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Tampa General may sue counties for patients' bills

Officials at financially strapped Tampa General Hospital are considering going to court to get reimbursement for medical care provided to poor patients admitted from Pinellas, Pasco and other counties outside of Hillsborough. During a Finance Committee meeting Monday, Hillsborough County Hospital Authority members asked their attorneys to research the possibility of a lawsuit against one or more of the 59 counties whose indigent patients left the 971-bed public hospital with uncollectible medical bills.

"People are taking advantage of Tampa General and Hillsborough County, and it's wrong," said authority member Rob Williams. "It's unethical, and if we have to file a lawsuit, if we have to fire a shot across someone's bow, I say we do it."

Tampa General wrote off $60.4-million in debt for charity care in fiscal 1989-90, of which $13.28-million was for patients admitted from counties other than Hillsborough. About $6.8-million for care for indigent patients from Pinellas, Pasco and Polk was uncollectible and ended up being charged off as bad debt.

More than $5.7-million worth of care was provided to out-of-county patients below the federal poverty level, which for a family of four is $12,000 a year. Those families are eligible for public assistance from their home counties.

Authority officials said they suspect that non-cooperation from other county governments prevented Tampa General from recapturing payment for much of that $5.7-million.

"It's a matter of how eager the other county is to get a patient qualified," said hospital Director of Admissions Alex Freeman. "Sometimes they're not motivated to go out to the patients' homes" to complete the paper work needed for reimbursement of the hospital's costs.

Hospital President Newell France said many of the out-of-county patients are admitted to Tampa General because it operates the only Level I Trauma Center in West Central Florida, a state designation reserved for facilities with advanced capabilities 24 hours a day.

Without increased state support, authority members complained, Tampa General might not be able to treat all of approximately 2,300 patients seeking care at the hospital's trauma unit annually.

"It's going to be a very difficult ethics question," said authority member Frank Fleischer. "But if the state is going to recognize this as a regional trauma center, it's going to have to pay for it."

A bill sponsored by state Rep. Ron Glickman, D-Tampa, and approved by the Legislature in 1988 provided a more efficient mechanism for Tampa General to collect for care provided to out-of-county indigents. But authority members grumbled Monday that the law still had too many restrictions, including a ceiling on how many days can be collected under Medicaid.

In other business Monday, members of the hospital's Alternative Resource Committee agreed to:

Recommend that the authority pursue a plan under which all 3,400 of the hospital's employees would be placed in a private, non-profit corporation with their services to be leased back to Tampa General.

The arrangement, which still must be approved by the Internal Revenue Service, would exempt employees from mandatory participation in the Florida Retirement System. Consultants say a private pension plan with equivalent benefits would save $50-million for Tampa General in the first seven years.

An Oct. 17 opinion by lawyer Ralph Dell said that the employee leasing corporation would be legal but warned that, with the corporation's creation, the authority would forfeit direct control over management of hospital personnel.

Study the possibility of selling the eight-story Harborside Medical Tower for offers France said ranged from $7-million to $11-million. Rents in the professional office building next to the hospital total about $700,000 annually, but expenses are nearly double that.