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.

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— Thought bubble —

There’s a clear split emerging on vaccines — and it’s not just between parties, it’s within them. In Washington, Republicans are quietly moving away from vaccine fights as polling and political reality set in.

Even the MAHA movement isn’t unified on the issue, with supporters more focused elsewhere.

Gov. Ron DeSantis is pushing in the opposite direction, reviving vaccine exemption legislation that stalled during the Session. But it’s worth noting: the Legislature, led by Speaker Danny Perez, already read the room. The House declined to take up the bill, signaling little appetite to force members into a politically fraught vote.

That leaves the Florida Senate with a choice: take the off-ramp the House already chose or continue advancing a fight that could complicate the GOP’s path heading into election season.

— The Forgotten Smoker —

A new report from Philip Morris International’s U.S. arm argues that America’s decades-long progress in reducing smoking has created a dangerous illusion: the problem isn’t solved — it’s just less visible.

According to “The Forgotten Smoker,” while smoking rates have dropped dramatically over the past 50 years, an estimated 25 million to 30 million U.S. adults still smoke, and nearly half a million people die each year from smoking-related causes.

The report returns repeatedly to a disconnect between declining smoking rates and persistent illness and death. A national survey commissioned alongside the paper found that 79% of Americans say more should be done to address smoking-related harm, even as policymakers and public health systems increasingly treat the issue as a relic of the past.

“The Forgotten Smoker” says the remaining smoking population is disproportionately made up of people facing economic stress, health challenges, or limited access to care. It also highlights a gap between intent and outcomes: roughly two-thirds of smokers say they want to quit, but fewer than one in 10 succeed using currently approved cessation tools.

A major barrier, the paper argues, is widespread misinformation about nicotine and relative risk. More than half of those surveyed incorrectly believe nicotine directly causes cancer, and large majorities think all tobacco and nicotine products carry the same level of harm — a misconception the report says discourages smokers from considering noncombustible alternatives.

“The FDA has recognized that tobacco and nicotine products exist on a continuum of risk — but too often that science hasn’t trickled down to the people who interact with smokers every day, including medical professionals,” said Keagan Lenihan, Chief External Affairs Officer of PMI U.S.

“If we’re serious about ending cigarette smoking, the leading cause of preventable death in the U.S., we need the FDA to assess and authorize better alternatives to combustible cigarettes in a timely fashion and take a leading role in educating health care providers, policymakers and the public about tobacco harm reduction and the role smoke-free products can play. This is how we will move this issue out of the shadows and solve it once and for all.”

The report calls for a shift toward “tobacco harm reduction,” an approach that emphasizes moving smokers away from combustible cigarettes — the most dangerous form of nicotine consumption — and toward alternatives such as nicotine replacement therapies, e-cigarettes and heated tobacco products.

Among its recommendations: improving public education around nicotine and risk, expanding access to FDA-authorized smoke-free alternatives, reforming regulatory backlogs that slow product approvals, and adopting tax policies that differentiate between higher- and lower-risk products.

The report also points to international examples, including Sweden and Japan, where broader adoption of smoke-free alternatives has coincided with sharper declines in cigarette use.

Ultimately, the report argues that ending smoking in the U.S. will require a “whole-of-society commitment to giving adults who smoke better pathways to a smoke-free future.”

— WebMD gap filler —

WebMD, a medical advice company, is beginning a program to help fill the gap in federal government funding distribution, particularly in rural areas.

Some $50 billion is set to be spread across all 50 states through 2030 to help transform health care in rural areas. But as WebMD officials point out, there’s no infrastructure in place to deploy the funding quickly.

The company launched a program this week, WebMD Ignite, to help distribute funds in rural areas. The program is part of the Health Education & Access for Rural Transformation (HEART) program. It’s a digital platform designed to enable patient engagement and education programs across states, health systems and rural hospitals within regional networks, while reducing the necessary investment in information technology.

HEART seeks to assist an estimated 60 million people who live in rural American communities. HEART helps states provide targeted distribution of federal funds to health systems and assist those communities in sustaining health care funding beyond the federal government’s distribution, which will end in about five years.

