Senate Bill 31 started out as a relatively simple proposal related to a Georgia health agency board. That bill passed the Georgia Senate overwhelmingly last month.
But late Wednesday afternoon, a substitute version of that Senate legislation called for something entirely different: an easing of state restrictions on Cancer Treatment Centers of America.
And the sudden switch – and resulting testimony on the new bill – led to a fiery exchange between a hospital industry lobbyist and the chair of the House Health and Human Services Committee.
This change on SB 31 is part of the give-and-take, addition and subtraction of language on bills in the final days of the General Assembly. The House health panel also transformed two other Senate bills in the same way.
The committee chair, Rep. Sharon Cooper (R-Marietta), in explaining the changes, indicated that some health care proposals that the House passed were stuck in the Senate and in danger of getting no action before the legislative session ends.
But it was the Cancer Treatment Centers proposal that created the fireworks.
The new language in SB 31 would relax the restrictions on CTCA’s Newnan facility in terms of its size and the percentage of Georgia patients it can serve.
Sen. Matt Brass (R-Newnan) sponsored the new version, saying that CTCA is “wanting to grow their business.’’ Under the current regulatory system in the state, known as certificate of need or CON, Brass said, “We’re telling them, ‘No.’ ”
Cancer Treatment Centers of America is a high-profile chain with hospitals serving various regions of the United States. The Georgia Legislature in 2008 allowed CTCA to build its facility for the Southeast in Newnan, south of Atlanta, and gave it an exemption from the CON process as a “destination’’ cancer hospital. But legislators also set restrictions on the Newnan facility, requiring that it have no more than 50 beds, and that no more than 35 percent of its patients come from Georgia. Those restrictions are what the new bill seeks to end.
Because of the 35 percent rule, Brass told the House committee, “My district leads the state in patients denied’’ the opportunity of going to the Newnan center.
The new version, while it would benefit CTCA, also includes a pledge from the hospital that it increase its obligation to charity or uncompensated care from 3 percent of adjusted gross revenues to 5 percent. It also pledges an additional 1 percent of those revenues or $1 million, whichever is less, to the Indigent Care Trust Fund for five consecutive years.
The last-ditch attempt to get helpful legislation for CTCA wasn’t a surprise. And it met the expected strong opposition from the Georgia Alliance of Community Hospitals and the Georgia Hospital Association.
Tim Kibler, an Alliance vice president, told the panel that CTCA received a special exemption from the Legislature to build the Newnan facility, and that the company agreed to the limits in the legislation. Many other hospitals in Georgia offer cancer care, Kibler added.
But Cooper, the panel chair, challenged the hospital industry on its arguments against CTCA.
She said the 35 percent limit was imposed on CTCA as a “take it or leave it’’ proposition.
“There is such animosity’’ against the cancer center, Cooper said. If you’re a cancer patient, she argued, “you ought to have a choice about where you want to go.’’
A lobbyist for CTCA, Ray Williams, told the panel that the organization has been surprised by the number of Georgians who want to get treatment at the Newnan facility. Williams said CTCA is treating a growing number of Medicare and Medicaid patients. He cited a poll showing support for allowing patients to pick their cancer facility.
But Rep. Michele Henson (D-Stone Mountain) questioned CTCA on what she called “negative advertising’’ on the choice issue. “I felt that was misleading.”
Later, Ethan James, a Georgia Hospital Association vice president, told the committee that Cancer Treatment Centers of America “is going to come back to you, year after year’’ to ease the restrictions. “They do it every year.’’
James also said that CTCA has not lived up to the agreement reached a decade ago, and that other hospitals lose much more money on emergency care, Medicare and Medicaid.
Cooper suggested James was exaggerating the problem. “You’re so afraid of this one hospital in Newnan,’’ she told him, calling it an “irrational fear.’’
No vote was taken, and the CTCA proposal is still considered a long shot for passage by both chambers.
The House panel, though, did pass two other Senate bills with brand-new language.
A substitute to Senate Bill 202 now contains language that would facilitate the formation of multi-agency teams across the state to share information and coordinate efforts to fight elderly abuse. It mirrors House Bill 635.
And SB 325 now would create a pilot program providing coverage for bariatric surgery in treatment of obesity under the state benefits plan. It would also limit the insurers’ practice of “step therapy,’’ in which patients are required to “fail” on a series of treatments before they can obtain the medication prescribed by their physician.