The Commercial Appeal

Medicare to review spine surgeries in centers

- Christina Jewett Kaiser Health News

Medicare is reviewing whether seniors should have spine operations 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 review proposal says Medicare officials will examine whether such procedures “pose a significan­t safety risk” to patients and continue to “meet the criteria” for Medicare payment.

The 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 for which it pays 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.

The nation’s more than 5,600 Medicare-certified surgery centers are required to have an internal governing body that decides which surgeries it will perform on the center’s patients. However, the federal agency decides which operations it will pay for in surgery centers, continuous­ly proposing and adding some procedures during annual rule-making.

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