35 things for ASC leaders to know for February

Here are 35 updates from the last month.

MedPAC proposes eliminating ASC payment updates next year
The Medicare Payment Advisory Commission is proposing to eliminate payment updates for ambulatory surgery centers in 2017. MedPAC also recommended updating inpatient and outpatient hospital payments in 2017, projected at 1.75 percent.

Certain off-campus HOPDs subject to site-neutral payments
Provider-based, off-campus hospital outpatient departments will be subject to site-neutral payments starting Jan. 1, 2017. The payment regulation is a provision of the Balanced Budget Act of 2015 and will apply to provider-based, off-campus HOPDs established after Nov. 1, 2015.

Outpatient surgery can save $1,000s, BCBS on board
A Blue Cross Blue Shield Association study found patients who underwent outpatient procedures in 2014 saved $320 on average for lumbar spine surgeries, $483 for hysterectomies and $924 on gallbladder removals.

Medicare payments vary by site
The report's authors said a 40-day cardiac imaging episode performed in a physician office yielded a risk adjusted average Medicare payment of $655, compared to $2,078 for the same procedure performed in a hospital. The report comes in the wake of Congress discussing how to best implement a new regulation enable site-neutral payments in specific instances

Justice Department investigates pain compounding cream for $500M potential fraud
The Justice Department is investigating a potential $500 million healthcare fraud scheme, in which companies allegedly sent out more products than were ordered, overbilled and automatically refilled prescriptions without being asked. In recent months, sales for compounding creams increased after endorsements from professional athletes including former NFL quarterback Brett Favre. Mr. Favre is reportedly an investor in World Health Industries, one of the company's the FBI is investigating.

Physician receives 2nd-degree murder sentence for overprescribing pain medication
A judge sentenced Lisa Tseng, MD, to 30 years to life for the murder of three people after prescribing the patients painkillers including Percocet and Vicodin. The conviction is the first time a physician has been sentenced for murdering patients by overprescribing pain medication.  Dr. Tseng will be eligible for parole after serving 30 years in prison.

HHS: 30% Medicare payments change to value-based payments by end of 2016
United States Department of Health & Human Services Secretary Sylvia Mathews Burwell said the agency will meet their goal of transitioning 30 percent of fee-for-service Medicare payments to value-based payments by the end of this year. In 2015, HHS set a goal tying 50 percent of Medicare payments to alternative payment models by the end of 2018.

CMS clarifies final overpayment rule
The Centers for Medicare & Medicaid Services published the final rule on self-identified overpayments for Medicare Part A and B. The rule states overpayments have to be reported and returned only if a person identifies the overpayment within six years of the date the organization received the overpayment.

Williamsport Regional Medical Center to open upgraded surgery center
Williamsport (Pa.) Regional Medical Center's upgraded center offers renovated operating rooms with advanced equipment. The hospital spent millions of dollars on the upgrades.

Tenet ambulatory net revenue reaches $397M
On a pro forma basis, Tenet's ambulatory segment generated net operating revenue of $397 million, up nearly 29 percent from $308 million in the same period of 2014. For more on Tenet's fourth quarter and full year 2015 results, click here.

Tenet sets aside $238M for federal kick-back investigation
The lawsuit alleges Tenet, its four hospitals and Health Management Associates, which operates 71 hospitals in 15 states, paid kickbacks to Georgia-based Clinical de la Mama for Medicaid patient referrals. Tenet increased its reserve for the investigation from $20 million to $238 million, reducing the company's net income by nearly $184 million during the fourth quarter of 2015.

SCA net revenue reaches $306M in Q4
Surgical Care Affiliates released its fourth quarter and full year results. SCA total net operating revenue increased nearly 24 percent in the fourth of 2015, reaching $305.9 million, compared to $247.2 million during same period of 2014. SCA total net operating revenue increased nearly 24 percent in the fourth of 2015, reaching $305.9 million, compared to $247.2 million during same period of 2014.

The Center for Minimally Invasive Surgery in Illinois partners with SCA
The Center for Minimally Invasive Surgery in Illinois partnered with Surgical Care Affiliates, expanding SCA's presence in the Chicagoland area. The partnership went into effect Jan. 1, 2016. SCA currently has five locations in the Chicago area.

Rush University Medical Center to open $500M outpatient center
Chicago-based Rush University Medical Center is opening a $500 million comprehensive care outpatient center. Rush's new outpatient center will consolidate multiple campus outpatient clinic sites.

Physicians Endoscopy acquires DeKalb Endoscopy Center
Physicians Endoscopy and DeKalb Gastroenterology Associates' physicians formed a joint venture relationship, which went into effect on Dec. 31, 2015. Physicians Endoscopy acquired a minority interest in Decatur, Ga.-based DeKalb Endoscopy Center.

DuPage Medical Group buys majority stake in Naperville Surgical Center for $1.7M
DuPage Medical Group plans to acquire majority ownership in Naperville (Ill.) Surgical Center for $1.7 million. The four operating room center is a 51 percent physician-owned and a subsidiary of Advocate Healthcare.

Erlanger Health System to build $35M outpatient center
On Jan. 27, Chattanooga, Tenn.-based Erlanger Health System launched its public fundraising drive to build a new Children's Hospital outpatient center. Erlanger Health System has raised nearly a third of the money they will need to build the $35 million facility. So far, Erlanger raised $8 million in contributions and pledges.

Hospital for Special Surgery opens new outpatient center in Westchester County
New York-based Hospital for Special Surgery leased a space in White Plans (N.Y.) to open its new outpatient center. Construction is set to begin in September 2016 and will be the largest of HSS' outpatient centers.

