N.J. OKs Self-Referrals But Blocks New ASCs

New Jersey's surgeons will be permitted, under certain conditions, to refer patients to their own ASCs under recently passed legislation, but they won't be able to start up new, non-hospital-affiliated centers.

The legislature's bill, which Gov. Jon Corzine is expected to sign, reverses a previous court decision banning physician self-referrals in the Garden State and clarifies the conditions under which doctors will be allowed to treat patients in ASCs in which they have an ownership stake. According to a published report, self-referrals will be permitted when:

  • "The physician who referred the patient personally performs the procedure.

  • "Financial compensation is not tied to the volume of patient referrals.

  • "All clinical decisions are made by practicing physicians and are in the best interest of patients.

  • "Patients are given prior written notice of the physician's financial interest."

    The Medical Society of New Jersey praised the compromise and also welcomed a provision exempting one-room surgery centers associated with private medical practices from a tax on licensed, multi-specialty ASCs. The legislation does, however, require that those smaller centers register with the state health department.

    The Ambulatory Surgery Center Association, on the other hand, warns that the bill's moratorium on the construction of new ASCs that are not affiliated with a hospital could encourage other states to follow suit.

    Irene Tsikitas

  • Woman Sues Over Retained Object

    A medical device left in a patient's body is an uncommon, but not unusual, complication of certain types of surgery. But the way in which one suburban Chicago patient discovered a retained object after her procedure is far from typical.

    Shu-Fang Sherry Yeh is suing surgeons at Advocate Good Shepherd Hospital in Barrington, Ill., accusing them of negligence in failing to remove a "metallic/plastic" device used in her February 2007 gynecological surgery. According to a published report, Ms. Yeh allegedly passed an abnormal bowel movement containing the device four days after her procedure.

    Ms. Yeh and her husband are suing the hospital for more than $400,000 in damages due to "continuing and permanent injuries" which have required additional surgeries and treatments, diminished her livelihood and hampered her marital relations, according to the report.

    "Advocate Good Shepherd Hospital and the physician members of its medical staff place patient safety as the number one, paramount priority," says Michael Deering, a spokesman for the hospital. "We take this claim extraordinarily seriously, as we do any such allegation."

    Daniel Cook

    Medtronic to Report Physician Payments

    Medical device manufacturer Medtronic is planning to disclose all consulting fees, royalties and honoraria of more than $5,000 that it pays physicians each year, beginning in 2011.

    In the face of increased federal scrutiny over the relationship between pharmaceutical and device firms and the physicians who study, use and promote their products, the Minneapolis-based company hopes to show that its payments are more than just kickbacks.

    "Through greater transparency about the nature of these relationships, we will help people better understand how important they are to developing life-saving and enhancing products for patients who need them," says Bill Hawkins, Medtronic's chairman and CEO.

    The company says that it will begin gathering information in 2010 and make its first on-line disclosure in March 2011. More extensive disclosures may become necessary. The Physician Payments Sunshine Act of 2009, currently in Congress, would require disclosure of all payments of $100 or more beginning in 2011.

    Last month, Sen. Charles Grassley (R-Iowa) revealed in a letter that while Thomas Zdeblick, MD, a professor in and chairman of the Department of Orthopedics and Rehabilitation at the University of Wisconsin at Madison, reported that he'd received $20,000 or more from Medtronic each year, he had in fact been given more than $19 million over a five-year period.

    Kent Steinriede

    Instapoll: How Do You Prefer Your Industry News?

    Nearly six out of 10 (57 percent) of the 46 readers who answered last week's online poll say they enjoy being able to read industry trade publications such as Outpatient Surgery Magazine both online and in print. One-fifth (21 percent) said they prefer to hold a paper version of a magazine in their hands and another one-fifth (22 percent) said they prefer to read them online. At Outpatient Surgery, we're currently planning to launch a digital edition of our print publication.

    This week's poll asks if you're overweight. Go to our front page to participate in the poll and view real-time results.

    Dan O'Connor

    News & Notes
  • Tip of the week A packet of adhesive labels can help you to minimize waste in your supply budget by tracking expiration dates. Shannon Holley, RN, CNOR, RNFA, pastes red dot stickers on implants and other surgical supplies set to expire during the current calendar year. Then she writes the expiration month for each on the sticker. "As a result, the staff knows which implants to pull first, and I scan the shelves on the last week of each month to find out what's expiring," she writes. "Then you can contact the manufacturer and see if it can swap out your soon-to-expire implants with a hospital that's about to use the same implants."

  • Medicare clarifies bariatric coverage CMS has specified that type 2 diabetes is one of the co-morbidities which, if suffered by a morbidly obese Medicare patient, would lead it to consider covering the patient's prospective bariatric surgery. Since 2006, Medicare has covered gastric bypass, open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and open and laparoscopic biliopancreatic diversion with duodenal switch surgeries among patients whose body mass indexes are 35 or higher and who suffer from such co-morbidities as hypertension, coronary artery disease or osteoarthritis, as long as the surgeries are performed at facilities certified by the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery to undertake bariatric procedures.

  • Ortho doc shortage? Two studies presented at the American Academy of Orthopaedic Surgeons' annual meeting last week claim that the increasing number of younger patients requiring hip and knee replacements will soon outpace the availability of orthopedic surgeons qualified to perform the procedures. Thomas K. Fehring, MD, an orthopedic surgeon from Charlotte, N.C., claims that 46 percent of needed hip replacements and 72 percent of needed knee replacements in 2016 will not be completed if the number of physicians able to perform the procedures continue at the current rate. Meanwhile, research conducted by Steven M. Kurtz, PhD, corporate vice president and office director at Exponent, Inc., an engineering and scientific consulting firm in Philadelphia, Pa., projects that more than half of patients requiring hip and knee replacements will be under age 65 by 2011 and 2016, respectively.
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