process that will, in a timely manner, eliminate drugs from maximum allowable cost lists or modify drug prices to remain consistent with changes in pricing data used in formulating maximum allowable cost prices and product availability.

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