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Medical referrals bill stirs up big-money battle

With the legislative session drawing to a close, a multimillion-dollar war has broken out over the future of health care in Florida.

Wednesday marked a day of fighting between the Florida Medical Association and hospitals; attempts to slip last-minute amendments into legislation; and intense lobbying of lawmakers.

At issue: A 1992 law that limited the extent to which doctors in group practices can accept referrals for services such as diagnostic imaging, laboratory services, physical and radiation therapy.

With a push from the Florida Medical Association, the House tacked an amendment on a bill to remove all limitations on group practices accepting such referrals.

But lawmakers picked the wrong bill to amend. Its sponsor: state Sen. Ginny Brown-Waite, R-Spring Hill, the chairwoman of the Senate's Health Care Committee.

"It's a non-acceptable amendment," she said. By the end of the day, her office had released a four-page criticism of the amendment, saying it could "radically shift" the delivery of health care services from hospitals to group practices. She said she won't put her bill up for a final vote in the Senate with the amendment tacked on.

Hospital lobbyists were up in arms as well, saying hospitals rely on these services for profits that subsidize expenses such as health care for uninsured patients.

Ralph Glatfelter, of the Florida League of Health Systems, said diagnostic imaging statewide is a $500-million business. Hospitals could lose half of that to group practices.

Donald "Scotty" Fraser, a senior vice president at the Florida Medical Association, said the amendment was merely a starting point for negotiations.

By the end of the day, House Rules chairman John Thrasher, a former general counsel for the Florida Medical Association, said the issue is "off the table." But he would not rule out taking up the issue up if the Senate sends the House a bill on the subject.