Also, CMS clarified that all hospitals, including specialty hospitals—even if they don't have an emergency department—will be required to comply with the transfer provisions of the Emergency Medical Treatment and Labor Act. That means they must accept transfers and provide emergency services for patients, regardless of their ability to pay.
Mr. Fenninger said specialty hospitals were in agreement with this provision.
As expected, CMS found that specialty hospitals provide less charity care than acute care hospitals do—an average 4% for cardiac hospitals, 1% for orthopedic hospitals, and 0.2% for surgical hospitals in fiscal 2004 and 2005, compared to 8% for general facilities.
Again, Mr. Fenninger said this was not surprising, claiming that most specialty hospitals were in geographic areas that did not serve many charity care cases.
CMS agreed that there might be extenuating circumstances, and pointed out that “the profile of services offered by specialty hospitals may contribute to the differences in patient mix.”
The agency said that Congress should consider whether further reforms are needed to ensure greater delivery of charity care by the facilities.
Dr. McClellan said the report should not be seen as a signal that the federal government would stop monitoring physician-owned facilities.
“When it comes to enforcing the requirements of the law when it comes to specialty hospitals, we mean it and we're going to do it,” he said.