'Con' repeal, direct primary care teed up in House

TALLAHASSEE, Fla. – After repeatedly pursuing the ideas in recent years, the House could vote Thursday to repeal the “certificate of need” regulatory process for hospitals and encourage the use of direct primary-care agreements between doctors and patients.

The House on Wednesday took up the proposals and positioned them for votes. Under the certificate-of-need process, hospitals are required to seek approval from the state Agency for Health Care Administration before adding new facilities or programs.

Rep. Heather Fitzenhagen, a Fort Myers Republican sponsoring the repeal bill (HB 27), said getting rid of the so-called CON process could help spur competition in the hospital industry and improve patient access to care. But Rep. John Cortes, D-Kissimmee, raised a concern that new hospitals in affluent areas could “cherry pick” patients, hurting older hospitals that serve large numbers of indigent patients.

The direct primary-care bill, meanwhile, involves agreements in which patients or their employers would make regular payments to doctors to provide primary-care services.

The bill (HB 37), filed by Rep. Danny Burgess, R-Zephyrhills, would make clear that the agreements are not insurance and would not be regulated under insurance laws. Burgess said direct primary care would provide another health-care option for patients.

But Democrats raised questions about issues such as whether doctors would be able to drop patients who use large amounts of services.

The House has passed such bills in the past but has not been able to get the Senate to agree.