From: Becker Scott <>
Subject: [Becker's ASC E-Newsletter] Senate Bill Would Ban New Physician-Owned Hospitals; Top 10 Billing Errors ASCs Make; Hospital Not Duty-Bound to Disclose Drug Problem; Fewer Than 40 Spots Remain for June Orthopedics and Spine Driven ASC Conference
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May 20, 2008
June 08 ortho short
Senate Bill (Together With House Bill) Would Ban New Physician-Owned Hospitals 

New physician-owned hospitals would be banned under language added to the Senate version of the Supplemental Appropriations Bill that was finalized late last week. Over the past several months, the House of Representatives has consistently added language to bills that would prohibit physician ownership of hospitals. Up until now, the Senate counterpart bills have not included similar prohibitions; now, the appropriations bill passed by the Senate has similar restrictions to the House bills. A lot can happen between here and actual law, but now that the Senate has passed anti-physician-ownership legislation, this is a very ominous development.

The language also contains a few important exceptions made primarily due to amendments offered by Sen. Ben Nelson (D-Neb.) and Sen. Herb Kohl (D-Wis.). The amendments mostly affect existing facilities. Under the new language there is no "buy down" requirement for existing hospitals requiring that physicians own no more than 40 percent on aggregate and 2 percent individually. A great number of changes to the language were also made regarding how and whether existing hospitals will be allowed to grow. In addition, the language now includes a specific deadline for under-development hospitals to receive their Medicare number in order to be grandfathered.

For follow-up coverage and analysis, visit

10 of the Most Popular Articles Recently Posted at

Here are 10 of the most popular articles that have been posted recently at

1. Top 10 Billing Errors ASCs Make. Using CMS's comprehensive error rate testing system, which measures the accuracy of Medicare fee-for-service payments, a Medicare contractor has reviewed Medicare Part B claims from Texas ASCs to determine the top 10 billing errors that lead to denial or rejection of claims. Go here for the complete story.

2. Utah State Senator Outlines Barriers, Solutions in Political Landscape for ASCs. ASCs are valuable, and the services they provide appreciated by those familiar with them - the problem is, not enough politicos are in the know, and it's hurting the industry, said Utah state Sen. Allen Christensen (R) in addressing the crowd at the first ASC Association annual meeting, ASCs 2008, in San Antonio, Texas. For the full recap, go here.

3. 10 Valuation Facts and Statistics for ASCs. Valuation multiples for ASCs were higher than ever in 2007, and orthopedics, ENT, ophthalmology and general surgery are the most desirable specialties, among other findings, according to the 2008 ASC Valuation Survey by HealthCare Appraisers. Get the complete story here.

4. California Licensure and Accreditation Concerns -- Ambulatory Surgery Centers. A California court case in combination with action by the state Department of Health prohibiting the department from issuing licenses to ASCs has created some confusion regarding whether ASCs must be licensed or accredited or both to operate in California. Go here for the full analysis.

5. N.J. Decision May Cause Big Challenges for State's Physician-Owned ASCs. A new case (Endo Surgi Center v. Liberty Mutual Insurance Company), in the aftermath of the original Garcia v. Health Net of New Jersey (also known as the Codey Case), may spell larger problems for New Jersey-based surgery centers. Endo Surgi Center holds that a New Jersey payor need not pay a physician-owned ASC that operates out of compliance with the Codey Act. For more, go here.

6. 10 Interesting Facts and Statistics for ASCs. The 2007 edition of a leading benchmarking guide for ASCs, developed and published by VMG Health, has been released. The guide covers financial and operational benchmarks for various specialties performed within ASCs, multi- and single-specialty ASCs and varying procedure volumes. For the full list, click here.

7. 10 Benchmarking Statistics for Ambulatory Surgical Centers. The following highlights another 10 terrific statistics on ASCs from the 2007 Multispecialty ASC Intellimarker. This publication is authored by VMG Health, an outstanding valuation firm with a focus on ASCs. For more, go here.

8. 10 Keys to Turning Around Financially Troubled ASCs. The healthcare sector is not immune to the weak economy and, as such, some ASCs may be finding themselves increasingly in financial trouble. This was the subject of a McGuireWoods teleconference entitled "10 Keys to Turning Around Financially Troubled Ambulatory Surgery Centers: A Case Study Approach." Brent Lambert, MD, FACS, one of the founders of Ambulatory Surgical Centers of America, and Tom Mallon, the CEO of Regent Surgical Health, presented examples of some solutions for ASCs that are struggling financially. Click here for the full report.

9. 12 Interesting Statistics From the VMG Health Endo Centers Financial and Operational Benchmark Study. This article briefly outlines 12 findings from the VMG Health Endo Centers Benchmarking Study. The study, together with the IMA Health Multi-Specialty Center Study, is an outstanding resource for ASCs. Get the complete list here.

