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Bill would raise trauma center fund

March 29, 2006|by TAMELA BAKER

ANNAPOLIS

Four years ago, action by Western Maryland doctors convinced state officials to pay trauma physicians for uncompensated or undercompensated care when the trauma center at Washington County Hospital shut down for four months.

Now, legislation to expand the subsidy program for trauma centers appears to be on its way to passage.

The bill approved unanimously by the House is now under consideration in the Senate, where a companion bill has been sponsored by Senate Finance Committee Chairman Thomas M. Middleton.

It expands coverage to some specialties not covered in the original law and adds more facilities to the Maryland Trauma Physicians Services Fund.

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Washington County Hospital's trauma center closed for four months in the summer of 2002. Trauma surgeons were not fully reimbursed for care given to uninsured or underinsured patients. After the retirement of two neurosurgeons limited the pool of available surgeons to three, the remaining doctors found it difficult to fill the coverage gap.

To reopen the trauma center, the hospital negotiated new contracts with the physicians and downgraded from a Level II to a Level III center, allowing doctors to be on call rather than at the hospital around the clock.

When the General Assembly reconvened in January 2003, Del. John P. Donoghue, D-Washington, and House Speaker Michael E. Busch helped push legislation that resulted in the Maryland Trauma Physicians Services Fund to compensate physicians for trauma services.

But it didn't include every specialty involved in trauma care. The new bill is a step in expanding services eligible for compensation.

The bill increases reimbursement rates from up to 20 percent to up to 30 percent of reasonable costs for a Level II trauma center and repeals the cap on annual reimbursements from the fund to emergency physicians.

The bill stipulates that at Level II facilities, trauma surgeons, orthopedic surgeons and neurosurgeons on call are eligible for reimbursement.

Donoghue initially cosponsored the bill with lead sponsor Del. David Rudolph, D-Harford/Cecil. Since the bill was filed, it has won the sponsorship of the entire House Health and Government Operations Committee.

The fund was established by the 2003 General Assembly with money from the vehicle registration fee. Since then, the fund has grown enough to include all the physicians involved in trauma care, Donoghue said.

The Washington County Hospital Association and The Johns Hopkins Institutions have endorsed the bill.

In her letter supporting the bill, Deborah A. Samuels, vice president for patient care services, said the hospital treated 957 trauma cases during its 2005 business year.

"The trauma bill's a big deal," Karl Riggle, chief of surgery at Washington County Hospital, said last week. "The services not being supported are at risk" if the bill doesn't pass, he said.

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