Kirk Long, chief executive officer of NeuroMedical Center Hospital in Baton Rouge, predicts this year's thwarted battle merely sets the stage for a future one. "Health care providers can't rely on found money to continue financing gaps in Medicaid funding," he says.
Long, who helped build Park Place Surgical Center in Lafayette, also is the executive director of the Louisiana Association of Focused Care Facilities, which represents the state's 16 specialty hospitals.
The original bill, proposed by Rep. Sidney Mae Durand of Parks, called for a one half of 1 percent tax on gross revenues gathered by most health care providers in the state. The bill was proposed on behalf of Gov. Kathleen Blanco's administration.
The state hospital association, however, countered with a proposed bill that would have taxed only small "boutique" hospitals, facilities that concentrate on providing specific care. Under that plan, rural and community hospitals that treat indigent patients would have been exempt from the new tax.
In Lafayette, there are four specialty hospitals, including Park Place, Heart Hospital of Lafayette, Lafayette General Surgical Center (operated in partnership with Lafayette General Medical Center) and Lafayette Surgical Specialty Hospital. The recently opened hospitals compete for patients with the large hospital providers, including Lafayette General Medical Center, Our Lady of Lourdes and Medical Center of Southwest Louisiana.
And they are succeeding.
The infighting over the proposed tax highlights a growing enmity between the large hospital health providers and the doctor-owned specialty hospitals. The large hospitals argue that the specialty centers are siphoning off profitable procedures, like heart surgeries, that help pay for loss leader trauma units and burn wards. And since the specialty hospitals don't accept indigent patients, they avoid the cost of absorbing care for the uninsured.
Long says Durand's bill, by her own admission, was introduced to jumpstart a discussion about self-taxation of the hospital industry.
"It's obvious there is a need for hospitals to solve revenue problems," Long says. He equates the problem to challenges faced by nursing homes in the 1990s; the nursing home industry responded by taxing itself and placing the money in a trust that receives matching funding from the federal government. "The feds have restricted many of these matching fund programs," Long says, but they are still available for health care. "It's a big opportunity for hospitals and other health care providers to raise revenue."
The large health care providers might be wary of a tax that would raise matching funds, says Joe Donchess, executive director of the Louisiana Nursing Home Association. The industry in 1992 was a "reluctant proponent" of a bill passed to tax the nursing homes, but only because the matching funds were supposed to be funneled back to the nursing homes.
That happened for a couple of years, Donchess says, before the Foster administration began diverting the money to other health care programs.
He estimates that the nursing home industry alone raises $67 million a year, money that is matched by the federal government. The tax also applies to the mental health care and pharmacy industries, which raise a collective $30 million annually that's matched by the feds.
"We are what is called the cash cow of state government," says Donchess. The nursing home industry has paid some $770 million in taxes, generating $1.8 billion in federal matches.
A bill proposed this year would return those matching funds to the nursing home industry, Donchess says.
On the other hand, he adds, he does not think the federal government will allow Louisiana to tax only one segment of the industry ' like specialty hospitals ' in order to receive matching grant money.
He says the large hospitals might be more agreeable to a provider tax, but only if the Blanco administration will promise in the language of the law that the money collected goes to the hospitals that provide indigent care.
Long argues that an LSU study shows that only 2.1 percent of the total cost spent on providing health care in this state is spent on indigent care at the largest community hospitals. That study, conducted by Donald Smithburg, chancellor of the LSU hospital system, shows that the national average is 6 percent.
"The charity hospitals take care of the vast majority of indigents [in Louisiana]," Long says, noting that the for-profit Medical Center of Southwest Louisiana currently accepts no Medicaid patients, while the non-profit Our Lady of Lourdes pays no taxes.
He adds that the focused care association had no problem with Durand's broad-based hospital tax, agreeing that it was time for hospitals to help fill in funding gaps.
Under the state association plans, money raised through a hospital tax would be returned to the community hospitals to help pay for the treatment of the uninsured and to raise their Medicaid rates, says Burton Dupuis, chief executive officer of St. Martin Hospital. His facility would have been exempt under the hospital association plan.
The debate is just getting started. After multiple requests for comment, John Matessino, state hospital association president and CEO, would only say, "We are still discussing positive health care reform with the administration and are optimistic."
