Becker's Spine Review

6 SPINE New Jersey hospital must pay neurosurgeons $24.3M, appeals court rules By Alan Condon A n appellate court on Aug. 9 upheld a $24.3 million award to a group of neurosurgeons who found the Valley Hospital in Ridgeview, N.J., breached the implied covenant of good faith and fair dealing with them when it signed an exclusive agreement with another surgical group, according to Law.com. Five notes: 1. e 11 neurosurgeons and their practice, Oradell-based New Jersey Brain and Spine, provided on-call coverage for the hospital's ER and were "instrumental" in obtaining specialized equipment — including biplane angiography and a Gamma Knife — that allowed Valley Hos- pital to treat stroke patients rather than transfer cases to Columbia University in New York City, according to court documents. 2. Valley Hospital recruited Patrick Roth, MD, and his neurosurgical group to join its staff in 2003, when the hospital had only three active neurosurgeons on staff who specialized in spine surgery, according to the lawsuit. Dr. Roth indicated the mandate was to curb the flow of patients out of the hospital by building a contemporary neurosurgi- cal practice. In the following years, he said the hospital developed an endovascular program, a biplane suite and was designated a compre- hensive stroke center by HHS. 3. Hackensack (N.J.) North reopened in 2013, 6 miles from Valley Hospital, which previously made an unsuccessful attempt to purchase the site. Two of the plaintiff neurosurgeons met with Valley Hospital board president, Audrey Meyers, who allegedly was upset about their "lack of loyalty," according to the report. e surgeons claim Ms. Mey- ers was particularly displeased with the appointment of Roy Vingan, MD, as chair of surgery at Hackensack North. 4. e relationship between Valley Hospital and New Jersey Brain and Spine ended in 2015 when the hospital inked an exclusive agreement with St. Elizabeth, N.J.-based Columbia Group, providing its neuro- surgeons exclusive access to the Gamma Knife and biplane angiogra- phy, according to court documents. e surgeons at New Jersey Brain and Spine sued Valley Hospital in several claims, including breach of contract, breach of the implied covenant of good faith and fair deal- ing, and tortious interference with prospective economic advantage. 5. A jury returned a no-cause verdict on the breach-of-contract claim but found in favor of the neurosurgeons on the implied covenant claim. Valley Hospital's appeals and motion for a new trial were ul- timately rejected because its arguments lacked merit and the court found no miscarriage of justice on the part of the plaintiffs, according to the court opinion. n Cost of 9 orthopedic procedures at ASCs vs. HOPDs By Claire Wallace C osts of procedures vary between ASCs and HOPDs, with orthopedic procedures for those with original Medicare and no supplement being cheaper at ASCs, according to data from Medicare.gov. Average cost for patients after insurance for nine proce- dures at ASCs vs. HOPDs: Carpal tunnel injection ASC: $20 HOPD: $64 Tendon sheath incision for trigger finger ASC: $208 HOPD: $344 Anterior cruciate ligament repair ASC: $1,025 HOPD: $1,479 Repair of shoulder rotator cuff using an endoscope ASC: $799 HOPD: $1,479 Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone graft ASC: $415 HOPD: $721 Removal of loose or foreign body, arthrotomy, hip ASC: $798 HOPD: $1,478 Arthroscopy, knee, surgical; with meniscus repair ASC: $413 HOPD: $719 Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixa- tion (including debridement of base of lesion) ASC: $930 HOPD: $1,434 Neuroplasty and transposition; ulnar nerve at elbow ASC: $287 HOPD: $481 n

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