Politics
Diagnosis for 11.2.26: Checking the pulse of Florida healthcare news and policy
Welcome back to Diagnosis, a vertical focused on the intersection of healthcare policy and politics.
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— Middlemen, meet microscope —
Florida’s insurance regulator is signaling an enforcement push against pharmacy benefit managers before year’s end.
Insurance Commissioner Michael Yaworsky told attendees at the Future of Florida Forum that the Office of Insurance Regulation will announce “a number of actions” involving PBMs in the coming months.
“We will shed a great deal of light on that industry and take action wherever appropriate,” Yaworsky said.
The Legislature gave OIR responsibility for regulating PBMs, which operate between insurers, drug manufacturers, and pharmacies. Yaworsky described them as “hidden actors in the insurance space” whose purchasing power is supposed to help drive down prescription drug costs.
He framed the coming actions as part of Florida’s effort to make health coverage more transparent and affordable. While Yaworsky offered a sunny diagnosis of the state’s recovering property and auto insurance markets, he was considerably less satisfied with healthcare.
“I know that collectively, as a society, we are not delivering on that promise,” he said, adding that too many people end up in financial trouble simply because they get sick.
Florida is the nation’s largest Affordable Care Act market, with more than 3 million participants, according to Yaworsky. He said the state’s size, growth, and unusual demographics make it a natural testing ground for changes to healthcare delivery and insurance.
He said the PBM actions will advance Florida’s effort to create a system consumers can understand and trust to give them a fair deal.
— Double payments, single patient —
Florida TaxWatch wants lawmakers to tighten the state’s defenses against improper Medicaid payments, but its latest briefing cautions that many costly mistakes stem from outdated technology and administrative breakdowns rather than criminal schemes.
The watchdog group focused on duplicate capitation payments, the fixed monthly payments Florida makes to managed care organizations for each Medicaid enrollee regardless of how much care that person receives. Duplicate identification numbers, outdated enrollment records, or coverage in multiple states can cause the government to pay the same beneficiary more than once.
A federal audit found that in August 2020, Florida made $15.8 million in erroneous concurrent payments for 55,164 people who were also enrolled in Medicaid in another state.
The potential exposure is enormous. Florida’s $36.1 billion Medicaid appropriation represents nearly one-third of the state budget and 76% of health and human services spending. Nationally, Medicaid’s estimated improper payment rate reached 6.12% in 2025, or $37.39 billion.
TaxWatch stressed that improper payments are not synonymous with fraud, which requires criminal intent. More than three-quarters of improper payments nationally resulted from administrative errors, missed steps, or missing paperwork.
TaxWatch President and CEO Jeff Kottkamp said problems involving deceased enrollees or duplicate identification numbers are “not so much the result of beneficiaries and vendors trying to game the system” as the program’s size and “arcane technology currently used to administer it.”
TaxWatch wants lawmakers to allow the Agency for Health Care Administration to seize provider or owner assets to compel repayment, remove existing limits on pharmacy audits, and require more useful annual reporting on anti-fraud work. It also recommends automated payment reconciliation, a master patient index, routine checks against federal death records, and tracking retroactive disenrollment.
“It is important to remember that the true victims of multiple Medicaid capitation payments are program enrollees, honest service providers, and hard-working Florida taxpayers,” Kottkamp said.
— Four of Florida’s best —
Four Florida Behavioral Health Association member organizations earned spots on Newsweek’s 2026 list of America’s Best Residential Addiction Treatment Centers.
The Florida honorees are Hanley Center, Broward Addiction Recovery Center, Agape Network, and Meridian Behavioral Healthcare. They were among 22 facilities recognized statewide.
Newsweek and research partner Statista recognized 440 residential treatment centers nationwide. To qualify, facilities had to provide inpatient or residential addiction treatment for at least 30 days. The rankings combined recommendations from addiction treatment professionals, accreditation and licensing information, available care services, and patient reviews.
Professional reputation carried the most weight in the scoring, followed by credentials recorded by the federal Substance Abuse and Mental Health Services Administration. The top 10% to 15% of eligible facilities in each state or region made the final list.
“This recognition underscores the significant role our community providers play in delivering high-quality addiction treatment services across Florida,” said FBHA President and CEO Melanie Brown-Woofter. “It is a testament to our incredible members, working each day to better the lives of Floridians.”
