KEY STORY

Key Story-Florida’s Hospitals Meet with Congressional Delegation at FHA Hill Day

This week, dozens of Florida Hospital Association members gathered in our nation’s Capital to advocate for hospitals and health care workers. Member hospital executives and FHA staff met with 24 Congressional offices from Miami to the Panhandle, including the offices of both FL Senators, to advocate for the protection of the Medicaid Hospital Directed Payment Program, increased Medicare reimbursement to align with current inflationary pressures, the health care workforce, 340b relief, and more. Additionally, between the AHA Annual Meeting, the FHA member dinner, FHA Reception with Florida Delegation, and the FHA Hill Day congressional visits, our members had several opportunities to connect with colleagues, hear from policymakers and elected officials and dedicate time to the industry’s most pressing issues. We thank each of you who joined to lend your voice toward successful hospital advocacy.

One of the key focuses of the visits was to urge Congress to protect Florida’s Medicaid Hospital Directed Payment Program, which provides crucial reimbursement to reduce the shortfall hospitals receive compared to their costs in the Medicaid program. The program has come under scrutiny from CMS before a Texas court raised questions about the Centers’ authority to prevent this arrangement. FHA met with Representative Aaron Bean – FL-4 and Representative Jared Moskowitz – FL-23 who has penned a letter to key health care regulators in support of the program. FHA raised this issue with many Congressional offices to ask them to sign on to the letter, receiving affirmative support from at least 14 offices at the time of publication.

Addressing the health care workforce shortage remained a key message on this trip to D.C. FHA members and staff shared meaningful data about skyrocketing workforce costs, historically high turnover and vacancy rates, and the financial pressure this is creating in Florida’s hospitals. FHA voiced its support for Congressional changes to Graduate Medical Education to address the disproportionate amount of GME that is allocated to Florida following caps put in place decades ago. We also advocated for sensible workforce immigration legislation that would increase the number of visas allocated to qualified foreign health care workers to practice in the U.S.; a critical measure as the State Department has announced that they have already reached their statutory visa limit for the year, and will not process applications submitted after June 2022.

Two health care champions in Congress joined for FHA’s Hill Day Reception on Tuesday evening. Congressman Aaron Bean – FL-4 greeted hospital guests and gave excellent remarks about his experience so far in D.C. and the state of health care policy in Congress. Congresswoman Sheila Cherfilus McCormick FL-20, a former health care executive, also spoke about the need for preventative, early health care so that Floridians can flourish and live their best lives.

FHA thanks the following members for joining in our advocacy efforts this week: AdventHealth, Baptist Jax, Baptist Health South Florida, BayCare Health System,Brooks Rehabilitation, Cleveland Clinic, Encompass Health, Halifax Health, Lakeland Regional Health, Lee Health, Mayo Clinic, Memorial Healthcare System, Orlando Health, and Tampa General Hospital.

Florida Members of Congress Urge CMS to Withdraw DPP Informational Bulletin

17 Members of Florida’s congressional delegation have signed on to a letter that will be sent to the Centers for Medicare and Medicaid Services urging the Agency to withdraw a February 17, Directed Payment Program (DPP) Informational Bulletin that “creates needless uncertainty for the hospitals that serve [their] communities.” The letter goes on to state that the DPP financial management review currently being conducted by the agency “must be conducted under established law,” and on that count the Informational Bulletin “misses the mark.” FHA thanks all who signed the letter, and Congressmen Moskowitz and Bean for leading this effort.

STATE ADVOCACY

State Budget Conferencing Continues

Florida needs financially stable hospitals to deliver high-quality health care and subsidize accessible services in the community. FHA continues to be actively involved in the state budget negotiations as lawmakers plan to wrap up conferencing in the coming days. We have held countless meetings with lawmakers to educate them on the growth in hospital costs, the consequences of a historic health care worker shortage, and the value of Medicaid services to patients across the state. We are pleased by the current proposals being offered by the House and Senate and we invite you to catch up on this week’s activity at the following links. Please view FHA’s budget alerts from April 26 & April 27.

FHA will be providing further analysis in the coming days as the budgets are finalized.

PBM Legislation

HB 1509 by Representative Chaney has quickly cleared its last two committee stops and will now head to the House floor. The bill has been the subject of a flurry of legislative activity in the final weeks of session. Representative Randy Fine did explicitly express concerns about the white-bagging section of the bill and his belief that these changes will increase costs to private healthcare insurers and the state’s Medicaid plan.

FHA is pleased to see that through the amendment process, the provisions relating to clinician-administered drugs/white bagging have largely stayed consistent in the bill. FHA will continue to advocate on your behalf for appropriate regulations on PBMs and laws which provide a more level playing field for providers in their negotiations with insurers.

