Checking the pulse of Florida health care news and policy

Welcome back to Diagnosis, a vertical focused on the intersection of health care policy and politics.

— Big impact —

Florida hospitals contributed more than $198 billion to the state’s economy in 2023, according to a new report from the Florida Hospital Association.

According to the report, the state’s 337 hospitals and health systems employed 343,952 full-time workers and provided $34.5 billion in wages, salaries and benefits to Florida families.

The association pointed to a recent Wall Street Journal article, “Health Care Is Propping Up the Job Market,” to place the findings in a broader context. Nationally, employment in health care and social assistance has grown 12.5% over the past three years, outpacing other industries.

The report, titled “Economic Contributions of Florida Hospitals and Affiliated Healthcare Businesses in 2023,” shows continued growth at the state level. From 2021 to 2023, Florida hospitals increased employment by 11% and expanded their overall economic impact by 6.8%. Beyond direct jobs and payroll, hospitals are significant purchasers of goods and services, creating additional ripple effects across the state.

“Hospitals are the heart of medical care in our communities and are supporting health care systems to effectively meet growing demand and deliver innovative, world-class care,” said Mary Mayhew, President and CEO of FHA. “The latest economic impact data underscores their contributions – not only of the lifesaving care they provide, but also as powerful economic engines driving Florida’s future.”

Association leaders emphasized that maintaining hospitals’ financial strength and workforce capacity is essential to preserving access to high-quality care, particularly as the state’s population ages and demand for services increases.

— Screening reqs —

A bill that would expand Florida’s newborn screening requirements to include a liver disease test advanced through its first Committee last week.

SB 1574, titled “Mattie’s Law,” requires that all newborns be screened for biliary atresia by testing direct bilirubin levels using the blood specimen already collected for standard newborn screenings. It also creates a new statutory section requiring hospitals that provide birthing services to conduct biliary atresia screening as part of their newborn care obligations, effective Jan. 1, 2027.

The measure, sponsored by Sen. LaVon Bracy Davis, amends existing law to require the Department of Health to consult with the Genetics and Newborn Screening Advisory Council before adopting rules related to screening methods, follow-up procedures, or the addition of new conditions to the state’s screening panel.

In addition, the bill directs the Department of Health to implement a statewide public health education campaign by Oct. 1, 2026, to increase awareness of biliary atresia. The campaign must educate parents on symptoms and the importance of early diagnosis and guide physicians and nurses on identifying the condition and the risks of delayed treatment.

SB 1574 earned unanimous approval from the Senate Health Policy Committee. It now heads to the Appropriations Committee on Health and Human Services. If signed into law, the bill would go into effect on July 1.

— High stakes —

House budget writers are escalating pressure on Medicaid managed care plans: reduce infant mortality or lose money.

A provision in the House health care spending plan would continue a 2% withholding on plans’ capitation payments — in place since October — but overhaul how they recoup it. Under the proposal, only two of the state’s eight managed care plans could recover the full 2%: the plan with the largest year-over-year reduction in infant mortality rate and the plan with the greatest raw reduction in infant deaths.

Other plans could recover 1% if they show improvement at the rate. Any plan that backslides would forfeit the entire 2% and face a four-month suspension from Medicaid auto-assignment.

Rep. Alex Andrade, the Pensacola Republican who chairs the House health care budget panel, said the change is designed to inject competition into the system and sharpen focus on a single outcome as Florida confronts rising infant mortality trends.

“The idea is, so long as you show improvement, you’ll get at least 1% of your revenue back,” Andrade said. “If you show the most improvement, you’ll get the full 2%.”

The auto-assignment penalty could carry significant financial consequences. When beneficiaries fail to choose a plan within 60 days, the state assigns them — typically steering enrollees to lower-volume plans to balance the market. In past transitions, the pool has been sizable.

— ROSTER —

Gov. Ron DeSantis has reappointed Audrey Butler, Harold Goodemote, Andrew Lupoli, and Thomas McCall to the Halifax Health Board of Commissioners.

Butler is an Ambassador for Embry-Riddle Aeronautical University, a former member of the PACE Center for Girls, the Ormand Memorial Art Museum and Gardens, and the United Way of Volusia-Flagler Counties Board of Directors. She earned her bachelor’s degree and her doctorate in chemical and materials engineering from the University of Iowa.

Goodemote is the former vice president of Coleman Goodemote Construction Company, a member of the NASCAR Foundation Board of Directors and previously served as an Adjunct Faculty Member at Daytona State College. He earned his bachelor’s degree from Bowling Green State University and his MBA from Stetson University.

Lupoli is the Assistant Treasurer at Brown & Brown Insurance and the Treasurer for Homes Bring Hope. He was recognized as a Rising Star Award Recipient from the Florida Institute of Chief Financial Officers. Lupoli earned his bachelor’s degree in accounting from the University of Central Florida.

