BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                    THIRD READING


          Bill No:  SB 1297
          Author:   Hueso (D)
          Amended:  5/5/14
          Vote:     21


           SENATE HEALTH COMMITTEE  :  6-1, 4/30/14
          AYES:  Hernandez, De Le�n, DeSaulnier, Evans, Monning, Wolk
          NOES:  Morrell
          NO VOTE RECORDED:  Beall, Nielsen

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


           SUBJECT  :    Hospital Safety and Transparency Act of 2014

           SOURCE  :     SEIU California


           DIGEST  :    This bill requires the Office of Statewide Health  
          Planning and Development (OSHPD) to publish on its Internet Web  
          site historical and current information collected by state and  
          federal regulators about hospitals, including information  
          regarding Medi-Cal payment suspensions and provider preventable  
          conditions (PPCs), as specified.

           ANALYSIS  :    Existing federal law requires, as part of the  
          Affordable Care Act (ACA), that state Medicaid programs prohibit  
          payments by states for services related to PPCs.  Federal law  
          defines a "PPC," in part, as a condition occurring in any health  
          care setting that has been found to be reasonably preventable  
          through the application of procedures supported by  
          evidence-based guidelines.
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          Existing state law:

          1.Licenses general acute care hospitals under the Department of  
            Public Health (DPH).

          2.Establishes OSHPD, and designates OSHPD as the single state  
            agency to collect specified health facility or clinic data for  
            use by all state agencies.

          3.Establishes the Department of Health Care Services (DHCS),  
            which administers the Medi-Cal program, and requires DHCS to  
            place a provider under Medi-Cal payment suspension upon a  
            credible allegation of fraud, as defined. 

          This bill:

          1.Requires OSHPD to publish on its Internet Web site, historical  
            and current information collected by state and federal  
            regulators about hospitals, including, but not limited to,  
            information regarding Medi-Cal payment suspensions, as  
            specified, and PPCs, as specified.

          2.Makes various legislative findings and declarations, including  
            that the findings of reviews are dispersed across multiple  
            state entities, often in multiple locations and varying  
            formats, and as a result, consumers do not have access to a  
            comprehensive profile of a hospital's status and performance  
            on quality and compliance with state and federal laws.

           Background
           
           PPCs  .  The ACA requires that Medi-Cal withhold payment from  
          providers for treatment associated with PPCs.  PPCs are defined  
          to include Other Provider-Preventable Conditions which are to be  
          reported in all health care settings and Health Care-Acquired  
          Conditions in acute inpatient hospital settings only.  Health  
          Care-Acquired Conditions include air embolisms, blood  
          incompatibility, catheter-associated urinary tract infections,  
          foreign object retained after surgery, and certain surgical site  
          infections, among others.  According to DHCS, it will  

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          investigate all reports of PPCs to determine if payment  
          adjustment is necessary.  DHCS states that it uses PPC reports  
          to determine if payment adjustment is appropriate, that it is  
          required to report PPCs to the federal Centers for Medical and  
          Medicare Services (CMS) and abide by confidentiality  
          requirements, and that it will also evaluate the data of  
          reported PPCs to develop quality improvement programs.  It is  
          unclear if PPCs will be made publicly available.

           Information on hospitals can be hard to find, and is spread out  .  
           Under existing state law, at least three different agencies  
          have some form of regulatory authority over hospitals.  DPH  
          licenses and regulates all health facilities, including  
          hospitals, and conducts inspections both for state licensing  
          purposes, and on behalf of CMS to ensure hospitals can continue  
          to be an approved provider under federal payment programs.   
          OSHPD has oversight over the construction and modification of  
          health facility buildings, including ensuring compliance with  
          seismic safety laws, and also serves as the data collection  
          entity for many different types of hospital reports, including  
          discharge data reports and summary financial reports.  DHCS, as  
          the administrator of the Medi-Cal program, approves, and can  
          suspend, hospitals and other providers for purposes of  
          participation in the Medi-Cal program.

          On DPH's Internet Web site, there is a link for "Consumer  
          Information System," which includes information about  
          administrative penalties levied against hospitals, penalties for  
          breaches of patient confidentiality, and a map of infection  
          rates by hospital.

          OSHPD has a "Healthcare Information Division," which includes  
          quality reports on hospitals (such as risk-adjusted outcome  
          reports), hospital financial reports, patient discharge reports,  
          emergency department encounters, ambulatory surgery reports, and  
          a number of other types of reports.

          DHCS, though not easy to find, has a link to an excel report  
          that lists all of the providers that have been suspended from  
          receiving payment from the Medi-Cal program.  The vast majority  
          of the provider payment suspensions are for individual  
          physicians or clinics, but includes six hospitals that have been  
          suspended, the most recent being Los Angeles Doctors Hospital,  
          which was suspended indefinitely in 2012.

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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  5/20/14)

          SEIU California (source)

           ARGUMENTS IN SUPPORT  :    According to the sponsor, the  
          California State Council of the Service Employees International  
          Union (SEIU California), this bill seeks to improve transparency  
          for Californians about hospital quality by consolidating  
          information already collected by state and federal regulators on  
          the OSHPD Internet Web site.  SEIU California states that there  
          is no easily accessible online source that shows whether a  
          hospital was excluded from receiving Medicare/Medicaid payments  
          due to deficiencies revealed during inspection, information  
          about Medi-Cal withholds and suspensions, and provider  
          preventable conditions, however all of these are significant to  
          a consumer's understanding of a provider's standing with its  
          regulating bodies and the quality of care delivered.  SEIU  
          California states that this information is dispersed among  
          numerous state departments and entities.  This bill takes a  
          modest approach to offering Californians greater transparency  
          about hospital quality by requiring OSHPD to post this important  
          information along with all the information it currently posts  
          related to health providers and facilities.
          

          JL:e  5/20/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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