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Florida's health care providers are stuck between federal and state COVID-19 rules

In their package of bills designed to thwart COVID-19 mandates, Florida lawmakers may have put health care facilities between a proverbial rock and a hard place due to conflicting federal and state laws.
ann gadd
In their package of bills designed to thwart COVID-19 mandates, Florida lawmakers may have put health care facilities between a proverbial rock and a hard place due to conflicting federal and state laws.

The Legislature voted to add a string of opt out provisions to any COVID-19 mandates that have created confusion and uncertainty for facilities that must abide by federal rules.

Florida lawmakers voted this past week to clamp down on COVID-19 mandates from businesses and the federal government.

Hours before the Legislature convened a special session, doctors with the Committee to Protect Health Care held a media event via Zoom. They pleaded with the Legislature to reject what they referred to as Gov. Ron DeSantis’ anti-health proposals.

"Gov. DeSantis’ COVID-19 response has led and will continue to lead to unnecessary and avoidable suffering and death," said Dr. Fred Southwick, an infectious disease specialist in Gainesville. "Vaccinations prevent the virus from spreading and mutating to become more resistant to vaccines. Vaccinations add to the number of people in the community who are protected from getting COVID-19. These are the facts.”

Republican leaders say their efforts are about freedom and saving jobs. The Legislature voted to add a string of opt-out provisions to any COVID-19 mandates in the public and private sector, which has created confusion and uncertainty for healthc are facilities that must abide by federal rules.

Specifically, a new rule issued by the federal Centers for Medicare & Medicaid Services (CMS) requires health care workers to be vaccinated. It allows only two exemptions, for medical or religious reasons. Health care providers that don’t comply could lose some of their federal Medicaid and Medicare funding.

"It has our members very concerned,” says LeadingAge Florida president and CEO Steve Bahmer. The association advocates for older adults and their care. Members include assisted living facilities and nursing homes.

"It's very challenging just in terms of the policy, the discrepancies and the concern about potential enforcement that comes from those inconsistencies,” Bahmer says.

He points out that federal law supersedes state law. Yet health care providers could face fines from the state if their workers follow the federal rule as required.

"The challenge is that CMS has some pretty dramatic enforcement power. They can deny payments; they can disenroll providers from the Medicare/Medicaid programs," Bahmer says. "We don't know what enforcement will look like or how serious that will get. But our members take the CMS enforcement power very seriously.”

Rep. Carlos Guillermo Smith, D-Orlando, also sees a problem. "Have you considered any sort of exemptions for our Medicaid and Medicare providers who are in a tough position here?"

That question was for Rep. Erin Grall, R-Vero Beach. She sponsored the bill cracking down on vaccine mandates. Guillermo Smith unsuccessfully tried to amend the bill to exclude health care providers from the additional exemptions. Grall said the amendment was unnecessary because she expects the CMS rule to be blocked by the courts.

“There are times when federal law will in fact preempt state law. But that will be worked out in a very swift fashion due to the extensive nature of these mandates," Grall said during discussion on the House floor. "I'm certain that there will be clarity in the coming weeks before these mandates have to be fully implemented."

The governor signed the bills two days after the special session.

The CMS rule calls for health care workers to be fully vaccinated by Jan. 4.

Florida Attorney General Ashley Moody filed a lawsuit asking a judge to block the rule before Dec. 6, the day health care workers are required to have at least one dose. U.S. District Judge M. Casey Rodgers issued an order this past weekend denying the request. Moody's office appealed that decision to the 11th U.S. District Court of Appeals on Wednesday.

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Gina Jordan is the host of Morning Edition for WFSU News. Gina is a Tallahassee native and graduate of Florida State University. She spent 15 years working in news/talk and country radio in Orlando before becoming a reporter and All Things Considered host for WFSU in 2008. She left after a few years to spend more time with her son, working part-time as the capital reporter/producer for WLRN Public Media in Miami and as a drama teacher at Young Actors Theatre. She also blogged and reported for StateImpact Florida, an NPR education project, and produced podcasts and articles for AVISIAN Publishing. Gina has won awards for features, breaking news coverage, and newscasts from contests including the Associated Press, Green Eyeshade, and Murrow Awards. Gina is on the Florida Associated Press Broadcasters Board of Directors. Gina is thrilled to be back at WFSU! In her free time, she likes to read, travel, and watch her son play football. Follow Gina Jordan on Twitter: @hearyourthought