Cat bill strays into health policy reform

Posted June 7, 2016

— Senate leaders say a House bill naming the bobcat as North Carolina's official cat will be gutted and turned into the latest attempt to end the certificate of need system, which governs when health providers can open new facilities or buy large pieces of equipment.

Senate Rules Committee Chairman Tom Apodaca announced the move in his committee Tuesday. Sen. Ralph Hise, R-Mitchell, the primary author of the health policy language, said he expects the bill to be heard in the Senate Health Committee on June 14.

The legislative language poised to jump into House Bill 161 is similar, if not identical, to a provision the Senate proposed as part of last year's budget. That language was removed before the 2015-16 budget was enacted into law.

Health Care Costs Bills seek end to 'Mother, may I?' system for new health care equipment "Everyone knows this is an antiquated law," Hise told reporters Tuesday, saying it imposes "the most restrictive regulations on some of the largest employers in the state."

Under the certificate of need system, health providers cannot simply open a nursing home or buy an MRI machine. They must ask the state for permission to make those moves. A division of the Department of Health and Human Services then certifies that there is enough demand in the market to justify the expansion or rejects the move.

Some medical providers have chafed under the regulations. Specialty doctors, for example, often argue they could provide procedures such as eye surgeries or knee repairs faster and with less cost if they were allowed to expand the use of outpatient surgical centers. But hospitals and other large providers argue that allowing new facilities to open piecemeal would drain the most profitable bits of the health care business into silos, leaving large community health centers to struggle.

"These large employers say these (certificate of need) regulations are necessary to stabilize the market," said Cody Hand, a lobbyist with the North Carolina Hospital Association.

Hospitals are already dealing with big changes in progress to the state's Medicaid system and changes wrought by the federal Affordable Care Act. The health care marketplace is shifting so quickly, advocates say, that adding in another major factor would be harmful.

In its current form, Hise's bill would take effect in 2021. He said that the date may shift to give hospitals and others more time to adjust.

Hand said that any timeline, whether it would be five years or longer, would "create chaos" in the health care marketplace. However, while hospitals wouldn't support removing certificate of need entirely, they could support changes to how those certificates are issued to make the process less cumbersome.

"The process to get (a CON) hasn't been updated in 24 or 25 years," he said.

While similar measures have been popular in the Senate over the past four years, the House has pursued a much more deliberate path. Rep. Marilyn Avila, R-Wake, introduced a bill last year that would remove certain types of facilities from the CON process but leave the overall law otherwise intact.

​Meanwhile, Rep. Bobbie Richardson, D-Franklin, apparently was not told her bill was slated to become something else. She approached Apodaca, R-Henderson, after Tuesday's Rules Committee meeting asking if the language involving the state cat might be preserved. He said no.

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  • Stacie Hagwood Jun 7, 2016
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    State cat? WTH are we electing? The news of the GA antics gets worse every day.