Legislative

FSP NEWSLETTER – Where Did the Time GO???
November, 2009
By Amy J. Young, FSP Legislative Consultant

Amy Young, Legislative ConsultantThis year marks my 25th Anniversary representing the Florida Society of Pathologists. (Maybe you are NOT wondering, but I feel compelled to share that I am BARELY hanging on to my 40’s!!).

I was hired by this Society in 1984………I was a lobbyist with a state-wide law firm at the time. Dr. Wayne Schrader and Dr. Glenn Hooper were President and President-elect at the time. I was recently asked, on this SILVER anniversary, to put together some history of our evolution. Memory lane is a long and winding, but very happy road for me.
However, recreating some of our history is especially difficult since most of our early past is not stored on Microsoft documents (but in deteriorating banker’s boxes in the archives of my offices as well as my deteriorating BRAIN).

Nevertheless, it has been quite a journey. Many of you who have served as Past Presidents and officers of this Society can probably fill in so many "holes" in historical events. I know that Dr. Mario Gonzalez (FSP President, 1994, 1996, 1997, 2005 AND 2006), who was our Legislative Chair for almost twenty years, has many tall tales to tell for all the years he worked with me in Tallahassee as my accomplice! Now Dr. Luis Rey (FSP President, 2007 and 2008) has filled those shoes and spends countless hours with Dr. Mike Abels (FSP Reimbursement Committee Chairman) and FSP President Dr. Ross Wheeler weeding through legislation filed each year that impacts your bottom line and the way you manage your daily practices  

Dr. Tom Wood (FSP President, 1977), Dr. Chuck Manning and Dr. Jerry Harris (FSP President, 1990) have also been our resident Tallahassee experts who have come to our aid with their eloquent testimony in committee. Now we are grateful to have Dr. Margaret Neal who is assisting us with our efforts in Tallahassee.

So, as best as I can, here is my VERY abbreviated attempt to share the political progression of FSP as well as some of our most significant past legislative successes.

FSP Political Action

We have come a long way since we first established the FSP Political Action Committee (FSP-PAC) in 1984. For the last several decades, we have had the opportunity to contribute to several hundred candidates who believe in the FSP mission. During the last several election cycles, we have had a 95% success rate with state House and Senate races as well as Gubernatorial and Cabinet campaigns.

In addition to the FSP PAC contributions, we created a FSP Leadership Fund in 2005 under Dr. Gonzalez’ reign as President; under this model, we ask FSP members to pledge a total of $1,000 per year for additional personal contributions to candidates. These pledges are collected after an educational presentation to full membership on the importance of legislative and political activity during the Annual Business Meeting held each year at the FSP Convention in February.  When the FSP PAC Board approves support for a particular candidate, we not only have the ability to contribute a $500 check, we can now collect additional checks from members of our "FSP Leadership Club" in order to contribute multiple checks at once to a particularly loyal incumbent/candidate. We then strive to have officers and our lobbyist attend a social event with the candidate to discuss our issues and show our support. 

Legislative Successes

We have had some interesting, even fierce battles over the past few years that have saved the practice of Pathology.  During the last eight Legislative Sessions, we have defeated numerous amendments and legislation filed which would have required the reimbursement for pathology services to be limited to a percentage of the Medicare rate.  This was an obvious attempt to eliminate reimbursement of the professional component of pathology services.
Over these many years we have also had extraordinary successes, including the defeat of legislation which would have "sunsetted" (or, eliminated) the Clinical Laboratory Act.  This was a battle to keep the exemplary standards for our clinical laboratories in place.  We have also fought for many years to keep clinical laboratory directors as MD’s or PhD’s.  We have had podiatrists, chiropractors and even lab technicians proposing legislation that would have allowed them to practice as clinical laboratory directors.  We have also defeated attempts to allow optometrists and midwives to supervise testing in clinical laboratories.

