25 things for ASC leaders to know for September

Here are 25 updates for ambulatory surgery center leaders to know from the past month.

SCA, Executive Surgery Center partner
Surgical Care Affiliates partnered with Executive Surgery Center in Tomball, Texas. A physician-led center, Executive Surgery Center offers services including orthopedic, sports medicine and pain management.

Ambulatory care services spending hits $244.3B; up 7.3% in Q2
A Census' Quarterly Service Survey found ambulatory care services spending totaled $244.3 billion, up 7.3 percent from the second quarter last year. Within ambulatory care services, outpatient care spending increased 9.2 percent and home health services rallied 6.8 percent.

Mylan to offer $300 generic to EpiPen auto-injector in effort to save face
Pharmaceutical company Mylan has faced heat after news broke about the company increasing EpiPen's price by more than 450 percent since 2004, prompting the company to offer a generic product. In 2008, EpiPen cost nearly $100, with the drug's current list price totaling $600. Mylan is launching an EpiPen generic alterative in the coming weeks with a $300 list price.

Medicare spends $87.9M on EpiPen users in 2014, up 1,000%+ in 7 years
Between 2007 and 2014, Medicare spending on the EpiPen increased 1,151 percent. Medicare spent $7 million on EpiPen in 2007 for 79,980 users in 2007, with that figure increasing to $87.9 million in 2014.

AmSurg-Envision merger closer to final stages as Hart-Scott-Rodino waiting period expires
The Envision Healthcare/AmSurg merger's wait period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 has expired. The wait period pertains to the Federal Trade Commission's review of the proposed merger between the two parties. AmSurg and Envision separately received a request for information from the antitrust division of the State of Florida Attorney General's office. Both organizations are cooperating with the request.

Donald Trump's gastroenterologist speaks out; Dr. Harold Bornstein has no regrets over letter
Donald Trump's gastroenterologist Harold Bornstein, MD, recently released a four-paragraph letter, stating, "If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency." In an interview with CNN, Dr. Bornstein said he doesn't have any regrets regarding his letter on Mr. Trump's health. Dr. Bornstein's letter stated Mr. Trump's lab results were "astonishingly excellent."

Yorkville Endoscopy sues insurance agency for not covering $200k in bills related to Joan Rivers' case
New York City-based Yorkville Endoscopy, the surgery center that came under fire in 2014 after comedian Joan Rivers died, is suing The Hartford Financial Services Group for not covering $200,000 in legal bills related to the star's botched surgery. Following Ms. Rivers' death, federal and state officials started investigations into the surgery center, with Yorkville paying their attorneys to respond to the agencies' inquiries related to the investigation. Hartford claims Yorkville Endoscopy's policy with the payer did not cover such bills. However, Yorkville says the policy explicitly mandates the payer "defend Yorkville employees in regulatory proceedings."

Zika projected to strike these 8 states, next
Biostatisticians predict 395 non-travel Zika infections will strike Florida before summer draws to a close and a slew of southeastern states will also see their fair share of Zika infections. The eight states where Zika will likely hit, next, include: Alabama, Arkansas, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina and Texas.

Yearlong CON battle over Green Mountain Surgical Center continues
For more than a year, an independent physician group has challenged the Vermont Association of Hospitals and Health Systems and St. Albans, Va.-based Northwestern Medical Center over state certificate-of-need approval for Green Mountain Surgical Center in Colchester, Va. In the regulatory filings, the surgery center investors said the center would bring in 14 percent of patient surgeries from University of Vermont Medical Center and 3 percent from Northwestern Medical Center.

Novant Health receives CON approval for $9.8M Kernesville ASC
North Carolina-based Novant Health received certificate-of-need approval to build its ambulatory surgery center in Kernersville, N.C. The surgery center costs nearly $9.8 million and hopes to be operational in April 2018. In the plan, Novant Health proposed moving two operating rooms from Winston-Salem, N.C.-based Forsyth Medical Center to Kernersville Outpatient Surgery.

Cigna defends $48M merger with Anthem
As the Anthem-Cigna antitrust case continues, Cigna defended the potential merger saying the $48 billion deal would provide Americans increased access to affordable healthcare. Both Cigna and Anthem said federal attorneys are using out-of-context quotes from internal documents to create a misleading image.

