Hello, and welcome to Friday ...
After 11 years of being on the front lines of the battle against Obamacare, will this week’s U.S. Supreme Court ruling finally end Florida’s fierce resistance to the federal health care law?
It may seem like ancient history now, but former Florida Attorney General Bill McCollum led the charge in the initial major challenge to the Affordable Care Act, filing the first lawsuit after then-President Barack Obama signed the landmark legislation.
In a 5-4 decision, the U.S. Supreme Court in 2012 preserved much of the law. But the challenge resulted in an important concession, with the court holding that the government could not withhold federal Medicaid funds from states that didn't expand Medicaid to low-income childless adults.
To date, 12 states, including Florida, have not expanded Medicaid.
The 2012 Supreme Court ruling triggered years of tussles in the Florida Legislature over Medicaid expansion. For a time, then-Gov. Rick Scott expressed support for an expansion before backing off. But the idea has always been stopped cold in the Florida House.
Former Attorney General Pam Bondi, who succeeded McCollum, added Florida to a separate challenge to Obamacare led by Texas. After taking office in early 2019, Attorney General Ashley Moody decided to keep Florida a part of the challenge, which ultimately was rejected Thursday in a 7-2 ruling by the high court.
Moody said in a statement that her office would “respect” the ruling but vowed to continue to fight against “any federal overreach.” Scott’s office also weighed in and asserted that Obamacare was a failure.
Democrats during this year's legislative session repeatedly called for expanding Medicaid to low-income childless adults, but the issue never received consideration from Republicans who control the House, Senate and governor's office.
Republicans, however, agreed to extend the length of time that Medicaid benefits are available to postpartum mothers, which was something authorized by Congress this spring. Also this session, Senate President Wilton Simpson, R-Trilby, saw the importance of providing low-income women access to long-acting, reversible birth control. Simpson included $2 million in the state budget for the hormonal contraception, though it was vetoed by Gov. Ron DeSantis.
In other news ... The 2019 repeal of the certificate of need program for hospitals was a near-Herculean lift, after more than two decades of legislative battling over the issue. Now, the Agency for Health Care Administration is learning that it is no easy task to carry out the nuts and bolts of the hospital-licensure revamp that will supplant the so-called CON program.
AHCA announced this week it will employ a rarely used administrative tool called "negotiated rulemaking" and was withdrawing a proposed rule to regulate neonatal intensive-care units. The proposed rule was challenged in state administrative court by Tampa General Hospital and the North Broward Hospital District, currently headed by Shane Strum, the former chief of staff to DeSantis.
AHCA won't say whether it offered to use the negotiating process to settle the rule dispute or whether the request was made by one of the hospitals. But in response to The News Service of Florida's request for information about the impetus of the negotiations, the agency provided a June 8 letter that Tampa General Hospital CEO John Couris sent to AHCA Secretary Simone Marstiller. In it, Couris thanked Marstiller for the opportunity to work with the agency on "the common goal of providing high quality health care to Floridians that is accessible and affordable."
But Couris also asked that the agency consider negotiated rulemaking on a proposed rule regarding organ transplants. It was one of five other rules dealing with hospital services that AHCA withdrew this week. Those services once were regulated by certificate of need.
The question is: Will the state agree to Couris' request?
Florida law requires agencies to announce their intent to enter into negotiated rulemaking. AHCA withdrew the proposed neonatal intensive-care unit rule early Monday. Before the close of business that day, the agency sent out a notice announcing it intended to proceed with negotiated rulemaking.
When AHCA announced two days later it was withdrawing the other five rules, there was no follow-up announcement regarding negotiated rulemaking.
In a prepared statement to the News Service, AHCA noted that, from the "onset of rule development, the agency has reiterated the importance that Florida’s health care regulatory environment is of the highest quality, ensures consumer choice and promotes transparency. "
RULES
The Department of Children and Families proposes amending Rule 65D-30.0038 regarding substance abuse treatment facilities and administrative fines. More here.
DCF proposes amending Rule 65C-28.008 to update two incorporated forms and remove some responsibilities of the child protection investigator and case manager. More here.
The Department of Health proposes amending Rules 64D-4.002 and 64D-4.003 regarding the definitions and eligibility requirements for the AIDS Drug Assistance Program. More here.
AHCA is withdrawing proposed Rule 59A-3.065 regarding definitions. More here.
AHCA is withdrawing proposed Rule 59A-3.066 regarding licensure procedures. More here.
AHCA is withdrawing proposed Rule 59A-3.246 regarding licensed programs. More here.
AHCA is withdrawing proposed Rule 59A-3.248 regarding pediatric cardiac programs. More here.
AHCA is withdrawing proposed Rule 59A-3.278 regarding rehabilitation, psychiatric and substance abuse programs. More here.
AHCA is withdrawing proposed Rule 59A-3.249 regarding neonatal intensive care units. More here.
AHCA proposes amending Rule 59G-6.010 regarding the payment methodology for nursing home services. More here.
The Board of Dentistry proposes amending Rule 64B5-14.0025 regarding required anesthesia/sedation permits. More here.
The Board of Dentistry proposes amending Rule 64B8-41.001 to update the fee language. More here.
The Board of Occupational Therapy proposes amending Rule 64B11-4.003 to adjust the minimum and maximum disciplinary guidelines. More here.
The Board of Hearing Aid Specialists proposes amending Rule 64B6-7.0025 to add new guidelines for telehealth providers and health care providers who approve emotional support animals. More here.
The Board of Hearing Aid Specialists proposes amending Rule 64B6-7.002 to clarify and amend existing guidelines for disposition of disciplinary cases. More here.
The Board of Osteopathic Medicine proposes amending Rule 64B15-6.011 regarding disciplinary guidelines for physician assistants. More here.
The Board of Medicine proposes amending Rule 64B8-30.015 regarding disciplinary guidelines for physician assistants. More here.
LOBBYING
Greg Black and Brian Jogerst have registered to lobby for Horizon Therapeutics.
WEEK IN REVIEW
–Countercyclical ... Pandemic swells Medicaid enrollment to 80 Million people, a ‘high-water mark.’ More here.
–Canine care ... Gov. Ron DeSantis on Friday signed a bill that will allow emergency-medical technicians and paramedics to treat and transport law-enforcement canines injured in the line of duty. More here.
–Health equity for all ... Gov. Ron DeSantis on Thursday signed a bill that details a series of requirements for the state Office of Minority Health and Health Equity. More here.
–Caregiver, care for thyself ... About 70 percent of caregivers reported having at least one adverse mental-health condition during the COVID-19 pandemic, according to a report released Thursday by the federal Centers for Disease Control and Prevention. More here.
–No pot for you, deux ... For the second time in two months, the Florida Supreme Court on Thursday rejected a proposed constitutional amendment aimed at allowing people to use recreational marijuana. More here.
–Don't worry, be happy ... As the federal Centers for Disease Control and Prevention on Tuesday labeled the Delta variant of the novel coronavirus a “variant of concern,” Gov. Ron DeSantis downplayed the potential impact it could have on the state. More here.
CALENDAR
June 23
9 a.m. The Early Steps Child and Family Outcomes Stakeholder Group meets. Meeting link here.
June 24
4 p.m. The Department of Children and Families meets to reply to any questions regarding DCF ITN 2021 023 regarding the delivery of domestic violence services. Meeting link here. Contact Kimberly.McMahon@myflfamilies.com for a copy of the agenda.
June 25
9 a.m. The Board of Nursing meets. Call (888) 585-9008; participant code: 27512502.