Health care legislation divides House

Feb 28, 2012

The following article was published in The Florida Current on February 28, 2012:

Health Care Legislation Divides House

By Christine Jordan Sexton

A divided Florida House on Tuesday waged a fierce and bipartisan fight over a lengthy health care bill.

Two GOP medical doctors wound up changing HB 1419 even though House Speaker Dean Cannon, R-Winter Park, and Republican leaders opposed the amendments.

One amendment removed a hotly contested provision that would have required hospitals to be part of a managed care plan’s network so an HMO can expand into additional counties and bid on the state’s Medicaid program when the state starts its mandatory Medicaid managed care program. This provision has been viewed as one that would benefit certain smaller HMOs now operating in South Florida.

The other amendment deleted a provision of the bill that would have turned upside down the state process for regulating trauma centers. The bill initially deleted a requirement that the Florida Department of Health determine the appropriate number of trauma centers. Trauma center regulation has been the center of a legal fight.

The changes to the bill were pushed by Reps. Ronald “Doc” Renuart, R-Jacksonville, and Paige Kreegel, R-Punta Gorda.

Renuart said allowing trauma centers to proliferate as allowed under the bill would have hospitals competing for a limited number of qualified specialists, such as neurosurgeons, who are required to be on call. Renuart said that availability of physicians “will go down and costs will go up.”

Rep. Fred Costello, R-Ormond Beach and a dentist, also supported Renuart’s attempt to strip the provision of the bill noting that, “quantity does not make quality.”

But others, including Reps. Matt Gaetz, R-Shalimar; Jimmy Patronis, R-Panama City; Chris Dorworth, R-Heathrow; Debbie Mayfield, R-Vero Beach, and Robert Schenck, R-Spring Hill, argued against “government regulations” with Gaetz arguing that government “shouldn’t get in the way of good health care.”

The amendment was debated for more than 20 minutes before it ultimately passed by a 62-51 margin.

Several new emergency care centers, including a new $40 million trauma center at Orange Park Medical Center and Regional Medical Center Bayonet Point in Hudson and Blake Medical Center in Bradenton have been given provisional approval by the Florida Department of Health to open and operate.

Shands Jacksonville Medical Center, Tampa General Hospital and St. Joseph’s Hospital in Tampa — which have trauma centers — challenged the DOH’s initial decision to award the new trauma centers to HCA-owned facilities. 

The hospitals argued and an administrative law judge agreed that the underlying rule the DOH used to award the new trauma centers was invalid.

The main bill made changes to how the state Agency for Health Care Administration regulates health care facilities such as hospitals and nursing homes, but along the way it became a vehicle for other health-care related issues including contracting issues between hospitals and HMOs.

The Kreegel amendment deleted the provision in the bill that mandated contracts between hospitals and Medicaid HMOs. The debate on the Kreegel was much shorter than the previous debate.

Kreegel argued that if the Florida House believes in a free market health care system then it shouldn’t include language in the bill that would force hospitals to contract with managed-care plans. That amendment deleting that language also passed by a comfortable 65-44 margin.

The Senate Subcommittee on Health and Human Services Appropriations struck a similar provision — also with bipartisan support — from a companion bill, SB 1884. The Senate amendment was offered by Sen. Steve Oelrich, R-Gainesville.

The House measure, which is now poised for a final vote, also was changed to include provisions that would allow clinics to post charges on an electronic messaging board in clinics.

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