Rate-setters question St. Agnes Hospital offered 2nd day's stay after childbirth

February 15, 1996|By M. William Salganik | M. William Salganik,SUN STAFF

Officials of St. Agnes Hospital and the state's hospital rate-setting board met yesterday but failed to resolve their dispute over St. Agnes' decision to offer a free second day in the hospital to mothers who give birth.

The rate-setters say St. Agnes needs their permission to offer the free care, and the hospital must support its request with documentation to show the offer does not force other patients to pay more.

The two sides will continue to meet, and both say they hope for a resolution in the next few days.

"We're trying our best to reach an acceptable solution," said Robert Murray, executive director of the Health Services Cost Review Commission, which sets hospital rates in Maryland.

Maternity hospital stays have been controversial in Maryland. Some insurers will pay for only 24 hours in the hospital for a normal birth.

Concerned that this might lead to medical complications for mothers and babies, the General Assembly last year passed a law requiring insurers to pay for a second day or offer home-care nursing. Most elected to offer the home care, angering those who felt a two-day stay in the hospital is better for health.

St. Agnes stepped into the dispute Monday when Robert E. Pezzoli, the hospital president and CEO, offered a second day free to the mother and baby in normal births -- whether or not the insurance company would pay for it.

St. Agnes became the first hospital in Maryland to make such a promise, although some hospitals in other states have made similar pledges.

"It is very clear in statute and regulations that a hospital cannot change rates without advance approval," Mr. Murray said.

Before approving such a change, he said, the rate-setters would be interested in reviewing the details with an eye to "assuring that other patients are not going to pay more."

Anita Olfson, director of public relations for St. Agnes, said yesterday, "We're not rescinding our offer. It still stands."

She said the cost of the free days -- about $500,000 -- "is coming off our bottom line. Nobody is being charged extra. It's not cost-shifting -- St. Agnes is eating the cost."

The hospital reported a profit of more than $15 million in 1995.

State Sen. Paula C. Hollinger, a Democrat from Baltimore County and a strong backer of the 48-hour bill, applauded St. Agnes' offer.

"Somewhere along the line, somebody's going to have to take responsibility for the inadequate care given by insurance companies," she said. "St. Agnes did the right thing."

She said she also thought the concerns of the rate-setters were "legitimate." She said representatives of the cost review commission and other state health officials should meet to discuss how to deal with the problem if cost-conscious insurance companies are promoting poor care.

"Who ever heard of a legislature having to pass laws about how long somebody's going to be in the hospital?" she asked.

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