Monday, December 31, 2007 - 2:17 PM EST

Lawsuit filed over surgery center ruling

Atlanta Business Chronicle

The Georgia Alliance of Community Hospitals and its 59 member hospitals today filed a lawsuit to invalidate a new state rule designed allowing general surgeons to establish free-standing ambulatory surgery centers without going through Georgia's certificate-of-need process.

The battle is over a new rule approved Dec. 13 that exempts general surgeon-owned outpatient surgery centers from Georgia's laborious certificate-of-need (CON) rules, which limit or prevent the construction of new centers.

Hospitals oppose the rule change, which will become effective in January, arguing physician-owned surgery centers siphon off lucrative commercially insured patients, leaving the burden of the uninsured for hospitals to bear.

Monty Veazey, president of the Georgia Alliance of Community Hospitals, said in a statement, "As the Department of Community Health and its Board members know full well, the new general surgery rule flies in the face of multiple court decisions and is a naked and illegal attempt to override the will of the General Assembly of Georgia. DCH has been publicly and repeatedly advised by its own legal counsel - the State Attorney General - that it lacks the authority to make this rule change. It also flies in the face of sound health planning policy. This rule is not about increasing access to care. It will in fact hurt the ability of Georgia's hospitals to continue to provide care to all Georgians. The General Assembly has long recognized the gravity of this proposed rule change and the fact that it would have a profoundly destabilizing effect on Georgia's health care system. It is, in short, both a stunning abuse of governmental authority and a reckless attempt to cater to a powerful special interest at the clear expense of the health care needs of Georgia's nine million citizens."
The lawsuit was filed in Dougherty County Superior Court against the Georgia Department of Community Health and Albany Surgical P.C., an general surgery practice that plans to build a free-standing ambulatory surgery center under the new rule.

The lawsuit seeks a court ruling that the new general surgery rule is in excess of DCH's statutory authority.

 

FASA Submits Comments to CMS on Proposed New ASC Payment System and ASC List”  FASA submitted comments to CMS regarding the proposed new ASC payment system and changes to the ASC list. We expect CMS to issue a final rule on the changes sometime next year. To view FASA’s comments, click here . FASA would like to extend a big thank you to everyone who submitted their own comments to CMS. 

• CMS has issued a proposed rule detailing the following:
• Which ASC rates will be cut in 2007
• What procedures will be added to the ASC list in 2007
• How ASC payments will change in 2008
• How ASC list will change in 2008

Click here

•  From www.modernphysician.com  (make link)  By Jennifer Lubell / December 1, 2006

The Government Accountability Office recommended that Medicare go forward with a plan to pay ambulatory surgery centers based on the hospital outpatient prospective payment system. The GAO said ambulatory surgery centers perform procedures similar to those done at hospital outpatient departments but at a lower cost. Using one type of analysis, the GAO estimated ambulatory surgery centers’ costs at about 84% of hospital outpatient department costs. Another source of data resulted in a cost ratio of about 40%. The CMS, meanwhile, has proposed setting payments for ambulatory surgery centers at 62% of the outpatient rate. The American Association of Ambulatory Surgery Centers said the lower GAO estimate was flawed and urged the CMS to use the higher estimate in setting payments. The move to the same basic payment system for ambulatory surgery centers and outpatient departments is part of a congressionally mandated effort to streamline Medicare. Craig Jeffries, executive director of the surgery center association, said the CMS is likely to issue final regulations on the change in the spring.

• Toxic Anterior Segment Syndrome (TASS) Outbreak Final Report  from The American Society of Cataract and Refractive Surgery September 22, 2006

The TASS Task Force, sponsored by the ASCRS and under the leadership of Dr. Nick Mamalis, has been meeting on an ongoing basis and has compiled data regarding the increased incidence of TASS that began in early 2006.  This final report addresses the findings and recommendations of the Task Force as a result of those efforts.  For more information, click here.