Hospitals in Florida may have to pay nearly $9 million to the state's indigent-care trust fund this year if the state Agency for Health Care Administration gets its way.
At issue is whether hospitals count home health agency revenues in their annual budget reporting requirements. Of the 100 hospitals that operate home health agencies, 71 did not report those revenues to the state and 29 did.
Last year, the AHCA declared that hospitals should count home health revenues, which would be subject to the state's 1.5% indigent tax. The 29 hospitals that reported home health revenues in 1995 paid $4.4 million to the fund, which totaled $225 million last year.
The trust fund supports indigent care at public hospitals, such as Tampa (Fla.) General Hospital and Jackson Memorial Hospital in Miami, that treat high numbers of poor patients.
"The agency has known for years that hospitals don't count home health revenue," said Bill Bell, general counsel for the Florida Hospital Association. "We thought it was OK. Now they tell us it is not. It really is a fairness issue. Do they just want to collect more money for the trust fund?"
Bell said the FHA is poised to issue a challenge if the agency moves to enforce the rule.
Columbia/HCA Healthcare Corp. executives already have informed the agency they will challenge the reporting requirement, an agency official said. Columbia officials were unavailable for comment.
Florida's hospitals have been experiencing large increases in home health revenues. For example, some 20 home health agencies owned by hospitals in the Tampa-St. Petersburg market increased home health revenues 56% in 1994 to $161 million, the agency said.