Week 7 Report-February 26, 2016
Below is a summary of the priority issues impacting BioFlorida.This update accompanies the detailed BioFlorida Legislative Tracking Report that includes more than80 bills impacting the life sciences industry.
Transparency Initiative—Hospital Setting
House Bill Passes Final Committee This Week & Will be Heard on House Floor Next Week
SB 1496 by Senator Rob Bradley (R-Fleming Island) and HB 1175 by Rep. Chris Sprowls (R-Palm Harbor) are aimed at increasing transparency in health care pricing and transparency in quality measures. The legislation requires licensed health care facilities and health professionals to provide written good faith estimates of reasonable anticipated charges to treat patients. The bills also require the AHCA to provide a consumer-friendly, Internet-based platform to research the cost of health care services and procedures and allow for price comparisons. The bills contain provisions on health provider cost estimates to patients, fines for noncompliance, hyperlinks for the claims database, and exemptions from data reporting. SB 1496 is ready for floor consideration and HB 1175 will be heard on the House floor on March 1st.
Patient Protection/Right Medicine Right Time
Senate Bill Amended to Include Fail-First Provision This Week
SB 212 by Senator Don Gaetz (R-Destin) and HB 85 by Rep. Heather Fitzenhagen (R-Fort Myers) allow ambulatory surgical centers to keep patients for 24 hours. The Senate bill was amended in the Appropriations Committee on February 25th to include fail-first protocol provisions that provide if a managed care plan restricts the use of prescribed drugs through a fail-first protocol, it must establish a clear and convenient process that a prescribing physician may use to request an override of the restriction from the managed care plan. The House companion bill does not include these provisions and is scheduled to be heard on the House floor on March 1st.
HB 963 by Rep. Shawn Harrison called the “Florida Patient Protection Act" require Medicaid managed care plans, insurers, or HMOs to allow a prescribing provider to request an override of a restriction on the use of a medication imposed through step-therapy or fail-first protocols. The legislation streamlines the step therapy and fails first protocols to ensure that physicians have a clear pathway to navigate a health plan’s step therapy protocols. In addition, the legislation prohibits insurers from discriminating against vulnerable populations and lays out clear continuity of care guidelines. No committee hearings have been held on the bill.
SB 1084 by Senator Don Gaetz (R-Destin) creates the “Right Medicine, Right Time Act” which requires Medicaid managed care plans, HMOs, and insurers that restrict medications by a step-therapy or fail-first protocol to have a clear and convenient process to request an override of the protocol. The bill requires these entities to grant an override of the protocol within 24 hours, under certain conditions. The bill also prohibits an HMO from requiring that a health care provider use a clinical decision support system or a laboratory benefits management program in certain circumstances. The bill is in the Appropriations Committee, awaiting a hearing.
Differing House and Senate Versions Moving Through Process
HB 7087 by the House Select Committee on Affordable Healthcare Access and Rep. Chris Sprowls (R-Palm Harbor) allows professionals both inside and outside of Florida to use telehealth to provide health care services. The bill also limits providers’ ability to prescribe controlled substances to treat chronic nonmalignant pain and requires reporting to the state about telehealth costs and access. The bill also authorizes out-of-state health care professionals to use telehealth to deliver health care services to Florida patients if they register with the Department of Health (DOH), meet certain eligibility requirements, and pay a fee. Under the bill, a registered telehealth provider may use telehealth, within the relevant scope of practice to provide health care services to Florida patients, but is prohibited from opening an office in Florida and from providing in-person health care services to patients located in Florida. The bill allows health care providers who are authorized to prescribe a controlled substance to use telehealth to do so except for chronic nonmalignant pain. The bill also requires biannual registration for out-of-state providers and requires the reporting of disciplinary action within five days. On March 1st, HB 7087 will be considered by the full House.
SB 1686 by Senator Aaron Bean (R-Fernandina Beach) creates the Telehealth Task Force within AHCA and requires the task force to submit a report to Governor and Legislature. The bills require the task force to compile and analyze certain data and to conduct comparative analysis of the health insurance coverage available for telehealth services and for in-person treatment. On February 25th, SB 1686 passed the Appropriations Committee by a vote of 17 to 0.
Medical Marijuana / Right to Try Act
Senate Bill Taken off Special Order This Week
On February 17th, the Health and Human Services Committee combined HB 307 by Rep. Matt Gaetz (R-Fort Walton Beach) with the provisions of HB 1313 by Reps. Jason Brodeur (R-Sanford) and Katie Edwards (D-Plantation). The new House committee proposal eliminates the expansion of the number of nurseries licensed to grow and sell medical marijuana. The combined bills allow people with terminal illnesses to use medical marijuana and allow five nurseries, already chosen by the Department of Health, to grow low-THC cannabis under the 2014 law, and establish dispensaries. Under the new rewrite, three additional nurseries could be licensed, as well, if the total number of medical marijuana patients surpasses 250,000 in Florida. Additionally, the rewrite requires a physician to meet certain criteria before ordering low-THC cannabis and medical cannabis, including establishing a patient relationship for at least three months, meeting certain education requirements, and obtaining written informed consent from the patient or the patient’s legal representative. The bill prohibits an ordering physician from being a medical director employed by a dispensing organization and subjects a medical director to disciplinary action if the medical director receives compensation from a dispensing organization related to the ordering of low-THC cannabis or medical cannabis.
