Sara Brinkman and Lauren Gennett on Overlapping Surgeries [Podcast]

Compliance Perspectives

By Adam Turteltaub Well, it turns out that you can be in two places at once, if you are a surgeon. Even better, you can bill the government under the Medicare program for being at both of them. It’s not quite as strange as it sounds, explains Sara Brinkmann, Partner, and Lauren Gennett, Counsel, of King & Spalding, and, of course, there are rules. Overlapping surgeries occur when one attending surgeon is responsible for procedures that overlap in time. The attending may perform the critical part of the procedure in both, assuming they are not supposed to happen at the exact same time. Non-critical portions of the procedure, such as closing the patient, are left to a resident. There must also be a backup surgeon in case something goes awry. Payment for both surgeries is possible so long as there are the requisite safeguards in place and the various other CMS rules are followed. There may also be state requirements to be mindful of as well. If those rules aren’t followed, there is substantial risk. As they explain, overlapping surgeries have been the subject of intense scrutiny and enforcement actions. Listen in to learn more, and, for the record, overlapping podcast listening is not approved. Listen now