Health board may exempt outpatient surgery
Change in CON law aimed at health care costs

ATLANTA - The state agency with jurisdiction over health policy is looking to make it easier for general surgeons in Georgia to open outpatient centers.

The Department of Community Health's governing board gave preliminary approval Thursday to exempting general surgeons from a state law that regulates where medical facilities can be built.

If the proposal wins final approval following a public hearing, general surgery would be declared a single specialty in Georgia.

Under a 1991 exemption to the state's Certificate of Need law, single specialty physicians are allowed to own and operate outpatient centers without state approval.

"Patients are really the winners today," Kathy Browning, executive director of the Georgia Society for General Surgeons, said following Thursday's unanimous vote.

"Patients of general surgeons will have options they don't have now to get high-quality health care for lower cost at outpatient surgery centers."

General surgeons lobbied hard during this year's legislative session for the exemption as part of a broader overhaul of the CON law.

But a massive bill introduced on behalf of Gov. Sonny Perdue was shelved amid intense opposition from hospital administrators worried that an influx of freestanding surgery centers would lure away their paying patients, leaving them to serve higher concentrations of poor and uninsured.

While federal law requires hospitals to treat patients regardless of ability to pay, physician-operated health care facilities face no such mandates.

Last June, after the General Assembly had adjourned for the year, the Board of Community Health voted to ask lawmakers to reconsider an exemption for general surgeons during the 2008 session.

But on Thursday, Department of Community Health Commissioner Rhonda Medows said the agency decided to move forward and pursue the change administratively to be fair to general surgeons.

"We're leveling the playing field between general surgeons and other surgical specialties," she said.

But hospital officials question whether the DCH board has the legal authority to change the CON law administratively.

During the June meeting, a senior assistant attorney general warned board members that such an attempt could result in a lawsuit.

"It's pretty odd to us that the Department of Community Health would act contrary to their own attorney general," said Kevin Bloye, spokesman for the Georgia Hospital Association.

But Medows said the DCH is within its legal rights to consider an exemption for general surgeons.

A public hearing will be held on the proposal on Nov. 28.

"I expect a lot of feedback from hospitals," Medows said. "I expect the public hearing to be very well attended."