Key Bills Sent to the Governor: What Physicians Need to Know
By Jeff Scott, Esq., FMA General Counsel

More than three months after the end of the 2022 Legislative Session, all the bills that passed both chambers have finally been presented to and acted upon by Gov. DeSantis. The following is a summary of the healthcare-related bills that were tracked by the FMA, including the action taken by the Governor and the effective date of the legislation.

HB 5 – Reducing Fetal and Infant Mortality (Rep. Grall, Sen. Stargel) Creates fetal and infant mortality review committees in all regions of the state to gather data and develop recommendations on how to reduce fetal and infant mortality rates.

Prohibits abortions if the physician determines the gestational age of the fetus is more than 15 weeks. Only exception is to save the life of the mother or if the fetus has not achieved viability and has a fatal fetal abnormality. Does not include the Texas civil remedy provision.

Approved 4/14/22 – Effective 7/1/22

HB 173 – Care of Students with Epilepsy or Seizure Disorders (Rep. Duran, Sen. Garcia) Requires schools to provide epilepsy or seizure disorder care based on student’s individualized seizure action plan. The ISAP must be developed and signed by medical professional in consultation with the student’s parents. Medical professional is defined as MD, DO, PA or APRN.

Approved 3/25/22 – Effective 7/1/22

SB 282 – Mental Health and Substance Use Disorders (Sen. Rouson, Rep. Fetterhoff) Allows for peer specialists to assist in recovery from substance abuse or mental illness. Requires peer specialists to meet specified qualifications and modified background screening and be reimbursed for services.

Approved 3/10/22 – Effective 7/1/22

SB 292 – Newborn Screenings (Sen. Polsky, Rep. Aloupis) Requires hospitals, prior to the earlier of discharge or 21 days after birth, to test newborns for congenital cytomegalovirus if the newborn fails the screening for the detection of hearing loss.

For home births, the healthcare provider in attendance must make this referral – if none, the newborn’s primary healthcare provider is responsible for coordinating the referral.

Approved 4/6/22 – Effective 1/1/23

SB 312 – Telehealth (Sen. Diaz, Rep. Fabricio) One of the last bills passed. The Senate version contained a provision to include audio-only in the definition of telehealth, but the House refused to concur. As passed, the sole provision in this bill is that physicians will be able to prescribe Schedule III-V controlled substances via telehealth.

Approved 4/6/22 – Effective 7/1/22

HB 357 – Pharmacies and Pharmacy Benefit Managers (Rep. Toledo, Sen. Rodriguez) Transfers the audit provisions of the Florida Pharmacy Act to the Florida Insurance Code giving the Office of Insurance Regulation (OIR) the authority to enforce provisions and respond to violations. The bill also authorizes pharmacies to appeal audit findings made by health plans and PBMs using the existing dispute resolution program available through the Agency for Health Care Administration (AHCA). It also establishes a financial penalty for PBMs that fail to register with OIR. Lastly, the bill establishes a $10,000 fine for any PBM failing to register with OIR and makes health insurers or HMOs responsible for violations of the pharmacy audit provisions, even if a PBM is contracted to manage benefits for the insurer or HMO.

Approved 6/20/22 – Effective 7/1/22

HB 459 – Step-Therapy Protocols (Rep. Wilhite, Sen. Harrell) Not the same FMA-supported bill as in years past, but one that takes a few small steps toward solving the problems with step therapy. This legislation requires health insurers that have a step-therapy protocol to actually tell the patient and the physician what the protocol requires. If a protocol exemption request is denied, the insurer must provide a written explanation that includes the reason for the denial, the supporting clinical rationale, and the procedure for appeal.

Approved 4/6/22 – Effective 7/1/22

HB 469 – Patient Care in Health Care Facilities (Rep. Trabulsy, Sen. Bradley) Allows for certain unlicensed persons (home health aides and certified nursing assistants) to assist patients with specified tasks (for example, the self-administration of medications) in an assisted living facility. Allows a registered nurse to delegate to a home health aide or CNA, in a home health setting or a county detention facility, the direct administration of a prefilled insulin syringe.

