Questionable State Enforcement of CTCA’s Charity Care Commitment

Reporters at the Atlanta Journal-Constitution have done some digging into public records of Georgia’s “destination cancer hospital” run by the Cancer Treatment Centers of America and made possible by the passage of SB 433 in 2008. This law requires destination hospitals to admit Medicaid patients and provide a certain amount of charity care, but questions remain on CTCA’s compliance.

CTCA filed another report with the state that demonstrated that the cancer hospital provided $4 million worth of uncompensated indigent and charity care to Georgia residents in 2013. That amounted to 3.5 percent of the adjusted gross revenues it earned from its Georgia patients only. The cancer hospital said it was instructed to demonstrate its charity care using that approach.

State health officials wouldn’t comment, but the community hospitals that fought against CTCA questioned the approach, saying that’s not how they demonstrate their own charity care commitments.

Because the cancer hospital attracts most of its revenues from out of state patients, it would have to spend much more on uncompensated charity care to reach the 3 percent threshold if those revenues were included in the calculation.

Assuming that, like patients served, 65.5% of the hospital’s revenue comes from out-of-state patients, calculating three percent of all adjusted gross revenue (instead of just revenue from Georgia patients) would have obligated CTCA to provide nearly $6 million more in charity care in 2013. Under Georgia state law, failing to meet indigent care requirements means that a hospital owes the state “a monetary penalty in the amount of the difference between the amount of services so agreed to be provided and the amount actually provided.”

So far, it appears that $372,650 of campaign contributions to Georgia political campaigns, including $22,100 to Lieutenant Governor Casey Cagle and $13,600 to Governor Nathan Deal, works out to be much cheaper than providing an estimated $6 million worth of care to needy Georgians or penalties to the state treasury.


  1. xdog says:

    Well, I guess it comes down to how the contracts are structured versus Georgia law but on its face the deal sounds pretty rank.

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