Issue link: https://beckershealthcare.uberflip.com/i/1074723
26 PRACTICE MANAGEMENT Midwest Orthopaedics at Rush to open 3rd location west of Chicago: 5 things to know By Laura Dydra C hicago-based Midwest Orthopaedics at Rush opened a new facility in Oak Brook, Ill., according to a Daily Herald report. Five things to know: 1. The multi-floor facility features 16 patient exam rooms as well as space for physical therapy and occupational therapy. The building includes MRI and X-ray imaging services. 2. On the third floor, the new facility has an outpatient surgery center with six operating rooms and two procedure rooms as well as 28 patient-bays. 3. The Oak Brook location is the practice's third western suburban location, and it plans to open a fourth in Naperville, Ill., late this year. 4. Specialties at the new Oak Brook center are sports medicine, spine, knee and hip replacement in addition to extremities care. The facility also includes a sports performance center to help patients transition from physical therapy to more intense activity. 5. The new center opened Jan. 2, 2019. n Judge rules in favor of orthopedic surgeon in $209K Aetna reimbursement case: 5 things to know By Mackenzie Garrity A New Jersey judge refused to dismiss a lawsuit between an orthopedic surgeon and Aetna aer the insurer failured to reimburse the surgeon $209,000, according to Law 360. Five things to know: 1. Aetna sought to dismiss the case, citing the federal Employee Retirement Income Security Act. However, the judge ruled that state law claims involved in the lawsuit weren't preempted by any ERISA plan. 2. U.S. District Judge Anne ompson sided with Cary Glastein, MD, stating the orthopedic surgeon's claims didn't require inquiry into the patient's ERISA plan. 3. Dr. Glastein performed a medically nec- essary surgert in October 2016. However, because Dr. Glastein was not in-network with Aetna, the orthopedic surgeon con- tacted the insurer prior to the surgery. Aet- na sent him a written authorization for the procedure. 4. Dr. Glastein then billed Aetna $209,000, which represented "normal and reasonable charges given the complexity of the proce- dure and plaintiff 's qualification," accord- ing to Law 360. However, he never received reimbursement. 5. e judge's decision goes against several other New Jersey federal court cases in- volving surgeons and out-of-network pro- viders. In previous cases, judges have ruled the claims were preempted by ERISA. n Rothman Orthopaedic Institute brings joint replacement services to New York: 5 insights By Mackenzie Garrity P hiladelphia-based Rothman Orthopaedic Institute is launching hip and knee joint replacement services at its New York City location. Five insights: 1. Eric Grossman, MD, will lead the joint replacement services at the New York City office, and Daniel Smith, MD, will be the head of joint replacement services at the institute's Tarrytown, N.Y., location. 2. Both orthopedic surgeons began seeing joint replacement patients Jan. 7. Services are expected to expand the joint services already available, including shoulder, elbow, wrist and ankle. 3. Dr. Grossman previously served at CareMount Medical Group in Westchester Count, N.Y. He specializes in primary and revision joint replacement as well as robotic-assisted knee replacement. 4. Dr. Smith comes from Mount Sinai Hospital in New York City. He specializes in navigation-assisted joint replacement surgery. 5. Rothman Orthopaedic Institute surgeons perform more than 13,000 joint re- placement surgeries annually. n