Demand for Total Joint replacement on the rise in Pennsylvania

The Pennsylvania Orthopaedic Society (POS) acknowledged the findings of a Pennsylvania Health Care Cost Containment Council (PHC4) report released today.

Harrisburg, PA, April 04, 2012 - The Pennsylvania Orthopaedic Society (POS) acknowledged the findings of a Pennsylvania Health Care Cost Containment Council (PHC4) report released today. Information contained in the report, Orthopedic Surgery in Pennsylvania: Total Joint Replacement and Common Spine Procedures, indicates Pennsylvania has followed the national trend of increased joint replacement procedures and spinal fusion.

Total joint replacements are among the most commonly performed and clinically successful surgical procedures in the United States. Typical reasons for these joint replacement procedures are pain and decreased quality of life from osteoarthritis. “The Centers for Disease Control and Prevention (CDC) estimate that by 2030 the demand for total hip replacements will increase 175% and the demand for total knee replacements is projected to grow six fold”, stated POS President Greg Gallant, MD MBA. “The PHC4 data shows that Pennsylvania has a mature and active senior population who want to stay in the game. The Baby Boom generation has broken down many barriers and they are now conquering a sedentary old age. Advancing orthopedic technology will help pave the way to meet the need predicted by the CDC and demanded by Pennsylvania’s aging citizens.” New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that more than 4.5 million Americans are living with a total knee replacement (TKR), as the number of TKR surgeries has more than doubled over the past decade.

Joint replacement rates in Pennsylvania, according to the PHC4 report, are slightly higher than the national average. “The slight increase in this statistic is indicated by the Commonwealth’s aging population the percentage of citizens over the age of 65”, Gallant indicated, “according to 2010 national census data, Pennsylvania ranks 4th in the United States by percentage of population age 65 and older . The prevalence of osteoarthritis in an aging population is a significant contributor to the growing demand for joint replacement procedures.”

The PHC4 data also shows that Pennsylvania is in line with national trends in regard to common spine procedures.

“An increase in demand for procedures comes with a price, however,” said Gallant. “POS members are taking active steps to reduce hospital costs while simultaneously improving patient care. One of which is the development of a national joint registry. “ The American Joint Replacement Registry is designed to collect data from hospitals around the country in order to recognize patterns in implant performance. “Improved information on device and treatment effectiveness provides the opportunity to reduce revision rates, reduce complication rates, and improved device selection to maximize longevity and function; the intent is that the registry will bring both improved patient safety and a significant cost reduction.”

Restoring patient quality of life and maintaining patient safety are paramount in all total joint procedures. Surgeons and hospitals have taken steps to prevent infection and other complications which may result from these surgeries. “Surgeons are partnering with hospitals to implement cost effective patient centered care. Programs such as patient post-operative planning help increase mobility and improve outcomes,” said Gallant.

POS is a professional medical specialty organization representing over 1000 orthopaedic surgeons across Pennsylvania in advocating for excellence in the practice of orthopaedic medicine. For more information on the importance of bone, joint and muscle health at every age, visit the POS website at www.paorthosociety.org

Contact:

Beth Weachter

PA Orthopaedic Society

510 North Third Street

Harrisburg, PA 17101

717-909-8901

beth@paorthosociety.org

http://www.paorthosociety.org/

Abrams Fensterman Cautions Health Care Clients

Office of Inspector General Is Aggressively Asserting Its Authority to Exclude Owners, Officers and Managing Employees of Sanctioned Entities From Participation in Federal Health Care Programs

Lake Success, NY, August 02, 2011 - "The longstanding but little-used authority of the Office of Inspector General (OIG) to exclude from participation in any federal health care program, such as Medicare, any officer or managing employee of a health related entity that has been convicted of certain legal offenses, should now be top-of-mind for all general managers, business managers, administrators and directors of today’s health care facilities," says Patrick Formato, a partner at Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP (Abrams Fensterman).

Reflecting on his recent participation at June’s Annual Meeting of the American Health Lawyers Association, Formato is reaching out to his clients with a stern warning: "The OIG is becoming increasingly aggressive in targeting owners, managers and boards of sanctioned health care facilities. These individuals must keep a finger on the pulse of what is going on in every phase of their organization and they must be proactive about reporting their concerns."

Formato notes that exclusions under section 1128 (b) (15) of the Social Security Act are based upon the individual’s role or interest in a company that is excluded or is convicted of certain offenses. Individuals who have an ownership or a control interest in a sanctioned entity may be excluded if they knew or should have known of the conduct that led to the sanction. Officers and managing employees may be excluded based solely on their position within the entity.

"There is a higher standard for exclusion of an owner,"Formato points out. "The relevant statute requires evidence that the owner knew or should have known of the conduct that formed the basis for the sanction. In cases involving officers and managing employees, the statute includes a no knowledge element. The OIG therefore has the authority to exclude every officer and managing employee of a sanctioned entity." says Formato.

"As a practical matter, the OIG does not intend to exclude all officers and managing employees," Formato notes.

"But where the evidence supports the fact that a managing employee knew or should have known of the conduct, the OIG will probably operate with a presumption in favor of exclusion."

"Abrams Fensterman has one of the largest health care legal practices in New York state, representing approximately 125 nursing homes, a large number of medical groups and individuals in a variety of complex health care-related matters," says Howard Fensterman, Managing Partner of Abrams Fensterman.

"Some of our clients include physicians, medical societies, ambulatory surgery centers, diagnostic and treatment centers, hospitals, imaging facilities, dentists, podiatrists, chiropractors, early intervention agencies and other health care providers," Fensterman notes.

"This experience has led to our health care lawyers lecturing at bar associations, professional organizations, hospitals and colleges. At these meetings and through direct communications, Pat Formato and I, along with our entire senior health care-specialist team, will be underscoring what is clearly an environment of increased enforcement on the part of the OIG that is specifically related health care fraud. We want our clients to be proactive, diligent and aggressive so as to prevent legal action against their health care entities and the possibility of being sued and personally excluded from future participation in the industry," says Fensterman.

Howard Fensterman is Managing Partner and Patrick Formato is Senior Partner of Abrams Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP (Abrams Fensterman), located at 1111 Marcus Avenue, Suite 107, Lake Success, New York. The Firm’s website is abramslaw.com