Western Connecticut Orthopedic Surgical Center adds total knee replacement
Danbury, Conn.-based Western Connecticut Orthopedic Surgical Center performed Danbury's first single day, outpatient total knee replacement. Robert Deveney, MD, performed the procedure.

Surgical Center of Greensboro, Orthopaedic Surgical Center to break ground on $20M+ facility
Surgical Center of Greensboro (N.C.) and Orthopaedic Surgical Center are collaborating to open a new, single location for the practices. The surgery centers currently operate in separate buildings. The new 60,000-square-foot facility will cost between $23 million and $25 million.

Late Broward CEO hired private investigator, feared office was bugged
A private investigation is saying the late President and CEO of Broward Health, based in Fort Lauderdale, Fla., hired him last spring for an investigation into the public system that led to FBI involvement. The investigator, Wayne Black, detailed his conversations with Dr. El Sanadi in an email to Broward Health's general counsel. Dr. El Sanadi killed him on Jan. 24.

1% of physicians responsible for a third of malpractice claims
Nearly 1 percent of physicians accounted for 32 percent of paid medical malpractice claims. In the study, researchers found 84 percent of physicians incurred only one paid claim during the study period, accounting for 68 percent of all paid claims.

Georgia hospital CEO arrested for prescription drug fraud
Federal agents arrested Michael Gowder, DDS, CEO of 45-bed Union General Hospital in Blairsville, Ga., as part of a multi-state prescription drug sting. Dr. Gowder was one of six arrested and is being charged with two counts of fraudulently obtaining a controlled substance and one count of conspiracy to distribute.

4th UPMC patient with mold infection dies after outbreak
On Feb. 6, a patient that contracted a fungal infection after having a double lung transplant at UPMC Presbyterian in Pittsburgh passed away. In January, the patient and his wife sued UPMC Presbyterian, claiming his infection was connected to a mold outbreak at the hospital. The Allegheny County Medical Examiner stated the patient died from multi-organ system failure due to sepsis. The manner of death was listed as natural.  

Tennessee physician accused of performing surgery on wrong infant
A physician allegedly performed surgery on the wrong baby at University Medical Center in Lebanon, Tenn. The physician allegedly performed surgery on the wrong baby at University Medical Center in Lebanon, Tenn. University Medical Center refused to comment on what specifically happened.

Residents can work longer hours without compromising patient safety
A recent study found when residents worked longer than mandated hours, patients fared just as well as patients whose residents worked mandated hours. Researchers randomly assigned over 4,000 surgery residents to regulated hours or a more flexible schedule, allowing the residents to stay on a case after their shifts ended. In both resident groups, 9 percent of patients died or had serious complications following surgery.

Hackers shut down Hollywood Presbyterian Medical Center IT systems, demand $3.6M ransom
After hackers forced Hollywood (Calif.) Presbyterian Medical Center's computer offline, staff declared an internal emergency. The hackers are reportedly seeking more than $17,000 to turn the computer's back on.

Jury indicts former surgical tech who put 2.9k+ patients at risk
A grand jury indicted Rocky Allen, a Swedish Medical Center former surgical tech who tampered with a syringe containing pain medication. The former tech was indicted on the following charges — tampering with a consumer product and obtaining a controlled substance by deceit.

RN helped with surgery while drunk at VA hospital, police say
Police charged a Pennsylvania nurse with reckless endangerment, driving under the influence and public drunkenness after he was accused of helping with an emergency surgery at Wilkes-Barre (Pa.) VA Medical Center while drunk.  

CDC: Zika virus transmitted sexually in Texas
The CDC confirmed a patient in Texas was infected with Zika virus after having sexual intercourse with someone who returned from a country where Zika is present. On Monday, the World Health Organization declared Zika virus and its link to birth defects an international public health emergency.

Florida group settles anti-kickback case for $50k
Last week, the Office of the Inspector General settled allegations against Jupiter (Fla.) Imaging Associates. The anti-kickback case involved a physician practicing at Jupiter Imaging Associates allegedly giving gift cards to 100 referring physicians. Although the cards varied in amount, the physician allegedly determined value based on the physician referral volume.

Joint Commission names Dr. Ronald Wyatt patient safety officer
The Joint Commission named Ronald M. Wyatt, MD, the patient safety officer, the first position of its kind. Dr. Wyatt will focus on healthcare quality and patient safety in his new role on the organization level and healthcare system level.

HCA to buy bankrupt Texas hospital
Hospital Corporation of American signed a deal to buy Dallas-based Forest Park Medical Center – Frisco (Texas) from Sabra Health Care REIT. The hospital encountered financial trouble in 2015, and the system's Frisco hospital filed for Chapter 11 bankruptcy protection last September. The deal is expected to close by the end of March, and a bankruptcy court is scheduled for Feb. 18 to approve the transaction.

CMS, payers reach consensus on how to measure physician quality
For the first time, the Centers of Medicare and Medicaid Services and America's Health Insurance Plans agreed on how to measure physician quality in seven areas. The new measures are intended to help payers determine the value of care physicians provide, which will dictate payment. The American Medical Association, various medical groups, patient advocacy organizations and the insurance industry applauded the agreement.

Teen poses as a physician, practices medicine without license
Following a complaint about a person practicing medicine without a license, police launched an investigation this month into a teen who called himself "Dr. Robinson." The investigation found the teen opened a medical office in West Palm Beach and told patients he was a certified medical physician.

More healthcare news:
8 US states with lowest number of physicians
5 takeaways on the leading Republican candidates' views on healthcare
Dr. Matt Oliva offers sight to blind in Ethiopia: 5 notes

© 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