RegulatorySpine

Medicare Reconsiders Paying For Seniors’ Spine Operations At Surgery Centers

By Christina Jewett / July 30, 2018

Medicare is reviewing whether seniors should undergo spine surgeries at same-day surgery centers, the government-run health program announced Wednesday, five months after a USA Today Network-Kaiser Health News investigation revealed a spate of patient deaths following the procedures.

The proposal states that Medicare officials will examine whether these procedures “pose a significant safety risk” to patients and continue to “meet the criteria” for Medicare payment.

The news investigation found that in 2015 and in 2017 Medicare approved same-day spine operations for seniors even though at least 14 patients had died since 2008 after such procedures.

Some suffocated from a well-known complication of upper-spine surgery that can generally be reversed if caught immediately and treated properly.

The investigation also found that some medical professionals urging Medicare to pay surgery centers to operate on seniors’ spines failed to mention recent incidents of death at their own or an affiliated facility.

Dr. Nancy Epstein, a chief of neurosurgical and spine education at New York University Winthrop Hospital, lauded the proposal, saying patients face extensive risks after spine surgery.

“It’s about time,” Epstein said of the review proposal, which she expects to rankle some doctors who have a financial stake in a spine surgery center.

Bill Prentice, executive director of the Ambulatory Surgery Center Association, which represents the centers in policymaking discussions, said he supports Medicare stepping up its efforts to perform an internal and external review of the procedures it pays for at surgery centers.

“The more resources they use, the better,” Prentice said. “I think that the more data points they have, the more likely they are to make the right decision. … We believe these procedures can be performed very safely in the ambulatory surgery center space.”

Medicare announced the plan to re-evaluate its decision to pay for seniors’ spine procedures in an annual rule-making document released Wednesday. The agency is accepting comments on the proposed changes through Sept. 24 and is expected to release a final decision late in the year.

 

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Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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