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Supreme Court Rules on CON
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On Monday the South Carolina Supreme Court issued their opinion on the Certificate of Need (CON) case, ruling in favor of SCHA, SCHCA, and the members who filed the petition asking that the CON statute be upheld. Here is a link to the opinion.
SCHA is pleased with the favorable ruling from the Supreme Court that restores the CON program and ultimately defines the scope of the Governor's veto pen. Here are a few standout excerpts from the Court's legal analysis and conclusions:
The Governor's veto message leaves no doubt that she intended to use her line item veto power to abolish the entire CON program. However, the Governor is not empowered to exercise her veto pen in a manner that so broadly affects public policy and attempts to alter legislative intent by reaching back to repeal a permanent law.
To permit the Governor to exercise her line item veto power to abolish the CON program-a program mandated by permanent law-would certainly alter and amend legislative intent. Moreover, expanding the line item veto power to allow it to reach a permanent law enacted years earlier by vetoing a line item in an appropriations act would violate the separation of powers doctrine.
We find no irreconcilable conflict between the CON Act and the absence of funding in the 2013-2014 Appropriations Act. The failure to fund the CON program does not negate the directive issued by the General Assembly (and detailed in the CON Act) mandating DHEC administer the CON program.
While SCHA is glad that the Supreme Court ruled in our favor, uncertainty surrounding the CON program remains. Parties that relied upon DHEC's advisory letter and moved forward with projects that would otherwise have required a CON now find themselves in an unclear position.
In response to the CON ruling, Governor Haley and DHEC have indicated that they will continue their opposition to CON and intend to file a motion for reconsideration. SCHA is grateful for the decision rendered by the Supreme Court restoring the CON program, but until they rule on the reconsideration motion, it is unlikely that DHEC will enforce the statute. Therefore a degree of uncertainty will remain. |
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Senate Finance Committee Adopts CON Proviso
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The Senate Finance Committee completed the bulk of their work on provisos for the 2014-2015 State Budget this week. One of the recommendations that came out of the Senate Finance Health and Human Services subcommittee was to add a new proviso to direct that any project or equipment that was procured during DHEC's suspension of the CON program shall not require a CON, exemption, or non-applicability determination. However, the proviso would exclude any project or equipment which has been involved in a contested case or is under appeal. Here is the language adopted by the Senate Finance Committee under the new proviso:
34.con. (DHEC: Certificate of Need Project or Equipment Purchase) During the current fiscal year any project or equipment purchase procured by a facility that would require a Certificate of Need, where the procurement or project began during the department's suspension of the Certificate of Need program, may be placed in service without requiring a Certificate of Need, an exemption, or non-applicability determination. This provision does not apply if a contested case has been requested or an appeal is in process concerning the purchase of the same type of equipment or project if the equipment or project is to be located in the same service area as defined in the State Health Plan.
Click here for a full list of proviso recommendations adopted by the Senate Finance Committee pertaining to DHHS and DHEC.
Members of the Senate Finance Committee admitted that the current language for Proviso 34.con needs to be tweaked and will likely be amended. Senator Thomas Alexander (R-Oconee) is working with stakeholders to reach a consensus on the CON proviso. Senate Finance Committee Chairman Hugh Leatherman (R-Florence) insisted that any language that would grandfather in projects undertaken during the suspension of the CON program must have a concrete cutoff date. |
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Healthy Outcomes Initiative
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The Senate Finance Committee also adopted proviso 33.26 this week, a continuation of last year's Healthy Outcomes Initiative that seeks to improve health outcomes and reduce emergency room utilization by targeting chronically ill, uninsured South Carolinians. There was little discussion about the proviso, as the Senate Finance Committee opted to adopt most of the language adopted by the House Ways and Means Committee. Here are some highlights of the Healthy Outcomes Initiative for 2014 - 2015:
Healthy Outcomes Initiative - DHHS shall tie Disproportionate Share Hospital (DSH) payments to participation in the Healthy Outcomes Initiative (HOI) and may expand the program as DSH funding is available.
Rural Hospital DSH Payment - Medicaid-designated rural hospitals in South Carolina may be eligible to receive up to 100% of costs associated with uncompensated care. Funds shall be allocated from the existing DSH program and shall not exceed $25,000,000 in total funds. To be eligible, rural hospitals must participate in reporting and quality guidelines outlined in the HOI. Rural hospitals must also participate with DHHS and other stakeholders in efforts to design an alternative health care delivery system in these regions.
Primary Care Safety Net - DHHS shall implement a methodology to reimburse safety net providers to provide primary care, behavioral health services, and pharmacy services for chronically ill individuals who don't have access to affordable insurance. This would include Federally Qualified Health Centers, Rural Health Clinics, Free Clinics, local alcohol and drug abuse authorities, other clinics that serve the uninsured, and Welvista.
Telemedicine - DHHS shall allocate $10,000,000 in non-recurring funds to the MUSC Hospital Authority for telemedicine.
To be eligible for funds in the HOI, providers must provide the department with patient, service, and financial data, as well as price and quality transparency efforts initiated by DHHS. DHHS is looking to tie HOI payments to hospital participation, including how many patients hospitals are able recruit into their Healthy Outcomes Plans (HOPs). |
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Intros of Interest
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H.5107 (Harrell) - Introduced in the House last week, the concurrent resolution declares May 15, 2014 as "Fit Family Day" in South Carolina and recognizes the partnership that Coca-Cola has formed with the South Carolina Hospital Association, CVS Pharmacy, and parenting magazines to encourage healthy living through the Fit Family Challenge. |
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Pulse on Vacation
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With the South Carolina House and Senate set to furlough, the SCHA Advocacy Team will not publish the Pulse next week.
Both chambers will reconvene to continue their normal legislative schedule on April 29 at noon, and the Pulse will return to keep you updated on Statehouse activity that week.
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April 18, 2014
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