Hospitals paid twice for spinal surgeries

Some California hospitals benefiting from workers’ compensation loophole

California Workers’ Compensation Institute found state hospitals were paid twice for spinal surgeries performed on workers’ compensation patients in 2010.

Spinal surgeries performed under workers’ compensation trigger “pass-through” payments in which hospitals are reimbursed for hardware or surgical instruments, according to California Watch. Researchers estimated the pass-through system added $20,000 each to the cost of such surgeries, resulting in $11.4 million in additional costs to taxpayers, though researchers found the cost of the instruments was already covered by initial payments.

Sen. Ted Lieu (D-Torrance), who has penned legislation that would eliminate the pass-through payments, said they are the result of a “loophole” that has “unfortunately led to a cottage industry where you have some hospitals that do a huge proportion of workers’ compensation spinal-injury surgeries, and they take advantage of the double payment.”