McCall is the chief operating officer of ICI Homes and currently serves as the Chair of the Audit, Finance and Investment Committees for the Halifax Health Board of Commissioners. McCall earned his bachelor’s degree in accounting and criminal justice from the University of North Carolina, Charlotte.

— ICYMI —

“House advances ban on local net-zero policies” via Jim Saunders of State Affairs — Florida is suing the federal government to obtain records about a long-stalled state plan to expand a program that provides subsidized health insurance to children. The lawsuit, filed Monday in U.S. district court in Pensacola, alleges the federal Centers for Medicare & Medicaid Services has not complied with a Freedom of Information Act request for records about the proposed expansion of the KidCare program. Florida lawmakers in 2023 approved a plan that the lawsuit said “would extend access to health insurance to tens of thousands more Florida children.” But the proposal required federal approval, as KidCare operates as part of the federal Children’s Health Insurance Program and is partly funded by Washington. The proposal stalled, at least in part, because Florida objected to a requirement that the Biden administration issued for the Children’s Health Insurance Program.

“Ron DeSantis administration publishes proposed AIDS rules, halts state administrative court challenge” via Christine Sexton of Florida Phoenix — The DeSantis administration proposed rule changes that would allow it to pare back who qualifies for the federally funded AIDS Drug Assistance Program (ADAP) and limit the benefits available. Once adopted, the proposed rules would implement previously announced changes the DOH said would take effect March 1 to ADAP to avert a purported $120 million projected shortfall. Those changes — posted on the DOH website and outlined in letters sent to affected ADAP clients — would reduce income eligibility from 400% of the federal poverty level or $63,840 annually for an individual, to 130% of the federal poverty level or $20,748. Another change is the elimination of the premium assistance program that helps underinsured patients purchase costly drugs. The DOH previously announced it would also limit the medications ADAP patients can access.

“Cannabis firms challenge new Florida marketing rules” via Dara Kam of State Affairs Florida — Calling it a “sudden and dramatic shift” that would “invalidate years of effort and monetary investment,” a group of Florida medical-marijuana operators is challenging new regulations restricting how pot products are marketed, advertised and promoted. The challenges, filed at the state Division of Administrative Hearings, also alleged the Department of Health failed to follow rulemaking requirements before issuing the new regulations. The rule violates the companies’ First Amendment speech rights, the medical-cannabis operators’ complaints argue. Tallahassee-based Trulieve, Inc., the state’s largest medical-marijuana operator, is among the cannabis companies challenging the rule.

“House Committee OKs parental rights bill requiring teens to get permission for STD treatment” via Gabrielle Russon of Florida Politics — A second House Committee has backed a bill to forbid doctors from treating teens with sexually transmitted infections (STIs) or giving them information on contraceptives unless they get permission from their parents first. The House Judiciary Committee advanced HB 173, which contains several provisions to expand the Parents’ Bill of Rights for guardians to gain more control and access over their minor children’s medical records and health care decisions. The bill would also prohibit health care practitioners from prescribing drugs to a minor without first getting written parental consent. “What’s currently happening now is if you have a 12-year-old,” said Kendall, sponsor of the bill, “the doctor is pulling them aside and asking the 12-year-old … if they want their parents to have access to their medical records.”

— RULES —

The Board of Osteopathic Medicine’s final rule regarding approval of osteopathic physician office accrediting organizations goes into effect Feb. 24. More here.

The Board of Medicine’s final rule regarding approval of physician office accrediting organizations goes into effect Feb. 24. More here.

The Board of Nursing Home Administrators’ final rule regarding application for licensure goes into effect Feb. 19. More here.

The Board of Chiropractic Medicine’s final rule regarding citations goes into effect Feb. 24. More here.

The Board of Optometry’s final rule regarding endorsements goes into effect Feb. 19. More here.

— PENCIL IT IN —

Feb. 18

Happy birthday to Reps. Doug Bankson, Jenna Persons-Mulicka and Johanna López!

8 a.m. — The House Health & Human Services Committee meets. Room 17, House Office Building.

8:30 a.m. — The Senate Appropriations Committee on Health and Human Services reviews budget issues for AHCA, the Agency for Persons with Disabilities, the Department of Children and Families, the Department of Elder Affairs, the Department of Health and the Department of Veterans’ Affairs. Room 412, Knott Building.

10:30 a.m. — The House Health Professions & Programs Subcommittee meets. Room 102, House Office Building.

5 p.m. — The House Health Care Facilities & Systems Subcommittee meets. Room 404, House Office Building.

6 p.m. — The House Human Services Subcommittee meets. Room 314, House Office Building.

Feb. 23

Noon — Safety Net Hospital Alliance of Florida hosts Hospital Days at the Capitol.

Feb. 24

8 a.m. — Safety Net Hospital Alliance of Florida continues Hospital Days at the Capitol.

Feb. 25

8:30 a.m. — The Senate Appropriations Committee on Health and Human Services meets. Room 412, Knott Building.

Feb. 27

Happy birthday to Rep. Angie Nixon!