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  1. Florida Politics

Times surveys state lawmakers and governor about trauma fees

Published Apr. 7, 2014

Most Florida lawmakers declined to say whether they would support measures that could reduce hospital charges for trauma patients.

The Tampa Bay Times reported last month that trauma centers across the state are charging as much as $33,000 the moment a patient enters the hospital. These "trauma response" fees are charged on top of the cost of medical care — even to patients who need nothing more than stitches or other minor treatment.

Last week, the Times asked Gov. Rick Scott and each state legislator to weigh in on whether they would support three basic measures suggested by experts:

• Requiring the state agency that collects data on hospital charges to analyze and publish each hospital's trauma response fee.

• Requiring hospitals to base their fees on actual expenses.

• Capping the fee or taking other steps to rein in what trauma centers charge.

Elected officials were asked to answer "yes" or "no" to each question and were provided space to explain their answers. Results are posted online at tbtim.es/traumasurvey.

Of more than three dozen lawmakers who responded — about a quarter of the Legislature — almost all supported each of the measures.

Among them was Sen. Denise Grimsley, R-Sebring, who has already proposed legislation that would cap the fee at $15,000 for a year and convene an advisory council to make long-term recommendations.

Both the chair and vice chair of the Senate's Health Policy Committee, Sen. Aaron Bean, R-Jacksonville, and Sen. Eleanor Sobel, D-Hollywood, said they would support each of the measures.

"At the time of an emergency trauma response, price gouging is reprehensible," Sobel said. "Sticker shock can be prevented with more government regulations, increased transparency in pricing, and a graduated fee schedule based on the severity of the injury."

Rep. Dennis K. Baxley, R-Ocala, was the only lawmaker who responded to say he would not support any of the measures.

"I am very much a free-market guy," Baxley told the Times in an interview. "If it's worth it to the individual to receive that care, I don't think we need to be doing price management of every single thing in it. If you need that critical golden hour, it's worth every dollar."

In the first half of last year, Baxley's local Ocala Regional Medical Center, run by the for-profit Hospital Corporation of America, charged patients $19,500 to $24,500 for trauma response.

HCA's trauma centers charged more than any other center in the state, including higher-level teaching hospitals.

Non-HCA trauma centers charged an average $6,754 trauma fee in the first half of last year; HCA centers charged an average $27,644. The corporation's Regional Medical Center Bayonet Point in Pasco County charged the most, $33,000.

Rep. Amanda Murphy's district falls in an area served by Bayonet Point. The New Port Richey Democrat said she plans to file an amendment in the House that would require a state study of trauma fees and a review of cases where patients were charged a fee even though their injuries were not severe.

The Times found thousands of cases in which patients with minor injuries were charged the fee. Many of them spent less than a day in the hospital. For thousands, the trauma response fee was higher than the charges for all of their medical procedures combined.

Murphy said her amendment may mirror the proposals in Grimsley's legislation. Like the Senate bill, Murphy's amendment would be attached to pending legislation to help trauma centers run by HCA remain open despite court challenges by other trauma centers.

"There are multiple people who are definitely bringing up the fee issue," Murphy said. "It is a big deal."

House Speaker Will Weatherford, R-Wesley Chapel, did not respond directly to the questions, but did provide this statement:

"The Tampa Bay Times' reporting has helped to shed light on the charges associated with trauma treatment in Florida. This session, the House is considering options that would increase transparency and determine the necessary level of oversight within this industry. I believe it's an issue that should be addressed this session."

Neither Gov. Scott nor his staff will say if the governor supports efforts to rein in the fees.

In 1997, Scott resigned as chief executive officer of the corporation, then called Columbia/HCA.

In response to questions last week about the trauma fees, Scott's office provided a copy of the same statement it issued a month ago when first asked about the fees.

"I believe efforts to increase competition, transparency and empower consumers are critical to making health care more affordable and accessible with higher quality. Unfortunately, Obamacare does exactly the opposite. … ''

Times news systems editor William Higgins, computer-assisted reporting specialist Connie Humburg and staff writers Kris Hundley and Michael LaForgia contributed to this report. Alexandra Zayas can be reached at azayas@tampabay.com or (727) 893-8413.

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