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Diagnosis for 11.17.22: Checking the heart beat of Florida well being care information and coverage

Welcome again to Diagnosis, a vertical that focuses on the crossroads of well being care coverage and politics.

Despite ongoing stress from some members of Congress, the general public well being emergency declared on the onset of the COVID-19 pandemic is anticipated to remain in place for the primary quarter of 2023.

This declaration — and when it might finish — is important due to its impression on Florida’s mammoth Medicaid program.

The Biden administration promised to provide states 60-day discover if the administration plans to elevate the designation, which should be renewed each 90 days. The present declaration is because of expire Jan. 11, that means the notification deadline was Nov. 11.

Joe Biden is more likely to lengthen the COVID-19 state of emergency.

The Senate this week voted 62-36 in favor of a decision that might finish the general nationwide emergency declared resulting from COVID-19. Both Florida Senators — Rick Scott and Marco Rubio — voted to finish the emergency, however the Biden administration has vowed to veto the laws ought to it attain his desk.

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In an announcement, the administration stated that “while COVID-19 is no longer the disruptive threat that it once was, and we have made tremendous progress in combating the virus, the virus continues to pose a risk to the American people and our health care system.”

The continuation of a public well being emergency associated to COVID-19 will have an effect on general state spending on Medicaid since Florida is receiving a better share of federal reimbursement proper now. But that comes with a requirement that folks be allowed to stay enrolled in Medicaid. Medicaid enrollment is anticipated to peak at 5.35 million individuals throughout the present fiscal yr.

State economists had forecast final August that the general enrollment would start to drop as soon as the general public well being emergency is dropped and the state can begin to take away individuals from the rolls.

Because of the uncertainty, the National Association of Medicaid Directors despatched a letter Thursday asking that Congress step in and supply clear course on the “unwinding” of the general public well being emergency. The group requested for not less than a 120-day discover earlier than states ought to begin redetermining if somebody is eligible for Medicaid and supply a phased-out method to when the additional federal help now flowing into the state will cease.

“With the lack of an announcement from the U.S. Department of Human Services that the national COVID-19 Public Health Emergency (PHE) will end in January 2023, states are now assuming the PHE will extend into April 2023,” the letter learn. “This extension of the PHE — which would be the 12th such extension — exacerbates the uncertainties for state planning to resume normal Medicaid operations. This, in turn, increases the risk of unnecessary losses of health insurance coverage for Medicaid members.”

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The letter added the uncertainty across the destiny of the general public well being emergency is “untenable.”


Diagnosis shall be off subsequent week in honor of Thanksgiving however will return for publication Dec. 1.


I welcome your suggestions, questions and particularly your tips. You can e mail me at [email protected] or name me at 850-251-2317.

Time passages

Florida’s Medicaid managed care program is the most costly procurement within the state, and all eyes are on the upcoming bid.

The multiyear contracts are value billions of {dollars} to the profitable Medicaid managed care plans, and well being plans that aren’t chosen to take part in this system shall be shut out of Florida’s Medicaid marketplace for six years except they merge with or purchase a managed care plan that did submit a profitable bid.

The Agency for Health Care Administration (AHCA) repeatedly has stated it expects the procurement to start someday throughout the fourth quarter of the calendar yr 2022.

AHCA can nonetheless make its self-imposed timetable if it marks the start of the procurement cycle with the publication of what’s often known as the Medicaid Data Book.

The information e book is the Holy Grail of re-procurement. It holds all of the details about the state’s Medicaid program {that a} managed care plan needs or wants to know in regards to the security internet program that serves the poor, aged and disabled earlier than deciding whether or not it needs to compete for a contract.

The data e book should be printed not less than 90 days earlier than AHCA publishes its Invitation to Negotiate (ITN).

To date, AHCA has not printed the Medicaid Data Book (although the Governor’s workplace allegedly has the data and is reviewing it.)

Even if the e book have been to be printed tomorrow, the company wouldn’t have the ability to submit its ITN till the start of February.

Far out

Can a drug compound constructed from tomatoes restore age-related muscle loss?

Siobhan Malany, Ph.D., an affiliate professor of pharmacodynamics on the University of Florida College of Pharmacy, can’t wait to seek out out.

The Falcon 9 rocket is slated to launch from the Kennedy Space Center in Cape Canaveral subsequent week. On the rocket shall be a tiny laboratory that Malany and different UF scientists have constructed that plugs into the Space Station. The experiment will permit scientists to grasp how microgravity impacts human muscle biology.

The findings may result in new therapies for age-related muscle loss on Earth.

