Monday, July 27, 2009

BayCare sues Pinellas Sheriff Jim Coats for inmates' care costs

By David DeCamp, Times Staff Writer

Published Wednesday, May 20, 2009

CLEARWATER — Four local hospitals claim Pinellas County Sheriff Jim Coats has shortchanged them when they care for jail inmates.

The hospitals, part of the BayCare Health Systems network, are suing Coats and the County Commission for at least $807,000, plus unspecified interest, for the care of 161 uninsured inmates since May 2005.

The Sheriff's Office paid for detainees' medical care based on rates under Medicaid, the federal health care program for the needy. However, those rates are much less than the hospitals' standard charges.

The hospitals — St. Anthony's in St. Petersburg, Morton Plant in Clearwater, Mease Countryside in Safety Harbor and Mease Dunedin — want the difference.

"We do a lot of charity cases," BayCare spokeswoman Amy Lovett said. "The difference with the Pinellas County sheriff's department is once someone is an inmate or detainee, they have a responsibility for the care of the inmates."

Not so, said Chief Deputy Robert Gualtieri. The hospitals, he said, failed to show they could not collect money from detainees or insurers. And inmates have the responsibility to pay their bills.

Besides, paying the full charge for inmates' medical care would blow up the sheriff's budget, Gualtieri said. Those charges would be 80 to 85 percent higher — rates well above what insured people normally pay. Gualtieri also suggested the hospitals might have overbilled the sheriff, based on Medicaid rates and the time detainees were under the sheriff's control.

The agency is responsible for care only when people are in custody. Any care after that point, the patient or insurer is responsible.

"We don't owe them anything," Gualtieri said. "Actually, you could have a situation, based on statutes and other things, they really are owing us money. We may have overpaid them."

In a time of rising health care costs, a similar fight has broken out in at least a few other Florida counties, such as St. Lucie, where hospitals want to be paid and sheriffs face tighter budgets. But payment standards vary.

Pasco County has agreements to use Medicaid rates in some hospitals and negotiates payment in others, sheriff's spokesman Kevin Doll said. Orange County has contracts with hospitals for rates similar to Medicaid, though the Medicaid rates aren't actually used.

Hillsborough and other large counties did not immediately respond to requests for comment Wednesday.

A bill by state Rep. Ed Hooper, R-Clearwater, that would cap the fees hospitals could collect from sheriffs at Medicaid levels never got off the ground in the Legislature this spring. But he intends to file it next year.

"I was trying to look out for us the taxpayer, not so much the bottom line of the hospital or anything else," Hooper said, echoing the Sheriff's Office.

The Pinellas Sheriff's Office treats some inmates at its jail complex, but has to send others to hospitals.

The sheriff and the hospitals never struck a formal contract, leading to the legal fight after years of inmates receiving hospital care. The Sheriff's Office also has a contract to pay Medicaid rates at Bayfront Medical Center in St. Petersburg.

BayCare officials also learned Northside Hospital — another provider for the sheriff — had been reimbursed at rates higher than Medicaid's. That is no longer the case, Gualtieri said.

The Sheriff's Office cited its authority as a law enforcement agency to reimburse at lower levels, the lawsuit says.

"As a matter of law, the PCSO's position was inaccurate at best," the suit says, calling the rationale a "legal fiction."

County Attorney Jim Bennett declined to comment because he had not seen the lawsuit. The County Commission oversees the sheriff's budget.

David DeCamp can be reached at or (727) 445-4167.

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