Ongoing Debate Over Revised Cardiac Catheterization Standards

Larry Messina at Lincoln Walks at Midnight round up of latest links/articles discussing the ongoing debate over the revised certificate of need Cardiac Catheterization standards. The debate has pitted hospital against hospital and resulted in full page ads and a media blitz by both sides in the debate.

Governor Manchin has until Friday (tomorrow) to decide whether he will approve the revised standards developed by the West Virginia Health Care Authority or send them back with recommended modifications.

For more history on the standards with links to the revised standards see my previous post.

UPDATE (7/18/08): This morning Governor Manchin issued the following statement indicating that he is sending the proposed Cardiac Catheterization standards back to the West Virginia Health Care Authority to revise and clarify the "medical transport drive time" language.

The Daily Mail reports on the decision.

STATEMENT FROM THE GOVERNOR ABOUT HEALTH CARE AUTHORITY’S PROPOSED ANGIOPLASTY STANDARDS

Contact: Lara Ramsburg, 304-558-2000

Gov. Joe Manchin today released the following statement about his approval, WITH EXCEPTION, of new West Virginia Health Care Authority rules that would allow some smaller hospitals in the state to perform angioplasty and other cardiac catheterization procedures:

“Any time we’re charged with making a decision that affects the quality of health care for our citizens, it’s a decision that must be carefully considered. In this case, we’ve taken a very close look at data gathered over several years, and a number of other facts about the ability of our hospitals to perform heart angioplasty procedures that have the potential to save hundreds of lives, especially given our state’s high heart disease rates and rural nature.

“Based upon this research, and the recommendation of the Health Care Authority, I am approving the majority of the standards that will give our citizens easier access to important emergency heart procedures; however, I have directed the Health Care Authority to revise the rules as they pertain to elective cardiac catheterization service and return them to me for reconsideration as soon as possible.

“Due to the ambiguity in the term ‘medical transport drive time,’ the current language in the proposed standards does not make it clear as to which hospitals could provide the elective procedure to their patients, so I believe the standards should be written to make sure that the appropriate hospitals are allowed to provide this service, under the strict guidelines and monitoring of the Health Care Authority.

“This decision, in its entirety, is solely based upon one objective – to provide all of our citizens, regardless of their location, access to the best possible medical care in their time of need.”

– Gov. Joe Manchin

WVHCA Board Approves Modified Cardiac Catheterization Standards

Yesterday, the West Virginia Health Care Authority Board approved the changes to the Certificate of Need Standards for Cardiac Catheterization. The approved modification will now be delivered to Governor Manchin for review and approval.

Eric Eyre of the Charleston Gazette covers the story today in his article, Smaller hospitals get OK to offer heart procedures.

The new Standards will not go into effect until approved by the Governor. The current Cardiac Catheterization Standards were last updated and approved by the Governor on May 3, 2007.

For more on the process of modifying the standards check out my previous posts.

WVHCA: Update on the Proposed Cardiac Catheterization Standards

I previously posted about the proposed amendments to the Certificate of Need Cardiac Catheterization Standards issued by the West Virginia Health Care Authority for public comment.

Today, Charleston Gazette reporter, Eric Eyre, reports on the current debate over the standards. To learn more you can read the comments submitted regarding the proposed standards.

WVHCA Grants Motion to Dissolve Stay in Manor Care CON

Yesterday the West Virginia Health Care Authority issued an Order Dissolving Stay. The Order granted MCHCR's (Carlyle Group) Motion to Dissolve Stay but denied the Motion to Affirm the Initial CON Decision.

The Authority set January 7 as the date for initial briefs to be submitted by both parties as a result of the Reconsideration Hearing held on December 14.

Governor Manchin Rejects New Certificate of Need CT Standards

Eric Eyre reports in today's Sunday Gazette-Mail that Governor Manchin has rejected the proposed new Certificate of Need CT Standards approved by the West Virginia Health Care Authority last month.

The article indicates Governor Manchin sent a letter to the Authority's Board on Friday, December 7, asking that they re-examine the imaging equipment proposal and submit a revised plan. The article also indicates that Governor Manchin rejected the proposed new standards on the basis that the standards did not require physicians to accept low income patients.

For more background on the proposed new standards see my previous posts - here and here.

UPDATE (12/10/07): Governor Manchin's December 7, 2007 letter to the WVHCA.

UPDATE (1/26/08): On January 18, 2008, Governor Manchin approved the Authority's revisions to the Certificate of Need Computed Tomography Services Standards.

WVHCA Reconsiders HCR Manor Care CON

The State Journal provides background on the pending reconsideration hearing set for December 14, 2007 (9am), before the the West Virginia Health Care Authority regarding the Authority's granting of a certificate of need for the $6.3 billion buyout of HCR Manor Care by The Carlyle Group, a private global investment firm.

