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After a round of last minute revisions that advocates said significantly watered down the beleaguered Health Care Collaboration Act, the legislation passed out of the Senate Finance and Public Health Committees late Tuesday.
The bill currently headed to the Senate floor makes it easier for the University of Mississippi Medical Center to partner with private hospitals and healthcare providers around the state. And it loosens restrictions on how those collaborations purchase equipment.
But the original legislation contained a host of other benefits for the potential collaborations that representatives from UMMC say fell to protests from the Mississippi Hospital Association. Those provisions would have allowed the collaborations to issue bonds and would have exempted them from open meeting requirements and certain anti-trust regulations.
“It’s not the whole sandwich; it’s about 40 percent of the sandwich,” said Dr. LouAnn Woodward, vice chancellor of UMMC, in a conversation with Mississippi Today. “But it gives us something that we can get started on and that we can continue to work with in the next session… And I would expect that (opponents of the original legislation) are now supportive. At this point what they wanted has been addressed.”
The provisions that most concerned other hospitals have largely dropped out of the bill, according to Richard Roberson of the Mississippi Hospital Association, which represents more than 100 hospitals across the state, including UMMC. Although Roberson said the new legislation “better balances” the needs of UMMC and private hospitals, he withheld the organization’s seal of approval until all board members had vetted the amended bill.
“UMC is also a member of the MHA, and the membership was of the opinion that if UMC needed some additional flexibility to do somethings they needed to do, that was fine. It was just the fact that some things in the bill went farther than that and created unfair advantages for what is already the largest hospital in the state,” Roberson said.
The bill faced opposition from the moment it debuted in a House subcommittee in January. At that time the legislation contained language that some legislators said would give UMMC, which is the only academic teaching hospital in the state, an unfair advantage over private hospitals.
During a subcommittee meeting, Rep. Brent Powell, R-Brandon, said he was concerned that loosening regulations could be “creating a monster” among hospitals in the state.
“I don’t want a big ol’ giant that we can’t control later,” Powell said the time.
Among those unfair advantages, Roberson said, were exemptions from paying certain taxes and the Certificate of Need process as well as certain anti-trust regulations. The new collaborations would also have had the ability to fund their projects by issuing bonds. But all of these provisions were stricken from the most recent draft of the bill, a move that Roberson said “finally levels the playing field.”
“Leveling the playing field” was actually a line used by the bill’s sponsor, Rep. Jason White, R-West, back in January to illustrate how the original legislation might help UMMC, which White said was often at a disadvantage when it came to making deals in the state. Unlike private hospitals, UMMC has to go through the detailed procurement process required of state agencies. Woodward said collaborations often fall apart in the meantime.
“They’re asking for some flexibility to be able to be lean like these private (hospitals),” said Rep. Jason White, R-West, who sponsored the House legislation. “This is a work in progress. I don’t want to tip the scales in (UMMC’s) favor, but we want to hopefully level it from some of the regulatory burdens.”
But questions continued to dogg the bill as it worked its way from the House to the Senate committees. UMMC and representatives from the hospital association talked “almost every day” according to Woodward.
Revisions were being added up until the very last minute—few senators and neither representatives from the hospital association nor UMMC had time to review the legislation before it debuted in committee, a fact that some senators commented on in the Finance Committee meeting.
“This list of (hospitals) that you have, did they get the opportunity to read this bill? Because it was really hot when it was brought out here to committee,” said Sen. Derrick Simmons, D-Greenville.
The concerns of hospitals around the state came through in Tuesday’s Senate Finance Committee vote, which split along hospital, rather than party, lines, with Senators in districts with strong hospitals largely opposing the legislation. The 11 senators who voted no included Billy Hudson and John Polk, R-Hattiesburg (Forrest General Hospital), David Jordan, D-Greenwood (Greenwood Leflore Hospital), Kevin Blackwell, R-Southaven (Baptist DeSoto), and Nickey Browning, R-Pontotoc (Northeast Mississippi Medical Center).
Finance Committee Chairman Joey Fillingane, R-Sumrall, also added a reverse repealler that will allow legislators to continue working on the bill.
Despite the changes, Woodward said she is ultimately satisfied with the legislation that passed.
“I am happy that it is still alive and that it is moving forward and it did not die,” Woodward said. “It’s not the full enchilada, but it gives us time to work on some things.”