NEWS-SENTINEL EDITORIAL: Lawmakers wisely back off proposal that might have hurt Indiana hospitals
While Indiana lawmakers were eager to pass legislation that would supposedly help control the high costs of health care for Hoosiers, we are glad to see that common sense prevailed this week before a bad idea got made into law.
Legislators were considering a proposal that would cut how much insurance companies pay for medical services performed at sites not located on a hospital’s main campus.
Hundreds of doctors, nurses and hospital executives packed the Statehouse Monday to protest the payment limitations that had been added to a bill Republicans thought would be a step toward reducing growing health care costs. In reality, the hospitals say, the legislation could cripple Indiana’s health care system and lead to hospital closures.
Had it passed into law, the “site-of-service” language in the bill would have forced hospitals to charge for procedures based on where they are performed. The hospital would be paid less for medical services performed at a clinic not on its main campus, such as a cancer center.
Fortunately, lawmakers Monday rolled back the payment limitations.
A Senate committee had advanced the hospital billing proposal last week, even though some senators said the possible impact on hospitals hadn’t been sufficiently reviewed and legislators were struggling to sort out what should be considered a hospital service.
Indiana Hospital Association President Brian Tabor said the proposal would squeeze the revenue stream for many hospitals by upending the contracts they now have with insurance companies.
“It would be devastating — hundreds of millions of dollars, if not more, in cuts,” Tabor said in an Associated Press report. “That would mean closing services, reduction in staff and even the closure of entire hospitals.”
But with lawmakers facing a deadline next week to adjourn this year’s session of the General Assembly, a state Senate voice vote Monday was unanimous in favor of removing the provision. Instead, an amendment was adopted that would require hospitals to report to insurance companies details about the locations where procedures are performed.
The language for the original proposal was included in House Bill 1004, sponsored by Rep. Ben Smaltz, R-Auburn, until senators adopted the amendment to reverse it. Smaltz argued that while procedures provided in hospitals will be more expensive because of the costs of providing services such as 24-hour emergency rooms, procedures performed off-campus shouldn’t cost as much.
“That bill is less because it just makes sense, the overhead is less,” Smaltz reasoned.
But hospital officials say some high-level services, such as cancer centers, are deliberately located away from hospitals to reduce the exposure of patients to potential illnesses. Tabor said some landlocked hospitals have expanded a few miles away to better serve the community.
AP quoted Denise Dillard, the chief of advocacy for Methodist Hospitals in Gary and Merrillville, who said an off-campus clinic that provides services to pregnant women that was intentionally located away from the hospital to be more convenient for patients might be closed if the legislation had passed.
“It is about the patients we serve and access — making sure that they have a safe, high-quality place to go that is close to their home, not convenient to our structure,” Dillard said.
Sen. Ed Charbonneau, R-Valparaiso, told AP that in putting together HB1004, lawmakers were taking the first steps in a long process in addressing health care costs.
“We are not going to solve all of the problems in one session, and we have to take the long term look at this,” he said.
We trust legislators will take their time and make sure of the impact of the proposals they consider. We are grateful that in this case the hospitals’ concerns were considered and our elected officials had the wisdom to pass a sensible amendment to the bill.