Five Questions With: Sen. Joshua Miller

"RHODE ISLAND has great potential, through aggressive statewide planning, to make every hospital appropriate and viable for Rhode Island and its specific community," said Sen. Joshua Miller. / COURTESY R.I. GENERAL ASSEMBLY

With the opening of the 2012 session of the R.I. General Assembly, the spotlight – and much of the discussion – promises to be focused upon pension reform, budgets, revenue enhancements, and economic development initiatives.
Roiling beneath the surface of these legislative debates are a number of health care legislative initiatives. They include: changes to the current Hospital Conversions Act that Lt. Gov. Elizabeth H. Roberts has suggested may be broader than those sought by Steward Health Care to enable it to purchase additional non-profit hospitals in Rhode Island; a statewide plan for health care and hospitals that is being championed by Peter Andruszkiewicz, president and CEO of Blue Cross & Blue Shield of Rhode Island; and funding mechanisms for two of Rhode Island’s innovative health IT initiatives – the state’s Health Information Exchange and its All Payors Claims Database.
Providence Business News asked Sen. Joshua Miller, D-Cranston, chairman of the Senate Committee on Corporations, to preview some of the key health initiatives that may emerge in the General Assembly in 2012.

PBN: There has been much talk in the last year about the need for the creation of a statewide planning body for the delivery of health services in Rhode Island. Do you think this will be a legislative priority for the General Assembly in 2012?
MILLER:
I believe that with oncoming federal reform, and with the fragile financial condition of several Rhode Island hospitals as well as other providers, that coordinated planning should be critical in the short and long term.

PBN: There has also been discussion about potential changes and tweaks to the Hospital Conversions Act? Do you anticipate that this will be a priority in 2012?
MILLER:
I think that the Hospital Conversions Act should be updated based on current potential uses versus expected uses, as written, when enacted.

PBN: With Westerly Hospital in receivership, and with Landmark Medical Center’s proposed sale to a for-profit hospital system, the issues addressed by the Senate Commission on hospital costs that you chaired in 2011 look very prescient. What kind of legislative action do you believe is needed to preserve non-profit, acute care community hospitals in Rhode Island?
MILLER:
Rhode Island has great potential, through aggressive statewide planning, to make every hospital appropriate and viable for Rhode Island and its specific community.

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PBN: Some of the wrangling over the budget last year involved proposals to reduce eligibility and to raise fees for RIte Care parents and children. However, it was found that the numbers used by the House Finance Committee staff were inaccurate, and the increase in fees, which was enacted, was found to be illegal under federal Medicaid rules. Do you anticipate similar efforts will be made again this year?
MILLER:
There has not recently been a budget cycle that did not implement changes to RIte Care. It is the responsibility of all interested and effected parties to participate in this deliberation, not only to make sure the numbers are right, but also to make sure appropriate consideration is given to costs and quality of short-and long-term care for those who remain insured versus uninsured.

PBN: If the U.S. Supreme Court rules against the national health care reform law, do you think that Rhode Island will move ahead with the reforms and mechanisms it has already put into place? Is there any legislative action required to secure these reforms?
MILLER:
I am not a legal scholar, but as an observer, I believe any state can reform as aggressively as they wish. Look at efforts in Massachusetts, Vermont and Maryland, to name a few. Health care and health insurance reform are critical for all the obvious reasons, including economic development. If we can drive down the cost of health insurance for Rhode Island employers and employees alike, it could be the most important and effective economic difference and attraction Rhode Island could implement.

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