{"id":282533,"date":"2025-10-06T21:19:20","date_gmt":"2025-10-06T21:19:20","guid":{"rendered":"https:\/\/www.europesays.com\/us\/282533\/"},"modified":"2025-10-06T21:19:20","modified_gmt":"2025-10-06T21:19:20","slug":"checking-the-pulse-of-florida-health-care-news-and-policy-6","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/282533\/","title":{"rendered":"Checking the pulse of Florida health care news and policy"},"content":{"rendered":"

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.<\/strong><\/p>\n

___<\/p>\n

Florida TaxWatch<\/strong><\/a> is again warning that the trust fund covering public worker health benefits is heading toward insolvency, and it\u2019s proposing a solution to address the issue.<\/p>\n

A new report from the government watchdog<\/strong><\/a> argues that the state could shore up the State Employees\u2019 Health Insurance Trust Fund by expanding access to interdisciplinary pain management, a team-based approach that treats chronic pain through coordinated medical, psychological and rehabilitative care.<\/p>\n

The state group health insurance program covers about 171,000 employees and roughly 350,000 Floridians overall. Left unchanged, the fund that pays their health claims could fall $237 million into the red by the end of the current fiscal year and spiral to a nearly $1.7 billion deficit by the end of fiscal year 2029-30.<\/p>\n

\"\"<\/a>Dominic Calabro warns Florida\u2019s state worker health fund is nearing insolvency and backs interdisciplinary pain care. <\/p>\n

Florida TaxWatch says that while lawmakers have historically plugged shortfalls with general revenue, the state can\u2019t rely on those bailouts forever. Its January report called for aligning employee premium contributions with other large employers, a change that could save $446 million annually. But FTW President and CEO Dominic Calabro<\/strong> says that alone \u201cdoes not go far enough.\u201d<\/p>\n

This follow-up report focuses on how chronic pain increases program costs. Nationally, one in four adults experiences chronic pain and one in 12 reports \u201chigh-impact\u201d chronic pain that limits daily activity. For Florida\u2019s covered workforce \u2014 FTW says that \u201cthere is no reason to believe that the population covered by the SGIP is any different\u201d \u2014 that translates to an estimated 35,000 state employees contending with chronic pain each year, and accounts for $945 million in annual spending.<\/p>\n

\u201cReducing the costs of health care will reduce the likelihood that the Legislature would have to increase premiums paid by state employees, their dependents and retirees,\u201d said Jeff Kottkamp<\/strong>, the organization\u2019s executive vice president and General Counsel.<\/p>\n

The report cites outcomes from interdisciplinary programs in Georgia and South Carolina to illustrate the potential savings. Georgia\u2019s State Health Benefit Plan spends about $429 million annually treating chronic pain for 34,000 members out of its total pool of 700,000; South Carolina\u2019s program averages $105 million for just 7,600 members experiencing chronic pain.<\/p>\n

Beyond lowering claims, research suggests interdisciplinary programs can reduce hospitalizations and surgery rates by more than half, cut annual medical costs by $260 million across patient groups and help reduce opioid reliance.<\/p>\n

Florida TaxWatch recommends that the Department of Management Services include an interdisciplinary pain management pilot program in its plan to address the looming deficit. The report also urges lawmakers to authorize or expand such pilots in 2026 and require that all providers be accredited by the Commission for Accreditation of Rehabilitation Facilities<\/strong><\/a>.<\/p>\n

If successful, the pilot could provide a new template for bending Florida\u2019s health care cost curve without shifting more of the burden onto employees.<\/p>\n

\"\"<\/a><\/p>\n

\u2014 Fail First \u2014<\/strong><\/p>\n

Sen. Gayle Harrell<\/strong> is again challenging Florida\u2019s \u201cfail first\u201d rules for mental health treatment, re-filing legislation (SB 70) for the 2026 Legislative Session that would expand exceptions to so-called \u201cstep therapy\u201d protocols for Medicaid beneficiaries.<\/p>\n