The HEART program will provide digital health education hubs with videos and clinical advice. Also, risk assessments will be provided alongside outreach through multiple channels, such as digital, print and community outlets. Artificial intelligence will also be used for conversational communication on complex health topics and online dashboards will be used for reporting requirements.

— Guilty of fraud —

A Florida insurance company is pleading guilty to defrauding the federal government out of more than $100 million in federal subsidies by targeting unhoused and other vulnerable people for enrollment in Affordable Care Act plans they did not qualify for, according to a notice filed Monday in Florida federal court.

Fiorella Insurance Agency (AP of South Florida LLC) reached a plea agreement to resolve a charge of major fraud against the United States, according to federal prosecutors.

Fiorella is accused of deceptively marketing subsidized ACA plans to ineligible consumers who were unhoused, unemployed and had no income, including by paying some consumers bribes.

Fiorella allegedly inflated projections of consumer income to make consumers appear qualified.

Fiorella allegedly paid an entity called Strong Opportunities LLC, which does business as Florida Care Insurance, to solicit consumers into enrolling in ACA plans, including through street marketing. Strong Opportunities is not named as a defendant.

Fiorella allegedly knew Florida Care marketers offered cash bribes and gift cards to induce enrollment. Fiorella also allegedly knew marketers sometimes gave addresses and Social Security numbers that did not belong to the consumers applying for plans.

Some plan applications were submitted on behalf of consumers without their authorization or consent.

Some consumers, because of the false enrollments, experienced disruptions in care for mental health, substance abuse and other medical disorders.

Others lost access to free health benefits they previously had through Medicaid or local assistance programs and thus found themselves having to pay more to access medications for HIV, opioid dependence or mental health disorders, the information said.

The Centers for Medicare and Medicaid Services and the Internal Revenue Service ended up awarding at least $141.5 million in subsidies, of which at least $102.7 million was paid out, as a result of the fraudulent ACA plan enrollments, it said.

— Bulldozing barriers —

Sunshine Health is putting new dollars behind a familiar problem: the everyday logistics that keep people from getting and keeping jobs.

The Centene subsidiary announced it is awarding $100,000 in grants to five Florida nonprofits that are targeting two persistent barriers standing between Floridians and the workforce — child care and transportation.

The funding will reach more than 40 counties, supporting programs ranging from car repairs to after-school care.

“We are proud to partner with nonprofit organizations that are creating practical, sustainable solutions to help people build stronger futures for themselves and their families,” said Charlene Zein, president and CEO of Sunshine Health. “We are excited to see the lasting impact these partnerships will have across Florida.”

The grants are split evenly among the organizations. Wheels of Success will expand its program to provide vehicles or major repairs for working adults and students in the Tampa Bay region. At the same time, Vincent House will help cover transportation for job interviews and employment programs in Pasco, Pinellas and Hernando counties.

In North Central Florida, the Boys and Girls Club will use its share to offer no-cost child care, and Safe Families for Children Alliance will provide a mix of child care support and transportation assistance across a 37-county footprint. The Healthy Start Coalition of St. Lucie will focus on transportation help for families enrolled in home visiting programs.

For recipients, the funding is less about convenience and more about access. As Susan Jacobs of Wheels of Success put it, reliable transportation can be the difference between staying employed or falling behind.

“This support helps ensure they can get to work, stay in school, and build a more secure future,” she said.

— Building bright futures —

The Florida health care plan is also touting results from a longer-term investment in workforce development.

This week, Sunshine Health highlighted 2025 outcomes from its Sunshine Health Works program, a statewide effort aimed at easing staffing shortages while building career pipelines into the health care sector. Since launching, the initiative has supported nearly 1,900 participants through partnerships with colleges, providers and community organizations, offering scholarships, certifications and hands-on training tied to employment opportunities.

“By partnering with colleges, health care providers, and community organizations, we’re helping people gain the skills they need to thrive in health care careers while addressing urgent staffing needs across the state,” Zein said. “Sunshine Health Works is more than a workforce initiative. It’s a reflection of our mission to improve lives and create pathways to self-sufficiency for the Medicaid members we serve.”

The program spans 12 partner organizations, including Tallahassee State College, Florida A&M University and the University of South Florida. It offers 17 certification tracks such as Certified Nursing Assistant, Home Health Aide and Licensed Practical Nurse. Participants have earned nearly 800 industry-recognized credentials so far.

