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Bill would increase access to trauma fund

February 14, 2009|By ERIN CUNNINGHAM

ANNAPOLIS -- Some physicians who treat trauma patients at Washington County Hospital are not being paid for all of the services they provide, but legislation being considered by the Maryland General Assembly would help some doctors recoup money.

The bill introduced by Del. John P. Donoghue, D-Washington, also would add Washington County to the hospitals that have access to money in the state's trauma fund to help pay for trauma doctors to be on call.

Raymond Grahe, vice president of finance at Washington County Hospital, said Tuesday the hospital currently subsidizes about $1 million of those on-call costs.

While Grahe said he had not seen Donoghue's bill, he has seen a bill that was cross-filed in the Senate by Sen. George C. Edwards, R-Garrett/Allegany/Washington.

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Both bills would create increased access to the state trauma fund for three Maryland hospitals, including Washington County Hospital, and some doctors.

The state's trauma fund is sustained by the fees that all Maryland motorists are charged when they receive and renew their driver's licenses.

Some physicians, including orthopedic surgeons and neurosurgeons, currently have access to the fund. Under the bills proposed by Donoghue and Edwards, the definition of a trauma doctor would expand to include any physician who treats a trauma patient.

That would include plastic surgeons and doctors from other specialties who currently do not have access to those funds.

Donoghue said a Jan. 19 50-car pileup on Interstate 70 demonstrated the need for such legislation. He said it's likely some of the trauma doctors who treated patients will not be paid because patients don't have insurance and for other reasons. Donoghue said many ambulances took patients to Washington County Hospital from the crash, and some of those patients needed trauma care.

"There definitely is a problem, and we need to correct the reimbursement for physicians, especially in the rural areas ... or we're going to lose physicians," Donoghue said.

Grahe said he did not know if doctors were paid appropriately for the I-70 crash. He said the bill would allow them access to the trauma fund if they were not compensated.

Washington County Hospital physicians are not employees of the hospital. They are independent contractors, Grahe said, but the hospital pays them to be on call. Doctors then bill for the services rendered to the patient for surgeries and other care.

"That way, they can access the fund for the amount that they don't receive from the patient, and then the hospital gets reimbursed for the amount they pay (the physicians) to be on call," Grahe said. "The concept is that when they're on call, they can't do anything else. They have to be ready to meet the patient at the door."

Physicians and the hospital submit requests to the trauma fund about every six months. Eligible physicians are paid for unpaid services, and the hospital recoups a certain percentage of what it spent to pay physicians to be on call.

Donoghue said he is concerned about attracting quality doctors to Washington County and making it possible for them to stay. Donoghue said it can be difficult for doctors who have medical school bills and other expenses if they are not paid for some of their work.

"It's hard for them to stay afloat if they're basically treating people for nothing," he said.

Grahe said the hospital currently subsidizes about $1 million to pay doctors to be on call to treat trauma patients. He's hoping to recoup the same amount through the proposed bill.

"Yeah, but we're not going to get a million," he said. "The trauma fund doesn't have enough."

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