Becker's ASC Review

10 ASC MANAGEMENT Fraud scheme used dead people's names to get loans for procedures at Florida surgery center By Eric Oliver A lender affiliated with Weston, Fla.- based Best U Now, an aesthetic surgery center, allegedly gave out loans to people using the identities of the recently deceased, the Broward Palm Beach New Times reports. What you should know: 1. e lender, Health Credit Services, sued Best U Now in May 2019, claiming the center breached their contract and failed to cooperate in an inquiry related to the fraud. e credit company and Best U Now entered into a partnership in December 2018 to provide loans to patients who couldn't afford to pay for procedures. Court documents showed the practice gave out 20 loans to de- ceased people and 39 loans to patients who had unverified Social Security numbers. 2. e credit company and surgery center settled the case, but the Broward Sheriff 's Office continues to investigate. 3. Health Credit Services gave out more than $500,000 in confirmed or suspected fraudu- lent loans for procedures at Best U Now. 4. Center Director Dorian Wilkerson denied any involvement in the fraud, and said the procedures were not phantom bookings. He said: "For every application, there was a person we did surgery on. Was it the right person? No. We found out that it wasn't. at was news to us like it was to [the lender]." 5. e center said the loans were submitted through an online portal and were never authorized by the center. n FDA recalls about 3,600 GE Healthcare anesthesia systems — 4 insights By Eric Oliver T he FDA on Feb. 7 issued a class 1 recall for 3,599 GE Carestation 600 series an- esthesia systems because of a flaw that can cause the mechanical ventilation system to stop working. What you should know: 1. The devices were manufactured and distributed between August 2018 and July 2019. GE Healthcare initiated the recall Nov. 25, 2019. 2. The flaw stems from a loose cable con- nection. If the connection became loose, the system would emit a loud audio and visual alarm to alert the provider. The flaw will cause patients to have low blood oxygen levels if the anesthesiologist does not take action. 3. There have been no reported injuries or deaths. 4. GE Healthcare sent out representatives to correct the affected systems. GE also recom- mends that hospitals perform maintenance on the system every 12 months to ensure the cable is connected properly. n Study finds ASC patients received 'surprise' bill for provider in 17% of cases By Angie Stewart O ne-fifth of surgical patients who had in-network surgeons at in- network facilities received medical bills for out-of-network care, according to a study of insurance claims for 347,356 patients. Researchers from the University of Michigan in Ann Arbor examined claims involving patients who had elective knee cartilage repair, total knee replacement, full or partial colon removal, gallbladder removal, breast lump removal, or coronary artery bypass graft surgery. The findings were published on JAMA Network. Five takeaways: 1. Among 83,021 procedures performed at ASCs with in-network primary surgeons, 6.7 percent included an out-of-network facility bill and 17.2 percent included an out-of-network professional bill. 2. Overall, 20.5 percent of the various operations resulted in an out- of-network bill. For cases that involved balance billing, the average charge was $2,011. 3. Out-of-network bills stemmed from care provided by surgical assistants in 37 percent of the cases. These episodes came with an average charge of $3,633. 4. Out-of-network bills were associated with anesthesiologists in 37 percent of operations, with an average balance bill of $1,219. 5. Patients who were members in health insurance exchange plans were at significantly higher risk of receiving an out-of-network bill. The risk was also significantly higher for patients who had surgical complications. n

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