NewsOK: Oklahoma City News, Sports, Weather & Entertainment

Medicare cuts payments to Oklahoma City surgery center

[Thinkstock image]
[Thinkstock image]

Oklahoma City — Medicare cut off payments to an Oklahoma City surgical center in August for not meeting its safety standards, but the center's representatives hope to get back into the program soon.

The Centers for Medicare and Medicaid Services cut off payments to ESEC Surgery Center on Aug. 18, citing concerns about the electrical system and the set-up to sterilize instruments.

The sterilizers, used to clean instruments for surgery, were in a hall where they could be contaminated, and the electrical system was arranged in a way that it might not provide enough back-up for important equipment if the facility lost power while patients were on the operating table, according to an inspection report dated June 6.

The center already has moved the sterilizers and expects to have the electrical work done within a week, said Elisse Seals, regional vice president of operations for Solara Surgical Partners. Solara owns ESEC and other outpatient surgical centers.

CMS controls payments to doctors, hospitals and other facilities through Medicare and Medicaid. Facilities that lost their certification still could treat those patients, but wouldn't get paid for it. Decertification doesn't affect payments from private insurance.

Some facilities that rely heavily on Medicaid, like nursing homes, close after losing payments. Others have enough privately insured patients to keep going until they can address CMS' concerns and qualify for federal payments again.

The center isn't taking Medicare patients at the moment, because it can't get paid for them, but almost all doctors who work at ESEC also perform surgeries at other facilities, Seals said. She doesn't know of anyone who isn't getting a needed procedure because of CMS' decision.

Once the electrical work is done, an inspector from the Oklahoma State Department of Health will come verify that everything is order, and then CMS will consider restarting payments, Seals said. She wasn't sure what the electrical work would cost, but said she expects it to be “substantial.”

Seals said state inspectors didn't have a problem with the set-up when the facility opened in 2005, and noted the Health Department's former top lawyer granted a waiver so the facility wouldn't have to make changes a few years ago.

Tony Sellars, spokesman for the Health Department, said the department waived some of its standards, but couldn't waive the electricity rule, which is federal. A waiver on that rule would have to go through CMS, he said.

In a written timeline of the negotiations with the Health Department and CMS, Seals said the Health Department agreed to extend the deadline to comply multiple times while CMS considered the request for a waiver. CMS denied the request in early August, and a federal court declined to stop CMS from cutting payments to ESEC while it fixed the electrical issue.

“The way that the facility is now is the way that it was approved by the state 14 years ago,” Seals said. “This is in no way a patient safety matter.”

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›