legislators

Federal spending bill could limit physician hospital ownership

Wed, 04 Jun 2008 06:59:57 -0400

A group of Republican Congress members are raising objections to language in a war supplemental spending bill that they say would harm physician-owned hospitals. Sens. Jon Kyl (R-AZ) and Tom Coburn (R-OK), along with Texas republican Reps. Sam Johnson and Joe Barton, object to an amendment that would prohibit new physician owned hospitals built after this coming September, while offering no protection for hospitals still under development as of that date. They're also unhappy about rules that would force hospitals to meet what they deem "extreme qualifications" to expand, rather than grow as they see fit. In a letter to the Senate Appropriations Committee, the legislators call these provisions "a national certificate-of-need program... access to [which] would likely be denied to almost every physician-owned hospital."

To learn more about the legislators' challenge to physician-owned hospital regs:
- read this Modern Healthcare piece

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Pharma gift disclosure law wins Eli Lilly support

Wed, 14 May 2008 06:59:58 -0400

While its peers appear to be firmly opposed to such rules, pharmaceutical giant Eli Lilly has decided to support federal legislation that would require drugmakers to disclose payments to doctors. Although such initiatives have floundered in the past, Lilly's support may give the new law--which would go into effect beginning March 31, 2011--a better shot at passing.

Lilly got on board with The Physician Payments Sunshine Act, as the measure is known, when legislators agreed to raise the minimum reportable payment from $25 to $500, and extended the legislation to apply to all drug and medical devicemakers rather than only those with more than $100 million in annual revenue.

Another factor that swayed Lilly is that the federal law would pre-empt similar laws currently in affect in a few states. Lilly president John Lechleiter has said that such pre-emption was important, as it would help companies like his by establishing one uniform reporting standard.

To learn more about the bill, and Lilly's position:
- read this Associated Press piece
- read Lilly's statement on the subject

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AHA wants review of blockbuster PA health plan merger

Thu, 08 May 2008 06:59:58 -0400

The planned merger between Pennsylvania health plans Highmark and Independence Blue Cross has dragged out a while now, partly because of the size of the deal. The new entity would be a giant, with $22 billion in operating revenue, making it one of the country's largest health plans. While the boards of both plans announced the merger more than a year ago, the Pennsylvania Insurance Department hasn't approved the deal and, in fact, won't even begin hearings on the deal until this summer. In the meantime, those who oppose the merger as concentrating too much bargaining power in one entity have had time to get in gear.

Now, the American Hospital Association has joined the list of challengers questioning the merger. The AHA has sent a letter to the U.S. Department of Justice asking the agency to investigate--and maybe even block--the deal between the two large health plans. The department and the FTC, both of which have the right to intercede in mergers, didn't object when the deal initially was announced. However, the two plans must refile some deal-related document since the deal hasn't closed. This gives the department's Antitrust Division another chance to review the deal. The AHA would like the department to look into possible provider rate increases and fewer health plan choices in the state.

To learn more about the merger's progress:
- read this Modern Healthcare article (reg. req.)

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Study: Self-referral fuels growth in imaging scans

Fri, 25 Apr 2008 06:59:54 -0400

A new study suggests that the outcome feared by both legislators and payers--a growth in services ordered--is coming to pass when physicians invest in imaging centers and equipment. The study, published in the current issue of MedicalCare, concludes that the number of privately-insured patients referred for imaging scans in the U.S. has grown in recent times, due primarily to self-referrals by doctors who have an interest in imaging centers or hardware. To draw this conclusion, researcher Dr. Jean Mitchell of Georgetown University reviewed data from a large private insurer collected between 2000 and 2004 and compared the analysis to a report by the Medicare Payment Advisory Commission. Both showed a growth in imaging tests, but the majority of the increase was seen in patients with private health plans offering fee-for-service reimbursement, the study found.

To learn more about the study:
- read this HealthDay News article

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RI reviews med equipment CON process

Thu, 24 Apr 2008 06:59:55 -0400

Apparently concerned that something is lacking in how the process works, a group of Rhode Island lawmakers have set up a commission to study whether state health officials are managing the CON process correctly. Right now, state law dictates that hospitals need to obtain CONs before buying high-cost medical equipment--in an effort, of course, to cut down on medical cost inflation. Apparently, legislators aren't satisfied that current legislation is getting the job done. The commission study, which will be presented in May 2009, is part of a larger effort in which the state is taking a fresh look at its entire CON approach. In so doing, Rhode Island actually is taking a less aggressive approach than several other states, some of which are dropping CON rules entirely or thinking seriously about doing so.

