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At the Capitol: Hospitals, Witnesses, Prisons

Even though the entire fight will likely soon be moot, hospitals and the Agency for Health Care Administration are fighting over a plan to switch the Medicaid payment system to one like Medicare's.

The so-called "DRG system" pays a flat rate per diagnosis, rather than the arcane cost-based system Florida has been using for decades. AHCA's plan for switching to DRGs has made "safety-net hospitals" unhappy, because they'd lose money to for-profits.

The whole roiling mess in all its complexity came before the House Appropriations Subcommittee on Health and Human Services on Wednesday. After much back-and-forth, Sen. John Thrasher told Justin Senior, deputy AHCA Secretary for Medicaid, to go find a compromise.

“If you leave it to (us), I promise you may not be happy and they may not be happy,” Thrasher said. “Rather than take up the time of this Legislature, and us worry about who is right and wrong, you guys get in a room and work it out.”

As for why the matter is likely to be moot, the Florida Medicaid program will be turned over to managed-care companies as soon as the federal government grants a pending state request. At that point, hospital pay will be determined by private contracts.

In other action:

--The House spending panel on justice issues engaged in debate -- couched as questions -- over the privatization of prisons, including prison health care.  Republicans noted the savings, while Democrats said that was a bait-and-switch that would end up costing more. More details in the Florida Current.

--The House Civil Justice Subcommittee approved a bill that would tighten qualifications for expert witnesses in court cases, a matter that is important to physician groups and business. The bill passed the House each of the past two years but foundered in the Senate. More details from Jim Saunders of News Service of Florida on SaintPetersBlog.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.