Joseph Edward Grostas, the former business manager of the Surgery Center at Brinton Lake in Concord, Pa., has been charged with allegedly stealing about $225,000 from his employer.

He is currently free on $10,000 bail, according to Gina Espenschied, RN, BSN, CNOR, the center's administrator, who discovered Mr. Grostas' unauthorized purchases. She says they date back to January 2008, 4 months after he began working at the center.

Ms. Espenschied uncovered Mr. Grostas's alleged improprieties during a routine check of the facility's bank account on March 9. She noticed an unusually high balance on Mr. Grostas's company credit card and confronted him in his office.

"At first he looked at his wallet and said he must have pulled out the wrong card," says Ms. Espenschied. "But when I flipped the page and started to read off his other activities" - which included charging rental cars for a family vacation, college tuition for his wife, tutoring for his son, a motorcycle and several used cars - "his face went pale and he kept repeating 'I don't know, I don't know.'" She says he then left the facility and did not return.

A subsequent investigation reportedly revealed unauthorized charges to pay cell phone, cable and car insurance bills, according to a published report, which also notes that Mr. Grostas allegedly transferred $71,000 from the facility's bank account to his own, tapped $21,706.78 to pay his mortgage and withdrew more than $26,000 in cash. Ms. Espenschied claims that he took cash attached to bank deposit slips and says she discovered uncashed insurance checks totaling $123,000.

Mr. Grostas has notified the Pennsylvania State Police that he intends to waive his right to a preliminary hearing scheduled to take place on March 26, and that he plans on making full restitution to the center, according to Ms. Espenschied. His attorney declined to comment, citing the pending criminal trial.

"He systematically destroyed us," says Ms. Espenschied, who explains that the facility's insurance policy is expected to reimburse only $25,000 of the reported losses. "Any profit we forecasted for this year is gone, and he would have knocked us out of business entirely if his stealing went on for much longer."

Daniel Cook

In what is viewed as a reprieve for the state's ASC industry, New Jersey Governor Jon S. Corzine has signed a bill amending the state's medical self-referral regulations into law.

The amendments, which the state senate approved late last year and the state assembly voted up in February, offer exemptions to a 1991 law introduced by now-Senate President Richard J. Codey that limited physicians' self-referrals to surgery centers. Mr. Codey himself introduced the present amendments to the 18-year-old "Codey Law."

Aiming to strengthen oversight on New Jersey's ASCs, the amendments require all licensed ASCs to become accredited by the Joint Commission, AAAHC or AAAASF within 1 year, and all unlicensed, 1-OR ASCs to register with the state Department of Health within 1 year by obtaining certification by Medicare or accreditation by 1 of the 3 above-mentioned agencies.

The amendments state that only existing unlicensed ASCs and those with construction plans filed within 6 months are eligible to register with the state and participate in the amendments' self-referral exemptions. They also limit the health department's future issuance of ASC licenses to facilities under development which file construction plans within 6 months; existing facilities that transfer ownership; existing facilities that relocate within 20 miles or to a "health enterprise zone" without expanding their services; and facilities owned partly or entirely by a New Jersey hospital or medical school.

The Codey Law's provisions threatened New Jersey's ASC industry after a state judge ruled, in a 2007 insurance case, that a physician's referral to his surgery center violated the law. The ruling raised concerns that insurance carriers would begin denying ASCs' reimbursement on grounds that surgeons' referrals broke state law and constituted insurance fraud.

David Bernard

Dozens of federal lawmakers are urging the Centers for Medicare and Medicare Services to reverse their tentative decision not to fund virtual colonoscopies for Medicare recipients.

"National Medicare coverage of [computed tomography colonography] as a minimally-invasive screening test for colorectal cancer would not just encourage more patients to undergo screening, but it would potentially close or eliminate the gap in colorectal cancer screenings between whites and minority populations," write Reps. Kay Granger (R-Texas) and Patrick Kennedy (D-R.I.) in a letter to CMS signed by more than 40 legislators.

The letter cites a 70 percent uptick in colon cancer screenings at the National Naval Medical Center after the facility added CTC as an option. It also cites a study published in the New England Journal of Medicine that showed "CTC is comparable to standard colonoscopy in its ability to detect cancer and precancerous polyps." Rep. Danny K. Davis (D-Ill.) and 10 other members of the Congressional Black Caucus have signed a separate letter to CMS, also urging the agency to pay for virtual colonoscopy.

The lawmakers are joining a chorus of voices that have responded to CMS' February decision, the public comment period for which ended March 13. A letter signed by the American College of Radiology, patient groups and imaging equipment manufacturers, argued that "Medicare coverage of CTC would provide a critical opportunity to save lives from cancer, end unbearable suffering, as well as save taxpayer dollars."

CMS spokesman Don McLeod told CQ HealthBeat that the agency is taking "all such letters very seriously" and will respond to Congress "promptly."