Despite sweeping changes enacted by Gov. Bobby Jindal's administration, the health insurance program for state workers and public school employees will have to use $88 million from its reserve fund to cover its costs this year.
The LPSB races are sure to get heated between now and Nov. 4, and with only 9 available seats, this year's field of 20 candidates will surely be wanting to set themselves apart from the crowd early; they'll get their chance next week, starting Tuesday with the kick-off of a three-day series of candidate forums.
Lawmakers say they've received complaints that waits have spiked, with people being forced to wait in line for more than an hour — and sometimes three hours — to handle routine tasks.
The campaign announced that Rep. Stuart Bishop of District 43 and Nancy Landry, District 31, have thrown their support behind the Naval Academy graduate and entrepreneur in his bid to unseat current Hunter Beasley in District 8.
A Lafayette man with an alleged taste for child porn was busted Thursday evening during a cyber crime sting launched by the Attorney General’s Office.
U.S. Rep. Vance McAllister says his chief of staff is on temporary leave after being booked with drunken driving.
It was a rare moment in Congress this week as Republicans briefly put aside partisanship in support of President Barack Obama's request to train and arm Syrian rebels, and while a number of Democrats opposed the measure, Louisiana's Democratic Sen. Mary Landrieu found herself on the same side of the issue as her Republican challenger Rep. Bill Cassidy.
Home Depot breach bigger than Target; Alibaba IPO could be big; Rivers' last project and more national and international news for Friday, September 19, 2014.
Friday's Blogs from the Bog!
City-Parish President Joey Durel is asking the council to sign off on a resolution approving a pair of deals that would lead to razing the seedy Lesspay Motel at Four Corners to build a new police substation as well as transforming nearly a block Downtown where the old federal courthouse building now molders into a mixed-use development.
In 2013, the IRS — already the least popular governmental agency in the country — became the target of intense investigations after it was revealed that they had specifically and improperly scrutinized applications for tax-exempt status from organizations associated with the nascent Tea Party movement.
Improving the running game was "a point of emphasis" during the offseason and the results have manifested themselves in the form of substantially greater production.
Louisiana's health department said Wednesday that its evaluation of the state's Medicaid privatization was on target, despite criticism from the legislative auditor that it lacked key data and contained inconsistencies.
The feds converge on your office, seizing records on several employees as part of a pay-for-plea investigation. WWYD? If you’re Mike Harson, you give yourself a $12k raise.
It’s football season and after back-to-back winless weekends for the Saints and the Cajuns many citizens are finding it difficult to be civil much less happy. Well, chew on this.
Considering his repeated stays in the local penal system, David Narcisse Jr. should have known that having a semiautomatic shotgun, even one given to him by a friend, wasn’t the brightest of ideas.
A state district judge on Tuesday threw out a last-minute retirement hike lawmakers gave to the state police superintendent, ending a political firestorm over a pension boost passed without public scrutiny on the last day of the legislative session.
The House has passed a bill to increase oversight of veterans' hospitals under construction, following a report that some medical centers take three years longer to complete than estimated and cost an extra $366 million per project.
An obvious follow-up question for any Republican politician who accuses Democrats of being science deniers is one about science, to which Jindal bobbed and weaved like a welterweight champ.
The Lafayette City-Parish Council is expected to decide tonight (Tuesday) whether to go along with a proposal City-Parish President Joey Durel made in February’s State of the Parish Address and consolidate taxes for mosquito control and the parish health units into a broader tax program that would also cover animal control.
U.S. District Judge Richard Haik has dismissed Greg Davis’ lawsuit against the LPSB, yet in his ruling, the federal judge doesn’t bite his tongue in pointing out the "threat" being posed by certain board members.
Of all the political offices being contested throughout Lafayette Parish, the race for Broussard’s top police post has literally become one of the most heated.
A state district judge is deciding whether to issue an injunction against the enforcement of a last-minute retirement hike that lawmakers gave to the state police superintendent.
A new website is up for Louisiana's state government employees and retirees to choose their health insurance plans for next year, a choice they must make by October.
That fact that New Orleans led both games in the final 10 seconds of regulation, and lost each by a field goal or less, is of little solace.