NY ASC at risk of losing operation certificate for inadequate Medicaid, charity care

Surgicare of Manhattan in New York is applying for a two-year extension of its five-year limited life approval, which would include a two-year extension of its operating certificate. But, the New York Public Health and Health Planning Council could deny the application based on the surgery center's lagging number of charity and Medicaid cases, according to a Lexology report. 

ASCs operating under limited life certificates are required to provide and document charity care and care to Medicaid patients, but the amount of care is not specified. Rather, when submitting an application for an operating certificate, ASCs must provide an estimation of the amount of charity and Medicaid care expected, according to the report.

The council granted Surgicare of Manhattan initial approval for a limited life certificate in 2010. The surgery center estimated 4 percent of its procedures would be Medicaid and charity care cases, but the New York Department of Health found 1.5 percent of its cases were charity care and 0.03 percent of its cases were Medicaid cases in 2014. The center generated approximately $8 million in net income between 2013 and 2014, according to the report.

A number of the Public Health and Planning Council members have argued for ruling against approval of the ASC's request for an extension.

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