The Medicare program is reviewing whether seniors should undergo spine surgeries conducted same-day at surgery centers. The review will examine whether these procedures “pose a significant risk” or “meet the criteria” for Medicare payment.
Although 14 patients have died since 2008, Medicare previously approved same-day spine operations for seniors between 2015 and 2017.
The investigations found the following:
- Some of the cases with upper-spine surgery complications can be reversed if caught immediately or treated properly.
- The incidents of death have not been reported by the surgery centers that have requested payment for the surgeries.
- Dr. Nancy Epstein, a Chief of Neurosurgical and Spine Education at New York University Winthrop Hospital, and Bill Prentice, Executive Director of the Ambulatory Surgery Center Association, both support Medicare stepping up its efforts to perform an internal and external review of the procedures at surgery centers.
Medicare is accepting comments through September 24 on the proposed changes that are included in the annual Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems […] (CMS-1695-P). Medicare is expected to release the final decision later in the year.
The proposal will review 38 procedures added since 2015. Of the 38 procedures, 25 involve spine surgery, and Medicare will create an ongoing plan to continually review approved procedures.
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