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The many items remain separate measures in the Senate as the session's close draws near.

The Florida House has bundled a series of health care proposals together into two sweeping bills, an effort to breathe life into ideas as the annual session draws to a close.

What had been a sure-bet bill to protect three HCA-owned trauma centers from ongoing legal challenges now is an omnibus measure that would:

- Require doctors to use the Prescription Drug Monitoring Database and add requirements for use by law enforcement.

- Allow highly trained nurses to practice independent of physicians, an effort to expand primary care services.

- Create rules for virtual doctor visits, known as telemedicine.

- Establish a statewide medical tourism marketing plan.

Rep. Matt Hudson, the House's health care budget chief, said the size and scope of the revised House Bill 7113 should not scare off support since all the proposals have been individually vetted.

"For those that say we tacked too much on this bill and what's not good or what is good: You know what, I'm sorry," said Hudson, R-Naples.

One provision added to HB 7113 Thursday is new: Allowing certain hospitals that want to open new branches to skip the normal review process.

It was tailor-made for UF Health Jacksonville, which has petitioned the state to open up a second location 11 miles to the north. Jacksonville's Memorial Hospital, owned by HCA, has challenged the need for another facility within city limits.

So now the bill does something for HCA - and also for UF, which is among the hospitals that objected to the HCA trauma network expansion.

Rep. Mia Jones, D-Jacksonville, said UF needs the help in order to operate in an area where more patients have insurance.

"They're really teetering on the brink in terms of the level of uninsured that they handle as well as the Medicaid recipients that they deal with, and so they are trying to create an opportunity for them to access insured patients," Jones said.

The Health and Human Services Committee approved the new HB 7113 overwhelmingly, with two Republican members, Doc Renuart of Ponte Vedra Beach and Gayle Harrell of Port St. Lucie, voting no.

A second omnibus bill, HB 573, also passed easily. It took assisted-living facilities regulations - a big priority in the Senate - and added a limited grandparent visitation law and changes to post-operation recovery centers outside of hospitals.

The ALF reform passed with dissent from three Democrats, Jones, Amanda Murphy of New Port Richey and Joe Gibbons of Hallandale Beach.

The many subjects combined in the two House bills remain separate measures in the Senate.

The Senate Appropriations Committee approved SB 1276, its standalone version of the trauma grandfathering proposal on Thursday. The bill also creates a one-year, $15,000 cap on trauma activation fees and a one-year moratorium on new centers while the process to approve facilities is reconsidered. Sen. Aaron Bean, R-Fernandina Beach, Sen. Rob Bradley, R-Orange Park, and Sen. Arthenia Joyner, D-Tampa, were the no votes on SB 1276.

Rep. Jason Brodeur, R-Sanford, said the differing approaches don't mean they can't reach an agreement before the session ends May 2, a timetable that is even shorter since legislators are taking next week off.

"We just have to match up language, it may come in several different packages," he said.

Senators say the trauma bill is intended for three HCA centers - Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County and Ocala Regional Medical Center in Marion County - and clarified that it is not intended to help HCA open a closed facility in Orange Park. Sen. Denise Grimsley, who is in charge of health care spending, said the goal of the bill is to end fighting between HCA and safety net hospitals that has cost the state more than $1 million in legal fees.

"Both sides have made this really about them, and they've forgotten about the patient," said Grimsley, R-Sebring, said. "Which, quite frankly, as a health care provider it's disgusting."

Contact Tia Mitchell at (850) 224-7263 or