Panel reviewing health care law divided

ATHENS - A state commission reviewing Georgia's law regulating where hospitals and other health care facilities can be built will make several dozen recommendations for change, the panel's chairman said Tuesday.

But the commission's diverse membership couldn't agree on the crux of a dispute dividing doctors and hospital administrators: how to create a more competitive health care environment that will reduce costs without putting some hospitals out of business.

"We've got honest differences of opinion on the best way to address the problem,'' Dr. Daniel Rahn, president of the Medical College of Georgia, said during the final day of a three-day conference for new and returning legislators at the University of Georgia.

After more than a year of work, the commission will present a 200-page report to the General Assembly in time for the start of the 2007 legislative session next month.

Rahn said the panel of doctors, state health officials, hospital administrators and physicians will make 52 recommendations for updating Georgia's 27-year-old Certificate of Need Law.

The 42 that were adopted by the commission unanimously primarily suggest changes in the process the state uses to approve or deny applications to build or expand health care facilities or offer new or modified health services.

The list includes streamlining the appeals procedure for applicants who are denied a CON and exempting more projects from having to go through CON by increasing the capital spending threshold of projects that come under the law from $1.5 million to $1.75 million.

Rahn said the commission was able to settle one potentially sticky issue when it agreed to keep radiation therapy services under the CON law.

Hospital administrators had been worried that a host of new freestanding imaging centers not subject to the law could spring up across the state, siphoning off a profitable service they use to help balance their bottom lines.

But the commission also voted 5-3 to loosen the CON requirements for single-specialty outpatient surgery centers run by doctors, one of the biggest fears of hospital officials.

Hospital administrators say such facilities "cherry pick'' paying patients because they are not required by law to serve the indigent. Without enough paying patients to offset the costs of treating the uninsured, the argument goes, hospitals can run into financial trouble.

Sen. Don Balfour, R-Snellville, a member of the commission, said the threat is particularly serious to rural hospitals, and he urged his legislative colleagues to move cautiously in considering changes to the CON law.

"In rural Georgia, we can make a tweak or change and it could close a hospital,'' he said.

But Rep. Austin Scott, R-Tifton, also a member of the panel, pointed out that the commission's recommendation on outpatient surgery centers stipulates that they should be required to provide a certain level of charity care.

He said a less restrictive CON law would curb the price of health care by fostering competition.

"The current cost of health care is not sustainable,'' Scott said. "Some free-market (changes) will work to reduce costs.''

Rahn told the roomful of lawmakers that they ought to subject any proposed changes to the CON law to a litmus test. He urged them not to vote for any legislation that doesn't help reduce the number of uninsured, curb the growth in insurance costs, promote new medical technologies or stabilize the health care safety net.