FBHA represents community mental health and substance use treatment providers operating throughout Florida. Its members collectively serve more than half a million people annually, primarily uninsured, underinsured, and Medicaid patients.
— CHIME —
Baptist Health is wired into digital health services, according to the College of Healthcare Information Management Executives (CHIME).
The global network published its annual Digital Health Most Wired survey, which taps information technology professionals and services to issue its ratings. Baptist Health on the First Coast received a “Level 10” designation. That’s the highest possible rating for both acute and ambulatory categories.
Of the 235 healthcare organizations that pursued CHIME’s Level 10 certification, only 14 earned that top rating. It marks the fourth consecutive year Baptist Health has achieved the rating.
“Technology is a catalyst for better care, helping us serve patients in new and more meaningful ways,” said Matthew A. Zuino, President and CEO of Baptist Health.
“Earning this recognition for the fourth consecutive year demonstrates our continued commitment to excellence, innovation and the people we serve, while creating a more connected, accessible and patient-centered experience for those who trust us with their care.”
The CHIME survey considers technology used to improve healthcare. Factors include safety, communication, access, and patient experience.
Baptist Health was noted for developing its mobile application, Baptist Access, which helps patients manage personalized information and navigate Baptist Health locations in Northeast Florida. Baptist Health was also recognized for its voice recognition technology and artificial intelligence development.
— Check your benefits —
As Floridians compare health plans during open enrollment, some will find a new screening benefit in their 2027 coverage: a colorectal cancer blood test.
Major insurers, including UnitedHealth Group, have expanded coverage for Guardant Health’s Shield blood test. Guardant says more than 90 million Americans age 45 and older now have access through their coverage, with most covered patients paying nothing out of pocket, although costs and eligibility vary by plan. Eligible Medicare beneficiaries and VA Community Care patients are also covered, and Florida is one of two states offering Medicaid coverage for the test.
The FDA approved Shield in 2024 as the first blood test available as a primary colorectal cancer screening option for adults 45 and older at average risk. It requires a routine blood draw without the preparation or sedation associated with a colonoscopy.
In the clinical study supporting approval, Shield detected 83% of colorectal cancers. But it is not a replacement for diagnostic colonoscopies or surveillance for higher-risk people. A positive result must be followed by a colonoscopy, while a negative result does not guarantee that cancer is absent.
The expanded coverage arrives as the American Cancer Society estimates that 12,850 Floridians will be diagnosed with colorectal cancer this year and 4,240 will die from it.
For Floridians reviewing their 2027 benefits, the practical takeaway is simple: Check whether the test is covered and ask a doctor which screening method fits their age, medical history, and individual risk.
— AI, stat —
Tampa General Hospital says its partnership with Palantir has helped save more than 1,000 lives by identifying sepsis before patients deteriorate.
TGH President and CEO John Couris told attendees at the Florida Chamber’s Future of Florida Forum that the hospital system uses Palantir’s technology to continuously monitor 16 to 20 clinical indicators for patients who have, or may develop, sepsis.
When the system detects a potential problem, it alerts a rapid-response nurse who reviews the patient’s medical record. If the nurse confirms the warning, diagnostic, therapeutic, or multidisciplinary teams can be sent to the bedside.
The distinction is measured in lives. Couris said sepsis kills between 15% and 18% of affected hospital patients nationally, with the rate reaching 30% at some institutions. At Tampa General’s main academic medical center, he said, the rate is below 5%.
“Over the last few years that we’ve been deploying this, we have saved over 1,000 lives,” Couris said. “These are mothers and fathers and children and grandparents that are back in their homes, living their lives that otherwise would have been dead. That’s about as real as it gets when you’re marrying up intellectual property and people with technology.”
TGH now deploys more than 110 artificial-intelligence applications around the clock, Couris said, including about 60 powered by Palantir’s Foundry and AIP platforms.
Ted Mabrey, Palantir’s Head of Global Commercial, said the work shows why AI should expand doctors’ and other professionals’ reach rather than render them irrelevant. He said the same approach could detect the equivalent of “sepsis” in manufacturing equipment, supply chains, and other complex systems.
Couris offered business leaders a less flashy prescription: Start with the problem, not the technology.