Requires an ALS ambulance transporting a patient between two facilities to be occupied by two people, including one patient attendant who may be a paramedic, RN or a physician, but removes the requirement for the driver to be an EMT, paramedic, RN or physician.

Approved 4/6/22 – Effective 7/1/22

SB 534 – Prescription Drugs Used in the Treatment of Schizophrenia for Medicaid Recipients (Sen. Harrell, Rep. McFarland) A stronger, but very limited step-therapy bill. Provides that for a Medicaid patient, a drug product prescribed for the treatment of schizophrenia or delusional disorders may be approved without meeting the step-therapy prior authorization criteria if prior authorization has been granted previously for the prescribed drug and the medication was dispensed during the previous 12 months.

Approved 4/6/22 – Effective 7/1/22

HB 543 – Uterine Fibroid Research and Education (Rep. Omphroy, Sen. Gibson) Requires DOH to develop and maintain an electronic database of information related to uterine fibroids and requires healthcare providers who diagnose or treat a woman with uterine fibroids to submit information related to such diagnosis and treatment to DOH on a Department-approved form.

Approved 4/6/22 – Effective 7/1/22

SB 544 – Drug-Related Overdose Prevention (Sen. Boyd, Rep. Caruso) Allows pharmacists to order an emergency opioid antagonist with an autoinjection delivery system or intranasal application for patient or caregiver use.

Requires hospital emergency departments and urgent care centers that treat and release persons in response to a suspected or actual overdose of a controlled substance to report such incidents to DOH if the patient was not transported to the facility via ambulance.

Approved 4/6/22 – Effective 7/1/22

SB 768 – Department of Health Bill (Sen. Rodriguez, Rep. Drake) The Department of Health bill often becomes a train of multiple unrelated issues that dies of its own weight. This year’s version avoided becoming overly bloated and actually passed both chambers. The bill contains provisions on a number of subjects:

  • Encourages high-risk pregnant women to be tested for STDs
  • Contains provisions related to medical marijuana treatment centers
  • Makes changes to the Rare Disease Advisory Council
  • Requires physician applying for licensure to provide proof of payment of NICA fees
  • Increases those who are eligible for a retroactive increase in compensation under the NICA program and makes a few other small changes to the program
  • Makes minor changes to the Chiropractor, Psychologist and Midwife practice acts
Approved 4/20/22 – Most provisions take effect 7/1/22 but some of the provisions have a different effective date (notably, the NICA section.

SB 806 – Alzheimer’s Education (Sen. Perry, Rep. Salzman) Requires DOH, through existing programs, to provide physicians and APRNs with additional education on Alzheimer’s disease and related forms of dementia.

Approved 6/23/22 – Effective 7/1/22

HB 817 – Emergency Medical Care and Treatment to Minors without Parental Consent (Rep. Massullo, Sen. Bradley) The FMA fix to the parental consent bill that passed last session. Allows for the provision of emergency care to minors without parental consent in any situation, not just care provided in a hospital or college clinic. The FMA would have liked more to be done, but given the situation, fixing the emergency care exception through a change to a different statute was the best available option.

Approved 4/6/22 – Effective 7/1/22

HB 855 – Managed Care Plan Performance (Rep. Bartleman, Sen. Jones) Requires managed care plans participating in the Medicaid Managed Medical Assistance program to collect and report an expanded set of performance measures. Beginning in 2025, each MMA plan must collect and report all of the Adult Core Set behavioral health measures (not currently required by AHCA). Beginning in 2026, each MMA plan must stratify all performance data by recipient age, race, ethnicity, primary language, sex and disability status.

Approved 4/6/22 – Effective 7/1/22

SB 988 – “No Patient Left Alone Act” (Sen. Garcia, Rep. Shoaf) Requires hospitals, nursing homes and certain other facilities to establish visitation policies and procedures, which may not require proof of vaccination and must allow consensual physical contact between patients and visitors. Visitation policies and procedures must allow in-person visitation in enumerated circumstances. Allows for the designation of an “essential caregiver.” Must allow for in-person visitation by essential caregiver for at least two hours daily in addition to any other visitation authorized. Policies and procedures may require a visitor to agree in writing to follow provider’s policies and procedures and may suspend in-person visitation of a specific visitor who violates the established policies and procedures.

