Measures could help curb Nevadans' hospital costs By ELIZABETH WHITE ASSOCIATED PRESS
CARSON CITY, Nev. (AP) - The Nevada hospital industry lashed out Monday against a bill to shield insured patients who get costly emergency care at hospitals that don't normally accept their coverage - but backed another bill to increase their reporting requirements.
AB296, sponsored by Assemblywoman Ellen Koivisto, D-Las Vegas, would allow the hospitals to collect no more than 175 percent of the amount Medicare pays for the emergency services. Patients could pay their normal deductible or co-payment.
Jim Wadhams, a lobbyist for the Nevada Hospital Association, called the bill "price-fixing, pure and simple," especially when he said hospitals' profit margins are between 2 percent and 4 percent. Thursday, November 04, 2004 9:38:15 PMources and Education Committee, adding that he feels the bill is a "rifle shot" at emergency services.
The bill "is a dramatic shift in the public policy of this state. If that's the policy we want to take up I would suggest that this committee think long and hard," he said.
Sen. Joe Heck, R-Henderson, an emergency room doctor, said he also sees problems in the bill, particularly the 175 percent clause, which he said doesn't necessarily meet the needs of the hospital.
"Again, let's not take Medicare as the end-all, be-all as far as what appropriate reimbursement may be," he said.
Heck also said the bill, referred to a subcommittee for further consideration, would affect only about 11,000 people whose needs may fall under the measure when they aren't given the choice of what hospital they're admitted to or are taken to one simply because it's near their homes.
Andrew Brignone, a lobbyist for the Health Services Coalition, said the bill ensures that hospitals make a profit while also not overcharging patients whose insurers may not contract with a major hospital.
"It prevents employers and their employees and health plans from being held hostage ... by hospitals that won't contract for reasonable rates," he said. "It's an odd situation where you're subjected to an enormous bill and you had no choice about where to go."
Although hospital costs are spiraling out of control, Sen. Steven Horsford, D-North Las Vegas, said there has been little agreement on how to tamp them down.
"We need a comprehensive solution to many of the problems we're facing in health care," he said, adding, "My question, I guess, is if not AB296 then what and when and how?"
Horsford also said he wondered how a bill that could potentially affect 11,000 people could truly alter the bottom line of Nevada's major hospitals.
"That's where I feel like we're not doing enough to contain costs and the industry isn't at the table trying to figure out how these scenarios shouldn't happen," he said, referring to a bill of $234,000 he reviewed for a patient's hospital admission and pacemaker.
But Bill Welch, president and CEO of the hospital association, said "to always look to the hospital community to underwrite and fund this is very difficult to accept."
The association spoke in favor of another bill, AB342, sponsored by Assemblywoman Sheila Leslie, D-Reno.
The bill, as amended with the association's input, would require hospitals with 100 or more beds to submit to an audit and would require all hospitals to prepare five new reports for the state, including one on capital improvements, another showing the level of investment hospitals make in Nevada communities and one on hospitals' debt collection policies.
"We have heard a number of horrible stories of people's lives being ruined by medical debt," Leslie said. "We also know that medical debt has become the primary reason for personal bankruptcy."
Leslie said reporting requirements in other states are far stricter than those she's proposing.
"In Nevada we're not jumping to a regulatory framework," she said. "Instead, we're gathering needed information and really taking the time to understand the complexity of the problem."
The bill also requires the Legislative Committee on Health Care to develop a comprehensive plan to address the state's growing needs and what some call a crisis.
Assembly Speaker Richard Perkins, D-Henderson, said health care is a right, not a privilege, and added the reports will allow consumers to make better choices.
The Senate committee took no action on AB342. The panel's chairman, Sen. Maurice Washington, R-Sparks, said he's concerned that the bill will begin to socialize health care.
"I want to allow the free market to work," he said.