HB 1195 Fentanyl Testing

Rep Harris

Establish Gage's Law requiring hospitals to include a fentanyl test whenever a urine drug test is conducted for suspected overdose

• Directs hospitals to retain the test results in the patient’s clinical record.

Approved by Governor; Chapter No. 2025-19

SB 68 Health Facilities

Senator Martin

Expand the definition of health facility to include additional not-for-profit entities and associations, authorize new loan powers for health facilities authorities, and make confirmation fentanyl testing optional for hospitals.

Approved by Governor; Chapter No. 2025-179

HB 1545 Parkinson's Disease

Rep Busatta

Creates a consortium and an institute dedicated to Parkinson's disease research and care within the University of South Florida.

Approved by Governor; Chapter No. 2025-188

SB 2514 Health and Human Services

Appropriations

Among other things, requires coverage of blood-based biomarker tests for colorectal cancer screening as specified in federal Medicare determinations.

SB 1768 Stem Cell Therapy

Senator Trumbull

Establish requirements for Florida-licensed physicians to offer certain FDA-unapproved stem cell therapies, including ethical sourcing, facility accreditation, and patient disclosures, while prohibiting stem cells derived from aborted fetuses and providing penalties for violations.

Approved by Governor; Chapter No. 2025-185

HB 1255 Education

Rep Trabulsy

Modernize Florida's K-12 and teacher-related statutes but specific to health care:

Expands the definition of emergency opioid antagonists in public schools and clarifies liability protections and parental consent requirements for corporal punishment.

Approved by Governor; Chapter No. 2025-110

HB 647 Advanced Practice Registered Nurse Services

Rep Trabulsy

l authorizes advanced practice registered nurses providing hospice care and acting within an established protocol with a licensed physician to file a certificate of death or fetal death and certify the cause of a person’s death.

Approved by Governor; Chapter No. 2025-50

HB 677 State Group Insurance Coverage of Standard Fertility Preservation Services

Rep Trabulsy

Require the state group health insurance plan to cover standard fertility preservation services for individuals who may face iatrogenic infertility due to cancer treatments.

Awaiting Governor's Action

HB 907 Florida Institute for Pediatric Rare Diseases

Rep Anderson

Establishes the Florida Institute for Pediatric Rare Diseases at the Florida State University College of Medicine and implements a pilot program and consortium to enhance newborn genetic screening, research, and collaboration on pediatric rare diseases.

Approved by Governor; Chapter No. 2025-187

SB 994 Driver License Education Requirements

Senator Collins

Specify that applicants 18 years of age or older must complete a traffic law and substance abuse education course and require a department-approved driver education course for obtaining a learner’s license.

Approved by Governor; Chapter No. 2025-104

HB 0597 Diabetes Management in Schools

Rep Smith

Authorizing school districts or public schools to acquire and maintain a supply of undesignated glucagon for use on students with diabetes experiencing hypoglycemic emergencies.

Approved by Governor; Chapter No. 2025-15

SB 958 Type 1 Diabetes Early Detection Program

Rep Bernard

Establishes a Type 1 diabetes early detection program and ensures parents and guardians receive relevant information.

Approved by Governor; Chapter No. 2025-46

SB 1514 Anaphylaxis in Public Schools

Senator Smith

Requires public schools serving K–8 students to provide anaphylaxis training and maintain effective emergency plans for allergic reactions, including the administration of an epinephrine delivery device.

Approved by Governor; Chapter No. 2025-47

HB 1607 Cardiac Emergencies

Rep Yarkosky

Require public schools to expand first aid and cardiac emergency training while mandating the development of urgent life-saving emergency plans and placement of automated external defibrillators.

Approved by Governor; Chapter No. 2025-67

SB 1286 Harming or Neglecting Children

Senator Grall

The bill amends the definition of harm and neglect of a child in both dependency and criminal law to allow caregivers to let a sufficiently mature child partake in independent, unsupervised activities without considering these actions as harm or neglect of a child.

Approved by Governor; Chapter No. 2025-167

HB 1299 Department of Health

Rep Yarkosky

Extend the repeal date for the definition of 'messenger ribonucleic acid vaccine,' refine medical marijuana treatment center requirements, modify licensure endorsements and certifications for various health practitioners, update references to recognized physician specialty boards, and revise the Physical Therapy Licensure Compact definitions. READ MORE

HB 711 Spectrum Alert

Rep Borrero

Establishes a statewide Spectrum Alert system to rapidly locate missing children with autism spectrum disorder and enhance the effectiveness of law enforcement responses.

