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Hospital ER Legal Fight To Cost State

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The state Agency for Health Care Administration last month dropped an appeal in a long-running legal fight about payments to hospitals that provide emergency services to undocumented immigrants.

But an appeals court Wednesday ordered AHCA to pay the legal fees of a coalition of hospitals that have battled the agency for more than two years about the emergency-services issue.

The state's Medicaid program pays hospitals for emergency care provided to undocumented immigrants, but the case focused on the extent of services that should be covered.

In the past, payments were made when emergency services were considered "medically necessary." But in 2010, AHCA began using a more-restrictive standard that said payments would be made until patients are "stabilized." Hospitals filed a challenge, and an administrative law judge ruled in December 2012 that AHCA made the changes without following the required rule-making process.

AHCA took the case to the 1st District Court of Appeal but filed a motion last month to dismiss the challenge, after oral arguments were held in May. A three-judge panel of the appeals court Wednesday approved the dismissal but said, in part, AHCA "may not avoid its obligation to pay appellees' (the hospitals') reasonable appellate attorney’s fees by filing this belated notice of voluntarily dismissal."

It sent the case back to an administrative law judge to determine the amount of fees if the two sides cannot reach an agreement.

Meanwhile, the legal wrangling over the rules for paying hospitals to treat undocumented immigrants also might not be finished. The hospitals filed a document in the state Division of Administrative Hearings this week alleging that AHCA has not properly carried out the administrative law judge's 2012 order.

Ruling Goes Against Delaware In Dupont Trust Case

A Florida appeals court Wednesday rejected an attempt by the Delaware attorney general to intervene in a decade-old case involving a trust established after the death of industrialist Alfred I duPont to help pay for children's health care.

DuPont was a Duval County resident at the time of his death in 1935, and the trust funded the Nemours Foundation, which provides pediatric health care. Though the trust was administered in Florida, it included stipulations about providing care to Delaware residents, according to Wednesday's ruling.

Delaware Attorney General Beau Biden filed a motion last year to intervene in a case that, through a 2004 court judgment, made changes in criteria for services. Among other things, the judgment lowered an age limit from 21 to 18 and also expanded the trust's purpose to include preventative care for beneficiaries.

A divided three-judge panel of the 1st District Court of Appeal on Wednesday rejected Biden's attempt to intervene, saying he did not show his involvement was needed.

"Most importantly, the Delaware attorney general failed to show that his intervention was necessary to protect the interests of Delaware’s beneficiaries with regard to the 2004 judgment,'' said the majority opinion, written by appeals-court Judge Lori Rowe and joined by Judge Simone Marstiller. "Not only did the judgment expand benefits to Delaware beneficiaries to include over $111 million in preventative care services, but the interests of the Delaware beneficiaries were adequately represented in the 2004 proceedings."

But Judge Ronald Swanson dissented, pointing to a previous Delaware attorney general's involvement in a 1980 settlement agreement about the trust. Swanson wrote that the 1980 agreement made clear the attorney general represents the Delaware beneficiaries of the trust. He wrote that the state's attorney general had not been made a party to the case that led to the 2004 judgment.

Marijuana Foes Draw Comparisons to Colorado

With a battle building over a proposed constitutional amendment to legalize medical marijuana, a coalition of opponents held a news conference Wednesday to warn that the measure is worded too broadly.

The coalition, known as "Don't Let Florida Go to Pot," argued that the proposed constitutional amendment could be a step toward legalized recreational use of marijuana in the state. The news conference also included an anti-marijuana activist from Colorado, which allows recreational marijuana use.

"Let’s not kid ourselves,'' said Calvina Fay, executive director of the Drug Free America Foundation, which is part of the coalition. "This amendment that we are facing is in fact de facto legalization. It’s not just the legalization of the use of marijuana, and someone smoking pot in their bedroom. It’s a big marijuana industry that will be legalized if it passes."

Supporters of the proposed constitutional amendment, which will appear on the November ballot as Amendment 2, dispute the opponents' characterizations. They argue doctors should be able to recommend medical marijuana, if appropriate, in treating patients for diseases such as cancer.

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