Court decision means Colchester surgery center can’t immediately add new specialties

The Vermont Supreme Court denied an appeal by the Green Mountain Surgery Center to free it from a regulatory ruling that limits the services it can offer to patients, which also limits the options for care for residents of Chittenden County and beyond.

The court on Friday upheld an order from the Green Mountain Care Board that prevents the Colchester surgery center from adding new specialties without first getting approval from the board.

The surgery center was considering adding ear, nose and throat, podiatry, urology and cataract surgery to its services, but now Amy Cooper, CEO and co-owner of the center, said it will be five years before those specialties can be offered.

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Amy Cooper in one of the Green Mountain Surgery Center's operating rooms on Nov. 18, 2019.

Cooper sent an email to her staff on Saturday.

“I’m not surprised, as this was the path of least resistance, but I am disappointed — marginally for us, and mostly for Vermonters who won’t benefit from more broadly available high-quality services,” Cooper wrote.

No trouble ruling

In its ruling, the Supreme Court said it had “no trouble” concluding the Green Mountain Care Board has the power to limit the surgery center to the specialties “identified and discussed” in its initial application in 2015, asking to be allowed to open. This process is known as applying for a Certificate of Need.

One of the surgery rooms at Green Mountain Surgery Center.

“The (Certificate of Need) statute requires an applicant to notify the Board if it wishes to make changes to the project after a (Certificate of Need) is issued and authorizes the Board to review any proposed changes, even if those changes are considered to be nonmaterial,” the Supreme Court said in its decision.

The five areas of practice the surgery center is limited to under this ruling are gastrointestinal, pain management, gynecology, orthopedics and general surgery. The Care Board did previously agree to allow the surgery center to perform out-patient plastic surgery and eye surgery, except for cataracts, in addition to the five specialties in its application.

Court ‘unpersuaded’ by surgery center argument

In its appeal to the Supreme Court, the surgery center argued that while its approval from the Green Mountain Care Board imposes 29 conditions on operations, none of them include restrictions on the types of specialists the surgery center could accommodate.

Green Mountain Surgery Center in Colchester, on March 22, 2019.

But the court said it was “unpersuaded” by the surgery center’s claim that it was unfair for the Green Mountain Care Board to limit its practice based on its initial application for a Certificate of Need.

The court said the Care Board approved the surgery center based on “detailed projections” of expected caseloads in the five specialties it expected to offer.

“It was reasonable for the Board to interpret applicant’s project as being limited to these five specialties, and to consider the addition of other specialties to be a change,” the court wrote.

In an interview with the Burlington Free Press last December concerning the appeal, Cooper said the restriction on the specialties the surgery center could offer was “untenable” for her business. In her email to staff, she said the ruling doesn’t impact what the surgery center is doing now in any “meaningful way.”

It just means, she said, that the surgery center won’t be able to add any new specialties for about five more years.

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Contact Dan D’Ambrosio at 660-1841 or ddambrosio@freepressmedia.com. Follow him on Twitter @DanDambrosioVT. This coverage is only possible with support from our readers. Sign up today for a digital subscription.