A new federal study says that as many as 37 new specialty hospitals could open in the next year or so even if Congress extends the moratorium on physician referral to these niche facilities. If the 18-month moratorium, which officially ended Wednesday, is allowed to expire, "the increase would likely be much greater, but how much greater is uncertain," according to a new report from the Government Accountability Office. The agency also said the CMS has received 40 applications from specialty hospitals under development seeking determinations they were grandfathered under the provisions of the Medicare Modernization Act of 2003, which gave the go-ahead to cardiac, surgery and orthopedic centers that were already under development before the moratorium took effect in December 2003. Of those applications, 12 were approved and two were denied, though one facility is appealing that ruling.