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Senate Insurance Panel OKs FMA’s ‘Right Medicine, Right Time Act’

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The Senate Banking and Insurance Committee gave the green light to the Florida Medical Association’s top priority: a bill that precludes insurance companies and HMOs from limiting direct access to medications without prior approval from a government-housed clinical committee.

It’s being called the “Right Medicine, Right Time Act” and it most likely will be the center of the biggest tussle between the physician and insurance industries for the 2015 session.

Under the provisions in the bill an insurer and its chief medical officer can be sued if any prior authorization or step therapy changes are made without prior approval of the seven-member committee housed in the Florida Department of Health.

Before approving SB 784 the committee tagged on two “friendly” amendments supported by bill sponsor state Sen. Don Gaetz. Under the amended bill insurers also are required to post within 10 days changes to any preferred provider list.

While most speakers at the committee meeting on Wednesday supported the proposal and the committee approved it unanimously, there were opponents.

Associated Industries of Florida General Counsel Tami Perdue testified that the business community has concerns with the measure because of its potential cost impacts.  The bill was opposed by the Florida Association of Health Plans, also for cost reasons.

State Sen. Joe Negron, though, was critical of the insurance industry for not having data showing any cost increases. Negron said that similar legislation has passed in Mississippi, Louisiana and Kentucky but that costs haven’t spiked in those states. “I heard no evidence whatsoever that this costs more in other states,” Negron said.

The bill heads to the Health Policy and the Senate Appropriations Committee next. Gaetz serves on both committees. A companion bill–HB 863– was filed in the House on March 3 by state Rep. Shawn Harrison.

A similar bill passed the Senate last year and has considerable support in that chamber. However, it may be a different story in the House of Representatives, which was steadfast in its opposition to the proposal last year.

A committee with ties to the FMA  last month sent flyers to several House members, including Speaker Steve Crisafulli and Richard Corcoran, among others.  One flyer has an older woman with oxygen tubes up her nose. Across it in capital letters is the question, “Why Won’t Tallahassee Politicians Help Me?”

Another shows a female doctor with her hand to her head and above her it reads: “Current Health Insurance Policies Prevent Doctors From Serving Their Patients.” One of the flyers also shows a caregiver pushing a woman in a wheelchair. It reads in part: “We need policies that put patients first, not bureaucrats.”

Crisafulli said he took “offense” to the flyers and said that sending the flyers before the start of the session was a “flawed approach.”

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