‘Site of Service’ House amendment causes concern for hospitals

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INDIANAPOLIS, Ind. -- Indiana hospitals warn a proposal at the Statehouse could have terrible unintended consequences.

Administrators say an amendment passed this week could result in the closure of many off-campus hospital locations across the state.

Hendricks Regional Health Cancer Center in Avon is one of the locations that could be impacted.

Kristen Edwards is a patient at the center being treated for breast cancer.

She said she always gets quality care there.

“You are known as a patient, a name and not as necessarily a number,” said Edwards.

Edwards said the equipment is state of the art and the location is extremely convenient.

“I come to this center on my lunch hour between 1 and 2 and I do my treatment for about 15-30 minutes,” said Edwards.

But an amendment in House Bill 1004 would result in less reimbursement for hospital off-site locations like the Avon Cancer Center. At this point, it’s unclear how much less.

“This is a completely new system that would be set up that doesn’t exist anywhere," said Indiana Hospital Association President, Brian Tabor. "But basically, what it would mean is that big insurance company will only pay the hospital for the physician service but they wouldn’t be paying for the overhead cost.”

Lawmakers are debating the best ways to lower prices for patients, considering if a hospital’s location should determine the cost for the services it provides.

For example, an emergency room open 24/7 is more expensive to operate than an office Monday through Friday.

State Sen. John Ruckelshaus said it is worth the debate.

“A hospital needs to charge at a higher rate for all of that overhead, but would an ancillary facility need to charge for that? And the answer is, that’s a question.”

Lawmakers say they’re open to discussion on this “site of service” amendment.

“I think this legislation will probably come all the way down to the end, and it’s good and we welcome all the input from all the stakeholders,” said Ruckelshaus.

Tabor is proposing a solution.

“Provide complete transparency in where a medical procedure is performed. Was it performed at the hospital? Was it performed at an off-campus setting? And this would allow insurance companies to sit across from the table with providers and negotiate the appropriate rate for those services,” said Tabor.

Edwards hopes lawmakers and hospitals come to a compromise soon. If this facility were to close, her life would look much different right now.

“I wouldn’t be able to work full time Monday through Friday to get this treatment if I did not get to come to this facility here in Avon, Indiana," said Edwards.

This bill is now headed to the senate floor on second reading where it could be amended again.

If approved, the house would also have to agree on the new language.

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