Legislature gives final OK to hospital fee transfer

The state House overwhelmingly passed legislation Friday that would ease renewal of the hospital provider fee, almost certainly preventing a net budget hole in Medicaid of close to $500 million.

Now the bill, which hurtled through the General Assembly, goes to Gov. Nathan Deal for his signature. That could happen very quickly as well.

The GOP-backed legislation, which passed on a 147-18 vote, would transfer decisions on the assessment from the Legislature to the state’s Medicaid agency, the Department of Community Health. The current assessment is due to expire at the end of June.

Passage of Senate Bill 24 allowed for renewal of the fee without requiring Republican legislators to vote directly to renew it. The fee is unpopular with anti-tax activists, who normally have close ties to the GOP, which controls both houses of the General Assembly.

Rep. Brian Thomas (D-Lilburn) cited what he called legislative sidestepping in the 45-minute floor discussion Friday on the bill, saying, “I’m concerned we’re doing some ducking and dodging.’’

Nevertheless, Thomas said he would vote for the bill.

Supporters such as Majority Leader Larry O’Neal (R-Bonaire) noted that Community Health already has authority over another provider fee, one for nursing homes.

Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human Services Committee, said after the vote that legislators ‘‘had no choice’’ but to pass the legislation.

If legislators had not allowed the fee to be preserved, she told GHN, either Medicaid providers would have taken drastic pay cuts, or the General Assembly would have been forced to remove hundreds of millions of dollars from education, public safety and other programs.

The anti-tax activists, including the nationally known Grover Norquist, had urged legislators to abolish the fee, which many of them call a “bed tax.’’

But the hospital industry, unified in its concern about losing the fee, worked hard in support of the bill, running a strong grass-roots campaign to persuade legislators.

Hospital industry officials were clearly elated after the vote. “It’s a tremendous victory for the patients of Georgia,’’ said Earl Rogers of the Georgia Hospital Association. “Governor Deal worked diligently on this, as did House and Senate leadership.”

Jimmy Lewis of HomeTown Health said defeat of the bill could have led to the closing of more than 20 rural hospitals. “That would affect all patients, not just Medicaid.’’

Matthew Hicks of Grady Health System in Atlanta said not passing the bill would have meant Grady taking a $36 million hit.

And Julie Windom of the Georgia Alliance of Community Hospitals credited the unity of the hospital industry as a key factor in passage of the bill. She said Deal could sign the bill as early as Monday or Tuesday.

Rep. Terry England (R-Auburn), chairman of the House Appropriations Committee, said on the floor that Medicaid currently pays medical providers only 85 cents on the dollar.

If the bill didn’t pass, he said, the only other option to fill the huge Medicaid deficit would be to further lower those pay rates, causing a devastating effect in rural communities where “hospitals are economic engines.’’

Not passing the bill would have had a devastating impact on urban safety-net hospitals such as Grady, said Rep. Ed Lindsey (R-Atlanta).

Once the bill becomes law, the fee assessment still will have to be approved by the board of the Department of Community Health, who are appointees of the governor. The Community Health board is likely to take up the issue at its meeting this month.

There will be two parts for them to approve. One is a continuation of the current fee, and the second aims to draw down federal money for private hospitals. The latter would help smooth out the losses for organizations such as Piedmont Healthcare and Northside Hospital, which are net losers under the current fee formula.