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Bill limiting referrals to doctors' clinics okayed

A bill that would stop doctors from referring patients to certain clinics in which they own an interest sped through a Senate subcommittee Wednesday despite opposition from doctors and some clinics that would be driven out of business.

The bill is aimed at regulating the high cost of medical care at clinics that provide diagnostic imaging, radiation therapy, physical therapy, rehabilitation and laboratory services.

The bill has attracted a horde of Tallahassee lobbyists representing the doctors and clinics that would lose their investments, independent clinics that would gain business and clinics that want a share of Florida's multimillion dollar health-care industry.

The Senate bill, sponsored by Sen. Eleanor Weinstock, D-West Palm Beach, was amended at the last minute to include provisions the House adopted at the request of Dade lobbyist Ronnie Book.

It would prohibit doctors from referring patients to clinics they own, but would make an exception for the clinics run by Book's client.

Weinstock said adopting the Book amendment already attached to the House version may help pass the bill, which includes other measures to regulate services and rates at all clinics.

Studies have indicated that joint ventures between doctors and clinics result in overcharges to Florida patients of as much as $500-million a year.

"This may be the only big health thing we do," Weinstock said. "It could save millions of dollars."

Legislators are considering other bills that would improve health services, but most would require so much money they have little chance of passing in a tight budget year.

Book represents clinics operated by Cancer Treatment Holdings Inc. (CTHI), a Nevada corporation that owns radiation therapy clinics in Tampa, West Palm Beach and Coral Springs. Referring doctors own stock in the clinics and are officers of the corporation.

One of the directors at CTHI is Rep. Fred Lippman, D-Hollywood, a member of the House Health Care Committee. Lippman did not vote on the bill when it passed through his committee.

Book says clinics like those CTHI operates often provide better services with newer equipment; the doctors have gone into the business to make treatment available in areas where patients otherwise would be forced to travel long distances.

Among those objecting to provisions of the bill that would exempt one group of clinics was former House Speaker H. Lee Moffitt, lobbyist for a Tampa radiation therapy clinic jointly owned by St. Joseph Hospital and its doctors.

Moffitt said the radiation therapy clinic operated by the hospital and its doctors is not overused and doesn't gouge its customers.

"Consider grandfathering those that aren't gouging their customers," he pleaded. "Permit us to show you we are operating in a way you would be proud."

Radiation therapists who provide treatment for cancer patients at independently owned clinics strongly favor the bill. Joint ventures with doctors have driven up the cost of health care, they say, and led some doctors to overuse their clinics at the expense of those operated by public hospitals.

"This is not a Democrats vs. Republicans issue, it's a moral-ethical issue concerning a doctor's relationship to his patient," said Dr. Michael Isikoff, a Titusville radiologist.