Florida hospitals won victories in the waning days of the state legislative session that will allow them market will bear, pay less in taxes and require HMOs to pay for their enrollees' emergency room screening visits.
They also lost a controversial certificate-of-need battle that would have exempted from CON requirements the conversion of medical-surgical beds to skilled-nursing beds.
However, the state Agency for Health Care Administration has been ordered by a state district court of appeals in Tampa to develop a separate methodology to review CON requests for hospital bed conversions to skilled nursing, said Bill Bell, general counsel for the Florida Hospital Association.
Bell also said the much-criticized hospital rate review approval process also has finally been eliminated. "We think managed-care has rendered rate review moot," Bell said.
State law required each hospital to submit annual budgets for review. Based on a complicated formula, each hospital was allowed to raise prices to a specific level, based on a number of factors. They included inflation, operating margin, efficiency, discharges and payer mix.
Over the past two years, the majority of hospitals that applied for rate increases were owned by Columbia/HCA Healthcare Corp. (Oct. 9, 1995, p. 8).
On the tax front, hospitals will save an estimated $9 million annually in payments to the state's indigent-care trust fund. The Legislature specified that home health revenues should not be counted as operating revenues, which are subject to the state's 1.5% indigent-care tax (Feb. 26, p. 53).
In 1995, the trust fund collected a total of $225 million to support indigent care at several of the state's largest public hospitals. The FHA and Columbia successfully fought to exempt home health revenues, a growing source of profits for hospitals.