Issue link: https://beckershealthcare.uberflip.com/i/1412045
20 ASC MANAGEMENT Physician pays $2M to resolve allegations of selling ASC, practice above market value By Laura Dyrda A California-based interventional cardiologist agreed to pay millions of dollars to settle allegations of violat- ing the False Claims Act, according to a July 19 Justice Department statement. Siva Arunasalam, MD, allegedly sold his practice, High Desert Heart Vascular Institute in Victorville, Calif., and ASC to Prime Healthcare Services for amounts above fair market value in exchange for referrals to Desert Valley Hospital in Victorville. Prime allegedly overcompensated Dr. Arunasalam aer acquir- ing his practice through an employment agreement based on the volume and value of patient referrals, according to the Justice Department. Dr. Arunasalam paid $2 million while Prime and its CEO, Prem Reddy, MD, paid more than $35 million as part of the settle- ment agreement, which also resolves improper billing allega- tions. n Surgery Partners Q2 revenue up 45%, total joint cases soar 144%: 7 details By Laura Dyrda B rentwood, Tenn.-based Surgery Partners reported strong revenue growth during the second quarter and continued to strengthen its pipeline of new acquisitions, some set to close in the second half of the year. Seven details from Surgery Partners' second quarter financial report released Aug. 4: 1. Revenue jumped 45 percent year over year, reaching $543.3 million. Days adjusted same-facility revenue was up 45 percent as well. 2. Net loss hit $26.9 million in the second quarter, which ended June 30. 3. Surgery Partners spent $100 million of capital as of Aug. 4, and has more than $200 million of acquisitions under a letter of intent, according to CFO Tom Cowhey. 4. The company expects 2021 revenue will grow 18 per- cent to 20 percent over 2020 and new projects will have an adjusted earnings before interest, tax, depreciation and amortization of at least $325 million. 5. Surgery Partners had 123 surgical facilities in its portfo- lio on June 30, down from 127 at the end of the second quarter last year. Case volume was up from 82,779 in the second quarter of 2020 to 139,727 in 2021. 6. Same-facility revenue per case was down 14 percent in the second quarter to $3,568. 7. Total joint replacement volume was up 144 percent dur- ing the second quarter, and one-third of those cases were on Medicare beneficiaries. n ASC loses bid to recover $5.6M from Cigna for now By Laura Dyrda A n Arizona ASC will have to revamp its complaint against Cigna to recover $5.6 million by next month, or it will be dismissed entirely. Physicians Surgery Center of Chandler, a physician-owned ASC, sued Cigna in 2020 to recover $5.6 million in out-of- network payments. The insurer accused Physicians Surgery Center of Chandler of forgiving fees for patients while charging Cigna the full amount. Cigna told the ASC in 2018 that it would deny its claims until the center proved it collected full copays from Cigna members. Physicians Surgery Center of Chandler denied allegations of fee forgiveness for Cigna members and claimed Cigna owed it $5.6 million in the lawsuit. U.S. District Judge Michael Liburdi dismissed the allega- tions July 23 because the ASC didn't prove it had specific plan language to recover payments from Cigna, according to court documents. The judge will allow Physicians Surgery Center of Chandler to amend its complaint and resubmit by Aug. 20. n