Subscribe to The Pulse


Standalone rural ERs face a serious hurdle

Gov. Nathan Deal’s plan to help financially ailing rural hospitals, announced last month, has drawn strong praise from legislators and health industry leaders.

DCH Commissioner Clyde Reese

Clyde Reese

Deal proposed a change in licensing rules to permit a struggling rural hospital, or one that recently closed, to offer downsized services that would include an emergency department.

But a drawback has emerged – one that, if unchanged, may lower the chances of these freestanding ERs being built.

Such facilities, as proposed, would not be able to bill Medicare or Medicaid at the current hospital rates, but would have to bill those programs at a lower “provider’’ rate.

Clyde Reese, commissioner of the Department of Community Health, told GHN on Tuesday that it may take legislation, or regulatory approval from federal health officials, to create a format so these freestanding rural facilities would draw higher reimbursements than is now possible. full story

FTC seeks more time on Phoebe decision

The Federal Trade Commission on Monday requested 60 days beyond a previous deadline to decide whether to sign off on its 2013 antitrust settlement with an Albany hospital system.

Monday was the FTC’s deadline to finalize the agreement with Phoebe Putney Health System. But in a filing in U.S. District Court, the agency asked the court for more time.

In the filing, the FTC asked the court to give it until June 13 — or until 30 days after a state agency determines whether a potential divestiture of the Albany hospital that Phoebe Putney acquired in 2011 would require regulatory approval — whichever date is earlier.

The state agency’s decision could be pivotal to whether the FTC goes through with the settlement or resumes its legal battle in the high-profile antitrust case. full story

Key part of hospital provider fee still unresolved

Last year, a bill that would renew a financing mechanism for the state’s Medicaid program hurtled irresistibly through the Georgia General Assembly. Gov. Nathan Deal signed it into law almost as soon as it was passed.

The high priority the measure received was easy to understand. The funding mechanism, known as the hospital provider fee — called by opponents a “bed tax’’ — was designed to fill a nearly $500 million hole in the state’s Medicaid program.

smslogoThe main part of the provider fee was eventually approved by the feds last year.

But a second part of that provider fee, aimed at helping hospitals that were financial “losers’’ under the original distribution formula, has still not been approved by the U.S. Centers for Medicare and Medicaid Services (CMS).

Talks have gone on between the state and CMS since the fall of 2012 over what’s called “Tier II.” It’s designed to even out the losses for organizations such as Piedmont Healthcare and Northside Hospital, two large health care systems.

At stake is about $30 million in federal money for hospitals, according to the Department of Community Health, which runs Medicaid in the state. full story

FTC may revive Phoebe fight, seeks state guidance

Georgia’s high-profile hospital antitrust saga may not be over after all.

The Federal Trade Commission is asking a state agency whether a potential divestiture of the Albany hospital that Phoebe Putney acquired in 2011 would require certificate-of-need regulatory approval.

Phoebe Putney Memorial Hospital

Phoebe Putney Memorial Hospital

Last August, the FTC and Phoebe Putney Health System announced they were settling the agency’s long-running antitrust suit over the hospital acquisition, and that the deal would allow Phoebe to keep control of the former Palmyra Medical Center.

But that deal has not yet been finalized. And the FTC, in a letter Monday to the Georgia Department of Community Health, indicated that the legal opinion by state officials may make a difference in whether it goes through with the settlement.

The letter noted that the FTC gave preliminary agreement to the settlement based on its understanding that the state’s certificate-of-need (CON) laws — which limit the number of health care facilities in the state — would prevent a breakup of the merged hospitals.

But now the possibility of undoing the merger appears to be more than hypothetical. A potential buyer for the former Palmyra has come forward, the FTC letter said. full story

‘Navigator’ sees rising interest in ACA enrollment

For the past several months, a normal Wednesday for Kimberly Jenkins has meant meeting with four to six people wanting to know about Affordable Care Act coverage.

But as the enrollment deadline draws near, as many as 30 people a day are contacting Jenkins, seeking her help with insurance applications. She is what’s known as a health insurance “navigator” and is assigned to Wilkes and 11 other rural counties in northeast Georgia.

“People like to wait until the last minute,” said Jenkins.

YouTube Preview ImageThat “last minute” will come a bit later than many expected. The deadline had been March 31, but federal officials have extended it at least a couple of weeks into April for those who have had problems with enrolling on, the federal website being used in Georgia and 35 other states.

Administration officials said Wednesday that the surge in applications ahead of next week’s deadline to sign up for coverage had led to high traffic on the federal website. They say the application surge could keep consumers from completing enrollment before the deadline at 11:59 p.m. Monday.

Jenkins believes the new flexibility will give people a much-needed chance to finish their enrollment. “The extension will give us more time to do exactly what we were hired to do,” she says.

And the enrollment surge could help a local hospital that is financially struggling.

full story

  • Sign up for our mailing list.