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DHEC Presents Budget With No CON
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South Carolina Department of Health and Environmental Control (DHEC) Director Catherine Templeton made her first appearance before the House Ways and Means Healthcare Budget Subcommittee on Tuesday. Committee Chairman Murrell Smith (R-Sumter) received testimony along with Reps. Tracy Edge (R-Horry), Bill Herbkersman (R-Beaufort) and Bill Clyburn (D-Aiken).
While many attendees expected discussion about the agency's suspension of the Certificate of Need (CON) program, the hearing was overshadowed by controversy over the Pinewood Hazardous Waste Site in Chairman Smith's home county of Sumter. The site has operated for more than 20 years near the shores of Lake Marion, and DHEC recently announced it had insufficient funding to ensure the continued safety of Pinewood. Over one third of South Carolina relies on drinking water from Lake Marion, and Director Templeton will be working with the General Assembly on a plan to manage the Pinewood site.
There was no dialogue about CON or proposed healthcare spending in Tuesday's subcommittee hearing, but SCHA continues to support efforts to restore and strengthen South Carolina's CON program. |
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SCHA Opposes Medical Laboratory Personnel Mandate
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SCHA and Greenville Health System (GHS) spoke in opposition to H.3489 (Spires), a bill that establishes the regulation and licensing of medical laboratory personnel by the South Carolina Department of Labor, Licensing and Regulation (LLR).
Several medical laboratory technicians and medical laboratory scientists spoke in support of the legislation, citing that 11 states had similar legislation and regulations related to the licensing of medical lab personnel. Currently, medical lab personnel are certified through the American Society of Clinical Pathologists (ASCP) and the College of American Pathologists (CAP) under standards set by the Centers for Medicare and Medicaid Services (CMS). Supporters of the bill recognized that both organizations supported the legislation; however neither group adopted standards as high as the ones included in H.3489.
Members of the House Labor Commerce and Industry (LCI) Subcommittee chaired by Rep. Kris Crawford (R-Florence), an emergency room physician, felt it was unnecessary for South Carolina to further regulate medical lab personnel given they were already certified by two national organizations and regulated by CMS. Committee members were also concerned that the legislation did not apply to physician's offices, as supporters recognized that they were trying to avoid opposition from the South Carolina Medical Association (SCMA). They also indicated that licensing medical lab personnel was imperative to improving quality of care.
SCHA Vice President of State Government Relations, Elizabeth Harmon, testified on behalf of SCHA, highlighting the fact that medical laboratory personnel were already regulated federally, and that South Carolina's hospitals had been nationally recognized for their efforts to improve patient safety and quality of care. House LCI Chairman Bill Sandifer agreed, adding "I'm not sure there is justification to create an entire new regimen of regulations." With that, the House LCI subcommittee adjourned debate on H.3489. |
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House Subcommittee Discusses Hospital Cost Disparities
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Members of a House Medical, Military, Public and Municipal Affairs (3M) Subcommittee met on Wednesday to discuss legislation sponsored by Rep. Joe Jefferson (D-Charleston) that creates a study committee to examine the disparity in hospital charges for certain medical procedures across the state billed to Medicare. Rep. Jefferson serves on the subcommittee, and acknowledged that the main focus of his bill, H.4225, was to initiate conversations between the Department of Health and Human Services (DHHS) and the hospital community about medical cost disparities in South Carolina. He asked if anyone from SCHA could address the issue.
SCHA Vice President of Community Engagement Rozalynn Goodwin addressed the committee, citing initiatives already included in the 2013-2014 DHHS budget to address hospital pricing transparency. She explained that SCHA's efforts to increase transparency in hospital costs were already underway with DHHS, and that the process was already moving toward implementation.
In fact, on Monday afternoon DHHS will be hosting a live media briefing and webinar announcing a new website aimed at improving hospital transparency. The website will focus on hospital profitability based on Medicare cost reports similar to the information DHHS released last spring. Eventually the website will offer information on pricing, and SCHA is working with DHHS to make that information available.
South Carolina's hospitals support transparency and are committed to sharing information that is accurate, timely and useful to consumers. |
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Senate Medical Affairs Subcommittee Examines 'Air Ambulances'
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Sen. Ray Cleary (R-Georgetown) chaired a Senate Medical Affairs Subcommittee meeting that delved into the practices of emergency air transport providers. Senators Brad Hutto (D-Orangeburg), Tom Davis (R-Beaufort) and Shane Martin (R-Spartanburg) also serve on the subcommittee and participated in the discussion.
S.936, the "Air Ambulance Affordability Act," was introduced by Senate Majority Leader Harvey Peeler (R-Cherokee) to define an "air ambulance," mandate permitting by DHEC and provide for coverage of air ambulance transportation by group and individual health policies. The legislation was spurred by constituents of Sen. Peeler and Sen. Hutto who were left with costly medical transport bills after being air-vacced to hospitals in the state.
The subcommittee received testimony from Steve Langford with the South Carolina Air Ambulance Association. He explained that Medicare and Medicaid capped the amounts that they reimburse for emergency air transport, and that air ambulance services were often forced to make up those losses with a cost shift to the private market (sound familiar?). He went on to explain that air ambulances cost up to $5 million and are costly to maintain and fuel. He informed the committee that the federal government already mandated for the coverage of air transport and that South Carolinians could purchase a plan to cover emergency air transport for their household for $150 a year.
The subcommittee discussed several solutions to increase air transport affordability, including asking air ambulance service providers to negotiate a deal with the State Health Plan and state insurance providers. The bill was carried over for further review by the subcommittee. |
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Regulations: Hospital Licensure and CON
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Regulations to update and modernize South Carolina's hospital licensing process and CON process were received by the General Assembly this week.
Document 4383 updates regulation 61-15 that prescribes the CON process. Minor changes are necessary to coincide with the CON reform bill, S.568, sponsored by Sen. Harvey Peeler. The proposed amendments will lessen the regulatory burden on the regulated community by increasing the monetary threshold for capital expenditures by or on behalf of a health care facility from $2 million to $5 million, and by raising the existing monetary threshold on equipment used for diagnosis or treatment from $600,000 to $1.5 million. Finally, the amendments will allow more flexibility within the required 90 day submission period for requests for CON extensions. These proposed amendments are in keeping with the directive issued by the SC DHEC Board to evaluate and streamline the CON process.
Document 4430 updates regulation 61-16 that provides for the minimum standards for licensing hospitals. It was approved by the DHEC Board earlier this month. The Department substantially amended the regulation in April 1992 and again in 2002 for perinatal services. Since 1992, numerous improvements in healthcare practices and technology have enhanced the healthcare industry. This amendment updates the regulation and incorporates improvements in health care practice.
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January 24, 2014
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