J. Keith Arnold, senior principal – government relations, recently spoke to Miami Today about issues affecting the health care industry in Florida, including two bills before Florida’s legislature. One bill would increase the length of time patients would be permitted to stay in ambulatory surgical centers.

“It may seem like a small change, but the intent is very clear: to allow ambulatory surgical centers to be more hospital-like,” Arnold explains.

He adds, “If you need overnight care after surgery, it’s no longer an outpatient procedure, and that patient needs resources that must be available at a moment’s notice. We are concerned about the quality of the care that would be rendered. It’s inherently dangerous for a patient to stay overnight in anything other than a hospital in the event that patient needs nursing care or the resources that are available 24/7, 365 days a year, in a hospital.”

The other bill would create a new entity, the recovery center, for patients to stay in for 72 hours post-discharge from an ambulatory surgery or hospital.

“They are theoretically cheaper and more cost-effective than allowing the patient to remain in the hospital. Again, there are concerns with quality, and whether insurance carriers would try to dictate standards of care to them,” says Arnold of these recovery centers.

Arnold also weighed in about medical reimbursements and a plan of Florida Gov. Rick Scott to prosecute executives of hospitals as criminals if they try to charge Medicaid HMOs more than single Medicaid members.

“There are a lot of moving parts to reimbursement,” Arnold explains, adding that many hospitals, physicians and other providers refuse to accept Medicaid patients as the Medicaid program offers one of the lowest reimbursement rates for care. Medicaid HMOs have signed contracts with institutions that accept the program, which are often safety-net facilities charged with accepting all patients no matter what their ability to pay.

He adds, “The governor’s task force is looking at a variety of ways to shift the burden away from Medicaid HMOs, which they want to be fiscally viable, to safety-net hospitals.”

Read the full article – “Legislature’s bills could alter hospital surgery” (Miami Today, January 12, 2016)

Read the full article – “World of medical reimbursements becoming more complex” (Miami Today Health Update, January 14, 2016)