MacQuest Services

Welcome . . .

Thank you for stopping by my website -- I'm Tom Piper. Click on each of the links in the left column to discover more about how I can help you make the most of your work and play!

Certificate of Need, one of the many branches of health care planning and regulation, is the most prominent category where I have almost 40 years of health-related experience. I have over 32 years experience working with Apple computers and their many excellent related devices such as Macs, iPhones, iPads, and iPods. Soon, I will also be able to provide motivational and inspirational productions to audiences of all ages and disciplines with a primary focus on BALANCE.

Contact me by phone (573.230.5350), or email (macquest@mac.com).

Medical facility curbs proposed in Pennsylvania

By Andrew Conte and Luis Fábregas -- TRIB LIVE (Tribune-Review)

Pennsylvania needs to fight rising health care costs by bringing back a review process to avoid adding unnecessary hospitals and medical equipment, state Sen. Jim Ferlo said on Monday.

Responding to a series of articles in the Tribune-Review, Ferlo is seeking co-sponsors for legislation that would restore the so-called certificate of need review in which health care companies are required to obtain state approval to build facilities or purchase major equipment. Pennsylvania let its certificate of need law expire in 1996 and is among 13 states without such a program.

"If there's a lot of duplication, unnecessary facilities and a lack of primary care, we all should be concerned because we're all paying for it," Ferlo, D-Highland Park, said.

U.S. hospitals borrowed $144 billion from 2008 to November through public bond issues for construction, refinancing, equipment and other expenses, the Tribune-Review's yearlong series "Code Green: Bleeding Dollars" found. The fourth installment in the series highlighted how UPMC is building a $240 million hospital in Monroeville less than a mile from Forbes Regional Hospital.

For the rest of the story, go to http://triblive.com.

North Carolina CON Committee Releases Interim Report

by RPC Consulting

The North Carolina House Select Committee on the Certificate of Need Process and Related Hospital Issues (“CON Committee”) recently released a report to the General Assembly. The CON Committee’s interim report was issued in compliance with Section 9 of their Committee Charge. The thirteen page document provides a digest of what the CON Committee covered at each of their meetings, and concludes with a page on their findings and recommendations.

The interim report calls for more “transparency and accountability” on the part of the State Health Coordinating Council in developing the State Medical Facilities Plan (SMFP), and acknowledges public concerns that the State Health Coordinating Council may have “possible conflicts of interest.” The CON Committee also recommends that exemptions to need determinations in the SMFP be “greatly limited” to ensure that all applicants are subject to the same requirements.

The interim report noted that the CON Committee heard concerns that capital expenditure limits should be adjusted for inflation, and that certain medical equipment should be exempted from CON review. While the report does not issue a recommendation on those issues, it does call for “an expedited process for appellate review in order to shorten the overall Certificate of Need determination process.”

For the rest of the story, go to http://blog.rpcconsulting.com.

Michigan House Health Policy Committee to review certificate-of-need laws

By Jay Greene--Crain's Detroit Business

The Michigan House Health Policy Committee will hold a hearing at 9 a.m. ThursdayMay 3 to discuss the state’s certificate-of-need regulatory process for approving new hospitals, medical services and equipment.

On Monday, Crain’s reported that the state Senate Health Policy Committee had planned to hold a joint hearing with the House committee.

But the chairman of the Senate health committee, Jim Marleau, R-Orion Township, told Crain’s on Tuesday that he and Rep. Gail Haines, R-Waterford Township, chair of the House health committee, decided to change the lineup of the Thursday meeting on CON.

“It seemed more appropriate to Representative Haines and I that a first step should be an opportunity for House health policy members to receive an overview from the Certificate of Need Commission,” Marleau said in a statement.

For the rest of the story, go to http://www.crainsdetroit.com.

Bill Amendment Would Allow Iowa Physician to Operate Cedar Rapids Surgery Center

by Rob Kurtz -- BECKER'S ASC REVIEW

An amendment has been added to an Iowa spending bill that would allow ophthalmologist Lee Birchansky, MD, ABES, to operate a surgery center in Cedar Rapids, according to a Des Moines Register report. 

Dr. Birchansky has been seeking a certificate of need to own and operate a surgery center since 1996. After his first CON application to build a surgery center was denied, Dr. Birchansky built surgical suites at his ophthalmology practice, Fox Eye Laser and Cosmetic Institute, and operated them through a partnership with a local hospital. That partnership ended in 2004.

For the rest of the story, go to http://www.beckersasc.com/.

Supreme Court rules against Mercy in three-bed hospital suit

by E.B. Solomont, Reporter - St. Louis Business Journal

Could it be the end of fighting over a three-bed hospital in Washington, Mo.?

The Supreme Court of Missouri today ruled against Mercy in its legal case against physician group Patients First, the hospital’s owner.