Step therapy \u2014 a common insurance cost-control practice \u2014 requires patients to try lower-cost medications before insurers will cover more expensive prescriptions. Critics, including physicians and mental health advocates, say those policies delay effective treatment for patients with severe psychiatric conditions.<\/p>\n

\"\"<\/a>Gayle Harrell renews push to ease \u2018fail first\u2019 Medicaid rules, prioritizing faster mental health treatment. <\/p>\n

Harrell, a Stuart Republican and longtime health care policy leader, has made similar attempts in recent years. Her 2025 proposal (SB 264) carried a hefty estimated annual price tag of up to $50 million in new Medicaid costs, based on staff analysis of the bill. But she and others argue that short-term savings pale in comparison to the long-term social and economic toll of untreated or undertreated mental illness.<\/p>\n

That argument echoes findings from a 2023 analysis by the Regional Economic Consulting Group, which estimated that restrictive step therapy practices cost Florida\u2019s economy<\/strong><\/a> $271.5 million each year, including more than $52 million borne by the Medicaid program alone. The study attributed those losses to decreased productivity, higher hospitalization rates and, in severe cases, suicide.<\/p>\n

At the time, Harrell\u2019s Senate version and a House companion, introduced by Tampa Republican Rep. Karen Gonzalez Pittman,<\/strong> drew broad bipartisan support and backing from business and patient groups, such as reThink Brain Health Florida and the Florida State Hispanic Chamber of Commerce.<\/p>\n

\"\"<\/a><\/p>\n

\u2014 Get well soon \u2014<\/strong><\/p>\n

Rep. Felicia Robinson<\/strong> is pushing new safety and licensing standards for Florida\u2019s growing number of postsurgical recovery centers \u2014 many of which cater to cosmetic surgery patients and operate with little direct oversight.<\/p>\n

Her bill (HB 81<\/strong><\/a>), titled the \u201cPostsurgical Recovery Home Safety Act,\u201d would require such facilities to be licensed through the Agency for Health Care Administration and subject to regular inspections, background checks and insurance verification. Operators would also be mandated to maintain 24-hour licensed nursing coverage, meet minimum staffing ratios, and comply with stringent facility safety standards.<\/p>\n

\"\"<\/a>Felicia Robinson proposes stricter licensing, staffing, and safety standards for Florida\u2019s unregulated postsurgical recovery homes. <\/p>\n

The legislation follows reports of unregulated \u201crecovery homes\u201d springing up across South Florida, particularly in the vicinity of Miami\u2019s booming cosmetic surgery industry. Unlike assisted living facilities or other care settings, postsurgical recovery homes aren\u2019t clearly defined under current law, leaving a regulatory gap that has drawn increasing concern from health officials and lawmakers.<\/p>\n

Under Robinson\u2019s proposal, advertising or operating an unlicensed recovery home would result in fines, license suspension or revocation and, in some cases, felony penalties. AHCA would be empowered to establish and enforce detailed rules governing licensing, inspections and staff training.<\/p>\n

\"\"<\/a><\/p>\n

\u2014 Innovation pays \u2014<\/strong><\/p>\n

The Florida Department of Health has opened applications for its new Health Care Innovation Loan Program<\/strong><\/a>, a $50 million annual initiative aimed at transforming the delivery of care across the state.<\/p>\n

Created under 2024\u2019s Live Healthy legislative package (SB 7018), the revolving loan fund will support hospitals, nursing homes, ambulatory centers and educational institutions that develop or implement new technologies and models to improve access, efficiency, and patient outcomes.<\/p>\n

The Health Care Innovation Council oversees the project, a public advisory body chaired by the Lieutenant Governor and composed of health, technology, finance and advocacy experts. The Council will review applications, identify best practices, and guide project selection with a focus on rural hospitals and nonprofit providers serving Medicaid patients.<\/p>\n

