BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 1297|
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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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