Physician-Led Healthcare for America said the expansion of a physician-owned hospital near the Texas-Mexico border is a "win" for patients.
CMS granted a "high Medicaid facility" expansion request from Edinburg, Texas-based Doctors Hospital at Renaissance to establish a new physician-owned hospital 55 miles away in Brownsville.
The Federation of American Hospitals heavily criticized the development as unlawful. The Affordable Care Act, enacted in 2010, prohibits expanding the capacity of existing Medicare-certified POHs unless they meet certain exceptions — status as a high Medicaid facility being one of them — and placed a moratorium on the establishment of new Medicare-certified POHs.
To qualify as a high Medicaid facility, a POH must show it is not the sole hospital in a county, it has the highest Medicaid admissions of any hospital in the county for the past three years, and must certify that it does not discriminate against federal healthcare beneficiaries.
The FAH argued that the 55-mile distance between DHR's main campus and new location makes it "a thinly veiled attempt to set up a new POH in a new service area."
Physician-Led Healthcare for America, a group established in 2001 to advocate for POHs, said DHR is in an underserved region with 30 percent uninsured and 32 percent Medicaid rates. The group called the CMS-permitted expansion a "win" for patients in the Rio Grande Valley.
"PHA is disappointed that special interest lobbyists in Washington, D.C., chose to offer harsh criticism of the expansion approval by CMS," the group said in its statement. "At a time when policymakers are seeking solutions to offer more healthcare options to Americans, now is not the time for special interest lobbyists to protect monopolies by blocking innovative healthcare solutions. Instead, these special interest lobbyists should be seeking innovative solutions, such as physician-led healthcare options."