Sens. Baucus, Grassley, Rep. Stark Call for Increased Scrutiny of Specialty Hospitals

Sens. Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) and Rep. Pete Stark (D-Calif.) on Tuesday said CMS has failed to ensure that patients in physician-owned specialty hospitals receive needed emergency care, CQ HealthBeat reports. CMS officials have responded to a request from the lawmakers for information on Medicare reimbursements to West Texas Hospital, after a patient entered respiratory arrest and died in January as a result of complications from elective spinal surgery performed at the facility (Reichard/Carey, CQ HealthBeat, 3/1). In the case, 44-year-old Steve Spivey underwent spinal disk fusion surgery at West Texas and entered respiratory arrest several hours later. West Texas staff, who could not help Spivey, called 911, and an ambulance transferred him to Abilene Regional Medical Center, where he died (Kaiser Daily Health Policy Report, 2/12). In their response to the request, CMS officials said the agency might issue a new guidance document to clarify that specialty hospitals, which are not required to have emergency departments, make arrangements to provide such care and ensure they can provide initial care until patients are transferred. According to CMS, Texas law requires hospitals in the state to have EDs, "and West Texas Hospital described itself to the public, state and CMS as having such capability." CMS also said that a Medicare agreement with West Texas will terminate on March 17 unless the hospital corrects problems identified by the agency.

Lawmaker Comments
In a statement, Stark praised CMS officials for their "swift response to the patient death at West Texas Hospital" but said "there is no good explanation for the death of yet another patient at a 'specialty hospital.'" He added, "It is tragic that it took a second death to highlight the grossly inadequate process that is in place to monitor whether these facilities are really hospitals and can safely provide the care they sell." Stark said that Congress "needs to intervene." Grassley said that information CMS provided "reveals serious problems with how Medicare and other responsible parties are handling these hospitals." He added, "I intend to keep up vigorous oversight of the specialty hospitals that are already operating and to seek meaningful curbs on the proliferation of these hospitals" (CQ HealthBeat, 3/1).