33 things for ASC leaders to know for June

Here are 33 updates from the past month.

AmSurg, Envision Healthcare finalize $10B merge
AmSurg and Envision Healthcare Holdings signed a definitive merger agreement, with the combined company having a pro forma market cap of nearly $10 billion. The combined entity, Envision Healthcare Corp., will have an enterprise value of approximately $15 billion, based on Envision and AmSurg's closing price on June 14. The new company will have headquarters in Nashville, Tenn., and Greenwood Village, Colo.

UnitedHealth to leave California ACA exchange; will offer plans in 6 states
Earlier this week, California officials stated UnitedHealth was leaving the state marketplace, leaving 1,200 Californians to find new policies. UnitedHealth Group reported it filed paperwork to offer insurance plans in merely six state Affordable Care Act marketplaces in 2017. In its filing, the company said it plans to offer On-Exchange products in Nevada, New York and Nevada next year. Harken Health, UnitedHealth Group's subsidiary, will sell plans in Florida, Illinois and Georgia on a "limited basis."

Common landscape mulch may have ignited Mid-Valley Oral Maxillofacial & Implant Surgery fire
On May 14, a fire caused significant damage at Mid-Valley Oral Maxillofacial & Implant Surgery in Salem, Ore. New reports show ignited mulch may have caused the fire. David C. Swiderski, DDS, MD, a board-certified oral and maxillofacial surgeon, owns the facility and plans to rebuild the center.

Medicare Fraud Strike Force charges 301 individuals in $900M billing scheme
The Medicare Fraud Strike Force charged 301 people for submitting fraudulent bills totaling $900 million, marking the largest nationwide healthcare fraud takedown in nine years. Of those arrested, the task force charged more than 60 people with Medicare Part D drugs benefit fraud.

SCA establishes its 1st physician advisory board
Deerfield, Ill.-based Surgical Care Affiliates established its inaugural Physician Advisory Board, composed of six board members. The board members will offer guidance and industry expertise to enhance patient care and serve SCA's physicians. Andrew Hayek, SCA's chairman and CEO; Goran Dragolovic, SCA's senior vice president; and James Grant, MD, SCA's regional vice president, will be the board's company representatives.

SCA names Rebecca Craig board of directors' president
Rebecca R. Craig is the newly elected board of directors' president for the Ambulatory Surgery Center Association as well as the Ambulatory Surgery Center Association Foundation. In her new role, Ms. Craig will be the chief spokesperson and advise ASCA and ASCAF leadership. She will serve as the director on different projects and task forces.

SCA partners with Grove Place Surgery Center
Vero Beach, Fla.-based Grove Place Surgery Center's physician members selected Surgical Care Affiliates to become a partner in the center. A physician-led outpatient center, Grove Place Surgery Center offers services including general surgery, orthopedics, otorhinolaryngology, pain management and podiatry.

ASD Management celebrates 20 years in business
ASD Management celebrated its 20th anniversary on June 1, 2016. Robert Zasa co-founded ASD Management with Joseph Zasa. Mr. Robert Zasa commented the company's client-centered emphasis led it to success. He added the company has never taken on too many projects, which allows a partner to be involved in every project.

Regent Surgical Health names Chris Bishop CEO
In his new role as CEO, Chris Bishop will oversee the surgery center management company's daily operations, as well as Regent's global partnerships. Mr. Bishop will also work to ensure Regent's long-term growth while also driving the company's roll of new outpatient services lines, such as outpatient joint replacement through bundled payment initiatives.

Surgery Partners adds former Tenet executive Sarath Degala
Former Tenet Healthcare executive Sarath Degala is joining Surgery Partners as chief development officer. Mr. Degala will be a C-level officer at Surgery Partners and is the eighth member of the company's leadership team.

Surgery Partners acquires Riverside Pain Physicians
Surgery Partners purchased Riverside Pain Physicians, headquartered in Jacksonville, Fla., and some of its affiliates from Brown Gibbons Lang. Following the transaction, Riverside will be Surgery Partner's foundation for its pain platform in the southwestern United States.