“Don’t get swept up in the sexiness of AI,” he said. “Think about it as a practical tool to create real value in your businesses.”
— Bedside questions, research answers —
Tampa General Hospital and the USF Health College of Nursing are launching a yearlong fellowship to help front-line nurses turn questions that arise during patient care into formal research.
The inaugural TGH/USF Nursing Research Fellowship pairs hospital nurses with clinical and academic research experts for structured education, mentorship, and support. Fellows will learn the full research process, including developing questions, evaluating existing evidence, designing studies, navigating institutional review, and analyzing data.
The first 2026-27 class includes four TGH nurses whose projects will examine pediatric oncology, diabetes education, skin failure, and the transition of newly graduated nurses into clinical practice.
“Our goal is to give nurses the mentorship, encouragement, and resources to take that first step and to see themselves not only as consumers of evidence, but also as contributors to the science that shapes nursing practice,” said Wendi Goodson-Celerin, TGH’s Executive Vice President and Chief Nursing Executive.
TGH Nurse Scientist Lakeshia Cousin leads the hospital’s nursing research program and the new fellowship. The program also draws support from TGH clinical research, professional development, and library teams; the Cancer Institute; and USF nursing faculty.
The partners envision the fellowship becoming an annual pipeline for nurse researchers, giving clinicians a way to evaluate bedside ideas and translate findings into better patient care, future studies, and potential outside funding.
— Keeping livers alive —
Tampa General Hospital has completed its 1,000th liver perfusion, a milestone hospital officials say has nearly doubled its liver transplant program and cut the median wait from placement on the transplant list to less than a month.
Normothermic machine perfusion keeps a donated liver functioning outside the body at near-normal temperature while oxygenated blood and nutrients circulate through it. That allows the transplant team to watch how the organ performs before surgery and consider livers that might otherwise go unused.
TGH first used the technology in October 2022 and has routed every liver transplanted at the hospital through perfusion since September 2023. By making perfusion routine and keeping the expertise within its own transplant team, TGH says it has expanded the pool of donor organs available to patients.
“Our experience goes beyond operating a machine,” said Dr. Vijay Subramanian, a transplant surgeon and Director of Liver Machine Perfusion at the TGH Transplant Institute. “It is about understanding how each liver performs during perfusion and applying that knowledge to transplant decisions.”
The milestone builds on more than 50 years of transplant work at TGH. The hospital has completed more than 15,000 organ transplants and performed 895 across its programs in 2025, keeping it among the nation’s five highest-volume transplant centers.
— Tampa General financial expert promoted —
TGH is getting a new Executive Vice President and Chief Financial Officer.
Lijah Lokenauth, currently TGH’s senior vice president of Finance, has been promoted to the role. Hospital officials say he will take over on Jan. 4.
In his new role, Lokenauth will oversee financial strategy and operations supporting the hospital’s long-term sustainability and strategic priorities.
Lokenauth rose through the ranks at TGH, where he began as Corporate Controller in 2018. Hospital officials credit him with strengthening the hospital’s financial systems, focusing on financial reporting, decision support, and productivity management. He has also built partnerships with clinical and operational leaders.
“Lijah is a steady, collaborative and highly respected leader who has earned this opportunity through his accomplishments, skill, and his strategic collaborative approach to his work and supporting his colleagues,” said Couris.
“He has demonstrated sound judgment under pressure, a willingness to take on new challenges and a commitment to leading with the professionalism, curiosity, kindness, consistency and initiative that reflect our values. I’ve witnessed his growth firsthand, and I have tremendous confidence in his ability to lead our complex financial operations as we continue to expand access to academic medicine across Florida.”
Lokenauth said he is grateful for the promotion.
“What makes this next chapter exciting is not just how much we’ve grown, but the opportunity to build on that progress. As we look ahead, our focus will be on maintaining a strong financial foundation, making disciplined decisions about how we allocate our resources, and positioning the organization to navigate both the opportunities and challenges ahead,” Lokenauth said.
— Florida Board of Medicine —
Gov. Ron DeSantis is appointing or reappointing seven members to the Board that oversees medical regulation in the state.