Approved by Governor; Chapter No. 2025-123

HB 0791 Surrendered Infants

Rep Cobb

The bill authorizes hospitals, EMS stations, and fire stations that are staffed 24 hours per day to use infant safety devices to accept surrendered infants, and establishes criteria for their use.

Approved by Governor; Chapter No. 2025-17

SB 480 Nonprofit Agricultural Organization Medical Benefit Plans

Senator DiCeglie

Authorize nonprofit agricultural organizations to offer medical benefit plans not regulated as insurance.

Approved by Governor; Chapter No. 2025-54

HB 547 Medical Debt

Rep Partington

Broadens the definition of extraordinary collection actions by facilities and allows facilities to sell certain medical debt under strict conditions.

Approved by Governor; Chapter No. 2025-98

HB 1091 Substance Abuse and Mental Health Care

Rep Gonzalez Pittman

Enhance crisis services through a new 988 suicide and crisis lifeline call center, revise procedures for involuntary treatment and outpatient services, and update training requirements for mental health professionals.

Approved by Governor; Chapter No. 2025-143

HB 1099 - Arrest/ Detention Individuals with Significant Medical Conditions

Rep Canady

A law enforcement officer may use their discretion based on the totality of the circumstances when determining whether to make an immediate arrest of a person who has a significant medical condition, including an arrest for an offense committed against an elderly person or a disabled adult.

Approved by Governor; Chapter No. 2025-64

SB 1620 Mental Health & Substance Use Disorders

Senator Rousson

Require use of standardized functional assessment tools, strengthen treatment plan and discharge requirements, expand telehealth for school-based services, promote person-first language, and enhance statewide mental health workforce and facility reviews. READ MORE

Approved by Governor; Chapter No. 2025-184

HB 961 Department of Highway Safety and Motor Vehicles

Rep Maney

Among other things, the bill creates a lifetime disabled parking permit for certain permanently disabled persons, extend renewal periods for disabled parking permits, and allow broad use of previously issued disability certificates for replacements.

Approved by Governor; Chapter No. 2025-125

SB 768 Controlling Business Interests by Persons with Ties to Foreign Countries of Concern

Senator Calatayud

Prohibit genetic sequencing software from foreign countries of concern in state laboratories and clarify licensure requirements regarding controlling interests from those countries.

Approved by Governor; Chapter No. 2025-96

SB 108 Administrative Procedures

Senator Grall

Modernize and streamline Florida's administrative rulemaking process by establishing stricter requirements, new deadlines, and enhanced oversight for agencies adopting, reviewing, and amending rules.

Approved by Governor

HB 797 Veteran and Spouse Nursing Home Beds

Rep LaMarca

Authorize certain nonprofit skilled nursing facilities to designate or reclassify beds for veterans and spouses and exempt them from certain certificate-of-need requirements.

Approved by Governor; Chapter No. 2025-17

HB 1353 Home Health Care Services

Rep Franklin

Removes certain geographic restrictions on home health agency administration, allows contract staff to perform key nursing visits, and revises criteria for the Excellence in Home Health Program.

Approved by Governor; Chapter No. 2025-127

HB 0421 Peer Support for First Responders

Rep Maggard

Adds law enforcement personnel who are involved in investigating a crime scene or collecting or processing evidence to the definition of a “first responder,” receiving the same benefit of confidentiality with respect to peer support communications

Approved by Governor; Chapter No. 2025-9

HB 929 Firefighter Health and Safety

Rep Booth

Enhance firefighter health and safety by expanding the Division of State Fire Marshal’s authority to address chemical hazards, mental health best practices, and stricter enforcement measures.

Approved by Governor; Chapter No. 2025-124 

Vetoed By The Governor

HB 6017 Recovery of Damages for Medical Negligence Resulting in Death

Rep Trabulsy

Removes statutory barriers preventing certain individuals from recovering damages in wrongful death cases involving medical negligence (adult children and by parents of adult children) and updates related provisions.

Awaiting Governor's Action 

HB 1421 Improving Screening for and Treatment of Blood Clots

Rep Black

Establishes new statewide requirements for screening, training, and reporting to improve venous thromboembolism prevention and care in healthcare and assisted living facilities.

HB 1427 Health Care

Rep Griffitts Jr.

Amends program application, approval, and regulation requirements for nursing education programs in Florida.