ASCs reduce outpatient procedure costs by $38B per year compared to HOPDs
ASCs can reduce outpatient surgery's cost by more than $38 billion dollars annually compared to hospital outpatient departments. ASCs can reduce a patient's out-of-pocket costs by more than $5 billion each year through lower deductibles and coinsurance payments.

Top 5 states with the highest ASC patient burn rates
CMS released the results for its 2014 Ambulatory Surgical Center Quality Reporting Program, which cited the states with the highest rates and lowest rates for patient burn. The national average in 2014 for these sentinel events was 0.364, up from the 2013 average of 0.247. The states with the highest rates include Colorado, Connecticut, Delaware and Florida as well as Washington, D.C.,

Ohio becomes 13th ACA co-op to close
Last week, the Ohio Department of Insurance submitted a request to liquidate Ohio's co-op, InHealth Mutual, marking the 13th Affordable Care Act co-op of the original 23 co-ops to close. With the closing, almost 22,000 state residents will have 60 days to replace their InHealth policy with another company's plan on the federal exchange.

Forbes: Theranos CEO Elizabeth Holmes now worth nothing, company worth $800M
Forbes revised its estimated net worth of Theranos Founder and CEO Elizabeth Holmes, to $0 from $4.5 billion, removing her from the No. 1 spot on its list of "America's Richest Self-Made Women." Theranos is facing investigations and lawsuits, with insider information revealing Theranos revenues are less than $100 million. Forbes lowered Theranos' estimated net worth to $800 million from $9 billion.

Aetna to partially fund Humana deal with $3.2B bond
Aetna reported the payer plans to take out a $3.2 billion bond to help fund its proposed $37 billion Humana acquisition. Despite many Aetna and Humana stockholders and shareholders approving the merger, some Humana stockholders filed three class action complaints opposing the merger. The stockholders filed two suits in the Circuit Court of Jefferson County (Ky.) and one in the Court of Chancery of the State of Delaware.

Top Blue Shield of California executives rake in $18.8M
After facing critiques about lack of transparency on executive compensation, Blue Shield listed the compensation for its 10-highest paid executives by name. The top 10 Blue Shield executives received $18.8 million in 2015, with chief executive Paul Markovich reportedly earning $3.5 million in 2015.

BCBS of North Carolina sues federal government over $147M risk corridor payments
Last week, Blue Cross Blue Shield of North Carolina filed a suit against the federal government for not paying the insurer more than $147 million that BCBS claims the government owed under the Affordable Care Act's risk corridor program. In 2014 and 2015, BCBS of North Carolina said it suffered more than $400 million losses on the ACA. The payer attributes part of that steep loss to its reduced risk-corridor payments.

Maryland co-op sues government over $22M+ potential fees
Evergreen Health Cooperative, a Maryland co-op, filed a lawsuit against the federal government to avoid more than $22 million in fees. Evergreen Health is the first co-op to file a lawsuit against the federal government, and claims the Affordable Care Act's risk adjustment program is "dangerously flawed."

St. Elizabeth Healthcare to testify against Christ Hospital's $24M ASC
Edgewood, Ky.-based St. Elizabeth Healthcare CEO Garren Colvin said the provider is filing a state hearing with the Cabinet for Health and Family Services to fight Cincinnati-based Christ Hospital's plan to build a $24 million ambulatory surgery center.

Patient claims self defense in choking, death of roommate at Mount Sinai in Miami Beach
Police found 55-year-old Alejandro Ortega dead in the bathroom of his room at Mount Sinai Medical Center in Miami Beach, Fla., on Saturday. Around the corner from the room is a TV lounge, where police said they found Mr. Ortega's roommate, 23-year-old Andre Brown. When Mr. Brown saw the officers, police said he put his hands behind his back and said, "It was self defense. I had to do it." Police arrested Mr. Brown and charged him with second-degree murder. Police found Mr. Brown had an outstanding warrant on drug charges.

16 Huntington Hospital patients infected due to tainted duendoscope use from 2013 to 2015
The Pasadena Public Health Department report found the drug-resistant Pseudomonas aeruginosa bacteria from duendoscopes infected 16 patients at Huntington Hospital in Pasadena, from January 2013 to August 2015. Eleven of the 16 patients died. However, health officials said only one death certificate listed the bacteria spread by the duendoscopes as the cause.

