Hospitals lose round in bid to close medical centers

January 04, 1994|By Patricia Meisol | Patricia Meisol,Staff Writer

An unusual attempt by hospitals to close down four independent endoscopy centers that are taking away patients ran into a roadblock yesterday when a hearing officer concluded the centers had been properly opened.

In a motion filed Sept. 21, Greater Baltimore Medical Center and St. Joseph Hospital had argued that four gastroendoscopy centers that have opened in the region since late 1992 should have undergone the review process that typically accompanies the opening of new medical centers.

In rejecting the complaint, Joan Y. Harris, a member of the Maryland Health Resources Planning Commission, ruled that the centers are nonsurgical ambulatory facilities and, thus, exempt from the process of determining need before a health care facility can open.

Endoscopy is a minimally invasive technique in which doctors insert a scope into the body to examine and treat the gall bladder and other organs of the digestive system. It is most often used for diagnostic examinations that in the past would have involved major surgery.

Ms. Harris' recommendation will be taken up by the full planning commission a week from today, and the outcome is uncertain. The decision could have far-reaching impact on hospitals, which are losing revenues to outpatient centers of all types, and on doctors, who are being directed by insurance companies to practice at less-costly facilities.

Three other hospitals -- Holy Cross Hospital, Washington Adventist Hospital and Shady Grove Hospital -- joined in their motion.

In their brief, the hospitals estimated GBMC would lose 0.9 percent of its gross revenue and St. Joseph 1.8 percent unless the outpatient centers were shut down.

The outcry from hospitals led to a study of the issue by a special committee, set up in August by state planners, of whether gastrointestinal endoscopy procedures should be defined as surgery.

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