SB 460 by Senator Rob Bradley (R-Fleming Island) amends Florida’s Right to Try Act to include medical marijuana to a list of experimental treatments available to terminally ill patients. Under the bill, an eligible patient and the eligible patient’s legal representative may purchase and possess cannabis for the patient’s medical use and an approved dispensing organization (DO) and its owners, managers, and employees may manufacture, possess, sell, deliver, distribute, dispense, and lawfully dispose of cannabis so long as the requirements of the Right to Try Act are met. Such persons are exempt from criminal penalties under the bills. An eligible patient and his or her legal representative may only obtain the cannabis from a DO approved under statute. SB 460 was scheduled to be heard by the full Senate on February 23rd; however, after more than two dozen floor amendments were filed on the bill, President Gardiner referred the bill to the Rules Committee on February 29th to work out the language. Last fall, DOH selected five nurseries to be the state's first dispensing organizations to grow, process, and dispense low-THC cannabis products. Senator Bradley was offering an amendment to SB 460 which mirrored the House proposal to allow those five winning applicants to continue as DOs and allow any future winners of any court or administrative challenge to also have dispensing organization licenses.
Appropriations Chairmen Senator Tom Lee (R- Brandon) and Rep. Richard Corcoran (R-Land O’Lakes) made substantial progress this week toward resolving the stalemate over budget allocations in the various budget areas of health and human services, criminal justice, transportation, economic development, etc. Traditionally, allocations must be resolved before conference committees begin negotiating the details of each budget area. Both Senate President Andy Gardiner (R-Orlando) and House Speaker Steve Crisafulli (R-Merritt Island) convened budget conference on Friday at 5:30pm, meetings will continue over the weekend.
Fund Basic Research
The House and Senate have taken positions on these individual research programs (James and Esther King Biomedical Research Program, the Ed and Ethel Moore Alzheimer’s Disease Research Program, and the Bankhead/Coley Cancer Research Program) and we are tracking these through the budget conference process. SB 941 by Representative Gonzalez passed the Health Care Appropriations Subcommittee on February 2; this bill is the Department of Health’s 2016 legislative package which includes technical changes in reporting for the research funds from the James and Esther King Biomedical Research Program, the Ed and Ethel Moore Alzheimer’s Disease Research Program, and the Bankhead/Coley Cancer Research Program. These updates were due to an auditor general report and also include carry forward language for the unexpended balance of funds. The bill passed the Health and Human Services Committee on February 17.
The carry forward language for the Ed and Ethel Moore Alzheimer’s Disease Research Program in HB 5103 passed the House and Senate on February 11 and has been enrolled and sent to the Governor for action.
Economic Development and Tax Incentives
House and Senate hold Positions as Budget Conference Begins
The House passed the economic development package, HB 1325 by Representative Jim Boyd (R—Bradenton) this week. The vote was 79-39, with a mixture of Republicans and Democrats on each side. This bill will now go to the Senate, the companion, SB 1646 by Senator Latvala (R—Clearwater) is still waiting to be heard in the Appropriations Committee. Both bills include the establishment of the Florida Enterprise Fund, the entity that will evaluate proposals and distribute incentive. The House bill does not specify a funding amount but Governor Scott and the Senate have recommended $250 million.
Economic incentives continue to be a main bargaining chip as the legislature moves into budget conference.
The House passed the tax package, HB 7099, on February 11; this close to $1 billion package had a final vote of 96-17. The Senate has taken a more measured approach, taking tax proposals singularly. Below are a few of the priority tax credits BioFlorida is following.
Research and Development Tax Credit
The House has included the research and development corporate income tax credit in their tax package, HB 7099, by Representative Matt Gaetz (R—Fort Walton Beach) the language states that the 2017 total amount granted is $18 million, a $9 million increase over the recurring base credits. This bill passed the House floor February 11. The Senate’s version is in a standalone bill by Senator Latvala (R—Clearwater), SB 1646, which simply retains the base $9 million. This bill still needs to be heard in the Appropriations Committee, its final stop.
Manufacturing Tax Credit
The Senate Finance and Tax Committee unanimously passed SB 98 by Senator Hukill (R—Port Orange) which extends the current manufacturing equipment tax exemption. This bill continues to have bipartisan support and language will likely appear in the budget conference process. The Revenue Estimating Conference has determined that this tax exemption will reduce General Revenue receipts by $62.8 million. The House has included the manufacturing tax credit in Chair Gaetz’s tax cut package proposal, HB 7099. The large tax package bill passed off the House floor February 11, while SB 98 still needs to be heard in the Appropriations Committee, its final stop.
Tax on Commercial Leases
The House tax incentive package, HB 7099, reduces the state sales tax rate on rental of commercial real estate (also known as the business rent tax) from 6% to 5% in 2017, with an additional one percentage point reduction (to 4%) in 2018. This bill passed the House floor on February 11. The Senate also addresses the business rent tax in SB 116 by Senator Hukill; however, it is only a reduction of one percent. The Senate bill has a final committee stop, the Appropriations Committee.