Because of Florida’s three-year legal dispute between “safety net” urban hospitals and suburban trauma care centers, state senators and representatives alike introduced multiple bills this year to settle the differences.
But when the legislative session adjourned, lawmakers went home without voting on key bills concerning trauma care centers.
The legislation they cast aside would not only keep three trauma centers open in Manatee, Pasco and Marion counties and give guidelines for future trauma care centers but also would help to protect the consumers, namely patients. Historically, safety net hospitals provide a significant level of care to low-income, vulnerable and uninsured populations.
But one, Blake Medical Center in Bradenton, serves clients suffering severe trauma in Manatee, Sarasota, and Desoto counties, plus south Hillsborough County.
The lawsuit centers on the fact that the Florida Department of Health allowed the trauma centers in Manatee, Pasco and Marion counties to open in 2011 and 2012, using an invalid rule in granting the approvals. The DoH will not be allowed to approve any new trauma centers until July 1, 2015, though the department is seeking a legal loophole to keep moving forward.
Florida senators and representatives alike authored bills to protect the trauma centers against the bigger public hospitals so that convenient services would not end at these smaller health-care facilities for Florida residents. However, lawmakers went home without passing Senate Bill 1354 and Senate Bill 1276, though representatives did pass House Bill 7113, with a 115-page amendment, minutes before the legislative session ended. The Senate did not take up the House bill. That was expected because HB 7113 was considered a legislative “train” that had had a preponderance of issues tied to it, even though lawmakers stripped the bill Thursday.
“We are certainly disappointed that the legislative session ended without much-needed trauma legislation,” said Melissa Morgan, spokeswoman for Blake Medical Center. “Trauma patients throughout Florida that receive treatment at trauma centers such as the one at Blake Medical Center would have benefited from the creation of a foundation for a 21st-century statewide trauma system.”
She said, “Our trauma center has had the opportunity to serve Manatee, Sarasota, and DeSoto counties for almost three years now, providing lifesaving trauma care to over 2,600 trauma patients. We will continue to fight in the division of administrative hearings, the courts and the legislature to ensure that our trauma center remains open for the citizens and visitors in these communities.”
As always, there are two sides to every issue.
Investigative reporting done by Tampa Bay Times reporters this past year also dug up evidence that the smaller trauma centers were consistently charging extremely large admission fees to trauma patients in comparison with those fees charged by the safety net hospitals. Three Hospital Corp. of America trauma centers topped the list: Blake Medical Center in Bradenton, Regional Medical Center in Pasco County and Ocala Regional Medical Center.
To complicate matters, a non-profit seniors’ organization, 60 Plus Association, has sponsored ads targeting Tampa General Hospital, Bayfront Health and St. Joseph’s Hospital. The advertisements contend that these hospitals have been trying to squeeze out the smaller suburban trauma care centers across the state, even though administrators say their role is important because a traumatic injury needs to be treated immediately at a nearby facility.
Though HCA supports the ads, it is not saying whether it paid for them. Also, the senior advocacy group is not required to disclose its donor list because it is also considered a political advocacy group.
Meanwhile, the conservative advocacy group is spending $250,000 this year on a “Save Our Trauma Centers” drive.
The types of traumatic accidents found in urban areas differ from those in suburban areas. Basically, insurance companies pay for automobile accidents, but not for injuries happening from gun or knife fights. The larger urban areas also include the uninsured, which puts another dynamic into play when keeping hospitals open is considered a crucial element.
Insurance companies also seem to be getting involved in this battle, while Florida residents are wondering where they will go for immediate, acute care in the future.
The Health Innovation subcommittee sponsored HB 7113, with Rep. Jason Brodeur, R-Sanford, and Rep. Greg Steube, R-Parrish, introducing it. It was a full health-care bill, which would allow nurse practitioners to prescribe controlled substances; enforce stricter telemedicine regulations; allow for virtual doctor visits; and, more importantly, would allow the three HCA trauma medical centers to remain open, including Blake Medical Center in Bradenton, though fee restrictions would be applied.
By Friday, lawmakers had stripped the nurse practitioner and telemedicine portions from the bill, and approved an amendment to revamp part of the bill that would ensure that the three trauma medical centers would remain open so the bill would pass.
Senate Bill 1354 revised contract requirements for Medicaid managed-care programs; the requirement of health insurers to use a standardized prior authorization form; established a process for providers to override certain treatment restrictions; prohibited an insurer from retroactively denying a claim in certain circumstances, and so on.
Written by Sen. Denise Grimsley, R-Sebring, it was expanded to protect trauma centers from potential lawsuits. However, these facilities would have to place a temporary $15,000 cap on the trauma activation fees until July 2015; the DoH would have a one-year moratorium on allowing new trauma centers to be planned; and an advisory committee would be created to approve new trauma centers in the future. The bill also included regulation of certain aspects of the state’s Medicaid managed-care program.
Senate Bill 1276, also written by Grimsley, addressed limiting trauma service fees, requiring the Department of Health be restricted from verifying, designating or provisionally approving hospitals as trauma centers, and requiring that DoH convene the Florida Trauma System Plan Advisory Council by a specified date.
An editorial recently published in the Tampa Tribune advised that these three trauma hospitals, including Blake Medical Center, should be shut down to protect the market share of establishment hospitals in Tampa and St. Petersburg. In that editorial, it was argued that there were not enough good doctors to provide quality care in the new trauma centers, and that the larger public hospitals would lose some of their patients.
However, patients needing immediate attention could have to travel an hour or more to an “established hospital,” which could be dangerous in an emergency situation.
