On March 12, 2003, State Representative Jon Peterson ( R – Delaware ) gave sponsor testimony before the House Health and Family Services Committee on House Bill 71. This bill prohibits physicians from referring patients to hospitals in which they have an ownership interest. At the hearing, Representative Peterson explained to the Committee that he was sponsoring the bill at the request of the Ohio Hospital Association, who represents Ohio's non-profit community hospitals. According to Peterson, the bill is no longer primarily about conflict of interest, but rather, the "competitive advantage that a physician-owned hospital has over our community hospitals - self referral." Peterson said he believes "we could be on the threshold of a major health care crisis in Ohio." Peterson said his bill only applies to physicians referring to inpatient hospitals in which they have an ownership interest. He said the bill is not anti-competitive and is not a new Certificate of Need program. This bill will protect the viability of community hospitals.
The bill would prohibit a physician or podiatrist from making certain referrals for inpatient hospital services and makes other revisions to the law prohibiting certain referrals for designated health services. Currently, section 4731.65 ( B ) establishes that “designated health services” means any of the following: clinical laboratory services; home health care services; and outpatient prescription drugs. As amended “inpatient hospital services” are also included under the definition of “designated health services.”
New Division ( H ) defines “inpatient hospital services” as the use of facilities, personnel, and supplies in the admission, diagnosis, prevention, or treatment of an individual’s medical condition, disease or impairment, or for the assessment of health of an individual during a hospital inpatient admission, including services a hospital provides for its patients that are furnished either by the hospital or by others under arrangements with the hospital. “Inpatient hospital services” do not include professional services performed by a health care practitioner if a third party or governmental health care program reimburses the services independently and not as part of the inpatient hospital services.
Current division ( H ) has been re-lettered to become division ( I ). Under current law, this language establishes that a “referral” includes both of the following: 1.) A request by a holder of a certificate under this chapter for an item or service, including a request for a consultation with another physician and any test or procedure ordered by or to be performed by or under the supervision of the other physician; and 2.) A request for or establishment of a plan of care by a certificate holder that includes the provision of designated health services. Division ( I ) (1) has been amended to establish that a request by a holder of a certificate under this chapter for a designated health service, including a request for a consultation with another physician and any test or procedure ordered by or to be performed by or under the supervision of the other physician. As amended “designated health service” replaces “an item or service.” For a copy of an analysis of HB 71 prepared by the AMC/NOMA lobbyists go to our web site at www.amcnoma.org.