\"\"<\/a>Jay Collins highlights Florida\u2019s new $50 million loan program to boost health care innovation.<\/p>\n

\u201cThe launch of the Health Care Innovation Revolving Loan program represents yet another significant step in Florida\u2019s efforts to foster a culture of innovation within Florida\u2019s health care community,\u201d Lt. Gov. Jay Collins <\/strong>said in a news release. \u201cAs the Council Chair and newest member, I am honored to work with the Council to support health care innovation by implementing solutions that address the evolving needs of our state\u2019s health care system.\u201d<\/p>\n

Surgeon General Joseph Ladapo<\/strong> added, \u201cThis loan program reflects Florida\u2019s commitment to patient-centered innovation and medical choice. We are investing in the lives of Floridians by supporting solutions that improve care delivery and outcomes.\u201d<\/p>\n

Loans carry a maximum 1% interest rate and will be distributed annually through 2034\u201335. Projects eligible for funding include workforce training programs, new service delivery models, and technology deployments designed to reduce costs and enhance the state\u2019s health care infrastructure.<\/p>\n

The initiative\u2019s future was briefly in doubt earlier this year<\/strong><\/a>. In March, a House budget panel proposed eliminating both the 10-year, $500 million program and the 15-member Council that oversees it \u2014 a move Harrell told the Florida Phoenix left her \u201cnot happy\u201d and \u201cseriously concerned.\u201d Lawmakers ultimately backed off the proposal, allowing the Department to proceed with implementation.<\/p>\n

\"\"<\/a><\/p>\n

\u2014 ROSTER \u2014<\/strong><\/p>\n

Seven Oaks Health<\/strong><\/a> \u2014 the parent company of Big Bend Hospice \u2014 has named Norman Pasley<\/strong> as its new Chief Nursing Officer, tapping the longtime Tallahassee Memorial HealthCare leader to oversee clinical operations across the eight-county Big Bend region.<\/p>\n

Pasley brings more than three decades of clinical and administrative experience to the role, including 20 years at TMH, where he served in several senior positions. His leadership helped TMH\u2019s Rehabilitation Center earn a five-star rating from the Centers for Medicare & Medicaid Services and guided its Home Health program to a 3.5-star rating from CMS. Most recently, he managed multiple service lines, including home health and outpatient neurology, where the clinic served between 70 and 90 patients daily.<\/p>\n

\"\"<\/a>Norman Pasley was named Chief Nursing Officer, bringing decades of clinical leadership to Big Bend Hospice.<\/p>\n

A U.S. Army veteran, Pasley spent seven years as an active-duty combat medic and licensed practical nurse, concluding his service at Walter Reed Army Medical Center. He holds master\u2019s degrees in nursing and business administration and is pursuing a Doctor of Nursing Practice in executive health care leadership at Florida State University.<\/p>\n

\u201cNorman\u2019s exceptional track record at TMH and his deep commitment to clinical excellence make him the ideal leader to guide clinical operations at Big Bend Hospice,\u201d said Bill Wertman<\/strong>, CEO of Seven Oaks Health and Big Bend Hospice. \u201cOur partnership with TMH has always been essential to providing compassionate, seamless care in our community, and Norman\u2019s appointment strengthens that bond.\u201d<\/p>\n

In his new position, Pasley will lead clinical services for Big Bend Hospice, advancing Seven Oaks Health\u2019s mission to deliver high-quality, compassionate hospice and palliative care while strengthening collaboration with community partners throughout the Big Bend.<\/p>\n