Sunshine Health Works also includes more specialized tracks, including a doula training partnership that has credentialed nearly 200 participants across 10 counties, as well as recovery peer specialist training with the National Alliance on Mental Illness Florida and social work licensure support through USF.

The broader goal is twofold: to help individuals re-enter or advance in the workforce and to provide employers with a more reliable talent pipeline. As one participant put it, the program can be a reset button.

“After being laid off last year, this experience has been a turning point for me,” said Adrienne A, who is studying to become a medical administrative assistant. “Thanks to Broward College and Sunshine Health, I now feel confident in pursuing a position as a medical administrative assistant.”

— Giving 110% —

Three local bills — HB 4019, HB 4059 and HB 4041 — were signed into law last week, placing new limits on how much health care providers can charge for treating jail inmates in Lake, Polk and Indian River counties.

The measures, sponsored by Reps. Nan Cobb, Jon Albert and Robbie Brackett, apply similar frameworks across the three counties, capping payments to providers without contracts with local governments.

In most cases, reimbursement is tied to a percentage of Medicare rates, generally set at 110%, with higher caps allowed in limited circumstances, including for certain hospitals operating at a loss or for trauma care.

The legislation also places comparable limits on emergency medical transportation services for inmates and clarifies that the caps primarily apply to out-of-network providers, leaving existing county contracts unaffected.

Each bill applies only within its respective county, but the language and rate structures are nearly identical across all three measures.

All three bills took effect upon being signed and are now law.

— Medical freedom —

U.S. Rep. Byron Donalds’ health care policy platform emphasizes consumer choice and transparency to give consumers options and recourse.

His “Your Doctor, Your Price” initiative, rolled out this week in The Villages, would require health care providers to post real cash prices for their top 20 services offered.

Donalds’ plan would also align Florida’s prescription drug program with federal costs and promote the freedom to choose health care providers without pre-authorizations or surprise billing.

“When it comes to health care, one thing I’ve learned: The doctors are frustrated, the patients are frustrated,” Donalds said. “When you’re seeing the workers in that system and the users of that system, both, quite frankly, pulling their hair out … what it means is we have a responsibility to bring real reforms that will make this system and this process better.”

Donalds acknowledged that Florida’s health care challenges affect seniors and families in large cities and small towns alike, vowing to pursue quality health care that is affordable and transparent and protect what he calls the “Florida Dream.”

“We want to make sure that those prices and that transparency is available to everybody — so that we have stability, we have certainty, we have efficiency, we have competition and, in short, all of you get the very best out of the best state in all of America.”

— Rural health: Round 1 —

Florida is opening the door for vendors to help stand up a major rural health initiative.

The Agency for Health Care Administration is announcing the first round of procurement opportunities tied to the state’s Rural Health Transformation Program, a $209 million effort backed by the Centers for Medicare & Medicaid Services.

The program, authorized by Congress last year, is designed to bolster health care access in rural communities through new care models, technology upgrades and workforce investments.

“Under the leadership of Gov. Ron DeSantis, Florida continues to prioritize access to quality health care,” AHCA Secretary Shevaun Harris said. “The Rural Health Transformation Program gives us a powerful opportunity to strengthen health care delivery in rural communities across our state.”

The first wave of procurements includes contracts for a grant management system, independent evaluation services, technical assistance for sub-awardees and education and outreach aimed at helping patients navigate coverage options.

State officials say the contracts are intended to build the backbone of the program — tracking outcomes, ensuring compliance and supporting local providers as funding flows out.

AHCA said it will soon announce a second round of procurements focused more directly on expanding access to care in rural areas. The funding is fully supported through federal dollars, with the state overseeing implementation.

Vendors looking to apply for one of the contracts can find more information and application materials on AHCA’s Rural Health Transformation Program portal.

— Florida’s meh for kids —

When it comes to child health care, compared to other states, Florida is mediocre.

A new analysis published by WalletHub, a personal finance company, shows Florida certainly isn’t the worst state for children’s health care. But it’s far from the best.

Overall, Florida was ranked the 24th best state for children’s health care in the U.S. While that may be in the middle compared to the rest of America, Florida was the highest-ranked among Southern states except Virginia, which was ranked 18th.

