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."
A push to expand Louisiana's Medicaid program as allowed under the federal health care has been overwhelmingly rejected by the Senate health committee.
Louisiana welfare recipients would be prohibited in state law from spending the federal assistance at lingerie shops, tattoo parlors, nail salons and jewelry stores, under a bill that received the support Wednesday of a House committee.
Senators will consider whether to prohibit private businesses in Louisiana from paying unequal wages to employees of different genders for the same job.
Rep. Joel Robideaux has delayed bill hearings and said unless a compromise can be reached, he won't bring up the legislation this session.
Once again, Lafayette Parish School Board President Hunter Beasley is focused on an issue that has nothing to do with the educational well-being of our public school children.
After exhausting his appeals all the way to the state Supreme Court, the owner of the Tiger Truck Stop in Grosse Tete has no legal remedy left save one: do an end run around the high court via a bill that would grandfather his “right” to keep a 550-pound tiger enclosed in a pin at his roadside business.
Louisiana poet Darrell Bourque has won the 2014 Louisiana Writer Award, given annually to recognize outstanding contributions to Louisiana's literary and intellectual life.
Drivers would have to secure dogs riding in truck beds while on interstate highways, if the Senate agrees to a bill backed by the House.
Here's your daily look at late-breaking national and international news, upcoming events and the stories that will be talked about Wednesday, April 23, 2014:
Wednesday's Blogs from the Bog!
An effort to prohibit employers from discriminating based on sexual orientation or gender identity was shelved Tuesday for the legislative session.
Louisiana won't lessen its penalties for marijuana possession, keeping laws on the books that allow people to be jailed up to 20 years for repeat offenses of having the drug in hand.
“This is one of the oldest divides that exists, and that divide is about the haves and the have-nots.”
It took a few weeks for the pitfalls to emerge in the governor’s $25 billion budget, but the time of judgment has finally arrived.
With pressure continuing to build for him to resign, Congressman Vance McAllister announced plans recently to remain secluded during the Easter break, but the Swartz Republican has said he’ll be back on the Hill casting votes and attending committee meetings when the congressional recess ends April 28.
A bid to limit the use of unmanned aircraft on private property in Louisiana stalled Monday in the Louisiana Senate.
A Shreveport lawmaker said Monday he's scrapping his proposal to name the Bible as Louisiana's official state book.
Attorney hopes fellow lawyers will join him in urging the D.A. to step aside and allow a competent, ethical challenger to take over the scandal-ridden office.
An official with the Louisiana Department of Education was arrested on a range of charges Friday after allegedly breaking into a home and brandishing a knife.
State Rep. Stuart Bishop says he’s concerned with the quality of Capitol Lake, but when it comes to Louisiana’s coastline, this Lafayette Republican doesn't seem to give a damn.
Democrats sweating this year's elections may be hoping that the Obama administration's latest delay to the proposed Keystone XL pipeline takes a politically fraught issue off the table for the midterms.
Louisiana lawmakers are entering the second half of their three-month regular legislative session, which must end by June 2. Where some of the major issues stand:
Local and state agents Thursday night raided The Keg, the popular college bar located in the area known as The Strip, leading to the (at least) temporary closure of the venue.
Time and time again, the Lafayette Parish School Board shows an overwhelming tendency toward idiocy, but Wednesday night’s contentious discussion over Northside High School’s teen mother program tops the list of dumb discussions.
“The accomplishment of this goal within the next ten years is not only critical for the region to effectively compete with other regions for residents and businesses, but also to provide an amenity for everyone in Acadiana to enjoy.”