Florida Record

Thursday, April 2, 2020

Weather prompts rescheduling of arguments in indigent care reimbursement case

By Kristin Danley-Greiner | Dec 2, 2016

General court 09

TALLAHASSEE -- Oral arguments will not resume until Feb. 8 in the constitutional battle over a 2003 state law requiring Sarasota County to reimburse private hospitals for providing indigent care due to the weather.

When Hurricane Matthew neared Florida, attorney Geoffrey Smith, who represents the former Venice Regional Medical Center in the case, requested a postponement of the arguments because his home was in Brevard County, which was in the hurricane’s path.

An individual at Smith’s office said the attorney lives in Melbourne, Florida, but was in Miami for depositions in another case before he was scheduled to present oral arguments in Tallahassee. Because Melbourne was under a mandatory evacuation due to the hurricane, the attorney had to return home to pack up belongings and evacuate, the individual said.

The former Venice Regional Medical Center, now known as Venice Regional Bayfront Health, along with Sarasota Doctors Hospital Inc. and Englewood Community Hospital Inc., went to the Florida Supreme Court after the 2nd District Court of Appeal ruled last year that part of the law establishing who can receive reimbursement for providing indigent care was unconstitutional. They’re seeking the same reimbursement provisions as was given to Sarasota Memorial Hospital.

The case is based originally on “obscure language” in a 1959 state law that actually would require the county to pay the three private hospitals $100 million in reimbursement for medical care they provide to the indigent. The county, however, says the provision is unconstitutional.

The 1959 law established a hospital taxing district in Sarasota County. The law states the board of county commissioners shall “in like manner reimburse any other hospital in Sarasota County, approved by the state board of health, for hospital services rendered to medically indigent persons.”  Sarasota County is the only county in the state with such a law that allows hospitals to bill a government for indigent care.


A three-judge panel with the district court of appeal sided with Sarasota County and declared the reimbursement requirement was an “improper special law,” because it singled out private hospitals in the county for payments.

Frederick J. Elbrecht, deputy county attorney, said on Oct. 12, 2012, along with the co-defendant, Sarasota County Hospital District, that the county filed a joint motion for summary judgment.

“On Oct.10, 2013, a hearing was conducted on that motion, as well as a cross-motion for summary judgment filed by the plaintiff private hospitals,” Elbrecht told the Florida Record. “Judge Bonner granted the county/hospital district’s motion for summary judgment holding that the special act is unconstitutional and cannot be enforced because it violates the Florida Constitution prohibition on special laws that grant a privilege to a private corporation. Judge Bonner also held that the unconstitutional portion of the special act was severable from the rest of the special act, which remains in force.”

Stephen E. DeMarsh, Sarasota County attorney, shared that opinion Aug. 14, 2015, that the county received a “favorable ruling.”

“We argued to the trial court that the special act was unconstitutional on several grounds, including that it provided an unconstitutional privilege to private corporations,” DeMarsh told the Florida Record.

DeMarsh also said the trial court found the special act unconstitutional but the plaintiffs appealed.

“The Second District Court of Appeal affirmed the trial court ruling, also finding the special act indigent care provision unconstitutional,” he said.

County officials believe the provision is unconstitutional, because a revision of the 1968 Florida Constitution did not contain any such language stating that governments were required to pay for indigent care. They argue that the revised constitution trumps the 1959 law. But the for-profit hospitals allege the 1959 law still applies to the situation, because it was reaffirmed in 2003 by the legislature when all laws creating special districts were readopted.


County officials do not believe the for-profit hospitals have experienced too big of a financial dent from providing indigent care. That’s because Health Management Associates, which owns Venice Regional Medical Center, reported $186 million in profits last year, according to Securities and Exchange Commission (SEC) filings. The company that owns the other two hospitals in the suit, HCA, reported $1.2 billion in profits last year, the SEC noted.


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State of FloridaFlorida Supreme CourtFlorida 2nd District Court of Appeal