Florida Newspaper Investigates Lobbyist Influence in AHCA

The South Florida Sun-Sentinel investigates how the "influence of lobbyists" may have affected decisions at Florida's Agency for Health Care Administration, which is tasked with regulating the state's health care system. Ruben King-Shaw, secretary for AHCA, has been tapped to become deputy director of HCFA, where he will oversee spending for the Medicare and Medicaid programs. However, the Sun-Sentinel investigation found that King-Shaw has "dined with lobbyists dozens of times at private clubs and expensive restaurants and billed taxpayers for trips to visit projects pushed by the lobbyists." Examples of lobbyist influence at AHCA cited by the newspaper include the following:

• Larry Overton, a lobbyist who represents more than 30 health-related companies, including hospitals and HMOs, was listed for 25 meetings on King-Shaw's 1999-2000 calendar. AHCA allowed one Overton client, a chain of home health agencies, to collect Medicaid payments retroactively, even though the agency's policy states that retroactive enrollment is "prohibited."
• Missouri health care executive Sarah Grim went to the FBI last year alleging that two lobbyists told her they could "guarantee her company would win the AHCA contract to review Medicaid spending in Florida" if she paid them more than $1 million.
• Wuesthoff Memorial Hospital employed a "team of lobbyists" and secured permission to build a hospital, even though a judge ruled that AHCA should turn down the request because it "was not financially feasible." Lobbyists for the hospital included Robert Ashburn, who dined with King-Shaw for 12 of their 18 meetings, and Paul Bradshaw, husband of Gov. Jeb Bush's (R) former chief of staff.
• Lobbyists accounted for nearly 40% of the more than 1,800 people King-Shaw met with in 1998 and 1999, while AHCA staff comprised 37% and health care advocates and consumers less than 1%. More than 25% of King-Shaw's meetings with lobbyists were conducted over meals.

Legal Run-ins?
Florida law stipulates that state employees cannot accept gifts from lobbyists worth more than $100, although Bush lowered that limit to $25. Some Democrats say that King-Shaw's record creates "the perception of undue influence at the agency." Bob Poe, chair of the Florida Democratic Party, said, "It makes it look like the agency is for sale. ... This clearly violates the spirit, the intent ... of Gov. Bush's ethics policy." State House Democratic Leader Lois Frankel added, "You have to speak to lobbyists, but there is a line. You can do your job without having fancy dinners." Poe said he plans to ask Bush to investigate the agency's conduct. Bush did not comment on the issue, but a spokesperson from his office said, "There are two sides to every issue and sometimes the losing group attempts to smear or undermine the decision process. The governor is very proud of Secretary King-Shaw's leadership on health care issues and his advocacy on behalf of the people he served."

King-Shaw's Response
For his part, King-Shaw said "his agency is not beholden to lobbyists" and that all decisions are "based on the merits of each individual case." He added that his calendar, studied by the newspaper, did not "reflect a complete picture of his meetings" and said the hospital industry was "using the [newspaper] to discredit him," adding that the allegations by hospitals and the Sun-Sentinel were motivated by "racism" and were "blatantly anti-Republican" and an "attempt to disrupt [his] appointment to a federal position" (Kestin/Schulte, South Florida Sun-Sentinel, 4/29).