Mercy and Patients First began fighting in the fall of 2010 after Patients First sought to build a three-bed hospital near Mercy Hospital Washington for under $1 million, meaning it did not require a Certificate of Need (CON) from state health planners. Mercy filed a lawsuit, which was dismissed by St. Louis County Circuit Court. The $4 billion health system later filed an appeal, but the Court of Appeals ruled against Mercy in July.

For the rest of the story, go to http://www.bizjournals.com/.

For a PDF copy of the decision, go to http://www.courts.mo.gov/SUP (click blue text next to SC92015).

Certificate of Need Bill Passes State House

by Birmingham Medical News

Legislation streamlining the CON process passed the Alabama House of Representatives on March 15, and has been forwarded to the state senate for consider.

House Bill 370 was sponsored by Representative Mary Sue McClurkin (R) of Pelham, who represents District 43 in Jefferson and Shelby counties.

“The bill sends appeals directly to the Court of Civil Appeals rather than requiring them to go through Circuit Court,” McClurkin said. “Our goal is to speed the process to help future applicants get a definite answer faster without burdening providers and their patients with the expense of a long series of legal battles.”

Unlike legislation proposed by McClurkin last year, this bill does not have a retroactive provision. It would apply only to future CON applications, which could make it more likely to pass the senate and become law.  It would not affect the outcome of Trinity Medical Center’s plan to move to Highway 280, which has been hotly contested by Brookwood Medical Center and St. Vincent’s.

For the rest of the story, go to http://birminghammedicalnews.com.

New Hampshire House Votes to Exempt Specialty Hospitals From CON Process

Written by Sabrina Rodak-- BECKER'S HOSPITAL REVIEW 

The New Hampshire House of Representatives voted 198 to 161 to permit for-profit specialty hospitals to bypass the certificate of need process for building a new facility, according to a Concord Monitor report. 

Specialty hospitals are defined as hospitals with 50 or fewer beds that provide diagnostic, therapeutic and rehabilitative care to inpatients and outpatients.

Under the bill, state officials would be required to seek an exemption from the federal Medicaid Enhancement Tax — which other hospitals pay — for all specialty hospitals. The bill also specifies that 65 percent of a specialty hospital's patients would have to come from out of state to prevent the hospital from "cherry picking" too many in-state patients, according to the report. 

For the rest of the story, go to http://www.beckershospitalreview.com/.

 

House Votes To Dismantle Certificate Of Need Board

By RACHEL GOTBAUM -- NHPR: NEW HAMPSHIRE NEWS

The Certificate of Need Board approves new hospitals and expansions of existing medical centers in the state. Wednesday the house voted 166-140 to get rid of the board entirely. The House rejected an amendment which would have overhauled the existing board and phase it out over five years. The idea was to reconfigure the board with non-stakeholders, such as not allowing hospital representatives to serve.

Republican Representative Marilinda Garcia of Salem urged her colleagues to vote against the amendment which would have preserved the CON process. She cited studies that show CON boards do not help states save in healthcare costs, but do just the opposite.

"The CON laws have been ineffective at best, likely counterproductive, and at worst a serious impediment to optimum healthcare standards," says Garcia.

But supporters of the amendment to reconfigure the board say that the CON process actually prevents more expensive healthcare outlets from being built and therefore keeps costs down.

For the rest of the story, go to http://www.nhpr.org/.

Analysis: CON challenge before Miss. high court

By Jack Elliott Jr.-- Associated Press, WausauDailyHerald.com

JACKSON, Miss. (WTW) — Mississippi's certificate-of-need law, which limits where hospitals can locate and expand and what services they can provide, is back before the state Supreme Court.

From its inception by the federal government in 1974, the CON program has led to Herculean legal battles, most of them among Mississippi's largest hospitals.

Congress created the CON program to help rural areas struggling to recruit and retain doctors, clinics and hospitals.

Hospitals, for the most part, fear competition as threats to their financial survival. Aggressive action by one medical center brings opposition from others.

For the rest of the story, go to http://www.wausaudailyherald.com/.

Lawmakers tackle streamlining CON process – again

by Evan Belanger -- Birmingham Business Journal

The Alabama Legislature is again attempting to streamline the state’s criticized certificate of need review process, which controls the expansion of health care facilities statewide.

In a bill filed Feb. 21, Rep. Mary Sue McClurkin, R-Indian Springs, is again stumping for a host of tort reforms aimed at preventing abuse of the state’s CON process, which is administered by the State Health Planning and Development Agency in Montgomery.

One of 34 state CON programs nationwide, Alabama’s CON process is intended to control the cost of health care by limiting expansion of facilities to the needs of the local community. But ...

To see the rest of the story, go to http://www.bizjournals.com/.