We also passed legislation authorizing rulemaking authority regarding Mark-up’s of laboratory charges as follows:

59A-7.037 Rebates Prohibited - Penalties.
(1) No owner, director, administrator, physician, surgeon, consultant, employee, organization, agency, representative, or person either directly or indirectly, shall pay or receive any commission, bonus, kickback, rebate or gratuity or engage in any split fee arrangement in any form whatsoever for the referral of a patient. Any violation of Rule 59A-7.037, F.A.C., by a clinical laboratory or administrator, physician, surgeon, consultant, employee, organization, agency, representative, or person acting on
behalf of the clinical laboratory will result in action by the agency under Section 483.221, F.S., up to and including revocation of the license of the clinical laboratory. In the case of any party or individual not licensed by the agency acting in violation of this Rule, a fine not exceeding $1,000 shall be levied and, as applicable, the agency shall recommend that disciplinary action be taken  (2) No licensed practitioner of the healing arts or licensed facility is permitted to add to the price charged by any laboratory
except for a service or handling charge representing a cost actually incurred as an item of expense. However, the licensed practitioner or licensed facility is entitled to fair compensation for all professional services rendered. The amount of the service or handling charge, if any, shall be set forth clearly in the bill to the patient. (3) Each licensed laboratory shall develop a fee schedule for laboratory services which shall be available to the patient, the authorized person requesting the test or agency upon request and shall be subject to subsection 59A-7.037(2), F.A.C.
Specific Authority 483.051 FS. Law Implemented 483.221, 483.245 FS. History–New 11-20-94, Amended 12-27-95.

We have also had many wars over professional component billing at the legislative level as well as in the Courts.  Legislatively, we were able to redefine the definition of "comprehensive health care services" to include "technical and professional clinical laboratory services" in Chapter 641, the Florida Statutes that govern HMO’s.
Also in our success column, is the amendment of Chapter 483 to define a "clinical laboratory examination" as a procedure which includes "oversight or interpretation".  These were "backdoor" approaches to change Florida law to recognize the importance and significance of professional component billing.  Both of these statutory changes have been instrumental in our judicial successes.
This will again be a controversial Legislative Session and we are preparing our defensive strategy for another tough battle against the insurance industry. 

Other legislative accomplishments made possible by your FSP dues:

  • Passed legislation in the HMO statute to mandate payment of the professional component of pathology;
  • Passed legislation to require prompt payment from an HMO for services rendered by pathologists
  • Defeated legislation which would have assessed clinical laboratories a fee based on the number of specimens received and reviewed annually;
  • Defeated attempts by the Governor and the Florida Legislature to adjust Medicare rates for pathology services across the board to an RBRVS methodology;
  • Passed legislation mandating that clinical laboratory directors be MD’s or PhD’s holding a doctoral degree in chemistry, physical or biological science;
  • Defeated attempts by the trial lawyers to remove the ability of a pathologist to self-insure for professional liability coverage;
  • Passed legislation to repeal mandatory billing of the $2 co-payment of Medicaid patients;
  • Defeated legislation which would have required patients to be advised in writing of the qualification and precise functions of pathologists involved in each medical procedure.

On this, my Silver Anniversary, I want to take this opportunity to thank all of the FSP Presidents I was fortunate enough to serve under since 1984 and to thank every FSP member for their continued support of our Society and our essential PAC.

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
1984WayneH.Schrader,M.D.
1985GlennS.Hooper,M.D.
1986Gerald E. Byrne,Jr., M.D.
1987Frank C. Coleman, M.D.
1988Stephen E. Vernon, M.D.
1989Wallace M. Graves, Jr., M.D.
1990Jerry L. Harris, M.D.
1991Francisco Civantos, M.D.
1992Charles M. Karpas, M.D.
1993Richard A. Essman, M.D.
1994Mario S. Gonzalez, M.D.
1995Louis S. McCann, Jr., M.D.
1996Mario S. Gonzalez, M.D.
1997Mario S. Gonzalez, M.D.
1998Louis S. McCann, Jr., M.D.
1999Louis S. McCann, Jr. M.D.
2000H. David Greider, M.D.
2001H. David Greider, M.D.
2002Steven E. Levine, M.D.
2003Steven E. Levine, M.D.
2004Edward Wilkinson, M.D.
2005Mario Gonzalez, M.D.
2006Mario Gonzalez, M.D.
2007Luis Rey-Martinez, M.D.
2008Luis Rey-Martinez, M.D.
2009Ross C. Wheeler, M.D.