DeSantis announced the appointments to the Florida Board of Medicine on Friday. New appointees are Andrea Aguilera, Lisa Kay Mao, and Elyse Young. Returning members are Scot Ackerman, Gobi Balaji, Matthew Benson, and Hector Vila.
The Board of Medicine oversees licensing and regulation of medical professionals in Florida. It also disciplines practitioners and enforces safety and ethical standards for doctors, physician assistants, and other medical professionals.
Aguilera, a practicing pediatrician with Emergency Resources Group, previously worked for Nicklaus Children’s Health System. She completed her medical residency at Indiana University Health.
Mao, a practicing clinical ophthalmologist, has three decades of medical experience in Florida.
Young joins the Board after 20 years in state government, with expertise in budgeting, legislative analysis, finance, and policy development. She has also worked on federal healthcare policy and regulation.
Ackerman, Medical Director of the Ackerman Cancer Center, oversees the Ackerman Cancer Foundation and serves on the Board of WeCare Jacksonville.
Balaji is the Founder, President, and CEO of Brevard Health Center, where he also practices. He serves on the Board of the Health First Foundation, the University of Central Florida College of Medicine Admissions Committee, and the Holmes Regional Medical Center Credentials Committee. He previously chaired the Melbourne Regional Medical Center Credentials Committee and served as President of the Brevard County Medical Society and the Brevard Indian Medical Dental Association.
Benson is a pediatric endocrinologist at Nemours Children’s Health. He is a member of the American Academy of Pediatrics, the Pediatric Endocrine Society, the Endocrine Society, the American Society for Bone and Mineral Research, and the American Diabetes Association. He received the Gladys P. Soler, M.D. Ambulatory Pediatrics Award and was named Most Outstanding Pediatric Resident at the University of Florida College of Medicine – Jacksonville.
Vila owns Pediatric Dental Anesthesia Associates, where he practices anesthesiology. He serves as Treasurer of the Florida Society of Anesthesiologists Board of Directors and is a member of the Florida Medical Association.
The Florida Senate still must approve the appointments and reappointments.
— ROSTER —
DeSantis announced a slate of appointments to three healthcare Boards Friday.
For the Board of Chiropractic Medicine, DeSantis appointed Pari Limbachia, clinical director of Shant Wellness, and reappointed Walter Melton, owner of Downtown Chiropractic and Sports Development. Both appointments require Senate confirmation.
DeSantis reappointed Leigh Mathes, Director of Operations for Coastal Med of Florida; Cristina Medina, a CVS Health pharmacist; Darrell Miller, a consultant Pharmacist for DSM Consultants; and Dorinda Segovia, vice president and Chief Pharmacy Officer for Memorial Healthcare System, to the Board of Pharmacy. The Senate must also confirm the appointments.
For the Health Care District of Palm Beach County, DeSantis appointed Kelly Smallridge, President and CEO of the Business Development Board of Palm Beach County, and reappointed former state Rep. Patrick Rooney, president of the Palm Beach Kennel Club.
— LOBBYISTS —
Ron LaFace, Megan Fay, Matt Floyd, Capital City Consulting: AMIkids
Jennifer Green, Ethan Merchant, Timothy Parson, Adam Potts, Liberty Partners of Tallahassee: Heart’n Soul Hospice
Cynthia Henderson, Converge Government Affairs of Florida: Indivior
James McFaddin, Erica Thomas, The Southern Group: Artera
— ICYMI —
“Why 2026 is a healthcare election” via Jonathan Cohn of The Bulwark — If you really want to know why this is a healthcare election, your best source isn’t the politicians or the pollsters. It’s the people on the front lines. One of them is Raymond Rion, a family medicine physician and executive director of Packard Health, a small clinic network spanning Ann Arbor and Ypsilanti on the western outskirts of the Detroit metro area. Packard is a Federally Qualified Health Center, where anyone can get care regardless of income or insurance status. Like similar safety-net providers across America, it has benefited directly from the Affordable Care Act over the past decade. Compared to 2011, many more patients have Medicaid or private coverage purchased through HealthCare.gov, so the uninsured rate has fallen from about one in three to one in ten. It’s much easier to get referrals for these insured patients, so thanks to the influx of paying customers, Packard can do much more on its own.
