Georgia hospitals fighting bill to benefit cancer center

More information about House Bill 482 is available online from the AJC's Legislative Navigator:

Unlike other Georgia hospitals, Cancer Treatment Centers of America was allowed to open a hospital in 2012 without having to prove that the state needed its services. That’s because the Newnan hospital was designated a “destination cancer hospital” obligated to draw patients from throughout the nation.

The General Assembly in 2008 stipulated that 65 percent of patients for the destination hospital must come from outside of Georgia. Lawmakers also limited the size of the special hospital and required it to treat Medicaid patients and provide a set amount of charity care.

Now, Cancer Treatment Centers of America wants the Legislature to let it serve more Georgians, by changing the law that includes the out-of-state requirement and a 50-bed cap. A House subcommittee is scheduled to take up the issue today.

“CTCA is currently turning away Georgia patients because of the 65 percent requirement, which is unfair to those patients,” said Victor Moldovan, an Atlanta attorney who represents CTCA, in a statement. “Individuals battling this disease should have the fundamental right to choose where they want to go.”

But Georgia's hospitals strongly oppose House Bill 482, which contains the changes that Cancer Treatment Centers of America supports. If the hospital wants to see more Georgia patients, it should go through the same stringent "Certificate of Need" process that every other Georgia hospital faces when it wants to open or expand, said Monty Veazey, president of the Georgia Alliance of Community Hospitals, which represents nonprofit and community facilities. That process is intended to hold down health care costs by avoiding duplication of expensive medical facilities and equipment.

“The reason we oppose the bill is, under this legislation, they would no longer be a destination hospital,” Veazey said.

The for-profit hospital is pushing for the change while public records obtained by The Atlanta Journal-Constitution raise questions about the hospital’s commitment to serving low-income Georgians as state law requires.

Georgia hospitals contend that the Newnan facility cherry-picks the patients with the highest-paying coverage, which hurts hospitals with heavy Medicare, Medicaid and uninsured caseloads.

“CTCA is seeking additional special concessions that will allow it to undermine the ability of existing hospitals to care for all Georgians,” said Georgia Hospital Association CEO Earl Rogers in a statement.

State law says the Newnan cancer hospital will see Medicaid patients and provide uncompensated indigent or charity care “which shall meet or exceed 3 percent of its adjusted gross revenues.” Medicaid is the joint state and federal program that serves eligible low-income Georgians, including those with certain types of cancer.

Cancer Treatment Centers of America at Southeastern Regional Medical Center saw a total of 10 patients covered by Medicaid in 2014 and was paid $12,787 for seeing those patients, according to the Georgia Department of Community Health, which administers the program. That tally covers both outpatients and people admitted to the hospital.

In a separate report filed on Friday covering inpatients only, the hospital said it admitted three Medicaid patients last year out of its total 1,007 admissions. That is less than 1 percent.

Patients with private insurance made up 88 percent of its hospital admissions, according to the report, while Medicare patients accounted for another 10 percent. Medicare is the federal health plan that covers most elderly Americans.

The hospital reported three admissions for self-pay patients in 2014 — the designation generally used by hospitals for uninsured patients who often qualify for charity care. Competing hospitals said such a low number of self-pay patients raises questions about the hospital’s commitment to providing charity care.

Hospitals generally get the highest payments from private insurance, and most hospitals have nothing close to the Newnan hospital’s percentage of privately insured patients.

Veazey also said most Georgia hospitals treat dozens of Medicaid patients every single day.

“If they only saw 10, they do not see Medicaid patients,” Veazey said.

CTCA said in a statement that it is in compliance with the state’s requirements, including the mandates to see Medicaid patients and to provide charity care.

Georgia’s hospitals must disclose how much indigent and charity care they provide, but the financial report covering 2014 is not due until later this year.

Cancer Treatment Centers of America has hospitals in Philadelphia, Chicago, Tulsa and Phoenix, in addition to the Newnan facility. The chain, which has become well-known nationally through its extensive advertising, bills itself as offering a unique, patient-centered approach to cancer that combines the latest treatments with natural therapies.

Last fall, the hospital completed an expansion of its hospital that reached its state-mandated cap of 50 beds. The expansion also included a four-story outpatient clinic and infusion center, a radiation therapy suite and two additional surgical suites.