Wellmark Blue Cross and Blue Shield, Des Moines, Iowa, has filed a lawsuit to stop two Des Moines hospitals from building replacement facilities without seeking state approval. The lawsuit, filed in Polk County District Court, seeks a permanent injunction prohibiting Mercy Medical Center and Iowa Lutheran Hospital from proceeding with their planned construction projects without obtaining certificates of need from the Iowa Department of Public Health.
The 1.8 million-member insurer claims it is concerned that the projects, which could total about $200 million, could cause healthcare costs to rise. According to its lawsuit, the insurer isnt opposed to the projects but wants to ensure there is a public process to review them. Mercy plans to close its Capitol campus on the eastside and replace it with a 146-bed hospital in West Des Moines.
Iowa Lutheran, also on the east side, plans to close and build a 200-bed replacement hospital next to Mercys new facility. Hospital officials have said they are not required to obtain certificates of need under a state rule that exempts new buildings that would replace existing facilities within the same county.
A state council agreed with the hospitals last month, ruling that the two projects could move forward without being reviewed. Council members expressed skepticism about the need for two, side-by-side hospitals in West Des Moines, but they said their hands were tied by the state rule.
Wellmark, however, contends that the rule clashes with a state law that requires a state review for relocation of a hospital but not for replacement, and it claims that the hospital projects fit the definition of relocation better than that of replacement. It seeks to have the exemption rule, passed by the health department in 2005, declared unlawful. The lawsuit also names 25-bed Jones Regional Medical Center, Anamosa, which also plans to build a new facility under the same exemption. Wellmark officials said they were less concerned about the Anamosa project, but had to include it for legal reasons. -- by Laura B. Benko