“Scientists have turned to space to study the effects of aging because microgravity can accelerate muscle mass changes,” Matany stated. “If we can take what we learn in space and apply it to drug development on Earth, then we’re taking a big step forward in developing new therapies for muscle loss in older adults.”

New analysis investigates tomatoes as a method of slowing down muscle loss in seniors.

Muscle loss in older adults results in a decline in mobility, which results in scores of different issues together with falls and fractures.

The UF-built lab options an automatic tissue chip system, which feeds vitamins to 3D muscle bundles each six hours. The chips have electrodes that may permit scientists to review muscle contractions. The laboratory additionally has a microscope digital camera system that may seize photos.

While different chip-based experiments carried out on the International Space Station can take weeks of crew time, the UF experiment is totally automated and doesn’t require work from the Space Station crew.

Moreover, the experiment additionally assessments advances within the automation of human tissue-chip expertise by way of miniaturized labs. According to UF, the long-term objective is to, amongst different issues, exchange using animal fashions.

The National Institutes of Health and the National Center for Advancing Translational Sciences funded the analysis. It can be supported by AdventHealth Orlando, Micro-gRx Inc., Micro Aerospace Solutions Inc., Space Tango and the UF Department of Biomedical Engineering.

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— Apprentice alternatives —

The Florida Behavioral Health Association (FBHA) developed the primary behavioral well being apprenticeship mannequin in Florida after receiving a grant from the Florida Department of Education final yr.

Dubbed Health Quest, FBHA President and CEO Melanie Brown-Woofter stated this system’s objective is to bolster employment within the behavioral well being discipline by supporting recruitment and retention efforts and inspiring extra people to think about getting into the sector.

Melanie Brown-Woofter is one among Florida’s main advocates for psychological well being.

People are given three apprenticeship tracts to select from: addictions counselor, behavioral well being technician and peer specialist.

Since it’s National Apprenticeship Week, there’s no time like the current to tout its success.

According to the FBHA, almost one dozen professionals have enrolled in this system since its launch. Forty-seven-year-old Charli Cole, a particular tasks director at STEPS in Orlando, was a type of enrollees.

She stated the chance was a life changer.

“The apprentice program gave me the opportunity for on-the-job training and experience to help me advance my education and job skills while maintaining my employment. Thanks to full support from my employer, pursuing the certification for the Addictions Counselor gave me more confidence,” Cole stated in a ready launch. “It also encouraged me to go back to school and further my education, knowing that I had such a supportive work environment.”

— Drive safely —

Forty-five individuals died and one other 255 have been critically injured final yr after 4,585 vehicle accidents occurred over 5 days final yr round Thanksgiving on Florida’s highways and byways.

To guarantee the protection of all highway customers this vacation season, the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) and its division of the Florida Highway Patrol (FHP) launched the Safe Holiday Travel campaign. The multi-phased security messaging shall be staggered all through November and December, specializing in road-ready automobiles, particularly road-ready tires.

Adult upset driver man in front of automobile crash car collision accident in city road
The Florida Department of Highway Safety and Motor Vehicles needs you to have a contented — and protected — vacation season.

According to the company, unhealthy tires brought on greater than half the accidents (2,811) occurring over the 5 days final yr. Thirty-two individuals died in these accidents, and one other 76 have been critically injured.

“Florida continues to be a top holiday destination for visitors and residents, making our roads some of the busiest during the upcoming months,” stated FLHSMV Executive Director Terry Rhodes. “As you prepare to hit the road this Thanksgiving, or at any point this holiday season, make sure you and your vehicle are ready for the trip, always buckle up, and remember that safety is always in season.”

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— The Board of Medicine proposes Rule 64B8-9.019 in regards to the follow requirements for treating gender dysphoria in minors. More here.

— The Board of Osteopathic Medicine proposes Rule 64B15-14.014 in regards to the follow requirements for treating gender dysphoria in minors. More here.

— The Board of Hearing Aid Specialists proposes amending Rule 64B6-6.005 in regards to the {qualifications} for unbiased testing brokers. More here.

— The Board of Hearing Aid Specialists proposes amending Rule 64B6-6.008 about promoting and enterprise location necessities. More here.

— The Board of Occupational Therapy proposes amending Rule 64B11-4.001. More here.

— The Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling proposes amending Rule 64B4-3.001 to replace rule language and incorporate an utility type. More here.

— The Department of Health (DOH) proposes growing guidelines for genetic counseling, together with Rule 64B4-1.001, which features a licensure utility type and Rule 64B4-1.002, which addresses persevering with training necessities. More here.

— The DOH Division of Disease Control proposes amending Rule 64D-3.042 relating to sexually transmitted ailments and being pregnant and supply. More here.


