A Verbal Showdown over Cancer Hospital Proposal

A patient’s right to choose. Legislative authority on health care. “Cherry picking’’ the privately insured.

These themes highlighted the vehement arguments made at a state agency hearing in Atlanta on Tuesday as advocates and critics clashed over a proposal to eliminate state requirements for a Newnan cancer hospital.

The Department of Community Health’s board will vote next month on the controversial proposal to allow Cancer Treatment Centers of America’s Georgia facility to reclassify as a general acute-care hospital.

The idea has generated strong reactions within political and health care circles. Leaders of key health committees in the Georgia Senate and House have voiced their concerns about the rule change.

The proposal, if it gains final approval from the board, would allow CTCA to seek a reclassification as a general hospital. And if the cancer hospital wins a “certificate of need’’ (CON) for that change, it could then avoid the current restriction of having no more than 35 percent of its patients come from Georgia.

CON is the regulatory apparatus in Georgia, as in some other states, that governs the construction and expansion of health care facilities. Under Georgia law, hospitals are required to obtain CON licenses for major construction projects and expansions of service.

Cancer Treatment Centers of America is a for-profit company known for its sophisticated marketing. It operates five regional cancer hospitals: the one in Newnan, which opened in 2012, as well as centers in Philadelphia, Tulsa, Phoenix and Chicago.

Other Georgia hospitals have been highly critical of CTCA’s approach to the business, and they have opposed efforts to expand its footprint here.

 

Impassioned arguments

At the hearing, Rod Echols of Fayetteville told a packed audience that he received good care for his colorectal cancer at the Newnan facility, and he said he wants all Georgia patients to have the right to choose the hospital.

“A law should not dictate where we should go,’’ said Echols, 42. “We want others to have that option.”

CTCA executive David Kent added that “we are not seeking to circumvent Georgia’s CON law.”

Opponents of the CTCA rule change wore buttons proclaiming their positions at a hearing Tuesday

“It’s about patients,’’ Kent said. “We will continue to fight for their choice.”

The proposal could pave the way for the cancer hospital to see more Georgia patients, including those on Medicaid, said Victor Moldovan, an attorney representing CTCA.

But large hospital organizations, along with officials with individual health systems, testified against the proposal.

Earl Rogers, president of the Georgia Hospital Association, said CTCA has the reputation of “cherry picking’’ patients with the best insurance coverage. He called the reclassification idea “an end-around”’ the General Assembly’s authority over health care. And Rogers noted that if CTCA converts to a general hospital, would not have to offer emergency room services.

“Not one [other] hospital supports this rule change,’’ he declared.

Jeff Baxter, general counsel for Emory, said the proposal gives CTCA “a free pass from where they are to where they want to go.”

Many people attending the hearing wore buttons in opposition to the CTCA proposal.

The Georgia Alliance of Community Hospitals said nonprofit hospitals give “vast amounts of care’’ to indigent patients and those covered by Medicare and Medicaid — people whose care receives lower levels of reimbursement.

Jerry Fulks, CEO of West Georgia Health in LaGrange, said, “CTCA has not fulfilled their commitment to indigent care.”

And Dr. Doug Patten of the Georgia Hospital Association said some patients with Medicare coverage have been turned away by CTCA.

Cancer Treatment Centers of America has operated under certain restrictions in Georgia since it opened its Newnan facility. The restrictions were imposed by the Georgia General Assembly to satisfy the concerns of critics of the chain.

CTCA has been lobbying state lawmakers to ease the restrictions, but it dropped that effort this year after its support for new legislation was unsuccessful. The proposal for a Community Health reclassification represents a starkly different avenue toward achieving the same goal.

CTCA’s Kent told the hearing that the cancer hospital has produced $1.3 billion in new economic activity in Georgia and employs more than 1,000 here. CTCA has provided more than $365,000 in contributions to charitable organizations, Kent added.

 

Controversy either way

Clyde Reese, the Community Health commissioner, acknowledged recently that the CTCA proposal “will be problematic to many hospital competitors’’ of the cancer hospital.

“The proposal would “build a bridge that does not exist today,” he added.

During the Georgia General Assembly session, the high-profile hospital chain supported House Bill 482, which would have eliminated the requirement that 65 percent of the cancer hospital’s patients come from out of state. That rule was imposed by the Legislature in 2008 when it allowed the construction of the facility.

The legislation, which met strong opposition, also would have also allowed the cancer hospital to expand its bed capacity.

Reese said recently, “We’re changing the venue of the fight. This issue is not going away.”

He added that if the CTCA proposal passes the board, and if the company wins its CON, it would need a separate CON to expand its bed capacity past its current limit of 50.

State Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human Services Committee, told the AJC that her panel is watching the Community Health action.

“I and the rest of my committee members will closely monitor the board’s action, and we reserve the right to intervene or take corrective action, if necessary,” Cooper said.

The AJC’s James Salzer reported this week that 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 the Georgia Hospital Association 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.

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