Posted on 03/27/2007 3:21:50 PM PDT by Ragnar54
Certificate of need bill to start journey By Travis Fain TELEGRAPH STAFF WRITER ATLANTA - Gov. Sonny Perdue waded deep into one of the most contentious issues of this General Assembly session Thursday - what to do about the state's certificate of need program, which governs hospital expansions.
Perdue is backing a bill that would reform the process and ease requirements for surgery centers looking to offer one or a few specific types of surgery as opposed to a full range of procedures available from a hospital.
Most legislators said Thursday that they haven't yet read House Bill 568, some 90 pages long, but they're sure it will be a centerpiece of discussion as the certificate issue is reviewed.
A presentation about the bill is expected today when a special committee appointed to look at the certificate of need issue meets at 10:30 a.m. in Room 606 of the Coverdell Legislative Office Building, across the street from the Capitol.
Perdue's staff, and his floor leaders, referred to the bill Thursday as a good starting point for debate, and they stressed that the governor is more than willing to see its details change.
But the Georgia Hospital Association has already come out against the bill, denouncing it in strong language.
Still, the GHA, which represents state hospitals, has agreed to work with the governor and Legislature on the issue, which has pitted hospitals against doctors in a high-dollar and highly contentious battle over health-care regulation.
"(The governor's) analogy is he's dropping the hockey puck right in the middle (with this bill)," state Rep. Jim Cole, R-Forsyth, who is an assistant floor leader for Perdue, said after meeting with the governor on the bill. "He's going to leave it open for debate."
Dan McLagan, Perdue's communications director, called it "the best starting point for the debate on this important and complicated topic."
Under current law, hospitals need state approval to add services and to do most significant expansions. Likewise, individual doctors can't open surgery centers without the state agreeing that the new facility is needed.
The rules are complicated, and many doctors have pushed to either change them or do away with them altogether. That would foster competition and lower prices, according to the Medical Association of Georgia, which is pushing that argument at the Capitol.
Hospital officials have generally argued that surgery centers would siphon off too many paying customers, leaving hospitals in the lurch because of their mandate to provide indigent care.
"The General Assembly may choose to follow the governor on this policy," the Georgia Hospital Association said in a prepared statement Thursday. "But it needs to do so in the full and certain knowledge that it is about to let the genie of uncontrolled health care costs out of the bottle once and for all."
The Medical Association of Georgia also provided a statement, but only to say it is reviewing the bill.
State Rep. Rich Golick, R-Smyrna, who will carry the bill for the governor as his top floor leader, said the bill attempts "to strike a balance between competing priorities" as well as promote transparency and competition in the medical field.
Golick said the bill would allow single- and multi-specialty surgery centers to open without facing certificate of need requirements, but these centers would have to devote a percentage of their practice to indigent care. The percentage, he said, would vary by region.
The GHA said the bill amounts to "completely deregulating the ambulatory surgery center and imaging industries in Georgia." That would further weaken full-service hospitals already suffering because of centers that have opened under an existing exemption in state regulations, the GHA said.
Said Golick: "Everything in the bill is up for negotiation."
Whatever happens, the issue is ripe to move quickly in the coming days and weeks. Golick said he gets the "clear sense that both the House leadership and the governor are working toward a finished product (for this session)."
Likewise, state Rep. Sharon Cooper, R-Marietta, who is chairing the special committee on certificate of need, said House Speaker Glenn Richardson's mandate to her has been clear - solve the problem this year.
The governor's bill joins other bills already filed on the matter, including one to completely do away with the certificate of need program and another that would make changes in line with a study committee's recommendations.
State Rep. Jill Chambers, R-Atlanta, who is sponsoring the bill calling for a complete repeal of the certificate program, said she's "excited" about the governor's bill. She said it appears to be "somewhere between" her repeal proposal and a proposal by state Rep. Austin Scott, R-Tifton, which came out of the previous study committee.
-------------------------------------------------------------------------------- To contact Travis Fain, e-mail tfain@macontel.com or call (404) 659-8735.
The CON in its many guises is proof that bad ideas are hard to kill and REALLY bad ones seem to be immortal.
The fact that the CON concept originated in the Carter Administration should tell you all you need to know.
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