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Monday, September 23, 2002
Bills Introduced to Limit Specialty Hospitals
Two pieces of legislation were last week introduced by Rep. Ray Miller (D-Columbus) in response to some proposed physician-owned specialty hospitals in Central Ohio. House Bill 636 would prevent doctors from referring patients to facilities in which they have a financial interest. House Bill 637 would restore the certificate of need program for the establishment of a new hospital or for certain other health-related activities.

OHA is currently analyzing both bills. The OHA Board of Trustees last week approved a plan seeking legislation similar to HB 636 to expand existing conflict-of-interest prohibitions to physicians who would refer patients to inpatient facilities in which the physician has an ownership interest. (Jeff Klingler, jeffk@ohanet.org)

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(Editor’s note: StateHealthClips.com has gone to a subscription service. Please note that the link to access clips will change daily. If you visit www.statehealthclips.com, you will be required to enter a subscriber password. No password is required for the link published in HEALTH e-NEWS Plus.)

Tuesday, September 24, 2002
ODJFS Reports on Medicaid Cost Containment
Pursuant to a mandate in the last state budget bill, director of the Ohio Department of Job and Family Services (ODJFS) Tom Hayes last week submitted the first cost containment report to the Ohio General Assembly. Senate Bill 261, sponsored by Sen. Jim Carnes (R-St. Clairsville), requires ODJFS to present a Medicaid cost containment report every three months to the legislature.

Hayes noted that the strategies are primarily focused on the areas of greatest cost: long-term care facilities, prescription drugs and hospital services. The report outlined ongoing cost containment activities such as:

Auditing Medicaid providers to help eliminate provider fraud and identify over-payments
Investigating whether Medicaid recipients have private health insurance or third-party resources and requiring that these sources pay before Medicaid
Requiring prior approval and documentation of the medical necessity of expensive or unusual medical services
Managing the necessity and cost effectiveness of recipients’ use of Medicaid services
Requiring prior authorization for certain drugs, and substitution of generic for brand name drugs when appropriate

OHA will be working with large Medicaid providers to pursue a strategy for the next biennium when Medicaid is anticipated to have a $2 million shortfall. (Bridget Gargan, bridgetg@ohanet.org)

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Wednesday, September 25, 2002
Tort Reform Remains Hot Issue
The issue of medical malpractice and tort reform remains a key health care issue on both the state and national levels.

Sen. Eric Fingerhut (D-Cleveland) and Rep. Ed Jerse (D-Euclid) called on Gov. Bob Taft to take immediate action to address Ohio’s malpractice insurance problems. They referred to Senate Bill 281, which includes a cap on non-economic damages, suggesting that the General Assembly meet before the election to enact legislation. They also announced their intent to introduce legislation they felt was a better solution than SB 281, which is currently being considered by the Ohio Senate Insurance, Commerce and Labor Committee. Other tort reform bills, SB 120 and SB 179, which would provide joint and several liability and peer review protection, respectively, are under consideration in the Ohio House Civil and Commercial Law Committee. If any of the state tort reform bills are enacted, the Ohio Supreme Court can be expected to rule on their constitutionality.

Also at the state level, the Ohio State Medical Association (OSMA) is sponsoring a statewide rally on Oct. 30 at the statehouse to support efforts to solve Ohio’s professional liability crisis. Physicians and their staffs, patients, friends, spouses, families and colleagues are invited to attend. Preregistration is available at the OSMA Web site at www.osma.org.

On the federal plane, the House Energy and Commerce Committee and the House Judiciary Committee passed House Resolution 4600, the Help Efficient Accessible, Low Cost, Timely Health Care Act of 2002. The liability reform bill now awaits House floor action. (Rick Sites, ricks@ohanet.org)

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(Editor’s note: The news clips are being password-protected on the OHA Web site. OHA members will be notified separately of the password. HEALTH e-NEWS Plus subscribers can still access news clips through the daily e-mail without a password.)

Thursday, September 26, 2002
Med Mal and Birthing Centers Get Board Attention
The OHA Board of Trustees took action to explore alternatives for medical malpractice insurance for physicians and to support state regulation of freestanding birthing centers in its September meeting.

The Board approved a recommendation by an OHA Medical Malpractice Task Force headed by Board Member Kevin Martin, president and CEO of EMH Regional Healthcare System in Elyria, to engage in a study of potential risk-financing alternatives to help key physicians secure and maintain medical malpractice insurance. The study will be conducted in cooperation with OHIC. A model is expected to be developed in time for the task force to recommend additional action by the OHA Board in November.

At the request of the OHA Small and Rural Hospitals and the Quality Improvement & Accreditation Committees, the Board voted to urge the Ohio Department of Health to regulate freestanding birthing centers serving Amish and Mennonite communities. The committees said state regulation should help improve quality of care and outcomes for births in Ohio’s Amish communities.

In other action, the Board approved plans to create a Medicaid task force and authorized it to, among other things, develop a strategy for resolving issues in litigation OHA and the Ohio State Medical Association brought against the state over administration of the Medicaid managed care program. The Ohio Supreme Court recently revived that litigation after it had been dismissed by lower courts. (Jim Castle, jimc@ohanet.org)

Correction
Tuesday’s Health e-News Plus article “ODJFS Reports on Medicaid Cost Containment” stated that Medicaid is anticipated to have a $2 million shortfall in the next biennium. The article should have reported an anticipated $2 billion shortfall.

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Friday, September 27, 2002
America’s Health Improving as Delivery of Health Care Evolves
Over the last 50 years, the health of Americans has changed dramatically for the better as the face of health care has evolved. People are living longer and stronger as health care providers work to improve how they provide care and expand access to care, according to a recently released report of the U.S. Department of Health and Human Services. The report, available at http://www.cdc.gov/nchs/hus.htm, looks at trends in fighting illness, chronic disease and mortality going back to 1950. It also examines where Americans get their health care, how much it costs and who pays for it.

Of the $1.3 trillion spent on health care in the U.S. in 2000, 32 percent went for hospital care. The average length of stay decreased from 11.4 days in 1975 to 6.8 days in 2000. In community hospitals in 1980, 16.3 percent of surgeries were outpatient procedures. By 2000, that number had soared to 62.7 percent. Americans are making healthier choices in regards to tobacco use. In 2000, 23.1 percent of Americans were smokers compared to 25.3 percent in 1990 and 41.9 percent in 1965. However, the prevalence of overweight and obesity among adults has increased substantially since the late 1970s. For more, see the September OHA HealthBeat at http://www.ohanet.org/healthbeat/2002/healthbeat0902.htm.

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