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    Committee seeks to ban concurrent surgeries

    Panel also urges careful control over overlapping procedures

     

    Recommendations for health care institutions

    The report made these recommendations for hospitals and other health care institutions that perform surgeries and accept Medicare and Medicaid payments:

    • develop a concurrent and overlapping surgical policy that clearly prohibits concurrent surgeries and regulates overlapping surgeries consistent with the ACS guidance
    • identify the critical portions of particular procedures, to the extent practicable, as well as those portions unsuitable for overlap
    • develop processes to ensure patient consent discussions result in a complete understanding by the patient that his/her surgery will overlap with another patient’s; develop materials such as Frequently Asked Questions; and educate patients prior to their surgeries, providing sufficient time for them to review materials and fully consider their options
    • identify the backup surgeon in advance when scheduling overlapping surgeries
    • develop mechanisms to enforce the established concurrent and overlapping surgical policies and monitor and enforce their outcomes.

    The report also recommended that CMS modify its regulations or survey processes and direct accrediting organizations to modify their hospital standards or survey processes to ensure that hospitals eligible for payment from Medicare and Medicaid have policies consistent with the ACS’s revised guidance.

    Read: How will health care change under a Trump presidency?

    The committee staff pointed out that CMS’s billing requirements apply only to teaching physicians operating in hospitals and should be extended to non-teaching scenarios, such as when a physician is assisted by a technician or in a setting such as an ASC.

    Following the publication of the Boston Globe article, the committee staff contacted 20 teaching hospitals querying them about the practice of concurrent or overlapping surgeries at their institutions. Initially, the staff report said, officials and staff at those hospitals “were largely skeptical of concerns regarding the safety of the practice of concurrent surgeries.”

    Since then, however, the staff said the committee recognizes that many of the hospitals and medical professionals have taken steps in a short period of time to address many of the concerns.

    But the staff pointed out that it has no way of knowing what the larger population of 4,900 hospitals and other facilities nationwide that receive Medicare payments are doing to address the issue, noting that in 2014, hospitals performed over 26 million surgeries, including 9 million inpatient and 17 million outpatient procedures.

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    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

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