Telehealth Audio-only Nearing Passage in Both Chambers

HB 267 by Representative Fabricio passed the House Floor unanimously. Specifically, the bill revises the definition of telehealth to include telephone calls in the telehealth technology authorization statute. This is not expected to significantly impact health care practice, as health care providers currently commonly provide services telephonically, and current law does not prevent them from doing so. In addition, this change does not affect whether health insurers will reimburse health care practitioners for services provided through telephone calls.

The bill’s Senate companion, SB 298 by Senator Boyd, has been placed on the calendar for its 2nd reading and should pass the Senate Chamber in the coming days.

As a 2023 FHA legislative priority, we are pleased with the passing of this legislation, which increases access to care and eliminates red-tape regulation.

COVID Mandates (SB 252 / HB 1013)

House and Senate bills regulating facial covering policies and alternative treatments for COVID-19 are postured to pass in both chambers. While no new language has been added, the Senate version was temporarily postponed ahead of its scheduled 2nd reading on Thursday; indicating that negotiations related to future amendments are ongoing. FHA will continue to monitor and provide timely analysis to member hospitals.

Immigration (SB 1718/HB 1617)

SB 1718 and HB 1617 were heard and passed favorably this week by their final committee stops. Specifically, this legislation requires hospitals and health systems to ask for patient immigration status upon admission or a hospital visit. FHA successfully sought an amendment that uses the term “emergency visit” to ensure that patients receiving routine lab work or radiology at a hospital are not captured in the law.

Additionally, some hospitals raised concerns regarding human smuggling and emergency medical transportation provisions. FHA worked with member organizations and legislators to address these concerns, which are reflected in the most recent amendment. Both bills have been placed on 2nd reading in their respective chambers. FHA will continue monitoring this legislation and update you on any changes.

Health Care Expenses (SB 268/ HB 1413)

On Monday, HB 1413 was reported favorably by the Health and Human Services Committee; the bill will now head to the House Floor for its 2nd reading. On the other hand, SB 268 was postponed on its second committee stop by the bill sponsor, Senator Brouder, in the Appropriations Subcommittee on Health & Human Services. Since the Senate had its final committee meetings Monday, it is unlikely that the Senate version will pass the chamber.

FHA continues to monitor for any negotiations between the House and Senate that could change this result. While we appreciate efforts to provide consumers with meaningful pricing information, the bills are duplicative of existing federal rules that are still in their infancy.

Protections of Medical Conscience Moves Through Floor Process

SB 1580 was read a second time by the Senate as several minority members’ amendments were defeated. The bill will receive a vote/pass a floor vote while HB 1403 will be read a second time and be considered for amendments on Friday.

Gender Clinical Interventions (SB 254)

SB 254 continues to be negotiated as Senate President Kathleen Passidomo stated she is not on board with the House proposal that bans private insurance companies from providing coverage for gender-affirming care.

The Senate passed SB 254 by Senator Yarborough in early April; however, the House amended the Senate bill last week, combining its version of the gender-affirming ban into the Senate bill.

There were three drastic differences between the House and Senate bills. Specifically, the House version proposed to ban insurance companies from covering transgender care, ban minors from taking puberty blockers or other hormones by Dec. 31, 2023, and ban transgender people from changing their birth certificates.

FHA continues to monitor SB 254 and will provide necessary updates. However, despite unaligned views on this issue from the Senate and House Republicans, the bill is likely to pass since it is a high priority for the Governor.

Survey to Assess Workforce Staffing Challenges

On April 26th, all Florida hospitals were sent the Vacancy and Turnover Survey by the FHA Finance and Data Analytics team. This survey looks to address healthcare staffing issues such as workforce burnout, nursing shortages, and the high costs of maintaining a stable workforce. We ask all hospitals to fill out the Vacancy Turnover survey and return it to the FHA by May 30th. Hospital and health system-specific data will remain confidential, and only aggregate-level data will be released. If you have any questions, comments, or concerns, please contact Stephanie Scanlon at [email protected] or Ana Rivas at [email protected].

OPPAGA Graduate Medical Education (GME) Surveys

As part of OPPAGA’s review of GME in Florida, a link to an online survey was sent to all hospitals that receive state funding for GME programs at their facilities. To make sure that all hospitals can complete this survey for OPPAGA’s review, the survey deadline has been extended to Friday, April 28, 2023. Please remember that a separate information request, which was sent as an Excel spreadsheet, is due back to OPPAGA on Friday, May 5, 2023. You will be receiving an email from OPPAGA today with additional details about this extension. If you have any questions about either request, please direct them to OPPAGA’s email inbox for this review, [email protected].