A recent decision of the US Court of Appeals in Washington, DC ("the DC Circuit") could have major implications for the role of government in medical decision making. Specifically, in the case of New York State Ophthalmological Society v Bowen,1 the court held that the constitutional "right of personal privacy" does not extend to a Medicare patient's interest in using private funds to pay for the services of an assistant surgeon during cataract surgery. It therefore upheld a federal statute that makes it unlawful for a physician to charge a Medicare patient for the services of an assistant cataract surgeon (CAS) without prior government approval.
Before 1987, Medicare reimbursed patients for the use of a CAS if such use was the " 'generally accepted procedure among ophthalmologists in the local community.' "1(p1381) However, based on the experiences of nine states in which regional carriers had restricted CAS reimbursement, the
Portman RM. Prohibition on Charges for Services of Assistant Cataract Surgeons Upheld by Federal Court of Appeals. Arch Ophthalmol. 1989;107(7):975-977. doi:10.1001/archopht.1989.01070020037024