Published: Apr 25, 2014 5:12 PM EDT

MIAMI (AP) - The Florida House on Friday passed an omnibus health bill laden with multiple provisions that would increase access to care by expanding the power of nurse practitioners and promoting the use of telemedicine.
    
The controversial bill passed 74-42 Friday, even though most lawmakers complained the omnibus bill, which started out as several separate bills, had undergone significant changes in recent weeks as new requirements were tacked on, including a provision addressing trauma centers.
    
Advocates stressed the bill would give patients access to more health professionals while also lowering costs. They said current regulations have been holding Floridians back from those benefits.
    
The bill establishes standards for advanced practice registered nurses to practice without a doctor's supervision but does not increase their scope of practice beyond their training. Nurse practitioners are also required to maintain medical malpractice insurance under the proposal.
    
"This is access to good primary care," said Rep. Cary Pigman, an emergency room doctor who supported the bill and has overseen dozens of nurse practitioners in his career.
    
Pigman, an Avon Park Republican, noted the current supervision mandate for nurse practitioners is so loose that doctors are allowed to supervise them from hundreds of miles away.
    
"Why are we seeking to favor one licensed professional at the expense of another licensed professional when there is no public safety concern," he said.
    
The Florida Medical Association and other critics have complained that nurse practitioners should not have powers to prescribe controlled substances without a doctor's supervision, noting the state has been a hotbed for pill mills.
    
Several lawmakers also expressed concern that doctors would be allowed to practice in Florida through telemedicine even though they aren't licensed in the state.
    
Rep. Ronald Renuart, who is also a doctor, referred to the bill as "Florida's Deplorable Care Act," saying the telemedicine component lowers state standards and leaves patients with no recourse for malpractice.
    
Supporters said doctors will be held accountable through the insurance company or the doctor's network they practice within.
    
"The basic tenant is do no harm," said Rep. Gayle Harrell, R-Port St. Lucie. "This is the massive bill of harm."
    
Both sides agreed the state must act quickly to address a serious doctor shortage.
    
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. Telemedicine saves money by reducing hospital and ER admissions and doesn't require medical transportation, supporters say.
    
"The face of medicine is changing and we need to lead or at least keep up with that fact," said Republican Rep. Larry Ahern.

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