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Senate counters House with Medicaid expansion but Tom Lee says other health care issues could be in play during an extended session

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The Florida Senate has not backed off its position that working uninsured Floridians need to have access to health insurance and that the Medicaid supplemental program known as Low Income Pool should remain intact.

In a counteroffer to the House’s offer to put $200 million into healthcare financing the Senate held firm on its Medicaid expansion and puts $604.8 million in contingencies to offset LIP losses and to shore up Medicaid HMOs that are at risk because of increased pharmaceutical costs.

It also offered to plow a million of the $263.8 million that would be generated from implementing the FHIX plan into public education funding.

Additionally the Senate counteroffer makes clear that the chamber will seek guidance from the Centers for Medicare and Medicaid Services in regards to LIP funding as well as the potential approval of the Florida Health Insurance Exchange program, commonly called FHIX.

The Senate made its counteroffer as it ended session on Friday. Like the House the night before, the offer was made in a very public way, before the press and the full chamber. It is unusual for “allocations” to be publicly negotiated, but it has been an unusual session.

Meanwhile, there will be more than healthcare financing that will be discussed as the chambers try to resolve healthcare funding.

Senate Appropriations Committee Chairman Tom Lee said he has heard “a lot of conversation, a lot of  background chatter about CON, med surg centers selling insurance across state lines, major changes to scope of practice, things of that nature, that would need to go along with some dramatic reforms.”

Those issues have been important to the House, which wants to “disrupt the status quo” when it comes to healthcare delivery and financing. At its last regularly scheduled meeting of the 2015 session, House Health and Human Services Committee Chairman Jason Brodeur told his committee that cetificate of need, healthcare mandates, and medical malpractice changes would be front and center during the 2016 session.

The House did not propose CON reforms this session but the chamber has championed a bill, HB 999, that would allow ambulatory surgical centers to care for patients for up to 24 hours. The bill also creates a new licensure category for “recovery care centers”  where stable patients can stay for up to 72 hours. Recovery care centers would not be part of a hospital and, morevoer, would be in direct competition with hospitals.

Senate President Andy Gardiner thanked House Speaker Steve Crisafulli and Gov. Rick Scott for the Thursday night offer to provide $200 million, given the previous opposition they have shown to “backfilling” the loss of federal Low Income Pool dollars with general revenue.

Gardner, meanwhile, told his members to go home over the weekend and advised that the Senate won’t go into session until 1 p.m. Monday. Gardiner reiterated the position that the Senate is prepared to remain in an extended session until June 30. An extended session would preclude members from being able to fundraise.

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