After more than two decades of debate about the issue, the Florida Legislature on Monday approved eliminating the “certificate of need” regulatory program for hospitals and passed a high-profile measure aimed at importing prescription drugs from Canada.
A priority for House Speaker Jose Oliva, R-Miami Lakes, the House voted 81-34 to pass a bill (HB 21) to eliminate the certificate-of-need program. The vote came hours after the Senate passed the bill in a 23-17 vote, as Oliva took major steps toward his priority of revamping the health-care system.
“I think today is a monumental step in the right direction,” Oliva told reporters.
The House passed the bill to eliminate so-called CON regulations for new general hospitals --- as well as “tertiary” health care services. Under the longstanding regulations, hospitals have needed to receive certificates of need from the state Agency for Health Care Administration before they can build new facilities or provide tertiary services, which include such things as organ transplants.
The bill now will go to Gov. Ron DeSantis. If he signs it, the CON repeal would take effect July 1 for general hospitals and tertiary services. It would eliminate certificates of need for specialty hospitals in two years.
The measure, however, is not a complete deregulation of the CON program as the House initially advocated. The bill maintains CON requirements for nursing homes and hospices and intermediate care facilities for the developmentally disabled.
Oliva argues that the state should take a more free-market approach to health care, which could help hold down costs and provide access to care. But the CON process was designed, at least in part, to avoid a duplication of services that proponents of the regulations say drives up costs.
The bill will have a far-reaching impact on the state’s hospital industry, and it was controversial among hospital administrators. Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach, told the News Service that hospital executives were calling him directly expressing worries about the bill.
In a statement to the News Service, Tampa General Hospital CEO John Couris said the “changes to the safeguards for health care” won’t impact the quality of care provided at his hospital.
“With the high volume of complex, high-risk services we perform, patients can have confidence that they will find the most-practiced experts in Florida and the best possible outcomes at Tampa General Hospital,” Couris said.
In addition to eliminating the licensure program, the House and Senate on Monday also approved a DeSantis priority aimed at importing lower-cost prescription drugs from Canada. Ultimately, importation programs would require approval from the federal government, but the bill passed Monday gives state officials authority to seek approval.
The House voted 93-20 to pass the importation bill (HB 19), after the Senate approved it earlier in the day in a 27-13 vote. DeSantis’ office did not have immediate comment.
Oliva backed DeSantis on the drug-importation proposal, and the speaker also saw another one of his priorities pass Monday when the House and Senate signed off on a bill (HB 23) that establishes a regulatory framework for “telehealth” in the state.
Telehealth, also known as telemedicine, involves using the internet and other technology to provide health-care services to patients. While many hospitals and other providers already are using telehealth, lawmakers have struggled for years to agree on regulations.
The bill passed Monday, in part, would make clear that insurance companies and HMOs can use out-of-state physicians so long as they register with the state. Regarding payment for telehealth, the bill would allow HMOs and insurance companies to have voluntary contracts that allow telehealth services to be reimbursed at different levels than face to face services. Health care providers would need to initial the contracts.
Despite the accomplishments Monday on health-care issues, Oliva told reporters that the Legislature’s job is not done.
“There’s still a great deal of work to do in health care,” he said.
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