—Ronald L. Book and Kelly C. Mallette have registered to foyer for Bright Health Group.

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Ron Book picks up a brand new well being care shopper.

—Foyt Tipton Ralston has registered to foyer for Dialysis Clinic, Inc.

—Sharon C. Smoley has registered to foyer for Embrace Families, Inc.

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— Tracy Cantella has been named Secretary of the Senate. Cantella has labored for the Senate for greater than 20 years, beginning her profession within the Senate Secretary’s Office. For the final decade, she has served as skilled employees to the Senate Committee on Rules, coaching underneath John Phelps, the previous clerk for the House of Representatives and the Rules Committee Staff Director.

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Congratulations to Tracy Cantella, the brand new Secretary of the Senate.

— Centene Corporation has appointed Monte Ford to its Board of Directors. Ford is a number one technologist who has labored for Fortune 500 corporations throughout varied industries. He at present sits on the boards of JetBlue Airways, Iron Mountain and Akamai Technologies, and lately served on the Health Care Service Corporation (HCSC) board.

Ivan Matos Diaz, M.D., has joined Miami Neuroscience Institute, part of Baptist Health, as co-director of cerebrovascular neurology. Before becoming a member of Miami Neuroscience Institute, Matos was with Hennepin Healthcare, the place he served as a neurohospitalist, in addition to medical director for the Hennepin Healthcare Comprehensive Stroke Center.

Ed Daech has been named chief human assets officer at UF Health Shands. He begins Jan. 2.

— ETC —

— American Medical Association (AMA) President and California doctor Jack Resneck Jr. delivered a fiery speech this week at an interim assembly of the AMA House of Delegates in Honolulu. His message: “When politicians insert themselves in our exam rooms to interfere with the patient-physician relationship … when they politicize deeply personal health decisions or criminalize evidence-based care … we will not back down. We will always stand up for our policies … for physicians … and for our patients.” Watch Resneck’s speech here.

— There at the moment are two docs within the Florida House of Representatives. Joel Rudman, M.D., was elected to House District 3. He joins Rep. Ralph Massullo, M.D., who gained re-election in House District 23.

massullo rudman
There at the moment are two docs within the House.

— The University of North Florida Brooks College of Health has been named one of many high 50 faculties for on-line well being care administration training by reviewed greater than 7,700 accredited faculties and ranked qualifying faculties for every well being care self-discipline based mostly on educational counseling providers, profession placement providers, student-to-faculty ratio, tuition, share of scholars receiving school-based monetary help and quantity of school-based help per scholar. UNF’s on-line well being care administration program earned high honors for general high quality, affordability and dedication to scholar success.

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In case you missed them, here’s a recap of different crucial well being care coverage tales lined in Florida Politics this previous week.

No surprises: Gov. Ron DeSantis will hold Surgeon General Joseph Ladapo round for a second time period. Ladapo, who had been on the school of the University of California at Los Angeles, has been a key companion with DeSantis since approaching board greater than a yr in the past. He has been skeptical of COVID-19 vaccines and lately led the cost to persuade state medical regulators to draft new guidelines that forestall docs from prescribing gender-affirming look after minors. In a tweet Monday, DeSantis stated Ladapo “has done a great job” in his position as Surgeon General and Secretary of the Department of Health.

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Joseph Ladapo will get one other time period. Image by way of AP.

Roll with the changes: As Florida’s medical marijuana market grows and prospers, the DeSantis administration has modified management within the Office of Medical Marijuana Use (OMMU). Christopher Phillip Kimball was named the director of the OMMU Nov. 11, Department of Health (DOH) Deputy Chief of Staff Weesam Khoury instructed Florida Politics Wednesday afternoon. Kimball replaces Chris Ferguson, a longtime division worker who headed the workplace for the final three years.

Legalize it: A record-high 68% of Americans assist hashish legalization, an October Gallup Poll finds, up from simply 12% assist in 1969 when Gallup first requested about legalization and up from polls taken since 2016 when assist averaged not less than six in 10. Conservatives, spiritual Americans and older people are the least more likely to assist hashish legalization.

Another review: The Florida Supreme Court has been requested to weigh in on a high-profile medical malpractice concern: Are adversarial medical incident experiences topic to disclosure underneath so-called Amendment 7 to the state’s structure or are they protected against discovery underneath a 2005 federal legislation? The Florida Supreme Court already addressed the problem in 2017, however the 1DCA is asking the courtroom, which is extra conservative than the 2017 bench, to re-examine the questions. DeSantis appointed 4 of the seven justices.


Aside from protection by Florida Politics, these tales are value your time.

