1. What has happened with this debate since mid-2006? The growth of specialty hospitals has become a debate as physician ownership has absorbed 70% of specialty hospitals and seen it compared to local full-service community hospitals. In November 2003, Congress expressed concern about the specialty hospital health system when they passed the Medicare Prescription Drug, Improvement and Modernization Act. This act provided an 18-month moratorium for new enrollment applicants. The moratorium focused on the specific harm that physician-owned specialty hospitals caused their competitors, but not on the reasons for the difference between specialties and nonspecialties. Two or three years later the moratorium expired and CMS proposed MedPAC. Another part of the debate involved CMS's proposal to implement a rule that specialty hospitals would be required to accept patient transfers under the Emergency Medical Treatment and Labor Act. Specialty hospitals are less likely to have an emergency room or offer 24-hour emergency care as a community hospital would. The real debate was about revenue because specialty hospitals are likely to steal future patient revenue from non-specialty hospitals in their market. Therefore, specialized facilities allow specialty hospitals to manage hospital resources more successfully. “The challenge for policymakers is to find a way to inspire competition, while ensuring that regulatory gaps are not unfairly exploited.” (David N. Heard, 2005)2. How could one attempt to reach an objective conclusion? One focus would be whether or not physician-owned specialty hospitals have an unfair advantage or great promotion in the healthcare market. The purpose of the moratorium was to ban p...... middle of paper ...... Works Cited David N. Heard, J. (2005). THE SPECIALIZED HOSPITAL DEBATE: THE DIFFICULTY OF PROMOTING FAIR COMPETITION WITHOUT STUFFING EFFICIENCY. HOUSE. J. HEALTH L. & POL'Y, 215-243. Retrieved from https://www.law.uh.edu/hjhlp/Issues/Vol_61/Heard.pdfLowes, R. (2011, October 6). MedPac recommends the new "Doc Fix". Retrieved from MedScape: http://www.medscape.com/viewarticle/751097 Pyrek, K. M. (2005, May 1). MedPAC recommends extension of moratorium in specialty hospitals; ASHA continues to support the cause through its “Truth” campaign. Retrieved from Surgi Strategies: http://www.surgistrategies.com/articles/2005/05/medpac-recommends-extending-specialty-hospital-mo.aspxUnited States Government Accountability Office [GAO] 2005. “Specialty Hospitals: Information on Potential Facilities." GAO-05-647R. Washington, DC: GAO http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654166/#!po=3.84615