Some Florida hospitals have ignored House request for financial disclosures

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Naples Daily News by Alexandra Glorioso

April 14, 2017

As Florida lawmakers look to make cuts in state payments to hospitals, two-thirds of the hospitals have provided financial disclosures requested by House leaders.

So far, just six of the state’s 24 for-profit health care systems, including stand-alone hospitals, have responded to the House request, and 41 of the state’s 44 nonprofit hospital systems, including stand-alone and teaching hospitals, have responded. Nine of the state’s 13 public systems responded.

Florida dolled out $5.1 billion in 2015 to hospitals through the state-federal program known as Medicaid that reimburses hospitals for seeing a large number of low-income patients. For-profits received $1.2 billion of the money.

“It’s a ton of money, and they are very, very well represented in Tallahassee and have a big vested interest in what happens up here,” said Rep. Carlos Trujillo, chairman of the House appropriations committee.

This year’s legislative session is past the halfway point as both chambers have passed their budgets and are preparing for negotiations next week.

Hospitals are facing cuts from both the House and Senate this session. The House is proposing to cut $622 million, and the Senate, typically more hospital-friendly, is proposing to cut $258 million.

 Trujillo, R-Miami, said the hospitals that don’t provide financial disclosures might as well surrender their state funding to Safety Net Hospitals, including for-profits, which didn’t play ball when Gov. Rick Scott made the same disclosure request in 2015.

He said the extra financial information hospitals provided to the Legislature would “absolutely influence the cuts this year.”

The three for-profit systems that receive $1.1 billion of the Medicaid money — Hospital Corporation of America, Tenet Health and Community Health Systems — have disclosed their records to the Legislature but are requesting they not be released publicly because of trade secrets.

“House general counsel is reviewing whether their claim is accurate,” said Trujillo, whose staff requested the disclosures. “If we find that it’s not exempt from public record, our intent is to release it.”

“Only the salary information is confidential,” wrote HCA’s lawyer, Stephen Ecenia, in an email.

The three for-profit hospitals handled 26.6 percent of all hospital visits paid through Medicaid reimbursements.

HCA, which Scott used to run, served 17.9 percent of the population, according to an analysis by the Naples Daily News using worksheets provided by the Legislature, governor’s office and Safety Net Alliance.

HCA received the largest reimbursement rate out of any hospital chain in the state: $696.2 million, or more than 13 percent of the Medicaid money, the analysis shows.

Although HCA received the most Medicaid money, the House is proposing to take the most away — $51.1 million — from a non-profit health care system known as Adventist Health System, which received $375.3 million from the state in 2015 and served 7.3 percent of the Medicaid visits to hospitals overall.

Rep. Jose Oliva, the House Rules and Policy Committee chairman who is a leader in Florida’s health care debate, said non-profit hospitals should come under greater scrutiny than for-profits because they are mission-based.

“Non-profits have the additional burden by seeking the tax protection they’ve sought in establishing their mission is one of providing good health care and not profits,” Oliva, R-Miami, said. “If the public is going to grant not-for-profit status, then the public gets to have some scrutiny.”

“Like all hospital reimbursements, we will be looking closely at this too,” Rep. Jason Brodeur, R-Sanford, the House’s subcommittee chairman on health care appropriations, said about how for-profits are figuring into funding cuts.

The disclosures from hospitals released thus far show spending on lobbying and salaries, as well as full-time employees, private fundraising and other details.

Of the hospitals that did respond, the average amount spent on lobbying last year was reported at $253,695 for public hospitals, $103,938 for nonprofits and $14,182 for for-profits.

Lee Health in Lee County reported spending $294,271 on lobbying; Indian River Medical Center in Indian River reported spending $162,932; Tallahassee Memorial in Leon County reported $50,217 on lobbying; NCH Healthcare System in Collier County reported spending $44,000; and Kindred Hospital in Brevard reported spending $6,000

The average reported CEO pay was $896,848 for public hospitals, $925,116 for nonprofits and $226,218 for private hospitals.

NCH North Naples Hospital in Collier County pays its CEO $912,173, Health First Holmes Regional Medical Center in Brevard pays its CEO $681,882, Parrish Medical Center in Brevard pays its CEO $522,995 and Indian River Medical Center in Indian River pays its CEO $457,771.

On Wednesday, Scott announced Florida received $1.5 billion for the state-federal match program to help pay for hospital care provided for low-income patients who can’t pay, but neither chamber has incorporated the full amount into its budget. [READ MORE]

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