Transparency of Hospital Records in Question 

Georgia Health News ran a thorough recap earlier this week of an evolving issue regarding the privacy of hospital records in Georgia. Specifically, the issue relates to the "open records" status of business and financial documents at private Georgia hospitals that have converted from public hospital authorities.

The Georgia Court of Appeals held in late March, in the case of Smith v. Northside Hospital, inc., that Northside Hospital did not have to disclose certain records as the long-term lessee of the Fulton County Hospital Authority. The Georgia Supreme Court is expected to decide soon whether to hear the case, GHN reports. 

The law at the center of the dispute is the Georgia Open Records Act, O.C.G.A. § 50-18-70. This law requires hospital authorities to disclose many records that would be confidential in a private context, and has been extended in the past to private, nonprofit hospitals converted from hospital authorities. However, the Court of Appeals distinguished Northside’s case from these past rulings because, among other things, 1) Northside’s contract with the hospital authority does not  provide for Northside to act on behalf of the authority to the same extent as other hospital authority conversions, and 2) the specific records sought related to private transactions in which the hospital authority board played no role. 

While the Court of Appeals ruling is limited to the specific facts of the case, if affirmed it would almost certainly lead to an increase in open records denials by Georgia’s many converted hospital authorities. 

CMS Proposed Rule Has Huge Ramifications for Hospital Outpatient Departments

Last week’s CMS proposed rule regarding the Hospital Outpatient Prospective Payment System (OPPS) contained a significant proposal to change the way hospitals bill for outpatient procedures in off-campus “provider-based” departments. 

Finding that the current practice of coupling facility payments (made under OPPS) with professional payments under the physician fee schedule (MPFS) contributes to higher charges to CMS and to patients, the proposed rule would shift all such payments to the MPFS for 2017 while the agency “explore[s] operational changes” to compensate hospitals under a new system (likely not OPPS) in 2018 and beyond. 

Off-campus provider-based departments that were billing CMS before November 2, 2015, might be allowed to continue billing under OPPS, but their ability to expand or relocate services would be limited. 

CMS will accept comments on the proposed rule until September 6. 

Arkansas Telemedicine Rules Suffer Unexpected Defeat

Arkansas’s recently proposed telemedicine rules, aimed at undoing the requirement of an in-person examination before a telemedicine visit, failed in committee Monday. Despite the Arkansas Medical Board’s recommending the rules this spring, the legislative committees were concerned that a last-minute amendment to the draft rules had changed various stakeholders’ views after the public comment period had closed, according to the Arkansas Democrat-Gazette. The amendment related to the definition of “store and forward technology.”

If the Board and the legislature can agree on a new set of rules, Arkansas would take a critical step forward from its current “failing” position, according to the American Telemedicine Association, as one of only two states to prohibit telemedicine encounters without a preceding in-person examination. 


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