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We need healing, not double dealing

By Dr. Terry Bennett (editorial)

What is your worst nightmare as a "health care consumer"?

(We used to refer to you as a patient.)

Maybe that you would no longer have a "personal advocate" who would see to it that you got value for money spent and no chicanery?

(We used to refer to them as "private doctors.")

Or, perhaps, that the once-upon-a-time local "not for profit hospital," the one in your town, the one where you go for all your health care needs, has quietly morphed into a "for-profit" clone, which now owns all the "means of health care production," all the doctors, and all the beds, all the machines, but it is a clone that is not managed as well as a comparable for-profit center would be?

For the rest of the story, go to http://www.seacoastonline.com/.

Certificate of Need Law Under Microscope

Hospitals, surgeons square off in battle on regulating new facilities
By Dan Way -- Carolina Journal News Reports

North Carolina surgeon and physician groups are squaring off against hospitals in a regulatory reform battle with potentially hundreds of millions of taxpayer and insurance dollars at stake.

Private surgeons and physicians want to reform the state’s certificate of need law — the legal process to obtain state approval for a variety of equipment, facilities, and procedures to ensure they are not duplicative of existing situations.

The surgeons want to make it easier to establish lower-cost, single-specialty ambulatory surgery centers that markedly would reduce payments the state makes to hospitals for Medicaid patients and for state employees under the state health plan. Hospitals say specialty surgery centers will cherry-pick the insured patients hospitals need to cover the costs of treating the indigent and uninsured.

They want to eliminate hospitals’ ability to monopolize the surgery market and collect higher government-paid hospital rates at off-campus surgery centers.

"Hospitals in North Carolina have had many years of very limited competition from the few existing ambulatory surgery centers and diagnostic centers, and it's time for us to allow for competition,” said Cathy Wright, a lobbyist for the North Carolina Orthopaedic Association.

For the rest of the story, go to http://www.carolinajournal.com/.

STUDY SUPPORTS (CON) REGULATION OF HOSPITALS

by contact(s): Andy Henion, Paul Delamater, Joseph Messina

Hospital beds tend to get used because they’re available, not necessarily because they’re needed, according to a first-of-its-kind study that supports continued regulation of new hospitals.

Michigan State University researchers examined all 1.1 million admissions at Michigan’s 169 acute-care hospitals in 2010 and found a strong correlation between bed availability and use, even when accounting for myriad factors that may lead to hospitalization. These factors include nature of the ailment, health insurance coverage, access to primary care and patient mobility.

For the rest of the story, go to http://msutoday.msu.edu/.

Certificate of Need – Reform Schedule Remains Unclear

By The Editorial Team

As a follow-up to our May 31, 2012 post, the Department of Health’s Public Health and Health Planning Council (PHHPC) has yet to issue a complete schedule regarding the implementation of the recently adopted recommendations to reform New York’s Certificate of Need (CON) program.

On June 7, 2012, the PHHPC unanimously adopted a CON reform package comprised of nine separate recommendations that had been proposed earlier this year. (For more information on the original recommendations, please see our previous post available here.) Certain recommendations adopted on June 7 will require regulatory amendments to implement, which may take six months or more to complete once the process is commenced. The other recommendations – including much of the substance of the CON reform package – may be implemented immediately by the PHHPC. However, the PHHPC has yet to commence fully implementing these recommendations and it remains unclear when and how the PHHPC will proceed.

For the rest of the story, go to http://blog.harrisbeach.com/.

Governor vetoes hospital-expansion certificate program

By SARITA CHOUREY-- Savannah Morning News

Among her list of budget vetoes, Gov. Nikki Haley has axed the (South Carolina) hospital-expansion regulatory program, known as the Certificate of Need process.

The so-called CON program’s funding was a section of H. 4813, the state’s general appropriations bill for the fiscal year that began this month, which includes $6.7 billion in state money. In targeting the CON program, the governor’s veto message specifies $727,189 in total funds.

“I believe in the virtues of free markets and open competition, and for that reason, I am vetoing the Certificate of Need program, as I did last year,” Haley wrote in her veto message, which targeted 74 specific items across various agencies.

“Bureaucracy should not be telling us which community has or does not have sufficient need for a hospital or a particular piece of complex medical equipment.”

For the rest of the story, go to http://savannahnow.com/.

 

Doctors challenge Virginia's certificate-of-need requirement

by Kent Hoover, Washington Bureau Chief--The Business Journals 

Several doctors have teamed with the Institute of Justice to challenge Virginia’s requirement for medical providers to obtain a certificate of need before providing new services.