But compared to other areas, the Southeastern states were woefully lacking. North Carolina was the next-closest state to Florida and ranked 31st. Mississippi was ranked last in the nation, coming in at 51st, and the rankings included the District of Columbia. Kentucky ranked 47th, Georgia 45th, Texas 44th, Oklahoma 43rd, Arkansas 42nd and Louisiana 40th.

WalletHub analysts used 33 key indicators to compile the list, with different indicators used to aggregate overall health care for kids. Multiple factors were used to calculate a child’s health care score, with Florida scoring 51.38. That’s compared to the top state, which was Massachusetts and a score of 67.34. Rhode Island’s score was 61.77 for second place, and Connecticut ranked third with a score of 60.91.

There were elements where Florida excelled beyond the middle of the pack. The Sunshine State ranked 10th in the percentage of children in excellent or very good health. Florida ranked 15th in the percentage of children with excellent or very good teeth and 18th in the percentage of obese children.

But Florida is seriously lagging in other areas of child health care. WalletHub analysts found Florida ranked 45th in the percentage of uninsured children and 41st in the percentage of overweight children. Infant death rates, percent of children with unaffordable medical bills, pediatricians and family doctors per capita were all ranked in the 30s.

— Killing clipboards —

A Florida health care technology company says it’s closer to making patient paperwork a thing of the past.

WellConnector, headquartered in Tallahassee, has designed a digital application to securely store and share patient health history transmitted to health care providers. The company debuted a demonstration in Washington, D.C., this month.

Company officials were at the Centers for Medicare & Medicaid Services Health Tech Ecosystem Live! First Wave launch on April 9. The event highlighted “patient-facing” applications geared toward reducing red tape in the health care industry.

The WellConnector company team demonstrated their application, which they say supports the “Kill the Clipboard” initiative. This seeks to create a seamless and secure data exchange that reduces the need for patients to repeatedly call health care providers and write out their medical history.

“The timing of these broader shifts in the health care ecosystem creates new opportunities to scale and collaborate, including testing through a broader network of partners and platforms,” said Allison Aubuchon, WellConnector cofounder and CEO. “This CMS initiative means there will be greater consensus around standards for identity, security, and interoperability, reducing barriers when exchanging information across health care systems.”

WellConnector employees demonstrated the system live on a stage before other health care officials and companies. The key component was tight security for the application and preventing unauthorized access to medical records.

“Our mission remains focused on improving the intake process — the very first step of a patient’s health care experience,” said Aubuchon. “We believe getting that right, and doing so in Tallahassee, which we proudly see as a Capital Region Healthcare Innovation Hub, will improve care for patients in our community and beyond.”

— Go Bulls! —

The University of South Florida Athletics is announcing a first-of-its-kind jersey patch partnership with Tampa General Hospital (TGH) that will put the hospital’s logo on Bulls football uniforms beginning this season.

The partnership is the first college athletics jersey sponsorship of its kind in Florida and among the first nationally involving a health care provider. While the patch is new, the partnership expands on a relationship that dates back more than 25 years.

The jersey patch will make its on-field debut at the Bulls’ season opener on Sept. 5, marking a milestone moment for both institutions and a potential blueprint for similar partnerships across Florida college athletics.

USF Athletics CEO Rob Higgins said the move is part of a broader evolution in collegiate athletics, where programs are increasingly turning to corporate partnerships to generate revenue in the name, image and likeness (NIL) era.

“We are proud to have TGH represented on our jerseys in recognition of their profound impact on our community, steadfast support of our student-athletes and continued partnership in realizing our vision for the future of USF Athletics,” Higgins said. “This is more than a partnership — it’s a shared commitment to excellence, innovation and the relentless pursuit of greatness.”

For Tampa General, the agreement formalizes and elevates its role as USF’s exclusive hospital-based health care provider.

“As members of our Tampa Bay community, we have the privilege of caring for student-athletes on and off the field,” said John Couris, president and CEO of Florida Health Sciences Center — which operates TGH. “At its heart, this partnership is about just that: delivering world-class, comprehensive care — powered by academic medicine — that supports their health, safety and performance year-round.”

