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HCA pleased with final bill

By Christine Jordan Sexton
4/28/2009 © Health News Florida

HCA Healthcare Corp. didn’t succeed in killing the panel that recommends spending of $1 billion a year in Medicaid dollars. But it will leave the session satisfied, as Florida lawmakers on Monday sent a measure overhauling the panel to Gov. Charlie Crist.

With little debate, the Florida Senate voted unanimously to change the membership of the Low Income Pool Council, a move that would block professional lobbyists from serving on the group. 

It will force out two high-profile members now serving on the panel – chairman Paul Belcher of the Florida Hospital Association and Tony Carvalho of the Safety Net Hospital Alliance of Florida. 

“The Florida House and Senate sent a strong message – that our limited LIP Council funds should be protected from the influence of Tallahassee insiders,’’ said Rep. Jimmy Patronis, R-Panama City. “I hope the governor quickly signs this bill, which will enable the Legislature to receive unbiased information about the best way to use taxpayers’ dollars.’’ 

At the start of the 2009 session a shadowy group called Floridians for Government Accountability began pushing for the complete elimination of the Low Income Pool (LIP) council, which was set up as part of the state’s “Medicaid Reform” pilot. The organization – which has refused to disclose its donors – sent mail to voters in Tampa and Tallahassee and aired television ads calling on lawmakers to kill the LIP council entirely. 

Instead of killing the council outright, lawmakers reached a compromise to alter the membership of the group. The legislation that heads to Crist’s desk adds seven members to the council, bringing its membership up to 24, and bars lobbyists from serving as LIP Council members.

Two of the new members to the council must be physicians who treat patients at a trauma center or emergency department and will be appointed by the House speaker and Senate president. The legislative leaders will also have two more appointments to the council. Other new members to the council will include a representative from a federally qualified health center as well as a representative from the Department of Health and the Agency for Health Care Administration. The AHCA representative will chair the council. 

One of the bill’s biggest backers was HCA, a for-profit hospital chain based in Nashville that made more than $300,000 in political contributions in Florida in the first quarter of 2009. Some went to political committees controlled by legislative leaders, including House Majority Leader Adam Hasner, and more than $100,000 went to the Republican Party of Florida.

The corporation has dozens of hospitals and other health-care facilities in Florida but got much less LIP Council money than the non-profit and public hospitals that treat large numbers of Medicaid and uninsured patients. (For more details, see Hospitals fight over $1B fund

.)

Some counties contribute money to use as federal match, and those counties are favored in recommendations on spending LIP money. The recommendations generally are accepted by the Legislature, which appropriates the money in the state budget. 

Until this session few had ever heard of the LIP Council. But discussions about the council this year drew standing-room-only crowds, leading Sen. Don Gaetz to call it an “economic stimulus bill” for lobbyists. 

HCA Corporation lobbyist Stephen Ecenia said his clients were pleased with the bill. “The dialogue was very healthy,” he said, adding “the bill eliminates the issues with the LIP Council." 

--Contact Christine Jordan Sexton.