TALLAHASSEE — A plan to shield three disputed trauma centers from legal action — while also placing limits on trauma center access fees — faces an uncertain future as the legislative session winds down.
The so-called "trauma drama" fix is weighed down with language from at least 10 other proposals, turning into an omnibus bill that may be too unwieldy to gain Senate approval.
House Bill 7113 is expected to be approved today in the House, but the Senate is already expressing reservations.
"Any time you have a piece of legislation that big, it's usually problematic," said Sen. Denise Grimsley, R-Sebring, the health care budget chief.
Both HB 7113 and Grimley's SB 1276 grandfather in three HCA-owned trauma centers that have faced years of litigation: Regional Medical Center Bayonet Point in Pasco County, Blake Medical Center in Manatee County and Ocala Regional Medical Center in Marion County. They also creates a one-year, $15,000 cap on trauma activation fees and a one-year moratorium on new trauma centers unless new rules are finalized for establishing future centers.
The fee limitations were added after a Tampa Bay Times investigation revealed that hospitals across the state were charging huge fees to trauma patients even when they needed little more than first aid. HCA, which has entered the Florida trauma market in the past few years, had fees averaging $27,644 per patient in the first half of last year, compared with $6,754 at other hospitals in the state.
The amendment approved by the House on Thursday also requires Ocala Regional, whose trauma center now holds provisional licensing status, to meet requirements needed to get to verified status by the end of the year. Legacy trauma centers like Tampa General Hospital, Bayfront Health St. Petersburg, St. Joseph's Hospital and Shands Jacksonville Medical Center have agreed to drop their lawsuits challenging the HCA facilities if that condition is met.
"Safety net hospitals have always supported a statewide trauma system that gives all Floridians timely access to high-quality, lifesaving care when they need it," said Ron Bartlett, a spokesman for the Safety Net Hospital Alliance of Florida. "The amended legislation passed by the House today is a step forward that addresses our chief concerns with earlier bills and allows our hospitals to focus resources on patient care instead of the courtroom."
But the House plan now also includes new requirements that doctors consult the state's Prescription Drug Monitoring Program, authorization allowing highly trained nurses to practice independently, regulations for virtual doctor visits by certain types of providers and a statewide medical tourism marketing plan.
Still more was added to the bill Thursday, including relaxing current rules so pharmacists can supervise more pharmacy technicians and doctors can supervise more physician assistants.
Another provision in the House bill that applies only to Miami-Dade County is not included in any Senate bill. Neither is another portion of HB 7113 that would allow UF Health Jacksonville to circumvent the normal review process to open up a new branch in northern Duval County.
Other components of the omnibus HB 7113 are in direct conflict with Senate proposals. For example, the House wants to let highly trained nurses open practices outside of doctor supervision. The Senate legislation, SB 1352, allows nurse practitioners to perform additional tasks but stops short of allowing them to practice independently. The bill was never voted out of committee to get to the full Senate.
Provisions found in HB 7113 are located in at least 11 Senate proposals. Sen. John Thrasher, R-St. Augustine, said "trains" combining several pieces of legislation into huge bills are not the preferred way of doing business.
"I don't set the rules or procedures down in the House, so whatever they send us we have to try to take a look at it — and look at it from the standpoint of is it good public policy or not," he said.
House Health and Human Services Chairman Richard Corcoran, R-Land O'Lakes, sounded more optimistic.
"When everyone is focused on finding a way to improve our citizens' health care, we'll find a way to make it work," he said.
Times/Herald staff writers Mary Ellen Klas and Kathleen McGrory contributed to this report.