Health bill dies in Florida Legislature

Florida lawmakers ended the session Friday with a lot of last minute wrangling on an omnibus health bill that ultimately died, taking down provisions that would have expanded the powers of nurse practitioners and promoted the use of telemedicine .

The House tacked on a massive amendment late Friday night by Rep. Jason Brodeur addressing everything from assisted living facilities and laser dermatology to HIV testing, orthotics and pneumonia vaccines for new nursing home residents. The changes came after the Senate killed proposals that would allow nurse practitioners to work without a doctor's supervision and promote the use of telemedicine. Proponents said both measures would reduce health care costs and address a critical shortage of primary care physicians in the state.

Senators nixed the House's telemedicine provision, worrying that allowing doctors to practice without a Florida license would compromise patient safety and leaves patients with no recourse for malpractice. Several hospitals around the state have had success with telemedicine in recent years, helping patients in rural areas connect to specialists or getting multiple consultations conducted simultaneously for acute emergency cases.

But the powerful Florida Medical Association opposed the telemedicine provision and warned that nurse practitioners should not have powers to prescribe controlled substances without a doctor's supervision in a state that has been a hotbed for pill mills.

The bill went through numerous changes as several provisions were tacked on in recent weeks, including ones addressing the management of trauma centers and the number of technicians a pharmacist could oversee. Senators did support an amendment that keeps three trauma centers open, an issue that had become contentious between the two chambers.