—”Florida fund for injured kids wrongly stuck Medicaid with tab. Now it’s repaying $51 millionby way of Carol Marbin Miller of the Miami Herald — Administrators of Florida’s long-troubled compensation fund for infants born with catastrophic mind accidents have resolved one of many program’s thorniest and longest-standing disputes: the declare that they prevented tons of of thousands and thousands in well being care prices by raiding the protection internet for impoverished Floridians. The Birth-Related Neurological Injury Compensation Association, or NICA, settled a three-year-old whistleblower criticism that alleged this system grew property of almost $1.7 billion partly by dumping well being care and caregiving prices onto Medicaid, the state-federal insurer for poverty-stricken and disabled Floridians.

birth related neurological infants
NICA made a significant settlement over improperly transferring prices to Medicaid.

Florida diabetics scramble to find drugs suddenly popular for non-intended uses: weight lossby way of Cindy Krischer Goodman — Florida diabetics are struggling to purchase prescribed drugs to assist management their blood sugar now that the medicines have gone viral on social media as a weight reduction resolution. The demand from dieters for Ozempic, bought as a liquid resolution administered as an under-the-skin injection, has brought on shortages of the treatment and Trulicity, an injectable diabetes medication. The buzz has created critical points for individuals who really want the prescribed medicines to regulate diabetes.

Why most Tampa Bay hospitals are relaxing mask rulesby way of Christopher O’Donnell of the Tampa Bay Times — In one other signal of life returning to one thing akin to regular throughout the COVID-19 pandemic, most native Tampa Bay hospitals have relaxed once-strict guidelines about sufferers, guests and medical staffers carrying masks. The surgical mouth coverings — as soon as necessary at medical amenities to forestall the unfold of the virus — at the moment are merely really helpful at many of the area’s main hospitals, though there are exceptions. The transfer follows new pointers issued by the Centers for Disease Control and Prevention in September that stated masks are now not required in well being care settings like hospitals, docs’ workplaces and nursing properties in communities the place COVID-19 transmission ranges are low.

What happened to monkeypox? LGBTQ community appears to have quashed spread for nowvia Caroline Catherman of the Orlando Sentinel — Despite concerns that the end of summer vacation or even Pride events could further exacerbate monkeypox’s spread, the virus has fallen dramatically in the U.S. and Central Florida since peaking in August — though there’s no guarantee it will stay that way. Experts say the spread may have faltered mainly because of actions by the LGBTQ community. “The community that largely was affected was very responsible,” stated Jill Roberts, an affiliate professor on the University of South Florida College of Public Health. “If that had not been the case, we would have definitely seen a lot of spread well beyond the men who have sex with men population and into other populations.”

Bridging breast and prostate cancer disparities among Blacks is focus of new Miami studyby way of Michelle Marchante of the Miami Herald — With Black women and men at a better threat of growing and dying from aggressive breast or prostate most cancers, a brand new Miami examine is looking for to grasp higher tips on how to detect and deal with the ailments throughout Black communities within the United States, the Caribbean and Africa. Researchers at Sylvester Comprehensive Cancer Center will work to establish cancer-causing mutations amongst U.S. Blacks recognized with breast or prostate most cancers, together with within the Miami space, in addition to Blacks within the Bahamas, Barbados, Haiti, Jamaica and Trinidad and Tobago within the Caribbean.



Happy birthday to Sen. Geraldine Thompson.

Another journey across the solar: Happy birthday to Geraldine Thompson.


Happy birthday to Rep. Rick Roth.

11 a.m. The Statewide Human Trafficking Council meets.

2 p.m. AHCA holds a public listening to on proposed adjustments to Rule 59A-4.110 relating to meals and diet providers. Place: AHCA, Building 3 Conference Room C, 2727 Mahan Drive, Tallahassee, 32308.


10 a.m. Florida House Organizational Session. Place: House Chambers, The Capitol, 400 S. Monroe St. Tallahassee, 32399.

10:30 a.m. Florida Senate Organizational Session. Place: Senate Chambers, The Capitol, 400 S. Monroe St. Tallahassee, 32399.

12:30 p.m. Post-Session media availability with Speaker Paul Renner. Place: Room 333 The Capitol, 400 S. Monroe St. Tallahassee, 32399.

1:30 p.m. Post-Session media availability with Senate President Kathleen Passidomo. Place: Senate Chamber, The Capitol, 400 S. Monroe St. Tallahassee, 32399.

1:30 p.m. The Medicaid Medical Care Advisory Committee meets. The assembly shall be digital. Participants should register prematurely for the assembly.


Happy birthday to Sen. Linda Stewart.


Happy Thanksgiving!

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