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House healthcare bills roll to third reading

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After a regular session where the House presented no healthcare plan or alternative to the headline-grabbing Senate FHIX proposal, the House on Thursday rolled to third reading a number of bills that will comprise its package.

House Democrats peppered state Rep. Heather Fitzenhagen with questions before the House rolled to third reading a bill that authorizes in statutes recovery care centers and also allows ambulatory surgical centers to operate for 24 hours.

HB 33 A is one of a number of bills that the House Republicans are offering as options to lower healthcare costs.

The House also is advancing legislation, HB 21A, that would rewrite the state group health insurance program. The bill would require, effective next open enrollment, state employees to start paying higher premiums for HMO coverage.

The bill also establishes a “three-year price transparency pilot program” for state employees. Under the new approach, the state would publish the prices of certain diagnostic and surgical procedures and share savings with employees who can get the services at lower than published costs.

It’s modeled after a program in California called CalPERS, implemented by the California Public Employees Retirement System in 2011. Researchers for the Center for Studying Health System Change found that the reference pricing initiative saved money “without shifting significant costs to enrollees or sacrificing quality.”

Researchers went on to say that “little is known about how CalPERS implemented the program and whether other purchasers could successfully replicate the approach.” Additionally researchers noted that those who responded to the study flagged key limitations to reference pricing,  including “a limited potential for cost savings since reference pricing is suitable only for a narrow range of services.”

Another controversial bill the House tackled was HB 31A, which eliminates certificate of need for new hospitals as well as tertiary services. Like recovery care centers and the state group health insurance rewrite, the move to eliminate CON is controversial. It is opposed by the Florida Hospital Association, one of the biggest proponents of Medicaid expansion and the Florida FHIX plan, and is supported by Gov. Rick Scott.

The bill was amended to bump back the date of repeal to 2016 to ensure that the state had rules in place by the time CON was eliminated.

Another proposal the House rolled to third reading is HB 25 A. The bill amends insurance code to make clear that prepaid arrangements between physicians and individuals –or their employers– is not “insurance.” Dubbed “direct primary care” by proponents, the bill is a product of the House Subcommittee on Health Innovation, which heard testimony from Florida doctors whose practices rely on the model.

The bill is a priority of National Federation of Independent Business Florida.

The coverage does not meet the individual mandate under the Affordable Care Act. However, if it is wrapped with a catastrophic plan it does meet the requirements of the Affordable Care Act.

Bill sponsor state Rep. Fred Costello read a lengthy script off the floor describing the bill but was not asked a single question. He received a bipartisan round of applause from other lawmakers.

Another bill, HB 29A, also was rolled to third reading without any questions. Sponsored by state Rep. Colleen Burton, the bill requires hospitals to notify obstetrical physicians before closing its obstetrical department or obstetrical services.

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