In the ongoing war between general and specialty hospitals, Nashville-based HCA is notifying authorities when it identifies planned surgical hospitals that may not qualify under the limitations of last year's Medicare modernization act. The law effectively established an 18-month moratorium against physicians making new investments in inpatient specialty facilities to which they refer patients. HCA spokesman Jeff Prescott said company officials have identified several surgical hospitals that the officials believe were not far enough along in development by Nov. 18, 2003, the date the moratorium took effect, to qualify for an exemption. Prescott said one hospital, 16-bed North Texas Hospital in Denton, has applied for a state license as a general hospital but will serve almost exclusively as a surgery center, "obviously circumventing the moratorium." "When we're aware of that happening, we're making it known," Prescott said. North Texas officials could not be reached for comment. The hospital broke ground earlier this year across the street from HCA-owned Denton Regional Medical Center.
To be exempt from the moratorium, specialty hospitals must have received funding, completed architectural plans, met all zoning requirements and received necessary approvals from state agencies when the moratorium took effect. A CMS spokeswoman said eight surgical hospitals -- including five in Texas -- have requested expedited advisory opinions to determine whether they qualify. -- by Michael Romano