The federal lawsuit could have national implications since Virginia is one of 36 states that require medical providers to prove that their new services are needed. In theory, the certificate-of-need requirement holds down health care costs by preventing excess capacity.

In practice, however, the CON requirement simply protects the profits of existing medical providers, according to the Institute for Justice. The Arlington, Va.-based organization is a leading legal advocate for economic liberty.

“Virginia’s CON program is nothing more than the government’s permission slip to compete, amounting to a certificate of monopoly for favored established businesses,” said Robert McNamara, an attorney for the institute. “Patients and doctors -- not the government -- are in the best position to decide what medical services and equipment are needed in Virginia.”

For the rest of the story, go to http://www.bizjournals.com/.

Updated story at http://www.ama-assn.org/.

Medical facility curbs proposed in Pennsylvania

By Andrew Conte and Luis Fábregas -- TRIB LIVE (Tribune-Review)

Pennsylvania needs to fight rising health care costs by bringing back a review process to avoid adding unnecessary hospitals and medical equipment, state Sen. Jim Ferlo said on Monday.

Responding to a series of articles in the Tribune-Review, Ferlo is seeking co-sponsors for legislation that would restore the so-called certificate of need review in which health care companies are required to obtain state approval to build facilities or purchase major equipment. Pennsylvania let its certificate of need law expire in 1996 and is among 13 states without such a program.

"If there's a lot of duplication, unnecessary facilities and a lack of primary care, we all should be concerned because we're all paying for it," Ferlo, D-Highland Park, said.

U.S. hospitals borrowed $144 billion from 2008 to November through public bond issues for construction, refinancing, equipment and other expenses, the Tribune-Review's yearlong series "Code Green: Bleeding Dollars" found. The fourth installment in the series highlighted how UPMC is building a $240 million hospital in Monroeville less than a mile from Forbes Regional Hospital.

For the rest of the story, go to http://triblive.com.

North Carolina CON Committee Releases Interim Report

by RPC Consulting

The North Carolina House Select Committee on the Certificate of Need Process and Related Hospital Issues (“CON Committee”) recently released a report to the General Assembly. The CON Committee’s interim report was issued in compliance with Section 9 of their Committee Charge. The thirteen page document provides a digest of what the CON Committee covered at each of their meetings, and concludes with a page on their findings and recommendations.

The interim report calls for more “transparency and accountability” on the part of the State Health Coordinating Council in developing the State Medical Facilities Plan (SMFP), and acknowledges public concerns that the State Health Coordinating Council may have “possible conflicts of interest.” The CON Committee also recommends that exemptions to need determinations in the SMFP be “greatly limited” to ensure that all applicants are subject to the same requirements.

The interim report noted that the CON Committee heard concerns that capital expenditure limits should be adjusted for inflation, and that certain medical equipment should be exempted from CON review. While the report does not issue a recommendation on those issues, it does call for “an expedited process for appellate review in order to shorten the overall Certificate of Need determination process.”

For the rest of the story, go to http://blog.rpcconsulting.com.

Michigan House Health Policy Committee to review certificate-of-need laws

By Jay Greene--Crain's Detroit Business

The Michigan House Health Policy Committee will hold a hearing at 9 a.m. ThursdayMay 3 to discuss the state’s certificate-of-need regulatory process for approving new hospitals, medical services and equipment.

On Monday, Crain’s reported that the state Senate Health Policy Committee had planned to hold a joint hearing with the House committee.

But the chairman of the Senate health committee, Jim Marleau, R-Orion Township, told Crain’s on Tuesday that he and Rep. Gail Haines, R-Waterford Township, chair of the House health committee, decided to change the lineup of the Thursday meeting on CON.

“It seemed more appropriate to Representative Haines and I that a first step should be an opportunity for House health policy members to receive an overview from the Certificate of Need Commission,” Marleau said in a statement.

For the rest of the story, go to http://www.crainsdetroit.com.

Bill Amendment Would Allow Iowa Physician to Operate Cedar Rapids Surgery Center

by Rob Kurtz -- BECKER'S ASC REVIEW

An amendment has been added to an Iowa spending bill that would allow ophthalmologist Lee Birchansky, MD, ABES, to operate a surgery center in Cedar Rapids, according to a Des Moines Register report. 

Dr. Birchansky has been seeking a certificate of need to own and operate a surgery center since 1996. After his first CON application to build a surgery center was denied, Dr. Birchansky built surgical suites at his ophthalmology practice, Fox Eye Laser and Cosmetic Institute, and operated them through a partnership with a local hospital. That partnership ended in 2004.

For the rest of the story, go to http://www.beckersasc.com/.