Legislature(2007 - 2008)CAPITOL 106
02/09/2008 09:00 AM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB337 | |
| HB345 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 337 | TELECONFERENCED | |
| *+ | HB 345 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 345-MEDICAL FACILITY CERTIFICATE OF NEED 10:29:12 AM CHAIR WILSON announced that the final order of business would be HOUSE BILL NO. 345, "An Act amending the certificate of need requirements to exclude expenditures for diagnostic imaging equipment in certain circumstances." 10:29:42 AM REPRESENTATIVE MIKE KELLY, Alaska State Legislature, disclosed his uncompensated service to the Greater Fairbanks Community Hospital Foundation and to the Committee on Governance for the American Hospital Association. He, as the prime sponsor, introduced HB 345 and stated that the bill is a compromise that attempts to eliminate the CON program for a portion of businesses, thus is a step in the direction of more competition in the health care industry. Representative Kelly pointed out that provisions for a [health care commission] and a health care information office are not included in HB 345, and he expressed his concerns that both of these provisions constitute increased government involvement in private business. In addition, he opined that 50 percent of the industry is not included in the information office data. 10:3:55 AM CHAIR WILSON noted that, page 6, [paragraph (2)] of HB 337, read: The facility cost and provider cost... 10:34:22 AM REPRESENTATIVE KELLY opined that the requirement to disclose costs by private sector businesses was an "additional step." He then asked his staff to review HB 345. 10:34:34 AM DEREK MILLER, Staff to Representative Mike Kelly, Alaska State Legislature, presented the sectional analysis for HB 345, Version E, on behalf of Representative Kelly, sponsor. Mr. Miller informed the committee that Section 1 adds a cross- reference to an additional exemption to the Certificate of Need process in existing statute. Section 2 defines "critical access hospital" as a small, rural, hospital that is financially challenged given the population that it serves. Section 3 adds an exemption that permits a person to make an expenditure of $1 million or more for diagnostic imaging equipment, without authorization under the terms of the CON process, as long as the equipment is located in a borough with a population of 60,000 or more, in a city that does not have a critical access hospital, and is at least 50 percent owned by one or more licensed physicians who are qualified to and actually perform interpretations of the images produced at the facility. Finally, Section 4 provides applicability standards for health care facilities in existence or proposed after the effective date of the act. 10:36:19 AM REPRESENTATIVE SEATON asked for an explanation of the requirement of 50 percent ownership, by physicians, of the diagnostic imaging facility. REPRESENTATIVE KELLY suggested that the percentage was chosen as a compromise between the opposing parties. 10:38:43 AM REPRESENTATIVE SEATON further asked for the purpose of requiring physician ownership, if the intent of the bill is to open competition. REPRESENTATIVE KELLY explained that physician ownership is not prevented, but if participation is less than 50 percent by physicians, CON laws still apply. The intent is to encourage competition, as long as the two parties are working together. 10:40:53 AM REPRESENTATIVE GARDNER asked whether this was a compromise between the hospitals and the physicians. REPRESENTATIVE KELLY said that the bill was a significant compromise, but the dispute is not entirely between hospitals and physicians. House Bill 345 was a solution based on what has been done in other states that have improved their CON laws. 10:42:04 AM REPRESENTATIVE GARDNER asked for the position of the consumers in the division between the hospitals and the doctors. REPRESENTATIVE KELLY opined that it depends on where the federal government leads this debate. Unlike fire, car, and life insurance, the consumer is a small part of health care and remains uninformed, uninvolved, and under served. In Anchorage and Fairbanks, physicians are not accepting Medicare patients; this will soon be a crisis as the number of seniors will double in Alaska by 2030. Representative Kelly pointed out that all three aspects of HB 337 would not solve the issues that HB 345 would solve by compromise. 10:45:50 AM REPRESENTATIVE GARDNER asked whether HB 345 would resolve any, or all, of the pending lawsuits. REPRESENTATIVE KELLY expressed his understanding that this bill would settle from 75 percent to 90 percent of the lawsuits. He blamed weak regulations for the legal problems and provided analogies to the California power system deregulation. Representative Kelly predicted that a sudden change in the CON system would cause a similar situation. 10:49:49 AM REPRESENTATIVE CISSNA opined that one's health is 80 percent based on personal choices and learned habits. She acknowledged that the CON program needs work, but expressed her concern about the health of the hospitals that are needed to provide emergency care. She asked how HB 345 will safeguard the health of a hospital. REPRESENTATIVE KELLY observed that HB 345 was a carefully crafted compromise. He suggested that, if it is not passed, this struggle will continue. Furthermore, HB 345 is supported by a large sector of the health care system. 10:53:13 AM REPRESENTATIVE ROSES expressed his concern that the limitation on the cost of equipment may affect the quality of care. REPRESENTATIVE KELLY agreed and pointed out that HB 345 eliminates this possibility. 10:54:39 AM REPRESENTATIVE ROSES clarified his question. 10:54:59 AM REPRESENTATIVE KELLY confirmed that the exemptions provided by HB 345 negate the applicability of the CON under the conditions described by Representative Roses. 10:55:21 AM REPRESENTATIVE ROSES further asked whether the 50 percent ownership requirement was supported by the negotiated rule making committee. REPRESENTATIVE KELLY assured the committee that the support of the negotiated rule making committee was considered in the drafting of HB 345. 10:56:34 AM CHAIR WILSON announced that further testimony would be heard on the nineteenth of February, 2008. [HB 345 was held over.]
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