"Health & Medical News"

Georgia physicians and hospitals are wrangling over a rule change that paves the way for general surgeons to establish ambulatory surgery centers without going through the certificate-of-need process.

The state’s Dept. of Community Health in December 2007 unanimously approved a rule that reclassifies general surgery as a single specialty rather than a multispecialty. It amends related certificate-of-need requirements for physician-owned ambulatory surgery facilities. Georgia law exempts surgery centers focusing on a single specialty, such as orthopedics or obstetrics and gynecology, from demonstrating need.

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A New Jersey trial court ruling puts most, if not all, of the 200 physician-owned ambulatory surgery centers there in violation of the state’s anti-referral law.

A 1989 law called the Codey Act prohibits doctors from referring patients to an entity in which they have a financial interest, except in certain circumstances, such as for radiation therapy or if the service is provided at the doctor’s medical office.

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A group practice’s proposal to allow referring health professionals to invest in an ambulatory surgery center would run afoul of the federal anti-kickback statute, states a recent advisory opinion by the U.S. Dept. of Health & Human Services’ Office of Inspector General.

Legal experts said the Oct. 19 opinion affirms the government’s stance that the arrangements can be susceptible to fraud and abuse and are permissible only under specific conditions.

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When it comes to low back pain, physicians generally advise exhausting nonsurgical options before resorting to surgery. But a new study shows that for degenerative spondylolisthesis with spinal stenosis, surgery provides significantly better results than nonsurgical alternatives.

The study, published in the May 31 issue of the New England Journal of Medicine, is the second in a series reporting findings of the Spine Patients Outcomes Research Trial (SPORT), a five-year, multicenter study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health.

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