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Plan to help same-day surgery centers will get more study

By Renee Elder and Ames Alexander
aalexander@charlotteobserver.com

RALEIGH A proposal that would have made it easier for physicians to open same-day surgery centers will be deferred for a year while a study committee takes an in-depth look at state and federal regulation of medical facilities.

Rep. Mark Hollo, chairman of the state House Health and Human Services Committee, said the original bill was amended to give lawmakers more time to gather information about the state’s complex certificate-of-need process before making any changes.

“The original bill was controversial,” said Hollo, a Republican from Taylorsville. “People were concerned, so we were not ready to put it through without more study.”

House Bill 177 was originally written to exempt certain single-specialty surgical facilities from having to obtain a certificate of need from the state Department of Health and Human Services. The certificate is required before medical facilities such as hospital rooms and surgical centers can begin accepting patients.

DHHS officials say that process prevents unnecessary duplication of medical facilities and is intended to keep costs down, but supporters of the bill to exempt same-day surgery centers maintain that the process limits competition and drives patient bills even higher. Same-day surgery centers typically charge far less than hospitals for outpatient procedures.

The N.C. Hospital Association lobbied heavily against the original bill, sponsored by Rep. Marilyn Avila of Raleigh. Backers included the N.C. Orthopaedic Association and the State Employees Association.

Connie Wilson, a lobbyist who was working for the bill on behalf of the orthopedic association, said she’s optimistic that a study will lead to the changes her clients have sought.

“It used to be that hospitals didn’t have to answer questions. They were untouchable,” Wilson said.

Now, she said, recent coverage about hospitals has “made them more politically vulnerable than they’ve ever been.”

A series of investigative stories in the Observer and the News & Observer of Raleigh last year explored how the growing market power of hospitals has driven up prices. The stories examined soaring profits at nonprofit hospitals, huge executive salaries, minimal spending on charity care and efforts by the hospitals to sue uninsured patients delinquent on their bills or turn over the accounts to collection agencies.

Hollo said members of the Health and Human Services Committee want to know more about the certificate of need process “and why it is used in some states and not others” before making any changes.

The bill to set up a legislative research committee was approved in the House last week by a vote of 112-2. If it passes the Senate, the special committee would be appointed by the speaker and begin meeting later this year, Hollo said.

Ambulatory surgery centers have expanded across the country, along with the trend toward shorter postoperative hospital stays and increases in outpatient surgeries. There are 114 such centers in North Carolina, according to a report by Strategic Healthcare Consultants.

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