SB 890 - Improving Screening for and Treatment of Blood Clots

Senator Clay Yarborough, R Jacksonville

Enhances screening and treatment protocols for blood clots and pulmonary embolisms in Florida healthcare facilities and establishes a related registry.

• Amends legislative findings to include chronic critical illnesses and genetic predispositions for blood clots in chronic diseases.
• Creates a Blood Clot and Pulmonary Embolism Registry, mandating state healthcare facilities report specific patient data.
• Specifies confidentiality and use limitations for personal data in the registry, allowing certain disclosures for epidemiological and medical research.
• Allocates funds specifically for the registry's setup, maintenance, and data quality.
• Requires high-risk facilities to perform initial risk assessments for blood clots upon patient admission and mandates ongoing staff training.
• Updates training protocols for nursing home staff to include recognizing symptoms of blood clots and emergency response techniques.
• Revises assisted living facility standards to include identification and response protocols for residents at risk of developing blood clots.
• Adds blood clot risk identification and response to core training requirements for assisted living administrators.

Bill Analysis

Members voiced concerns about the bill’s definitions, training requirements, and facility protocols – particularly around how certified nursing assistants and assisted living facilities would identify and respond to blood clots – while expressing support if refinements were made. The measure ultimately advanced unanimously, with the sponsor pledging further amendments to address these issues

FAVORABLE by Senate Health Policy - 2 remaining committee stops

________________________________________

SSB 942 - Invalid Restrictive Covenants in Health Care

Senator Colleen Burton, R Lakeland

The bill provides exceptions from the prohibition for restrictive covenants related to research, related to physicians whose individual compensation is $250,000 per year or more, or related to physicians who have an ownership interest in a medical business, practice, management services organization, or entity of any kind who sells a specified type of related asset.

The bill specifies that its provisions apply to restrictive covenants entered into on or after July 1, 2025.

Bill Analysis

In committee, members discussed how the bill’s $250,000 salary threshold would influence restrictive covenants, weighing concerns about the continuity of patient care and young physicians’ ability to establish a practice versus the protection of small, privately owned offices. Questions centered on whether physicians terminated without cause or who cross salary thresholds mid-contract should remain locked into noncompete agreements, with some senators seeking further consideration of discipline-related exceptions.

FAVORABLE by Health Policy - 2 remaining committee stops        

________________________________________

SB 294 - Collaborative Pharmacy Practice for Chronic Health Conditions

Senator Gayle Harrell, R Stuart

SB 294 amends s. 465.1865, F.S., relating to collaborative pharmacy practice agreements. Under current law, collaborative pharmacy practice describes an arrangement in which a physician authorizes a pharmacist to provide specified patient care services relating to chronic health conditions to one or more of the physician’s patients. The bill provides that the term “chronic health condition” does not include heart failure, coronary heart disease, and cardiac rhythm disorder.

Bill Analysis

Senator Harrell explained that the bill prevents adding complex cardiac conditions to collaborative pharmacy practice protocols. Support came from medical groups emphasizing physician oversight for such complex conditions, and no opposition was voiced.

FAVORABLE by Senate Rules -No remaining Committee stops

________________________________________

SB 110 - Rural Communities

Senator Corey Simon, R Quincy

To further healthcare access in rural communities, the bill:

• Creates the Stroke, Cardiac, and Obstetric Response and Education (SCORE) Grant Program within DOH
• Creates the Rural Access to Primary and Preventative Care Grant Program (RAPP-C) program within the DOH
• Expands the existing Rural Hospital Capital Improvement Grant Program (RHCI)
• Amended to add Board Certified Emergency Physicians working in Florida's rural hospitals to the Medical Student Loan Repayment Program (FRAME)

Bill Analysis

Known as the Rural Renaissance and priority of Senate President Ben Albritton

FAVORABLE by Senate Fiscal Policy -No remaining Committee stops

________________________________________

SB 668 - Storage and Disposal of Prescription Drugs & Sharps

Senator Danny Burgess, R Zephyrhills

Requires the Department of Health, in collaboration with the Department of Environmental Protection, to study and assess the safe collection and proper disposal of sharps used in home healthcare.

Requires a comprehensive report on the study's findings and recommendations, including evaluations of collection methods, current local practices, and possible statewide implementation costs, to be submitted by July 1, 2026.

Bill Analysis

In the discussion, Senator Berman (D) highlighted the increasing use of sharps, such as Ozempic injections, and queried how both individual and commercial disposal would be addressed, while Senator Burgess (R) emphasized the bill’s aim to resolve conflicts between state and federal law to ensure safe, efficient prescription drug and sharps disposal. No opposition was raised.

