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Disputed HCA trauma centers would be protected by House plan

The Regional Medical Center Bayonet Point is among three HCA trauma centers being challenged by other trauma centers that contend the state acted improperly in allowing them to open.
The Regional Medical Center Bayonet Point is among three HCA trauma centers being challenged by other trauma centers that contend the state acted improperly in allowing them to open.
Published Mar. 12, 2014

TALLAHASSEE — Three HCA trauma centers that are being challenged in court would be protected under a measure that advanced in the Florida House on Tuesday — even as legislators expressed concern over hospital billing practices revealed in a Tampa Bay Times investigation.

A House committee agreed to sponsor the bill, which would allow Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County and Ocala Regional Medical Center in Marion County to continue operating. All three have been challenged by other trauma centers that contend the state acted improperly in allowing HCA to open them.

A yearlong investigation by the Times found that trauma centers across the state are charging thousands of dollars just to get through the doors, a fee that frequently goes even to patients who are not severely injured.

The average trauma response fee in Florida has risen from $2,555 in 2006 to $10,825 last year, an increase 20 times the rate of inflation.

HCA, whose average $28,000 trauma response fee is by far the highest in the state, has opened six trauma centers in recent years, including the three affected by the new proposal. If it can win state approval, the company has ambitions to open more this year.

The Times found the trauma fee frequently is just the start of the high charges. HCA hospitals, as a group, are charging tens of thousands of dollars more in average total charges than Florida's other trauma centers.

That information wasn't enough to stop the House's Health Innovation Subcommittee from approving the proposal on an 8-4 vote, with members of both parties on each side of the issue.

Committee Chairman Jason Brodeur, R-Sanford, said the bill should end ongoing lawsuits and administrative hearings pushed by hospitals with long-standing trauma centers that accused the state of approving new centers improperly.

The legacy centers argue that too many trauma centers can actually reduce quality of care by spreading specialists and money too thin, and have petitioned to get the newer centers shut down. Brodeur says that shouldn't be allowed to happen.

"Forcing these trauma centers to close and reapply under new rules would have a negative impact on the health and safety of the residents of these regions," Brodeur said.

Rep. Doc Renuart, a Ponte Vedra Beach physician, was the only Republican to vote against the measure, saying the Legislature should not be intervening.

"I don't believe that injecting politics into this is the right answer," Renuart said.

Jeffrey Frehn, an attorney for Tampa General Hospital and Bayfront Health St. Petersburg, said the bill would allow HCA to skirt rules that determine when and where new centers are needed.

"There is no justification for allowing the HCA trauma centers to circumvent the need requirement that every other trauma center is subject to," he said. Bayfront has been particularly hard hit by the opening of Bayonet Point to its north and Blake to its south.

But the HCA centers also had advocates in the room Tuesday.

"At least for Ocala, don't take it away from us because you'll get a whole bunch of crazy women like me coming up here yelling," said Dawn Bowman, whose relative was treated at the HCA trauma center there.

Brodeur introduced the proposal Tuesday by imploring his colleagues not to factor the Times' findings into its deliberations.

"We've heard a lot about charges in these facilities in the last few days, but cost charges and reimbursement in trauma care is a complicated matter not addressed in this bill," Brodeur said.

Hospitals face virtually no government oversight of how they set their charges. Trauma patients have no choice in where they are taken for care, and so are obviously in no condition to comparison shop.

Brodeur said those facts concern him, and he wanted to look more into the Times' report. Tuesday, he said he wasn't prepared to discuss including cost controls in the trauma center bill, but suggested he might consider it later.

"It's a separate issue, but I think it's germane to the bill and would be something we would be interested in looking at, certainly," he said.

The bill would allow any trauma centers that have been in existence for at least 12 months to remain open as long as they submit an application to the American College of Surgeons Committee on Trauma for a site visit by June 31, 2015.

The Senate has a separate proposal that grandfathers in the three existing HCA trauma centers and also sets new standards for approving future centers. Senate Bill 1276 hasn't been heard in committee yet.

Hospitals are an important special interest group, contributing millions of dollars to political parties, committees and campaigns each election cycle.

HCA has contributed $1.3 million this cycle, including donations to nearly every member of the House committee that reviewed the trauma center proposal Tuesday. The Florida Hospital Association has contributed $207,000 so far.

Times/Herald staff writers Letitia Stein and Mary Ellen Klas contributed to this report. Tia Mitchell can be reached at or (850) 224-7263.