Elite Surgery Centers

Pursuant to a Consolidation Order issued July 3, 2007, Heggeness, Sweet, Simington & Patrico serves as lead defense counsel in a $26 million WCAB consolidation in San Diego involving pre-fee schedule liens of three ambulatory surgical centers called Point Loma Surgical Center; Elite Surgical Centers; Escondido; and Elite Surgical Centers, Del Mar.  On behalf of CIGA, Chartis, Wal-Mart, Solar, ICW, Explorer and other firm clients, HSSP contends that Elite’s ASC charges are grossly unreasonable pursuant to the WCAB en banc decision in Kunz and Tapia. 

Elite’s bills were up to 50 times the maximum fee schedule allowance for the same ASC services provided after January 1, 2004. For example, Elite charged an average of $7,900 for simple epidural injections (CPT Code 62263), an amount 9 times the maximum fee schedule allowance for ASCs after January 1, 2004 and nearly double the amount maximum amount allowed for all 21 San Diego County hospitals for which included 3.7 days of inpatient hospitalization. 

HSSP contends that Elite has actually been overpaid $3.5 million dollars by all defendants. On behalf of its clients, HSSP is seeking credit and restitution from Elite for the firm’s client’s overpayments.

HSSP completed discovery in this complex case and filed a Declaration of Readiness to Proceed.  In response, Elite now seeks to have the Elite case “deconsolidated.”  San Diego Presiding Workers’ Compensation Judge Clifford Levy has just issued a Notice of Intent to limit the Elite consolidation only to HSSP clients and those other defendants that provide written notice of a desire to participate setting the matter for a conference on January 27, 2010.

Links:

Consolidation Order
Kunz
Tapia
Notice of Intent

To learn more about how we can help you with your case, please contact us today!

Message

Heggeness, Sweet, Simington & Patrico, A P.C.
.........................................
Locations:

San Diego
7071 Convoy Court
Suite 200
San Diego, CA
92111-1023
Phone (858) 874-2100

Riverside
6180 Quail Valley Court
Suite 110
Riverside, CA
92507-0757
Phone (951) 656-1944

Santa Ana
600 West Santa Ana Boulevard
Suite 700
Santa Ana, CA
92701-4555
Phone (714) 550-1133