10. Long-Term Nursing Picture Bleak, But There Is Short-Term Relief. The nursing shortage could hit the half-million mark by 2025 if there is no letup in healthcare's growth and, therefore, demand for nurses. However, the current weak economy is prompting nurses back into the work force, at least temporarily. For the full story, go here.

Surgical Notes new for 17x run
Preview of "60 People to Watch" in June/July Becker's ASC Review

The July/Aug. issue of the Becker's ASC Review will feature 60 people to watch in the ASC industry. Here is a preview of six of those key figures.

1. Andrew Hayek. Andrew Hayek is the new president and CEO of Surgical Care Affiliates (SCA), which operates more than 130 ASCs and surgical hospitals nationwide. Before joining SCA on May 1, Mr. Hayek most recently served as president of VillageHealth, an insurance and care management company owned by DaVita, the nation's leading independent provider of kidney dialysis services. Mr. Hayek has also served as president and COO of Alliance Imaging, a $450 million-revenue diagnostic imaging and radiation oncology business that operates in 43 states; and worked for Capstone Consulting (an operations consulting firm affiliated with private equity firm Kohlberg Kravis Roberts & Co.), The Pritzker Organization (a merchant banking firm affiliated with the Pritzker family of Chicago, owners of Hyatt Hotels), and the Boston Consulting Group.

2. Beverly Kirchner, RN, BSN, CNOR, CASC. Beverly Kirchner serves on the AORN board of directors, has authored many AORN manuals and leads research in collaboration with the organization on violence in the nursing workplace. She serves on a Joint Commission task force charged with rewriting ASC standards and has been named to the Ambulatory Surgery Center Quality Collaboration, which comprises individuals, healthcare organizations and companies that have joined with CMS and the National Quality Forum to develop improved quality indicators for ASCs. As the owner and CEO of Genesee Associates, Ms. Kirchner has been involved in design, development and management of ASCs since 1985. She also serves on GPO Med Assets' advisory board for ambulatory care and on the board of directors of celebrity medical.

3. Donald Kramer, MD. With a medical practice spanning more than 25 years, Donald Kramer, MD, has developed several successful ASCs in the Houston market and, building on that success, has founded Northstar Healthcare, which develops and, in conjunction with physician partners, owns and operates significant ASCs in concentrated markets. Serving as president and medical director for Northstar, in addition to maintaining an active pain management practice, Dr. Kramer coordinates care provided by the medical staff, establishes policies and is responsible for ensuring state and federal compliance at each of the company's facilities. In addition, he is a founding partner of and large shareholder in Foundation Surgery Affiliates; Dr. Kramer divested himself of his significant ownership in FSA in early 2006. He is also an active member of the Texas Ambulatory Surgery Center Society.

4. Christopher Holden. Christopher Holden joined AmSurg in October 2007 as its president, CEO and director. Mr. Holden is a healthcare industry veteran of more than 21 years, engaged during most of his career directly in multi-facility and multi-market healthcare management. Before joining AmSurg, Mr. Holden served as senior VP and a division president of Triad Hospitals, of which he was a founding team member and officer in May 1999. From August 1994 until May 1999, he held several positions with Columbia/HCA Healthcare.

5. Susan Kizirian, RN, MBA. Susan Kizirian is the chief operating officer of Ambulatory Surgery Centers of America. Ms. Kizirian has more than 17 years' experience in all aspects of ASC operations, having served as an executive director and a consultant for ASC management and development. Most recently before joining ASCOA, Ms. Kizirian worked with the University of Virginia Health System ASC program. Additionally, she has 15 years of practice management experience and eight years of expertise with clinical site research. Ms. Kizirian currently serves as lifetime past president emeritus on the board of directors of the Florida Society of Ambulatory Surgery Centers, is past treasurer of AAASC and past president of the Ambulatory Surgery Management Society of the Medical Group Management Association.

6. David Shapiro, MD. David Shapiro, MD, is the chair of the board of the ASC Association. He is also co-chair of the ASC Quality Collaboration, an industry-wide effort to identify specific measures for quality appropriate to ASCs; the collaboration has already produced five quality measures that have been approved by the National Quality Forum and are now being considered by CMS. Dr. Shapiro, an anesthesiologist, is a past-president of AAASC and has served as a medical director in ASCs.

Earn Up to 13.5 CME, CEU or CASC Credits at June Orthopedics and Spine Driven ASC Conference; Fewer Than 40 Spots Left 

The 6th Annual Orthopedics, Pain Management and Spine Driven ASC Conference: Improving Profits, Legal and Business Issues, will be held June 19 to 21 in Chicago. This is an opportunity for great education and great networking. You can earn up to 13.5 CME and 13.5 CASC credits by attending. There are fewer than 40 attendee registrations available and no exhibit spaces left.

