OHA Advocacy Network

Advocacy Report • Friday, May 26, 2006

STATE

Legislature Enacts Hospital Transparency Bill

Legislation making additional information on hospital quality and pricing available to consumers passed the Ohio Senate late Wednesday and the House of Representatives approved Senate changes Thursday. The bill, which was debated for nearly two years, now heads to Gov. Bob Taft for final approval.

OHA supports House Bill 197, sponsored by Rep. Jim Raussen (R-Cincinnati), after an amendment offered in Senate Health, Human Services & Aging Committee last week by Sen. David Goodman (R-Bexley) addressed hospitals' outstanding concerns. The amendment:

Limits the number of quality indicators hospitals could be required to submit to the Ohio Department of Health (ODH);
Gives ODH director discretion in choosing which quality measures hospitals will be required to report, but limits him or her to choosing only measures developed by four national entities (the Centers for Medicare & Medicaid Services, the Joint Commission on Accreditation of Healthcare Organizations, the Agency for Healthcare Research and Quality and limited measures from the National Quality Forum). Previous versions of the bill required hospitals to submit all of those measures.
Requires the director to consider any financial implications for hospitals when deciding which measures will be reported;

In a separate amendment obtained by OHA, hospitals will no longer be required to submit quality reports they have been submitting to the department since the late 1990s. Commonly referred to as the Senate Bill 50 quality reports, hospitals have been reporting 136 quality measures under nine health service areas. Senate Health Committee Chairman Kevin Coughlin (R-Akron) offered the amendment deleting the SB 50 quality reports so ODH staff can shift its focus to the new reporting requirements under HB 197.

Once the law takes effect, which should be mid September, OHA will begin working with ODH to help hospitals comply with the new data disclosure requirements. The following is a timeline for some of the new requirements under the bill:

In mid September, hospitals will be required to post on their Web sites a price information sheet listing room and board charges, and other charges such as x-ray and lab procedures and emergency room and delivery room services. For years, hospitals have been required to develop this price list and make it available to patients upon request. The new law merely requires that the list be posted on hospitals’ Web sites
In April 2007, hospitals will be required to submit the quality indicators chosen by the director.
In May 2007, hospitals will be required to submit average charges and number of cases for their top 60 outpatient procedures. Since the late 1980s, hospitals have submitted the average charges, number of cases and other information for their top 100 inpatient procedures. The new law expands that decades-old requirement to include outpatient charges and volume.

OHA will produce a more detailed member bulletin in the coming weeks. For more information on the issue of public disclosure, visit http://www.ohanet.org/advocacy/state/issues/public_disclosure.htm. (Jeff Klingler, jeffk@ohanet.org)

Legislative TEL Proposal Does Not Include Local Government Expenditures/Funds

The House and Senate approved several amendments to Senate Bill 321, the $763 tobacco settlement proposal, which amend the state spending cap as proposed by Secretary of State Ken Blackwell. Included were the following provisions:

Spending growth is capped at 3.5% or the sum of the rates of state population change and inflation, whichever is larger.
The cap is tied to a base year (2007) rather than the prior year and the base is reset every four years.
Spending cap applies only to state general revenue funds. (Prior Tax Expenditure Limitation (TEL) also limited the spending of local government money.)
Cap does not apply to reappropriations for money unspent by agencies from year to year.
Policymakers may exceed the cap in cases of emergency as declared by the governor or through a two-thirds vote by the House and Senate.

A document prepared by the Ohio Legislative Service Commission outlining the impact of this proposal, along with the distribution of the tobacco settlement, is available at www.lbo.state.oh.us/fiscal/fiscalnotes/126ga/SB0321HR.htm.

