SJR 15: Health-Care Delivery Systems

The 2007 Legislature approved Senate Joint Resolution 15, calling for a study of health-care delivery systems in Montana to determine how the different means of providing health care services affect the cost and quality of care.

Draft Study Plan (Revised Sept. 12, 2007)
Topics to Consider

SJR 15 Subcommittee

A subcommittee made up of Sen. Dan Weinberg and Rep. Ernie Dutton is specifically addressing the specialty hospital moratorium and economic credentialing issues involved in the SJR 15 study. Separate bills are proposed: LC 38 for economic credentialing and disclosure related to conflicts of interest and LC8888/LC8887 for specialty hospitals. Background materials include explanations of LC38 and a draft review of the Stark and Antikickback Acts.

Next Meeting: No other meetings of the subcommittee are planned. The full committee will review bill drafts at the Aug. 22 portion of its meeting.

Previous Meetings:
June 11, 2008 -- Agenda -- Minutes -- Listen
March 17, 2008: Agenda -- Minutes -- Listen -- News Release
Feb. 11, 2008: Agenda -- Minutes -- Listen
Jan. 31, 2008: Brief conference call to discuss Feb. 11 agenda. Notes -- Announcement
Jan. 24, 2008: Agenda --Minutes -- Listen

Meeting Materials

The following materials are being prepared for the August meeting:
--Latest version of LC 38, with explanations and review of federal laws
--Versions of specialty hospital bills, LC8888 and LC8887

The following materials were prepared for the June 10-11 meeting:
--Revised version of LC 38 with May 28 comments. Decision options
--- Additional MHA comments
--- Comment from MT Physical Therapy Assn.
--- Comment from Great Falls Clinic representative
--- Comment from Billings Clinic representative
--- Options for economic credentialing; referrals; conflict of interest
--Health Care Facility Survey: Summary, Services, Staffing, Payor Mix 1, 2
--Employment, Staffing, and Insurance Issues Briefing Paper

The following materials were discussed at the March 17 subcommittee meeting:
-- LC 38:Economic Credentialing/Conflict of Interest -- Initial -- April Version
-- LC8888:Specialty Hospitals -- Initial -- Revised
-- Memo on Initial Bill Drafts -- Memo on Revised Bill Drafts
-- MHA Comments on LC 38
-- MHA Proposed Revisions to LC 38
-- Great Falls Clinic Comments on Bill Drafts
-- HealthCenter Northwest Comments on LC8888
-- Jim McClean's Comments on Bill Drafts (for physical therapists)
-- Anderson & Baker Comments on Bill Drafts
-- Iowa conflict of interest policy statement

The following materials were presented at the Feb. 11 subcommittee meeting:
-- Bill Draft on Conflict of Interest, Economic Credentialing
-- Comments on Specialty Hospitals

The following staff-generated materials were presented at the Jan. 24 subcommittee meeting:
-- Discussion Document: Economic Credentialing/Self-Referral Concerns
-- State Statutes: Specialty Hospitals and Economic Credentialing

The following materials were among those handed out by speakers at the Jan. 24 subcommittee meeting.
--Benefis Statement from Amy Astin
--Byorth Statement
--Jones Statement
--St. Peter's Hospital Statement, Conflict of Interest Policy

Staff Reports

• Health Care Facility Summary, Services, Staffing, Payor Analysis 1 and 2
• Employment, Staffing, and Insurance Issue Briefing Paper
• Health Care Facility Survey Update: Pat Murdo, March 2008
• Hospice and End-of-Life Care in Montana: Pat Murdo, March 7, 2008
• Charity Care and Other Community Benefits: Pat Murdo, March 7, 2008
• Requirements in Selected States -- Health Care Facility Pricing/Quality and Insurance Information: Pat Murdo, January 2008
• Pricing/Quality Transparency: PowerPoint Presentation by Pat Murdo, Nov. 16, 2007
• Table of SJR 15-Related Definitions, Issues: Pat Murdo, September 2007
• Table of Montana Hospitals: Pat Murdo, Updated November 2007
  
• Table of Specialized Health Care Facilities in Montana: Pat Murdo, Updated November 2007
• Table of Community Health Centers and Rural Health Clinics: Pat Murdo, September 2007
• Tax Treatment of Nonprofit Entities: Lee Heiman, September 2007
• Review of Related Court Cases: Lisa Mecklenberg Jackson, September 2007

Related Study Materials & Links

• April American Hospital Association article on physician self-referral
• January 25 presentations by MHA: MHA Billing and Community Benefit Policies, MT Hospitals Compiled Charity Care, AHA policy, 990Form H
  
• Montana's Hospitals -- Issues and Facts Related to Charitable Purposes: Lawrence L. White, University of Montana
• Delivering Healthcare through Community Health Centers: Lil Andersen, Jan. 25, 2008
  
• State Statutes: Specialty Hospitals and Economic Credentialing
  
• Health Information Technology: Continuity of Care Record
• National Council of State Legislatures: Community Benefit and Tax Exemption Come Under the Microscope
• National Council of State Legislatures: State Legislation Relating to Health Care Price Disclosure
• Texas: Center for Health Statistics
• Arizona: Hospital Cost Comparisons
• Wisconsin: PricePoint
• Medicare Payment Advisory Commission: Analyses of Medicare Procedures Provided in Multiple Ambulatory Settings
  
  

Draft Legislation

The committee may request draft legislation in the spring or summer of 2008. Bill drafts will be posted as they are approved.