By Mike Shields
KHI News Service
TOPEKA, March 15
The Senate Public Health and Welfare Committee will return Wednesday to discussion of a House bill that has specialty and general hospitals feuding over proposed new licensing definitions.
After hearing testimony from those for and against House Bill 2418, Sen. Jim Barnett, R-Emporia, the committee chairman, announced work on the proposed legislation would resume next week.
Last month, the House passed the bill, 109-12, after accepting an amendment offered by House Health and Human Services Committee Chairman Brenda Landwehr, R-Wichita. The amendment, intended to neutralize some specialty hospital opposition, allowed extension of current general hospital licenses until the end of 2009, under certain circumstances.
The bill was originally sought by the Kansas Hospital Association, which said it was time to update the state”s licensing definitions so that distinctions were made between general and specialty hospitals. There has been friction between the two industry segments over the definition issue for about three years, stemming from the fact that they compete with one another. The current bill, though relatively innocuous, has specialty hospitals worried it would set the stage for later legislation that could bring them financial harm.
Kansas has seen fast growth of specialty hospitals, which often are doctor-owned. Their critics say they “cherry pick” more profitable patients from the general hospitals. They typically do less free and Medicaid care than general hospitals.
“Currently there are medical care facilities that want to enjoy the privileges of general hospitals, but don”t want to incur the costs that accompany the responsibilities,” HCA-Wesley Chief Operating Officer Sam Serrill, testified to the committee. “These facilities selectively admit patients based on acuity and insurance type, cherry-picking the most profitable patients and services.”
But supporters say the specialty hospitals bring innovation and provide better treatment for the conditions in which they specialize.
Gregory Duick, chairman of Kansas Heart Hospital, a Wichita hospital that specializes in treating cardiac patients from across the state, said “we”re rated number one in cardiovascular services in Kansas.”
He said patients were funneled to his hospital from emergency rooms across Kansas by doctors seeking the best treatment for them.
“Kansas is our emergency room,” he said. “We are the treatment center.”
Duick said in his view HB 2418 was “very good for big hospitals and very bad for small, rural hospitals.”
HB 2418 would require the following for a hospital to be licensed as general:
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A dedicated emergency room and 24-hour emergency services.
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Participation in the statewide trauma system and any applicable plan for delivering emergency services in its region.
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Participation in the Kansas Medicaid plan
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Be focused on providing in-patient care.
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The bill also specifically targets hospitals that specialize in orthopedic or cardiac care and sets percentages aimed at excluding them from the general hospital definition.
Next week the committee is expected to hear neutral testimony from Joe Kroll of the Kansas Department of Health and Environment and Sheldon Weisgrau, a senior analyst with the Kansas Health Institute who authored a recent report on specialty hospitals.
Also next week, the Kansas Health Policy Authority board has been reviewing the hospital definition issue and is expected to have its recommendations ready for the Legislature.
-Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
mshields@khi.org
or at 785-233-5443, ext. 123.