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CON Stalemate
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Debate on the Certificate of Need (CON) program continued this week, as stakeholders continue to negotiate language in H.3983 (Sellers) that would direct how projects undertaken while the CON process was not enforced will be addressed. The contentious points are that if there is a grandfather clause, whether it should expire on April 15, 2014 or June 30, 2014, and whether or not there should be an expedited appeal process for those projects.
The SCHA has no position on the grandfather clause language, but does support most of the CON reforms that have now been attached to the bill. Several of these SCHA-supported provisions are based on the recommendations of the DHEC CON Review Panel aimed at streamlining the CON process to make it less onerous on hospitals. This includes a "loser pays" provision aimed at reducing the number of frivolous CON lawsuits, and raising the threshold on capital expenditures to reduce the amount of projects that require a CON.
Senator Ray Cleary (R-Georgetown) took the Senate floor this week to explain the amendment to H.3983, but warned that the new language would be removed if a compromise could not be reached. The original intent of H.3983 is to provide emergency care to the people of Bamberg since the county's only hospital closed in 2012. "If we can't come up with language that makes sense, I will remove the CON language," said Cleary. He does not want to risk the possibility of providing free-standing emergency services in Bamberg County.
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Budget Heads Back to House
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The House carried over the 2014-2015 State Budget (H.4701) this week setting up debate on the appropriation bill for next week. Here are some of the provisos the SCHA Advocacy Team will be watching when debate begins on Tuesday:
- Certificate of Need - During the current fiscal year, the department shall not expend any funds to and no person supported by state funds may take any enforcement action against a person or health care facility that undertook a project or purchase of equipment from June 28, 2013 until April 15, 2014, without obtaining a Certificate of Need, an exemption, or a non-applicability determination, based on the assertion of the department that the Certificate of Need program was suspended and that the department would not take enforcement actions under Certificate of Need for activities undertaken during this period of purported suspension. This provision does not apply if a contested case has been requested or an appeal was in process concerning the same type of project or equipment purchase, if the project or equipment is to be located in the same service area as defined in the State Health Plan, so long as the appeal or contested case was initiated prior to June 28, 2013.
- Birth Centers - For this fiscal year, birthing centers must register an on-call agreement and any transfer policies with the department. The on-call agreement shall contain provisions which provide that the on-call physician is readily available to provide medical assistance either in person or by telecommunications or other electronic means, which means the physician must be within a reasonable drive of the birthing center, must be licensed in the State of South Carolina, and shall provide consultation and advice to the birthing center at all times it is serving the public. Furthermore, a birthing center shall document in its practice guidelines and policies the ability to transfer care to an acute care hospital with obstetrical and newborn services and must demonstrate this by: (A) coordinated transfer care plans, protocols, procedures, arrangements, or through collaboration with one or more acute care hospitals with appropriate obstetrical and newborn services; or (B) admitting privileges at one or more hospitals with appropriate obstetrical and newborn services by a birthing center's consulting physician. The department may assess a $25.00 registration fee for agreements containing such a provision.
- Healthy Outcomes Initiative - Ties 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 - The MUSC Hospital Authority is directed to continue the development of its Telemedicine network and determine which hospitals are best suited for a Telemedicine partnership. In conjunction with DHHS, the MUSC Hospital Authority shall study how to partner with existing rural hospitals to ensure that these regions maintain access to medical care.
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20 Week Abortion Ban Set for Special Order
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This week the South Carolina Senate voted to set H.4223 (Nanney), legislation that would ban abortions after 20 weeks, for special order. Granting the legislation a special order slot means that the Senate is making the bill a top priority and it forces the body to take up the issue. The bill has already advanced through the House, giving it a good chance of passing this session.
H.4223 is based on questionable science that purports that a fetus develops pain receptors at 20 months, and the purpose of the legislation is to protect the fetus from pain. The bill does have exemptions for medical emergencies, rape, incest and severe fetal anomalies, and requires physicians who perform abortions to calculate the probable time of conception age before performing or inducing an abortion. It also provides penalties for physicians who do not comply with the law.
The Senate could begin debate on the bill as soon as next week. |
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Medical Marijuana Legislation Awaits Governor's Signature
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Legislation that would allow oil extracted from marijuana to be used to treat children with severe epilepsy, S.1035 (Davis) was passed by the General Assembly this week. The House approved the bill overwhelmingly by vote of 92-5.
The legislation establishes the Medical Cannabis Therapeutic Treatment Program at the Department of Health and Environmental Control (DHEC) and provides that a physician is not subject to arrest or prosecution for providing written certification for the medical use of cannabidiol for a patient with severe epilepsy that is not adequately treated by traditional medical therapies. |
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Chamber Actions
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H.4354 (Harrell) - Provides that a patient may receive their medical record or have it transferred to another physician as a photocopy reproduction or in an electronic format stored on digital media, and specifies what fees may be charged. Amended in Senate and carried over.
H.3827 (Pitts) - Provides that a party may request a contested case hearing on a DHEC decision before the Administrative Law Court to provide timely resolutions regarding decisions made by DHEC. Read across the Senate desk and carried over.
H.4929 (Allison) - A concurrent resolution to urge all South Carolina hospitals to offer the flu shot to inpatients sixty-five years and older, prior to discharge. The resolution is not a mandate on hospitals, but simply resolves that both the South Carolina House and Senate encourage all hospitals to offer the influenza vaccine to elderly patients before discharge. Adopted by the Senate and returned to the House for concurrence.
H.3236 (Sellers) - Enacts the "Cervical Cancer Prevention Act" to provide that DHEC may offer the cervical cancer vaccination series to adolescent students enrolling in the seventh grade on a voluntary basis. Read across the Senate desk and carried over.
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Intros of Interest
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H.5282 (Harrell) - The "Sine Die" resolution provides that the respective houses of the General Assembly adjourn on June 5, 2014, no later than 5:00pm, and to return in statewide session from Tuesday, June 17 to Thursday, June 19 for the consideration of certain specified matters. |
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May 23, 2014
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