— Next reporter up —

A new byline is taking over the health care beat at the Tampa Bay Times.

Reporter Lauren Peace is stepping into the role following Christopher O’Donnell’s move to the paper’s Investigations Team, marking a full-circle moment for Peace.

Peace first pursued the job back in 2021 when she was a health reporter at the Mountain State Spotlight in West Virginia. Though she lost out to O’Donnell, she did land in the Times’ newsroom covering Pinellas government.

With the seat opening, Peace is ready to hit the ground running.

“To me, health journalism is about so much more than the medical centers we go to when seeking treatment (though those are important). It’s about the social systems — or lack thereof — that make it possible for people to live happy, fulfilling lives,” she said in an email announcing the newsroom shuffle.

Peace’s experience on the health care beat includes coverage of the opioid crisis, HIV outbreaks and rural hospital access, along with more recent enterprise work humanizing the challenges faced by people in the Tampa Bay area.

O’Donnell, who held the beat for five years, earned a reputation for translating complex health issues with clarity and empathy — a standard Peace acknowledged as she steps into the role.

“I aim to fill big shoes,” she wrote.

— ICYMI —

“Top Dem think tank unveils next big health care push” via Jonathan Cohn of The Bulwark — The Center for American Progress introduced a set of proposals to limit what hospitals and insurance companies can charge, while also limiting the ability of insurers to deny coverage that doctors recommend to their patients. The proposals aren’t fully fleshed out in the way, say, a bill in Congress would be. It’s a starting point for future legislation — a set of ideas that political leaders could debate and refine, tout on the campaign trail and, eventually, attempt to pass into law. CAP is widely known as the unofficial policy incubator for moderate-to-liberal Democrats, which means its proposals are likely to get a serious hearing in Washington. Veterans of past Democratic administrations are heavily represented in the group’s upper ranks. Many would probably end up back in the executive branch — or with jobs on Capitol Hill — if Democrats get control of either or both chambers in upcoming elections.

“Where U.S. science has been hit hardest after Donald Trump’s first year” via Carolyn Y. Johnson, Lydia Sidhom and Susan Svrluga of The Washington Post — While courts and Congress have stopped some of [President Trump’s] harshest cuts, fewer projects are moving forward. … American science is shrinking. … [H]alfway through this fiscal year, the number of competitive grants awarded by the National Institutes of Health is down by more than half compared with the same period last year. Biomedical funding has also undergone a shift … cutting the U.S. research footprint across nearly every major disease area — including fewer grants focused on women’s health, cancer and mental health. A spokesperson for the Department of Health and Human Services said in an email that the “Democrat-led shutdown” late last year was responsible for delays and that the NIH was catching up.

“Florida 2026 childhood vaccination rates fall, even as measles cases hit record levels” via Cindy Krischer Goodman of the Orlando Sentinel — The vaccination rate for Florida kindergartners now hovers just under 89% for the second school year in a row, after having been well above 90% in the decade before the pandemic, according to newly released Florida Department of Health data. In 2016, the rate had been as high as 94%. Immunization levels for seventh graders in Florida dropped from 92.1% last school year to 91.9% in the 2025-26 school year, the lowest level in more than a decade. Those levels are well below what is considered adequate for herd immunity, which typically requires a vaccination rate of 95% to prevent the spread of highly contagious diseases.

“Intact but not in use: Florida’s AIDS drug formulary advisory panel” via Christine Sexton of the Florida Phoenix — The Florida Department of Health limited access to lifesaving drugs for people with HIV without consulting its hand-picked advisory committee. Some members of the HIV Section Medication Formulary Workgroup aren’t sure whether the panel still even exists. “My understanding is, it’s been disbanded,” Dr. Jonathan Appelbaum, a member of the panel, told Leon County Circuit Judge Jonathan Sjostrom during a recent hearing. Appelbaum isn’t the only panel member to think that. When asked whether the drug workgroup still exists, member Dan Wall said, “Probably not.” … “And I answer it that way because there’s been no formal communication from the state with anybody about anything.”