FAVORABLE by Senate Fiscal Policy - 2 remaining committee stops

________________________________________

Week 2 HOUSE Highlights

HB 1119 - Health Care Patient Protection

Rep Vanessa Oliver, R Punta Gorda

Improves pediatric readiness in hospital emergency departments (EDs), the bill requires the AHCA, in consultation with the Florida Emergency Medical Services for Children State Partnership Program, to adopt rules that establish minimum standards for pediatric patient care in hospital EDs.

Requires all hospitals with EDs to develop and implement policies and procedures for pediatric patient care, and to designate a pediatric emergency care coordinator.

Requires all hospital EDs to conduct the National Pediatric Readiness Assessment every five years. Each hospital ED must submit the results of the assessment to AHCA, and AHCA must publish the results of the assessment score for each and provide a comparison to the national average score.

Bill Analysis

During the discussion, members emphasized the importance of ensuring that emergency departments are prepared to treat pediatric patients, raised questions about integrating new protocols into existing hospital systems, and ultimately signaled unanimous support for enhanced pediatric care standards.

FAVORABLE by HC Facilities & Systems - 1 remaining Committee stops

________________________________________

HB 883 - Advanced Practice Registered Nurse Autonomous Practice

Rep Jason Shoaf, R Port St Joe

The bill authorizes a psychiatric nurse registered for autonomous practice to engage in the practice of psychiatric mental health services, as defined by the Board of Nursing, without an established physician protocol.

Psychiatric nurses are licensed APRNs who hold a master’s or doctoral degree in psychiatric nursing and a national advanced practice certification as a psychiatric mental health advanced practice nurse.

Bill Analysis

In the Health Professions & Programs Subcommittee meeting, members examined whether psychiatric APRNs should practice autonomously to address mental health needs, posing questions about scope expansion, patient safety, and oversight. The debate included personal stories and concerns about physician supervision, with the bill ultimately passing.

FAVORABLE by Health Professions & Programs - 1 remaining Committee stops

________________________________________

HB 519 - Administration of Controlled Substances by Paramedics

Rep Robin Bartleman, R Weston

Specifies that certified paramedics can administer controlled substances but only under direct supervision and during emergency services, ailing state law with federal law.

Bill Analysis

FAVORABLE by Health Health Professions & Programs- 1 remaining committee stops

_______________________________________________

HB 231 - Pub. Rec./Medical Examiners

Rep Kim Kendall, R

• Defines "medical examiner"
• Establishes a public records exemption for the personal identifying and location information of current and former medical examiners, along with their spouses and children

Bill Analysis

FAVORABLE by Criminal Justice -2 remaining committee stops

BILL TRACKING

Large Strategies Cheat Sheet Moving HC Bills

HC Bills on Agenda NEXT WEEK

House Block Calendar WEEK 3

From comprehensive list:

Click here to view LIVE Senate Calendar

Senate Block Calendar WEEK 3

From comprehensive list:

Click here to view LIVE House Calendar

May 2

END of the 2025 Legislative Session

View Videocast

Healthcare Session 2025 Recap of "Capitol Conversations" as we ADVOCATE in 2025

Content provided by Toni Large, Large Strategies

First Week SENATE Spotlight

SB 110 - Rural Communities

https://static-s3.lobbytools.com/bills/2025/pdf/analysis_110_03-03-25_post_2342.pdf

• To further healthcare access in rural communities, the bill:
• Creates the Stroke, Cardiac, and Obstetric Response and Education (SCORE) Grant Program within the Department of Health (DOH) to implement training, purchase equipment, establish telehealth capabilities, and develop quality improvement programs with the goal of improving patient outcomes and increasing access to high-quality stroke, cardiac, and obstetric care in rural communities;
• Creates the Rural Access to Primary and Preventative Care Grant Program (RAPP-C) program within the DOH to provide incentive funding for primary care physicians and autonomous Advanced Practice Registered Nurses to open new practice locations in rural and underserved areas of the state; and
• Expands the existing Rural Hospital Capital Improvement Grant Program (RHCI) to allow rural hospitals to use grant funds to establish mobile care units to provide primary care services, behavioral health services, or obstetric and gynecological services in rural health professional shortage areas (HPSA) or to establish telehealth kiosks to provide urgent care services in rural HPSAs.

