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Governor enters hospital regulation debate

ATLANTA - Gov. Sonny Perdue has waded into one of the most controversial issues facing the legislature this year with a bill making it easier for doctors to open surgical centers that would compete with hospitals.

Comprehensive Legislation introduced into the House on Thursday on the governor's behalf is expected to emerge as the key measure among a flurry of bills aimed at overhauling the law governing where hospitals and other health care facilities can be built in Georgia.

"We're going to send a very clear message that the debate needs to move forward,'' said Rep. Rich Golick, R-Smyrna, Perdue's floor leader in the House and the bill's chief sponsor.

The governor's bill takes middle ground on an issue that has been percolating since Perdue created a study commission more than two years ago to review Georgia's Certificate of Need law, which requires applicants to demonstrate there's a need for the new medical facilities or health services they wish to provide in a community.

Perdue's bill goes farther than legislation introduced by Sen. Don Balfour, R-Snellville, which would stick to changes in the law recommended unanimously by the commission.

However, it stops short of repealing the law, a solution offered in a House bill sponsored by Rep. Jill Chambers, R-Atlanta.

At the heart of the bill is a provision that would allow doctors to open freestanding outpatient surgery and radiology centers without seeking approval under the CON law, a lengthy, cumbersome process.

In return, physician entrepreneurs would be required to pay "civic rent'' by serving patients enrolled in Medicaid or PeachCare for Kids as well as uninsured patients.

"We want to encourage competition ... with the moral imperative of making sure the indigent care issue is addressed,'' Golick said.

But Kevin Bloye, spokesman for the Georgia Hospital Association, said the bill's indigent care commitments wouldn't be substantial enough to prevent the damage a sudden proliferation of freestanding health centers would do to hospitals.

A coalition of hospitals formed to oppose overhauling the CON law argues that physician-owned facilities would siphon off paying patients from hospitals, which by law must serve anyone who walks in regardless of ability to pay.

"The administration has to understand that deregulating imaging and ambulatory surgery centers will drive up overall health care spending in this state while diverting vital profitable revenues that hospitals need to sustain emergency rooms, trauma services and other high-cost services,'' Bloye said in a prepared statement on behalf of the Save Georgia Healthcare Coalition.

"It goes far beyond the ... recommendations of the CON Study Commission.''

Also folded into Perdue's bill is a provision incorporating separate legislation pending in the House and Senate that would allow an Illinois-based company to open a small cancer treatment center in Georgia.

The bill's sponsors have testified in committee hearings that Cancer Treatment Centers of America would bring in mostly out-of-state patients seeking a form of holistic treatment the company offers.

To alleviate existing hospitals' concerns about competition, the original bills would require that 65 percent of the patients come from outside of Georgia. Perdue's bill increases that requirement to 75 percent.

Perdue spokesman Dan McLagan said the governor expects the bill to undergo changes as it makes its way through the legislative process, starting with a special House committee formed to consider only CON-related bills.

"We believe this is the appropriate starting point for the discussion of this important and complicated issue,'' McLagan said.