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Legal Aliens' Hospital Stays Likely To Be Trimmed Back

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By CATHERINE DOLINSKI, The Tampa Tribune

Published: October 10, 2007

TALLAHASSEE - State lawmakers are cutting back on hospital care for poor, legal, noncitizen residents but agreed this week to give hospitals a little more help deciding how long those patients can stay.

The House and Senate have resolved to scale back Medicaid coverage of inpatient hospital treatment for those legal residents to the point at which those patients are 'stabilized.' That, as House Speaker Marco Rubio has explained, is the point at which the federal Medicaid program stops paying its share of a resident alien's hospital bills. There is no such federal limit on Medicaid payments for care of U.S. citizens.

Florida has spent state money to treat such patients more comprehensively. Dropping back to the federal minimum amounts to a $14 million state spending cut. Hospitals and advocates for immigrants have warned that the plan could endanger patients' health, make it more likely they would have to return for more care and increase the rate of uncompensated care.

'We're going to pay for people with health conditions, one way or the other,' said Karen Woodall, a lobbyist on health care and immigration issues. 'I continue not to understand this setting up of different criteria for treating people based on their immigration status, when in fact they're in the country legally.'

The budget proposal that state lawmakers released on Tuesday broadens the definition of 'stabilization' to include, at a minimum:

•Any days when a patient is in the intensive care unit
•The length of stay that doctors believe is necessary to prevent 'emergent readmission within 48 hours.'

'This is really a national policy question that ought to be answered,' said Durell Peaden, R-Crestview, who chairs the Senate Health and Human Services Appropriations committee.

The additional guidance from lawmakers will help, said Jan Gorrie, a Tampa-based lobbyist for the Safety Net Hospital Alliance of Florida. Several hospitals in the Tampa Bay area also will benefit from lawmakers' agreement to scale back cuts to Medicaid payment rates. The budget plan reduces payments to most hospitals by 3 percent, but by only 1 percent for those designated as trauma centers.

Such hospitals, which include Tampa General, All Children's, St. Josephs and Bayfront, tend to treat disproportionate numbers of Medicaid and uninsured patients.

Lawmakers also have decided against budget language that would have denied about 90 hospitals a court-ordered reimbursement of $37 million for overpaid taxes.

The proposed budget is scheduled for a final vote on Friday.

Reporter Catherine Dolinski can be reached at (850) 222-8382 or cdolinski@tampatrib.com.

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