Becker's ASC Review

14 ASC MANAGEMENT How New York hospitals are fighting payers to keep orthopedic procedures By Eric Oliver E xecutives from New York hospitals are fighting to keep profitable orthopedic proce- dures despite pressure from CMS and private payers to transition lower- acuity procedures to the ASC setting, Buffalo Business First reported Dec. 13, 2020. One such executive is Joseph Ruffolo, CEO of Niagara Falls (N.Y.) Memo- rial Medical Center. e hospital re- cently entered into a partnership with Buffalo-based UBMD Orthopedics & Sports Medicine to have the practice provide sports medicine services to Niagara Falls-based Niagara Univer- sity's sports program. e move was a strategic one to establish relation- ships with the group's surgeons and have them use the hospital for their orthopedic procedures. e hospital's orthopedic service line has grown 10 percent year over year, Mr. Ruffolo said to the publication. "e key to competing with [ASCs] is to make it very efficient and conve- nient for a joint replacement surgery," Mr. Ruffolo said. "ey can go back and forth as if they were in an ambu- latory surgery setting. at's the key for ortho docs." COVID-19 was beneficial to the ASC industry as it accelerated procedure migration to ASC settings, which were largely isolated from COVID-19 cases. CMS, too, has seen the value of ASCs and continues to add more orthopedic procedures to the ASC payable list. n Texas surgical hospital settles Stark Law violation allegations, whistleblowers get $13.9M By Laura Dyrda A Plano, Texas-based heart hospital settled allegations its agreement with physician owners violated the False Claims Act, and the whistleblowers making the allegations received millions of dollars. Four details: 1. Texas Heart Hospital of the Southwest was accused of violating Stark Law by re- quiring owners to meet a 48-patient contact requirement to maintain ownership. 2. Former owners Mitchell Magee, MD, and Todd Dewey, MD, sued the hospi- tal. The federal government played a primary role in discussions that led to the settlement. 3. The hospital and its wholly-owned subsidiary, THHBP Management, agreed to pay the U.S. $48 million to settle allegations brought by the lawsuit. 4. The whistleblowers received $13.9 million of the settlement collectively. "We commend the whistleblowers and their counsel for uncovering this ar- rangement and pursuing the case to a point where defendants and the United States were able to reach a resolution that both protects the taxpayer and ensures patient care free from financial influence,"a news release from the U.S. Attorney for the Eastern District of Texas stated. n Laid-off Pennsylvania anesthetists fight to have union recognized By Eric Oliver N ineteen CRNAs with Wilkes-Barre (Pa.) General Hospital requested their employer, Capital Anesthesia Solutions, recognize their union Dec. 30, 2020, The Citizens' Voice reports. The anesthetists were laid off by North American Partners in Anesthesia in August 2020 after NAPA and the hospital cut ties due to a dispute over unpaid bills. Capital Anesthesia Solutions hired the CRNAs and took over anesthesia services at the hospital and two other hospitals in Pennsylvania. The group then spread the unionized workers between the three facilities. The anesthetists are attempting to rebuild their union and have Capital Anesthe- sia Solutions recognize it. Upon taking over anesthesia services, Capital Anesthesia Solutions switched how the anesthetists were paid, pivoting from a wage model to a salaried mod- el. The pivot exempts the group from having to follow the Fair Labor Standards Act, avoiding overtime pay. Capital Anesthesia Solutions offers its employees a per diem rate to come in for extra shifts that the anesthetists claim is lower than their overtime rate. The anesthetists are members of the Wyoming Valley Certified Registered Nurse Anesthetist Association. Capital Anesthesia Solutions can either recognize the union or force a union election. n

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