Valeant Pharmaceuticals' Salix to pay $54M for alleged illegal kickbacks
Valeant Pharmaceuticals is paying $54 million to settle kickback charges against its Salix unit. Valeant's Salix unit, focused on licensing, developing and marketing gastroenterology disorder treatment products, allegedly paid illegal kickbacks to physicians for prescribing seven of its products. As per the settlement, Salix will pay $46.53 million to the United States and $7.47 million to various states.

Senate bolsters NIH funding to $34B
This year's Senate spending bill allotted an additional $2 billion to the National Institute of Health, bringing the agency's total budget to nearly $34 billion. While many research advocates applaud the funding boost, others are concerned as to whether the funding will come from other health agencies, such as the CDC.

Ambulatory care spending rose 7.4% in Q1 2016
A U.S. Department of Commerce Quarterly Services Survey found ambulatory care spending increased 7.4 percent in the first quarter of 2016, compared to the first quarter of 2015. Within the ambulatory care industry, outpatient centers saw a spending increase of 11 percent in the first quarter, compared to the first quarter of 2015. Physicians' offices experienced a 7.4 percent increase from the first quarter of 2015.

AHIP undergoes significant transformations: 4 things to know
On June 7, America's Health Insurance Plan reported it is scrutinizing its membership fees and will undergo "major restructuring." Despite UnitedHealth Group and Aetna leaving AHIP, the lobby group appointed two chairmen, including Anthem CEO Joseph Swedish for 2017 and Kaiser Permanente CEO Bernard Tyson for 2018.

Employee found dead in Bronx hospital
An employee at NYC Health + Hospitals/North Central Bronx Hospital was found dead in the hospital last week. The 48-year-old man was found deceased at about 10 a.m. Police sources told New York Daily News that the employee may have died of a heart attack, and no foul play is suspected.

AMA asserts gun violence is a 'public health crisis'
The American Medical Association voted to declare gun violence "a public health crisis," following our nation's deadliest mass shooting in Orlando, Fla. During the early hours of June 12, 29-year-old Omar Mateen shot and killed 49 people and injured another 53 people at a nightclub. AMA's decision marks the first time the organization labeled gun violence a public health crisis.

Healthcare CEO gets 10 years for fraud that led to 2 patient deaths
The CEO and co-owner of a Maryland diagnostics company has been sentenced to 10 years in prison for charges related to healthcare fraud resulting in the deaths of two patients. According to evidence presented at trial, Dr. Chikvashvili was involved in a scheme to defraud Medicare and Medicaid.

HHS allots $20M to help small practices succeed under MACRA
HHS is providing $20 million for Medicare small group providers to receive sufficient training and education to succeed in CMS' Quality Payment program. HHS' $20 million funds will offer providers hands-on training, catered to help small practices succeed. Medicare clinicians in individual or small group practices of 15 clinicians or fewer can participate in the training programs.

A $20 meal may entice physicians to prescribe certain drugs
JAMA Internal Medicine published a study which found physicians who received one free meal from a pharmaceutical company were more prone to prescribe the company's drug than physicians who did not receive a free meal. A study author argued pharmaceutical companies could better spend their money on medical research for innovative medicine.

Medicare funds depleting fast; may run out of funds by 2028
The Obama administration found Medicare's primary trust fund may run out of money as early as 2028. By 2034, the administration found Social Security will run out of funds, with both Social Security and Medicare comprising 40 percent of federal spending last year.

Joint Commission denies Virginia Mason full accreditation after discovering safety issues
The Joint Commission denied the Virginia Mason Medical Center full accreditation following a review in May, which found noncompliance with 29 standards. The accreditation announcement follows news of a possible hepatitis B exposure at the hospital affecting nearly 650 patients.

More healthcare news:
The never-event costing the US healthcare system billions & how Stryker is taking the lead to change that
Why ASCs should prioritize personalities in staff recruitment: Select Physicians Surgery Center's administrator shares insight
Obama administration to update Medicare Part B payment proposal, but will this be enough to squash opposition?

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months