“‘Ambitious’ timeline means Ron DeSantis could pass new vax rules before he leaves office” via Christine Sexton of Florida Phoenix — DeSantis’ efforts to pare back the number of vaccines children must receive to enter school or daycare could pay off for him before he leaves office on Jan. 5 in light of a state administrative judge’s agreement Thursday to expedite a hearing on challenges to them. Florida Division of Administrative Hearings Judge David Watkins consolidated two separate challenges to the proposed new rules and set the week of Dec. 14 to hear arguments. Although the time frame is tight, the schedule could allow the DeSantis administration to implement the changes if Watkins recommends in favor of the Florida Department of Health, Jacksonville healthcare attorney Chris Nuland said. “It’s ambitious, but not impossible. The judge would have to be diligent in preparing an order during the Christmas and the New Year holidays,” Nuland told the Phoenix.
“MAHA Action backs Anna Paulina Luna for third term in Congress” via Jesse Mendoza of Florida Politics — MAHA Action, a political advocacy group that supports President Donald Trump’s Make America Healthy Again agenda, is endorsing Anna Paulina Luna’s bid for a third term representing Florida’s 13th Congressional District. The organization called Luna “one of Congress’s strongest MAHA champions,” citing her efforts to improve food transparency and hold pesticide manufacturers accountable. Luna faces Democrat Leela Gray in the Nov. 3 General Election. Recent polling has shown a close contest, while Cook Political Report and Inside Elections have shifted the race from Likely Republican to Lean Republican. Gray also outraised Luna in the latest reporting period, though Luna had about $747,000 in cash on hand, compared with Gray’s $656,000, as of Oct. 14.
“With $47M federal backing, Moffitt to build radiopharma hub at Speros” via Anjelica Rubin of the Tampa Bay Business Journal — A coalition led by Moffitt Cancer Center has secured $47.3 million in federal funding to build out radiopharmaceutical manufacturing, laboratory and startup infrastructure at its Speros life sciences campus in Pasco County, advancing a vision projected to support 4,000 jobs across Tampa Bay. The U.S. Economic Development Administration award will fund five projects to establish a regional hub for developing and manufacturing radiopharmaceuticals — targeted therapies that use radioactive compounds to diagnose and treat diseases, including cancer. The initiative, known as the Florida Oncology and Radiopharmaceutical Growth Engine, or FORGE, brings together Moffitt and Speros with Embarc Collective, the University of South Florida and Pasco-Hernando State College.
“BayCare plans pilot program for robotic blood-draw devices at two Pinellas labs” via Rick Mayer of WUSF — BayCare is planning a pilot program for Florida’s first FDA-approved, image-guided robotic blood-draw device. The Aletta device uses real-time imaging to guide blood collection. According to the manufacturer, Vitestro, Aletta has achieved a 94.5% first-stick success rate. “The needle remains out of the patient’s view during the robotic procedure,” a BayCare press release says. The 18- to 24-month pilot will begin in late 2027 at two of BayCare’s busiest laboratory service centers in Pinellas County: the Suncoast Medical Office Building in St. Petersburg and the BayCare HealthHub in the Bardmoor Medical Arts Building in Largo.
— RULES —
The Department of Health’s final rule (64-4.214) regarding Application for MMTC Licensure goes into effect today. More here.
The Board of Physical Therapy Practice’s final rule (64B17-9.001) regarding Continuing Education goes into effect on Wednesday. More here.
The Agency for Health Care Administration, Health Facility and Agency Licensing’s final rule (59A-35.060) regarding Licensure Application Process goes into effect on Wednesday. More here.
The Agency for Health Care Administration, Health Facility and Agency Licensing’s final rule (59A-9.020) regarding Licensure Procedures goes into effect on Wednesday. More here.
The Board of Pharmacy’s final rule (64B16-26.103) regarding Continuing Education Credits; Renewal goes into effect on Monday. More here.
The Board of Nursing Home Administrators’ final rule (64B10-12.0001) regarding Fees goes into effect on Nov. 11. More here.
— PENCIL IT IN —
Nov. 3
Happy birthday to Rep. Susan Valdés!
2 p.m. — The Board of Opticianry meets to consider licensure applications, rules, disciplinary matters, and other Board business. Via Microsoft Teams. Join here.
Nov. 4
Happy birthday to Reps. Demi Busatta and Felicia Robinson!
