Vermont surgery center appeals state limitations to state Supreme Court — 6 insights

Amy Cooper, CEO and co-owner of Colchester, Vt.-based Green Mountain Surgery Center, is appealing a decision by the state's health board to limit the multispecialty ASC to five specialties, the Burlington Free Press reports.

What you should know:

1. The Green Mountain Care Board decided in June to limit the center to the five specialties listed in its certificate-of-need application from 2015, unless the care board approves a new offering. The center is approved to offer five specialties and is allowed to perform plastic surgery and eye surgeries, except for stand-alone cataract procedures.

2. The case stems from the care board's decision to prevent the surgery center from performing cataract surgery, which Green Mountain sought to do. The board did not allow the center to perform stand-alone cataract surgeries, but did allow the center to perform cataract surgeries in conjunction with retina surgeries.

3. The limitation seems to have been imposed in response to a series of objections. Juli Larson, MD, founder and medical director of South Burlington, Vt.-based The Eye Center, the state's other surgery center, objected to allowing Green Mountain to perform cataract procedures. She argued that the duplicated offering would affect her center financially and could cause her current patients to seek care elsewhere.

4. The Eye Center's other four owners sent letters to the board distancing themselves from Dr. Larson and her position. They said The Eye Center took no position on the case.

5. Ms. Cooper argued the board was being used to "carve up monopolies for some people," and that the board's decision undermined the surgery center's viability. Ms. Cooper said the five specialties in her initial CON filing were based on the center's minority owners, and that she intended to allow the surgery center to serve any board-certified physician in the state.

6. When the board made its decision in June, it said it anticipated there would be strong demand from Green Mountain to add specialties, but that the certificate-of-need approval did not act as an all-encompassing approval to do so.

In its ruling, the board wrote: "Finally, while the board acknowledged the potential for future demand from surgeons in other specialties, it clearly intended to limit the types of procedures that could be done at [Green Mountain]. It expressly declared that it was imposing conditions in the [certificate of need] 'that limit the expansion of services.'"

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