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State Appeals Court Refuses To Halt High-Stakes Hospital Fight

George Hodan
Public Domain Pictures

The decision bolstered the case brought by three Sarasota County private hospitals that contend they should be reimbursed for indigent care, at least in part because of a 2003 state law.

In a decade-long legal fight that could involve hundreds of millions of dollars, a state appeals court this past week refused to halt a case that argues Sarasota County is required to reimburse private hospitals for providing care to indigent patients.

A three-judge panel of the 2nd District Court of Appeal backed a circuit judge’s decision that denied the county’s request for a summary judgment that could have ended the case. The county argued that it should be shielded by sovereign immunity, which generally is designed to protect government agencies from lawsuits.

Wednesday’s decision bolstered the case brought by what is now Venice Regional Bayfront Health, Doctors Hospital of Sarasota and Englewood Community Hospital, which contend they should be reimbursed for indigent care, at least in part because of a 2003 state law.

The legal fight started in 2011, with the private hospitals saying the county had been collecting property taxes for indigent care but had not been providing reimbursements. At the time, Venice Regional Bayfront Health was Venice Regional Medical Center.

A footnote in Wednesday’s appeals-court decision said, “The sum of the hospitals’ invoices, we are informed, now exceeds half a billion dollars.”

The case has already gone once to the Florida Supreme Court, which in 2017 upheld the constitutionality of the 2003 state law that directed Sarasota County to reimburse hospitals for indigent care.

The Supreme Court overturned a 2nd District Court of Appeal decision that said part of the 2003 law was unconstitutional because it singled out private hospitals in Sarasota County. The 2003 measure was passed as what is known as a “special law,” dealing only with Sarasota County, rather than a general law that would apply to hospitals throughout the state.

After the Supreme Court ruling, the county took a different legal tack by arguing that it was entitled to summary judgment because of sovereign immunity, according to Wednesday’s decision. The hospitals disputed the county’s position, including arguing that the 2003 law had helped create an “express contract” that could be enforced regardless of sovereign immunity.

A circuit judge rejected summary judgment, leading the county to ask the appeals court to “prohibit the circuit court from allowing the case to be litigated any further,” Wednesday’s ruling said.

But in a main opinion and two concurring opinions that covered 38 pages, appeals-court Judges Matthew Lucas, Morris Silberman and J. Andrew Atkinson turned down the county’s arguments.

In the main opinion, Lucas pointed to remaining legal questions about whether an “express contract” existed that would prevent the sovereign-immunity protections for the county.

“We cannot agree that what the hospitals allege to be a contract --- written, legislative enactments directing remuneration to private hospitals in exchange for services --- would be beyond the ken of what Florida law would recognize for purposes of waiving sovereign immunity,” Lucas wrote. “At bottom, then, the circuit court was not faced with a pure question of law, but whether a potentially valid express contract was, in fact, formed. There was a disputed question of material fact on that issue, and that precluded summary judgment.”

Jim Saunders is the Executive Editor of The News Service Of Florida.