Hospitals Double Dip on Spine Surgeries (Biloine Young @ OTW)
Some California hospitals collect duplicate payments for spinal surgeries—get paid twice—according to a report by California Watch, founded by the Center for Investigative Reporting. Reporter Bernice Yeung writes in the June 19 news release that this practice amounted to additional costs of $67.5 million in 2010. And it is all due to the way California’s workers’ compensation program reimburses providers for spine surgery.
The California workers’ compensation program pays hospitals 120%, as compared to what Medicare pays, for injured workers’ medical services. However, spinal surgeries trigger additional payments, called “pass-through” payments. These are intended to reimburse hospitals for the cost of the devices implanted in the patients during spinal surgery.
What the California Watch study discovered was the fact that the cost of the instruments was already factored into the hospitals initial charges and their reimbursement. The report, based on 3,350 surgeries, estimates that the duplicate payments for spinal devices added $20,000 to the cost of each procedure.
Yeung quotes a representative of the California Hospita...
