Subscriptions

Advertising

Resources

About Us

Contact Us

Create An Account Forgot Your Password?
Trouble logging in or creating an account? click here
Home This Month E-Weekly Newsletter Building a Facility Article Archive Second Opinions
Search:
Benchmarking
General Surgery
Accrediting/Quality
Anesthesia
Code/Bill/Reimburse
Building/Renovating
/_media/adv/web/images/2010/20100511_Arthrex_LB_154x100.gif
/_media/adv/web/images/2010/20100126_ImageFirst_LB-154x100.gif
/_media/adv/web/images/2010/20100407_ORX_LB-01_154x100.gif
Outpatient Surgery E-Weekly

News & Notes

Tip of the week Are red-bag wastes, sharps, recyclables and unshredded sensitive paperwork routinely ending up in your regular trash bins? Line those ...

InstaPoll: Do You Check Your Work E-Mail on Vacation?

Be honest: When you're on vacation, do you feel compelled to check your work e-mail 2 or 3 or 4 times a day? Or do you manage to leave it all behind...

N.Y. Hepatitis Outbreaks Linked to Propofol Reuse

An investigation into a pair of hepatitis outbreaks in New York City has revealed that the same anesthesiologist was responsible for spreading 6 cas...

Archive > January, 2008 Vol. IX, No. 1

Legal Update

Facility Fees for Doc-owned ASCs Under Fire

John Fanburg

In a recent ruling, a New Jersey Superior Court judge declared that physicians referring patients to ASCs in which they have ownership interests are violating state law. The ruling has the state's legal and medical communities pondering its impact on surgery centers. Facing the possibility that future referrals to their ASCs will be ruled impermissible, physician-owners are also forced to contemplate whether filing claims for ASC facility fee reimbursement might be seen as insurance fraud.

Categories: Code/Bill/Reimburse, Legal/Regulatory
Keywords:
The facts; The co-insurance complaint; The fraud complaint; Resulting questions; ASC-hospital; ASC. As; ASCs; Act; Appeals; Board; Codey Law; Codey Law. The; Codey Law. In; Codey Law. One; Codey Law? New Jersey; Contillo; Court; D. Fanburg, JD Resulting; Examiners; Examining; Facing; Fanburg, JD Resulting; Fraud Prevention Act; Garcia; Health Net; Insurance Fraud Prevention Act; JD Resulting; Jersey; Jersey Superior Court; Jersey's Board; Jersey. Although; John D. Fanburg, JD Resulting; Judge Contillo's; Judge Robert P. Contillo; Law; Law. The; Law. In; Law. One; Law? New Jersey; Medical Exami... show all keywords
The facts; The co-insurance complaint; The fraud complaint; Resulting questions; ASC-hospital; ASC. As; ASCs; Act; Appeals; Board; Codey Law; Codey Law. The; Codey Law. In; Codey Law. One; Codey Law? New Jersey; Contillo; Court; D. Fanburg, JD Resulting; Examiners; Examining; Facing; Fanburg, JD Resulting; Fraud Prevention Act; Garcia; Health Net; Insurance Fraud Prevention Act; JD Resulting; Jersey; Jersey Superior Court; Jersey's Board; Jersey. Although; John D. Fanburg, JD Resulting; Judge Contillo's; Judge Robert P. Contillo; Law; Law. The; Law. In; Law. One; Law? New Jersey; Medical Examiners; Medicare; Net; November; P. Contillo; Prevention Act; Robert P. Contillo; Stark; Superior Court; absence; accepting; act; action; addressed; advisory; agreement; alleged; allowing; applies; apply; arises; arrangement; articulated; assignment; authorized; avoided; aware; basis; believed; billed; board; broader; business; called; case; cases; center; citing; civil; claim; claimed; claims; co-insurance; collect; collecting; commingling; commit; communities; companies; complied; concluded; confused; connection; considered; contemplate; context; court; coverage; covered; cripple; decision; declaration; declared; decline; defining; designated; determined; directly; dismissed; draft; element; emergency; exception; extension; facility; facts; failing; false; family; federal; fee; fees; filing; financial; finding; forced; found; fraud; full; future; general; generally; grounds; health; healthcare; highly; his/her; hold; hospital; hundreds; impact; imparting; important; in-network; includes; indicating; industry; insulate; insurance; insurance-related; insured; insurer; intact; integral; integrity; intent; interest; interests; involved; issued; joint; judge; knowing; knowledge; law; lawmakers; legal; legally; list; medical; misleading; model; notice; notion; obligated; obligation; offered; office; open; opinion; outcome; overstepped; ownership; owns; parallels; partial; patient; patients; pay; payment; perceived; performed; physician; physician-owned; physician-owners; physicians; plan; pondering; portion; position; possibility; practice; practitioner; predicated; private; procedures; professional; prohibits; provided; purposes; pursue; question; recent; refer; referrals; referred; referring; regulatory; reimburse; reimbursement; rejected; relevant; rely; remains; remarks; removed; response; restriction; risk; routinely; rule; ruled; ruling; safeguard; satisfying; seeking; self-referral; self-referred; served; service; significant; spite; standards; state; stated; statement; stating; statute; statutory; submitting; surgeon; surgeries; surgery; survival; taking; uncertainty; understanding; unexpected; unlawfully; venture; version; view; violate; violating; violation; violations; wake; wholly; widely; widespread; won; working
Already have an account? Please sign in:
Email Address:
Password:
PRODUCT & SERVICE RESOURCES
Product & Service Showcase
A showcase of products and services geared to make your facility better.
Professional Services Platinum Pages
A guide of people and companies to help make your facility better.
Products In This Issue
Protect your staff!

MD Technologies

Worry-free anesthesia.

Somnia

We fix surgery centers.

ASCOA

Turn up the power.

Arizant Healthcare

Other Articles That May Interest You
Surgeons: Donda West Law Won't Do Much for Patient Safety
California requirements for cosmetic surgery are already commonplace among "reputable physicians," experts say.
Texas Considers Law to License AAs
Anesthesiologist assistants already practice in Texas, but are unregulated.
Coding & Billing
Mastering Podiatry Coding