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Health Net allows knee, hip replacement in select California ASCs

Health Net Medical Director Michael Fine, MD, recommended the Health Net Medical Advisory Committee allow some minimally invasive knee and hip replacements performed in ambulatory surgery centers for commercial members after meeting with the California Ambulatory Surgery Association Board and ASC leaders, according to a CASA report.

The Health Net MAC approved the recommendation and issued a new policy, stating minimally invasive knee and hip replacements can be performed in specific outpatient facilities that Health Net contractually approves. The approval is based on "the facility's ability to select the appropriate patients, capability to provide 23 hour observation and have evidence that there is an agreement with a hospital to transfer and accept complications."

CASA and California ASC leaders have been meeting with payers for several years to advocate for these procedures in the outpatient setting.

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