Trauma, Medicaid changes move forward in Florida House

With House Republican leaders looking to make major health-care changes, a key panel Monday approved proposals that would erase limits on the numbers of trauma centers in the state and revamp parts of the Medicaid program.

The bills, approved by the House Health Care Appropriations Subcommittee, are particularly drawing interest from the hospital and nursing-home industries.

RELATED: Complete Florida Legislature coverage

The bill (HB 1077) that would eliminate limits on the numbers of trauma centers comes after years of legal battles in the hospital industry about whether the Florida Department of Health should approve proposals to open new trauma facilities. State law caps the number of trauma centers at 44 statewide and, within that, also includes limits in 19 different geographic regions.

Echoing a theme that is part of House leaders’ push for changes in the health-care system, bill sponsor Jay Trumbull, R-Panama City, pointed to taking more of a free-market approach. He said more trauma centers could meet the needs of a growing population and increasing numbers of tourists.

“What we’re saying is that we’re going to allow the free market the ability to be able to open up other trauma centers across the state,” Trumbull said.

But many major hospitals that have long operated trauma centers oppose the proposal. They argue, in part, that trauma centers need a steady flow of patients for the specialized types of care and that allowing new facilities would “dilute” quality.

“The dilution and proliferation of trauma centers is going to create a substandard level of care, in our view, in the state,” said Mark Delegal, a lobbyist for the Safety Net Hospital Alliance of Florida, which represents public, teaching and children’s hospitals.

Gov. Rick Scott has also backed eliminating the limits on trauma centers, but a Senate version of the bill (SB 746) has not been heard in committees as the annual legislative session enters its final three weeks.

The House Health Care Appropriations Subcommittee on Monday also moved forward with a bill (HB 7117) that seeks a series of major changes in the Medicaid program. As an example, the bill, spearheaded by Health & Human Services Chairman Travis Cummings, R-Orange Park, would direct the state Agency for Health Care Administration to seek federal approval to require Medicaid beneficiaries to make premium payments of $10 or $15 a month, depending on their income levels.

But perhaps the part of the bill drawing the heaviest lobbying deals with payments to nursing homes that care for Medicaid beneficiaries enrolled in managed-care plans.

Under current law, the Agency for Health Care Administration sets rates for payments to each nursing home. The bill would lead to nursing homes negotiating rates with managed-care plans, similar to how other Medicaid providers negotiate rates.

The Florida Health Care Association, a nursing-home industry group, is fighting the idea.

“Giving managed-care companies the ability to reduce those rates further without a floor in place would jeopardize the care of our state’s seniors, and centers would have to make difficult decisions to cut services that our residents have come to rely on to enhance their quality of life,” said Tom Parker, director of reimbursement for the association.

But Health Care Appropriations Chairman Jason Brodeur, R-Sanford, said the current system leads to payments ranging from $165 to $300 a night “basically for the same patient.” He said the state needs to look at changes in the way nursing homes are paid.

“That’s just too big of a spread for the state to continue to support,” he said.

Reader Comments ...

Next Up in Politics

Florida governor, GOP lawmakers weigh options after mass shooting
Florida governor, GOP lawmakers weigh options after mass shooting

A second gun-related bill has been postponed in the Florida Senate in the wake of last week’s mass shooting at a Parkland high school, as legislative leaders craft a multi-pronged response to the massacre and Gov. Rick Scott plans a series of workshops about school safety and ways to keep guns away from people struggling with mental illnesses...
Gun control could become key issue in Florida in November
Gun control could become key issue in Florida in November

An aversion to gun-rights restrictions has been a bedrock of Republican campaigns in Florida — a testing ground for model NRA-backed legislation — for years. But a 19-year-old killer, armed with a semi-automatic rifle he purchased legally and used to fatally gun down 14 students and three faculty members at a Broward County high school...
Education issues key to end of session for Florida Legislature
Education issues key to end of session for Florida Legislature

Florida lawmakers will use the last three weeks of the 2018 session to decide the fate of a number of major education bills that address everything from school bullying to teachers to university tuition. The decisions will begin unfolding Tuesday when the Senate Education Committee takes up a nearly 200-page bill (HB 7055) that is important to House...
Trump fumes about Russia investigation as nation mourns
Trump fumes about Russia investigation as nation mourns

As the nation mourned, President Donald Trump kept largely silent about the Florida school shooting victims and the escalating gun control debate, instead raging at the FBI for what he perceived to be a fixation on the Russia investigation at the cost of failing to deter the attack. From the privacy of Mar-a-Lago, Trump vented about the investigation...
Why Parkland students have emerged as a powerful political voice
Why Parkland students have emerged as a powerful political voice

The boldest voices to emerge in the wake of last week's mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. have been unexpected ones. Surviving students at the school quickly spoke out on social media and to news cameras both about the incident and, more broadly, about political leadership which they saw as having let them...
More Stories