Approved 4/6/22 – Effective upon becoming law (thus 4/6/22)

HB 1099 – Living Organ Donors (Rep. Barnaby, Sen. Cruz) Life insurance companies may not limit coverage for an individual solely due to the person’s status as a living organ donor.

Approved 4/6/22 – Effective 7/1/22

HB 1209 – Administration of Vaccines (Rep. Tuck, Sen. Burgess) Allows registered pharmacy technicians to administer certain vaccines if they meet certain educational requirements. Removes the current one to one ratio of supervision in favor of a one to five ratio of pharmacists to interns or registered pharmacy technicians.

Approved 4/6/22 – Effective 7/1/22

SB 1222 – Acute Hospital Care at Home (Sen. Bean, Rep. Altman) Allows for the provision of acute and post-acute healthcare services in a qualified patient’s permanent residence through a program approved by CMS and AHCA. Allows paramedics to provide basic and advanced life support services to patients in their homes as specified in the paramedic’s supervisory relationship with a physician.

Approved 4/6/22 - Effective 7/1/22

HB 1239 – Nursing Homes (Rep. Melo, Sen. Albritton) The bill reduces required CNA direct care from 2.5 hours to 2 hours per resident per day and retains current law requiring 1 hour of licensed nurse direct care per resident per day. For the remaining 0.6 hours of the required 3.6 weekly average of total hours of direct care, the bill allows nursing homes to count care provided by any combination of the following categories of disciplines and professions: nursing; dietary; therapeutic; mental health; and paid feeding assistants. The bill requires nursing homes to maintain records documenting compliance with minimum staffing requirements for at least five years and makes evidence of such compliance inadmissible as evidence of compliance with federal standards.

Approved 4/6/22 – Effective upon becoming law

SB 1260 – Independent Hospital Districts (Sen. Gruters, Rep. Botana) Establishes a process and requirements for the conversion of an independent hospital district to a nonprofit entity.

Vetoed by Governor on 6/24/22

SB 1262 – Mental Health and Substance Abuse (Sen. Burgess, Rep. Massullo) Revises the rules regarding the ability of a patient receiving services in a mental health facility to communicate with persons outside of the facility. Allows for the release of a patient receiving involuntary services at a mental health facility through telehealth and makes other revisions concerning the timing of release after the 72-hour examination period.

Approved 4/6/22 – Effective 7/1/22

SB 1374 – Clinical Laboratory Testing (Sen. Rodriguez, Rep. McClure) Exempts registered nurses from clinical laboratory personnel licensure requirements under certain circumstances.

Approved 4/6/22 – Effective 7/1/22

SB 1844 – Mental Health and Substance Abuse (Sen. Bean, Rep. Chaney) Revises the voluntariness provision under the Baker Act to allow a minor's voluntary admission after a clinical review of the minor’s assent, rather than a hearing on the minor’s consent, has been conducted. It also requires a clinical review be held to verify the voluntariness of a minor’s assent before a minor patient’s status is transferred from involuntary to voluntary. Lastly, the bill grants law enforcement officers the discretion on how they transport individuals for an involuntary examination to eliminate the requirement that the individual be handcuffed.

Approved 4/6/22 – Effective 7/1/22

SB 1950 – Statewide Medicaid Managed Care Program (Sen. Brodeur, Rep. Garrison) Revises the procurement process for the managed medical assistance program, including changing the number of regions in the state and the number of allowable plans in each region. Adds certain Florida cancer hospitals to the list of statewide essential providers.

There were a couple of contested provisions the House wanted that it ultimately backed off from.

Approved 4/6/22 – Effective 7/1/22

SB 7014 – COVID-19 Related Claims Against Health Care Providers (Sen. Burgess, Rep. Burton) Extends the COVID-19 liability protections for healthcare providers passed in 2021 for another year. The protections were set to expire in March 2022.

Approved 2/24/22 – Effective upon becoming law