\"\"<\/a><\/p>\n

\u2014 ICYMI \u2014<\/strong><\/p>\n

\u201cSubpoenas are flying over Hope Florida scandal with grand jury reportedly imminent<\/strong><\/a>\u201d via Gabrielle Russon of Florida Politics \u2014 Subpoenas are being issued to Gov. Ron DeSantis\u2019<\/strong> staffers over the Hope Florida spending scandal. Former acting Attorney General John Guard<\/strong> and longtime staffer Kate Strickland<\/strong> are set to receive subpoenas. James Holton<\/strong>, the former Chair of St. Petersburg-based Save Our Society from Drugs, one of the nonprofits that received millions from the Hope Florida Foundation, was also subpoenaed, according to an associate of Holton. The subpoenas come as prosecutors in Tallahassee are convening a grand jury to meet during the week of Oct. 13, according to the Miami Herald\/Tampa Bay Times.<\/p>\n

\"\"<\/a>Subpoenas target Ron and Casey DeSantis\u2019 inner circle as Hope Florida grand jury looms. Image via AP.<\/p>\n

\u201c\u2018Tristin Murphy Act,\u2019 designed to protect mentally ill in jails, goes into effect<\/strong><\/a>\u201d via Drew Dixon of Florida Politics \u2014 An emotional journey for legislation designed to protect incarcerated individuals suffering mental health issues enters its final phase as it takes effect Oct. 1. The measure is named after Tristin Murphy<\/strong>, who committed suicide in a Florida prison in 2021. The legislation calls for the state to establish probation conditions for defendants with mental illness, sets requirements for work assignments for those detainees and expands training options under the criminal justice, mental health and substance abuse grant programs. Sen. Jennifer Bradley<\/strong>, a Fleming Island Republican, crafted the Senate\u2019s original bill (SB 168). Senate President Ben Albritton<\/strong>, a Wauchula Republican, personally championed the Tristin Murphy Act. When DeSantis finally approved it, he became emotional.<\/p>\n

\u201cCommission votes 3-2 to negotiate \u2018payment structure\u2019 and sale of TMH to FSU<\/strong><\/a>\u201d via Elena Barrera of the Tallahassee Democrat \u2014 The Tallahassee City Commission met this morning to discuss the future of Tallahassee Memorial HealthCare. After months of largely being kept in the dark, Commissioners are finally learning about the deal TMH has worked out with Florida State University as a step toward creating an academic medical center in Tallahassee. The non-binding agreement was announced on Sept. 16 and would merge TMH into FSU Health, with the university taking control of all the city-owned assets of the hospital.<\/p>\n

\u201cHospitals challenge transplant proposal<\/strong><\/a>\u201d via Jim Saunders of News Service of Florida \u2014 Three major hospital systems have challenged a new state proposal about approving organ-transplant programs, alleging it does not include adequate safeguards for quality of care. Tampa General Hospital, UF Health Shands Hospital in Gainesville and Jackson Memorial Hospital in Miami filed the challenges after the Florida Agency for Health Care Administration in August issued a proposed rule for transplant programs. The challenges, filed this month at the state Division of Administrative Hearings, came after years of debate and disputes about approving transplant programs. Tampa General, UF Health Shands and Jackson provide procedures such as heart, liver, lung and kidney transplants. The proposed rule, in part, would revise standards for hospitals that want to begin providing such procedures. \u2014 and continue providing them after getting initial approvals.<\/p>\n

\u00a0\u2014 RULES \u2014<\/strong><\/p>\n

The Agency for Health Care Administration rule regarding waivers for individual budgeting for developmental disabilities services (59G-13.081) goes into effect Oct. 12. More here<\/strong><\/a>.<\/p>\n

AHCA\u2019s Division for Health Facility and Agency Licensing has proposed amending Rule 59A-4.200 regarding the requirements for obtaining a Gold Seal Award to update application requirements and termination criteria. More here<\/strong><\/a>.<\/p>\n

The Board of Orthotists and Prosthetists has issued a final rule (64B14-4.002) on initial licensure and registration requirements that went into effect Oct. 6. More here<\/strong><\/a>.<\/p>\n

\u00a0\u2014 PENCIL IT IN \u2014<\/strong><\/p>\n

Oct. 7<\/strong><\/p>\n

9 a.m. <\/strong>\u2014 The Senate Health Policy Committee will hear presentations from the Agency for Health Care Administration and the Department of Health on the implementation of recently enacted health care laws. Room 412, Knott Building.<\/p>\n