Aetna and Humana in-house lawyers have restrictions placed on them in antitrust case
Special master Richard Levie, who is overseeing the evidence gathering process in the antitrust case, rejected a request from four in-house lawyers for Aetna and Humana to review confidential information. Mr. Levie — the court-appointed official ensuring judicial orders are executed properly — sided with the Justice Department and ruled "that the risk for inadvertent disclosure outweighed the need for the four in-house lawyers to have access to confidential information."

This ingredient may put patients at a higher infection risk from contaminated scopes
Researchers uncovered the ingredient, infant gas relief drops, may be leading to scope contamination. Investigators found white fluid inside various colonoscopies and gastroscopes after they had been disinfected and determined ready for use. Based on these findings, researchers advise providers to try avoiding these products until they can conduct more research on the drops' impact on patient safety.

Political views may impact perception of healthcare quality
Journal for Healthcare Quality found political views may impact a person's perception of the care they receive. However, the study found no differences between parties' personal experiences within the healthcare system. Among respondents who had a recent hospital stay, 80 percent of both Democrats and Republicans were satisfied with their care.

Florida pediatric clinic reports stolen information from 13k patients in identity theft & fraud case
An indictment filed in a U.S. district court in Tampa, Fla., claims Pediatric Gastroenterology, Hepatology and Nutrition of Florida administrative employee worked with two other individuals to commit tax, mail, wire, access and device fraud and identity theft. The accused allegedly stole personal identifiable information from the clinic and other sources, which included patient names, birthdays and Social Security numbers.

Willis Eye, CMS tangle over hospital classification
In 2013, Willis Eye re-established inpatient care services at its main building and applied for Medicare enrollment as a hospital after years of being classified as an ASC; now, Willis Eye is at odds with CMS over the classification.

Physician employment up nearly 50% in 3 years
Physicians Advocacy Institute published the "Physician Practice Acquisition Study: National and Regional Employment Changes," showing a steep increase in the number of hospital-employed physicians and hospital-owned practices.

Patient data for 14,000 taken in University Gastroenterology data breach
Rhode-Island based University Gastroenterology and its 19 offices were victims of a data hacking scam, where an individual gained access to the network, copied information for 14,000 patients and then encrypted it.

Uninsured rate hits 9.1% with 4M Americans gaining coverage
Census Bureau survey figures found the uninsured rate hit 9.1 percent last year, with 4 million Americans gaining coverage in 2015.

Are settlement talks between CMS & payers in the works?
Many payers sued the federal government after they suffered huge losses on the Affordable Care Act's risk corridor program, with CMS Acting Administrator Andy Slavitt saying the agency may be discussing possible settlements with payers.

267 patients at risk after Air Force Academy treats them with improperly processed endoscopy equipment
The Air Force Academy notified 267 patients they're at risk for several infectious diseases after they were treated with improperly processed endoscopy equipment.

Physicians give insight into Hillary Clinton's health records & what the records are missing
Hillary Clinton's personal physician Lisa Bardack, MD, released an update of a July 2015 letter, featuring two new medical conditions, including a sinus and ear infection and pneumonia. Physicians not linked to Ms. Clinton claim Dr. Bardack's letters do not include essential information, such as Ms. Clinton's height and weight. They also argue the letters should include a more detailed history of Ms. Clinton's blood clots and her 2012 concussion.

Colonoscopies inaccurate when determining surgical site for cancer cases
A study found colonoscopies do not accurately determine the proper surgical location for nearly 33 percent of all colon cancer cases. Although colonoscopy is a valuable tool to screen and diagnose colorectal cancer, its effectiveness for localization or surveillance of tumors is being challenged by co-author Jennifer Nayor, MD, of the division of gastroenterology, hepatology and endoscopy at Brigham and Women's Hospital and Harvard Medical School, both located in Boston.

33% of physicians now independent practice owners
The Physicians Foundation's 2016 Survey of America's Physicians: Practice Patterns & Perspectives found hospital employment is rising, along with administrative work, serious dissatisfaction and much more.

80% of physicians feel overextended, at capacity
The changing healthcare landscape has left many physicians feeling burned out, according to a "2016 Survey of America's Physicians: Practice Patterns and Perspectives." Eighty percent of physicians reported being overextended or at capacity, leaving no time to see additional patients.

More healthcare news:
Some payers & providers are moving toward value-based care, while others are lagging — 6 key findings
Alaska health department and Xerox settle over botched Medicaid payments: 7 things to know
TriHealth to open multispecialty surgery center — 5 things to know


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