Company skips hospital hearing

Last modified: 2/8/2012 12:00:00 AM
Lawmakers deciding whether to bend state rules and waive Medicaid taxes for a private, out-of-state cancer hospital were left with several unanswered questions yesterday because the hospital sent no one to testify on its behalf at a scheduled public hearing.

'Is anyone from the company or the CEO speaking?' asked Rep. Robert Fredette, a Hillsboro Republican. The answer seemed to surprise him. 'No?' Fredette asked.

Unanswered questions included: Would Cancer Treatment Centers of America offer treatment currently unavailable here? Does it discharge patients if they can no longer pay? And how many jobs would it really create and not just shift?

After the hearing, Fredette said he was 'downright shocked and totally surprised' the company, Cancer Treatment Centers of New Hampshire, did not have a representative available for questions. 'I don't know how they expect to get this passed.'

Center officials, based in Illinois, have time to oblige lawmakers if they wish. Yesterday's hearing will continue tomorrow morning at 9 because people were still waiting to testify yesterday when the hearing ended. A spokesman for the center, which is based in Illinois, did not respond yesterday to a phone call and email seeking comment.

Salem Rep. Marilinda Garcia's bill, which is before the House Health, Human Services and Elderly Affairs Committee, would exempt specialty 'destination cancer hospitals' from the state's rigorous evaluation process and Medicaid taxes that the state's other hospitals face. Doctors from the state's existing cancer treatment hospital testified against the bill yesterday, largely because they believe there is already top-notch cancer treatment available.

The doctors also believe the bill would give the center an unfair advantage by excusing it from state review and Medicaid taxes.

Garcia, whose co-sponsors include House Speaker Bill O'Brien and Majority Leader D.J. Bettencourt, said her bill is not for Cancer Treatment Centers of America in particular but any cancer hospital that will draw 65 percent of its patients from out of state. But Garcia did acknowledge yesterday that the center is the only such hospital interested in New Hampshire.

She has also told the Monitor that center officials helped her write the bill and that it's modeled on legislation the center helped shepherd through the Georgia Legislature in 2008.

Yesterday's hearing ran about 90 minutes and began with remarks from Bettencourt and O'Brien.

Bettencourt complained that the news media had cast 'aspersions' on the legislation and its sponsors and said he's supporting the bill to bring new jobs and taxes to the state. The center would pay the state's two business taxes because it is a for-profit hospital.

'This Legislature has been tasked with creating jobs,' he said. 'Here is an opportunity to create jobs, and it astonishes me that some of the same voices who are asking for jobs are attacking this legislation.'

Bettencourt continued.

'I believe we have an obligation to the 38,000 of our friends and neighbors who are currently looking for work to create jobs every responsible way possible,' he said. 'This is a jobs bill in one of its most virtuous forms.'

Fredette asked Bettencourt how many jobs the center has said it will create.

'I don't know,' Bettencourt said. 'A range has been given. At this time we are going to take every job we can get.'

Garcia later said the center has told her what it has predicted in its other locations, including Georgia and Arizona: It will create 500 jobs over five years.

O'Brien told committee members the state certificate-of-need process that current hospitals face and that the cancer hospital would skip under the bill is an out-of-date way of determining how many treatment facilities a state can support. Cancer Treatment Centers of America is different, O'Brien said, because it would draw 65 percent of its patients from outside the state.

'In fact, our residents typically have to travel to Boston for high-end specialists,' O'Brien said. 'Why shouldn't we put ourselves in a position to have people from across the Northeast and even from other countries coming here, and helping our economy, to get their specialty care?'

Several doctors challenged O'Brien's premise that New Hampshire residents have to go elsewhere for specialty treatment. The cancer treatment center, which would not take Medicaid patients or people unable to pay for their care, offers nothing that isn't already here, they said.

Dr. Mark Israel, director of the Dartmouth-Hitchcock Norris Cotton Cancer Center in Lebanon, said the center, which has 17 locations in the state, sees 100 new cancer patients a week and more than 30,000 patients a year.

Not only does the Norris Cotton Cancer Center offer top cancer care, Israel said, but it also does research and serves as a teaching hospital. The Cancer Treatment Centers of America do neither, he said. Israel echoed a concern of many who testified against the bill: If the center refused to take uninsured or underinsured patients, as it has stated, that will leave the other hospitals with more of the patients who can't pay. In addition, the patients who can pay will be siphoned off by the center, they said.

'The ability to provide care is a delicate balance of patients who can actually pay for their care, those who pay less than it costs to take care of them or who pay nothing at all,' Israel said. 'We provide (them) all care. We are . . . payment blind.'

(Annmarie Timmins can be reached at 369-3323 or at

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