Community Health board rejects loosening rules on surgery centers

A proposal to loosen Georgia rules on multispecialty surgery centers went nowhere in this year’s General Assembly session.

The quest for such a change shifted on Thursday to a new venue – the state’s main health care agency.

But the board of the state Department of Community Health, on a 6-2 vote, rejected “initial adoption’’ of a proposal to ease rules on multispecialty surgery centers. That vote blocked the proposal from getting a public hearing, which would have preceded a potential final adoption.

The idea of exempting multispecialty surgery centers from the state’s complex licensing laws, known as certificate of need (CON), is not new. Single-specialty surgery centers, such as those limited to orthopedic operations, already have an exemption.


State Sen. Ben Watson, a Savannah physician, pushed a proposal in the Legislature this year to extend the exemption to multispecialty centers. But the legislation drew ferocious opposition from the hospital industry in Georgia, and never got traction.

Hospitals see this surgery as one of the few profitable services they offer, and say they need it to offset losses from trauma care and other money-losing services.

Physicians such as Watson have argued that allowing the multispecialty centers a CON exemption would offer more choice to patients and lower health care costs for insurers, patients and employers.

CON, which grants licenses for construction of health care facilities and expansions of services, has long been a contentious apparatus. Almost annually, state legislators have wrangled over bills to alter the program, and such efforts are generally unsuccessful.

The Georgia Alliance of Community Hospitals argued against the multispecialty surgery center rule change, and sent a letter to Community Health board’s chairman, Norm Boyd, dated Thursday, noting that the Legislature has “repeatedly rejected several efforts’’ to exempt the facilities from CON.

The president of the hospital group, Monty Veazey, also said in the letter that the proposed rule “conflicts with controlling decisions of the Georgia Supreme Court, which preclude an agency from usurping the jurisdiction of the Legislature through rulemaking.”

And Veazey said the proliferation of such multispecialty surgery centers ‘’would likely have a devastating impact on the financial viability of many Georgia hospitals.”

Board members at Thursday’s meeting questioned whether they even had legal authority to make the change.

One member, Russ Childers, asked after the vote whether the agency could seek an opinion on the legality question from the state attorney general. Boyd said he is neither for or against the surgery center proposal itself, but believes a legal opinion is needed before the agency devotes time and resources to the issue.

Andrew Johnson, deputy commissioner of Community Health, said the agency had not obtained a legal opinion before making the rule change proposal.

Community Health’s goal in raising the multispecialty center proposal was ‘‘to bring this idea into a public forum,’’ Johnson told the board

A  spokeswoman for the agency said the rule change proposal had originated within the department, but declined to comment on it beyond issuing a brief statement.

After the board vote, Veazey told GHN that he expected the push for a surgery center exemption to return to the General Assembly next year. The idea, he said, “is not dead.’’

The Medical Association of Georgia said in a statement that it “supports the repeal of certificate of need laws in general and specifically as they apply to physician-owned and operated outpatient diagnostic centers, imaging centers, ambulatory surgical centers, laboratories and ancillary services.”