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."
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.”
Education Superintendent John White says a continued push to try to keep Louisiana from using tests associated with the Common Core education standards are creating "a state of chaos" for public school teachers.
Gov. Bobby Jindal's plan to use $210 million in surplus and one-time money to help balance next year's budget received the backing Thursday of the State Bond Commission, support that was needed for the maneuver to work.
State wildlife and fisheries agents have arrested a 39-year-old man accused of stealing crawfish.
An East Feliciana Parish lawmaker has jettisoned his proposal to make it harder for a condemned prisoner to appeal a death sentence.
Senators advanced a proposal Wednesday that would let the governor remove New Orleans-area levee board members for violating what he considers to be public policy, despite concerns it would introduce political meddling into state flood protection.
Here's your daily look at late-breaking national and international news, upcoming events and the stories that will be talked about Thursday, April 17, 2014:
Thursday's Blogs from the Bog!
The Lafayette City-Parish Council on Tuesday will vote on a resolution that if approved would clear the way for a December ballot proposition asking voters to approve a 1-cent sales tax parishwide to help fund the construction of a new terminal at Lafayette Regional Airport.
Just days before the fourth anniversary of the 2010 Deepwater Horizon disaster and oil spill, the Coast Guard has moved cleanup of Louisiana's coast to a new phase, allowing BP to end its "active" efforts in the area.
Legislators still must leave their guns at the door of the Louisiana Capitol.
Sen. Fred Mills may have an "R" behind his name, but his actions in the Louisiana Legislature transcend the established boundaries of his party.
The Louisiana House overwhelmingly rejected a repeal of the state's unconstitutional anti-sodomy law Tuesday.
The Louisiana Senate sided with Gov. Bobby Jindal and the oil industry Tuesday, agreeing to void a lawsuit that a south Louisiana flood board filed against more than 90 oil and gas companies for coastal damage.
Acadian rep notifies would-be supporters that an April 25 fundraiser for the embattled U.S. rep won’t go on as planned.
While it isn’t all too unusual for public bodies to have hired security present during meetings, the LPSB’s push to do so is arguably a response to the antics of one board member.
“I’m running. Why would I be raising all this money? Just to have to return it to people?”
With incumbent U.S. Sen. Mary Landrieu watching from afar, and with a united Democratic Party in her corner, the fight to get the GOP officially behind Congressman Bill Cassidy is gaining just as much momentum as it is hushed controversy.
15th Judicial District Judge Durwood Conque has announced that he will not seek re-election after 27 years on the bench.
The controversial standardized tests are set to be used in third-grade through eighth-grade public school classrooms next year.
The Louisiana Senate has agreed to prohibit unmanned aircraft from flying over chemical plants, water treatment systems, telecommunications networks and other items considered "critical infrastructure" in Louisiana.
It didn’t take long for KATC TV 3 to jump all over the news of a dead body found in Girard Park, but in its rush to produce headlines, the local TV station got sloppy.
An unholy trinity of civil-society upheavalers whose first names are not Conner, Tanner or Logan are facing charges in Eunice.
Now that lawmakers have shot down efforts to cap annual interest rates for payday loans, supporters for stricter regulations of the storefront lenders are rallying behind another strategy.