Senator Corey Simon, R Quincy

Know as the Rural Renaissance Priority of Senate President Ben Albritton

FAVORABLE by Community Affairs

Remaining Committee Stops: Senate Fiscal Policy

_________________________________________

SB 526 - Nursing Education Programs

https://static-s3.lobbytools.com/bills/2025/pdf/analysis_526_03-05-25_post_2351.pdf

Amends s. 464.019, F.S., adding the the following requirements to the application process for nursing education program approval:

• Must have evaluation and standardized admission criteria that identify students who are likely to need additional educational support
• Must have a comprehensive examination to prepare nursing students for the NCLEX;
• Criteria for remediation that will be offered to students who do not successfully pass the exit examination.

A program with NCLEX passage rates at least ten % points below the average passage rate must offer remediation at no additional cost or refer the student to an approved remedial program.

The bill requires the BON to deny or revoke an application that has had adverse action taken against it by another regulatory jurisdiction in the U.S.

READ MORE

Supporters maintained the need to raise Florida’s last-place NCLEX pass rates

Senator Gayle Harrell, R Stuart

FAVORABLE by Senate Health Policy

Remaining Committee Stops:

Appropriations Committee on Health and Human Services; Fiscal Policy

___________________________________

First Week HOUSE CONCERNS

HB 649 - Autonomous Practice by a Certified Registered Nurse Anesthetist

https://static-s3.lobbytools.com/bills/2025/pdf/analysis_649_03-05-25_post_2320.pdf

The bill authorizes autonomous CRNAs to perform CRNA-specific acts without an established supervisory protocol. The bill also exempts autonomous CRNAs practicing in certain facilities from the statutory requirement that they only administer anesthesia under onsite physician or dentist supervision and within an established protocol. The bill allows such facilities to require an autonomous CRNA to operate under an established protocol approved by the medical staff or the governing board of the facility.

Members asked whether CRNAs are adequately trained, insured, and prepared to handle emergencies, while supporters noted that removing physician supervision aligns with other states and addresses workforce gaps, and opponents argued that ultimate responsibility should remain with physicians for patient safety.

Rep Mike Giallombardo, R

Cape Coral

FAVORABLE by Health Professions & Programs SubCommittee

Remaining Committee Stops: Health & Human Services Committee

___________________________________

HB 6017 - Recovery of Damages for Medical Negligence Resulting in Death

https://static-s3.lobbytools.com/bills/2025/pdf/analysis_6017_03-05-25_post_2322.pdf

Expands the application of the Florida Wrongful Death Act by repealing exceptions that prohibit certain parents and children of a deceased patient who dies due to medical negligence from recovering noneconomic damages

Currently, neither an adult child (25+) of an unmarried person who dies due to medical negligence, nor the parents of an adult child (25+) who dies due to medical negligence, may recover noneconomic damages (commonly referred to as “pain and suffering damages”). They may, however, recover through the estate economic damages such as net accumulations, final medical bills, and funeral and burial expenses.

In the Senate Judiciary Committee, members such as Senator Hooper (R) and Senator Passidomo (R) debated accountability versus containing malpractice premiums. The bill ultimately passed, with supporters emphasizing justice for survivors and opponents calling for stronger oversight of negligent providers.

In the House subcommittee hearing, members asked whether repealing the provision might drive up medical malpractice premiums or if there had been any recent surge in such cases. The bill sponsor noted that the intent was to establish parity rather than respond to increased suits.

Rep Dana Trabulsy, R Ft Pierce

FAVORABLE (18-0) by Civil Justice & Claims

Remaining Committee Stops: Judiciary

The Senate companion, SB 734 also received favorable passage in Judiciary

(9-2); Remaining stops: Appropriations Committee on Health & Human Services; Rules

Senator Sponsor: Clay Yarborough, R Jacksonville

___________________________________

Up Next Week

Want to know what health care legislation has been filed as of today?

We have a comprehensive report on all heath care bills being considered before the Florida Legislature.

Find an updated tracking chart in each new addition.

https://files.constantcontact.com/2a3b97ad701/1bd498c1-a19e-422d-8ac8-3f212e45b163.pdf?rdr=true

HC Bills on Agenda NEXT WEEK

*Note: House & Senate have short committee agenda notice timeframes.

This is not a comprehensive listing, just the bills on agenda at time of email.

