Three Congressmen are re-opening questions regarding physician-owned specialty hospitals after a patient died in Texas last month after a procedure in one such facility.
The case attracted the senators' attention because the 44-year-old man had to be transferred from 14-bed West Texas Hospital, Abilene, after the hospital's staff placed an emergency "911" call after the patient went into respiratory shock.
In its coverage, The Abilene Reporter reported that the patient was pronounced dead at Abilene Regional Hospital.
The senators, who have long voiced concerns about the potential for self-referrals to physician-owned specialty hospitals, include Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) and Rep. Pete Stark (D-Calif.). They asked the Centers for Medicare and Medicaid to account for any Medicare dollars that may have gone to the facility.
At issue is whether the facility received any Medicare payments during a Congress-approved moratorium on Medicare payments to physician-owned specialty hospitals. The moratorium expired in June 2005, but was extended until last August, when CMS produced a plan for handling such facilities.
West Texas opened in the spring of 2005, according to its Web site.
The hospital primarily lists surgical services as its primary services. The Web site said about 60 physicians are on staff, but none specialize in emergency medicine.
The government "clearly must take action and ensure that physician-owned facilities that hold themselves out to be public 'hospitals' have the requisite staff and abilities to ensure that basic lifesaving measures can be employed," said a letter sent by the congressmen to CMS on Thursday, Feb. 8.
The Senate Finance Committee previously launched an investigation of the death of a patient at a physician-owned specialty hospital that had opened during the statutory moratorium.
While the letter didn't indicate whether the panel would launch a similar inquiry, it indicated that the congressmen "are trying to set the payment issue right and to further assess CMS' actions with regard to specialty hospitals."
"This is a strong reminder that doctors' financial stakes in a hospital can cloud judgment and blur priorities," Baucus said. "We can't let that happen."
In their letter to CMS, the congressmen criticized the specialty hospitals for the risks brought on by their for-profit nature.
"These facilities present themselves as 'hospitals,' but perform only the most profitable of operations," Stark contended. "In so doing, they suck money out of already strapped community hospitals. If specialty hospitals are unable to provide adequate care to Medicare beneficiaries, we should shut them down."