The legislature also adopted an amendment that changes Ohio’s petition law by allowing TEL supporters to withdraw it from consideration on the November general election ballot. Furthermore, a hearing is scheduled for June 9 to invalidate the TEL petitions. By all accounts, the TEL language will be removed from the ballot. (Bridget Gargan, bridgetg@ohanet.org)

County Hospital Bill Clears Senate 33-0, Moves to House

The Ohio Senate this week passed SB 126 (Wachtmann – R – Napoleon), legislation that would modify the laws governing county hospitals. This legislation enables county hospitals to become more cost effective and efficient. The flexibility provided by the bill would also help insulate county hospitals from local political battles, assist them in remaining financially viable and better enable the Board of Trustees to govern the hospital. SB 126 now awaits committee assignment in the House. (Bridget Gargan, bridgetg@ohanet.org)

Med Mal Bill Heads to House

A substitute version of Senate Bill 88 passed the full Senate 23-10 this week. The legislation, sponsored by Sen. Kevin Coughlin (R-Cuyahoga Falls), would establish a 10-year pilot program mandating arbitration for claims of medical negligence prior to filing a complaint in court. The substitute version included language requiring that the arbitration panel only consider liability and not damages. Earlier in the week, Dr. John Clough with the Cleveland Clinic testified in support of the bill stating that, “It provides an additional method of helping to control the runaway costs of medical malpractice insurance that have led the American Medical Association to identify Ohio as a medical liability crisis state.” Tim Maglione, senior director of government relations for the Ohio State Medical Association (OSMA), stated that the OSMA has a position of neutral on the bill. He mentioned that previous arbitration efforts had been eliminated by the legislature for various concerns, including the invalidation of cost-savings. OSMA would like to see additional work on the legislation before it takes on its final form. The Ohio State Bar Association provided opponent testimony, raising concerns about the length of the proposed pilot project and the administration of the program by the Ohio Department of Insurance rather then the Ohio Supreme Court. The issues will be addressed by the House Insurance Committee. (Bridget Gargan, bridgetg@ohanet.org)

SB 5 Clears Insurance Committee, but Does Not Receive Floor Vote

Senate Bill 5 was amended and passed by Senate Insurance, Commerce and Labor Committee this week. The legislation, sponsored by Sen. Jay Hottinger (R-Newark), would permit small employers to offer health care plans without benefits otherwise required by statute, while providing for the operation of health savings accounts consistent with federal laws. The sub bill was not greeted with enthusiasm by employer groups or the insurance industry. The employer groups were seeking language to modify the rating system for small group coverage by being rated as a group rather than individuals. The proposal was not adopted due to opposition from the insurance industry. SB 5 now awaits a vote of the full Senate. (Bridget Gargan, bridgetg@ohanet.org)

FEDERAL

U.S. House Passes Budget Resolution Without Medicaid, Medicare Cuts

Thanks in part to lobbying efforts of the hospital community, the U.S. House of Representatives this week approved a fiscal year 2007 budget resolution that excludes specific cuts to Medicare and Medicaid. The resolution also includes a nonbinding amendment to allow roughly $7.1 billion in increased funding for discretionary programs administrated by the U.S. Departments of Labor and Health and Human Services if offsetting cuts to other programs can be negotiated with the Senate. Under a separate amendment, at least $1 billion of these offsets would come from an Iraq reconstruction fund. The Senate also approved a budget resolution that would bolster federal spending by $7.1 billion and exclude Medicare and Medicaid cuts.

The resolution, which passed the House along party lines, now goes to a conference committee between the House and Senate to iron out differences. It remains unclear whether conservatives and moderates will be able to agree on a mutual budget resolution. Absent a mutual resolution, each chamber will continue its budget and appropriations process under the terms of its own budget resolution. The budget resolution is a nonbinding blueprint for congressional appropriation bills and is the first step in the annual budget process. (Jonathan Archey, jonathana@ohanet.org)

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The OHA Advocacy Network is a service of the Ohio Hospital Association, 155 E. Broad St., Columbus, OH 43215-3620, 614-221-7614, 614-221-4771 (fax)

Visit us on the Web at: www.ohanet.org

Direct questions on OHA’s advocacy agenda to:

Bridget Gargan, Vice President, State Policy & Advocacy (bridgetg@ohanet.org)

Jeff Klingler, Director, State Policy & Advocacy (jeffk@ohanet.org)

Jean Scholz, RN, Director, Health Policy (jeans@ohanet.org)

Rick Sites, General Counsel (ricks@ohanet.org)

Stacey Conrad, Specialist, State Policy & Advocacy (staceyc@ohanet.org)

Jonathan Archey, Manager, Federal Relations (jonathana@ohanet.org)

Laura Landis, Executive Assistant, State Policy & Advocacy (laural@ohanet.org)