Florida lawmakers unveil 'robust' healthcare package: 5 notes on what's in it

Florida lawmakers are proposing a package of healthcare laws for the state's 2024 legislative session that would expand the healthcare workforce, address emergency room crowding, and create a loan program for healthcare innovators. 

The bundle of legislation is called "Live Healthy." Florida Senate President Kathleen Passidomo led a trio of Republican lawmakers to unveil the proposal, which she described as a "robust package of policy enhancements and strategic investments," on Dec. 7. 

Some legislation within it is up for consideration by a Senate committee next week, while other bills are set to be filed in coming weeks. 

The legislation currently available is SPB 7016, pertaining to the healthcare workforce, and SPB 7018, pertaining to healthcare innovation. Those two pieces of legislation, summarized in the takeaways here, call for approximately $873 million in appropriations. 

Legislation addressing out-of-state providers, establishment of a new category of teaching hospitals for behavioral health, expansion of services for Floridians with disabilities and expansion of healthcare price transparency are due to be filed in weeks ahead. 

The Florida Hospital Association applauded Live Healthy upon its proposal.

Here are five high-level takeaways about Live Healthy and its contents released so far: 

1. A multipronged plan to bolster the healthcare workforce. The legislation has earmarked $797 million in funds for a number of workforce efforts in the short-, mid- and long-term. These include the creation of 700 new residency positions, a requirement for lab schools affiliated with medical schools to formalize pathways to healthcare professions, funding to healthcare organizations to offset the costs of maintaining clinical training programs, and a new pathway for experienced foreign-trained physicians. 

2. Changes to Florida's existing licensing and regulatory requirements for healthcare professionals. It expands Florida's Areas of Critical Need Program to allow physician assistants and advanced practice registered nurses to receive temporary certificates to practice in areas of critical need, which is currently the system in place for physicians. It also creates a licensing program for graduate assistant physicians who have passed their licensing exam but not yet attended a residency program, allowing them to work under the supervision of a fully licensed Florida physician. The legislation also eases experience requirements for clinical psychologists and psychiatric nurses to practice in hospitals. 

3. Measures to curb patient volumes in emergency departments and acute-care hospitals. Legislation directs the state's Agency for Health Care Administration to seek federal approval for hospital at home as a reimbursable service in the Medicaid program, for one. 

It also creates partnerships between hospitals and primary care settings to "improve coordination and encourage patients to establish a medical home to prevent future emergency department visits for non-urgent care." Under this legislation, all hospitals with emergency departments — which Ms. Passidomo "the most expensive real estate in our state" — are required to create a plan to help patients access the appropriate care setting if and when they present to the ED with a non-emergent condition or do not have regular access to primary care. 

The bill would also broaden eligibility for community-based free and charitable clinics from 200% to 300% of the federal poverty level, allowing more low-income residents to access the care at these settings that play "a key role in emergency room diversion," as lawmakers said.

4. Additional appropriations for hospitals and services, including $152 million for enhanced hospital Medicaid reimbursement rates for maternal care and labor and delivery and a recurring $100 million toward graduate medical education in Florida teaching hospitals that provide highly specialized tertiary care. 

5. Incentivization of healthcare innovation with the creation of a 15-member Health Care Innovation Council, made up of healthcare experts who would hold public meetings across the state to learn of new solutions for workforce supply and care access. The legislation would also create a "revolving loan program" with a pot of $75 million per year for 10 years for the implementation of innovative solutions. Certain licensed providers can apply for the loans, with interest rates no higher than 1%; priority would be given to rural hospitals and nonprofits that serve Medicaid patients in rural or medically underserved areas. 

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