Pointing surgical fingers

It’s hospitals in one corner and day-surgery centers in the other in Colorado. Two large hospital chains in Colorado, Centura and HCA/HealthONE, are being sued by four day-surgery centers. The day-surgery centers, which are owned by doctors, claim the hospital chains and insurers are trying to put them out of business. The hospitals, on the other hand, say the day-surgery centers are probably committing insurance fraud and violating kickback laws.

In their antitrust federal lawsuit, the day-surgery centers say the hospitals are influencing large insurance companies, including Kaiser and UnitedHealthcare, to exclude the new day-surgery centers from their networks of approved providers. The centers also believe the hospitals are preventing their own doctors from referring patients to these outside day-surgery centers, and they feel the hospitals are refusing to admit patients from the day-surgery centers who need additional care.

For much more on this story, see this article.