Download the complete program brochure and agenda here.

Here are just six of the valuable seminars you can attend if you register:

  1. Dr. Scott Glaser, of Pain Specialists of Greater Chicago, will present clinical and business views of pain management in both the ASC and office settings.

  2. Dr. Brent Lambert, principal in ASCOA, will speak about using orthopedics, spine and pain management to turn around and drive an ASC's success.

  3. Tom Yerden, the CEO and founder of TRY Health Care Solutions, will present a case study on managing conflicts and keeping an orthopedic- and pain-driven ASC profitable.

  4. James Jackson of USPI will present a talk called "How and ASC Can Thrive With Physicians, a Hospital and a Management Company: Tips for Success and How to Avoid Problems."

  5. Tom Pliura, MD, JD, the president and CEO of zChart, will speak about how insurers are fighting ASCs and imaging facilities, and whether you can still use out-of-network as a billing option.

  6. Robyn Finnegan, the VP of managed care at Prexus Health Partners, will present a talk entitled "Payor Contracting With Carve-Outs for Orthopedics and Pain."

Download the complete program agenda and event brochure here. CME, CEU and CASC credits available. Paid subscribers to the Becker's ASC Review can receive a $100 discount. E-mail Rob Kurtz if you are a paid subscriber and would like to take advantage of this special offer. Additional discounts apply when registering two or more attendees. Book your hotel room soon -- the block is almost sold out.

There are four easy ways to register:

  • Online. Register through our secure Web site.

  • Fax. Complete the order form and fax it to (312) 706-2526. Please show ASC Communications c/o a5 as the subject line.

  • Mail. Complete the order form and mail it to ASC Communications; c/o a5 Inc.; 1 N. LaSalle Street, 47th Floor; Chicago IL 60602.

  • Phone. Call (312) 546-6042 to register.
Meridian begin 0520
Small Hospital Review Logo Hospital Not Duty-Bound to Disclose Drug Problem; $7.75M Settlement in Overpayment Case; FTC Tries to Block Hospital Merger; Iowa Hospitals May Gain CON Exemption; Chicago Hospital to Remain Open

1. Hospital Did Not Have Duty to Disclose Fired Anesthesiologist's Drug Problem, Says Federal Court. A Louisiana hospital did not have a duty to disclose an anesthesiologist's drug problem in a reference to a prospective hospital employer, and therefore cannot be held liable for patient injuries the impaired physician subsequently caused at the new hospital, a federal appeals court has ruled. For more analysis, go here.

2. Health System Settles Overpayment Claims With Feds for $7.75 Million. Baptist Health South Florida Inc., a healthcare system headquartered in Miami, has agreed to pay the United States $7,775,000 to settle claims that it violated the False Claims Act and the Stark Statute between 2003 and 2005, by paying excessive compensation to an oncology group that was a source of patient referrals to two of Baptists hospitals, the U.S. Department of Justice has announced. For the full story, click here.

3. FTC Tries to Block Inova Health, Prince William Hospital Merger. The Federal Trade Commission, joined by the Commonwealth of Virginia, has filed a complaint in federal court to block Northern Virginia's Inova Health System Foundation's proposed acquisition of the Prince William Health System in Manassas, Va. Click here for the complete story.

4. In the News: Iowa Hospitals May Become Exempt From CON Requirements. Iowa lawmakers have passed a bill that would exempt the state's hospitals from having to seek certificate of need approval for construction of new facilities, reports the Chicago Tribune. For more, go here.

5. Major Chicago-Area Hospital to Remain Open Under New Ownership. St. Francis Hospital & Health Center in Blue Island, Ill., will remain open and change from a non-profit to a for-profit hospital after a transfer of ownership, according to the hospital. Get the full story here. May 08
Question of the Month

What are the most effective means you use to reduce costs?

E-mail Rob Kurtz your thoughts to this question by clicking here. Be sure to include your name and business name.

In a few weeks, we will publish a selection of the responses we receive and choose one response as our "answer of the month." The winner will receive a free six-month subscription to Becker's ASC Review (current subscribers will receive an additional six months on their existing subscriptions).

Register Now: Orthopedic Coding in ASCs -- An Audio Conference -- June 11; Earn 1.5 CEUs

In this audio conference, ASC coding expert Stephanie Ellis, RN, CPC, of Ellis Medical Consulting will discuss orthopedic coding challenges in ASCs, and will help you to capture the reimbursement your center earns and deserves. If your ASC performs orthopedic surgery or will do so in the near future, you will not want to miss this seminar.