To learn more about the commission:
- read this Modern Healthcare article (reg. req.)

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Hospital says IA House speaker used position for retaliation

Wed, 23 Apr 2008 06:59:56 -0400

An Iowa hospital is accusing state House Speaker Pat Murphy of using his position to punish it after a labor dispute involving his wife. The facility, Dubuque-based Finley Hospital, notes that the speaker was involved in a dispute between the Service Employees International Union and management at the hospital. During the argument, Murphy urged the hospital's leaders to resign, contending that they'd engaged in unfair job terminations. Now, Finley says, Murphy has struck back, writing a bill raising Medicaid reimbursements to the state's medical providers by 1 percent--while specifically excluding Finley from the increase. While the bill has passed both houses of the state legislature, some legislators remain concerned that excluding Finley may lead CMS to reject the planned increase entirely.

To learn more about the dispute:
- read this Chicago Tribune article

Farm bill would restrict MD-owned specialty hospitals

Mon, 21 Apr 2008 06:59:58 -0400

In a piece of gamesmanship worthy of Capitol Hill, legislators behind a pending agriculture bill have slipped in a provision that would ban physician ownership of specialty hospitals. Versions of the measure already had been passed by the House and Senate without such provisions, but the ban was added during the final process of reconciling the House and Senate bills. The notion is that this would somehow help to pay the costs of the $280 million farm bill by generating some $2.4 billion in new money. (It appears that this involves some form of Medicare savings.) The AMA, of course, is hopping mad, particularly given the last-minute nature of the ban's inclusion. The AHA and the Federation of American Hospitals support the provision, not surprisingly given their consistent opposition to competition from such hospitals.

To learn more about this bill:
- read this Modern Healthcare piece (reg. req.)
- read this statement from the AMA

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NJ officials say more hospital closures are OK

Thu, 10 Apr 2008 06:59:56 -0400

Things look bad for many New Jersey hospitals. Four have closed in the last 18 months, four others are planning to close, five filed for bankruptcy protection and about half of the others are losing money. Despite the carnage in the industry, state health officials say that things are working out the way they should. State Health Commissioner Heather Howard told lawmakers that the industry can't strengthen financially until some hospitals close, a stance that seems based on similar premises as policies in neighboring New York state.

This is part of a larger shift in New Jersey politics, under which leaders now are pursuing a "sink or swim" strategy in which sick hospitals are allowed to die. Gov. Jon Corzine's proposed 14 percent cut in state hospital aid should only continue the process, completely eliminating state aid for 26 hospitals and less for 37, says the New Jersey Hospital Association.

To learn more about New Jersey's plans for its hospitals:
- read this Philadelphia Inquirer piece

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GA may approve sweeping CON changes

Wed, 02 Apr 2008 07:59:56 -0400

Georgia seems well on its way to approving a new bill that would remove most of the state's Certificate of Need restrictions. The state House of Representatives is considering a measure, championed by a few legislators, which would help general surgeons open ambulatory surgery centers. It also would let hospitals build parking decks and other non-clinical projects without state permission and lift obstetrics restrictions on some hospitals, as well as allowing more hospitals to perform heart procedures like diagnostic catheterizations. If passed, the bill would institute the biggest changes in the CON system since it was enacted more than 25 years ago.

Despite gifts to the hospital industry, some hospital officials remain in opposition. They're uncomfortable with a few facets of the bill, particularly the ambulatory surgery changes. Their lobbyists argue that the bill would give the ASCs an unfair advantage. Other hospital groups, including rural hospitals, are in favor of its passage.

To learn more about the CON changes:
- read this Atlanta Journal-Constitution piece

Related Articles:
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NYC's Cabrini to close

Mon, 17 Mar 2008 07:59:54 -0400

New York City's Cabrini Medical Center will be closing its doors earlier than expected after failing to make payroll this week. The 236-bed hospital originally was slated to close in June. "They have had trouble making payroll, and we did advise them earlier this week to begin shutting down their emergency department," said a state health department spokeswoman. The center is one of several New York City hospitals slated for closure. Exact dates haven't been given for Cabrini's closure, but the hospital already has stopped taking emergency patients

This is all part of New York's effort to shore up the ailing hospital industry by closing under-utilized hospitals, paying off the closing hospitals' debts, and assisting with re-purposing hospital real estate. Meanwhile, the state will pump money into high-tech upgrades for remaining viable hospitals.

For more on the closure:
- see this article

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