1. Advisory opinion. The Office of Inspector General recently issued an advisory opinion relating to holding ownership interest in a center by non-safe-harbor-compliant physicians. There, the OIG highlighted heavily several different prophylactic steps being taken by the surgery center to avoid indirect referrals.
2. Pain management. CMS and the OIG continue to have great concern as to the extent of pain management being performed nationally.
3. Imaging. The OIG now believes that imaging costs more than the Iraq war. In all seriousness, each month a new report seems to be issued by the government that highlights the extent of their concern about the overuse of imaging. This has led to several different new initiatives aimed at reducing physician-owned imaging.
4. Syndicate-and-flip transactions. Recently, we have seen situations where parties examine the concept of selling units on one day and then having those physicians as well as others sell their units to a national company on the next day. This type of transaction structure can cause great concern from an Anti-Kickback Statute perspective. It can have the net effect of letting physicians own shares for almost no cost because they are able to sell half their units and profit on that sale and thereby almost wholly offset the cost of investing.
5. Electronic health records. The hospital sector and physician sector continue to exponentially increase the extent by which electronic health records are becoming the norm. The OIG issued an advisory opinion that sets forth the kinds of linkage modules that do not constitute competition. The OIG has also issued an exception to the Stark Act to allow for the joint sharing of the development costs and implementation cost of EHR. There, physicians must pay 15 percent of the costs. A detailed discussion of these issues will be set forth in the Nov./Dec. Becker’s ASC Review. It can also be found on the Web site at www.BeckersASC.com.
15th Annual ASC Conference, Oct. 23 to 25. We have our 15th Annual Conference this fall, in association with the ASC Association and the Ambulatory Surgery Foundation. We have an outstanding program. To register, take any of the following actions.
1. contact the Ambulatory Surgery Foundation at (703) 836-5904;
2. register on line at www.ascassociation.org/ chicagooct.cfm; or
3. send an e-mail to registration@ascassociation. org.
Here are some of the sample topics that are being discussed at that meeting. Overall, there will be more than 75 presentations. We expect an outstanding turnout.
• "Gastroenterology, ENT, Ophthalmology, Pain Management and Bariatrics in ASC — What Works and What Doesn’t" — Anne Roberts, RN, Surgery Center of Reno; Steve Blom, RN, MAHSM, CASC, San Antonio Surgery Center; John Poisson, executive VP, Physicians Endoscopy; Doug Hoisington, DO
• "Successful Structuring of Physician/Hospital ASC Joint-Ventures" — Joe Zasa, CEO, Woodrum ASD; Deanne Manchester, USPI; Amber Walsh, JD; Elissa Moore, JD
• "Orthopedics in ASCs — What Can You Expect in the Next Five Years" — John Cherf, MD, department of orthopedics, The Neurological & Orthopedic Hospital of Chicago
• "How to Reduce Staffing Hours Per Case" — Lisa Cooper, administrator, El Camino Surgery Center; Mary Sturm, SVP of clinical operations,Surgical Management Professionals; Michelle Smith, director of clinical operations, Nueterra
• "The State of the Union for ASCs" — Kathy Bryant, JD, president, ASC Association
• "Making Urology a Success in Your ASC" — Bill Mobley, MD, Urology Specialists; Herb Riemenschneider, MD, Knightsbridge Surgery Center
• "How to Turn Around Your ASC" — Luke Lambert, CEO, and Tom Bombardier, MD, chairman, Ambulatory Surgical Centers of America
• "Can Two Centers Thrive by Merging?" — Tom Yerden, CEO and founder, TRY Health Care Solutions
• "Practical Case-Costing and Benchmarking for ASCs" — Alsie Sydness-Fitzgerald, RN, chairperson, ASC Association
• "Assessing the Profitability of Different Specialties in ASCs" — Luke Lambert, CEO, ASCOA
• "From ASC to Hospital — What Are the Pros and Cons of a Conversion to a Hospital?" — Brett Gosney, CEO, Animas Surgical Hospital
• "Will the Stark Laws Close Down ASCs?" — Amber Walsh, JD, and Melissa Szabad, JD, McGuireWoods
• "10 Key Statistics You Should Review Each Week" — Boyd Faust, CPA, CFO, Titan Healthcare
• "How to Recruit and Retain Great Directors of Nursing and Great Nursing Staff" — Lisa Cooper, Mary Sturm, Michelle Smith
• "Safe Harbor, OIG Work Plan and Out-of- Network Issues" — Scott Becker, JD, CPA, and Scott Downing, JD, McGuireWoods
• "Key Steps to Establishing ASCs" — Bill Southwick, president and CEO, Healthmark Partners
The Hospital Review. We are excited about the growth in ASC Communications. We are launching The Hospital Review — Business and Legal Issues for Hospital Leadership this month and its related Web site. Also, the Becker’s Orthopedic and Spine Review will be launched in January.
Should you have questions, please contact myself at 312-750-6016 or at sbecker@mcguirewoods.com.