Ms. Ellis will highlight

  • new challenges presented by Final Rule additions and revisions of procedures to the Medicare list of ASC-approved procedures;

  • common coding errors with current procedures, such as chondroplasties performed with other knee procedures and subacromial decompressions performed with open rotator cuff repair;

  • challenges with coding implants;

  • modifier misuse;

  • and other issues.


Date: Wednesday, June 11

Starting time: 11:00 a.m. (Pacific), Noon (Mountain), 1:00 p.m. (Central), 2:00 p.m. (Eastern)

Length: 90 minutes

Credits: 1.5 AAPC-approved CEUs

Cost: $199; or $99 for paid subscribers of Becker's ASC Review (e-mail Rob Kurtz if you are a paid subscriber and would like to take advantage of this special offer).

For more information, go here. To register, go here.

Medtegrity 12 weeks consec
Thank You to 10 Great Companies in the ASC Industry

This week we want to thank and highlight the following advertisers and sponsors who have recently begun to support or increased their support of the Becker's ASC Review and ASC Communications.

1. Marshall Erdman & Associates. For more than 50 years, the name Marshall Erdman & Associates has been synonymous with the delivery of innovative healthcare facility solutions. Erdman is now the exclusive sponsor for construction, design and build for the October conference, "Improving Profits and Business and Legal Issues for ASCs," presented by ASC Communications and the ASC Association. For more on Erdman, go here.

2. Industrial Pharmacy Management. Industrial Pharmacy Management provides an end-to-end program enabling healthcare providers to dispense medication to their workers' compensation and personal injury patients before they leave the facility, regardless of claim status. IPM will exhibit at the June Orthopedics-, Pain Management- and Spine-Driven ASC Conference, presented by ASC Communication. Read more about the company here.

3. Eveia Health Consulting & Management Company. Founded by I. Naya Kehayes, MPH, Eveia Health Consulting & Management is comprised of a team of seasoned professionals who are experts in reimbursement management, managed care contracting, and business management with a specialization in ASCs and surgical practices. Eveia has signed on to co-sponsor the conference at-a-glance at the October conference. Go here to learn more about Eveia.

4. Symbion. Headquartered in Nashville, Tenn., Symbion is a leading provider of high quality surgical services across many specialties. Symbion has signed on to co-sponsor the conference at-a-glance at the October conference. Learn more about Symbion here.

5. Affiliated Credit Services. Affiliated Credit Services is a Colorado-based professional account receivables management firm which focuses on increasing businesses cash flow by providing superior collection services. The company will sponsor the water bottles at the October conference. Read more about Affiliated Credit Services here.

6. AAAHC. The Accreditation Association for Ambulatory Health Care, also known as AAAHC, currently accrediting more than 3,600 organizations, making it a leader in ambulatory healthcare accreditation. AAAHC will begin a run of ads in the Becker's ASC E-Weekly. Click here to learn more about AAAHC.

7. Kimberly-Clark Health Care. Kimberly-Clark Health Care manufactures and markets surgical drapes, gowns, sterilization wrap and pouches, personal protective apparel and face masks, and patient care products. The company will exhibit at the June conference. Learn more about Kimberly-Clark here.

8. Spine Surgical Innovation. Spine Surgical Innovation exclusively markets and distributes the Holmed Swivel Port System, which is designed for ease of use and intended for posterior or lateral lumbar surgery. The company will exhibit at the June conference. Click here to learn more about Spine Surgical Innovation.

9. Surgical Management Professionals. With a seasoned team of healthcare professionals, Surgical Management Professionals specializes in the management and development of ASCs and surgical specialty hospitals. SMP recently renewed its run of ads in the ASC Review. For more on SMP, go here.

10. Medical Protective. Medical Protective is a national leader in primary medical professional liability coverage and risk solutions to healthcare providers. It will exhibit at the October conference. Learn more about Medical Protective here.

Becker's ASC Review Subscriber Benefits

If you are a Becker's ASC Review paid subscriber, you are entitled to the following new benefits:

  1. Becker's ASC Review delivered to your door.
  2. Subscriber discounts on the cost of audio conference and Webinar registrations.
  3. $100 off registration for both main and pre-conference sessions at the June conference.
  4. $50 off registration for both main and pre-conference sessions at the October conference.
  5. Free copy of the VMG Health Intellimarker benchmarking survey, an extremely valuable guide.

To subscribe to the Becker's ASC Review go to

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    Upcoming ASC Conferences
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    Oct. 23 to 25, 2008

    7th Annual Orthopedics-, Pain Management- and Spine-Driven ASC Conference
    Presented by ASC Communications

    June 11 to 13, 2009

    16th Annual Improving Profitability and Business and Legal Issues for ASCs
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    Oct. 8 to 10, 2009

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