SENATE, No. 1398
STATE OF NEW JERSEY
INTRODUCED JULY 25, 1996
By Senator LaROSSA
An Act providing for the licensure of adult cardiac surgery services at an acute care hospital in Mercer County and supplementing Title 26 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Notwithstanding the provisions of section 7 of P.L.1971, c.136 (C.26:2H-7) to the contrary, the Commissioner of Health shall, no later than 30 days after the effective date of this act, grant a license to an acute care hospital located in Mercer County for the provision of adult cardiac surgery services, subject to the provisions of this section.
b. (1) The hospital shall be a provider of cardiac catheterization services on the effective date of this act and shall have met the minimum utilization criteria established by the Department of Health for the continued provision of these services.
(2) In 1995, the hospital shall have provided not less than 18.9% of its total medically appropriate invasive cardiac catheterization services to residents of the city of Trenton, to minority patients and not less than 7% of its total medically appropriate invasive cardiac catheterization services to residents of the city of Trenton, to Medicaid or indigent self-pay patients, as determined by the Department of Health.
c. The hospital shall provide adult cardiac surgery services in accordance with the following requirements:
(1) The hospital shall annually provide medically appropriate invasive cardiac catheterization services at its 1995 service levels as provided in paragraph (2) of subsection b. of this section, or higher, with the required service level for minority patients to be derived by calculating the average annual percentage of minority patients residing in the city of Trenton who were hospitalized for acute myocardial infarction, except as follows:
(a) the minority patient service level requirement may be modified annually by the Department of Health, based upon changes in acute myocardial infarction rates for minority residents of the city of Trenton, but no sooner than six months after the department has notified the hospital in writing of the modified service level requirement; and
(b) the Medicaid and indigent self-pay patient service level requirement may be modified annually by the Department of Health, based upon cardiac catheterization utilization data derived from uniform billing records, but no sooner than six months after the department has notified the hospital in writing of the modified service level requirement.
(2) Upon the receipt of licensure to provide adult cardiac surgery services pursuant to this act, the hospital shall provide not less than 12% of its total annual medically appropriate open heart surgery procedures to residents of the city of Trenton, to minority patients and not less than 7% of its total medically appropriate open heart surgery procedures to residents of the city of Trenton, to Medicaid or indigent self-pay patients, as determined by the Department of Health, with the required service level for minority patients to be derived by calculating the average annual percentage of minority patients residing in the city of Trenton who were hospitalized for cardiac surgery, except as follows:
(a) the minority patient service level requirement may be modified annually by the Department of Health, based upon changes in cardiac surgery rates for minority residents of the city of Trenton, but no sooner than six months after the department has notified the hospital in writing of the modified service level requirement; and
(b) the Medicaid and indigent self-pay patient service level requirement may be modified annually by the Department of Health, based upon open heart surgery procedure utilization data derived from uniform billing records, but no sooner than six months after the department has notified the hospital in writing of the modified service level requirement.
(3) The hospital shall report annually to the Department of Health as to its compliance with the provisions of paragraphs (1) and (2) of this subsection. The department shall review any failure by the hospital to meet these service level requirements and may revoke the hospital's adult cardiac surgery license on those grounds.
(4) The hospital shall demonstrate to the Department of Health by the end of its third year of operation of its adult cardiac surgery program that it has attained a minimum volume of not less than 350 open heart surgery procedures and that each cardiac surgeon holding privileges at the hospital is performing not less than 100 open heart surgery procedures annually.
(5) The hospital shall not deny access to invasive cardiac catheterization or adult cardiac surgical services to any clinically suitable person on the basis of that person's diagnosis, race, religion, gender or ability to pay.
(6) The hospital shall not charge an indigent person, either as an inpatient or outpatient, for services associated with invasive cardiac catheterization or adult cardiac surgery, including, but not limited to, physician fees and drug therapies.
d. The requirements imposed upon a hospital pursuant to this act shall be in addition to, and not in limitation of, any other requirements imposed by law or regulation.
2. This act shall take effect immediately.
STATEMENT
This bill provides for the licensure of an acute care hospital in Mercer County, which is currently providing invasive cardiac catheterization services, to provide adult cardiac surgery services, under the terms and conditions specified in the bill, in order to alleviate the problems caused by the lack of available cardiac surgery services in the city of Trenton and Mercer County. The required service levels for services provided pursuant to this bill shall apply to patients who are residents of Trenton.
Currently, there is no acute care hospital in Trenton or Mercer County to provide adult cardiac surgery services, even though all other New Jersey cities with comparable populations to Trenton have such services. The poor and minority residents of Trenton are in particular need of these services, as evidenced by the fact that: the incidence of disease of the heart and blood vessels in the city is approximately 50% above the State average; and, in the last six years, the number of deaths from cardiovascular disease has increased by 88% among the minority population of Trenton. This increase in mortality can reasonably be associated with the lack of available cardiac surgical services in Trenton. Because of the need for, and lack of access to, cardiac surgical services, the Department of Health has identified the minority and poor population of Trenton as a medically underserved special needs population.
In addition, the lack of available cardiac surgical services in Trenton and Mercer County has caused many patients to be referred to an out-of-State facility for cardiac surgical procedures. Over half of the Mercer County residents who receive heart surgery do so in another State, which translates into a loss of commercial revenues and tax dollars for New Jersey. It should be noted that the licensure of adult cardiac surgery services in Mercer County would have virtually no impact on existing cardiac surgery centers in New Jersey.
Establishes adult cardiac surgery program at acute care hospital in Mercer County.