The Authority granted HCR Manor Care a certificate of need on October 19, 2007, however, on November 15 the Service Employees International Union Local 1199 filed a Request for Reconsideration with the Authority along with an Appeal to the Office of Judges.

On November 20, the Authority issued its Decision on Request for Reconsideration granting the reconsideration and ordering a stay of its October 19, 2007 decision pending resolution of the request for reconsideration.

UPDATE (12/10/07): Jeff Mehalic at the West Virginia Business Litigation blog picks up on my post and includes uploaded links of some of the CON pleadings in the matter, including the:

• Authority's October 19, 2007 CON Decision approving the merger between Manor Care and Carlyle Group
  
• SEIU District 1199's Request for Reconsideration
• the Authority's Decision on Request for Reconsideration granting reconsideration, a hearing on the reconsideration and a stay of its October 19 Decision and
  
• the Amended Notice of Administrative Hearing set for December 14.

Thanks to Jeff for the link and for uploading some of the key public documents in this pending certificate of need matter.

WVHCA Issues Proposed Amendments to Cardiac CatheterizationStandards

The West Virginia Health Care Authority issued and approved on November 14, 2007, proposed amendments to the Cardiac Catheterization Standards.

The Notice of Public Comment Period indicates that comments must be submitted to the Authority by December 14, 2007.

WVHCA Approves New Certificate of Need CT Standards

Eric Eyre of the Charleston Gazette reports on the board decision by the West Virginia Health Care Authority approving new Computerized Tomography (CT) Standards under West Virginia's Certificate of Need Program. The proposed standards will now be sent to Governor Manchin for final approval.

Eyre reports:

A state agency cleared the way Wednesday for doctors across West Virginia to put diagnostic imaging equipment in their offices, a move hospital executives predict will drive up health costs and force them to raise rates.

West Virginia Health Care Authority members voted unanimously to approve standards that doctors’ offices must meet before the state allows them to buy and use computed tomography machines, also known as CT scanners.

The authority wrestled with the standards for nearly a year. “We tried to strike a balance between all of the competing interests,” said board chairwoman Sonia Chambers. “We tried to keep the best interests of the citizens of West Virginia in mind.”

The authority plans to send the standards to Gov. Joe Manchin, who has 30 days to give them final approval. . .

For more background information check out my previous post. Additional background information, including comments by various groups on the proposed standards, can be found on the the Authority's CT Services Workgroup Meeting site.

Injunction Halts WVHCA Cardiac Demonstration Project

Today's State Journal reports on Kanawha County Circuit Judge Stucky's granting of a preliminary injunction halting the West Virginia Health Care Authority from moving forward with a demonstration program that would enable three West Virginia hospitals to perform therapeutic angioplasties without having open heart backup services. The injunction was filed in seperate actions by St. Mary's Medical Center and St. Joseph's Hospital.

Details on the demonstration pilot project can be found under Section VII of the State Health Plan Cardiac Catheterization Standards.

WVHCA Issues Proposed CT Standards

Yesterday, July 11, the West Virginia Health Care Authority issued proposed CON Standards covering computerized tomography (CT) services in West Virginia.

The proposed Computed Tomography Services CON Standards provide a new need methodology process for new, additional or replacement CT scanning services by hospital and non-hospital applicants. The proposed standards set forth a weighted need methodology threshold of 3,000 scans per year and provide an exemption for CT scanners costing less that $300,000.

Although I've not read anything official from the Authority, today's Charleston Gazette article indicates that the Authority will accept comments on the proposed standards during the next 30 days and the Authority's board will vote on the regulations at its September meeting. The new standards will then be sent to Governor Manchin for final approval. UPDATE: The Authority has now posted information about submitting comments. The deadline for submitting comments is August 10, 2007.

The Charleston Gazette reports on the new standards today in its article, "Doctors' offices to be allowed to buy CT scanners". Additional background information on the development of the CT Standards can be found on the Authority's CT Services Workgroup Meeting site. For comparison, the old 1992 CT Standards are available.

UPDATE 8/22/07: It appears that the Authority has extended the deadline for submitting comments until August 31, 2007 based upon the Notice of Public Comment listed on the Authority's website. Also the Authority has uploaded the comments submitted on the proposed CT Standards.

WVHCA Issues Proposed CON Standards For Bone Marrow Transplantation Service

The West Virginia Health Care Authority has issued new proposed Certificate of Need Standards for Bone Marrow Transplantation Services. For more information go to the "Notice of Public Comment Period".

The proposed CON standards are out for public comment. Public comments can be submitted to the WVHCA no later than July 6, 2007. Notice of the proposed standards were published in today's Charleston Gazette legal advertisement (June 16, 2007).

The proposed standards indicated that West Virginia bone marrow transplants are currently performed exclusively at West Virginia University Hosptials, Inc. The standards state that WVUH "performed 43 bone marrow transplants in 2003, 37 in 2004 and 46 in 2005." The proposed standards indicate that WVUH will be the exclusive provider of bone marrow transplantations service in West Virginia.