Florida Legislature Derails Healthcare ‘Train’

By  //  May 5, 2014


Last month, the Florida House Health & Human Services Committee passed an omnibus healthcare bill that combined three controversial issues in the hope that packaging them would make it harder for the Senate to kill or dilute any of them.

The Florida Senate stripped proposals dealing with autonomous practice of nurse practitioners and lax state licensure for telemedicine services from the House’s omnibus healthcare bill, derailing the legislative “train.”

HB 7113 protected private for-profit trauma centers, allowed for independent practice for nurse practitioners and allowed out-of-state doctors to participate in telehealth without a Florida license.

A law packaged like HB 7113 is sometimes called a “train” in legislative vernacular. The idea of a train is that it’s a bunch of connected railcars, and it would be hard to cut out one of them without causing them all to derail. In reality, it is a strategy to force some lawmakers to accept a proposal they don’t like in order to get one they really want.

However, by the time the dust cleared on Friday, the final day of the 2014 legislative session, the “train” derailed.


The Senate stripped out the proposals dealing with autonomous practice of nurse practitioners and licensure of telemedicine providers, both of which were vehemently opposed by the Florida Medical Association. The Senate deleted both proposals from HB 7113 during a flurry of amendments on Thursday.

Senate President Don Gaetz, R-Niceville, and other senators have long said they opposed a House proposal to allow nurse practitioners to provide primary care without the supervision of physicians.


Senators also objected to and passed an amendment deleting the House’s broad proposal aimed at increasing the use of telemedicine, based, at least in part, on concern about allowing out-of-state doctors providing telemedicine services to Florida patients without being licensed in Florida.


Segments of Florida’s hospital industry have battled for three years over the Department of Health’s approval of new trauma centers. The House and Senate have generally been on the same page with this issue, which would ensure the trauma centers at Blake Medical Center in Manatee County, Regional Medical Center Bayonet Point in Pasco County and Ocala Regional Medical Center in Marion County remain open — despite opposition from major hospitals in the Tampa Bay and Gainesville areas.

An ultimate legislative disposition to grant HCA the right to keep three trauma centers open regardless of the outcome of court cases seeking to shut them down stalled at the end of the 2014 Florida legislative session.

The Hospital Corporation of America (HCA) health-care chain, which includes the three disputed trauma centers, lobbied for the bills, while the Safety Net Hospital Alliance of Florida, which includes hospitals with longstanding trauma facilities, lead lobbying efforts in opposition.

Despite both Senate and House support, the proposals in the bills died Friday after becoming tangled in broader health-care issues, leaving the fate of the trauma programs at the HCA facilities still up in the air.

This SpaceCoastDaily story produced in collaboration with News Service of Florida

Related Articles:

Megabill Sets Stage For Healthcare Debate

Florida Senate President Opposed To ARNP Autonomy

FL House Considering Bill To Give NPs More Autonomy

Physicians and Nurses At Odds Over NP Autonomy