Becker's ASC Review

8 ASC MANAGEMENT Justice Department cracks down on ASC, anesthesia provider arrangements By Patsy Newitt R ecent government actions involving ASC-anesthesia provider arrangements point to a need to carefully vet these partner- ships, according to a June 20 article in JDSupra from the law firm Waller Lansden Dortch & Davis. In April, anesthesia management services company Care Plus Management, its founders Paul Weir and John Morgan, MD, and 18 anesthesia entities Care Plus owned and operated agreed to pay $7.2 million to settle allegations of kickbacks and false claims. Between 2012 and 2016, Mr. Weir and Dr. Morgan were alleged to have convinced ASC physician owners to award exclusive service agreements in exchange for partial ownership in Care Plus anes- thesia entities that would service the ASCs. A whistleblower alleged Care Plus Management unlawfully split a percentage of anesthesia service revenue with referring gastroenterologists, vascular surgeons and podiatrists, who were also owners of the ASCs. e government took issue with the ownership structure of the an- esthesia company and its affiliations and the exclusive services they provided to referring physicians' ASCs. e arrangement created "sham joint ventures" — Care Plus Management and the physician- owners of each ASC would create a joint venture anesthesia company dedicated to each respective ASC. According to the report, this case is similar to a settlement from No- vember, when three anesthesia providers and several Georgia ASCs, along with their physician-owners and an administrator, agreed to pay more than $28 million to resolve allegations that they entered kickback agreements. e suit alleges that Ambulatory Anesthesia of Atlanta and North- side Anesthesiology Consultants, both in Atlanta, paid a number of ASCs for medications, supplies, equipment and labor in exchange for patient referrals between 2005 and 2015. When structuring anesthesia contracts, the report's authors advise ASCs do the following: 1. Monitor overlapping ownership between a service provider and the referral source. 2. Arrange for coverage by the anesthesia provider and require each party to bill patients and payers separately. 3. Be wary of scenarios in which the provider performing and bill- ing for services is outsourcing the financial risk. 4. Note that contracting facilities are also at risk, so ASCs should monitor the way the contracting provider is structured. n Data breach hits 500,000 people at Illinois physician group By Marcus Robertson C hampaign, Ill.-based Christie Clinic, a physician- owned multispecialty group practice, suffered a data breach that placed the personal data of 502,869 people at risk, according to the HHS breach portal. One of Christie Clinic's business email accounts was ac- cessed by an unauthorized user from July 14, 2021, to Au- gust 19, 2021, the practice said in a March 24 statement. An investigation suggested that the purpose was to inter- cept a business transaction between Christie Clinic and a third-party vendor. Affected individuals may have had their personal infor- mation compromised, including address, Social Security number, medical information and health insurance infor- mation, the practice said. No EMRs were accessed. Christie Clinic said that since the incident, the practice has added more safeguards to patient data. n Pennsylvania surgery center closes By Alan Condon The Surgery Center of Pottsville (Pa.) is closed on June 28 after 17 years in operation. Several recent physician-owner departures and retire- ments have made it challenging to run the business ef- ficiently, The Republican & Herald reported June 23. The ASC opened with 13 surgeons in 2006, but now has only nine physicians, with one David Abraham, MD, an orthope- dic surgeon, planning to move to Florida. The surgery center's owners decided in May to close, and patients were informed earlier in June. Otolaryngologist Mohammad Akbar, MD, founded the ASC with Adam Altman, MD; Glenn Freed, DO; Calvin Stoudt, DO; Richard Greco, DO; Myran Haas, DO; Neil Fisher, DO; Dr. Abraham; Carlos Villarreal, MD; and Daniel Bobrowski, MD. Drs. Haas, Villarreal and Gerald Ravitz, MD, are among the physicians who retired, according to Dr. Akbar, while Drs. Greco, Fisher and Bobrowski are practicing elsewhere. An- other physician, Sultan Khan, MD, died in 2011, he said. n

• Cover