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CON reform gets stuck in House panel

ATLANTA - A House committee Monday approved two narrowly focused bills that would change Georgia's law governing where hospitals and doctor-owned outpatient centers can be built.

But the panel became bogged down over a more comprehensive measure being pushed by Gov. Sonny Perdue and put off a vote until at least Wednesday.

The debate over whether to overhaul the state's Certificate of Need law has been among the most complicated and - at the same time - most emotional to wrack the General Assembly this year.

Early in the session, House Speaker Glenn Richardson, R-Hiram, appointed a special committee to concentrate solely on the flurry of CON bills being introduced.

The dispute has pitted doctors seeking the right to own and operate outpatient surgery centers without going through the cumbersome CON process against hospital officials who have warned that allowing such centers to proliferate would threaten hospitals' financial viability and, thus, reduce patients' access to health care.

"Thousands of doctors across Georgia today are able to perform the miracles they perform because ... hospitals have the resources to provide them the tools,'' said Kurt Stuenkel, CEO of Floyd Medical Center in Rome and co-chairman of a coalition of hospitals opposing major changes to the CON law.

Stuenkel addressed a rally of nearly 300 doctors, nurses and other health care workers organized by the coalition on the steps of the Capitol.

Later Monday, many packed a legislative office building to watch the special committee approve two of the three CON bills brought forward by Rep. Sharon Cooper, R-Marietta, the panel's chairman, by identical 6-3 votes.

One of the measures would set up a new category of hospitals within the CON law to allow Illinois-based Cancer Treatment Centers of America to open a small hospital for cancer patients in Georgia.

The other would declare general surgery a single specialty, a change in the law that would let general surgeons open outpatient centers without going through CON.

Most of the discussion Monday focused on the cancer center legislation, a bill supporters have pitched as an economic boon to the state that would bring in patients from out of state for the different treatment approach the company offers.

Rep. Ron Stephens, R-Garden City, the bill's sponsor, said the new category the bill would create under CON - "destination acute-care specialty hospital'' - would include requirements to prevent the planned hospital from competing with existing hospitals in Georgia.

He said the hospital would be limited to no more than 50 beds and at least 65 percent of the patients would have to be from out of state. Also, at least 3 percent of the hospital's annual adjusted gross revenue would have to go toward care for indigent patients.

"They'll lose their CON license if they don't follow this,'' Stephens said. "This is a very fair bill.''

But Rep. Judy Manning, R-Marietta, said that indigent-care guarantee compares poorly to many hospitals across the state.

"Three percent is such a pittance,'' she said. "Most of our sales taxes are more than that.''

But Stephens argued that 3 percent is adequate since the vast majority of patients with the resources to travel to the hospital from out of state would not be indigent.

The committee agreed, however, to amend the bill to ensure that all of the 3 percent commitment would go to indigent Georgians.

Both bills the committee approved on Monday are contained within Perdue's comprehensive bill.

But the committee couldn't get through the 106-page measure because members were called away to other legislative business.

"It's a complex issue,'' said Rep. Austin Scott, R-Tifton, a member of the special panel and one of the legislature's strongest advocates for reforming the CON law. "We have to make sure the language is right.''

The committee won't have much time when it resumes consideration of Perdue's bill. After today, Day 29 of the 40-day session, only one legislative day will remain for House bills to reach the floor in time to be taken up by the Senate this year.

Day 30, known as Crossover Day in the General Assembly, is set for next Tuesday, after a weeklong recess.

"I expect it to happen,'' Scott said.