Advocacy and Health Policy
Home Page Members Only Table of Contents Search This Site Contact Us Site Index

April 2007

Note: Questions relating to state legislative activity or any of the items noted in ACS Cross Country may be directed to Mindy Baker, State Affairs Associate, at mbaker@facs.org. 

New Jersey's DOBI Proposes Tying Out-of-Network Fee Schedules to Medicare

Image: New Jersey
The New Jersey Department of Banking & Insurance (DOBI) proposed regulations late last year that will increase the amount that patients pay directly out-of-pocket for out-of-network medical care.  The proposal ties a cap on physician fees to a percentage of the Medicare fee schedule.  The medical community has expressed strong opposition to this proposal since it believes that patient choice of physician will be severely restricted for patients who are no longer able to afford to go to out-of-network physicians.  Higher out-of-pocket expenses will create a larger pool of patients seeking specialty care from the few specialists who are in-network, producing greater delays in receiving necessary treatment from an already limited number of in-network specialists.

Many New Jersey surgeons have utilized the Surgery State Legislative Action Center to contact the DOBI regarding this proposal.  There is still some time left in the public comment period, and all New Jersey surgeons are urged to contact the department.  To send a letter, visit the action center at http://capwiz.com/sslac/issues/alert/?alertid=9320866.

  

Wild Rumors Sink CON Legislation in Georgia

Image: Surgeons
In a major disappointment to the surgical community, all three certificate-of-need (CON) reform bills under consideration in the Georgia General Assembly failed to make the “crossover” deadline of March 27. “Crossover” is the point at which bills are passed in one house and sent on to the other chamber or are seen as dead for the year. (Legislative language can still be adopted in the latter instance if amended to a bill that survived the deadline.) One of the bills, H.B. 337, specifically would have redefined general surgery as a single specialty. Currently, general surgery is defined as a multispecialty in Georgia and, therefore, is ineligible for the single-specialty exemption in the state’s CON law for ambulatory surgery centers.  It appeared that H.B. 337 might make it through the business session of the Georgia House on March 27 until rumors started circulating alleging that approval of the bill would make it possible for general surgeons to perform complex surgical procedures in their offices and open abortion clinics. As a result, with a procedural vote of 112-52, the bill was recommitted to the House Rules Committee.
  

Connecticut ACS Chapter Advocates Against Health Care Service Tax

As is the case in many states, the Connecticut legislature is grappling with the thorny issue of universal health care.  Primary legislation to address this issue is HB 6652, An Act Establishing the Connecticut Healthy Steps Program.  One serious roadblock to implementing universal health care is funding, and HB 6652 contains a number of taxes on physicians and surgical services.

One particularly onerous tax, the health care service tax, would have assessed a 3% tax on revenue derived from furnishing health care services in the state and applied to all providers of medical services including physicians, hospitals, nursing homes and other facilities.  However, the Connecticut Chapter of the American College of Surgeons, the Connecticut State Medical Society, and other major physician organizations joined together to testify against this tax and other provisions of HB 6652 (a 6% tax on cosmetic services; requirement that all health care providers accept HUSKY A and B recipients as well as Medicaid fee-for-service patients; and a prohibition on physicians from charging more than 200% of Medicare payments for any service).  This coordinated advocacy effort resulted in the health care service tax being removed from HB 6652, and these groups continue to vigorously oppose the other negative provisions of the bill. 

 

Trauma Funding Legislation Falls Short in Arkansas and Georgia

Image: Ambulance
It is estimated that a fully funded, healthy trauma system could save 200 lives1 in Arkansas and 700 lives2 in Georgia every year.  However, trauma systems in both states have failed to get the funding they need in 2007.

In Arkansas, a conference committee was appointed to work out a compromise on a funding solution for the program that was created in HB 1575.  Unfortunately, the committee could not reach an agreement, and the legislature adjourned for (essentially) the next two years.  (Because the Arkansas Legislature only meets in odd years, trauma centers will have to wait until 2009 for relief.)

Senators on the committee supported Senate President Jack Critcher’s  (D) proposal to place a quarter of a percent (1/4 %) tax increase on insurance policies (exempting fixed life insurance policies) coupled with a $50 fee on DUIs to fund the state’s trauma system program.  According to a report in the Insurance Journal, House members “roundly rejected the tax increase.”1

Critcher’s proposal was the third suggestion for funding that was presented during this legislation season.  Other suggested funding sources were increasing the fines on certain moving violations and DUIs and/or placing a $1 a month fee on every automobile insured in the state.  A conference committee was assembled when Gov. Mike Beebe (D) said he would not support the $1 monthly fee.

Meanwhile, in Georgia, several trauma funding bills were introduced this session.  Only two are still “alive,” and, unfortunately, neither of those bills is expected to generate the money needed  to “fix” Georgia’s ailing trauma system. 

The combined revenue of HB 77 & SB 125 is estimated to generate less than half of the $80-$85 million recommended by the Joint Comprehensive Trauma Services Study Committee in its final report.  (The Joint Comprehensive Trauma Services Study Committee was created in 2006 to examine “Georgia’s trauma services and location of trauma centers, including the delivery of such services report issued... and any other issues related thereto.”  (2006 SR 785)

Georgia’s legislature is expected to adjourn sometime in April.  Both bills have passed their chambers of origin, but have not yet been assigned to committees in their “new” chambers.

1Jon Gambrell, Insurance Journal, Proposed Trauma Center Funding Fails in Ark. Legislative Committee, April 4, 2007, www.insurancejournal.com/news/southcenteral/2007/04/04/78471.htm.
2Georgia Hospital Association, It’s About Time Fact Sheet, www.georgiaitsabouttime.com, June 2006)
 

Past Issues of ACS Cross Country:

ACS State Affairs
Division of Advocacy and Health Policy
Jon H. Sutton
Manager, State Affairs
Chicago Headquarters
312-202-5358
jsutton@facs.org		 Mindy Baker
State Affairs Associate
Chicago Headquarters
312-202-5363
mbaker@facs.org

Some of these files are in Adobe Acrobat format. To view Portable Document Files (PDF) download the free Adobe Acrobat Reader. Reminder: The Adobe Acrobat Reader ranges from 3.9 mb to 7.4 mb depending on the operating system your computer uses. Please allow for sufficient download time.

 

Revised April 12, 2007

Advocacy and Health Policy

 

This page and all contents are Copyright © 2003-2007
by the American College of Surgeons, Chicago, IL 60611-3211