From comprehensive list:

Click here to view live Senate Calendar

Click here to view live House Calendar

SB 0890

Improving Screening for and Treatment of Blood Clots (Yarborough)

SENATE On Committee agenda - Health Policy, 03/11/25, 1:30 pm, 412 K

SB 0294

Collaborative Pharmacy Practice for Chronic Health Conditions (Harrell)

SENATE On Committee agenda - Rules, 03/12/25, 11:00 am, 412 K

HB 0723

Type 1 Diabetes Early Detection Program (Tant)

HOUSE On Committee agenda - Education Administration Subcommittee, 03/11/25, 8:00 am, 102 H

HB 1119

Health Care Patient Protection (Oliver)

HOUSE On Committee agenda - Health Care Facilities & Systems Subcommittee, 03/11/25, 8:00 am, 404

HB 0791

Surrendered Newborn Infants (Cobb)

HOUSE On Committee agenda - Health Care Facilities & Systems Subcommittee, 03/11/25, 8:00 am, 404 H - PCS

HB 0355

Emergency Opioid Antagonists in Public K-12 Schools and Postsecondary Educational Institutions (Alvarez (J))

HOUSE On Committee agenda - Human Services Subcommittee, 03/11/25, 10:30 am, 314 H

___________________________________

House of Representatives

Tuesday Mar 11

Health Care Facilities & Systems Subcommittee

8AM-10AM

Human Services Subcommittee

10:15AM-12:15PM

Wednesday Mar 12

Health Care Budget Subcommittee 1:00PM-4:00PM

Thursday Mar 13

Health Professions & Programs Subcommittee 1:00PM-4:00PM

Insurance & Banking Subcommittee 1:00PM-4:00PM

Friday Mar 14

Insurance & Banking Subcommittee 8:00AM-10:00AM

Senate

Tuesday Mar 11

Health Policy 1:30PM-3:30PM

Wednesday Mar 12

SESSION

Chamber 3:00PM-5:00PM

Rules 11:00AM-1:00PM

Thursday Mar 13

SESSION

Chamber 1:30PM-5:30PM

May 2

END of the 2025 Legislative Session

Please join this campaign.

Stop what you are doing today and call your U.S. representative every week, preferably Monday or Friday until we get this issue resolved. Even better, visit their local office in person to make a greater impact. However, a call is essential. You can find your representative’scontact information here.

When you call, ask your representative to support and co-sponsor House Resolution 879, introduced by U.S. Rep. Greg Murphy, MD. The bill stops January’s 2.83% Medicare cut forced on physicians and replaces it with a 2% payment increase to counter the rising costs of running a practice. 

Remember to share a personal story about how the ongoing cuts have affected the sustainability of your practice and/or your patients’ access to care. Examples include:

• Having to limit or close your practice to Medicare patients
• Difficulty finding primary care physicians for your patients
• Long wait times for appointments or specialist referrals

Stories that illustrate how these cuts affect patients are the most compelling and will resonate with lawmakers.

Thank you in advance for supporting this patient-focused grassroots campaign, which will help to move H.R. 879 forward.

Fraser Cobbe

Executive Director

Physicians Society of Central Florida

We Need Your Help Documenting the Impact of these Practices

The Physicians Society of Central Florida (PSCF) supports legislation being filed in Tallahassee that ensures timely and appropriate care without the fear of retroactive denials, which can delay necessary treatments and negatively impact patient health.  Retroactive denials occur when a physician receives authorization from an insurance company to render a service to a patient, only to have that service denied after the service has been rendered.

The Florida Legislature fixed this issue last year for Dentists (Section 627.6131, Florida Statutes) by requiring insurance companies to be transparent if a patient is delinquent on their insurance premiums, the so called “grace period”.   Furthermore, it holds them accountable for providing reliable information for physicians to act upon.  These protections promote fairness and transparency, and prevents physicians and hospitals from carrying avoidable debt.

The Impact is Real

According to a study conducted by Premier:

• Nearly 15 percent of all claims submitted to private payers for reimbursement are initially denied, including many that were pre-approved to move forward through the prior authorization process.
• Denied claims tended to be more prevalent for higher-cost treatments, with the average denial pegged to charges of $14,000 and up.
• Over half (54.3%) of denials by private payers were ultimately overturned and the claims paid, but only after multiple, costly rounds of provider appeals.
• The average cost incurred by providers fighting denials is $43.84 per claim – meaning that providers spend $19.7 billion a year just to adjudicate with payers.

https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims

Take Action to Help Us in this Fight

If you have been impacted by a retroactive denial, please complete this short submission form below to share your story and provide documentation we can use in this fight.  

TAKE ACTION NOW!

https://form.jotform.com/250364860426053