State looks at surgical centers

January 29, 1994|By Patricia Meisol | Patricia Meisol,Staff Writer

A new state panel examining the impact of outpatient surgery centers that are not part of hospitals wants to halt the growth of such centers while it considers the issue.

A six-month moratorium on approvals for new centers, if agreed to by the Maryland Health Resources Planning Commission next month, would be the opening move of the Health Planning and Strategy Committee, a panel formed Jan. 12 by the commission and composed of some of its members.

The proposed hiatus, which will go before the full commission Feb. 8, has come under stiff criticism from doctors, insurance companies and others who are trying to establish a presence in a shifting marketplace.

The centers have been under attack from members of the Maryland Hospital Association, who claim the centers are draining paying patients from hospitals. The issue is likely to be the subject of considerable debate this spring in the Maryland General Assembly as hospitals and managed-care companies battle over constraints on competition.

Free-standing outpatient centers generally are less costly and more efficient than hospitals because of lower overhead costs and because they are not required to treat people without health insurance.

The proposed moratorium would narrow the number of medical specialties permitted to operate such centers to the three cited by law -- eye, dental, or foot -- from a current list of 10 specialties. A 1987 state law exempted doctors in the three areas from obtaining permission to perform surgery in their offices. The law leaves it up to state planners whether to exempt the seven that have been added, including gynecologists and dermatologists.

"Putting a halt to the development of outpatient surgery centers of alltypes . . goes in the wrong direction," said Stephan Sfekas, a health care lawyer with Weinberg & Green.

Mr. Sfekas said the commission's effort to block evolution of the system "prevents us from getting the very experience they need" to know how the market is affected.

James R. Stanton, executive director of the planning commission, said the proposed ban would allow his staff time to come up with criteria to determine what kind of specialists should be allowed to perform surgery in their offices or centers without state review or approval.

Permission is based on whether the specialty is needed in the region to be served.

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