The Republican Women of Clifton

republican, conservative women and their spouses

Health Care Issues

Folks, I worked in healthcare for a decade or so and the Certificate of Public Need (COPN) is one of the big driver of healthcare costs, so this is HUGE or shall we say YUGE to have this piece of legislation before us! Please SUPPORT SB 266 by calling your Senators! See more information below. 

ACTION: Call and e-mail your Senator in Richmond and tell him/her to vote for SB 266.

Find your senator and contact info here

A vote will be called Monday or Tuesday, the last day before "Crossover."

DON'T WAIT!! 

SB 266 allows multiple exceptions to the anti-market regulations known as Certificate of Public Need (COPN).   We've been trying for years to get COPN repealed in Virginia...

SB 266 would allow independent doctors to establish certain ambulatory services in their offices instead of forcing patients to use hospital facilities for routine tests like colonoscopy, MRI, or simple surgical procedures.  Patients pay less, and significant savings to Medicare are possible.

One doctor reports*: 

If you look at Medicare colonoscopies across the entire US, every year Medicare overpays a staggering $257,527,703.72 a year by having colonoscopy done in [hospital outpatient departments] ... rather than in the office.  

The issue is about the cost of health services, which COPN keeps artificially high by stifling competition.  The same physician states:

According to the Virginia Department of Health COPN website, “The program seeks to contain health care costs while ensuring financial viability and access to health care for all Virginia at a reasonable cost.”  Is the COPN program really fulfilling its stated mission and intent, or is it in fact part of the proble

OPN is a complex issue, but you don't need to be an expert to make a call to your Senator.  This bill may be our only chance this year to begin chipping away at the monopolistic control the hospital lobby maintains on Virginians' access to affordable health care. Please share this alert widely, and call your senator right away (leave a message and ask to be called back.)

*Below  are the remarks delivered by Dr. Keith Berger to the Senate Education and Health Committee on 9 Feb.  The bill he addressed was one of several that were combined into SB 266.  

In Support SB 235 to Allow an Exception to Virginia CON for Center for Health and Cancer

Prevention in Virginia Beach

Mr. Chairman and Members of the Committee:

● I’m Dr. Keith Berger, and I’m here in support of Senator DeSteph’s SB 235

I’m a board certified Gastroenterologist. In 1985, I was the first gastroenterologist in the State

of Virginia to offer GI procedures (such as colonoscopy) in the office as opposed to the hospital,

where costs were significantly higher. Since then, office based endoscopy has become the

standard of care in Virginia

● My current medical practice is called the Center for Health & Cancer Prevention (CHCP). We

operate a single bed, single physician office endoscopy unit . We specialize almost entirely in

the early detection and prevention of colon cancer , the second leading cause of cancer

mortality in Virginia and the US.

Our Center sees about 1400 patients per year, about 350 of which are Medicare patients

Medicare patients are at the highest risk for colon cancer , and colonoscopy is a highly effective

means of preventing it.

● So why this Bill? Running an office endoscopy practice requires a lot of resources, so a single

procedure in our office costs the practice around $500, which is, however dramatically less

than the cost of the same procedure at the hospital outpatient department (HOPD), $1213, or

250% higher (see the attached actual patient bill). Since we pioneered the use of office based

endoscopy in 1985, as a result of Virginia CON Law, we have never received a single dollar of

reimbursement for the facility costs of doing Medicare patients in our office , even though

these costs are reimbursable by Medicare. Virtually every insurance company in VA uses the

office based model. For 33 years, we have absorbed the Medicare facility costs ourselves even

though we could have done these patients instead at the hospital at no cost to the practice. We

estimate that we have saved patients and Medicare over this time between $4 million and

$9.25M.

Every year we do office based colonoscopy, the cost savings to patients and Medicare would be

$ 319,594. This figure represents only 1/10 of 1% of the (hospital’s) SVBGH’s total revenue , and

therefore would have no detrimental impact on the hospital.

If you look at Medicare colonoscopies across the entire US, every year Medicare overpays a

staggering $257,527,703.72 a year by having colonoscopy done in HOPD’s rather than in the

office.

Because of shrinking Medicare allowances for physicians, doing Medicare patients in my office

and having to absorb the facility costs now leaves the practices losing money on every Medicare

case because under CON, I cannot be reimbursed for any of my office costs, staff, equipment,

supplies etc. This is unsustainable.

● Moreover, I now find myself focused constantly on how to keep my practice running, spending

my attention and energy on just how to ‘survive.’

● All the while, the practice of medicine is becomingly increasingly complex , particularly with the

demands of EHR, complicated insurance billing, liability, changing referral patterns and hospital

consolidations. This leaves independent physicians struggling just to stay in practice, and forces

many excellent, experienced physicians to leave medicine altogether or take employed

positions. Many of us are ‘burned out.’ We are losing invaluable and irreplaceable resources.

● So far, independent physicians have not received much help from our State or Federal

government .

● One of the common objections to CON reform or repeal is that it would negatively affect

coverage for rural or indigent populations. I believe that using the CON Law is a poor and 

actually counter-productive means of accomplishing this. Instead, I believe that the way to

solve the ‘coverage’ issue is to begin to address the incredible waste and inefficiency in our

healthcare system . And colonoscopy is just one example. What if we could take that $257

million yearly windfall by moving colonoscopy from the outpatient department to the office, and

invest those savings into indigent care, rural health initiatives and other needed services?

● According to the Virginia Department of Health COPN website, “The program seeks to contain

health care costs while ensuring financial viability and access to health care for all Virginia at a

reasonable cost .” Is the COPN program really fulfilling its stated mission and intent, or is it in

fact part of the problem?

● Based on what has been presented here, I respectfully request that the committee consider

granting my practice an exception to the CON. It would allow me to continue my services to a

very important population and health issue, i.e., colon cancer prevention in middle aged and

elderly Virginians. It would allow me to expand my contribution in healthcare, which is what I

am here to do. 

 

Thank you for your listening.

Keith E. Berger, MD

The Center for Health and Cancer Prevention, LLC

757-412-7737 cell

Keith@rewritethefuturenow.com

 

 

Government of the people, by the people, for the people, shall not perish from the Earth
— Abraham Lincoln