“Medicare dollars are running out, and feds are turning to AI to slow it” via Anne Geggis of USA Today Network-Florida — Starting in January, the CMS launched a pilot program so that select services provided through traditional Medicare insurance can be AI-reviewed to determine if the expense is medically necessary, a process known as preauthorization. It’s called WISeR, or Wasteful and Inappropriate Service Reduction. And, given the new expansion of AI into insurance companies’ decisions — along with CMS’s stated target of eliminating the 25% waste in medical spending — it looks like the wave of the future. WISeR presents two new twists that have critics alarmed — a greater possibility that traditional Medicare claims will be subject to review for medical necessity and that task will be done by third-party private companies “experienced in using enhanced technologies to expedite and improve the review process for a pre-selected set of services that are vulnerable to fraud, waste and abuse.”

“Florida sits on millions in unspent funds for disability care while thousands wait” via Craig Patrick of Fox 13 Tampa Bay — In prior years, the Agency for Persons with Disabilities has attributed the multi-year backlog to a lack of dedicated funding. However, state financial records reveal a massive rolling surplus of $456 million in unspent funds allocated for home-based services. According to Jim DeBeaugrine, who directed the agency under former Govs. Jeb Bush and Charlie Crist, when combined with the federal match, that unspent total reaches approximately $1.06 billion. Leaving home-based care funds unspent may not ultimately save taxpayer money. By denying in-home support, caregivers are pushed to the breaking point. When families collapse under the strain, individuals with disabilities can be placed into Medicaid-funded institutions. Institutionalization costs taxpayers upward of $100,000 per patient per year, compared to less than $60,000 for home-based care.

“Okaloosa County School District opens new health clinic for employees” via Northwest Florida Daily News — Okaloosa Schools opened its new employee health clinic at Okaloosa Technical College, 1976 Lewis Turner Blvd., Fort Walton Beach. The clinic will serve employees and dependents enrolled in the district health plan and will provide preventive screenings, treatment, chronic condition support and prescription services. “By removing barriers like cost and access, we are making it easier for our staff to prioritize their health, something that directly impacts their ability to support our students each day,” Superintendent Marcus Chambers said.

“New Lee Health residency looks to help OB-GYN shortage in Southwest Florida” via Cary Barbor of WUSF — The U.S. Department of Health and Human Services projects a nationwide shortage of 5,000 OB-GYNs by 2030. But Lee Health is doing something to help. The first class of OB-GYN residents at the hospital will officially begin training on July 1. The program, run in conjunction with Florida State University, aims to repopulate the OB-GYN workforce in the region, starting with the six in this cohort. Fifty-seven additional residents will be training in other specialties.

— RULES —

The Board of Dentistry’s final rules (64B5-16.006) regarding remediable tasks that can be delegated to dental assistants (64B5-16.005) and dental hygienists go into effect on April 26.

The Board of Dentistry’s final rules regarding the delegation of remediable restorative functions to dental assistants (64B5-16.0051) and dental hygienists (64B5-16.0061) go into effect April 26.

The Board of Dentistry’s final rule (64B5-4.002) regarding advertising and soliciting by dentists goes into effect April 26. More here.

The Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling’s final rule (64B4-3.011) regarding the Professional Counseling Licensure Compact went into effect on April 20. More here.

— PENCIL IT IN —

April 27

Happy birthday to Rep. Adam Botana!

April 28

The Legislature will convene for a Special Session on Congressional redistricting, the so-called “AI Bill of Rights,” and “medical freedom.” The latter component is a continuation of Sen. Clay Yarborough’s Regular Session effort (SB 1756) that would’ve required informed consent from parents before vaccines could be administered, shielded doctors from liability if they give out ivermectin and allowed pharmacists to do the same upon request. Yarborough’s bill, which passed the Senate, also would’ve greenlit a “conscience-based objection” to childhood inoculations. Rep. Jeff Holcomb sponsored a similar but not identical bill (HB 917) that went unheard in the House.

May 1

Happy birthday to Rep. Richard Gentry!

11:30 a.m. — Lauren’s Kids 2026 “Walk in My Shoes” comes to Tallahassee. The event, held in Kleman Plaza, begins with a Fun Walk and Safety Fair at 11:30 a.m., followed by “The Final Miles” at 2 p.m. Tallahassee is the final stop of the organization’s monthlong, 1,500-mile trek across Florida. Full schedule and registration information are available on the Lauren’s Kids website.