2016 Blog Entries

10/7/2016

Ever wonder why so many Fortune 500 companies are moving to Georgia?  It's the tax exemptions and credits!

Here are the ones relevant to Healthcare:
(6) Sales to any Hospital Authority created by Article 4 of Chapter 7 of Title 31 of the Georgia Code. 
 

(7) Sales of tangible personal property and services used specifically in the treatment function when the sales are to a nonprofit (i.e., a tax exempt organization under the Internal Revenue Code) nursing home, inpatient hospice, general hospital or mental hospital. Application process is through Form ST-NH1. 
 

(7.05) From July 1, 2015 through June 30, 2018, sales of tangible personal property to a nonprofit health center in this state which has been established under the authority of and is receiving funds pursuant to, the United States Public Health Service Act, 42 U. S. C. Section 254b if such health clinic obtains an exemption determination letter from the commissioner. Application process is through Form ST-NHC. Annual application required. Application must be filed electronically through the Georgia Tax Center. Qualifying sales are exempt from the 4% state sales tax. These sales are subject to all local sales taxes.
 

(7.3) From July 1, 2015 to June 30, 2018, sales of tangible property and services to a nonprofit volunteer health clinic primarily treating patients with incomes below 200% of the poverty level and which property and services are used exclusively in performing a general treatment function when such clinic is a tax exempt entity under the Internal Revenue Code and obtains an exemption determination letter from the Commissioner. Application is through Form ST-NVHC. Annual application required. Application must be filed electronically through the Georgia Tax Center. 

(47) Sales or use of drugs that are lawfully dispensable only by prescription for the treatment of natural persons; Insulin regardless of whether the insulin is dispensable only by prescription; prescription eyeglasses and contact lenses; drugs dispensable by prescription for the treatment of natural persons without charge to physicians, hospitals, etc. by pharmaceutical manufacturers or distributors; drugs and durable medical equipment dispensed or distributed without charge solely for the purposes of a clinical trial approved by the FDA or an institutional review board. Note: This exemption does not include over-the-counter drugs, drugs sold for animal use, or nonprescription eyeglasses. 

(50) Sales of insulin syringes and blood glucose level measuring strips dispensed without a prescription. 

(51) Sales of oxygen when prescribed by a licensed physician
 

(52) Sale or use of hearing aids. 

(54) Sale to or use by a patient of any prescribed durable medical equipment or prescribed prosthetic device. 

(72) The sale to or use by a patient of all mobility enhancing equipment prescribed by a physician.

10/6/2016

One of the most frustrating, and equally confounding, challenges for Healthcare providers in Georgia (historically has been a red state, yet this law completely defies laissez faire), is the CON filing process through the Georgie Department of Community Health.  The supposed purpose behind the law is to 'ensure the availability of adequate health care services to meet the needs of all Georgians, while safeguarding against the unnecessary duplication of services that perpetuate the costs of health care services.'  Below are a list of all projects that require a CON:

1. New hospitals, including general, acute-care and specialty hospitals
2. New or expanding Nursing Homes and Home health agencies
3. All multi-specialty and certain single-specialty Ambulatory Surgery Centers
4. Providers of Radiation Therapy, Positron Emission Tomography, Open Heart Surgery, and Neonatal Services
5. Major medical equipment purchases or leases (e.g. MRI, CT Scanners) that exceed the equipment threshold
6. Major hospital renovations or other capital activities by any health care facility that exceed the capital expenditure threshold
7. Before a health care facility can offer a health care service, which was not provided on a regular basis during the previous 12-month period, or add additional beds

Thresholds as of July 2016:
Capital Expenditures, O.C.G.A. § 31-6-40(a)(2) $ 2,903,530
Single-Specialty Physician-Owned Ambulatory Surgery Facilities, O.C.G.A. § 31-6-47(a)(18) $ 2,903,530
Joint Venture Ambulatory Surgery Centers, O.C.G.A. § 31-6-47(a)(19) $ 5,807,061
Equipment, O.C.G.A. § 31-6-40(a)(3) $ 1,246,165

During the filing process, what's commonly not mentioned is the legal counseling that specializes in CON/LNR law is highly recommended.  Most projects fail to take into account these costs which can easily breach five figures, even with the simplest of projects.

Recent reports have questioned this laws efficacy, now enforced in 35 states, with the latest stating it diminishes quality of care and in some cases even raises death rates.  The Fiscal Times has a great article shedding some light on this failed policy.

9/30/2016

Highly recommend paying Becker's website a visit.  Very few have the pulse on Healthcare like they do.

9/21/2016  
Questioning your processing techniques?  Both Cedars and Ectoolbox do a great job of supporting their users by posting tutorials and operating manuals.

Here are Cedars Tutorials

Here is Ectoolbox's operating instructions