Florida is an active state in promoting healthcare price transparency. A key effort is the state’s all-payer claims database, which was mandated by the legislature and implemented in 2016. It also has a consumer-facing website, FloridaHealthFinder.gov, which allows consumers to view performance and outcome data, including average costs, for healthcare facilities in the state. The website also provides consumers with the ability to compare health care costs at the national, state and local levels. Florida is also active in promoting the use of electronic Health Information Exchanges to streamline provider access to patient information and consequently lower costs and improve quality of care.
In 2019, the legislature enacted legislation that authorizes individual and group health insurers and health maintenance organizations to offer shared savings incentive programs. The laws require health insurers that offer the program to publish on an easily accessible webpage a list of shoppable health care services and health care providers and the shared savings incentive amount applicable for each service. Additionally, Florida law protects patients from surprise out-of-network bills by prohibiting balance billing for emergency services and requiring a no liability notice and hold harmless provision for non-emergency situations.
In healthcare market competition, Florida law limits enforceability of non-compete agreements for physicians but provides no statutory authority for oversight or review of mergers, acquisitions, and other transactions involving healthcare entities. In 2019, the legislature repealed certificate of need (CON) requirements, the state’s longstanding approval system for expanding healthcare facilities. The CON program will not be eliminated for nursing homes, hospices and intermediate care facilities for the developmentally disabled.
On the pharmaceutical front, the legislature continues to advance its efforts to rein in prescription drug costs. In recent sessions, the state enacted laws to allow drug importation from Canada and to promote price transparency by requiring pharmacists to inform customers of generic equivalents and whether cost-sharing obligations exceed the retail price of prescription.
See below for an overview of existing Florida state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
Latest Legislative Session: 1/11/2022 - 3/11/2022 (2022 term). *Current session bill updates are ongoing. Check back weekly for updates.
Florida operates on an annual budget cycle. The state’s fiscal year begins on July 1 with budget hearings beginning October and ending on June 30th of the following year. The legislature adopts a budget in April/May, which is required to pass by a simple majority, and becomes effective for the fiscal year beginning in July.
REGULATION & ENFORCEMENT
- The portal for accessing administrative enforcement orders from the Agency for Health Care Administration is here.
- On August 18, 2014, two Florida women, represented by the law firm of Cohen Milstein Sellers & Toll filed a class action law suit against JFK Medical Center and its owner, HCA Holdings, which owns 80 hospitals across the state, for grossly and unreasonably overcharging for medical services. Under a previous policy that HCA abandoned this year, uninsured patients were also charged a special trauma fee that could add $30,000 or more to their bills irrespective of the service rendered.