Chattanooga Times Free Press

Georgia House proposes bill to ease opening of more rural hospitals

- BY MICHELLE BARUCHMAN

Georgia hospitals, particular­ly those in rural areas and those providing psychiatri­c care, could open or expand more easily under a new House bill backed by the chamber’s Republican leaders.

The legislatio­n sponsored by state Rep. Butch Parrish, a Republican from Swainsboro, would roll back regulation­s to build new hospitals in counties with fewer than 50,000 people. It would also increase the pool of tax credits from $75 million to $100 million for taxpayers who donate to rural hospitals.

It leaves intact other parts of the regulatory process, known as the certificat­e of need system, or CON. That sets up a clash with the Senate, whose leaders have endorsed an effort to repeal the entire system.

Hospitals worry scaling back the system will make them fight over talent and profit, while some — particular­ly in rural communitie­s — have said the burdensome process leads to years of delays and scares away potential investment.

To open a new hospital in Georgia under current law, hospitals must demonstrat­e a significan­t need for care. The rules were created to help control the costs of government reimbursem­ents for Medicaid and Medicare.

In the House bill, those rules would be eliminated for rural hospitals so long as they meet certain criteria, including providing instructio­n for medical residency students and psychiatri­c care.

House Speaker Jon Burns supports the bill and assigned it to the House Health Committee on Tuesday.

“The speaker believes that this is a comprehens­ive, robust piece of legislatio­n that will increase transparen­cy, accountabi­lity and access to health care across our state while also supporting our rural hospitals, and looks forward to its favorable considerat­ion from the lieutenant governor and Senate,” Burns spokespers­on Stephen Lawson said.

Still, the legislatio­n is only a first step in a lengthier process.

Both the state House and state Senate are crafting versions of legislatio­n easing CON rules. However, the House version would seek a more limited path, preserving CON rules in certain circumstan­ces, compared with the Senate’s preference aiming to repeal all CON provisions.

“I’m glad to see the House take up this effort to increase competitio­n in the health care marketplac­e and reduce costs for Georgia families,” Jones said in a statement, adding that he would continue to make overhaulin­g CON “a reality.”

Under the House proposal, hospitals at 60% or greater capacity for a continuous 12-month period could expand capacity by up to 20% without needing CON approval. The bill does not specifical­ly address workforce concerns, including the fact that many hospitals have not had enough staffing to keep all beds available to them open.

However, the legislatio­n does seek to support medical residency programs by removing CON requiremen­ts for acute care facilities in rural counties that agree to be teaching centers, providing instructio­n to medical residency students.

Hospitals in rural counties would also have to agree to provide psychiatri­c care in order to be exempt from CON rules. And hospitals would not have to go through a CON process if they expand beds for inpatient psychiatri­c or substance use treatment or provide charity care for lowincome and uninsured patients for at least 5% of the hospital’s adjusted gross revenue.

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