Here are 28 updates from the last month:
NY ASC at risk of losing operation certificate for inadequate Medicaid, charity care
Surgicare of Manhattan in New York is in the application process for a two-year extension of its five-year limited life approval. The approval includes a two-year extension of its operating certificate. However, New York Public Health and Health Planning Council could deny the application based on the surgery center's trailing number of charity and Medicaid cases.
Large employers may be excluding outpatient surgeries in insurance plans
In 2015, companies with low-wage workers attempted to claim coverage without inpatient benefits met ACA guidelines, but regulators disagreed. This decision caused many employers to attempt a new cost-cutting measure: eliminating outpatient surgery coverage. The government does not require large employers to offer a list of "essential health benefits." Rather, large employers are mandated to offer minimum value as determined by an online calculator and regulatory guidance, or face a penalty. For more on the story, click here.
Former ASC founder Dr. Richard Moss to run for Congress
Richard Moss, MD, an original investor in St. Thomas Surgery Center, plans to run for Congress. Dr. Moss, an otolaryngologist from Jaspar, Ind., will challenge Larry Buchson, MD, for the Republican part nomination. Dr. Moss is running for the 8th Congressional district.
Anesthesiologist Dr. Christopher Robert's death ruled an accident; alcohol named as a factor
Anesthesiologist Christopher Robert, MD, whose body was found along an Interstate road in Minneapolis, died as a result of a fall. Alcohol intoxication was named as a factor and The Hennepin County Medical Examiner concluded that the death was an accident.
Physician burnout continues to spread
Medscape's 2016 Lifestyle Report found burnout is present across all specialties and demographics. Critical care physicians experience the highest rate of burnout (55 percent), followed by urology (55 percent) and emergency medicine (55 percent). The survey found burned out physicians reported bias at a rate of 55 percent, as opposed to physicians who did not report burn out (45 percent).
AHIP: We want UnitedHealth and Aetna back
America's Health Insurance Plans CEO Marilyn Tavenner said AHIP's main goal is having UnitedHealth and Aetna rejoin AHIP. She went on to say, "From my perspective, the door is open and we want them back, and both of them know that." UnitedHealth left AHIP in June 2015 and Aetna left earlier this year.
UnitedHealthcare Group settles NY anti-competitive investigation for $100k
The New York Attorney General ordered UnitedHealth to pay $100,000 after an anti-competitive practice investigation found the insurer engaged in anti-competitive activities associated with its elder and long-term care products.
UnitedHealth reports $720M losses on federal health insurance exchange
UnitedHealth Group reported losses on its individual-market health plans reached $720 million in 2015, which is almost $300 million more than estimates UnitedHealth made a few months ago. UnitedHealth said its huge ACA losses were due to sicker-than-average consumers enrolling in its health plans and many people signing up for insurance after the open-enrollment window.
Aetna leaves America's Health Insurance Plans
Aetna opted not to renew its America's Health Insurance Plans membership for 2016, but the payer intends to continue partnerships with groups working toward access to high-quality, affordable healthcare. Aetna claimed it pulled out, in part, due to antitrust scrutiny associated with the planned Humana merger and new regulations under the Affordable Care Act.
Virginia's CON program may come to an end
In the 2016 General Assembly session, Virginia legislators are proposing measures that seek to reform or dismantle the state's certificate of need program. Three delegates, Kathy Byron (R-Bedford), John O'Bannon, MD, (R-Henrico) and Christopher Peace (R-Hanover), are introducing eight legislative actions focused on the CON program.
Appeals court upholds Virginia's much-debated CON law
A three-judge panel of the 4th U.S. Circuit Court of Appeals in Richmond upheld Virginia's certificate of need program. The program requires state medical providers to prove the proposed construction and major equipment purchases are necessary for the region. While Colon Health Centers of America and Progressive Radiology challenged the CON law, U.S. District Judge Claude M. Hilton ruled against them.
Supreme Court rejects longshot challenge to ACA
The Sissel v. Department of Health and Human Services lawsuit claimed the ACA violated the origination clause of the Constitution, which mandates all revenue-raising bills to start in the House. Earlier this week, the U.S. Supreme Court dismissed the lawsuit and will hear another case later this year about the ACA's contraceptive mandate.
Quint Studer to resign from Studer Group
Quint Studer, founder of Studer Group, is opting to leave his healthcare consulting company to focus on a series of community projects. Mr. Studer founded Pensacola, Fla.-based Studer Group in 2000. He said he will step down on March 31 to pursue volunteer work.
