Specialty hospitals would be placed under an 18-month moratorium on new construction in a tentative deal struck between congressional conferees negotiating House and Senate versions of the Medicare reform bill, according to an e-mail circulated today by the American Hospital Association (AHA).
Randy Fenninger, a lobbyist for the American Surgical Hospital Association, representing the opposing side in an intensive lobbying struggle over the provision, says he confirmed the AHA report with a staff person for the conference committee.
According to the AHA e-mail, the moratorium would become effective the date that the conference report is signed but would grandfather in facilities "under development."
An AHA spokesperson verified the email but said the organization had no comment.
The e-mail says the compromise, reached last night, also would allow existing facilities to expand beds, but only on site, not by building a satellite facility.
The moratorium would allow the Medicare Payment Advisory Commission to complete a 15-month study on the impact of specialty hospitals on community hospitals and the healthcare system, as well as give Congress time to draft permanent legislation based on the study, according to the memo and Fenninger.
"Please note that this is a framework and is therefore not fully agreed to," the AHA memo warns, noting that it is still pushing for a 24-month moratorium.
Fenninger says he will try to clarify parts of the proposal, such as the exact definition of a specialty hospital, when the moratorium would start and how much a hospital must be "under development" to be granted an exception.
The issue of specialty hospitals has been a particularly difficult one for the conference committee to settle. The Senate version of the Medicare bill calls for an end to physician-only investments in specialty hospitals, a move that specialty hospitals say would end physician investments. The House version simply calls for a study, which community hospitals, led by the AHA, say is not strong enough.