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NJ decision would shut down state's surgery centers

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A new state court decision has put the future of ambulatory surgery centers (ASCs) in New Jersey into question. The decision, which arises from a dispute between one ASC and a health plan, held that the ASCs were violating a state law prohibiting physician self-referrals. If enforced, this ruling would effectively shut down the industry state-wide. Now, attorneys for the New Jersey Association of Ambulatory Surgery Centers, the Medical Society of New Jersey and other medical groups are fighting to get the decision over-ridden.

On its face, the case generating the controversy is just another contest between an insurer and a provider organization. In the case, health plan Health Net of New Jersey contended that the Wayne Surgical Center had committed insurance fraud and should not be paid its services. A judge concluded that while Wayne Surgical hadn't committed fraud, the ASC had violated a state law, the Codey Act, which prohibits doctor self-referral to facilities in which they have a financial interest.

To find out more about this legal wrangle:
- read this Philadelphia Inquirer article

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This story really hits home. I have had numerous medical testing procedures over the past decade or so. These required general anaesthesia and so had to be done in a hospital-type setting. Three were done over the years in small local hospitals; I was in and out the same day. These procedures are money-makers for the hospitals. My physician now utilizes a free-standing surgical center in which he has a financial interest (which is noted on the consent forms I had to sign). Two of the three small hospitals where I previously had the procedures done have since closed down for financial reasons. The third, a larger regional hospital with a nursing school attached has announced that it is up for sale.
This is not the fault of the physicians. They have a right to make a good living, and have to be creative as the health insurers cut their reimbursements and mickey-mouse the doctors' reimbursements to force them ever lower. But it is the public that suffers.

Absolute rubbish!
the NJ state Attroney general really needs to find something better to do!
ASC and office based surgical units have considerably reducced the cost of care for routine and low risk surgical services. In the era of vanishing reimbursements this is the dumbest move on the part of Attroney general. The easiest way to test what goes on in any medical facility is to send a few patients with specific questions to ask of the center. NO decent doctor would refuse to treat a patient in a center of patient's choice. Patients are usually good at deciding where and by whom they want to be treated. The cost of similar services in ASCs is about 65% of what it costs in a hospital and the same care costs about 60% in an office based facility. The risk of death causign infectiosn is extremely rare in office and ASC settings. They are rampant in hospitals. If the patient needs care why deny them this needed service. They have to get it somewhere. Now their choices are limited to going to the most expensive place for routine and low risk procedures. I would like to ask the NJ attorney general to have his colonoscopy in a hospital (of course without revealing that he is the state Attorney general) to see the problem he might be causing!

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