Advocate Health Care to run 56 metro Chicago Walgreens clinics
Advocate Health Care will own and operate 56 Healthcare Clinics at Walgreens stores across the Chicagoland area. Walgreens' clinics will enhance care coordination for Advocate patients and Advocate will brand the clinics as Advocate Clinic at Walgreens and will open under Advocate in May 2016.
HCA makes up 1.8% of Exchange Capital Management portfolio after 31-share acquisition
Exchanges Capital Management acquired 31 Hospital Corporation of America shares. Presently, Exchange Capital Management owns 63,565 HCA shares, with HCA comprising 1.8 percent of the hedge fund owner’s portfolio.
Physicians Realty Trust reports 2015 Q4 activity
Physicians Realty Trust, based in Milwaukee, closed its fourth quarter medical real estate investments with $152.8 million. The company's total investment activity reached $841 millions for the year, indicating 103 percent growth in gross real estate assets year over year.
MFC Director Jeffrey Clifford Lozon buys 1,000 company shares
Medical Facilities Corp. Director Jeffrey Clifford bought 1,000 shares of his company's stock in a transaction valued at CA$14,520. He purchased the shares for an average price of CA$14.52 per share.
CMS' Andy Slavitt hints at MU's finale
Andy Slavitt, acting administrator of CMS, said the meaningful use program will end soon in his Jan. 11 address at the J.P. Morgan Annual Health Care Conference. Mr. Slavitt said, "Now that we effectively have technology [in] virtually every place care is provided, we are now in the process of ending meaningful use and moving to a new regime culminating with the Medicare Access and CHIP Reauthorization implementation." To read the entire story, click here.
Obama defends ACA in State of the Union Address
President Obama implored Americans to reject Republican political attacks on the healthcare law and said the ACA has issued significant dividends in the last six years. He will head to Nebraska and Louisiana to urge residents to sign up for coverage before enrollment closes.
Bernie Sanders releases universal health plan
Presidential candidate Bernie Sanders released a healthcare plan that he claims would give Americans "a sense of freedom and peace of mind" through universal coverage. Sen. Sander's plans to create a single-pay healthcare system, which he estimates will cost nearly $1.38 trillion each year. For more on Sen. Sanders' healthcare proposal, click here.
Nurses to protest at landmark Supreme Court case
Earlier this month, nurses congregated on the steps of the U.S. Supreme Court to protest non-compulsory union fees. The national Nurses United claims the fees could possibly detriment the healthcare industry.
Orthopedic Institute for Children to open ASC in LA, names ASC clinical director
The Orthopedic Institute for Children is opening its OIC Ambulatory Surgery Center in Los Angeles in the summer. The center will be the region's first standalone surgery center centered on orthopedic pediatric care. The Orthopedic Institute for Children appointed Jamie Wells, RN, as clinical director of the ASC.
OMNI Surgery Center to officially open in NY
OMNI Surgery Center opened in South Utica, N.Y. The ASC will center on interventional pain management and will offer minimally invasive procedures to alleviate chronic low back pain and migraines.
NAPA partners with Riverside Medical Center & ASC
North American Partners in Anesthesia partnered with Riverside Medical Centers and Riverside Ambulatory Center, its affiliated ASC in Kankakee, Ill. Through the partnership, NAPA will be the exclusive provider of anesthesia services at Riverside Medical Center and Riverside ASC. Oleg Korolev, MD, will lead the onsite anesthesia team.
Island Eye Surgicenter breaks ground on new facility
Carle Place, N.Y.-based Island Eye Surgicenter broke ground on a new facility on a 3.5-acre site in Westbury, N.Y. The 27,000-square-foot center will house six operating rooms and 15 patient areas. The center will also have a waiting room, administrative office, a 12-bed recovery room, a staff lounge and patio.
NeuroSpine Institute opens Park City, Utah ASC
The NeuroSpine Institute opened a new ASC in Park City Utah. The first phase of the practice centered on diagnostics, rehabilitative care and sports spine injury management, with the second phase entailing the surgery center's opening. Robert Masson, MD, founder of NeuroSpine Institute, and Ken Yonemura, MD, will perform surgery at the center.
VA falls short by $1.9 billion
An audit of the VA's private healthcare program books discovered the VA failed to spend $1.9 billion of the $4.8 billion allotted for non-VA care in 2013. From Oct. 1, 2013 through March 31, 2015, VA medical center administrators overestimated the funds they would need to pay for outside care for veterans by $543 million, thus leaving that money unavailable for patient care.
APIC comments on proposed federal rule protecting human subjects
The Association for Professionals in Infection Control and Epidemiology commented on proposed revisions to the Federal Policy for the Protection of Human Subjects. The agency noted it recognizes the importance of balancing the protection of human subjects and facilitation of valuable research with the reduction in the burden to researchers.
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