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Corridor Ophthalmologist Files Federal Lawsuit to Perform Cataract Surgery

CR surgeon and local hospitals don't see eye to eye on cataract clinic

A Cedar Rapids doctor says his constitutional rights are being violated by the state of Iowa and he’s taking the case to federal court.

Ophthalmologist Lee Birchansky filed suit Wednesday in Des Moines with the assistance of the Institute for Justice. Dr. Birchansky says over the last two decades, the state has denied him a certificate-of-need on four different applications. The procedure is designed to discourage areas of the state from mass duplication of healthcare services.

Dr. Birchansky says in his case it’s fear of competition and he blames local hospitals.

“Every time I’m denied because the hospitals will tell the decision makers there is no need for additional operating rooms, that they have it covered. It’s not fair, it’s not right.“

As Birchansky walks through an addition built onto the Fox Eye Institute, he points to the empty waiting room, the empty recovery room, and a specialized microscope he calls the best in the area for cataract surgery, which sits idle because he is not allowed to use it without a certificate-of-need.

Dr. Birchansky says several other states are proving outpatient clinics which create healthy competition which can bring down costs. In addition he says coming to a clinic like his is safer for patients.

“Sick people go to hospitals, healthy patients do not belong in hospitals for a ten minute procedure.” Dr. Birchansky says after graduating from the University of Iowa and practicing Ophthalmology for more than 25 years he feels he has no other choice, but to fight back and see if the federal court agrees his constitutional rights are being violated by an outdated state requirement. “My goal is to provide people the safest location, the safest operation, the best outcome, the best experience for my patient and their family and that’s going to happen right here.”

He adds that it's frustrating to be turned down while watching hospitals add several outpatient offices in the corridor.

In response to questions from CBS2/FOX28, UnityPoint Health released the following statement:

UnityPoint Health – St. Luke’s Hospital believes the CON process prevents a duplication of expensive services, keeps health care costs down, maintains quality and makes health care accessible to many Iowans who would otherwise not have access to care.Iowa is one of many states with CON laws. According to the National Conference of State Legislatures 34 states currently maintain some form of CON program. Puerto Rico, the US Virgin Islands and the District of Columbia also have CON programs. St. Luke’s has opposed Dr. Birchansky’s previous CON requests to operate his own surgery center. In 2007 the Iowa Supreme Court ruled in St. Luke’s favor regarding one of Dr. Birchansky’s cases.We believe Iowa’s CON program has served as an important process to ensure that its communities do not become over-saturated with unnecessary health care services focused on “cherry picking” private payor or commercially-insured patients, while not providing emergency or charity care and other services that are core to the health care needs of communities. The CON law has helped keep health care costs down and boosted quality of care for Iowans.Iowa and Cedar Rapids in particular, provides high quality, low cost health care and has been nationally recognized for these achievements by the Institutes for Healthcare Improvement. In addition having a CON program ensures facilities operate at volumes that are sufficient to provide high quality services – thereby maintaining patient safety.

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