The Florida Legislature sent a number of bills to the governor's desk this session that will impact the Florida health are landscape. Health care legislation was a priority for many of Florida's new leaders and, as a result, much of the new legislation passed with strong support from the legislature. Several new laws serve to deregulate the health care industry while new additional regulations are on the horizon for health care practitioners.

Importantly, the legislature agreed to keep statewide health care funding, like Medicaid, fairly consistent with last year. It also agreed to fund children covered under the Florida Health Kids Corp. who are subject to full-pay rates, generally making a large number of currently uninsured children eligible for coverage under the program.

Below are some of the major pieces of health care legislation passed this session.

Certificate of Need—HB 21/SB 1721

After numerous attempts in recent years, the legislature passed a repeal of the certificate of need (CON) process and hospital licensure requirements. The bill repealed the data filing requirements for CON applications, the CON requirement for general hospitals and the CON requirements for all hospital services effective July 1, and the CON process for specialty hospitals effective July 1, 2021.

Hospitals with a high amount of medical and surgical discharges related to cardiac, orthopedic or oncology specialties, will still need to conform to the CON process.

Proponents argued that this bill will increase competition in the industry and ultimately lower costs for patients. However, opponents maintained that the repeal would result in a loss of low- cost or high-paying patients for hospitals and leave hospitals with high-cost or indigent patients.

Prescription Drug Importation Programs—HB 19/ SB 1528

The legislature directed the Agency for Health Care Administration to begin to explore and create two drug importation programs, the Canadian Drug Importation Program and the International Prescription Drug Importation Program, with the aim of reducing drug costs. The programs must be approved by the U.S. Food and Drug Administration before they become effective.

Telehealth—HB 23/SB 1526

Telehealth is a growing area of medicine where patients can access the services of health care providers remotely. However, regulations relating to telehealth have not kept up with the expansion of the service. This bill creates a definition of telehealth in Florida law and allows Florida-licensed health care providers and out-of-state health care providers who register in Florida to qualify as telehealth providers.

Office Surgery Centers—SB 732/HB 933

This bill prohibits office surgery centers from conducting procedures requiring sedation with general, spinal, regional or epidural anesthesia.

Health Care Legislation—HB 843/SB 7078

This general bill touches on many different areas of health care regulation:

• Creates a loan repayment program for dentists who treat underserved populations in underserved geographic areas.
• Loosens restrictions on patient stays at Ambulatory Surgical Centers (ASCs) for adults to up to 24 hours and allow children to be kept past midnight until the Agency for Health Care Administration implements rules allowing for 24-hour stays for children.
• Requires hospitals to notify a patient's primary care physician or specialist, if the patient has one, within 24 hours of the patient's admission to a hospital.
• Requires hospitals to provide specific data to all patients or their representatives, upon scheduling of nonemergency care within 24 hours of stabilization or discharge. The hospital will be required to disclosure the hospital's and the statewide average number of hospital acquired infections, the overall rating on the Hospital Consumer Assessment of Healthcare Providers Survey and the 15-day readmission rate.
• Voids noncompete clauses or restrictive covenants between an entity and physicians who practice a particular medical specialty if that entity employs or contracts with all physicians in a county who practice that medical specialty.
• Expands direct care agreements beyond physicians to include chiropractors, advanced practice nurses, physician assistants, dentists and primary care group practices.
• Prohibits health insurers and health maintenance organizations from requiring step-therapy protocol under a policy if the patient has previously been approved to receive the drug through the completion of step-therapy protocol.
• Requires hospitals to provide immediate written notice to patients when the patient is placed on observation status.

Health Insurance Savings Program—HB 1113/SB 524

This bill created a program where commercial insureds who are not insured by government programs like Medicaid may receive payments from their carriers when the insured chose a covered health care service from an insurer's shared savings list of providers.

Lastly, a number of bills died in the legislature this year, including laws relating to the regulation of outpatient C-section facilities, increasing restrictions on local government and taxing districts, imposing increased reporting requirements on hospitals and ASCs, personal-injury-protection (PIP) repeals, increasing price disclosures of insurance-covered services, establishing a process to challenge medical billing by hospitals, setting caps on reimbursement for worker's compensation products and increasing the supply of medicinal drugs available to patients upon discharge. Expect some of these to come back during next year's session.

Andrew Marcus is a member of Holland & Knight's healthcare & life sciences team and focuses on insurance and administrative law. He represents insurers, health care providers, third-party administrators and other related clients in front of state and federal government agencies.