Lawmakers not happy about cancer center rule change

Some state lawmakers are hot over what they see as a bureaucratic end-run by a politically connected cancer treatment company hoping to gain access to more insured patients from Georgia.

Now there is talk of special legislative committee meetings and lawsuits to stop Cancer Treatment Centers of America from getting what lawmakers wouldn’t approve during the 2015 General Assembly session.

“You can’t do 180 House members and 56 senators that way without there being repercussions,” said Senate Health & Human Services Chairwoman Renee Unterman, R-Buford. “It doesn’t work that way.”

The Department of Community Health board last week tentatively approved a rule change that could allow the company to shed its in-state patient cap. In doing so, it reignited a decade-long war between Georgia’s powerful hospitals and the national cancer treatment chain, two opponents with huge stables of well-connected lobbyists and a track record of generous giving to elected officials.

The company says the cap unfairly prevents Georgia patients from getting help at its facility.

Other hospitals counter that the company cherry-picks patients with the highest-paying insurance coverage while leaving other hospitals to shoulder the burden of care of Medicaid and other indigent cancer patients.

Georgia typically requires hospitals to go through a stringent “Certificate of Need” process that is intended to control costs and prevent an oversupply of health care facilities. But in 2008 the General Assembly allowed Cancer Treatment Centers of America to open the Newnan facility as a so-called “destination hospital” that would draw patients to Georgia. As such, lawmakers limited it to 50 beds and required that at least 65 percent of its patients come from out of state.

The new rule would give the hospital a pathway to become a general hospital that isn’t required to have an emergency room. With the new designation, it would no longer have to get most of its patient from out of state. It would also be able to apply, like other hospitals, to expand beyond 50 beds.

The DCH board’s decision kicked off a public comment period. A final vote is scheduled for November.

In a statement Tuesday, company officials said, “CTCA has not gone around the legislature; it has used the appropriate process to request a rule change which is available to every Georgia citizen. The rule simply provides a path to allow CTCA to be treated like every hospital in Georgia.”

Gov. Nathan Deal’s office said it knew about the vote but didn’t take a side.

The company’s executives helped organize a fundraiser for Deal in Newnan last fall during his re-election campaign. Deal collected $12,500 from Cancer Treatment executives Sept. 23 after attending a ribbon-cutting at their Southeastern Regional Medical Center.

After the DCH board vote last week, hospital groups talked of lawsuits to stop the rule change.

“I want there to be no mistake, that the Georgia Hospital Association and the Alliance of Community Hospitals, together, working united, will fight this proposal every step of the way up to and including court action,” said Earl Rogers, president of the hospital association. “We will not accept this rule lying down.”

Monty Veazey, president of the Georgia Alliance of Community Hospitals, said the cancer hospital has a track record of getting special treatment and failing to live up to its commitments to see Medicaid patients and provide charity care.

“They are a greedy bunch and we’re going to stop it,” Veazey said.

Lawmakers could act to stall the proposed rule change before the 2016 General Assembly session begins in January.

A seldom-used law would allow the health committees of the House and Senate - with a two-thirds vote - to stay a rule change. The committee could also decide to send the DCH board a message letting them know they object to the rule change. Typically agencies take the hint. After all, the General Assembly votes on their budget every year.

However, nothing is automatic when it comes to certificate-of-need issues or fights over who can provide what medical services. Such issues regularly develop into among the most highly charged and most expensive battles at the Capitol.

Since its push to enter Georgia began, Cancer Treatment Centers and its employees have contributed almost $400,000 to state party political action committees and the campaigns of lawmakers and other state leaders.

But they are up against some deep-pocketed players. The GHA and Georgia Alliance of Community Hospitals have contributed about $2 million to state lawmakers, candidates, state leaders and party political action committees over the past decade, according to disclosure reports reviewed by the AJC. Deal and his political action committee have collected more than $50,000 from the two groups. Lt. Gov. Casey Cagle’s campaigns have gotten almost $87,000.

Many Republican lawmakers aren’t big fans of laws regulating services that businesses like hospitals can provide. But the idea of using bureaucrats to skirt the legislative process rankles them.

“Why do we have CON laws if you can circumvent the law?” Unterman asked. “Why should you give CTCA an exception? Why are you picking and choosing winners?”

Rogers of the Hospital Association said other influential lawmakers feel the same way. “They are angry. They dealt with this last legislative session and decided not to go in the direction that this out-of-state hospital seeks,” he said. “So here comes CTCA attempting to do an end-around, which is indicative of exactly how they operate.”

But some of Unterman’s colleagues are sympathetic to CTCA.

“I think if any of these facilities want to expand to treat more patients and make people better, the Legislature needs to get out of the way,” said Rep. Chuck Martin, R-Alpharetta, whose mother was treated at the company’s facility. “This hospital and others want to treat more people, and anything we can do from a legislative standpoint to allow that to happen is better for Georgia.”