COMMITTEE REPORTS
Government Affairs: EM Days 2019 By Damian Caraballo, MD, FACEP Government Affairs Committee Chair • FCEP Secretary-Treasurer
March 11-13, 2019 marked the 30th annual Emergency Medicine Days: FCEP’s advocacy conference in Tallahassee. Similar to an ED shift, what was initially thought to be a “quiet” legislative session quickly descended into chaos for the House of Medicine, as House Speaker Oliva and the House Leadership unleashed a host of bills aimed at “disrupting” the delivery of medicine. Among the bills filed this session include:
• a bill which would allow pharma-
cists to test/diagnose strep and influenza in the pharmacy, while also adjusting patient prescriptions without the writing physician’s permission (HB 111 & SB 300); • independent autonomy for nurse practitioners and PA’s (who are now contemplating changing their name from physician assistants, given the sea-change in non-physician autonomy movements around the country) (HB 821); • a bill allowing law enforcement and psychologists to initiate involuntary holds to clinically sober and competent patients if they demonstrate a lack of control due to their chronic substance abuse disorder (HB 313), and • a bill which would apply a fee-schedule cap to all physicians in Florida at a price ceiling of 200% of Medicare (HB 1317 & SB 1790). Other bills include reinstituting malpractice caps, finding a PIP solution which did not squeeze out EMTALA providers, and continued funding and treatment for the opioid crisis. Needless to say, FCEP worked hard this session to play defense and kill bills which would further undermine quality emergency care in Florida. For those in attendance, this legislative session marked an eye-opening view at the hostility many lawmakers have towards current physicians and hospitals as healthcare costs continue 6
BILLS TO WATCH THIS SESSION: HB 1317 (Burton) & SB 1790 (Perry): DOH Adopt Statewide Fee Schedules for Services AGAINST
HB 111 (Plasencia) & SB 300 (Brandes): Testing & Treatment of Influenza and Streptococcus AGAINST
HB 313 (Gottlieb): Marchman Act AGAINST
SB 896 (Brandes) & HB 733 (Grall): Motor Vehicle Insurance (PIP Repeal) AGAINST
SB 528 (Rouson): Mental Health & Substance Use Disorders SUPPORT
HB 307 (Silvers) & SB 360 (Rouson): Insurance Parity for Mental Health & SUD SUPPORT
SB 418 (Simpson): Essential Health Benefits Under Health Insurance Policies & Contracts AGAINST
to skyrocket. Emergency physicians are erroneously being blamed for costs associated with emergency care, such as facility fees, out-of-network costs and high-deductibles. It’s our job to educate lawmakers on the true value of emergency physicians, given that we see more acute care patients than any other specialty and treat the highest number of uninsured and Medicaid patients in the state, without any regard to their ability to pay. As healthcare costs become a bigger portion of state and national budgets, we must work hard to prove our value as leaders in the healthcare field. This comes by forming relationships with our legislators during events such as EM Days. Fortunately, through years of hard work and fostering relationships, we appear to have enough backstops to halt many of these poorly written bills (we’ll have a better idea towards the end of session in May). Still, even if we manage to defeat bad bills this year, we know many will return in similar forms next year. It’s our hope that those in attendance, especially younger physicians and residents, EMpulse Spring 2019
HB 821 (Pigman): Advanced Practice of Registered Nurses AGAINST
now realize the uphill battle we face in protecting physician independence. As FMA President Dr. Corey Howard told FCEP members during his lecture, the House of Medicine needs to band together to find proper solutions to the crises facing modern healthcare. We need to find innovative ways to expand access and provide higher quality care, while standing up for physician rights to improve doctor-patient autonomy in an environment where every insurer, administrator, conglomerate company and even legislator is now trying to dictate how to provide healthcare. Next year’s EM Days will be in January 2020. It’s up to us to take back the practice of medicine and work together to improve emergency medicine—and the practice of medicine in general—in the upcoming years. FCEP Government Affairs strongly encourages you to join us in mapping out the future of our medical practice by joining us in advocacy efforts. Please contact us to find out how you can get involved in improving the practice of emergency medicine in Florida. ■
