A sweeping new bill on hospital oversight and industry reform is moving atop Beacon Hill, in what House Speaker Ron Mariano's aides consider the most important health care cost containment bill in more than a decade. It represents something.
The Legislature's Health Care Financing Committee on Tuesday combined lessons learned from the Steward Health Care crisis, major changes to how state regulators work to rein in health care spending, and new tools to address facility expansion. Moved to redraft 97 pages. And closed.
Mariano has already expressed support for the bill, which will likely come to the House floor for a vote in the coming months as Congress races toward a July 31 deadline. , this will add even more weight and complexity to the already packed agenda. To complete major tasks for the year.
But it's unclear what kind of reaction the bill will elicit in the Senate. Top Democrats in the Senate have long focused on reining in prescription drug prices.
“This bill restores stability to our health care system and strengthens accountability within the industry, with the ultimate goal of ensuring everyone in Massachusetts has access to quality, affordable health care.” Mariano said in a statement to the news service. . “To achieve these goals, this bill seeks to improve the regulation and oversight of the health care market, inspired not only by the Steward Health Care Crisis but also by the larger challenges of an industry that has not fully recovered from the pandemic.” We're making important updates to how we do it.
Officials in Mariano's office called the wide-ranging bill the first to contain health care costs since a 2012 law that established a Health Policy Commission, a Center for Health Information and Analysis, and an annual benchmark to target spending increases. He claimed that this is the biggest effort towards achieving this goal.
A company has expressed interest in acquiring part of the struggling Steward Healthcare.
The bill also effectively acknowledges that existing regulatory and analytical structures are not adequately equipped to keep cost and spending increases within reason, and many health care providers Patients across the state are under financial pressure as they face their own burdens.
This situation existed even before the turmoil at private equity-backed for-profit company Steward Healthcare captured public attention earlier this year, and the committee's expansion bill took the crisis center stage into account. I'm putting it in.
Mariano's office said the changes inspired by Steward are primarily forward-looking, aimed at preventing similar problems from occurring in the future, and do not immediately alter the current arc of the turmoil. He said no.
Acute-care hospitals would need to own the land on which they are built in order to obtain a state license, according to a summary of the bill prepared by the committee.
This is in contrast to Steward, which sold its properties to real estate investment trust Medical Properties Trust in 2016 and is now leasing back hospital properties. The operation appears to have placed a burden on hospitals that they are struggling to manage. In January, Medical Property Trust announced that Steward owed about $50 million in unpaid rent.
Hospitals licensed before April 1, 2024, including Steward hospitals, are exempt from the new requirements.
The bill would also effectively require creditors and vendors to notify the Department of Public Health 60 days before seizing medical or surgical equipment, and would void agreements with providers that allow for faster seizures. The contents are as follows.
This clause is also a direct response to the stewards. In January, The Boston Globe reported on the case of Sungida Rashid, a 39-year-old new mother who died after doctors at Steward Hospital St. Elizabeth Medical Center were unable to use embolic coils to treat internal bleeding. . Because a few weeks ago she had an unpaid bill garnished.
Another section would significantly strengthen data reporting requirements and consequences, an area where stewards have long been said to have failed to comply with current law and been challenged in court.
Hospitals would be required to disclose audited financial statements regarding the out-of-state operations of their parent organization, certain private equity investors, real estate investment trusts, and managed services organizations.
Additionally, if you fail to meet these requirements, the penalty increases from $1,000 to $25,000 per violation, with no upper limit. The bill further authorizes DPH to block approval of certain licenses or expansions for systems that fail to submit appropriate financial data to the state.
However, steward-related changes are just one category of reforms.
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The redraft would also overhaul health care cost containment and management at the state level, including changing the existing one-year standard to a three-year cycle. Mariano's office said a longer time period would better account for dips and spikes in spending by individual companies.
In recent years, the rate of growth in total health care costs has exceeded the target rate set by regulators, and regulators are pressuring lawmakers to provide new tools to better curb this trend.
Other provisions of the bill make it clear that “payers” such as health insurance plans will be subject to both HPC scrutiny and performance improvement plans. It is a key tool for independent agencies to order industry players to rein in spending and force insurers to phase in premium payments. Apply the same rates to all providers in your network.
The bill would expand the performance improvement planning process by giving HPCs the power to tell companies how to reduce costs, rather than leaving it up to hospitals and systems to come up with their own ideas for financial management.
Almost every area of the healthcare industry is currently under tremendous pressure. Patients face increasingly unaffordable costs and, in some cases, delayed treatment, and healthcare providers struggle with tight profit margins and staffing shortages exacerbated by the pandemic. They have their own ideas on how to overcome rocky terrain.
Parts of the new bill aim to protect BayStars from loss of services and strengthen small community hospitals from the growing threat posed by large academic medical centers, long-time priorities of Mariano. It is.
This law codifies the requirement that any entity seeking to open an ambulatory surgery center in an area already served by an independent community hospital must first secure the support of that existing facility. It turns out.
HPC will also be involved when hospitals and healthcare providers relocate to discontinue critical services. Under current law, a health care provider must notify her DPH of a planned closure, explain the expected impact to patients, and develop a plan to ensure access to similar services elsewhere. be.
The bill would require HPC regulators to produce their own analyzes of the impact of shutting down critical services, effectively ensuring that conclusions come from independent state experts rather than from the organizations pushing for closures. It becomes something to become.
The Health Care Financing Committee gave members until 9 p.m. Tuesday to consider the proposal. As with all joint committees, senators hold a majority of seats, so the chair's support will likely advance the bill with a favorable recommendation, regardless of how senators feel.
Mariano's office did not provide any specific plans for action Tuesday. The speaker himself said last week that redrafting the health care bill and Gov. Maura Healey's similarly rich housing bond and policy bill were high on his to-do list.
A spokeswoman for Senate President Karen Spilka did not commit to bringing forward or killing the Health Care Financing Commission bill, but indicated Tuesday that the Ashland Democrat is considering a similar topic.
“Under the leadership of Senate President Cindy Friedman, the Senate is committed to understanding the impact of private equity in health care to keep pace with the changing health care market in hopes of preventing new incidents like the stewards crisis.” “We have taken steps to do so,” the spokesperson said. . “The Senate is also considering the possibility of changing or expanding the role of the Health Policy Committee, as it has been more than a decade since that role was changed or expanded. As with any bill, the Senate President and members need time to review the bill and solicit feedback.”
Over the past several terms, legislative leaders have agreed on bills that include expanding access to mental health services, protecting reproductive and gender-related care, and expanding insurance coverage for telehealth.
But they also haven't been able to reach consensus on some of the top priorities in the arena. The House approved the Hospital Expansion Oversight Act last term, which provided the narrow basis for the move, but it was never voted on in the Senate, while Senate Democrats pushed back on their failed prescription drug price reform bill. I've been paying attention. To gain momentum in the House.
