Florida Legislative Review By Robert R. Reynolds and Associates, LLC. July 16-18, 2015 Naples, Florida

2015 Legislative Session During the 2015 Legislative session a total of 1,755 bills were introduced; however, only 231 passed. This was fewest amount of bills passed in 17 years. No consensus, no compromise, no budget. Wide divide between House and Senate positions.

2015 Legislative Session Overview Wide divide in policy between Senate and House positions. Medicaid expansion Senate- Create Public /private partnership. Online Florida Health Insurance exchange program (FHIX). 800,000 potential recipients who would choose from available plans.

2015 Legislative Session Overview Required to work or go to school to qualify. Sliding scale of monthly premiums. Co-pays Penalties for improper ER usage. 6 month lock for non-payment of premiums. Phase two of program would add Medically needy and kid Care programs.

House Cost Cutting Alternatives Eliminate certificate of need requirements for hospitals. Advanced Registered Nurse practitioners (ARNP’s) and Physician Assistants expand scope of practice to permit prescribing of controlled substances under supervision of Physician. (allowed in 49/48 states). Authorize direct primary care contracts and clarify they are not insurance for regulatory purposes. Create recovery care centers where stays of up to 72 hrs. are allowed. Create a new state employee insurance plan using a risk adjusted premium credit system.

Future Issues Nations Council of State Boards of Nursing (Nursing Compact) Medicaid Dialysis Services coverage policy ICD-10 Code Implementation-Workshops Medicaid Plan Amendment – Peritoneal Dialysis Increase from 3 to 7 weekly treatments Telemedicine ARNP Scope of Practice expansion MSW Internship cap of 5 years

Defense Wins Championships FRAA Legislative Successes Maintained current regulatory structure (no new AHCA licensure or other requirements). Stopped further health plan prior authorization requirements. Kept “proviso” language in budget for direct reimbursement of Pharmaceuticals, $ reimbursement rate and “enhanced Peritoneal Dialysis usage”. Preserved “Alonso Mourning access to care act. Medi- Gap for disabled under 65

State Agency Advocacy ESRD Advisory meeting- Justin Senior, Beth Kidder, Joshua Spagnola, Wendy Smith attended. Increased Treatments for Peritoneal Dialysis. Medicaid Policy coverage. Enhanced access To AHCA. Can’t put a price on that!

Support Florida Kidney Day! November 17 & 18, 2015 (tentative) PLEASE SUPPORT THE FLORIDA RENAL COALITION!