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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