1:30 p.m.<\/strong> \u2014 The Health Professions & Programs Subcommittee will hear an implementation briefing on legislation passed during the 2024 and 2025 Sessions from the Department of Health, Room 102, House Office Building.<\/p>\n

Oct. 8<\/strong><\/p>\n

10:30 a.m.<\/strong> \u2014 The House Health Care Facilities & Systems Subcommittee will receive implementation briefings on HB 885 (2024) Coverage for Biomarker Testing and SB 2514 (2025) related to biomarker testing. Room 404, House Office Building.<\/p>\n

Oct. 14<\/strong><\/p>\n

9 a.m. <\/strong>\u2014 The Senate Health Policy Committee is tentatively scheduled to meet at 9 a.m. in Room 412 of the Knott Building. The notice deadline is 2:30 p.m. on Oct. 7.<\/p>\n

3:30 p.m. <\/strong>\u2014 The Health Care Facilities & Systems Subcommittee is tentatively scheduled to meet at 3:30 p.m. in Room 404 of the House Office Building. The notice deadline is 5 p.m. on Oct. 7.<\/p>\n

Oct. 15<\/strong><\/p>\n

Happy birthday to Rep. Josie Tomkow<\/strong>!<\/p>\n

\"\"<\/a>Happy birthday to Rep. Josie Tomkow, celebrating another year of service and leadership in Florida.<\/p>\n

8 a.m.<\/strong> \u2014 The House Health Care Budget Subcommittee is tentatively scheduled to meet in Room 314 of the House Office Building. The notice deadline is 5 p.m. on Oct. 8.<\/p>\n

9 a.m.<\/strong> \u2014 The Senate Appropriations Committee on Health and Human Services is tentatively scheduled to meet in Room 412 of the Knott Building. The notice deadline is 2:30 p.m. on Oct. 8.<\/p>\n

11:30 a.m.<\/strong> \u2014 The House Health Professions & Programs Subcommittee is tentatively scheduled to meet in Room 102 of the House Office Building. The notice deadline is 5 p.m. on Oct. 8.<\/p>\n

Oct. 16<\/strong><\/p>\n

Happy birthday to Reps. Lisa Dunkley <\/strong>and Meg Weinberger<\/strong>!<\/p>\n

Oct. 20<\/strong><\/p>\n

5 p.m.<\/strong> \u2014 Rep. Anna V. Eskamani<\/strong> is hosting a town hall on vaccines and public health at the Beardall Senior Center, 800 Delaney Ave. #3897 in Orlando. In-person attendees are required to RSVP<\/strong><\/a>; the event will also be livestreamed on Facebook<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics. ___…\n","protected":false},"author":3,"featured_media":8882,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[10016,10017,10018,10019,10020,10021,10022,10023,10024,10025,210,1141,1142,3170,10026,10027,10028,10029,10030,10031,10032,10033,67,132,68],"class_list":{"0":"post-282533","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-acha","9":"tag-childrens-health-insurance-program","10":"tag-chip","11":"tag-cms","12":"tag-diagnosis","13":"tag-doh","14":"tag-fau-study","15":"tag-featured-post","16":"tag-hca-florida","17":"tag-hca-florida-healthcare","18":"tag-health","19":"tag-health-care","20":"tag-healthcare","21":"tag-medicaid","22":"tag-medicaid-florida","23":"tag-medicaid-managed-care-program","24":"tag-nurse-anesthetists","25":"tag-opt-out-provisions","26":"tag-oviedo-medical-center","27":"tag-physician-anesthesiologists","28":"tag-rural-health-care-access","29":"tag-scope-of-practice","30":"tag-united-states","31":"tag-unitedstates","32":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115329313851090761","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/282533","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=282533"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/282533\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/8882"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=282533"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=282533"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=282533"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}