10 a.m. — The Statewide Council on Opioid Abatement meets to discuss opioid-settlement spending, abatement efforts, and recommendations to state and local policymakers. Via Microsoft Teams. Join here.
1 p.m. — AHCA’s Health Information Exchange Coordinating Committee meets to discuss Florida’s health information exchange, electronic medical records, privacy, and security. Via Microsoft Teams. Join here. To get a copy of the agenda, contact crystal.ritter@ahca.myflorida.com.
1 p.m. — The Florida Interagency Coordinating Council for Infants and Toddlers holds its quarterly meeting to advise the Department of Health’s Early Steps Program. Via Microsoft Teams. Join here. A copy of the agenda may be obtained by contacting FICCIT@FLHealth.gov.
Nov. 5
8:30 a.m. — The Florida Association of Community Health Centers opens its Health Center Fiscal Summit, featuring sessions on financing, reimbursement, billing, and value-based contracting. Orlando World Center Marriott, 8701 World Center Drive, Orlando.
9 a.m. — The Florida Hospital Association opens its Managed Care Conference. AHCA Secretary Shevaun Harris will deliver a Medicaid managed care update at 2:30 p.m. at Signia by Hilton, Orlando. View the agenda.
1 p.m. — The Brain and Spinal Cord Injury Advisory Council meets to conduct Council business. Via Microsoft Teams. Meeting ID: 260 337 820 463 041; Passcode: q4ap2Hu2. A copy of the agenda may be obtained by contacting Kimberly.Robinson@FLHealth.gov.
1 p.m. — The Board of Dentistry meets to consider general Board business and disciplinary matters. Marriott North Hotel, 6650 N. Andrews Ave., Fort Lauderdale.
Nov. 6
7:30 a.m. — The Board of Dentistry continues its meeting on general Board business and disciplinary matters. Marriott North Hotel, 6650 N. Andrews Ave., Fort Lauderdale.
8 a.m. — The Florida Hospital Association’s Managed Care Conference continues with its second day of programming. Signia by Hilton, Orlando. View the agenda.
8:30 a.m. — The Florida Association of Community Health Centers holds its Uniform Data System training, covering federal health center reporting requirements. Orlando World Center Marriott, 8701 World Center Drive, Orlando, with a virtual attendance option.
Nov. 7
Happy birthday to Sen. Barbara Sharief!
Nov. 9
Happy birthday to Reps. Chad Johnson and Chase Tramont!
1:30 p.m. — The Department of Health’s Institutional Review Board reviews new studies involving human participants, changes to existing studies, and ongoing research for ethical and regulatory compliance. Via Microsoft Teams. Join here. A copy of the agenda may be obtained by contacting IRB@FLHealth.gov.
Nov. 10
2:30 p.m. — The Lower Florida Keys Hospital District’s Finance Committee holds its quarterly meeting, followed by the Lower Florida Keys Hospital District Board’s regular meeting at 3 p.m. DoubleTree Grand Key Resort, Key West.
Nov. 12
Happy birthday to Sen. Nick DiCeglie!
9 a.m. — The Florida Health Care Association and AHCA hold ‘Know the Code: 2026 Life Safety Program,’ covering nursing-home compliance, building and fire codes, plan review, surveys, and common deficiencies. Second-floor auditorium, USF Health CAMLS, 124 S. Franklin St., Tampa, with a simultaneous Zoom broadcast. Register here.
Nov. 13
Happy birthday to Rep. Sam Garrison!
9 a.m. — The Board of Osteopathic Medicine holds its quarterly general business meeting. DoubleTree Suites by Hilton–Disney Springs Area, 2305 Hotel Plaza Blvd., Lake Buena Vista. View the agenda.
Nov. 14
9 a.m. — The Florida Medical Association offers its Legal & Ethical Implications in Medicine/Laws & Rules course, covering Florida practitioners’ legal and ethical obligations. Registration closes Nov. 9. Via livestream.
Nov. 15
Happy birthday to Reps. Fiona McFarland, Michael Gottlieb, and Will Robinson!
Nov. 16
Noon — The Board of Nursing holds a Board meeting. Via telephone conference and GoTo Meeting. Meet Me #: (571) 317-3122; Participation Code: 696-354-381.
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