Irene Tsikitas

Joseph Edward Grostas, the former business manager of the Surgery Center at Brinton Lake in Concord, Pa., has been charged with allegedly stealing about $225,000 from his employer.

He is currently free on $10,000 bail, according to Gina Espenschied, RN, BSN, CNOR, the center's administrator, who discovered Mr. Grostas' unauthorized purchases. She says they date back to January 2008, 4 months after he began working at the center.

Ms. Espenschied uncovered Mr. Grostas's alleged improprieties during a routine check of the facility's bank account on March 9. She noticed an unusually high balance on Mr. Grostas's company credit card and confronted him in his office.

"At first he looked at his wallet and said he must have pulled out the wrong card," says Ms. Espenschied. "But when I flipped the page and started to read off his other activities" - which included charging rental cars for a family vacation, college tuition for his wife, tutoring for his son, a motorcycle and several used cars - "his face went pale and he kept repeating 'I don't know, I don't know.'" She says he then left the facility and did not return.

A subsequent investigation reportedly revealed unauthorized charges to pay cell phone, cable and car insurance bills, according to a published report, which also notes that Mr. Grostas allegedly transferred $71,000 from the facility's bank account to his own, tapped $21,706.78 to pay his mortgage and withdrew more than $26,000 in cash. Ms. Espenschied claims that he took cash attached to bank deposit slips and says she discovered uncashed insurance checks totaling $123,000.

Mr. Grostas has notified the Pennsylvania State Police that he intends to waive his right to a preliminary hearing scheduled to take place on March 26, and that he plans on making full restitution to the center, according to Ms. Espenschied. His attorney declined to comment, citing the pending criminal trial.

"He systematically destroyed us," says Ms. Espenschied, who explains that the facility's insurance policy is expected to reimburse only $25,000 of the reported losses. "Any profit we forecasted for this year is gone, and he would have knocked us out of business entirely if his stealing went on for much longer."

Daniel Cook

In what is viewed as a reprieve for the state's ASC industry, New Jersey Governor Jon S. Corzine has signed a bill amending the state's medical self-referral regulations into law.

The amendments, which the state senate approved late last year and the state assembly voted up in February, offer exemptions to a 1991 law introduced by now-Senate President Richard J. Codey that limited physicians' self-referrals to surgery centers. Mr. Codey himself introduced the present amendments to the 18-year-old "Codey Law."

Aiming to strengthen oversight on New Jersey's ASCs, the amendments require all licensed ASCs to become accredited by the Joint Commission, AAAHC or AAAASF within 1 year, and all unlicensed, 1-OR ASCs to register with the state Department of Health within 1 year by obtaining certification by Medicare or accreditation by 1 of the 3 above-mentioned agencies.

The amendments state that only existing unlicensed ASCs and those with construction plans filed within 6 months are eligible to register with the state and participate in the amendments' self-referral exemptions. They also limit the health department's future issuance of ASC licenses to facilities under development which file construction plans within 6 months; existing facilities that transfer ownership; existing facilities that relocate within 20 miles or to a "health enterprise zone" without expanding their services; and facilities owned partly or entirely by a New Jersey hospital or medical school.

The Codey Law's provisions threatened New Jersey's ASC industry after a state judge ruled, in a 2007 insurance case, that a physician's referral to his surgery center violated the law. The ruling raised concerns that insurance carriers would begin denying ASCs' reimbursement on grounds that surgeons' referrals broke state law and constituted insurance fraud.

David Bernard

Dozens of federal lawmakers are urging the Centers for Medicare and Medicare Services to reverse their tentative decision not to fund virtual colonoscopies for Medicare recipients.

"National Medicare coverage of [computed tomography colonography] as a minimally-invasive screening test for colorectal cancer would not just encourage more patients to undergo screening, but it would potentially close or eliminate the gap in colorectal cancer screenings between whites and minority populations," write Reps. Kay Granger (R-Texas) and Patrick Kennedy (D-R.I.) in a letter to CMS signed by more than 40 legislators.

The letter cites a 70 percent uptick in colon cancer screenings at the National Naval Medical Center after the facility added CTC as an option. It also cites a study published in the New England Journal of Medicine that showed "CTC is comparable to standard colonoscopy in its ability to detect cancer and precancerous polyps." Rep. Danny K. Davis (D-Ill.) and 10 other members of the Congressional Black Caucus have signed a separate letter to CMS, also urging the agency to pay for virtual colonoscopy.

The lawmakers are joining a chorus of voices that have responded to CMS' February decision, the public comment period for which ended March 13. A letter signed by the American College of Radiology, patient groups and imaging equipment manufacturers, argued that "Medicare coverage of CTC would provide a critical opportunity to save lives from cancer, end unbearable suffering, as well as save taxpayer dollars."

CMS spokesman Don McLeod told CQ HealthBeat that the agency is taking "all such letters very seriously" and will respond to Congress "promptly."

Irene Tsikitas